# Tuesday,

August 22, 2006



# Part II



# Department of

Health and Human

Services

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 410, et al.

Medicare Program; Revisions to Payment

Policies Under the Physician Fee

Schedule for Calendar Year 2007 and

Other Changes to Payment Under Part B;

Proposed Rule


# 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


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

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


# 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.


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

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

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

RVUs reflect all of the direct and indirect practice expenses of providing a particular service.

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

106

– 113) directed the Secretary 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)


# 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 errorsand 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 minimumsupply 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 thatare 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


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

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, 97803Medical 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


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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 homehealth 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


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

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 amountfor 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.

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# 48993 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

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.



# T ABLE 

# 3.—P AYMENT 

# L OCALITIES 

# W ITH 

# N EGATIVE 

# P ERCENT 

# C HANGE IN 

# GAF 1 

# B ETWEEN 

# 2006 AND 

# 2007 D UE TO



# R EMOVAL OF THE 

# 1.000 W ORK 

# F LOOR

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


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

T ABLE 

# 3.

— P AYMENT 

# L OCALITIES 

# W ITH 

# N EGATIVE 

# P ERCENT 

# C HANGE IN 

# GAF 1 

# B ETWEEN 

# 2006 AND 

# 2007 D UE TO



# R EMOVAL OF THE 

# 1.000 W ORK 

# F LOOR



# — 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

face π to π face ‘‘ hands on ’’ delivery of the same service. Requestors should submit evidence showing that the use of a telecommunications system does not affect the diagnosis or treatment plan as compared to a face π to π face 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


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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 notserve 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 theregistered 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


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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


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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 servicesthat 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


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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


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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 newsubparagraph (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


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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/

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

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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


# 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


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

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,


# 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


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

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 independentESRD 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 limitednumber 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-adjustedcomposite 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:


# 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 ourmethodology 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


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

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. Toremove 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.


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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


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

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 ablend 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.


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

T ABLE 

# 4.

— W AGE 

# I NDEX 

# T RANSITION 

# B LEND

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 CYs2008 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).

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T ABLE 

# 6.

— P ROPOSED 

# CY 2007 ESRD W AGE 

# I NDEX FOR 

# R URAL 

# A REAS 

# B ASED ON 

# CBSA L ABOR 

# M ARKET 

# A REAS

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

1 

# All 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.


# 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 contractualarrangement, 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


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

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 beprohibited 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 criticizedthe 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


# 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


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

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


# 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


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

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 vertebralabnormalities 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-photonabsorptiometry (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


# 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 couldconduct 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 18comments 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


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

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 insurancepolicy 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;


# 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


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

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


# 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


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

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


# 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


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

1 

# RAND 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. 2 

# Transforming 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.


# 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 Medicarebeneficiaries. 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 arecordkeeping 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


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

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


# 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.


# 49071 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

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


# 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.


# 49073 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

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


# 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** 



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

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


# 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.


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

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.



# T ABLE 

# 10.

— A CCOUNTING 

# S TATEMENT 

# :

C LASSIFICATION OF 

# E STIMATED 

# E X



# PENDITURES 

# , F ROM 

# CY 2006 TO

THE 

# CY 2007 ( IN 

# M ILLIONS 

# )

Category Transfers

Annualized Monetized

Transfers. Estimated decrease
in expenditures of $3,600


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

T ABLE 

# 10.

— A CCOUNTING 

# S TATEMENT 

# :

C LASSIFICATION OF 

# E STIMATED 

# E X



# PENDITURES 

# , F ROM 

# CY 2006 TO

THE 

# CY 2007 ( IN 

# M ILLIONS 

# )

— 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) * * *

* * * * *


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

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 vertebralabnormalities 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


# 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.** 



# * * * * *


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

(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


# 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


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

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 beingreported, 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 salesand 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.

* * * * *


# 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


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

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 periodreflect 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 sumof 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).


# 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.


# 49087 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007CPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal0003T ......... ............ C Cervicography ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0008T ......... ............ C Upper gi endoscopy w/suture ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0016T ......... ............ 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 XXX0017T ......... ............ C Photocoagulat macular drusen ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0018T ......... ............ C Transcranial magnetic stimul ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0019T ......... ............ 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 0.00XXX0021T ......... ............ C Fetal oximetry, trnsvag/cerv .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0024T ......... ............ C Transcath cardiac reduction .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0026T ......... ............ C Measure remnant lipoproteins ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0027T ......... ............ C Endoscopic epidural lysis .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0028T ......... ............ C Dexa body composition study ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0029T ......... ............ 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 XXX0030T ......... ............ C Antiprothrombin antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0031T ......... ............ C Speculoscopy ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0032T ......... ............ C Speculoscopy w/direct sample ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0041T ......... ............ 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 XXX0042T ......... ............ C Ct perfusion w/contrast, cbf .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0043T ......... ............ C Co expired gas analysis ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0044T ......... ............ C Whole body photography .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0045T ......... ............ C Whole body photography .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0046T ......... ............ C Cath lavage, mammary duct(s ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0047T ......... ............ C Cath lavage, mammary duct(s) ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0048T ......... ............ C Implant ventricular device ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0049T ......... ............ C External circulation assist .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0050T ......... ............ C Removal circulation assist ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0051T ......... ............ C Implant total heart system ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0052T ......... ............ C Replace component heart syst ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0053T ......... ............ C Replace component heart syst ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0054T ......... ............ C Bone surgery using computer ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0055T ......... ............ C Bone surgery using computer ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0056T ......... ............ C Bone surgery using computer ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0058T ......... ............ C Cryopreservation, ovary tiss .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0059T ......... ............ C Cryopreservation, oocyte .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0060T ......... ............ C Electrical impedance scan ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0061T ......... ............ C Destruction of tumor, breast .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0062T ......... ............ C Rep intradisc annulus;1 lev ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0063T ......... ............ 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 XXX0064T ......... ............ 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 XXX0065T ......... ............ C Ocular photoscreen bilat ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0067T ......... ............ C Ct colonography;dx ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0067T ......... 26 ....... C Ct colonography;dx ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0067T ......... 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 XXX0068T ......... ............ 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 XXX0069T ......... ............ C Analysis only heart sound ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0070T ......... ............ 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 XXX0071T ......... ............ C U/s leiomyomata ablate <200 ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0072T ......... ............ C U/s leiomyomata ablate >200 ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0073T ......... ............ A Delivery, comp imrt ....................................... 0.00 13.02 16.77 NA NA 0.13 13.15 16.90 NA NA XXX0075T ......... ............ 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 XXX0075T ......... 26 ....... C Perq stent/chest vert art ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0075T ......... 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 XXX0076T ......... ............ 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 XXX0076T ......... 26 ....... C S&i stent/chest vert art .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0076T ......... TC ...... C S&i stent/chest vert art .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0077T ......... ............ 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 XXX0078T ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00107 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49088 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal0079T ......... ............ 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 XXX0080T ......... ............ 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 XXX0081T ......... ............ 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 XXX0082T ......... ............ C Stereotactic rad delivery ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0083T ......... ............ C Stereotactic rad tx mngmt ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0084T ......... ............ 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 XXX0085T ......... ............ 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 XXX0086T ......... ............ C L ventricle fill pressure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0087T ......... ............ C Sperm eval hyaluronan ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0088T ......... ............ 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 XXX0089T ......... ............ 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 XXX0090T ......... ............ C Cervical artific disc ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0091T ......... ............ C Lumbar artific disc ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0092T ......... ............ C Artific disc addl .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0093T ......... ............ C Cervical artific diskectomy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0094T ......... ............ C Lumbar artific diskectomy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0095T ......... ............ C Artific diskectomy addl .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0096T ......... ............ 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 XXX0097T ......... ............ 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 XXX0098T ......... ............ C Rev artific disc addl ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0099T ......... ............ C Implant corneal ring ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0100T ......... ............ C Prosth retina receive&gen ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0101T ......... ............ 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 XXX0102T ......... ............ 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 XXX0103T ......... ............ C Holotranscobalamin ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0104T ......... ............ 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 XXX0105T ......... ............ 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 XXX0106T ......... ............ C Touch quant sensory test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0107T ......... ............ C Vibrate quant sensory test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0108T ......... ............ C Cool quant sensory test ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0109T ......... ............ C Heat quant sensory test ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0110T ......... ............ C Nos quant sensory test ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0111T ......... ............ 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 XXX0115T ......... ............ C Med tx mngmt 15 min ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0116T ......... ............ C Med tx mngmt subsqt .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0117T ......... ............ 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 XXX0120T ......... ............ C Fibroadenoma cryoablate, ea ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0123T ......... ............ C Scleral fistulization ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0124T ......... ............ C Conjunctival drug placement ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0126T ......... ............ C Chd risk imt study ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX0130T ......... ............ 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 XXX0133T ......... ............ C Esophageal implant injexn ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0135T ......... ............ 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 XXX0137T ......... ............ C Prostate saturation sampling ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX0140T ......... ............ C Exhaled breath condensate ph ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX0144T ......... ............ 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 XXX0144T ......... 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 0.00XXX0144T ......... 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 0.00XXX0145T ......... ............ C CT heart w/wo dye funct ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0145T ......... 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 XXX0145T ......... 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 0.00XXX0146T ......... ............ 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 XXX0146T ......... 26 ....... C CCTA w/wo dye ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0146T ......... 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 XXX0147T ......... ............ 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 XXX0147T ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00108 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49089 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules0147T ......... 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 XXX0148T ......... ............ 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 XXX0148T ......... 26 ....... C CCTA w/wo, strxr .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0148T ......... TC ...... C CCTA w/wo, strxr .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0149T ......... ............ 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 XXX0149T ......... 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 XXX0149T ......... 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 XXX0150T ......... ............ 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 XXX0150T ......... 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 0.00XXX0150T ......... 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 0.00XXX0151T ......... ............ 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 XXX0151T ......... 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 XXX0151T ......... 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 XXX0152T ......... ............ C Computer chest add-on ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0153T ......... ............ 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 XXX0154T ......... ............ 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 XXX0155T ......... ............ 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 XXX0156T ......... ............ C Lap redo gastr eltrd for mo ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0157T ......... ............ C Opn ins gastr eltrd for mo ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX0158T ......... ............ 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 XXX0159T ......... ............ C Computer breast MRI add-on ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00ZZZ0159T ......... 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 ZZZ0160T ......... ............ 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 XXX0161T ......... ............ 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 XXX10021 ......... ............ A Fna w/o image ............................................... 1.27 2.13 2.15 0.36 0.50 0.10 3.50 3.521.73 1.87 XXX10022 ......... ............ A Fna w/image .................................................. 1.27 2.13 2.44 0.38 0.41 0.08 3.48 3.79 1.73 1.76 XXX10040 ......... ............ A Acne surgery ................................................. 1.18 1.26 1.07 0.93 0.83 0.05 2.49 2.30 2.16 2.06 01010060 ......... ............ A Drainage of skin abscess .............................. 1.17 1.50 1.28 1.08 0.97 0.12 2.79 2.57 2.372.26 01010061 ......... ............ A Drainage of skin abscess .............................. 2.40 2.07 1.88 1.51 1.50 0.26 4.73 4.54 4.174.16 01010080 ......... ............ 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 01010081 ......... ............ 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 01010120 ......... ............ A Remove foreign body .................................... 1.22 2.10 2.15 0.94 0.96 0.12 3.44 3.49 2.282.30 01010121 ......... ............ A Remove foreign body .................................... 2.69 3.52 3.51 1.65 1.75 0.33 6.54 6.53 4.674.77 01010140 ......... ............ 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 01010160 ......... ............ 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 01010180 ......... ............ A Complex drainage, wound ............................ 2.25 3.30 3.06 1.83 1.94 0.35 5.90 5.66 4.43 4.54 01011000 ......... ............ A Debride infected skin ..................................... 0.60 0.73 0.62 0.16 0.21 0.07 1.40 1.29 0.83 0.88 00011001 ......... ............ 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 ZZZ11004 ......... ............ A Debride genitalia & perineum ........................ 10.31 NA NA 3.04 3.69 0.67 NA NA 14.02 14.67 00011005 ......... ............ A Debride abdom wall ...................................... 13.75 NA NA 4.06 5.19 0.96 NA NA 18.77 19.90 00011006 ......... ............ 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 ZZZ11010 ......... ............ A Debride skin, fx ............................................. 4.19 6.77 6.85 2.33 2.55 0.66 11.62 11.70 7.18 7.40 01011011 ......... ............ 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 00011012 ......... ............ 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 00011040 ......... ............ A Debride skin, partial ...................................... 0.48 0.68 0.56 0.16 0.20 0.06 1.22 1.100.70 0.74 00011041 ......... ............ A Debride skin, full ............................................ 0.60 0.73 0.68 0.19 0.30 0.10 1.43 1.38 0.89 1.00 00011042 ......... ............ A Debride skin/tissue ........................................ 0.80 0.96 0.97 0.25 0.39 0.13 1.89 1.901.18 1.32 00011043 ......... ............ A Debride tissue/muscle ................................... 3.00 3.64 3.45 2.71 2.62 0.32 6.96 6.77 6.03 5.94 01011044 ......... ............ 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 01011055 ......... ............ R Trim skin lesion ............................................. 0.43 0.82 0.63 0.11 0.16 0.05 1.30 1.11 0.59 0.64 00011056 ......... ............ 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 00011057 ......... ............ 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 00011100 ......... ............ A Biopsy, skin lesion ......................................... 0.81 1.83 1.40 0.37 0.37 0.03 2.67 2.241.21 1.21 00011101 ......... ............ 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 ZZZ11200 ......... ............ 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 01011201 ......... ............ 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 ZZZ11300 ......... ............ A Shave skin lesion .......................................... 0.51 1.17 1.04 0.20 0.21 0.03 1.71 1.580.74 0.75 00011301 ......... ............ A Shave skin lesion .......................................... 0.85 1.47 1.20 0.37 0.38 0.04 2.36 2.091.26 1.27 00011302 ......... ............ A Shave skin lesion .......................................... 1.05 1.73 1.41 0.47 0.46 0.05 2.83 2.511.57 1.56 00011303 ......... ............ A Shave skin lesion .......................................... 1.24 1.97 1.68 0.53 0.52 0.07 3.28 2.991.84 1.83 00011305 ......... ............ A Shave skin lesion .......................................... 0.67 1.06 0.90 0.20 0.25 0.07 1.80 1.640.94 0.99 00011306 ......... ............ A Shave skin lesion .......................................... 0.99 1.39 1.17 0.37 0.41 0.07 2.45 2.231.43 1.47 00011307 ......... ............ A Shave skin lesion .......................................... 1.14 1.66 1.38 0.46 0.48 0.07 2.87 2.591.67 1.69 00011308 ......... ............ A Shave skin lesion .......................................... 1.41 1.71 1.52 0.50 0.57 0.13 3.25 3.062.04 2.11 000



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# 49090 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal11310 ......... ............ A Shave skin lesion .......................................... 0.73 1.35 1.17 0.30 0.32 0.04 2.12 1.941.07 1.09 00011311 ......... ............ A Shave skin lesion .......................................... 1.05 1.60 1.32 0.46 0.48 0.05 2.70 2.421.56 1.58 00011312 ......... ............ A Shave skin lesion .......................................... 1.20 1.87 1.53 0.54 0.55 0.06 3.13 2.791.80 1.81 00011313 ......... ............ A Shave skin lesion .......................................... 1.62 2.13 1.88 0.71 0.72 0.10 3.85 3.602.43 2.44 00011400 ......... ............ 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 01011401 ......... ............ 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 01011402 ......... ............ 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 01011403 ......... ............ 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 01011404 ......... ............ 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 01011406 ......... ............ 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 01011420 ......... ............ 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 01011421 ......... ............ 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 01011422 ......... ............ 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 01011423 ......... ............ 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 01011424 ......... ............ 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 01011426 ......... ............ 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 6.6101011440 ......... ............ 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 01011442 ......... ............ 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 01011443 ......... ............ 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 01011444 ......... ............ 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 01011446 ......... ............ 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 01011450 ......... ............ 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 09011451 ......... ............ 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 09011462 ......... ............ 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 09011463 ......... ............ 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 09011470 ......... ............ 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 09011471 ......... ............ 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 09011600 ......... ............ 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 2.6701011601 ......... ............ 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 01011602 ......... ............ 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 01011603 ......... ............ 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 01011604 ......... ............ 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 01011606 ......... ............ 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 01011620 ......... ............ 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 2.6701011621 ......... ............ 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 01011622 ......... ............ 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 01011623 ......... ............ 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 01011624 ......... ............ 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 01011626 ......... ............ 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 7.3501011640 ......... ............ 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 01011641 ......... ............ 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 01011642 ......... ............ 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 01011643 ......... ............ 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 01011644 ......... ............ 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 01011646 ......... ............ 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 10.1601011719 ......... ............ R Trim nail(s) .................................................... 0.17 0.38 0.28 0.04 0.06 0.02 0.570.47 0.23 0.25 00011720 ......... ............ 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 00011721 ......... ............ 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 00011730 ......... ............ 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 00011732 ......... ............ 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 ZZZ11740 ......... ............ 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 00011750 ......... ............ 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 01011752 ......... ............ A Remove nail bed/finger tip ............................ 3.42 4.12 3.27 2.82 2.95 0.35 7.89 7.04 6.596.72 01011755 ......... ............ A Biopsy, nail unit ............................................. 1.31 2.02 1.68 0.76 0.77 0.14 3.47 3.13 2.21 2.22 00011760 ......... ............ A Repair of nail bed .......................................... 1.58 3.45 2.83 1.44 1.70 0.21 5.24 4.623.23 3.49 010



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# 49091 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules11762 ......... ............ A Reconstruction of nail bed ............................ 2.89 3.72 3.09 1.69 2.18 0.36 6.97 6.34 4.945.43 01011765 ......... ............ 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 01011770 ......... ............ A Removal of pilonidal lesion ........................... 2.61 3.49 3.48 1.53 1.51 0.33 6.43 6.42 4.474.45 01011771 ......... ............ 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 09011772 ......... ............ 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 09011900 ......... ............ 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 00011901 ......... ............ A Added skin lesions injection .......................... 0.80 0.98 0.74 0.38 0.36 0.03 1.81 1.57 1.211.19 00011920 ......... ............ R Correct skin color defects ............................. 1.61 2.40 3.38 1.12 1.10 0.24 4.25 5.23 2.972.95 00011921 ......... ............ R Correct skin color defects ............................. 1.93 2.67 3.64 1.26 1.27 0.29 4.89 5.86 3.483.49 00011922 ......... ............ R Correct skin color defects ............................. 0.49 0.93 1.09 0.22 0.24 0.07 1.49 1.65 0.780.80 ZZZ11950 ......... ............ 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 00011951 ......... ............ 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 00011952 ......... ............ 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 00011954 ......... ............ 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 00011960 ......... ............ A Insert tissue expander(s) ............................... 10.85 NA NA 10.58 10.44 1.31 NA NA 22.74 22.60 09011970 ......... ............ A Replace tissue expander ............................... 7.80 NA NA 6.20 6.15 1.05 NA NA 15.05 15.00 09011971 ......... ............ 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 09011975 ......... ............ N Insert contraceptive cap ................................ 1.48 1.55 1.45 0.34 0.51 0.17 3.20 3.10 1.99 2.16 XXX11976 ......... ............ 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 00011977 ......... ............ 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 XXX11980 ......... ............ A Implant hormone pellet(s) ............................. 1.48 1.17 1.10 0.55 0.54 0.13 2.78 2.71 2.162.15 00011981 ......... ............ A Insert drug implant device ............................. 1.48 1.92 1.76 0.59 0.66 0.12 3.52 3.36 2.192.26 XXX11982 ......... ............ A Remove drug implant device ........................ 1.78 2.05 1.97 0.71 0.80 0.17 4.00 3.92 2.66 2.75XXX11983 ......... ............ 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 XXX12001 ......... ............ A Repair superficial wound(s) ........................... 1.70 1.73 1.92 0.72 0.76 0.15 3.58 3.77 2.572.61 01012002 ......... ............ A Repair superficial wound(s) ........................... 1.86 1.79 1.98 0.83 0.88 0.17 3.82 4.01 2.862.91 01012004 ......... ............ A Repair superficial wound(s) ........................... 2.24 2.07 2.26 0.92 0.99 0.21 4.52 4.71 3.373.44 01012005 ......... ............ A Repair superficial wound(s) ........................... 2.86 2.52 2.75 1.06 1.17 0.27 5.65 5.88 4.194.30 01012006 ......... ............ A Repair superficial wound(s) ........................... 3.66 3.03 3.30 1.30 1.46 0.35 7.04 7.31 5.315.47 01012007 ......... ............ A Repair superficial wound(s) ........................... 4.11 3.40 3.72 1.49 1.73 0.45 7.96 8.28 6.056.29 01012011 ......... ............ A Repair superficial wound(s) ........................... 1.76 1.89 2.07 0.75 0.77 0.16 3.81 3.99 2.672.69 01012013 ......... ............ A Repair superficial wound(s) ........................... 1.99 2.05 2.22 0.88 0.92 0.18 4.22 4.39 3.053.09 01012014 ......... ............ A Repair superficial wound(s) ........................... 2.46 2.28 2.50 0.97 1.04 0.23 4.97 5.19 3.663.73 01012015 ......... ............ A Repair superficial wound(s) ........................... 3.19 2.76 3.04 1.11 1.22 0.29 6.24 6.52 4.594.70 01012016 ......... ............ A Repair superficial wound(s) ........................... 3.92 3.16 3.45 1.29 1.46 0.37 7.45 7.74 5.585.75 01012017 ......... ............ 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 01012021 ......... ............ 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 01012031 ......... ............ A Layer closure of wound(s) ............................. 2.15 3.82 2.67 1.73 1.15 0.17 6.14 4.99 4.053.47 01012032 ......... ............ A Layer closure of wound(s) ............................. 2.47 5.08 4.15 2.21 1.90 0.16 7.71 6.78 4.844.53 01012034 ......... ............ A Layer closure of wound(s) ............................. 2.92 4.50 3.52 1.93 1.57 0.25 7.67 6.69 5.104.74 01012035 ......... ............ A Layer closure of wound(s) ............................. 3.42 5.25 5.21 2.08 2.13 0.39 9.06 9.02 5.895.94 01012036 ......... ............ A Layer closure of wound(s) ............................. 4.04 5.38 5.51 2.22 2.46 0.55 9.97 10.10 6.817.05 01012037 ......... ............ 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 01012041 ......... ............ A Layer closure of wound(s) ............................. 2.37 3.77 2.85 1.72 1.28 0.19 6.33 5.41 4.283.84 01012042 ......... ............ A Layer closure of wound(s) ............................. 2.74 4.36 3.54 2.04 1.61 0.17 7.27 6.45 4.954.52 01012044 ......... ............ A Layer closure of wound(s) ............................. 3.14 5.27 3.73 1.89 1.67 0.27 8.68 7.14 5.305.08 01012045 ......... ............ A Layer closure of wound(s) ............................. 3.63 5.07 5.21 2.06 2.23 0.41 9.11 9.25 6.106.27 01012046 ......... ............ 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 01012047 ......... ............ 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 01012051 ......... ............ A Layer closure of wound(s) ............................. 2.47 4.01 3.46 1.86 1.55 0.20 6.68 6.13 4.534.22 01012052 ......... ............ A Layer closure of wound(s) ............................. 2.77 4.69 3.59 2.44 1.68 0.17 7.63 6.53 5.384.62 01012053 ......... ............ A Layer closure of wound(s) ............................. 3.12 5.23 3.74 2.05 1.66 0.23 8.58 7.09 5.405.01 01012054 ......... ............ A Layer closure of wound(s) ............................. 3.45 5.30 4.00 2.01 1.73 0.30 9.05 7.75 5.765.48 01012055 ......... ............ A Layer closure of wound(s) ............................. 4.42 6.00 4.86 2.10 2.12 0.45 10.87 9.73 6.976.99 01012056 ......... ............ 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 01012057 ......... ............ 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 01013100 ......... ............ A Repair of wound or lesion ............................. 3.12 4.32 4.12 2.39 2.32 0.26 7.70 7.50 5.775.70 01013101 ......... ............ A Repair of wound or lesion ............................. 3.91 5.79 4.94 2.88 2.73 0.26 9.96 9.11 7.056.90 01013102 ......... ............ 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 ZZZ13120 ......... ............ A Repair of wound or lesion ............................. 3.30 4.46 4.22 2.50 2.38 0.26 8.02 7.78 6.065.94 01013121 ......... ............ A Repair of wound or lesion ............................. 4.32 6.47 5.26 3.46 2.96 0.25 11.04 9.83 8.037.53 01013122 ......... ............ 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 ZZZ13131 ......... ............ A Repair of wound or lesion ............................. 3.78 4.86 4.49 2.78 2.71 0.26 8.90 8.53 6.826.75 01013132 ......... ............ 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



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# 49092 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal13133 ......... ............ 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 ZZZ13150 ......... ............ A Repair of wound or lesion ............................. 3.80 4.59 4.80 2.64 2.73 0.34 8.73 8.94 6.786.87 01013151 ......... ............ A Repair of wound or lesion ............................. 4.44 5.35 4.94 3.11 3.13 0.31 10.10 9.69 7.867.88 01013152 ......... ............ 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 01013153 ......... ............ 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 ZZZ13160 ......... ............ A Late closure of wound ................................... 11.76 NA NA 7.07 7.14 1.54 NA NA 20.37 20.44 09014000 ......... ............ A Skin tissue rearrangement ............................ 6.76 8.78 8.08 5.92 5.58 0.59 16.13 15.43 13.27 12.93 09014001 ......... ............ A Skin tissue rearrangement ............................ 9.52 10.90 9.78 7.40 7.15 0.82 21.24 20.12 17.74 17.49 09014020 ......... ............ A Skin tissue rearrangement ............................ 7.58 9.79 8.91 6.70 6.57 0.64 18.01 17.13 14.92 14.79 09014021 ......... ............ A Skin tissue rearrangement ............................ 11.10 12.13 10.52 8.40 8.31 0.81 24.04 22.43 20.31 20.22 09014040 ......... ............ A Skin tissue rearrangement ............................ 8.36 9.92 9.08 6.77 7.09 0.62 18.90 18.06 15.75 16.07 09014041 ......... ............ A Skin tissue rearrangement ............................ 12.59 13.17 11.24 9.03 8.76 0.73 26.49 24.56 22.35 22.08 09014060 ......... ............ A Skin tissue rearrangement ............................ 8.99 9.40 8.94 6.94 7.31 0.68 19.07 18.61 16.61 16.98 09014061 ......... ............ A Skin tissue rearrangement ............................ 13.58 14.41 12.30 9.84 9.59 0.76 28.75 26.64 24.18 23.93 09014300 ......... ............ A Skin tissue rearrangement ............................ 13.17 13.26 11.66 9.24 9.19 1.16 27.59 25.99 23.57 23.52 09014350 ......... ............ A Skin tissue rearrangement ............................ 10.73 NA NA 6.92 7.09 1.34 NA NA 18.99 19.16 09015000 ......... ............ 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 00015001 ......... ............ 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 1.54ZZZ15040 ......... ............ A Harvest cultured skin graft ............................ 2.00 3.86 4.39 1.03 1.11 0.24 6.10 6.63 3.273.35 00015050 ......... ............ A Skin pinch graft ............................................. 5.29 7.65 7.10 5.02 5.09 0.57 13.51 12.96 10.88 10.95 09015100 ......... ............ A Skin splt grft, trnk/arm/leg ............................. 9.66 9.84 11.90 6.73 7.55 1.28 20.78 22.8417.67 18.49 09015101 ......... ............ 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 ZZZ15110 ......... ............ 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 09015111 ......... ............ A Epidrm autogrft t/a/l add-on .......................... 1.85 0.89 1.19 0.64 0.75 0.26 3.00 3.30 2.752.86 ZZZ15115 ......... ............ 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 09015116 ......... ............ 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 ZZZ15120 ......... ............ 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 09015121 ......... ............ 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 ZZZ15130 ......... ............ 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 09015131 ......... ............ A Derm autograft t/a/l add-on ........................... 1.50 0.70 0.98 0.52 0.61 0.21 2.41 2.69 2.232.32 ZZZ15135 ......... ............ 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 09015136 ......... ............ A Derm autograft, f/n/hf/g add .......................... 1.50 0.68 0.84 0.53 0.64 0.20 2.38 2.54 2.232.34 ZZZ15150 ......... ............ 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 09015151 ......... ............ 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 ZZZ15152 ......... ............ A Cult epiderm graft t/a/l +% ............................ 2.50 1.08 1.44 0.87 1.01 0.35 3.93 4.29 3.723.86 ZZZ15155 ......... ............ 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 09015156 ......... ............ A Cult epidrm grft f/n/hfg add ........................... 2.75 1.18 1.47 0.98 1.18 0.36 4.29 4.58 4.094.29 ZZZ15157 ......... ............ A Cult epiderm grft f/n/hfg +% .......................... 3.00 1.37 1.67 1.07 1.28 0.39 4.76 5.06 4.464.67 ZZZ15170 ......... ............ 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 09015171 ......... ............ A Acell graft t/arm/leg add-on ........................... 1.55 0.65 0.67 0.51 0.59 0.19 2.39 2.41 2.252.33 ZZZ15175 ......... ............ 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 09015176 ......... ............ 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 ZZZ15200 ......... ............ 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 09015201 ......... ............ 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 ZZZ15220 ......... ............ A Skin full graft sclp/arm/leg ............................. 7.86 10.21 9.44 6.51 6.64 0.84 18.91 18.1415.21 15.34 09015221 ......... ............ A Skin full graft add-on ..................................... 1.19 2.01 2.24 0.50 0.55 0.16 3.36 3.591.85 1.90 ZZZ15240 ......... ............ 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 09015241 ......... ............ A Skin full graft add-on ..................................... 1.86 2.51 2.46 0.79 0.88 0.23 4.60 4.552.88 2.97 ZZZ15260 ......... ............ 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 09015261 ......... ............ A Skin full graft add-on ..................................... 2.23 2.91 2.75 1.12 1.33 0.21 5.35 5.193.56 3.77 ZZZ15300 ......... ............ 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 09015301 ......... ............ 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 ZZZ15320 ......... ............ 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 09015321 ......... ............ 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 ZZZ15330 ......... ............ 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 09015331 ......... ............ 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



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# 49093 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules15335 ......... ............ 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 09015336 ......... ............ 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 ZZZ15340 ......... ............ 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 01015341 ......... ............ A Apply cult skin sub add-on ............................ 0.50 0.72 0.64 0.17 0.19 0.06 1.28 1.20 0.730.75 ZZZ15360 ......... ............ 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 09015361 ......... ............ 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 1.671.73 ZZZ15365 ......... ............ 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 7.807.80 09015366 ......... ............ A Apply cult derm f/hf/g add ............................. 1.45 0.69 0.70 0.48 0.56 0.17 2.31 2.32 2.102.18 ZZZ15400 ......... ............ 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 09015401 ......... ............ A Apply skn xenogrft t/a/l add .......................... 1.00 1.02 1.67 0.35 0.42 0.14 2.16 2.81 1.491.56 ZZZ15420 ......... ............ A Apply skin xgraft, f/n/hf/g ............................... 4.83 5.04 4.85 3.86 3.81 0.52 10.39 10.209.21 9.16 09015421 ......... ............ 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 2.232.31 ZZZ15430 ......... ............ A Apply acellular xenograft ............................... 5.75 7.01 6.93 6.44 6.57 0.66 13.42 13.34 12.85 12.98 09015431 ......... ............ 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 ZZZ15570 ......... ............ 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 09015572 ......... ............ A Form skin pedicle flap ................................... 9.88 9.74 9.55 6.62 6.49 1.20 20.82 20.6317.70 17.57 09015574 ......... ............ 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 09015576 ......... ............ A Form skin pedicle flap ................................... 9.18 9.50 9.69 6.39 6.76 0.87 19.55 19.7416.44 16.81 09015600 ......... ............ A Skin graft ....................................................... 1.91 5.28 7.02 2.71 2.97 0.27 7.469.20 4.89 5.15 09015610 ......... ............ A Skin graft ....................................................... 2.42 5.55 4.91 3.03 3.32 0.35 8.327.68 5.80 6.09 09015620 ......... ............ A Skin graft ....................................................... 3.57 6.33 7.42 3.80 3.86 0.35 10.25 11.34 7.72 7.78 09015630 ......... ............ A Skin graft ....................................................... 3.90 6.89 7.00 4.18 4.16 0.34 11.13 11.24 8.42 8.40 09015650 ......... ............ 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 09015732 ......... ............ A Muscle-skin graft, head/neck ........................ 19.62 14.71 17.21 11.13 11.94 1.99 36.32 38.8232.74 33.55 09015734 ......... ............ 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 09015736 ......... ............ 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 09015738 ......... ............ A Muscle-skin graft, leg .................................... 18.86 14.03 16.99 10.41 11.39 2.65 35.5438.50 31.92 32.90 09015740 ......... ............ 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 09015750 ......... ............ A Neurovascular pedicle graft .......................... 12.64 NA NA 8.80 8.98 1.42 NA NA 22.86 23.04 09015756 ......... ............ A Free myo/skin flap microvasc ....................... 36.64 NA NA 18.38 20.02 4.61 NA NA 59.63 61.27 09015757 ......... ............ A Free skin flap, microvasc .............................. 36.85 NA NA 16.63 20.35 3.89 NA NA 57.37 61.09 09015758 ......... ............ A Free fascial flap, microvasc .......................... 36.60 NA NA 16.47 20.30 4.23 NA NA 57.30 61.13 09015760 ......... ............ A Composite skin graft ..................................... 9.61 10.14 10.05 6.84 7.16 0.85 20.60 20.51 17.30 17.62 09015770 ......... ............ A Derma-fat-fascia graft .................................... 8.64 NA NA 6.56 6.65 1.05 NA NA 16.25 16.34 09015775 ......... ............ R Hair transplant punch grafts .......................... 3.95 3.50 4.05 1.70 1.40 0.52 7.97 8.52 6.175.87 00015776 ......... ............ 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 00015780 ......... ............ 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 09015781 ......... ............ 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 09015782 ......... ............ 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 09015783 ......... ............ 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 09015786 ......... ............ A Abrasion, lesion, single ................................. 2.03 3.76 3.45 1.22 1.30 0.11 5.90 5.59 3.36 3.44 01015787 ......... ............ A Abrasion, lesions, add-on .............................. 0.33 0.83 1.03 0.10 0.15 0.04 1.20 1.40 0.470.52 ZZZ15788 ......... ............ 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 09015789 ......... ............ R Chemical peel, face, dermal ......................... 4.91 9.00 8.32 5.56 4.99 0.20 14.11 13.43 10.6710.10 09015792 ......... ............ R Chemical peel, nonfacial ............................... 1.86 6.85 7.03 3.46 4.20 0.13 8.84 9.02 5.456.19 09015793 ......... ............ A Chemical peel, nonfacial ............................... 3.73 5.54 6.10 3.27 4.10 0.19 9.46 10.02 7.19 8.02 09015819 ......... ............ A Plastic surgery, neck ..................................... 10.37 NA NA 6.67 7.05 0.97 NA NA 18.01 18.39 09015820 ......... ............ 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 09015821 ......... ............ 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 09015822 ......... ............ 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 09015823 ......... ............ 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 09015831 ......... ............ A Excise excessive skin tissue ......................... 13.57 NA NA 8.73 8.30 1.75 NA NA 24.05 23.62 09015832 ......... ............ A Excise excessive skin tissue ......................... 12.57 NA NA 8.30 8.33 1.66 NA NA 22.53 22.56 09015833 ......... ............ A Excise excessive skin tissue ......................... 11.62 NA NA 7.09 7.93 1.49 NA NA 20.20 21.04 09015834 ......... ............ A Excise excessive skin tissue ......................... 11.89 NA NA 7.73 7.70 1.61 NA NA 21.23 21.20 09015835 ......... ............ A Excise excessive skin tissue ......................... 12.71 NA NA 7.81 7.61 1.60 NA NA 22.12 21.92 09015836 ......... ............ A Excise excessive skin tissue ......................... 10.33 NA NA 7.02 6.84 1.34 NA NA 18.69 18.51 09015837 ......... ............ 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 09015838 ......... ............ A Excise excessive skin tissue ......................... 8.00 NA NA 4.88 5.77 0.58 NA NA 13.46 14.35 09015839 ......... ............ 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 09015840 ......... ............ A Graft for face nerve palsy ............................. 14.67 NA NA 8.55 9.62 1.32 NA NA 24.54 25.6109015841 ......... ............ A Graft for face nerve palsy ............................. 25.57 NA NA 13.05 14.51 2.54 NA NA 41.16 42.62 09015842 ......... ............ A Flap for face nerve palsy .............................. 40.55 NA NA 21.01 22.44 4.93 NA NA 66.49 67.92 09015845 ......... ............ A Skin and muscle repair, face ........................ 13.93 NA NA 8.77 9.17 0.81 NA NA 23.51 23.91 09015850 ......... ............ B Removal of sutures ....................................... 0.78 1.21 1.47 0.18 0.27 0.05 2.04 2.30 1.01 1.10 XXX15851 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00113 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49094 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal15852 ......... ............ 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 00015860 ......... ............ A Test for blood flow in graft ............................ 1.95 NA NA 0.70 0.76 0.27 NA NA 2.92 2.98 00015920 ......... ............ A Removal of tail bone ulcer ............................ 8.06 NA NA 5.83 5.62 1.04 NA NA 14.93 14.72 09015922 ......... ............ A Removal of tail bone ulcer ............................ 10.13 NA NA 7.01 7.16 1.42 NA NA 18.56 18.7109015931 ......... ............ A Remove sacrum pressure sore ..................... 9.89 NA NA 5.55 5.65 1.25 NA NA 16.69 16.79 09015933 ......... ............ A Remove sacrum pressure sore ..................... 11.49 NA NA 7.34 7.72 1.52 NA NA 20.35 20.73 09015934 ......... ............ A Remove sacrum pressure sore ..................... 13.45 NA NA 7.61 7.93 1.78 NA NA 22.84 23.16 09015935 ......... ............ A Remove sacrum pressure sore ..................... 15.45 NA NA 10.14 10.28 2.09 NA NA 27.68 27.82 09015936 ......... ............ A Remove sacrum pressure sore ..................... 12.96 NA NA 7.49 8.04 1.76 NA NA 22.21 22.76 09015937 ......... ............ A Remove sacrum pressure sore ..................... 14.91 NA NA 8.96 9.61 2.06 NA NA 25.93 26.58 09015940 ......... ............ A Remove hip pressure sore ............................ 10.05 NA NA 5.84 6.09 1.31 NA NA 17.20 17.45 09015941 ......... ............ A Remove hip pressure sore ............................ 12.13 NA NA 8.51 9.22 1.66 NA NA 22.30 23.01 09015944 ......... ............ A Remove hip pressure sore ............................ 12.16 NA NA 8.24 8.51 1.65 NA NA 22.05 22.32 09015945 ......... ............ A Remove hip pressure sore ............................ 13.45 NA NA 9.15 9.52 1.84 NA NA 24.44 24.81 09015946 ......... ............ A Remove hip pressure sore ............................ 23.72 NA NA 13.95 14.27 3.16 NA NA 40.83 41.1509015950 ......... ............ A Remove thigh pressure sore ......................... 7.83 NA NA 5.40 5.41 1.04 NA NA 14.27 14.28 09015951 ......... ............ 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 09015958 ......... ............ A Remove thigh pressure sore ......................... 16.42 NA NA 10.28 10.85 2.25 NA NA 28.95 29.52 09015999 ......... ............ 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 YYY16000 ......... ............ 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 00016020 ......... ............ A Dress/debrid p-thick burn, s .......................... 0.80 1.11 1.25 0.56 0.58 0.08 1.99 2.13 1.441.46 00016025 ......... ............ 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 00016030 ......... ............ A Dress/debrid p-thick burn, l ........................... 2.08 1.98 2.12 0.96 1.08 0.24 4.30 4.44 3.283.40 00016035 ......... ............ A Incision of burn scab, initi ............................. 3.74 NA NA 1.27 1.50 0.46 NA NA 5.47 5.7009016036 ......... ............ A Escharotomy; addIl incision .......................... 1.50 NA NA 0.49 0.57 0.20 NA NA 2.19 2.27 ZZZ17000 ......... ............ 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 01017003 ......... ............ 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 ZZZ17004 ......... ............ 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 01017106 ......... ............ A Destruction of skin lesions ............................ 4.58 4.56 4.59 3.18 3.29 0.35 9.49 9.52 8.118.22 09017107 ......... ............ 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 09017108 ......... ............ 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 09017110 ......... ............ 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 01017111 ......... ............ A Destruct lesion, 15 or more ........................... 0.92 2.23 1.81 1.09 0.88 0.05 3.20 2.78 2.061.85 01017250 ......... ............ A Chemical cautery, tissue ............................... 0.50 1.32 1.25 0.38 0.35 0.06 1.88 1.81 0.940.91 00017260 ......... ............ A Destruction of skin lesions ............................ 0.91 1.37 1.30 0.68 0.67 0.04 2.32 2.25 1.631.62 01017261 ......... ............ A Destruction of skin lesions ............................ 1.17 2.42 1.81 1.02 0.88 0.05 3.64 3.03 2.242.10 01017262 ......... ............ A Destruction of skin lesions ............................ 1.58 2.74 2.10 1.22 1.07 0.06 4.38 3.74 2.862.71 01017263 ......... ............ A Destruction of skin lesions ............................ 1.79 2.97 2.28 1.31 1.15 0.07 4.83 4.14 3.173.01 01017264 ......... ............ A Destruction of skin lesions ............................ 1.94 3.17 2.46 1.38 1.19 0.08 5.19 4.48 3.403.21 01017266 ......... ............ A Destruction of skin lesions ............................ 2.34 3.42 2.73 1.54 1.30 0.09 5.85 5.16 3.973.73 01017270 ......... ............ A Destruction of skin lesions ............................ 1.32 2.36 1.87 1.05 0.92 0.05 3.73 3.24 2.422.29 01017271 ......... ............ A Destruction of skin lesions ............................ 1.49 2.58 1.97 1.17 1.03 0.06 4.13 3.52 2.722.58 01017272 ......... ............ A Destruction of skin lesions ............................ 1.77 2.88 2.21 1.31 1.16 0.07 4.72 4.05 3.153.00 01017273 ......... ............ A Destruction of skin lesions ............................ 2.05 3.12 2.43 1.43 1.27 0.08 5.25 4.56 3.563.40 01017274 ......... ............ A Destruction of skin lesions ............................ 2.59 3.50 2.80 1.68 1.50 0.10 6.19 5.49 4.374.19 01017276 ......... ............ A Destruction of skin lesions ............................ 3.20 3.78 3.15 1.91 1.74 0.16 7.14 6.51 5.275.10 01017280 ......... ............ A Destruction of skin lesions ............................ 1.17 2.29 1.78 0.99 0.86 0.05 3.51 3.00 2.212.08 01017281 ......... ............ A Destruction of skin lesions ............................ 1.72 2.65 2.09 1.28 1.14 0.07 4.44 3.88 3.072.93 01017282 ......... ............ A Destruction of skin lesions ............................ 2.04 3.04 2.37 1.43 1.29 0.08 5.16 4.49 3.553.41 01017283 ......... ............ A Destruction of skin lesions ............................ 2.64 3.45 2.77 1.70 1.54 0.11 6.20 5.52 4.454.29 01017284 ......... ............ A Destruction of skin lesions ............................ 3.21 3.86 3.16 1.95 1.80 0.13 7.20 6.50 5.295.14 01017286 ......... ............ A Destruction of skin lesions ............................ 4.43 4.28 3.82 2.38 2.43 0.23 8.94 8.48 7.047.09 01017304 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00114 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49095 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules17305 ......... ............ 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 00017306 ......... ............ 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 00017307 ......... ............ 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 4.3200017310 ......... ............ 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 ZZZ17340 ......... ............ A Cryotherapy of skin ....................................... 0.76 0.33 0.36 0.36 0.36 0.05 1.14 1.17 1.17 1.17 01017360 ......... ............ A Skin peel therapy .......................................... 1.43 1.38 1.43 0.95 0.89 0.06 2.87 2.922.44 2.38 01017999 ......... ............ C Skin tissue procedure .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY19000 ......... ............ A Drainage of breast lesion .............................. 0.84 1.90 1.96 0.24 0.29 0.08 2.82 2.88 1.161.21 00019001 ......... ............ A Drain breast lesion add-on ............................ 0.42 0.24 0.25 0.12 0.14 0.04 0.70 0.71 0.580.60 ZZZ19020 ......... ............ A Incision of breast lesion ................................ 3.68 6.67 6.42 3.05 2.77 0.45 10.80 10.557.18 6.90 09019030 ......... ............ 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 00019100 ......... ............ 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 00019101 ......... ............ 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 01019102 ......... ............ 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 00019103 ......... ............ 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 00019110 ......... ............ A Nipple exploration .......................................... 4.29 6.45 5.96 3.28 2.97 0.57 11.31 10.82 8.14 7.83 09019112 ......... ............ 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 09019120 ......... ............ 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 09019125 ......... ............ A Excision, breast lesion .................................. 6.55 5.60 4.99 3.68 3.38 0.80 12.95 12.3411.03 10.73 09019126 ......... ............ 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 09019160 ......... ............ A Partial mastectomy ........................................ 5.98 NA NA 3.64 3.48 0.79 NA NA 10.41 10.25 09019162 ......... ............ 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 09019182 ......... ............ A Removal of breast ......................................... 7.72 NA NA 5.01 4.82 1.04 NA NA 13.77 13.58 09019200 ......... ............ A Removal of breast ......................................... 17.14 NA NA 8.22 8.03 1.92 NA NA 27.28 27.09 09019220 ......... ............ A Removal of breast ......................................... 17.74 NA NA 8.69 8.35 2.07 NA NA 28.50 28.16 09019240 ......... ............ A Removal of breast ......................................... 17.84 NA NA 8.85 8.36 2.12 NA NA 28.81 28.32 09019260 ......... ............ A Removal of chest wall lesion ........................ 17.53 NA NA 10.33 10.95 2.13 NA NA 29.99 30.6109019271 ......... ............ A Revision of chest wall ................................... 21.73 NA NA 16.03 17.47 2.62 NA NA 40.38 41.82 09019272 ......... ............ A Extensive chest wall surgery ......................... 24.68 NA NA 17.13 18.48 2.99 NA NA 44.80 46.1509019290 ......... ............ A Place needle wire, breast .............................. 1.27 2.85 2.85 0.39 0.41 0.07 4.19 4.19 1.731.75 00019291 ......... ............ A Place needle wire, breast .............................. 0.63 1.12 1.19 0.20 0.21 0.04 1.79 1.86 0.870.88 ZZZ19295 ......... ............ 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 ZZZ19296 ......... ............ 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 00019297 ......... ............ A Place breast cath for rad ............................... 1.72 NA NA 0.47 0.60 0.17 NA NA 2.36 2.49 ZZZ19298 ......... ............ 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 00019316 ......... ............ A Suspension of breast .................................... 10.92 NA NA 7.10 7.41 1.64 NA NA 19.66 19.97 09019318 ......... ............ A Reduction of large breast .............................. 15.85 NA NA 9.99 10.88 2.92 NA NA 28.76 29.65 09019324 ......... ............ A Enlarge breast ............................................... 6.59 NA NA 4.67 4.84 0.84 NA NA 12.1012.27 09019325 ......... ............ A Enlarge breast with implant ........................... 8.44 NA NA 6.46 6.51 1.33 NA NA 16.23 16.28 09019328 ......... ............ A Removal of breast implant ............................ 6.30 NA NA 5.03 5.02 0.91 NA NA 12.24 12.23 09019330 ......... ............ 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 23.0809019350 ......... ............ A Breast reconstruction .................................... 8.91 9.93 12.86 6.61 7.03 1.41 20.25 23.1816.93 17.35 09019355 ......... ............ 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 09019357 ......... ............ A Breast reconstruction .................................... 20.33 NA NA 15.50 15.58 2.93 NA NA 38.76 38.84 09019361 ......... ............ A Breast reconstruction .................................... 20.63 NA NA 12.36 12.41 2.92 NA NA 35.91 35.96 09019364 ......... ............ A Breast reconstruction .................................... 42.30 NA NA 22.88 23.38 6.22 NA NA 71.40 71.90 09019366 ......... ............ A Breast reconstruction .................................... 21.62 NA NA 10.10 11.21 3.24 NA NA 34.96 36.07 09019367 ......... ............ A Breast reconstruction .................................... 26.51 NA NA 15.33 16.35 4.03 NA NA 45.87 46.89 09019368 ......... ............ A Breast reconstruction .................................... 33.51 NA NA 18.23 18.75 5.52 NA NA 57.26 57.78 09019369 ......... ............ A Breast reconstruction .................................... 30.92 NA NA 15.98 17.80 4.50 NA NA 51.40 53.22 09019370 ......... ............ A Surgery of breast capsule ............................. 8.92 NA NA 6.86 6.89 1.29 NA NA 17.07 17.10 09019371 ......... ............ A Removal of breast capsule ........................... 10.34 NA NA 7.74 7.80 1.62 NA NA 19.70 19.76 09019380 ......... ............ A Revise breast reconstruction ......................... 10.13 NA NA 7.67 7.69 1.44 NA NA 19.24 19.26 09019396 ......... ............ 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 00019499 ......... ............ C Breast surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY20000 ......... ............ A Incision of abscess ........................................ 2.12 2.79 2.72 1.53 1.68 0.25 5.16 5.093.90 4.05 01020005 ......... ............ A Incision of deep abscess ............................... 3.53 3.72 3.55 2.04 2.20 0.46 7.71 7.54 6.036.19 01020100 ......... ............ A Explore wound, neck ..................................... 10.31 NA NA 3.63 4.25 1.21 NA NA 15.15 15.77 01020101 ......... ............ A Explore wound, chest .................................... 3.22 6.46 6.06 1.52 1.60 0.44 10.12 9.72 5.18 5.26 01020102 ......... ............ A Explore wound, abdomen ............................. 3.93 6.99 7.34 1.85 1.89 0.49 11.41 11.76 6.27 6.31 01020103 ......... ............ A Explore wound, extremity .............................. 5.29 7.72 8.37 2.73 3.23 0.75 13.76 14.41 8.77 9.27 01020150 ......... ............ A Excise epiphyseal bar ................................... 14.54 NA NA 7.73 7.21 2.03 NA NA 24.30 23.78 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00115 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49096 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal20200 ......... ............ A Muscle biopsy ................................................ 1.46 3.17 3.07 0.70 0.74 0.23 4.86 4.76 2.39 2.43 00020205 ......... ............ A Deep muscle biopsy ...................................... 2.35 3.86 3.88 1.11 1.17 0.33 6.54 6.56 3.79 3.85 00020206 ......... ............ A Needle biopsy, muscle .................................. 0.99 5.25 6.19 0.54 0.61 0.07 6.31 7.25 1.601.67 00020220 ......... ............ 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 00020225 ......... ............ 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 00020240 ......... ............ A Bone biopsy, excisional ................................. 3.23 NA NA 2.07 2.43 0.44 NA NA 5.74 6.10 01020245 ......... ............ A Bone biopsy, excisional ................................. 8.71 NA NA 5.79 6.38 1.31 NA NA 15.81 16.4001020250 ......... ............ A Open bone biopsy ......................................... 5.14 NA NA 3.74 3.56 1.02 NA NA 9.90 9.7201020251 ......... ............ A Open bone biopsy ......................................... 5.67 NA NA 3.91 4.10 1.15 NA NA 10.73 10.92 01020500 ......... ............ A Injection of sinus tract ................................... 1.23 1.30 2.02 0.85 1.36 0.12 2.65 3.372.20 2.71 01020501 ......... ............ 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 00020520 ......... ............ A Removal of foreign body ............................... 1.85 2.59 2.83 1.44 1.68 0.21 4.65 4.89 3.503.74 01020525 ......... ............ 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 01020526 ......... ............ 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 00020550 ......... ............ A Inj tendon sheath/ligament ............................ 0.75 0.63 0.69 0.28 0.24 0.09 1.47 1.53 1.121.08 00020551 ......... ............ 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 00020552 ......... ............ 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 00020553 ......... ............ 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 00020600 ......... ............ A Drain/inject, joint/bursa .................................. 0.66 0.67 0.66 0.31 0.34 0.08 1.41 1.401.05 1.08 00020605 ......... ............ A Drain/inject, joint/bursa .................................. 0.68 0.74 0.76 0.33 0.35 0.08 1.50 1.521.09 1.11 00020610 ......... ............ A Drain/inject, joint/bursa .................................. 0.79 1.07 0.98 0.40 0.42 0.11 1.97 1.881.30 1.32 00020612 ......... ............ 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 00020615 ......... ............ A Treatment of bone cyst ................................. 2.28 2.72 3.31 1.41 1.73 0.20 5.20 5.79 3.894.21 01020650 ......... ............ 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 01020660 ......... ............ A Apply, rem fixation device ............................. 2.51 3.39 3.14 1.50 1.58 0.59 6.49 6.24 4.604.68 00020661 ......... ............ A Application of head brace ............................. 5.06 NA NA 6.00 5.18 1.14 NA NA 12.20 11.38 09020662 ......... ............ A Application of pelvis brace ............................ 6.18 NA NA 4.85 5.35 0.56 NA NA 11.59 12.0909020663 ......... ............ A Application of thigh brace .............................. 5.54 NA NA 5.14 4.91 0.94 NA NA 11.62 11.3909020664 ......... ............ A Halo brace application ................................... 9.78 NA NA 8.13 7.31 1.74 NA NA 19.65 18.83 09020665 ......... ............ A Removal of fixation device ............................ 1.31 1.38 1.96 0.97 1.26 0.19 2.88 3.46 2.472.76 01020670 ......... ............ A Removal of support implant .......................... 1.74 6.70 10.33 1.68 2.00 0.28 8.72 12.35 3.704.02 01020680 ......... ............ A Removal of support implant .......................... 5.86 8.20 8.64 4.10 3.82 0.56 14.62 15.06 10.5210.24 09020690 ......... ............ 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 09020693 ......... ............ A Adjust bone fixation device ........................... 5.91 NA NA 4.54 5.22 0.98 NA NA 11.43 12.11 09020694 ......... ............ 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 09020802 ......... ............ A Replantation, arm, complete ......................... 42.16 NA NA 24.05 21.73 3.81 NA NA 70.02 67.7009020805 ......... ............ A Replant forearm, complete ............................ 51.00 NA NA 25.95 32.22 4.84 NA NA 81.79 88.0609020808 ......... ............ A Replantation hand, complete ........................ 62.63 NA NA 38.79 41.36 6.86 NA NA 108.28 110.8509020816 ......... ............ A Replantation digit, complete .......................... 31.64 NA NA 24.53 34.48 4.52 NA NA 60.69 70.64 09020822 ......... ............ A Replantation digit, complete .......................... 26.30 NA NA 22.24 31.50 4.18 NA NA 52.72 61.98 09020824 ......... ............ A Replantation thumb, complete ...................... 31.64 NA NA 25.77 33.85 4.61 NA NA 62.02 70.10 09020827 ......... ............ A Replantation thumb, complete ...................... 27.12 NA NA 23.90 33.33 3.66 NA NA 54.68 64.11 09020838 ......... ............ A Replantation foot, complete .......................... 42.42 NA NA 13.65 20.12 1.12 NA NA 57.19 63.6609020900 ......... ............ 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 09020902 ......... ............ A Removal of bone for graft ............................. 7.90 NA NA 5.84 6.62 1.30 NA NA 15.04 15.82 09020910 ......... ............ A Remove cartilage for graft ............................. 5.33 NA NA 4.62 5.04 0.71 NA NA 10.66 11.0809020912 ......... ............ A Remove cartilage for graft ............................. 6.34 NA NA 4.67 5.51 0.69 NA NA 11.70 12.5409020920 ......... ............ A Removal of fascia for graft ............................ 5.36 NA NA 4.36 4.26 0.66 NA NA 10.38 10.2809020922 ......... ............ 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 09020924 ......... ............ A Removal of tendon for graft .......................... 6.53 NA NA 5.00 5.66 1.04 NA NA 12.57 13.23 09020926 ......... ............ A Removal of tissue for graft ............................ 5.64 NA NA 4.41 4.67 0.87 NA NA 10.92 11.1809020931 ......... ............ A Spinal bone allograft ..................................... 1.81 NA NA 0.69 0.87 0.43 NA NA 2.93 3.11ZZZ20937 ......... ............ A Spinal bone autograft .................................... 2.79 NA NA 1.09 1.36 0.54 NA NA 4.42 4.69ZZZ20938 ......... ............ A Spinal bone autograft .................................... 3.02 NA NA 1.16 1.46 0.64 NA NA 4.82 5.12ZZZ20950 ......... ............ 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



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# 49097 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules20955 ......... ............ A Fibula bone graft, microvasc ......................... 39.90 NA NA 18.08 22.72 4.89 NA NA 62.87 67.5109020956 ......... ............ A Iliac bone graft, microvasc ............................ 40.79 NA NA 20.77 23.75 7.01 NA NA 68.57 71.55 09020957 ......... ............ A Mt bone graft, microvasc ............................... 42.17 NA NA 19.43 19.06 7.05 NA NA 68.65 68.28 09020962 ......... ............ A Other bone graft, microvasc .......................... 39.21 NA NA 21.28 25.21 6.55 NA NA 67.04 70.9709020969 ......... ............ A Bone/skin graft, microvasc ............................ 44.99 NA NA 20.27 25.04 4.79 NA NA 70.05 74.82 09020970 ......... ............ A Bone/skin graft, iliac crest ............................. 44.14 NA NA 20.21 24.09 6.60 NA NA 70.95 74.83 09020972 ......... ............ A Bone/skin graft, metatarsal ........................... 44.07 NA NA 17.61 19.84 5.30 NA NA 66.98 69.21 09020973 ......... ............ A Bone/skin graft, great toe .............................. 46.83 NA NA 15.05 22.63 5.54 NA NA 67.42 75.00 09020974 ......... ............ A Electrical bone stimulation ............................ 0.62 0.99 0.77 0.49 0.53 0.11 1.72 1.50 1.221.26 00020975 ......... ............ A Electrical bone stimulation ............................ 2.60 NA NA 1.48 1.65 0.51 NA NA 4.59 4.76 00020979 ......... ............ A Us bone stimulation ....................................... 0.62 0.58 0.75 0.19 0.30 0.09 1.29 1.46 0.90 1.01 00020982 ......... ............ 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 00020999 ......... ............ C Musculoskeletal surgery ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY21010 ......... ............ A Incision of jaw joint ........................................ 10.82 NA NA 5.85 6.78 1.11 NA NA 17.7818.71 09021015 ......... ............ A Resection of facial tumor .............................. 5.53 NA NA 4.30 4.83 0.70 NA NA 10.53 11.0609021025 ......... ............ 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 09021026 ......... ............ 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 09021029 ......... ............ 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 09021030 ......... ............ 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 09021031 ......... ............ A Remove exostosis, mandible ........................ 3.24 5.99 5.38 3.51 3.59 0.48 9.71 9.10 7.23 7.3109021032 ......... ............ A Remove exostosis, maxilla ............................ 3.24 6.07 5.52 3.37 3.48 0.47 9.78 9.23 7.08 7.19 09021034 ......... ............ A Excise max/zygoma mlg tumor ..................... 17.09 13.17 15.23 9.51 11.87 1.71 31.97 34.03 28.3130.67 09021040 ......... ............ A Excise mandible lesion .................................. 4.74 7.25 6.61 4.67 4.71 0.54 12.53 11.89 9.95 9.99 09021044 ......... ............ A Removal of jaw bone lesion .......................... 12.53 NA NA 7.48 8.90 1.12 NA NA 21.13 22.55 09021045 ......... ............ A Extensive jaw surgery ................................... 18.03 NA NA 10.01 11.77 1.52 NA NA 29.56 31.32 09021046 ......... ............ A Remove mandible cyst complex ................... 13.85 NA NA 11.62 11.83 1.85 NA NA 27.32 27.53 09021047 ......... ............ A Excise lwr jaw cyst w/repair .......................... 19.71 NA NA 9.74 12.52 2.12 NA NA 31.57 34.3509021048 ......... ............ A Remove maxilla cyst complex ....................... 14.35 NA NA 11.37 11.94 1.76 NA NA 27.48 28.05 09021049 ......... ............ A Excis uppr jaw cyst w/repair ......................... 18.96 NA NA 9.09 12.04 1.59 NA NA 29.64 32.5909021050 ......... ............ A Removal of jaw joint ...................................... 11.44 NA NA 8.18 9.13 1.47 NA NA 21.09 22.04 09021060 ......... ............ A Remove jaw joint cartilage ............................ 10.83 NA NA 7.52 8.34 1.38 NA NA 19.73 20.5509021070 ......... ............ A Remove coronoid process ............................ 8.44 NA NA 6.15 6.86 1.27 NA NA 15.86 16.57 09021076 ......... ............ 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 01021077 ......... ............ A Prepare face/oral prosthesis ......................... 33.70 18.26 28.06 12.31 22.58 4.55 56.51 66.3150.56 60.83 09021079 ......... ............ A Prepare face/oral prosthesis ......................... 22.31 13.35 19.46 8.28 14.93 3.15 38.81 44.9233.74 40.39 09021080 ......... ............ A Prepare face/oral prosthesis ......................... 25.06 15.43 22.23 9.22 16.83 3.74 44.23 51.0338.02 45.63 09021081 ......... ............ A Prepare face/oral prosthesis ......................... 22.85 14.17 20.27 8.48 15.24 3.20 40.22 46.3234.53 41.29 09021082 ......... ............ A Prepare face/oral prosthesis ......................... 20.84 14.12 18.04 8.42 13.90 3.11 38.07 41.9932.37 37.85 09021083 ......... ............ A Prepare face/oral prosthesis ......................... 19.27 14.06 17.61 7.91 12.80 2.88 36.21 39.7630.06 34.95 09021084 ......... ............ A Prepare face/oral prosthesis ......................... 22.48 15.56 20.71 8.82 15.48 2.18 40.22 45.3733.48 40.14 09021085 ......... ............ 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 01021086 ......... ............ A Prepare face/oral prosthesis ......................... 24.88 12.62 20.96 8.63 16.73 3.71 41.21 49.5537.22 45.32 09021087 ......... ............ A Prepare face/oral prosthesis ......................... 24.88 12.85 20.67 8.82 16.60 3.44 41.17 48.9937.14 44.92 09021088 ......... ............ 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 09021089 ......... ............ 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 09021100 ......... ............ A Maxillofacial fixation ...................................... 4.46 13.75 12.09 5.05 4.82 0.34 18.55 16.89 9.85 9.62 09021110 ......... ............ A Interdental fixation ......................................... 5.70 13.26 10.49 9.89 8.74 0.72 19.6816.91 16.31 15.16 09021116 ......... ............ A Injection, jaw joint x-ray ................................. 0.81 2.44 3.86 0.22 0.30 0.06 3.31 4.731.09 1.17 00021120 ......... ............ A Reconstruction of chin ................................... 4.92 10.02 10.44 6.88 7.34 0.60 15.54 15.96 12.40 12.86 09021121 ......... ............ A Reconstruction of chin ................................... 7.63 10.59 9.95 7.50 7.74 0.90 19.12 18.4816.03 16.27 09021122 ......... ............ A Reconstruction of chin ................................... 8.51 NA NA 7.64 8.38 1.07 NA NA 17.22 17.96 09021123 ......... ............ A Reconstruction of chin ................................... 11.14 NA NA 10.06 10.62 1.40 NA NA 22.60 23.16 09021125 ......... ............ 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 09021127 ......... ............ 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 09021137 ......... ............ A Reduction of forehead ................................... 10.06 NA NA 6.30 7.37 1.32 NA NA 17.68 18.75 09021138 ......... ............ A Reduction of forehead ................................... 12.67 NA NA 8.50 9.27 1.74 NA NA 22.91 23.68 09021139 ......... ............ A Reduction of forehead ................................... 14.84 NA NA 8.49 10.42 1.18 NA NA 24.51 26.44 09021141 ......... ............ A Reconstruct midface, lefort ........................... 19.13 NA NA 11.47 13.11 2.35 NA NA 32.95 34.59 09021142 ......... ............ A Reconstruct midface, lefort ........................... 19.84 NA NA 10.53 12.25 2.38 NA NA 32.75 34.47 09021143 ......... ............ A Reconstruct midface, lefort ........................... 20.61 NA NA 8.90 12.96 1.66 NA NA 31.17 35.2309021145 ......... ............ A Reconstruct midface, lefort ........................... 23.52 NA NA 12.75 13.61 2.84 NA NA 39.11 39.97 09021146 ......... ............ A Reconstruct midface, lefort ........................... 24.42 NA NA 9.45 13.86 3.09 NA NA 36.96 41.3709021147 ......... ............ A Reconstruct midface, lefort ........................... 26.01 NA NA 13.58 14.68 1.84 NA NA 41.43 42.53 09021150 ......... ............ A Reconstruct midface, lefort ........................... 25.70 NA NA 13.25 15.88 2.55 NA NA 41.50 44.13 09021151 ......... ............ A Reconstruct midface, lefort ........................... 28.76 NA NA 11.72 20.14 2.30 NA NA 42.78 51.20 09021154 ......... ............ A Reconstruct midface, lefort ........................... 30.95 NA NA 21.25 22.65 2.48 NA NA 54.68 56.08 090



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# 49098 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal21155 ......... ............ A Reconstruct midface, lefort ........................... 34.88 NA NA 13.43 21.28 6.64 NA NA 54.95 62.80 09021159 ......... ............ A Reconstruct midface, lefort ........................... 42.80 NA NA 15.27 25.63 8.18 NA NA 66.25 76.61 09021160 ......... ............ A Reconstruct midface, lefort ........................... 46.85 NA NA 23.11 26.38 4.13 NA NA 74.09 77.36 09021172 ......... ............ A Reconstruct orbit/forehead ............................ 28.01 NA NA 13.59 13.71 3.55 NA NA 45.15 45.27 09021175 ......... ............ A Reconstruct orbit/forehead ............................ 33.37 NA NA 12.92 16.57 4.83 NA NA 51.12 54.77 09021179 ......... ............ A Reconstruct entire forehead .......................... 22.47 NA NA 10.96 13.34 2.80 NA NA 36.23 38.6109021180 ......... ............ A Reconstruct entire forehead .......................... 25.40 NA NA 13.01 14.79 3.48 NA NA 41.89 43.6709021181 ......... ............ A Contour cranial bone lesion .......................... 10.14 NA NA 7.05 7.36 1.32 NA NA 18.51 18.82 09021182 ......... ............ A Reconstruct cranial bone .............................. 32.39 NA NA 14.29 17.91 2.80 NA NA 49.48 53.10 09021183 ......... ............ A Reconstruct cranial bone .............................. 35.51 NA NA 15.48 19.49 4.47 NA NA 55.46 59.47 09021184 ......... ............ A Reconstruct cranial bone .............................. 38.43 NA NA 21.02 21.71 5.70 NA NA 65.15 65.84 09021188 ......... ............ A Reconstruction of midface ............................. 22.91 NA NA 14.82 17.86 1.69 NA NA 39.42 42.46 09021193 ......... ............ A Reconst lwr jaw w/o graft .............................. 18.55 NA NA 10.06 12.00 2.23 NA NA 30.84 32.78 09021194 ......... ............ A Reconst lwr jaw w/graft ................................. 21.43 NA NA 11.45 13.18 2.02 NA NA 34.90 36.63 09021195 ......... ............ A Reconst lwr jaw w/o fixation .......................... 18.77 NA NA 13.26 14.43 1.64 NA NA 33.67 34.84 09021196 ......... ............ A Reconst lwr jaw w/fixation ............................. 20.44 NA NA 13.20 15.07 2.07 NA NA 35.71 37.58 09021198 ......... ............ A Reconstr lwr jaw segment ............................. 15.39 NA NA 11.05 12.29 1.44 NA NA 27.88 29.1209021199 ......... ............ 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 09021208 ......... ............ 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 09021209 ......... ............ A Reduction of facial bones .............................. 7.46 12.33 11.18 7.42 7.91 0.90 20.69 19.5415.78 16.27 09021210 ......... ............ A Face bone graft ............................................. 11.28 43.84 29.61 7.70 8.94 1.30 56.4242.19 20.28 21.52 09021215 ......... ............ 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 09021230 ......... ............ A Rib cartilage graft .......................................... 11.00 NA NA 6.94 7.77 1.29 NA NA 19.2320.06 09021235 ......... ............ A Ear cartilage graft .......................................... 7.21 9.70 9.81 5.89 6.28 0.61 17.52 17.63 13.71 14.10 09021240 ......... ............ A Reconstruction of jaw joint ............................ 15.65 NA NA 11.31 11.87 2.24 NA NA 29.20 29.76 09021242 ......... ............ A Reconstruction of jaw joint ............................ 14.20 NA NA 10.64 11.29 1.78 NA NA 26.62 27.27 09021243 ......... ............ A Reconstruction of jaw joint ............................ 23.83 NA NA 15.77 17.02 3.25 NA NA 42.85 44.10 09021244 ......... ............ A Reconstruction of lower jaw .......................... 13.23 NA NA 10.93 11.80 1.25 NA NA 25.41 26.2809021245 ......... ............ A Reconstruction of jaw .................................... 12.78 13.37 14.14 7.99 9.39 1.19 27.34 28.11 21.96 23.36 09021246 ......... ............ A Reconstruction of jaw .................................... 12.70 NA NA 6.67 8.45 1.35 NA NA 20.72 22.50 09021247 ......... ............ A Reconstruct lower jaw bone .......................... 23.91 NA NA 13.59 16.41 2.83 NA NA 40.33 43.1509021248 ......... ............ A Reconstruction of jaw .................................... 12.46 12.60 12.25 7.51 8.93 1.55 26.61 26.26 21.52 22.94 09021249 ......... ............ A Reconstruction of jaw .................................... 18.49 16.13 16.57 9.94 12.00 2.48 37.10 37.54 30.91 32.97 09021255 ......... ............ A Reconstruct lower jaw bone .......................... 18.00 NA NA 13.33 15.43 2.38 NA NA 33.71 35.8109021256 ......... ............ A Reconstruction of orbit .................................. 17.32 NA NA 9.98 11.36 1.50 NA NA 28.80 30.18 09021260 ......... ............ A Revise eye sockets ....................................... 17.66 NA NA 9.51 11.95 0.97 NA NA 28.14 30.58 09021261 ......... ............ A Revise eye sockets ....................................... 33.66 NA NA 14.88 21.89 3.42 NA NA 51.96 58.97 09021263 ......... ............ A Revise eye sockets ....................................... 30.60 NA NA 14.17 17.85 2.62 NA NA 47.39 51.07 09021267 ......... ............ A Revise eye sockets ....................................... 20.35 NA NA 16.14 18.86 1.70 NA NA 38.19 40.91 09021268 ......... ............ A Revise eye sockets ....................................... 26.66 NA NA 15.74 19.09 3.65 NA NA 46.05 49.40 09021270 ......... ............ A Augmentation, cheek bone ........................... 10.46 11.17 11.53 5.89 6.91 0.72 22.35 22.71 17.07 18.09 09021275 ......... ............ A Revision, orbitofacial bones .......................... 11.59 NA NA 7.41 7.97 1.29 NA NA 20.29 20.8509021280 ......... ............ A Revision of eyelid .......................................... 6.84 NA NA 5.84 5.90 0.42 NA NA 13.10 13.16 09021282 ......... ............ A Revision of eyelid .......................................... 4.05 NA NA 4.26 4.43 0.26 NA NA 8.57 8.74 09021295 ......... ............ A Revision of jaw muscle/bone ........................ 1.78 NA NA 2.61 2.55 0.16 NA NA 4.55 4.49 09021296 ......... ............ A Revision of jaw muscle/bone ........................ 4.61 NA NA 5.46 5.05 0.34 NA NA 10.41 10.00 09021299 ......... ............ C Cranio/maxillofacial surgery .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY21300 ......... ............ A Treatment of skull fracture ............................ 0.72 0.28 1.84 0.28 0.27 0.13 1.13 2.69 1.131.12 00021310 ......... ............ A Treatment of nose fracture ............................ 0.58 1.97 2.20 0.11 0.14 0.05 2.60 2.83 0.740.77 00021315 ......... ............ A Treatment of nose fracture ............................ 1.76 4.46 4.29 1.65 1.82 0.14 6.36 6.19 3.553.72 01021320 ......... ............ A Treatment of nose fracture ............................ 1.85 4.05 3.95 1.25 1.53 0.18 6.08 5.98 3.283.56 01021325 ......... ............ A Treatment of nose fracture ............................ 4.01 NA NA 6.72 8.15 0.31 NA NA 11.04 12.47 09021330 ......... ............ A Treatment of nose fracture ............................ 5.62 NA NA 7.44 9.14 0.56 NA NA 13.62 15.32 09021335 ......... ............ A Treatment of nose fracture ............................ 8.85 NA NA 7.74 9.15 0.74 NA NA 17.33 18.74 09021336 ......... ............ A Treat nasal septal fracture ............................ 6.46 NA NA 8.16 9.25 0.55 NA NA 15.17 16.26090



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# 49099 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules21337 ......... ............ A Treat nasal septal fracture ............................ 3.20 5.87 6.06 3.36 3.52 0.28 9.35 9.54 6.847.00 09021338 ......... ............ A Treat nasoethmoid fracture ........................... 6.70 NA NA 9.66 12.93 0.82 NA NA 17.18 20.45 09021339 ......... ............ A Treat nasoethmoid fracture ........................... 8.33 NA NA 10.63 13.08 0.96 NA NA 19.92 22.3709021340 ......... ............ A Treatment of nose fracture ............................ 11.25 NA NA 7.36 8.14 1.15 NA NA 19.76 20.5409021343 ......... ............ A Treatment of sinus fracture ........................... 14.01 NA NA 12.51 14.73 1.47 NA NA 27.99 30.21 09021344 ......... ............ A Treatment of sinus fracture ........................... 21.26 NA NA 13.04 15.64 2.43 NA NA 36.73 39.33 09021345 ......... ............ 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 09021346 ......... ............ A Treat nose/jaw fracture ................................. 11.21 NA NA 10.76 11.84 1.21 NA NA 23.18 24.26 09021347 ......... ............ A Treat nose/jaw fracture ................................. 13.29 NA NA 11.56 15.03 1.47 NA NA 26.32 29.79 09021348 ......... ............ A Treat nose/jaw fracture ................................. 17.28 NA NA 6.42 9.94 2.48 NA NA 26.18 29.70 09021355 ......... ............ 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 01021356 ......... ............ 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 01021360 ......... ............ A Treat cheek bone fracture ............................. 6.95 NA NA 5.25 5.76 0.74 NA NA 12.94 13.45 09021365 ......... ............ A Treat cheek bone fracture ............................. 16.42 NA NA 8.90 10.35 1.69 NA NA 27.01 28.4609021366 ......... ............ A Treat cheek bone fracture ............................. 18.36 NA NA 10.35 11.09 2.49 NA NA 31.20 31.94 09021385 ......... ............ A Treat eye socket fracture .............................. 9.40 NA NA 6.90 7.94 0.97 NA NA 17.27 18.3109021386 ......... ............ A Treat eye socket fracture .............................. 9.40 NA NA 5.69 6.73 0.97 NA NA 16.06 17.1009021387 ......... ............ A Treat eye socket fracture .............................. 9.94 NA NA 7.25 8.53 1.08 NA NA 18.27 19.5509021390 ......... ............ A Treat eye socket fracture .............................. 11.01 NA NA 7.05 7.61 0.90 NA NA 18.96 19.5209021395 ......... ............ A Treat eye socket fracture .............................. 14.58 NA NA 7.78 8.71 1.44 NA NA 23.80 24.7309021400 ......... ............ A Treat eye socket fracture .............................. 1.40 2.74 2.64 1.98 1.90 0.15 4.29 4.19 3.533.45 09021401 ......... ............ 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 09021406 ......... ............ A Treat eye socket fracture .............................. 7.25 NA NA 5.08 5.83 0.73 NA NA 13.06 13.8109021407 ......... ............ A Treat eye socket fracture .............................. 8.85 NA NA 5.89 6.62 0.94 NA NA 15.68 16.4109021408 ......... ............ A Treat eye socket fracture .............................. 12.61 NA NA 7.91 8.64 1.44 NA NA 21.96 22.6909021421 ......... ............ A Treat mouth roof fracture .............................. 5.70 12.09 10.02 8.96 8.47 0.73 18.52 16.4515.39 14.90 09021422 ......... ............ A Treat mouth roof fracture .............................. 8.56 NA NA 6.79 7.76 0.99 NA NA 16.34 17.3109021423 ......... ............ A Treat mouth roof fracture .............................. 10.63 NA NA 7.28 8.81 1.27 NA NA 19.18 20.7109021431 ......... ............ A Treat craniofacial fracture ............................. 7.66 NA NA 9.34 9.48 0.70 NA NA 17.70 17.8409021432 ......... ............ A Treat craniofacial fracture ............................. 8.72 NA NA 7.18 7.84 0.81 NA NA 16.71 17.3709021433 ......... ............ A Treat craniofacial fracture ............................. 26.05 NA NA 12.51 15.43 2.78 NA NA 41.34 44.26 09021435 ......... ............ A Treat craniofacial fracture ............................. 19.92 NA NA 10.77 12.22 1.98 NA NA 32.67 34.12 09021436 ......... ............ A Treat craniofacial fracture ............................. 29.89 NA NA 14.38 17.26 3.09 NA NA 47.36 50.24 09021440 ......... ............ A Treat dental ridge fracture ............................. 3.20 10.31 7.90 7.63 6.53 0.38 13.89 11.4811.21 10.11 09021445 ......... ............ A Treat dental ridge fracture ............................. 5.94 12.48 10.43 8.61 8.43 0.78 19.20 17.1515.33 15.15 09021450 ......... ............ A Treat lower jaw fracture ................................ 3.47 10.41 8.14 7.64 7.06 0.33 14.21 11.9411.44 10.86 09021451 ......... ............ A Treat lower jaw fracture ................................ 5.36 12.93 10.25 9.63 8.71 0.63 18.92 16.2415.62 14.70 09021452 ......... ............ A Treat lower jaw fracture ................................ 2.23 11.77 12.71 5.89 4.93 0.27 14.27 15.218.39 7.43 09021453 ......... ............ 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 09021454 ......... ............ A Treat lower jaw fracture ................................ 7.07 NA NA 5.64 6.11 0.82 NA NA 13.53 14.0009021461 ......... ............ 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 09021462 ......... ............ 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 09021465 ......... ............ A Treat lower jaw fracture ................................ 12.76 NA NA 8.26 9.42 1.50 NA NA 22.52 23.68 09021470 ......... ............ A Treat lower jaw fracture ................................ 17.12 NA NA 10.05 11.53 1.96 NA NA 29.13 30.61 09021480 ......... ............ A Reset dislocated jaw ..................................... 0.61 1.51 1.71 0.18 0.19 0.06 2.18 2.38 0.85 0.86 00021485 ......... ............ A Reset dislocated jaw ..................................... 4.48 12.20 9.22 9.18 8.04 0.51 17.19 14.2114.17 13.03 09021490 ......... ............ A Repair dislocated jaw .................................... 12.59 NA NA 7.86 9.23 1.96 NA NA 22.41 23.78 09021495 ......... ............ A Treat hyoid bone fracture .............................. 6.43 NA NA 9.57 8.71 0.46 NA NA 16.46 15.6009021497 ......... ............ A Interdental wiring ........................................... 4.35 11.96 9.33 9.14 8.02 0.50 16.81 14.18 13.99 12.87 09021499 ......... ............ C Head surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY21501 ......... ............ 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 09021502 ......... ............ A Drain chest lesion .......................................... 7.35 NA NA 4.77 5.42 0.97 NA NA 13.09 13.74 09021510 ......... ............ A Drainage of bone lesion ................................ 5.97 NA NA 4.71 5.42 0.80 NA NA 11.48 12.1909021550 ......... ............ 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 01021555 ......... ............ A Remove lesion, neck/chest ........................... 4.34 5.76 5.57 3.41 3.25 0.56 10.66 10.47 8.318.15 09021556 ......... ............ 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 09021600 ......... ............ A Partial removal of rib ..................................... 7.06 NA NA 5.79 5.75 0.99 NA NA 13.84 13.80 09021610 ......... ............ A Partial removal of rib ..................................... 15.70 NA NA 8.13 8.68 3.07 NA NA 26.90 27.45 09021615 ......... ............ A Removal of rib ............................................... 10.22 NA NA 5.46 6.38 1.45 NA NA 17.1318.05 09021616 ......... ............ A Removal of rib and nerves ............................ 12.44 NA NA 7.15 7.80 1.86 NA NA 21.45 22.10 09021620 ......... ............ A Partial removal of sternum ............................ 7.08 NA NA 4.88 5.70 0.98 NA NA 12.94 13.76 09021627 ......... ............ A Sternal debridement ...................................... 7.10 NA NA 5.62 6.13 1.02 NA NA 13.74 14.25 09021630 ......... ............ A Extensive sternum surgery ............................ 18.90 NA NA 10.55 11.52 2.58 NA NA 32.03 33.0009021632 ......... ............ A Extensive sternum surgery ............................ 19.40 NA NA 9.62 10.74 2.65 NA NA 31.67 32.7909021685 ......... ............ A Hyoid myotomy & suspension ....................... 14.77 NA NA 7.81 9.43 1.06 NA NA 23.64 25.26 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00119 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49100 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal21700 ......... ............ A Revision of neck muscle ............................... 6.18 NA NA 3.93 4.31 0.32 NA NA 10.43 10.81 09021705 ......... ............ A Revision of neck muscle/rib .......................... 9.77 NA NA 4.71 5.36 1.43 NA NA 15.91 16.56 09021720 ......... ............ A Revision of neck muscle ............................... 5.67 NA NA 4.32 2.93 0.91 NA NA 10.90 9.51 09021725 ......... ............ A Revision of neck muscle ............................... 7.04 NA NA 4.60 5.23 1.21 NA NA 12.85 13.48 09021740 ......... ............ A Reconstruction of sternum ............................ 17.43 NA NA 8.77 8.58 2.36 NA NA 28.56 28.37 09021742 ......... ............ 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 09021743 ......... ............ C Repair sternum/nuss w/scope ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.0009021750 ......... ............ A Repair of sternum separation ........................ 11.33 NA NA 5.45 5.95 1.63 NA NA 18.41 18.91 09021800 ......... ............ 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 09021805 ......... ............ A Treatment of rib fracture ............................... 2.75 NA NA 3.56 3.29 0.38 NA NA 6.69 6.42 09021810 ......... ............ A Treatment of rib fracture(s) ........................... 6.85 NA NA 5.27 5.05 0.94 NA NA 13.06 12.8409021820 ......... ............ A Treat sternum fracture ................................... 1.28 1.80 1.82 1.87 1.79 0.16 3.24 3.26 3.31 3.23 09021825 ......... ............ A Treat sternum fracture ................................... 7.58 NA NA 5.46 6.16 1.11 NA NA 14.15 14.85 09021899 ......... ............ C Neck/chest surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY21920 ......... ............ A Biopsy soft tissue of back ............................. 2.06 4.32 3.54 1.82 1.56 0.14 6.52 5.74 4.023.76 01021925 ......... ............ 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 09021930 ......... ............ A Remove lesion, back or flank ........................ 4.99 6.05 5.80 3.77 3.49 0.66 11.70 11.45 9.429.14 09021935 ......... ............ A Remove tumor, back ..................................... 18.29 NA NA 8.56 9.36 2.47 NA NA 29.32 30.1209022010 ......... ............ 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 09022015 ......... ............ A I&d, p-spine, l/s/ls .......................................... 12.38 NA NA 8.02 8.62 1.71 NA NA 22.11 22.71 09022100 ......... ............ A Remove part of neck vertebra ...................... 10.72 NA NA 8.01 7.65 2.13 NA NA 20.86 20.50 09022101 ......... ............ 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 09022103 ......... ............ A Remove extra spine segment ....................... 2.34 NA NA 0.89 1.13 0.44 NA NA 3.67 3.91 ZZZ22110 ......... ............ A Remove part of neck vertebra ...................... 13.72 NA NA 9.09 9.14 2.76 NA NA 25.57 25.62 09022112 ......... ............ 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 09022116 ......... ............ A Remove extra spine segment ....................... 2.32 NA NA 0.87 1.10 0.50 NA NA 3.69 3.92 ZZZ22210 ......... ............ A Revision of neck spine .................................. 25.03 NA NA 14.74 15.24 5.44 NA NA 45.21 45.71 09022212 ......... ............ A Revision of thorax spine ................................ 20.64 NA NA 12.49 13.08 3.90 NA NA 37.03 37.62 09022214 ......... ............ A Revision of lumbar spine ............................... 20.67 NA NA 12.59 13.51 3.91 NA NA 37.17 38.09 09022216 ......... ............ A Revise, extra spine segment ......................... 6.03 NA NA 2.37 2.94 1.29 NA NA 9.69 10.26 ZZZ22220 ......... ............ A Revision of neck spine .................................. 22.59 NA NA 13.42 13.57 5.06 NA NA 41.07 41.22 09022222 ......... ............ A Revision of thorax spine ................................ 22.74 NA NA 12.19 11.40 4.12 NA NA 39.05 38.26 09022224 ......... ............ A Revision of lumbar spine ............................... 22.74 NA NA 13.17 13.96 4.18 NA NA 40.09 40.88 09022226 ......... ............ A Revise, extra spine segment ......................... 6.03 NA NA 2.15 2.86 1.29 NA NA 9.47 10.18 ZZZ22305 ......... ............ 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 09022310 ......... ............ A Treat spine fracture ....................................... 3.61 2.99 2.85 2.50 2.39 0.50 7.10 6.966.61 6.50 09022315 ......... ............ A Treat spine fracture ....................................... 9.83 9.81 9.71 7.39 7.35 1.85 21.49 21.39 19.07 19.03 09022318 ......... ............ A Treat odontoid fx w/o graft ............................ 22.46 NA NA 13.25 13.35 5.28 NA NA 40.99 41.09 09022319 ......... ............ A Treat odontoid fx w/graft ............................... 25.07 NA NA 14.00 14.53 6.03 NA NA 45.10 45.63 09022325 ......... ............ A Treat spine fracture ....................................... 19.52 NA NA 12.03 12.06 3.87 NA NA 35.4235.45 09022326 ......... ............ A Treat neck spine fracture .............................. 20.56 NA NA 12.13 12.56 4.42 NA NA 37.11 37.54 09022327 ......... ............ A Treat thorax spine fracture ............................ 20.42 NA NA 12.07 12.29 3.98 NA NA 36.47 36.69 09022328 ......... ............ A Treat each add spine fx ................................ 4.60 NA NA 1.80 2.15 0.94 NA NA 7.34 7.69 ZZZ22505 ......... ............ A Manipulation of spine .................................... 1.87 NA NA 1.06 0.97 0.36 NA NA 3.29 3.2001022520 ......... ............ A Percut vertebroplasty thor ............................. 9.15 44.71 57.42 4.39 4.92 1.71 55.57 68.2815.25 15.78 01022521 ......... ............ A Percut vertebroplasty lumb ........................... 8.58 45.98 53.47 4.20 4.76 1.60 56.16 63.65 14.38 14.94 01022522 ......... ............ 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 16.5101022524 ......... ............ A Percut kyphoplasty, lumbar ........................... 8.79 NA NA 4.60 5.42 1.60 NA NA 14.99 15.81 01022525 ......... ............ A Percut kyphoplasty, add-on ........................... 4.47 NA NA 1.68 2.12 0.82 NA NA 6.97 7.41 ZZZ22532 ......... ............ A Lat thorax spine fusion .................................. 25.73 NA NA 13.79 14.56 4.34 NA NA 43.86 44.63 09022533 ......... ............ A Lat lumbar spine fusion ................................. 24.53 NA NA 13.43 13.55 3.15 NA NA 41.11 41.23 09022534 ......... ............ A Lat thor/lumb, addIl seg ................................ 5.99 NA NA 2.31 2.85 1.25 NA NA 9.55 10.09ZZZ22548 ......... ............ A Neck spine fusion .......................................... 26.78 NA NA 15.08 15.62 5.59 NA NA 47.4547.99 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00120 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49101 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules22554 ......... ............ A Neck spine fusion .......................................... 17.48 NA NA 10.74 11.94 4.45 NA NA 32.6733.87 09022556 ......... ............ A Thorax spine fusion ....................................... 24.42 NA NA 13.07 14.32 4.34 NA NA 41.8343.08 09022558 ......... ............ A Lumbar spine fusion ...................................... 23.25 NA NA 11.53 12.85 3.15 NA NA 37.93 39.25 09022585 ......... ............ A Additional spinal fusion ................................. 5.52 NA NA 2.09 2.62 1.25 NA NA 8.86 9.39ZZZ22590 ......... ............ A Spine & skull spinal fusion ............................ 21.48 NA NA 13.10 13.27 4.78 NA NA 39.36 39.53 09022595 ......... ............ A Neck spinal fusion ......................................... 20.36 NA NA 12.61 12.78 4.40 NA NA 37.3737.54 09022600 ......... ............ A Neck spine fusion .......................................... 17.12 NA NA 11.28 11.21 3.72 NA NA 32.1232.05 09022610 ......... ............ A Thorax spine fusion ....................................... 17.00 NA NA 10.88 11.28 3.52 NA NA 31.4031.80 09022612 ......... ............ A Lumbar spine fusion ...................................... 22.50 NA NA 12.92 13.88 4.46 NA NA 39.88 40.84 09022614 ......... ............ 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 09022632 ......... ............ A Spine fusion, extra segment ......................... 5.22 NA NA 2.01 2.50 1.16 NA NA 8.39 8.88 ZZZ22800 ......... ............ A Fusion of spine .............................................. 19.22 NA NA 11.15 12.37 3.75 NA NA 34.12 35.34 09022802 ......... ............ A Fusion of spine .............................................. 31.83 NA NA 16.17 18.74 6.15 NA NA 54.15 56.72 09022804 ......... ............ A Fusion of spine .............................................. 37.22 NA NA 18.20 21.57 6.98 NA NA 62.40 65.77 09022808 ......... ............ A Fusion of spine .............................................. 27.23 NA NA 13.85 15.69 4.92 NA NA 46.00 47.84 09022810 ......... ............ A Fusion of spine .............................................. 31.22 NA NA 14.93 17.50 5.13 NA NA 51.28 53.85 09022812 ......... ............ A Fusion of spine .............................................. 33.90 NA NA 16.75 19.23 5.28 NA NA 55.93 58.41 09022818 ......... ............ A Kyphectomy, 1–2 segments .......................... 34.12 NA NA 16.65 18.32 6.45 NA NA 57.22 58.89 09022819 ......... ............ A Kyphectomy, 3 or more ................................. 39.10 NA NA 19.45 19.90 7.65 NA NA 66.20 66.65 09022830 ......... ............ A Exploration of spinal fusion ........................... 11.07 NA NA 7.11 7.75 2.29 NA NA 20.47 21.1109022840 ......... ............ A Insert spine fixation device ............................ 12.52 NA NA 4.84 6.08 2.78 NA NA 20.14 21.38 ZZZ22842 ......... ............ A Insert spine fixation device ............................ 12.56 NA NA 4.86 6.09 2.74 NA NA 20.16 21.39 ZZZ22843 ......... ............ A Insert spine fixation device ............................ 13.44 NA NA 5.26 6.27 2.85 NA NA 21.55 22.56 ZZZ22844 ......... ............ A Insert spine fixation device ............................ 16.42 NA NA 6.47 8.18 3.18 NA NA 26.07 27.78 ZZZ22845 ......... ............ A Insert spine fixation device ............................ 11.94 NA NA 4.55 5.69 2.85 NA NA 19.34 20.48 ZZZ22846 ......... ............ A Insert spine fixation device ............................ 12.40 NA NA 4.72 5.93 2.95 NA NA 20.07 21.28 ZZZ22847 ......... ............ A Insert spine fixation device ............................ 13.78 NA NA 5.34 6.60 2.99 NA NA 22.11 23.37 ZZZ22848 ......... ............ A Insert pelv fixation device .............................. 5.99 NA NA 2.37 2.98 1.15 NA NA 9.51 10.12ZZZ22849 ......... ............ A Reinsert spinal fixation .................................. 19.02 NA NA 10.28 11.37 3.89 NA NA 33.1934.28 09022850 ......... ............ A Remove spine fixation device ....................... 9.69 NA NA 6.51 6.87 2.04 NA NA 18.24 18.60 09022851 ......... ............ A Apply spine prosth device ............................. 6.70 NA NA 2.58 3.17 1.49 NA NA 10.77 11.36 ZZZ22852 ......... ............ A Remove spine fixation device ....................... 9.24 NA NA 6.23 6.65 1.89 NA NA 17.36 17.78 09022855 ......... ............ 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 0.000.00 YYY22900 ......... ............ A Remove abdominal wall lesion ..................... 6.09 NA NA 3.56 3.31 0.76 NA NA 10.41 10.16 09022999 ......... ............ C Abdomen surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY23000 ......... ............ 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 09023020 ......... ............ A Release shoulder joint ................................... 9.16 NA NA 6.51 7.30 1.54 NA NA 17.21 18.00 09023030 ......... ............ A Drain shoulder lesion .................................... 3.42 6.32 7.12 2.41 2.78 0.57 10.31 11.116.40 6.77 01023031 ......... ............ A Drain shoulder bursa ..................................... 2.74 6.53 7.53 2.23 2.60 0.46 9.73 10.73 5.43 5.80 01023035 ......... ............ A Drain shoulder bone lesion ........................... 8.96 NA NA 7.02 7.96 1.47 NA NA 17.45 18.39 09023040 ......... ............ 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 4.174.11 01023066 ......... ............ A Biopsy shoulder tissues ................................ 4.15 7.72 7.68 3.60 3.89 0.63 12.50 12.46 8.38 8.67 09023075 ......... ............ 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 01023076 ......... ............ A Removal of shoulder lesion ........................... 7.68 NA NA 5.33 5.50 1.13 NA NA 14.14 14.31 09023077 ......... ............ A Remove tumor of shoulder ............................ 17.98 NA NA 9.81 10.11 2.33 NA NA 30.12 30.42 09023100 ......... ............ A Biopsy of shoulder joint ................................. 6.02 NA NA 5.15 5.53 1.04 NA NA 12.21 12.59 09023101 ......... ............ A Shoulder joint surgery ................................... 5.57 NA NA 4.58 5.14 0.96 NA NA 11.11 11.67 09023105 ......... ............ A Remove shoulder joint lining ......................... 8.28 NA NA 6.12 6.87 1.42 NA NA 15.82 16.57 09023106 ......... ............ A Incision of collarbone joint ............................. 5.95 NA NA 4.62 5.43 0.99 NA NA 11.56 12.37 09023107 ......... ............ A Explore treat shoulder joint ........................... 8.67 NA NA 6.27 7.11 1.49 NA NA 16.43 17.2709023120 ......... ............ A Partial removal, collar bone .......................... 7.16 NA NA 5.50 6.22 1.23 NA NA 13.89 14.61 09023125 ......... ............ A Removal of collar bone ................................. 9.44 NA NA 6.38 7.27 1.62 NA NA 17.44 18.3309023130 ......... ............ A Remove shoulder bone, part ......................... 7.54 NA NA 6.10 6.87 1.30 NA NA 14.94 15.71 09023140 ......... ............ A Removal of bone lesion ................................ 6.94 NA NA 4.82 5.12 1.08 NA NA 12.84 13.14 09023145 ......... ............ A Removal of bone lesion ................................ 9.20 NA NA 5.83 7.04 1.49 NA NA 16.52 17.73 09023146 ......... ............ A Removal of bone lesion ................................ 7.88 NA NA 5.99 6.83 1.35 NA NA 15.22 16.06 09023150 ......... ............ A Removal of humerus lesion .......................... 8.71 NA NA 6.06 6.71 1.32 NA NA 16.09 16.74 09023155 ......... ............ 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 09023170 ......... ............ A Remove collar bone lesion ............................ 7.03 NA NA 5.08 5.79 1.12 NA NA 13.23 13.94 09023172 ......... ............ A Remove shoulder blade lesion ...................... 7.13 NA NA 4.98 5.96 1.01 NA NA 13.12 14.10 09023174 ......... ............ A Remove humerus lesion ............................... 9.80 NA NA 7.30 8.10 1.65 NA NA 18.75 19.55 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00121 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49102 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal23180 ......... ............ A Remove collar bone lesion ............................ 8.76 NA NA 7.08 8.51 1.47 NA NA 17.31 18.74 09023182 ......... ............ A Remove shoulder blade lesion ...................... 8.38 NA NA 6.91 8.14 1.37 NA NA 16.66 17.89 09023184 ......... ............ 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 14.4509023195 ......... ............ A Removal of head of humerus ........................ 10.16 NA NA 6.80 7.50 1.70 NA NA 18.66 19.36 09023200 ......... ............ A Removal of collar bone ................................. 12.60 NA NA 7.51 8.42 1.93 NA NA 22.04 22.9509023210 ......... ............ A Removal of shoulder blade ........................... 13.07 NA NA 8.24 8.80 2.02 NA NA 23.33 23.89 09023220 ......... ............ A Partial removal of humerus ........................... 15.26 NA NA 9.09 10.39 2.48 NA NA 26.83 28.1309023221 ......... ............ A Partial removal of humerus ........................... 18.31 NA NA 6.67 10.46 3.05 NA NA 28.03 31.8209023222 ......... ............ A Partial removal of humerus ........................... 25.36 NA NA 13.58 15.23 3.94 NA NA 42.88 44.5309023330 ......... ............ A Remove shoulder foreign body ..................... 1.85 3.37 3.60 1.53 1.79 0.24 5.46 5.69 3.62 3.8801023331 ......... ............ A Remove shoulder foreign body ..................... 7.43 NA NA 5.89 6.57 1.27 NA NA 14.59 15.27 09023332 ......... ............ A Remove shoulder foreign body ..................... 12.14 NA NA 8.03 9.00 2.02 NA NA 22.19 23.16 09023350 ......... ............ 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 00023395 ......... ............ A Muscle transfer,shoulder/arm ........................ 18.19 NA NA 11.26 12.46 2.93 NA NA 32.38 33.5809023397 ......... ............ A Muscle transfers ............................................ 16.53 NA NA 9.70 10.95 2.73 NA NA 28.9630.21 09023400 ......... ............ A Fixation of shoulder blade ............................. 13.64 NA NA 8.57 9.70 2.29 NA NA 24.50 25.6309023405 ......... ............ A Incision of tendon & muscle .......................... 8.36 NA NA 5.97 6.68 1.45 NA NA 15.78 16.49 09023406 ......... ............ A Incise tendon(s) & muscle(s) ........................ 10.83 NA NA 6.95 7.99 1.87 NA NA 19.65 20.69 09023410 ......... ............ A Repair rotator cuff, acute .............................. 12.55 NA NA 7.84 9.01 2.16 NA NA 22.55 23.72 09023412 ......... ............ A Repair rotator cuff, chronic ............................ 13.47 NA NA 8.23 9.48 2.31 NA NA 24.01 25.26 09023415 ......... ............ 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 26.7427.54 09023430 ......... ............ A Repair biceps tendon .................................... 9.97 NA NA 6.81 7.78 1.73 NA NA 18.51 19.4809023440 ......... ............ A Remove/transplant tendon ............................ 10.46 NA NA 6.82 7.90 1.82 NA NA 19.10 20.18 09023450 ......... ............ A Repair shoulder capsule ............................... 13.50 NA NA 8.21 9.43 2.32 NA NA 24.03 25.2509023455 ......... ............ A Repair shoulder capsule ............................... 14.47 NA NA 8.60 9.98 2.49 NA NA 25.56 26.9409023460 ......... ............ A Repair shoulder capsule ............................... 15.59 NA NA 9.36 10.87 2.66 NA NA 27.61 29.1209023462 ......... ............ A Repair shoulder capsule ............................... 15.52 NA NA 9.11 10.34 2.59 NA NA 27.22 28.4509023465 ......... ............ A Repair shoulder capsule ............................... 16.07 NA NA 9.61 10.79 2.76 NA NA 28.44 29.6209023466 ......... ............ A Repair shoulder capsule ............................... 15.45 NA NA 10.11 11.06 2.46 NA NA 28.02 28.97 09023470 ......... ............ A Reconstruct shoulder joint ............................. 17.66 NA NA 10.20 11.74 2.98 NA NA 30.84 32.38 09023472 ......... ............ A Reconstruct shoulder joint ............................. 22.39 NA NA 12.25 13.87 3.66 NA NA 38.30 39.92 09023480 ......... ............ A Revision of collar bone .................................. 11.34 NA NA 7.37 8.42 1.94 NA NA 20.65 21.70 09023485 ......... ............ A Revision of collar bone .................................. 13.71 NA NA 8.33 9.50 2.33 NA NA 24.37 25.54 09023490 ......... ............ A Reinforce clavicle .......................................... 11.96 NA NA 6.69 8.19 1.47 NA NA 20.1221.62 09023491 ......... ............ A Reinforce shoulder bones ............................. 14.31 NA NA 8.89 10.26 2.46 NA NA 25.66 27.0309023500 ......... ............ A Treat clavicle fracture .................................... 2.08 2.64 2.81 2.71 2.57 0.30 5.02 5.195.09 4.95 09023505 ......... ............ A Treat clavicle fracture .................................... 3.68 4.03 4.32 3.63 3.79 0.61 8.32 8.617.92 8.08 09023515 ......... ............ A Treat clavicle fracture .................................... 7.40 NA NA 5.59 6.31 1.28 NA NA 14.27 14.99 09023520 ......... ............ A Treat clavicle dislocation ............................... 2.16 2.65 2.80 2.72 2.74 0.34 5.15 5.30 5.22 5.24 09023525 ......... ............ A Treat clavicle dislocation ............................... 3.59 4.51 4.53 3.92 3.94 0.46 8.56 8.58 7.97 7.99 09023530 ......... ............ A Treat clavicle dislocation ............................... 7.30 NA NA 5.28 5.77 1.20 NA NA 13.78 14.27 09023532 ......... ............ A Treat clavicle dislocation ............................... 8.00 NA NA 6.08 6.75 1.38 NA NA 15.46 16.13 09023540 ......... ............ A Treat clavicle dislocation ............................... 2.23 2.62 2.80 2.70 2.45 0.29 5.14 5.32 5.22 4.97 09023545 ......... ............ A Treat clavicle dislocation ............................... 3.25 3.75 4.08 3.27 3.34 0.35 7.35 7.68 6.87 6.94 09023550 ......... ............ A Treat clavicle dislocation ............................... 7.41 NA NA 5.54 6.16 1.25 NA NA 14.20 14.82 09023552 ......... ............ A Treat clavicle dislocation ............................... 8.62 NA NA 6.28 7.06 1.46 NA NA 16.36 17.14 09023570 ......... ............ 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 09023575 ......... ............ 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 09023585 ......... ............ A Treat scapula fracture ................................... 9.07 NA NA 6.52 7.36 1.54 NA NA 17.13 17.97 09023600 ......... ............ A Treat humerus fracture .................................. 2.93 4.08 4.43 3.66 3.58 0.48 7.49 7.84 7.07 6.99 09023605 ......... ............ A Treat humerus fracture .................................. 4.86 5.42 5.97 4.63 4.99 0.84 11.12 11.67 10.33 10.69 09023615 ......... ............ A Treat humerus fracture .................................. 10.83 NA NA 8.33 8.71 1.62 NA NA 20.78 21.16 09023616 ......... ............ A Treat humerus fracture .................................. 21.60 NA NA 11.56 13.50 3.69 NA NA 36.85 38.79 09023620 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00122 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49103 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules23625 ......... ............ A Treat humerus fracture .................................. 3.92 4.44 4.82 3.91 4.19 0.67 9.03 9.41 8.50 8.78 09023630 ......... ............ A Treat humerus fracture .................................. 7.40 NA NA 5.69 6.40 1.27 NA NA 14.36 15.0709023650 ......... ............ A Treat shoulder dislocation ............................. 3.38 3.27 3.65 2.80 2.77 0.30 6.95 7.33 6.486.45 09023655 ......... ............ A Treat shoulder dislocation ............................. 4.56 NA NA 4.17 4.17 0.69 NA NA 9.42 9.42 09023660 ......... ............ A Treat shoulder dislocation ............................. 7.48 NA NA 5.63 6.19 1.29 NA NA 14.40 14.9609023665 ......... ............ A Treat dislocation/fracture ............................... 4.46 4.85 5.21 4.26 4.61 0.71 10.02 10.389.43 9.78 09023670 ......... ............ A Treat dislocation/fracture ............................... 7.95 NA NA 5.89 6.60 1.36 NA NA 15.20 15.91 09023675 ......... ............ A Treat dislocation/fracture ............................... 6.04 6.16 6.66 5.16 5.66 1.01 13.21 13.7112.21 12.71 09023680 ......... ............ A Treat dislocation/fracture ............................... 10.22 NA NA 7.02 7.84 1.75 NA NA 18.99 19.81 09023700 ......... ............ A Fixation of shoulder ....................................... 2.52 NA NA 1.92 2.11 0.44 NA NA 4.88 5.07 01023800 ......... ............ A Fusion of shoulder joint ................................. 14.50 NA NA 7.55 9.70 2.35 NA NA 24.40 26.55 09023802 ......... ............ A Fusion of shoulder joint ................................. 18.07 NA NA 10.99 10.38 2.70 NA NA 31.76 31.15 09023900 ......... ............ A Amputation of arm & girdle ........................... 20.47 NA NA 10.72 11.46 3.18 NA NA 34.37 35.1109023920 ......... ............ A Amputation at shoulder joint ......................... 15.95 NA NA 9.56 9.83 2.46 NA NA 27.97 28.24 09023921 ......... ............ 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 YYY23930 ......... ............ 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 01023931 ......... ............ A Drainage of arm bursa .................................. 1.79 4.34 5.52 1.75 2.07 0.28 6.41 7.59 3.824.14 01023935 ......... ............ A Drain arm/elbow bone lesion ........................ 6.20 NA NA 5.14 5.72 1.05 NA NA 12.39 12.97 09024000 ......... ............ A Exploratory elbow surgery ............................. 5.93 NA NA 4.78 5.25 0.97 NA NA 11.68 12.15 09024006 ......... ............ A Release elbow joint ....................................... 9.54 NA NA 6.67 7.48 1.50 NA NA 17.71 18.52 09024065 ......... ............ 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 01024066 ......... ............ A Biopsy arm/elbow soft tissue ........................ 5.20 8.33 8.78 3.94 4.08 0.80 14.33 14.78 9.9410.08 09024075 ......... ............ A Remove arm/elbow lesion ............................. 3.91 7.22 7.32 3.27 3.37 0.56 11.69 11.79 7.747.84 09024076 ......... ............ 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 09024100 ......... ............ A Biopsy elbow joint lining ................................ 4.92 NA NA 4.28 4.46 0.85 NA NA 10.05 10.23 09024101 ......... ............ A Explore/treat elbow joint ................................ 6.12 NA NA 5.08 5.72 1.03 NA NA 12.23 12.87 09024102 ......... ............ A Remove elbow joint lining ............................. 8.08 NA NA 5.82 6.60 1.33 NA NA 15.23 16.01 09024105 ......... ............ A Removal of elbow bursa ............................... 3.60 NA NA 4.04 4.30 0.61 NA NA 8.25 8.51 09024110 ......... ............ 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 09024116 ......... ............ A Remove/graft bone lesion ............................. 12.03 NA NA 7.67 8.72 2.05 NA NA 21.75 22.80 09024120 ......... ............ A Remove elbow lesion .................................... 6.64 NA NA 5.22 5.75 1.10 NA NA 12.96 13.4909024125 ......... ............ A Remove/graft bone lesion ............................. 7.94 NA NA 6.03 6.13 1.06 NA NA 15.03 15.13 09024126 ......... ............ A Remove/graft bone lesion ............................. 8.42 NA NA 6.22 6.82 1.16 NA NA 15.80 16.40 09024130 ......... ............ A Removal of head of radius ............................ 6.24 NA NA 5.13 5.80 1.04 NA NA 12.41 13.08 09024134 ......... ............ 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 09024138 ......... ............ A Remove elbow bone lesion ........................... 8.22 NA NA 6.71 7.51 1.34 NA NA 16.27 17.07 09024140 ......... ............ A Partial removal of arm bone .......................... 9.35 NA NA 7.20 8.63 1.51 NA NA 18.06 19.49 09024145 ......... ............ A Partial removal of radius ............................... 7.63 NA NA 6.30 7.62 1.25 NA NA 15.18 16.5009024147 ......... ............ A Partial removal of elbow ................................ 7.59 NA NA 6.90 8.18 1.30 NA NA 15.79 17.0709024149 ......... ............ A Radical resection of elbow ............................ 15.80 NA NA 10.86 11.43 2.34 NA NA 29.00 29.57 09024150 ......... ............ A Extensive humerus surgery ........................... 13.61 NA NA 8.54 9.63 2.32 NA NA 24.47 25.56 09024151 ......... ............ A Extensive humerus surgery ........................... 15.98 NA NA 9.77 11.08 2.59 NA NA 28.34 29.65 09024152 ......... ............ A Extensive radius surgery ............................... 10.16 NA NA 6.29 7.37 1.48 NA NA 17.93 19.0109024153 ......... ............ A Extensive radius surgery ............................... 11.64 NA NA 4.92 5.41 0.74 NA NA 17.30 17.7909024155 ......... ............ A Removal of elbow joint .................................. 11.89 NA NA 7.61 8.20 1.92 NA NA 21.42 22.01 09024160 ......... ............ 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 09024200 ......... ............ 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 01024201 ......... ............ 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 09024220 ......... ............ 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 00024300 ......... ............ A Manipulate elbow w/anesth ........................... 3.74 NA NA 5.18 5.58 0.65 NA NA 9.57 9.97 09024301 ......... ............ A Muscle/tendon transfer .................................. 10.18 NA NA 6.85 7.85 1.66 NA NA 18.69 19.69 09024305 ......... ............ A Arm tendon lengthening ................................ 7.44 NA NA 5.66 6.45 1.15 NA NA 14.25 15.04 09024310 ......... ............ A Revision of arm tendon ................................. 5.97 NA NA 4.78 5.38 0.96 NA NA 11.71 12.3109024320 ......... ............ A Repair of arm tendon .................................... 10.66 NA NA 7.11 7.43 1.73 NA NA 19.50 19.82 09024330 ......... ............ A Revision of arm muscles ............................... 9.59 NA NA 6.64 7.57 1.60 NA NA 17.83 18.76 09024331 ......... ............ A Revision of arm muscles ............................... 10.75 NA NA 6.52 8.13 1.77 NA NA 19.04 20.6509024332 ......... ............ A Tenolysis, triceps ........................................... 7.69 NA NA 5.75 6.52 1.23 NA NA 14.6715.44 09024340 ......... ............ A Repair of biceps tendon ................................ 7.88 NA NA 6.00 6.74 1.36 NA NA 15.24 15.9809024341 ......... ............ 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 20.6809024343 ......... ............ A Repr elbow lat ligmnt w/tiss .......................... 8.89 NA NA 7.02 7.87 1.43 NA NA 17.34 18.19 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00123 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49104 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal24344 ......... ............ A Reconstruct elbow lat ligmnt ......................... 14.85 NA NA 10.06 11.16 2.36 NA NA 27.27 28.3709024345 ......... ............ A Repr elbw med ligmnt w/tissu ....................... 8.89 NA NA 6.98 7.76 1.44 NA NA 17.31 18.09 09024346 ......... ............ A Reconstruct elbow med ligmnt ...................... 14.85 NA NA 10.06 11.02 2.33 NA NA 27.24 28.20 09024350 ......... ............ A Repair of tennis elbow .................................. 5.24 NA NA 4.89 5.41 0.87 NA NA 11.00 11.5209024351 ......... ............ A Repair of tennis elbow .................................. 5.90 NA NA 5.01 5.69 1.02 NA NA 11.93 12.6109024352 ......... ............ A Repair of tennis elbow .................................. 6.42 NA NA 5.23 5.94 1.10 NA NA 12.75 13.4609024354 ......... ............ A Repair of tennis elbow .................................. 6.47 NA NA 5.25 5.93 1.07 NA NA 12.79 13.4709024356 ......... ............ A Revision of tennis elbow ............................... 6.67 NA NA 5.32 6.06 1.11 NA NA 13.10 13.8409024360 ......... ............ A Reconstruct elbow joint ................................. 12.44 NA NA 7.97 9.10 2.05 NA NA 22.46 23.59 09024361 ......... ............ A Reconstruct elbow joint ................................. 14.18 NA NA 8.78 10.13 2.18 NA NA 25.14 26.49 09024362 ......... ............ A Reconstruct elbow joint ................................. 15.09 NA NA 9.30 9.86 2.60 NA NA 26.99 27.55 09024363 ......... ............ A Replace elbow joint ....................................... 22.39 NA NA 12.26 13.35 3.01 NA NA 37.6638.75 09024365 ......... ............ A Reconstruct head of radius ........................... 8.44 NA NA 5.94 6.89 1.41 NA NA 15.79 16.74 09024366 ......... ............ A Reconstruct head of radius ........................... 9.18 NA NA 6.31 7.23 1.52 NA NA 17.01 17.93 09024400 ......... ............ A Revision of humerus ..................................... 11.10 NA NA 7.62 8.54 1.92 NA NA 20.64 21.56 09024410 ......... ............ A Revision of humerus ..................................... 14.86 NA NA 9.32 10.06 2.57 NA NA 26.75 27.49 09024420 ......... ............ A Revision of humerus ..................................... 13.48 NA NA 8.88 10.13 2.17 NA NA 24.53 25.78 09024430 ......... ............ A Repair of humerus ......................................... 14.99 NA NA 9.30 9.63 2.21 NA NA 26.50 26.83 09024435 ......... ............ A Repair humerus with graft ............................. 14.64 NA NA 9.86 10.63 2.27 NA NA 26.77 27.5409024470 ......... ............ A Revision of elbow joint .................................. 8.73 NA NA 6.43 7.40 1.48 NA NA 16.64 17.61 09024495 ......... ............ 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 09024500 ......... ............ A Treat humerus fracture .................................. 3.21 4.45 4.75 3.80 3.71 0.50 8.16 8.46 7.51 7.42 09024505 ......... ............ A Treat humerus fracture .................................. 5.16 5.87 6.42 4.90 5.27 0.89 11.92 12.47 10.95 11.32 09024515 ......... ............ A Treat humerus fracture .................................. 11.87 NA NA 8.09 9.06 2.02 NA NA 21.98 22.95 09024516 ......... ............ A Treat humerus fracture .................................. 11.99 NA NA 7.71 8.76 2.02 NA NA 21.72 22.77 09024530 ......... ............ A Treat humerus fracture .................................. 3.49 4.74 5.09 4.00 4.03 0.57 8.80 9.15 8.06 8.09 09024535 ......... ............ A Treat humerus fracture .................................. 6.86 6.82 7.59 5.86 6.43 1.18 14.86 15.63 13.90 14.47 09024538 ......... ............ A Treat humerus fracture .................................. 9.54 NA NA 7.22 8.33 1.64 NA NA 18.40 19.5109024545 ......... ............ A Treat humerus fracture .................................. 10.80 NA NA 7.24 8.15 1.82 NA NA 19.86 20.77 09024546 ......... ............ A Treat humerus fracture .................................. 15.91 NA NA 9.50 10.87 2.73 NA NA 28.14 29.51 09024560 ......... ............ A Treat humerus fracture .................................. 2.80 4.05 4.37 3.38 3.24 0.44 7.29 7.61 6.62 6.48 09024565 ......... ............ A Treat humerus fracture .................................. 5.55 5.86 6.42 4.97 5.38 0.93 12.34 12.90 11.45 11.86 09024566 ......... ............ A Treat humerus fracture .................................. 8.78 NA NA 6.97 7.86 1.30 NA NA 17.05 17.9409024575 ......... ............ A Treat humerus fracture .................................. 10.94 NA NA 7.27 8.12 1.86 NA NA 20.07 20.92 09024576 ......... ............ A Treat humerus fracture .................................. 2.86 4.45 4.68 3.74 3.72 0.46 7.77 8.00 7.06 7.04 09024577 ......... ............ A Treat humerus fracture .................................. 5.78 6.01 6.70 5.08 5.65 0.95 12.74 13.43 11.81 12.38 09024579 ......... ............ A Treat humerus fracture .................................. 11.88 NA NA 7.87 8.59 2.02 NA NA 21.77 22.49 09024582 ......... ............ A Treat humerus fracture .................................. 9.79 NA NA 8.21 8.89 1.48 NA NA 19.48 20.1609024586 ......... ............ A Treat elbow fracture ...................................... 15.55 NA NA 9.36 10.76 2.64 NA NA 27.55 28.95 09024587 ......... ............ A Treat elbow fracture ...................................... 15.56 NA NA 9.37 10.61 2.52 NA NA 27.45 28.69 09024600 ......... ............ A Treat elbow dislocation ................................. 4.22 3.87 4.61 3.29 3.45 0.50 8.59 9.33 8.01 8.17 09024605 ......... ............ A Treat elbow dislocation ................................. 5.41 NA NA 4.96 5.26 0.89 NA NA 11.26 11.5609024615 ......... ............ A Treat elbow dislocation ................................. 9.65 NA NA 6.59 7.51 1.60 NA NA 17.84 18.7609024620 ......... ............ A Treat elbow fracture ...................................... 6.97 NA NA 5.48 6.06 1.07 NA NA 13.52 14.10 09024635 ......... ............ A Treat elbow fracture ...................................... 13.47 NA NA 10.23 13.10 2.28 NA NA 25.9828.85 09024640 ......... ............ A Treat elbow dislocation ................................. 1.20 1.48 1.75 0.80 0.80 0.12 2.80 3.07 2.12 2.12 01024650 ......... ............ A Treat radius fracture ...................................... 2.16 3.44 3.70 3.00 2.81 0.35 5.95 6.215.51 5.32 09024655 ......... ............ A Treat radius fracture ...................................... 4.39 5.20 5.76 4.41 4.70 0.70 10.29 10.85 9.50 9.79 09024665 ......... ............ A Treat radius fracture ...................................... 8.13 NA NA 6.53 7.27 1.41 NA NA 16.07 16.81 09024666 ......... ............ A Treat radius fracture ...................................... 9.66 NA NA 7.00 7.80 1.62 NA NA 18.28 19.08 09024670 ......... ............ A Treat ulnar fracture ........................................ 2.54 3.74 4.02 3.16 3.09 0.41 6.69 6.976.11 6.04 09024675 ......... ............ A Treat ulnar fracture ........................................ 4.71 5.30 5.83 4.50 4.85 0.81 10.82 11.35 10.02 10.37 09024685 ......... ............ A Treat ulnar fracture ........................................ 8.85 NA NA 6.48 7.26 1.52 NA NA 16.85 17.63 09024800 ......... ............ A Fusion of elbow joint ..................................... 11.18 NA NA 7.66 8.47 1.63 NA NA 20.47 21.28 09024802 ......... ............ A Fusion/graft of elbow joint ............................. 14.09 NA NA 8.56 9.93 2.37 NA NA 25.02 26.39 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00124 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49105 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules24900 ......... ............ A Amputation of upper arm .............................. 9.95 NA NA 6.47 6.91 1.53 NA NA 17.95 18.39 09024920 ......... ............ A Amputation of upper arm .............................. 9.95 NA NA 6.45 6.82 1.61 NA NA 18.01 18.38 09024925 ......... ............ 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 09024931 ......... ............ A Amputate upper arm & implant ..................... 13.24 NA NA 8.23 6.35 1.89 NA NA 23.36 21.48 09024935 ......... ............ A Revision of amputation .................................. 16.20 NA NA 8.90 8.24 2.13 NA NA 27.23 26.57 09024940 ......... ............ 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 09024999 ......... ............ 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 YYY25000 ......... ............ A Incision of tendon sheath .............................. 3.37 NA NA 5.06 6.42 0.55 NA NA 8.98 10.34 09025001 ......... ............ A Incise flexor carpi radialis .............................. 3.62 NA NA 3.85 4.14 0.55 NA NA 8.02 8.3109025020 ......... ............ A Decompress forearm 1 space ....................... 5.91 NA NA 6.90 8.90 0.93 NA NA 13.74 15.74 09025023 ......... ............ 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 09025025 ......... ............ A Decompress forearm 2 spaces ..................... 17.67 NA NA 9.03 9.74 1.82 NA NA 28.52 29.23 09025028 ......... ............ A Drainage of forearm lesion ............................ 5.24 NA NA 6.25 7.68 0.81 NA NA 12.30 13.73 09025031 ......... ............ A Drainage of forearm bursa ............................ 4.13 NA NA 5.47 7.31 0.63 NA NA 10.23 12.07 09025035 ......... ............ A Treat forearm bone lesion ............................. 7.47 NA NA 8.88 12.41 1.24 NA NA 17.59 21.1209025040 ......... ............ A Explore/treat wrist joint .................................. 7.35 NA NA 5.90 6.95 1.15 NA NA 14.40 15.45 09025065 ......... ............ A Biopsy forearm soft tissues ........................... 1.99 4.19 3.46 1.90 1.90 0.15 6.33 5.60 4.044.04 01025066 ......... ............ A Biopsy forearm soft tissues ........................... 4.12 NA NA 5.46 6.66 0.64 NA NA 10.22 11.42 09025075 ......... ............ A Removal forearm lesion subcu ..................... 3.73 NA NA 4.90 5.64 0.55 NA NA 9.18 9.92 09025076 ......... ............ A Removal forearm lesion deep ....................... 4.91 NA NA 6.92 8.89 0.74 NA NA 12.57 14.54 09025077 ......... ............ 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 09025100 ......... ............ A Biopsy of wrist joint ....................................... 3.89 NA NA 4.28 5.02 0.59 NA NA 8.76 9.50 09025101 ......... ............ A Explore/treat wrist joint .................................. 4.68 NA NA 4.83 5.63 0.75 NA NA 10.26 11.06 09025105 ......... ............ A Remove wrist joint lining ............................... 5.84 NA NA 5.82 6.93 0.92 NA NA 12.58 13.6909025107 ......... ............ A Remove wrist joint cartilage .......................... 7.42 NA NA 7.16 8.05 0.99 NA NA 15.57 16.46 09025110 ......... ............ A Remove wrist tendon lesion .......................... 3.91 NA NA 5.29 6.61 0.62 NA NA 9.82 11.14 09025111 ......... ............ A Remove wrist tendon lesion .......................... 3.38 NA NA 4.10 4.55 0.53 NA NA 8.01 8.46 09025112 ......... ............ A Reremove wrist tendon lesion ....................... 4.52 NA NA 4.54 5.07 0.70 NA NA 9.76 10.29 09025115 ......... ............ A Remove wrist/forearm lesion ......................... 9.81 NA NA 10.21 13.08 1.31 NA NA 21.33 24.20 09025116 ......... ............ A Remove wrist/forearm lesion ......................... 7.28 NA NA 9.08 12.13 1.11 NA NA 17.47 20.52 09025118 ......... ............ 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 09025120 ......... ............ A Removal of forearm lesion ............................ 6.09 NA NA 7.93 11.04 1.00 NA NA 15.02 18.13 09025125 ......... ............ A Remove/graft forearm lesion ......................... 7.47 NA NA 8.75 11.82 1.06 NA NA 17.28 20.35 09025126 ......... ............ A Remove/graft forearm lesion ......................... 7.54 NA NA 8.78 11.95 1.27 NA NA 17.59 20.76 09025130 ......... ............ A Removal of wrist lesion ................................. 5.25 NA NA 5.21 6.12 0.80 NA NA 11.26 12.1709025135 ......... ............ A Remove & graft wrist lesion .......................... 6.88 NA NA 6.12 7.16 1.02 NA NA 14.02 15.06 09025136 ......... ............ A Remove & graft wrist lesion .......................... 5.96 NA NA 5.53 6.33 1.03 NA NA 12.52 13.32 09025145 ......... ............ A Remove forearm bone lesion ........................ 6.36 NA NA 8.12 11.08 1.01 NA NA 15.49 18.45 09025150 ......... ............ A Partial removal of ulna .................................. 7.20 NA NA 6.38 7.75 1.14 NA NA 14.72 16.09 09025151 ......... ............ A Partial removal of radius ............................... 7.50 NA NA 8.52 11.67 1.18 NA NA 17.20 20.35 09025170 ......... ............ A Extensive forearm surgery ............................ 11.25 NA NA 10.52 13.99 1.77 NA NA 23.54 27.0109025210 ......... ............ A Removal of wrist bone .................................. 5.94 NA NA 5.53 6.48 0.88 NA NA 12.35 13.3009025215 ......... ............ A Removal of wrist bones ................................. 7.94 NA NA 6.83 8.27 1.19 NA NA 15.96 17.4009025230 ......... ............ A Partial removal of radius ............................... 5.22 NA NA 4.96 5.85 0.79 NA NA 10.97 11.8609025240 ......... ............ A Partial removal of ulna .................................. 5.16 NA NA 5.27 6.53 0.81 NA NA 11.24 12.50 09025246 ......... ............ A Injection for wrist x-ray .................................. 1.45 2.70 3.26 0.48 0.48 0.09 4.24 4.802.02 2.02 00025248 ......... ............ A Remove forearm foreign body ...................... 5.13 NA NA 6.57 8.03 0.72 NA NA 12.42 13.88 09025250 ......... ............ A Removal of wrist prosthesis .......................... 6.59 NA NA 5.32 5.91 1.01 NA NA 12.92 13.51 09025251 ......... ............ A Removal of wrist prosthesis .......................... 9.62 NA NA 6.71 7.62 1.26 NA NA 17.59 18.50 09025259 ......... ............ A Manipulate wrist w/anesthes ......................... 3.74 NA NA 5.14 5.58 0.62 NA NA 9.50 9.94 09025260 ......... ............ A Repair forearm tendon/muscle ...................... 7.79 NA NA 9.22 12.29 1.19 NA NA 18.20 21.27 09025263 ......... ............ A Repair forearm tendon/muscle ...................... 7.81 NA NA 8.96 12.19 1.18 NA NA 17.95 21.18 09025265 ......... ............ 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 09025272 ......... ............ A Repair forearm tendon/muscle ...................... 7.03 NA NA 8.37 11.69 1.11 NA NA 16.51 19.83 09025274 ......... ............ A Repair forearm tendon/muscle ...................... 8.74 NA NA 9.20 12.52 1.36 NA NA 19.30 22.62 09025275 ......... ............ A Repair forearm tendon sheath ...................... 8.74 NA NA 6.50 7.31 1.31 NA NA 16.55 17.36 09025280 ......... ............ A Revise wrist/forearm tendon ......................... 7.21 NA NA 8.47 11.59 1.08 NA NA 16.76 19.88 09025290 ......... ............ A Incise wrist/forearm tendon ........................... 5.28 NA NA 9.17 13.54 0.82 NA NA 15.27 19.6409025295 ......... ............ 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 18.1909025301 ......... ............ A Fusion of tendons at wrist ............................. 8.39 NA NA 6.73 7.73 1.29 NA NA 16.41 17.41090



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# 49106 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal25310 ......... ............ A Transplant forearm tendon ............................ 8.19 NA NA 8.82 11.98 1.21 NA NA 18.22 21.38 09025312 ......... ............ A Transplant forearm tendon ............................ 9.62 NA NA 9.60 12.86 1.41 NA NA 20.63 23.89 09025315 ......... ............ A Revise palsy hand tendon(s) ........................ 10.48 NA NA 10.00 13.30 1.58 NA NA 22.06 25.36 09025316 ......... ............ A Revise palsy hand tendon(s) ........................ 12.67 NA NA 11.08 14.94 1.74 NA NA 25.49 29.35 09025320 ......... ............ A Repair/revise wrist joint ................................. 12.28 NA NA 10.38 11.14 1.61 NA NA 24.2725.03 09025332 ......... ............ A Revise wrist joint ........................................... 11.51 NA NA 7.74 8.81 1.83 NA NA 21.0822.15 09025335 ......... ............ A Realignment of hand ..................................... 13.16 NA NA 7.01 10.45 1.92 NA NA 22.09 25.53 09025337 ......... ............ A Reconstruct ulna/radioulnar .......................... 11.36 NA NA 9.39 10.66 1.61 NA NA 22.36 23.6309025350 ......... ............ A Revision of radius .......................................... 8.89 NA NA 9.27 12.80 1.46 NA NA 19.6223.15 09025355 ......... ............ A Revision of radius .......................................... 10.33 NA NA 10.03 13.47 1.73 NA NA 22.09 25.53 09025360 ......... ............ A Revision of ulna ............................................. 8.54 NA NA 9.13 12.69 1.41 NA NA 19.0822.64 09025365 ......... ............ A Revise radius & ulna ..................................... 12.68 NA NA 11.06 14.50 2.15 NA NA 25.89 29.33 09025370 ......... ............ A Revise radius or ulna .................................... 13.82 NA NA 11.97 15.05 2.28 NA NA 28.07 31.15 09025375 ......... ............ A Revise radius & ulna ..................................... 13.32 NA NA 11.33 15.15 2.26 NA NA 26.91 30.73 09025390 ......... ............ A Shorten radius or ulna ................................... 10.50 NA NA 9.94 13.42 1.65 NA NA 22.09 25.57 09025391 ......... ............ A Lengthen radius or ulna ................................ 14.05 NA NA 11.65 15.33 2.21 NA NA 27.91 31.59 09025392 ......... ............ A Shorten radius & ulna ................................... 14.35 NA NA 11.78 14.92 2.10 NA NA 28.23 31.37 09025393 ......... ............ A Lengthen radius & ulna ................................. 16.33 NA NA 13.18 16.48 2.76 NA NA 32.27 35.57 09025394 ......... ............ A Repair carpal bone, shorten .......................... 10.63 NA NA 6.80 7.75 1.59 NA NA 19.02 19.97 09025400 ......... ............ A Repair radius or ulna ..................................... 11.08 NA NA 10.18 13.94 1.82 NA NA 23.0826.84 09025405 ......... ............ A Repair/graft radius or ulna ............................ 14.78 NA NA 11.92 15.93 2.32 NA NA 29.02 33.03 09025415 ......... ............ A Repair radius & ulna ..................................... 13.57 NA NA 11.02 15.14 2.17 NA NA 26.76 30.88 09025420 ......... ............ A Repair/graft radius & ulna ............................. 16.79 NA NA 12.79 16.90 2.61 NA NA 32.19 36.30 09025425 ......... ............ A Repair/graft radius or ulna ............................ 13.49 NA NA 14.14 19.58 2.08 NA NA 29.71 35.15 09025426 ......... ............ A Repair/graft radius & ulna ............................. 16.22 NA NA 12.50 15.54 2.54 NA NA 31.26 34.30 09025430 ......... ............ A Vasc graft into carpal bone ........................... 9.49 NA NA 7.04 7.27 1.27 NA NA 17.80 18.03 09025431 ......... ............ 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 09025441 ......... ............ A Reconstruct wrist joint ................................... 13.06 NA NA 8.50 9.63 2.07 NA NA 23.63 24.76 09025442 ......... ............ A Reconstruct wrist joint ................................... 10.89 NA NA 7.32 8.49 1.53 NA NA 19.74 20.91 09025443 ......... ............ A Reconstruct wrist joint ................................... 10.43 NA NA 6.61 8.23 1.37 NA NA 18.41 20.03 09025444 ......... ............ A Reconstruct wrist joint ................................... 11.19 NA NA 7.65 8.69 1.71 NA NA 20.55 21.59 09025445 ......... ............ A Reconstruct wrist joint ................................... 9.68 NA NA 6.72 7.67 1.55 NA NA 17.95 18.90 09025446 ......... ............ A Wrist replacement ......................................... 17.07 NA NA 9.88 11.41 2.47 NA NA 29.42 30.95 09025447 ......... ............ A Repair wrist joint(s) ....................................... 10.85 NA NA 7.88 8.46 1.61 NA NA 20.3420.92 09025449 ......... ............ A Remove wrist joint implant ............................ 14.71 NA NA 9.05 10.27 2.21 NA NA 25.97 27.1909025450 ......... ............ A Revision of wrist joint .................................... 7.86 NA NA 7.34 9.48 1.36 NA NA 16.56 18.70 09025455 ......... ............ A Revision of wrist joint .................................... 9.48 NA NA 6.50 9.77 0.96 NA NA 16.94 20.21 09025490 ......... ............ A Reinforce radius ............................................ 9.53 NA NA 9.47 12.67 1.43 NA NA 20.4323.63 09025491 ......... ............ A Reinforce ulna ............................................... 9.95 NA NA 9.73 13.28 1.60 NA NA 21.2824.83 09025492 ......... ............ A Reinforce radius and ulna ............................. 12.43 NA NA 10.59 14.12 2.14 NA NA 25.16 28.69 09025500 ......... ............ 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 09025505 ......... ............ A Treat fracture of radius .................................. 5.20 5.87 6.37 5.01 5.32 0.90 11.97 12.4711.11 11.42 09025515 ......... ............ A Treat fracture of radius .................................. 9.29 NA NA 6.75 7.28 1.59 NA NA 17.63 18.16 09025520 ......... ............ A Treat fracture of radius .................................. 6.25 6.02 6.65 5.43 5.90 1.08 13.35 13.9812.76 13.23 09025525 ......... ............ A Treat fracture of radius .................................. 12.59 NA NA 8.74 9.68 2.12 NA NA 23.45 24.39 09025526 ......... ............ A Treat fracture of radius .................................. 13.33 NA NA 10.23 12.68 2.19 NA NA 25.7528.20 09025530 ......... ............ A Treat fracture of ulna ..................................... 2.09 3.48 3.69 2.97 2.89 0.34 5.91 6.125.40 5.32 09025535 ......... ............ 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 09025545 ......... ............ A Treat fracture of ulna ..................................... 9.01 NA NA 6.64 7.41 1.53 NA NA 17.18 17.95 09025560 ......... ............ A Treat fracture radius & ulna .......................... 2.44 3.40 3.62 2.87 2.67 0.35 6.19 6.41 5.665.46 09025565 ......... ............ 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 09025574 ......... ............ A Treat fracture radius & ulna .......................... 7.37 NA NA 6.64 7.06 1.21 NA NA 15.22 15.64 09025575 ......... ............ A Treat fracture radius/ulna .............................. 11.92 NA NA 9.00 9.38 1.81 NA NA 22.73 23.11 09025600 ......... ............ 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 09025605 ......... ............ 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



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# 49107 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules25611 ......... ............ A Treat fracture radius/ulna .............................. 9.14 NA NA 8.34 8.81 1.34 NA NA 18.82 19.2909025620 ......... ............ A Treat fracture radius/ulna .............................. 8.54 NA NA 6.27 7.01 1.42 NA NA 16.23 16.9709025622 ......... ............ 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 09025624 ......... ............ 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 09025628 ......... ............ A Treat wrist bone fracture ............................... 9.42 NA NA 7.34 7.70 1.37 NA NA 18.13 18.4909025630 ......... ............ 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 09025635 ......... ............ 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 09025645 ......... ............ A Treat wrist bone fracture ............................... 7.24 NA NA 5.80 6.42 1.20 NA NA 14.24 14.8609025650 ......... ............ 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 09025651 ......... ............ A Pin ulnar styloid fracture ............................... 5.60 NA NA 5.13 5.39 0.86 NA NA 11.59 11.85 09025652 ......... ............ A Treat fracture ulnar styloid ............................ 7.84 NA NA 6.21 6.80 1.21 NA NA 15.26 15.8509025660 ......... ............ A Treat wrist dislocation ................................... 4.75 NA NA 4.48 4.65 0.58 NA NA 9.81 9.9809025670 ......... ............ A Treat wrist dislocation ................................... 7.91 NA NA 5.99 6.74 1.28 NA NA 15.18 15.93 09025671 ......... ............ A Pin radioulnar dislocation .............................. 6.24 NA NA 5.53 6.00 1.00 NA NA 12.77 13.2409025675 ......... ............ A Treat wrist dislocation ................................... 4.66 4.88 5.46 4.14 4.52 0.62 10.16 10.749.42 9.80 09025676 ......... ............ A Treat wrist dislocation ................................... 8.09 NA NA 6.28 7.05 1.34 NA NA 15.71 16.48 09025680 ......... ............ A Treat wrist fracture ........................................ 5.98 NA NA 4.37 4.65 0.78 NA NA 11.13 11.41 09025685 ......... ............ A Treat wrist fracture ........................................ 9.89 NA NA 6.70 7.53 1.60 NA NA 18.19 19.02 09025690 ......... ............ A Treat wrist dislocation ................................... 5.49 NA NA 4.82 5.33 0.88 NA NA 11.19 11.70 09025695 ......... ............ A Treat wrist dislocation ................................... 8.33 NA NA 6.19 6.87 1.32 NA NA 15.84 16.52 09025800 ......... ............ A Fusion of wrist joint ....................................... 9.87 NA NA 7.28 8.64 1.57 NA NA 18.72 20.08 09025805 ......... ............ A Fusion/graft of wrist joint ............................... 11.50 NA NA 8.17 9.73 1.80 NA NA 21.47 23.03 09025810 ......... ............ A Fusion/graft of wrist joint ............................... 11.67 NA NA 8.56 9.57 1.67 NA NA 21.90 22.91 09025820 ......... ............ A Fusion of hand bones ................................... 7.44 NA NA 6.28 7.46 1.22 NA NA 14.94 16.1209025825 ......... ............ 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 09025900 ......... ............ A Amputation of forearm ................................... 9.36 NA NA 9.27 11.74 1.30 NA NA 19.93 22.40 09025905 ......... ............ A Amputation of forearm ................................... 9.41 NA NA 8.44 11.33 1.40 NA NA 19.25 22.14 09025907 ......... ............ A Amputation follow-up surgery ........................ 7.91 NA NA 7.81 10.77 1.10 NA NA 16.82 19.78 09025909 ......... ............ A Amputation follow-up surgery ........................ 9.13 NA NA 9.04 11.46 1.44 NA NA 19.61 22.03 09025915 ......... ............ A Amputation of forearm ................................... 17.30 NA NA 8.23 16.22 2.93 NA NA 28.46 36.45 09025920 ......... ............ A Amputate hand at wrist ................................. 8.85 NA NA 6.72 7.57 1.35 NA NA 16.92 17.7709025922 ......... ............ A Amputate hand at wrist ................................. 7.47 NA NA 6.40 6.89 1.12 NA NA 14.99 15.4809025924 ......... ............ 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 09025929 ......... ............ 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 09025999 ......... ............ C Forearm or wrist surgery ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY26010 ......... ............ 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 01026011 ......... ............ A Drainage of finger abscess ........................... 2.19 6.29 8.18 1.98 2.24 0.33 8.81 10.70 4.504.76 01026020 ......... ............ A Drain hand tendon sheath ............................. 4.90 NA NA 4.75 5.20 0.73 NA NA 10.38 10.83 09026025 ......... ............ A Drainage of palm bursa ................................. 4.93 NA NA 4.46 4.96 0.76 NA NA 10.15 10.6509026030 ......... ............ A Drainage of palm bursa(s) ............................ 6.10 NA NA 4.99 5.54 0.92 NA NA 12.01 12.56 09026034 ......... ............ A Treat hand bone lesion ................................. 6.40 NA NA 5.55 6.15 1.01 NA NA 12.96 13.5609026035 ......... ............ A Decompress fingers/hand ............................. 11.05 NA NA 8.01 7.91 1.47 NA NA 20.53 20.43 09026037 ......... ............ 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 09026045 ......... ............ A Release palm contracture ............................. 5.55 NA NA 4.88 5.45 0.93 NA NA 11.36 11.93 09026055 ......... ............ 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 09026060 ......... ............ A Incision of finger tendon ................................ 2.81 NA NA 3.06 3.40 0.45 NA NA 6.32 6.6609026070 ......... ............ A Explore/treat hand joint ................................. 3.68 NA NA 3.04 3.28 0.48 NA NA 7.20 7.4409026075 ......... ............ A Explore/treat finger joint ................................ 3.78 NA NA 3.41 3.69 0.53 NA NA 7.72 8.0009026080 ......... ............ A Explore/treat finger joint ................................ 4.29 NA NA 4.34 4.72 0.66 NA NA 9.29 9.6709026100 ......... ............ A Biopsy hand joint lining ................................. 3.66 NA NA 3.56 3.99 0.54 NA NA 7.76 8.1909026105 ......... ............ A Biopsy finger joint lining ................................ 3.70 NA NA 3.74 4.11 0.59 NA NA 8.03 8.4009026110 ......... ............ A Biopsy finger joint lining ................................ 3.52 NA NA 3.60 3.93 0.53 NA NA 7.65 7.9809026115 ......... ............ A Removal hand lesion subcut ......................... 3.85 9.84 12.28 4.21 4.63 0.59 14.28 16.72 8.659.07 09026116 ......... ............ A Removal hand lesion, deep .......................... 5.52 NA NA 5.29 5.82 0.84 NA NA 11.65 12.18 09026117 ......... ............ 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 09026123 ......... ............ A Release palm contracture ............................. 10.53 NA NA 8.23 8.70 1.43 NA NA 20.19 20.66 09026125 ......... ............ A Release palm contracture ............................. 4.60 NA NA 1.89 2.30 0.70 NA NA 7.19 7.60 ZZZ26130 ......... ............ A Remove wrist joint lining ............................... 5.41 NA NA 4.85 5.22 0.94 NA NA 11.20 11.5709026135 ......... ............ A Revise finger joint, each ................................ 6.95 NA NA 5.49 6.22 1.07 NA NA 13.51 14.24 09026140 ......... ............ A Revise finger joint, each ................................ 6.16 NA NA 5.17 5.82 0.92 NA NA 12.25 12.90 09026145 ......... ............ A Tendon excision, palm/finger ........................ 6.31 NA NA 5.19 5.84 0.97 NA NA 12.47 13.12 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00127 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49108 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal26160 ......... ............ 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 09026170 ......... ............ A Removal of palm tendon, each ..................... 4.76 NA NA 4.36 4.80 0.69 NA NA 9.81 10.25 09026180 ......... ............ A Removal of finger tendon .............................. 5.17 NA NA 4.77 5.25 0.78 NA NA 10.72 11.20 09026185 ......... ............ A Remove finger bone ...................................... 6.24 NA NA 5.81 5.98 0.81 NA NA 12.86 13.0309026200 ......... ............ A Remove hand bone lesion ............................ 5.50 NA NA 4.58 5.16 0.88 NA NA 10.96 11.54 09026205 ......... ............ A Remove/graft bone lesion ............................. 7.75 NA NA 5.85 6.63 1.20 NA NA 14.80 15.58 09026210 ......... ............ A Removal of finger lesion ............................... 5.14 NA NA 4.74 5.25 0.79 NA NA 10.67 11.1809026215 ......... ............ A Remove/graft finger lesion ............................ 7.09 NA NA 5.53 6.12 0.98 NA NA 13.60 14.19 09026230 ......... ............ 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 09026236 ......... ............ A Partial removal, finger bone .......................... 5.31 NA NA 4.55 5.13 0.81 NA NA 10.67 11.25 09026250 ......... ............ A Extensive hand surgery ................................. 7.54 NA NA 5.21 6.13 1.07 NA NA 13.82 14.7409026255 ......... ............ A Extensive hand surgery ................................. 12.71 NA NA 8.39 9.13 1.68 NA NA 22.78 23.5209026260 ......... ............ A Extensive finger surgery ................................ 7.02 NA NA 5.36 5.98 1.01 NA NA 13.39 14.0109026261 ......... ............ A Extensive finger surgery ................................ 9.20 NA NA 6.88 6.35 1.14 NA NA 17.22 16.6909026262 ......... ............ A Partial removal of finger ................................ 5.66 NA NA 4.66 5.16 0.88 NA NA 11.20 11.70 09026320 ......... ............ A Removal of implant from hand ...................... 3.97 NA NA 3.78 4.18 0.59 NA NA 8.34 8.74 09026340 ......... ............ A Manipulate finger w/anesth ........................... 2.50 NA NA 4.60 4.81 0.39 NA NA 7.49 7.70 09026350 ......... ............ A Repair finger/hand tendon ............................. 5.98 NA NA 9.45 13.32 0.93 NA NA 16.36 20.2309026352 ......... ............ A Repair/graft hand tendon .............................. 7.67 NA NA 10.04 14.03 1.13 NA NA 18.84 22.8309026356 ......... ............ A Repair finger/hand tendon ............................. 10.06 NA NA 13.68 17.20 1.21 NA NA 24.95 28.47 09026357 ......... ............ A Repair finger/hand tendon ............................. 8.57 NA NA 10.26 14.29 1.33 NA NA 20.16 24.1909026358 ......... ............ A Repair/graft hand tendon .............................. 9.13 NA NA 10.81 15.18 1.38 NA NA 21.32 25.6909026370 ......... ............ A Repair finger/hand tendon ............................. 7.10 NA NA 9.50 13.71 1.12 NA NA 17.72 21.9309026372 ......... ............ A Repair/graft hand tendon .............................. 8.81 NA NA 10.48 15.02 1.40 NA NA 20.69 25.2309026373 ......... ............ A Repair finger/hand tendon ............................. 8.21 NA NA 10.16 14.57 1.23 NA NA 19.60 24.0109026390 ......... ............ A Revise hand/finger tendon ............................ 9.24 NA NA 9.08 12.23 1.40 NA NA 19.72 22.87 09026392 ......... ............ A Repair/graft hand tendon .............................. 10.30 NA NA 11.02 15.30 1.57 NA NA 22.89 27.17 09026410 ......... ............ A Repair hand tendon ....................................... 4.62 NA NA 7.56 10.85 0.73 NA NA 12.91 16.20 09026412 ......... ............ A Repair/graft hand tendon .............................. 6.30 NA NA 8.57 12.10 0.97 NA NA 15.84 19.3709026415 ......... ............ A Excision, hand/finger tendon ......................... 8.33 NA NA 6.71 10.51 0.98 NA NA 16.02 19.82 09026416 ......... ............ A Graft hand or finger tendon ........................... 9.36 NA NA 8.70 13.12 0.79 NA NA 18.85 23.2709026418 ......... ............ A Repair finger tendon ...................................... 4.24 NA NA 8.07 11.26 0.67 NA NA 12.98 16.17 09026420 ......... ............ A Repair/graft finger tendon ............................. 6.76 NA NA 8.75 12.41 1.07 NA NA 16.58 20.2409026426 ......... ............ A Repair finger/hand tendon ............................. 6.14 NA NA 8.52 12.00 0.95 NA NA 15.61 19.0909026428 ......... ............ A Repair/graft finger tendon ............................. 7.20 NA NA 9.19 12.69 1.09 NA NA 17.48 20.9809026432 ......... ............ A Repair finger tendon ...................................... 4.01 NA NA 6.71 9.37 0.64 NA NA 11.36 14.02 09026433 ......... ............ A Repair finger tendon ...................................... 4.55 NA NA 6.93 9.83 0.72 NA NA 12.20 15.10 09026434 ......... ............ A Repair/graft finger tendon ............................. 6.08 NA NA 7.87 10.62 0.93 NA NA 14.88 17.6309026437 ......... ............ A Realignment of tendons ................................ 5.81 NA NA 7.71 10.61 0.89 NA NA 14.41 17.3109026440 ......... ............ A Release palm/finger tendon .......................... 5.01 NA NA 8.43 12.18 0.75 NA NA 14.19 17.94 09026442 ......... ............ 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 09026449 ......... ............ 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 11.0309026455 ......... ............ A Incision of finger tendon ................................ 3.63 NA NA 5.07 6.73 0.58 NA NA 9.28 10.9409026460 ......... ............ A Incise hand/finger tendon .............................. 3.45 NA NA 5.01 6.61 0.55 NA NA 9.01 10.61 09026471 ......... ............ A Fusion of finger tendons ............................... 5.72 NA NA 7.66 10.35 0.88 NA NA 14.26 16.9509026474 ......... ............ A Fusion of finger tendons ............................... 5.31 NA NA 7.48 10.41 0.76 NA NA 13.55 16.4809026476 ......... ............ A Tendon lengthening ...................................... 5.17 NA NA 7.39 10.05 0.79 NA NA 13.35 16.01 09026477 ......... ............ A Tendon shortening ........................................ 5.14 NA NA 7.47 10.16 0.81 NA NA 13.42 16.11 09026478 ......... ............ 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 09026480 ......... ............ A Transplant hand tendon ................................ 6.68 NA NA 9.57 13.67 1.02 NA NA 17.27 21.3709026483 ......... ............ A Transplant/graft hand tendon ........................ 8.28 NA NA 10.22 14.18 1.26 NA NA 19.76 23.72 09026485 ......... ............ A Transplant palm tendon ................................ 7.69 NA NA 9.94 14.01 1.15 NA NA 18.78 22.85090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00128 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49109 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules26489 ......... ............ A Transplant/graft palm tendon ........................ 9.66 NA NA 10.29 11.62 1.26 NA NA 21.21 22.54 09026490 ......... ............ A Revise thumb tendon .................................... 8.40 NA NA 8.89 11.84 1.21 NA NA 18.50 21.4509026492 ......... ............ A Tendon transfer with graft ............................. 9.61 NA NA 9.77 12.64 1.40 NA NA 20.78 23.6509026494 ......... ............ 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 23.3209026497 ......... ............ A Finger tendon transfer ................................... 9.56 NA NA 9.42 12.53 1.41 NA NA 20.39 23.50 09026498 ......... ............ A Finger tendon transfer ................................... 13.98 NA NA 11.48 14.99 2.10 NA NA 27.56 31.07 09026499 ......... ............ A Revision of finger .......................................... 8.97 NA NA 8.72 11.96 1.35 NA NA 19.0422.28 09026500 ......... ............ A Hand tendon reconstruction .......................... 5.95 NA NA 7.75 10.52 0.90 NA NA 14.60 17.37 09026502 ......... ............ A Hand tendon reconstruction .......................... 7.13 NA NA 8.34 11.10 1.13 NA NA 16.60 19.36 09026504 ......... ............ A Hand tendon reconstruction .......................... 7.46 NA NA 8.59 11.58 1.24 NA NA 17.29 20.28 09026508 ......... ............ A Release thumb contracture ........................... 6.00 NA NA 7.75 10.70 0.98 NA NA 14.73 17.68 09026510 ......... ............ A Thumb tendon transfer .................................. 5.42 NA NA 7.56 10.40 0.79 NA NA 13.77 16.6109026516 ......... ............ A Fusion of knuckle joint .................................. 7.14 NA NA 8.22 11.23 1.10 NA NA 16.46 19.47 09026517 ......... ............ A Fusion of knuckle joints ................................. 8.88 NA NA 9.21 12.43 1.41 NA NA 19.50 22.72 09026518 ......... ............ A Fusion of knuckle joints ................................. 9.07 NA NA 9.24 12.35 1.35 NA NA 19.66 22.77 09026520 ......... ............ A Release knuckle contracture ......................... 5.29 NA NA 8.81 12.62 0.80 NA NA 14.90 18.71 09026525 ......... ............ A Release finger contracture ............................ 5.32 NA NA 8.82 12.68 0.81 NA NA 14.95 18.8109026530 ......... ............ A Revise knuckle joint ...................................... 6.68 NA NA 5.43 5.96 1.04 NA NA 13.15 13.68 09026531 ......... ............ A Revise knuckle with implant .......................... 7.90 NA NA 6.15 6.88 1.17 NA NA 15.22 15.95 09026535 ......... ............ A Revise finger joint .......................................... 5.23 NA NA 4.04 3.82 0.71 NA NA 9.98 9.76 09026536 ......... ............ A Revise/implant finger joint ............................. 6.36 NA NA 9.14 9.52 0.96 NA NA 16.46 16.8409026540 ......... ............ A Repair hand joint ........................................... 6.42 NA NA 7.98 10.90 0.99 NA NA 15.3918.31 09026541 ......... ............ A Repair hand joint with graft ........................... 8.61 NA NA 9.04 12.30 1.28 NA NA 18.93 22.1909026542 ......... ............ A Repair hand joint with graft ........................... 6.77 NA NA 8.13 11.06 1.02 NA NA 15.92 18.8509026545 ......... ............ A Reconstruct finger joint ................................. 6.91 NA NA 8.32 11.18 1.05 NA NA 16.28 19.14 09026546 ......... ............ A Repair nonunion hand ................................... 10.41 NA NA 11.42 14.13 1.44 NA NA 23.27 25.98 09026548 ......... ............ A Reconstruct finger joint ................................. 8.02 NA NA 8.78 11.83 1.20 NA NA 18.00 21.05 09026550 ......... ............ A Construct thumb replacement ....................... 21.46 NA NA 15.40 17.04 2.45 NA NA 39.31 40.95 09026551 ......... ............ A Great toe-hand transfer ................................. 48.09 NA NA 21.71 29.76 7.96 NA NA 77.76 85.81 09026553 ......... ............ A Single transfer, toe-hand ............................... 47.78 NA NA 20.29 22.08 2.41 NA NA 70.48 72.27 09026554 ......... ............ A Double transfer, toe-hand ............................. 56.57 NA NA 19.56 33.04 9.41 NA NA 85.54 99.02 09026555 ......... ............ A Positional change of finger ............................ 16.86 NA NA 13.88 17.11 2.48 NA NA 33.22 36.45 09026556 ......... ............ A Toe joint transfer ........................................... 49.27 NA NA 17.86 29.46 2.57 NA NA 69.70 81.30 09026560 ......... ............ A Repair of web finger ...................................... 5.37 NA NA 7.09 9.12 0.85 NA NA 13.31 15.34 09026561 ......... ............ A Repair of web finger ...................................... 10.90 NA NA 9.41 11.61 1.45 NA NA 21.76 23.96 09026562 ......... ............ A Repair of web finger ...................................... 16.30 NA NA 13.88 16.33 2.23 NA NA 32.4134.86 09026565 ......... ............ A Correct metacarpal flaw ................................ 6.73 NA NA 7.90 10.98 1.00 NA NA 15.63 18.7109026567 ......... ............ A Correct finger deformity ................................. 6.81 NA NA 8.15 11.00 1.04 NA NA 16.00 18.85 09026568 ......... ............ A Lengthen metacarpal/finger ........................... 9.07 NA NA 10.13 14.11 1.49 NA NA 20.69 24.6709026580 ......... ............ A Repair hand deformity ................................... 19.40 NA NA 11.01 12.98 2.28 NA NA 32.69 34.66 09026587 ......... ............ A Reconstruct extra finger ................................ 14.28 NA NA 8.43 9.02 1.53 NA NA 24.24 24.83 09026590 ......... ............ A Repair finger deformity .................................. 18.43 NA NA 10.52 13.09 2.77 NA NA 31.72 34.29 09026591 ......... ............ A Repair muscles of hand ................................ 3.25 NA NA 6.26 8.78 0.48 NA NA 9.99 12.51 09026593 ......... ............ A Release muscles of hand .............................. 5.30 NA NA 7.73 10.28 0.78 NA NA 13.81 16.36 09026596 ......... ............ A Excision constricting tissue ........................... 8.94 NA NA 7.48 8.49 1.43 NA NA 17.85 18.8609026600 ......... ............ A Treat metacarpal fracture .............................. 2.40 3.83 3.67 3.48 2.86 0.30 6.53 6.37 6.185.56 09026605 ......... ............ A Treat metacarpal fracture .............................. 2.85 4.09 4.44 3.50 3.61 0.49 7.43 7.78 6.846.95 09026607 ......... ............ A Treat metacarpal fracture .............................. 5.35 NA NA 4.88 5.92 0.87 NA NA 11.10 12.1409026608 ......... ............ A Treat metacarpal fracture .............................. 5.35 NA NA 5.25 6.00 0.88 NA NA 11.48 12.2309026615 ......... ............ A Treat metacarpal fracture .............................. 5.32 NA NA 4.75 5.16 0.86 NA NA 10.93 11.3409026641 ......... ............ A Treat thumb dislocation ................................. 3.93 4.17 4.47 3.52 3.53 0.39 8.49 8.79 7.84 7.85 09026645 ......... ............ A Treat thumb fracture ...................................... 4.40 4.62 5.03 3.93 4.13 0.67 9.69 10.109.00 9.20 09026650 ......... ............ A Treat thumb fracture ...................................... 5.71 NA NA 5.62 6.42 0.94 NA NA 12.27 13.07 09026665 ......... ............ A Treat thumb fracture ...................................... 7.65 NA NA 5.87 6.43 0.90 NA NA 14.42 14.98 09026670 ......... ............ A Treat hand dislocation ................................... 3.68 3.55 4.08 2.96 2.95 0.39 7.62 8.15 7.03 7.02 09026675 ......... ............ A Treat hand dislocation ................................... 4.63 4.85 5.32 4.15 4.39 0.77 10.25 10.729.55 9.79 09026676 ......... ............ A Pin hand dislocation ...................................... 5.51 NA NA 5.57 6.41 0.91 NA NA 11.99 12.83 09026685 ......... ............ A Treat hand dislocation ................................... 7.03 NA NA 5.44 5.97 1.09 NA NA 13.56 14.09 09026686 ......... ............ A Treat hand dislocation ................................... 7.99 NA NA 6.12 6.71 1.24 NA NA 15.35 15.94 09026700 ......... ............ A Treat knuckle dislocation ............................... 3.68 3.32 3.65 2.95 2.88 0.35 7.35 7.68 6.98 6.91 09026705 ......... ............ A Treat knuckle dislocation ............................... 4.18 4.82 5.20 4.10 4.25 0.66 9.66 10.04 8.94 9.09 09026706 ......... ............ A Pin knuckle dislocation .................................. 5.11 NA NA 4.69 4.99 0.81 NA NA 10.61 10.91 09026715 ......... ............ A Treat knuckle dislocation ............................... 5.73 NA NA 4.92 5.36 0.91 NA NA 11.56 12.0009026720 ......... ............ 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 09026725 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00129 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49110 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal26727 ......... ............ A Treat finger fracture, each ............................. 5.22 NA NA 5.21 5.98 0.84 NA NA 11.27 12.0409026735 ......... ............ A Treat finger fracture, each ............................. 5.97 NA NA 5.00 5.41 0.95 NA NA 11.92 12.3309026740 ......... ............ 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 09026742 ......... ............ 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 09026746 ......... ............ A Treat finger fracture, each ............................. 5.80 NA NA 4.96 5.41 0.91 NA NA 11.67 12.1209026750 ......... ............ 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 09026755 ......... ............ 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 09026756 ......... ............ A Pin finger fracture, each ................................ 4.38 NA NA 4.86 5.51 0.71 NA NA 9.95 10.6009026765 ......... ............ A Treat finger fracture, each ............................. 4.16 NA NA 4.02 4.30 0.66 NA NA 8.84 9.12 09026770 ......... ............ A Treat finger dislocation .................................. 3.02 2.91 3.30 2.53 2.44 0.27 6.20 6.59 5.82 5.73 09026775 ......... ............ A Treat finger dislocation .................................. 3.70 4.54 5.03 3.81 3.81 0.54 8.78 9.27 8.05 8.05 09026776 ......... ............ A Pin finger dislocation ..................................... 4.79 NA NA 5.01 5.75 0.77 NA NA 10.57 11.31 09026785 ......... ............ A Treat finger dislocation .................................. 4.20 NA NA 4.08 4.42 0.68 NA NA 8.96 9.3009026820 ......... ............ A Thumb fusion with graft ................................. 8.25 NA NA 8.71 12.12 1.30 NA NA 18.26 21.67 09026841 ......... ............ A Fusion of thumb ............................................ 7.12 NA NA 8.69 12.10 1.18 NA NA 16.99 20.40 09026842 ......... ............ A Thumb fusion with graft ................................. 8.29 NA NA 8.95 12.27 1.32 NA NA 18.56 21.88 09026843 ......... ............ A Fusion of hand joint ....................................... 7.60 NA NA 8.17 11.31 1.15 NA NA 16.92 20.06 09026844 ......... ............ A Fusion/graft of hand joint .............................. 8.78 NA NA 9.14 12.31 1.33 NA NA 19.25 22.42 09026850 ......... ............ A Fusion of knuckle .......................................... 6.96 NA NA 8.29 11.22 1.06 NA NA 16.31 19.24 09026852 ......... ............ A Fusion of knuckle with graft .......................... 8.51 NA NA 9.12 11.95 1.22 NA NA 18.85 21.6809026860 ......... ............ A Fusion of finger joint ...................................... 4.68 NA NA 7.54 10.28 0.73 NA NA 12.9515.69 09026861 ......... ............ A Fusion of finger jnt, add-on ........................... 1.74 NA NA 0.71 0.88 0.27 NA NA 2.72 2.89 ZZZ26862 ......... ............ A Fusion/graft of finger joint ............................. 7.36 NA NA 8.68 11.43 1.10 NA NA 17.14 19.89 09026863 ......... ............ A Fuse/graft added joint ................................... 3.89 NA NA 1.58 1.98 0.56 NA NA 6.03 6.43ZZZ26910 ......... ............ 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 09026952 ......... ............ A Amputation of finger/thumb ........................... 6.30 NA NA 7.94 10.73 0.95 NA NA 15.19 17.98 09026989 ......... ............ C Hand/finger surgery ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY26990 ......... ............ A Drainage of pelvis lesion ............................... 7.77 NA NA 6.29 6.98 1.22 NA NA 15.28 15.9709026991 ......... ............ 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 09026992 ......... ............ A Drainage of bone lesion ................................ 13.30 NA NA 8.64 9.95 2.16 NA NA 24.10 25.4109027000 ......... ............ A Incision of hip tendon .................................... 5.61 NA NA 4.55 5.10 0.98 NA NA 11.14 11.69 09027001 ......... ............ A Incision of hip tendon .................................... 6.99 NA NA 5.23 5.88 1.24 NA NA 13.46 14.11 09027003 ......... ............ A Incision of hip tendon .................................... 7.63 NA NA 5.82 6.32 1.12 NA NA 14.57 15.07 09027005 ......... ............ A Incision of hip tendon .................................... 9.89 NA NA 6.79 7.56 1.72 NA NA 18.40 19.17 09027006 ......... ............ A Incision of hip tendons .................................. 9.91 NA NA 6.84 7.70 1.69 NA NA 18.44 19.30 09027025 ......... ............ A Incision of hip/thigh fascia ............................. 12.57 NA NA 8.10 8.44 1.84 NA NA 22.51 22.85 09027030 ......... ............ A Drainage of hip joint ...................................... 13.47 NA NA 8.10 9.26 2.26 NA NA 23.83 24.99 09027033 ......... ............ A Exploration of hip joint ................................... 13.91 NA NA 8.45 9.55 2.32 NA NA 24.68 25.78 09027035 ......... ............ A Denervation of hip joint ................................. 17.14 NA NA 9.53 10.81 2.15 NA NA 28.82 30.10 09027036 ......... ............ A Excision of hip joint/muscle ........................... 14.10 NA NA 8.98 9.75 2.26 NA NA 25.34 26.1109027040 ......... ............ 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 01027041 ......... ............ A Biopsy of soft tissues .................................... 10.00 NA NA 5.79 6.43 1.35 NA NA 17.14 17.78 09027047 ......... ............ 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 09027048 ......... ............ A Remove hip/pelvis lesion .............................. 6.36 NA NA 4.65 4.76 0.92 NA NA 11.93 12.04 09027049 ......... ............ A Remove tumor, hip/pelvis .............................. 15.12 NA NA 8.24 8.36 2.06 NA NA 25.42 25.5409027050 ......... ............ A Biopsy of sacroiliac joint ................................ 4.59 NA NA 3.79 4.26 0.60 NA NA 8.98 9.4509027052 ......... ............ A Biopsy of hip joint .......................................... 7.21 NA NA 5.68 5.83 1.08 NA NA 13.9714.12 09027054 ......... ............ A Removal of hip joint lining ............................. 9.01 NA NA 6.49 7.13 1.47 NA NA 16.97 17.6109027060 ......... ............ A Removal of ischial bursa ............................... 5.72 NA NA 4.38 4.37 0.80 NA NA 10.90 10.8909027062 ......... ............ A Remove femur lesion/bursa .......................... 5.60 NA NA 4.63 5.05 0.93 NA NA 11.16 11.58 09027065 ......... ............ 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 09027067 ......... ............ A Remove/graft hip bone lesion ....................... 14.47 NA NA 8.80 10.20 1.84 NA NA 25.11 26.51 09027070 ......... ............ A Partial removal of hip bone ........................... 11.36 NA NA 7.94 8.83 1.74 NA NA 21.04 21.9309027071 ......... ............ A Partial removal of hip bone ........................... 12.16 NA NA 8.54 9.73 1.92 NA NA 22.62 23.81090



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# 49111 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules27075 ......... ............ A Extensive hip surgery .................................... 36.71 NA NA 16.62 18.56 5.64 NA NA 58.97 60.91 09027076 ......... ............ A Extensive hip surgery .................................... 24.17 NA NA 12.75 14.07 3.70 NA NA 40.62 41.94 09027077 ......... ............ A Extensive hip surgery .................................... 42.48 NA NA 19.99 21.99 6.12 NA NA 68.59 70.59 09027078 ......... ............ A Extensive hip surgery .................................... 14.44 NA NA 8.79 9.65 2.22 NA NA 25.45 26.31 09027079 ......... ............ A Extensive hip surgery .................................... 14.81 NA NA 7.52 9.04 1.94 NA NA 24.27 25.79 09027080 ......... ............ A Removal of tail bone ..................................... 6.74 NA NA 4.72 4.80 0.93 NA NA 12.39 12.47 09027086 ......... ............ 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 01027087 ......... ............ A Remove hip foreign body .............................. 8.65 NA NA 5.66 6.41 1.35 NA NA 15.66 16.41 09027090 ......... ............ A Removal of hip prosthesis ............................. 11.49 NA NA 7.44 8.45 1.94 NA NA 20.87 21.8809027091 ......... ............ A Removal of hip prosthesis ............................. 24.07 NA NA 13.05 13.76 3.84 NA NA 40.96 41.67 09027093 ......... ............ A Injection for hip x-ray ..................................... 1.30 3.09 4.12 0.44 0.47 0.13 4.52 5.551.87 1.90 00027095 ......... ............ A Injection for hip x-ray ..................................... 1.50 3.73 5.22 0.50 0.52 0.14 5.37 6.862.14 2.16 00027096 ......... ............ A Inject sacroiliac joint ...................................... 1.40 2.54 3.90 0.33 0.33 0.08 4.02 5.38 1.81 1.81 00027097 ......... ............ A Revision of hip tendon .................................. 9.09 NA NA 6.35 6.40 1.57 NA NA 17.01 17.0609027098 ......... ............ A Transfer tendon to pelvis .............................. 9.12 NA NA 4.96 6.51 0.95 NA NA 15.03 16.5809027100 ......... ............ 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 22.3809027110 ......... ............ A Transfer of iliopsoas muscle ......................... 13.54 NA NA 8.61 8.99 2.18 NA NA 24.33 24.71 09027111 ......... ............ A Transfer of iliopsoas muscle ......................... 12.37 NA NA 8.13 8.88 1.94 NA NA 22.44 23.19 09027120 ......... ............ A Reconstruction of hip socket ......................... 19.00 NA NA 10.79 11.58 3.08 NA NA 32.87 33.6609027122 ......... ............ A Reconstruction of hip socket ......................... 15.86 NA NA 9.49 10.65 2.61 NA NA 27.96 29.1209027125 ......... ............ A Partial hip replacement ................................. 16.39 NA NA 9.69 10.39 2.54 NA NA 28.62 29.32 09027130 ......... ............ A Total hip arthroplasty ..................................... 17.40 NA NA 10.24 12.54 3.50 NA NA 31.1433.44 09027132 ......... ............ A Total hip arthroplasty ..................................... 25.41 NA NA 13.57 15.12 4.04 NA NA 43.0244.57 09027134 ......... ............ A Revise hip joint replacement ......................... 30.07 NA NA 14.86 17.06 4.94 NA NA 49.87 52.0709027137 ......... ............ A Revise hip joint replacement ......................... 22.49 NA NA 11.85 13.41 3.67 NA NA 38.01 39.5709027138 ......... ............ A Revise hip joint replacement ......................... 23.49 NA NA 12.24 13.85 3.84 NA NA 39.57 41.1809027140 ......... ............ A Transplant femur ridge .................................. 12.58 NA NA 7.81 9.01 2.11 NA NA 22.50 23.70 09027146 ......... ............ A Incision of hip bone ....................................... 18.64 NA NA 10.74 11.78 2.96 NA NA 32.3433.38 09027147 ......... ............ A Revision of hip bone ..................................... 21.79 NA NA 11.94 12.92 3.57 NA NA 37.30 38.28 09027151 ......... ............ A Incision of hip bones ..................................... 23.84 NA NA 12.44 9.07 3.91 NA NA 40.19 36.82 09027156 ......... ............ A Revision of hip bones .................................... 25.95 NA NA 13.54 15.43 4.21 NA NA 43.70 45.59 09027158 ......... ............ A Revision of pelvis .......................................... 20.79 NA NA 7.19 10.03 3.16 NA NA 31.1433.98 09027161 ......... ............ A Incision of neck of femur ............................... 17.64 NA NA 10.42 11.68 2.94 NA NA 31.00 32.26 09027165 ......... ............ A Incision/fixation of femur ............................... 19.97 NA NA 11.73 12.62 3.10 NA NA 34.80 35.69 09027170 ......... ............ A Repair/graft femur head/neck ........................ 17.40 NA NA 9.82 10.93 2.81 NA NA 30.03 31.14 09027175 ......... ............ A Treat slipped epiphysis ................................. 9.23 NA NA 5.80 6.45 1.46 NA NA 16.49 17.1409027176 ......... ............ A Treat slipped epiphysis ................................. 12.69 NA NA 8.26 8.82 2.22 NA NA 23.17 23.73 09027177 ......... ............ A Treat slipped epiphysis ................................. 15.84 NA NA 9.69 10.59 2.61 NA NA 28.14 29.04 09027178 ......... ............ A Treat slipped epiphysis ................................. 12.69 NA NA 8.26 8.38 2.08 NA NA 23.03 23.15 09027179 ......... ............ A Revise head/neck of femur ........................... 13.74 NA NA 8.56 9.63 2.25 NA NA 24.55 25.62 09027181 ......... ............ A Treat slipped epiphysis ................................. 15.90 NA NA 9.83 10.11 1.57 NA NA 27.30 27.58 09027185 ......... ............ A Revision of femur epiphysis .......................... 9.59 NA NA 6.69 7.31 2.39 NA NA 18.67 19.29 09027187 ......... ............ A Reinforce hip bones ...................................... 14.00 NA NA 8.72 9.92 2.37 NA NA 25.09 26.29 09027193 ......... ............ A Treat pelvic ring fracture ............................... 5.92 4.65 4.98 4.78 5.01 0.96 11.53 11.8611.66 11.89 09027194 ......... ............ A Treat pelvic ring fracture ............................... 10.00 NA NA 6.62 7.39 1.65 NA NA 18.27 19.04 09027200 ......... ............ 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 09027202 ......... ............ A Treat tail bone fracture .................................. 7.21 NA NA 11.28 15.47 1.06 NA NA 19.55 23.74 09027215 ......... ............ A Treat pelvic fracture(s) .................................. 10.39 NA NA 6.53 6.94 1.97 NA NA 18.89 19.30 09027216 ......... ............ A Treat pelvic ring fracture ............................... 15.65 NA NA 9.25 9.51 2.63 NA NA 27.53 27.79 09027217 ......... ............ A Treat pelvic ring fracture ............................... 14.57 NA NA 8.70 9.78 2.41 NA NA 25.68 26.76 09027218 ......... ............ A Treat pelvic ring fracture ............................... 20.85 NA NA 11.41 11.40 3.48 NA NA 35.74 35.73 09027220 ......... ............ 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 09027222 ......... ............ A Treat hip socket fracture ............................... 13.88 NA NA 8.50 9.60 2.19 NA NA 24.57 25.67 09027226 ......... ............ A Treat hip wall fracture ................................... 15.37 NA NA 9.00 8.11 2.48 NA NA 26.85 25.96 09027227 ......... ............ A Treat hip fracture(s) ....................................... 25.13 NA NA 13.44 14.91 4.05 NA NA 42.62 44.09 09027228 ......... ............ A Treat hip fracture(s) ....................................... 29.05 NA NA 15.03 16.97 4.66 NA NA 48.74 50.68 09027230 ......... ............ A Treat thigh fracture ........................................ 5.61 4.98 5.38 4.91 5.05 0.95 11.54 11.94 11.47 11.61 09027232 ......... ............ A Treat thigh fracture ........................................ 11.62 NA NA 6.00 6.88 1.85 NA NA 19.4720.35 09027235 ......... ............ A Treat thigh fracture ........................................ 12.80 NA NA 8.05 9.10 2.11 NA NA 22.9624.01 09027236 ......... ............ A Treat thigh fracture ........................................ 14.54 NA NA 9.10 10.56 2.71 NA NA 26.3527.81 09027238 ......... ............ A Treat thigh fracture ........................................ 5.57 NA NA 4.69 5.03 0.89 NA NA 11.15 11.49 09027240 ......... ............ A Treat thigh fracture ........................................ 13.56 NA NA 8.10 9.13 2.16 NA NA 23.8224.85 09027244 ......... ............ A Treat thigh fracture ........................................ 17.00 NA NA 9.71 10.90 2.77 NA NA 29.4830.67 09027245 ......... ............ A Treat thigh fracture ........................................ 21.01 NA NA 11.46 13.17 3.52 NA NA 35.99 37.70 09027246 ......... ............ A Treat thigh fracture ........................................ 4.70 3.93 4.33 3.97 4.31 0.81 9.44 9.849.48 9.82 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00131 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49112 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal27248 ......... ............ A Treat thigh fracture ........................................ 10.73 NA NA 7.01 7.91 1.81 NA NA 19.5520.45 09027250 ......... ............ A Treat hip dislocation ...................................... 7.12 NA NA 4.27 4.53 0.62 NA NA 12.01 12.27 09027252 ......... ............ A Treat hip dislocation ...................................... 10.85 NA NA 6.52 7.20 1.66 NA NA 19.03 19.71 09027253 ......... ............ A Treat hip dislocation ...................................... 13.38 NA NA 8.26 9.40 2.24 NA NA 23.88 25.02 09027254 ......... ............ A Treat hip dislocation ...................................... 18.71 NA NA 10.56 11.66 3.17 NA NA 32.4433.54 09027256 ......... ............ A Treat hip dislocation ...................................... 4.23 2.39 3.24 1.39 1.91 0.46 7.08 7.936.08 6.60 01027257 ......... ............ A Treat hip dislocation ...................................... 5.33 NA NA 2.57 2.75 0.69 NA NA 8.59 8.77 01027258 ......... ............ A Treat hip dislocation ...................................... 15.95 NA NA 9.45 10.52 2.64 NA NA 28.0429.11 09027259 ......... ............ A Treat hip dislocation ...................................... 22.95 NA NA 12.91 13.82 3.74 NA NA 39.6040.51 09027265 ......... ............ A Treat hip dislocation ...................................... 5.04 NA NA 3.98 4.59 0.63 NA NA 9.65 10.26 09027266 ......... ............ A Treat hip dislocation ...................................... 7.60 NA NA 5.55 6.14 1.29 NA NA 14.44 15.03 09027275 ......... ............ A Manipulation of hip joint ................................ 2.27 NA NA 1.89 2.05 0.39 NA NA 4.55 4.7101027280 ......... ............ A Fusion of sacroiliac joint ................................ 14.39 NA NA 9.05 9.96 2.53 NA NA 25.97 26.88 09027282 ......... ............ A Fusion of pubic bones ................................... 11.62 NA NA 7.83 7.96 1.86 NA NA 21.31 21.44 09027284 ......... ............ A Fusion of hip joint .......................................... 24.85 NA NA 12.86 14.29 3.92 NA NA 41.63 43.06 09027286 ......... ............ A Fusion of hip joint .......................................... 24.89 NA NA 13.47 15.21 3.12 NA NA 41.48 43.22 09027290 ......... ............ A Amputation of leg at hip ................................ 24.27 NA NA 12.53 13.68 3.43 NA NA 40.23 41.38 09027295 ......... ............ A Amputation of leg at hip ................................ 19.46 NA NA 9.79 10.93 2.95 NA NA 32.20 33.34 09027299 ......... ............ 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 YYY27301 ......... ............ A Drain thigh/knee lesion .................................. 6.60 8.23 9.61 4.66 5.02 1.04 15.87 17.2512.30 12.66 09027303 ......... ............ A Drainage of bone lesion ................................ 8.45 NA NA 6.07 6.75 1.43 NA NA 15.95 16.6309027305 ......... ............ A Incise thigh tendon & fascia .......................... 6.03 NA NA 4.63 5.04 1.01 NA NA 11.67 12.08 09027306 ......... ............ A Incision of thigh tendon ................................. 4.61 NA NA 4.07 4.56 0.85 NA NA 9.53 10.0209027307 ......... ............ A Incision of thigh tendons ............................... 5.91 NA NA 4.81 5.24 1.04 NA NA 11.76 12.1909027310 ......... ............ A Exploration of knee joint ................................ 9.80 NA NA 6.83 7.39 1.61 NA NA 18.24 18.80 09027315 ......... ............ A Partial removal, thigh nerve .......................... 7.02 NA NA 5.44 5.07 1.09 NA NA 13.55 13.18 09027320 ......... ............ A Partial removal, thigh nerve .......................... 6.29 NA NA 4.75 5.11 1.06 NA NA 12.10 12.46 09027323 ......... ............ 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 01027324 ......... ............ A Biopsy, thigh soft tissues .............................. 4.89 NA NA 3.85 4.10 0.75 NA NA 9.49 9.74 09027327 ......... ............ 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 09027328 ......... ............ A Removal of thigh lesion ................................. 5.56 NA NA 4.07 4.30 0.84 NA NA 10.47 10.7009027329 ......... ............ A Remove tumor, thigh/knee ............................ 15.60 NA NA 8.58 8.91 2.14 NA NA 26.32 26.65 09027330 ......... ............ A Biopsy, knee joint lining ................................ 4.96 NA NA 4.12 4.46 0.86 NA NA 9.94 10.2809027331 ......... ............ A Explore/treat knee joint ................................. 5.87 NA NA 4.84 5.35 1.02 NA NA 11.73 12.24 09027332 ......... ............ A Removal of knee cartilage ............................ 8.26 NA NA 6.15 6.88 1.43 NA NA 15.84 16.57 09027333 ......... ............ A Removal of knee cartilage ............................ 7.35 NA NA 5.73 6.44 1.26 NA NA 14.34 15.05 09027334 ......... ............ A Remove knee joint lining ............................... 8.99 NA NA 6.49 7.18 1.51 NA NA 16.99 17.6809027335 ......... ............ A Remove knee joint lining ............................... 10.35 NA NA 7.06 7.93 1.74 NA NA 19.15 20.0209027340 ......... ............ A Removal of kneecap bursa ........................... 4.17 NA NA 4.05 4.43 0.72 NA NA 8.94 9.32 09027345 ......... ............ A Removal of knee cyst .................................... 5.91 NA NA 4.89 5.44 1.00 NA NA 11.80 12.3509027347 ......... ............ A Remove knee cyst ......................................... 6.52 NA NA 5.26 5.38 0.98 NA NA 12.76 12.88 09027350 ......... ............ A Removal of kneecap ..................................... 8.46 NA NA 6.29 7.00 1.41 NA NA 16.16 16.8709027355 ......... ............ A Remove femur lesion .................................... 7.82 NA NA 5.87 6.55 1.32 NA NA 15.01 15.6909027356 ......... ............ A Remove femur lesion/graft ............................ 9.89 NA NA 6.86 7.60 1.65 NA NA 18.40 19.14 09027357 ......... ............ A Remove femur lesion/graft ............................ 10.93 NA NA 7.54 8.41 1.95 NA NA 20.42 21.29 09027358 ......... ............ A Remove femur lesion/fixation ........................ 4.73 NA NA 1.90 2.37 0.82 NA NA 7.45 7.92 ZZZ27360 ......... ............ A Partial removal, leg bone(s) .......................... 11.26 NA NA 8.13 9.20 1.83 NA NA 21.22 22.2909027365 ......... ............ A Extensive leg surgery .................................... 17.85 NA NA 10.52 11.39 2.79 NA NA 31.16 32.03 09027370 ......... ............ 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 00027372 ......... ............ 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 09027380 ......... ............ A Repair of kneecap tendon ............................. 7.27 NA NA 6.08 6.98 1.24 NA NA 14.59 15.49 09027381 ......... ............ A Repair/graft kneecap tendon ......................... 10.56 NA NA 7.56 8.71 1.79 NA NA 19.91 21.06 09027385 ......... ............ A Repair of thigh muscle .................................. 7.93 NA NA 6.36 7.31 1.36 NA NA 15.65 16.6009027386 ......... ............ A Repair/graft of thigh muscle .......................... 10.90 NA NA 7.98 9.13 1.85 NA NA 20.73 21.8809027390 ......... ............ A Incision of thigh tendon ................................. 5.38 NA NA 4.57 4.98 0.92 NA NA 10.87 11.28 09027391 ......... ............ A Incision of thigh tendons ............................... 7.31 NA NA 5.52 6.30 1.23 NA NA 14.06 14.84090



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# 49113 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules27392 ......... ............ A Incision of thigh tendons ............................... 9.43 NA NA 6.72 7.37 1.57 NA NA 17.72 18.3709027393 ......... ............ 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 09027396 ......... ............ A Transplant of thigh tendon ............................ 7.97 NA NA 5.93 6.73 1.34 NA NA 15.24 16.04 09027397 ......... ............ A Transplants of thigh tendons ......................... 12.38 NA NA 8.42 8.89 1.82 NA NA 22.62 23.09 09027400 ......... ............ A Revise thigh muscles/tendons ...................... 9.13 NA NA 6.17 6.98 1.31 NA NA 16.61 17.42 09027403 ......... ............ A Repair of knee cartilage ................................ 8.44 NA NA 6.09 6.91 1.44 NA NA 15.97 16.7909027405 ......... ............ A Repair of knee ligament ................................ 8.88 NA NA 6.44 7.23 1.51 NA NA 16.83 17.6209027407 ......... ............ A Repair of knee ligament ................................ 10.62 NA NA 6.67 7.91 1.78 NA NA 19.07 20.3109027409 ......... ............ A Repair of knee ligaments .............................. 13.48 NA NA 8.44 9.57 2.24 NA NA 24.16 25.2909027412 ......... ............ A Autochondrocyte implant knee ...................... 24.43 NA NA 13.66 14.52 4.35 NA NA 42.44 43.30 09027415 ......... ............ A Osteochondral knee allograft ........................ 19.69 NA NA 11.86 12.38 4.35 NA NA 35.90 36.4209027418 ......... ............ A Repair degenerated kneecap ........................ 11.37 NA NA 7.61 8.58 1.88 NA NA 20.86 21.83 09027420 ......... ............ 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 09027427 ......... ............ A Reconstruction, knee ..................................... 9.59 NA NA 6.70 7.53 1.63 NA NA 17.92 18.75 09027428 ......... ............ A Reconstruction, knee ..................................... 15.23 NA NA 10.13 10.96 2.42 NA NA 27.78 28.61 09027429 ......... ............ A Reconstruction, knee ..................................... 17.12 NA NA 11.33 12.14 2.70 NA NA 31.15 31.96 09027430 ......... ............ A Revision of thigh muscles ............................. 9.96 NA NA 6.89 7.72 1.69 NA NA 18.54 19.37 09027435 ......... ............ A Incision of knee joint ..................................... 10.60 NA NA 7.69 8.28 1.69 NA NA 19.98 20.57 09027437 ......... ............ A Revise kneecap ............................................. 8.75 NA NA 6.24 6.99 1.49 NA NA 16.48 17.23 09027438 ......... ............ 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 09027441 ......... ............ A Revision of knee joint .................................... 11.34 NA NA 7.50 6.91 1.88 NA NA 20.72 20.13 09027442 ......... ............ A Revision of knee joint .................................... 12.17 NA NA 7.78 8.63 2.09 NA NA 22.04 22.89 09027443 ......... ............ A Revision of knee joint .................................... 11.21 NA NA 7.40 8.39 1.90 NA NA 20.51 21.50 09027445 ......... ............ A Revision of knee joint .................................... 18.43 NA NA 10.53 11.90 3.08 NA NA 32.0433.41 09027446 ......... ............ A Revision of knee joint .................................... 16.18 NA NA 9.37 10.80 2.80 NA NA 28.35 29.78 09027447 ......... ............ A Total knee arthroplasty .................................. 20.81 NA NA 11.84 13.91 3.79 NA NA 36.44 38.51 09027448 ......... ............ A Incision of thigh ............................................. 11.40 NA NA 7.43 8.31 1.94 NA NA 20.77 21.65 09027450 ......... ............ A Incision of thigh ............................................. 14.38 NA NA 8.85 10.15 2.42 NA NA 25.65 26.95 09027454 ......... ............ A Realignment of thigh bone ............................ 18.89 NA NA 10.74 12.06 3.12 NA NA 32.75 34.0709027455 ......... ............ A Realignment of knee ..................................... 13.16 NA NA 8.40 9.51 2.24 NA NA 23.80 24.91 09027457 ......... ............ A Realignment of knee ..................................... 13.85 NA NA 8.26 9.51 2.34 NA NA 24.45 25.70 09027465 ......... ............ A Shortening of thigh bone ............................... 18.36 NA NA 10.30 10.24 2.47 NA NA 31.13 31.07 09027466 ......... ............ A Lengthening of thigh bone ............................ 17.03 NA NA 10.15 11.41 2.77 NA NA 29.95 31.2109027468 ......... ............ A Shorten/lengthen thighs ................................ 19.72 NA NA 11.28 12.08 3.30 NA NA 34.30 35.10 09027470 ......... ............ A Repair of thigh ............................................... 16.87 NA NA 10.22 11.40 2.79 NA NA 29.88 31.06 09027472 ......... ............ A Repair/graft of thigh ....................................... 18.47 NA NA 10.72 12.19 3.07 NA NA 32.26 33.73 09027475 ......... ............ A Surgery to stop leg growth ............................ 8.75 NA NA 6.65 7.07 1.36 NA NA 16.76 17.18 09027477 ......... ............ A Surgery to stop leg growth ............................ 9.96 NA NA 6.65 7.46 1.73 NA NA 18.34 19.15 09027479 ......... ............ A Surgery to stop leg growth ............................ 12.96 NA NA 5.11 8.51 2.78 NA NA 20.85 24.2509027485 ......... ............ A Surgery to stop leg growth ............................ 8.95 NA NA 6.24 7.11 1.53 NA NA 16.72 17.59 09027486 ......... ............ A Revise/replace knee joint .............................. 20.84 NA NA 11.74 13.05 3.36 NA NA 35.94 37.25 09027487 ......... ............ A Revise/replace knee joint .............................. 26.83 NA NA 14.14 15.95 4.39 NA NA 45.36 47.17 09027488 ......... ............ A Removal of knee prosthesis .......................... 17.32 NA NA 10.34 11.36 2.74 NA NA 30.40 31.4209027495 ......... ............ A Reinforce thigh .............................................. 16.31 NA NA 9.70 10.98 2.71 NA NA 28.72 30.00 09027496 ......... ............ A Decompression of thigh/knee ........................ 6.58 NA NA 5.02 5.46 0.99 NA NA 12.59 13.03 09027497 ......... ............ A Decompression of thigh/knee ........................ 7.64 NA NA 4.68 5.24 1.15 NA NA 13.47 14.03 09027498 ......... ............ A Decompression of thigh/knee ........................ 8.46 NA NA 5.37 5.81 1.24 NA NA 15.07 15.51 09027499 ......... ............ A Decompression of thigh/knee ........................ 9.23 NA NA 5.83 6.57 1.47 NA NA 16.53 17.27 09027500 ......... ............ 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 09027501 ......... ............ 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 09027502 ......... ............ A Treatment of thigh fracture ............................ 11.16 NA NA 6.92 7.81 1.78 NA NA 19.86 20.7509027503 ......... ............ A Treatment of thigh fracture ............................ 11.05 NA NA 7.26 8.03 1.84 NA NA 20.15 20.9209027506 ......... ............ A Treatment of thigh fracture ............................ 19.33 NA NA 11.21 12.39 3.03 NA NA 33.57 34.75 09027507 ......... ............ A Treatment of thigh fracture ............................ 14.33 NA NA 8.20 9.43 2.42 NA NA 24.95 26.1809027508 ......... ............ 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 09027509 ......... ............ A Treatment of thigh fracture ............................ 7.94 NA NA 6.57 7.61 1.34 NA NA 15.85 16.8909027510 ......... ............ A Treatment of thigh fracture ............................ 9.60 NA NA 6.34 7.08 1.53 NA NA 17.47 18.2109027511 ......... ............ A Treatment of thigh fracture ............................ 13.86 NA NA 9.11 10.68 2.37 NA NA 25.34 26.91 09027513 ......... ............ A Treatment of thigh fracture ............................ 19.37 NA NA 11.85 13.37 3.12 NA NA 34.34 35.86 09027514 ......... ............ A Treatment of thigh fracture ............................ 19.00 NA NA 11.98 13.01 3.00 NA NA 33.98 35.01 090



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# 49114 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal27516 ......... ............ 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 09027517 ......... ............ A Treat thigh fx growth plate ............................ 8.89 NA NA 6.04 7.10 1.22 NA NA 16.15 17.2109027519 ......... ............ A Treat thigh fx growth plate ............................ 15.72 NA NA 9.88 11.16 2.55 NA NA 28.15 29.43 09027520 ......... ............ A Treat kneecap fracture .................................. 2.86 4.11 4.43 3.53 3.46 0.47 7.44 7.76 6.86 6.79 09027524 ......... ............ A Treat kneecap fracture .................................. 10.17 NA NA 6.98 7.92 1.74 NA NA 18.89 19.83 09027530 ......... ............ A Treat knee fracture ........................................ 3.89 4.83 5.19 4.27 4.38 0.65 9.37 9.738.81 8.92 09027532 ......... ............ A Treat knee fracture ........................................ 7.35 6.45 7.13 5.67 6.26 1.26 15.06 15.74 14.28 14.87 09027535 ......... ............ A Treat knee fracture ........................................ 11.72 NA NA 8.26 9.65 2.00 NA NA 21.98 23.37 09027536 ......... ............ A Treat knee fracture ........................................ 17.11 NA NA 10.29 11.28 2.73 NA NA 30.1331.12 09027538 ......... ............ A Treat knee fracture(s) .................................... 4.86 5.54 5.98 4.92 5.12 0.84 11.24 11.6810.62 10.82 09027540 ......... ............ A Treat knee fracture ........................................ 13.38 NA NA 8.02 9.14 2.27 NA NA 23.67 24.79 09027550 ......... ............ A Treat knee dislocation ................................... 5.75 5.31 5.84 4.59 4.85 0.76 11.82 12.3511.10 11.36 09027552 ......... ............ A Treat knee dislocation ................................... 7.95 NA NA 6.12 6.74 1.36 NA NA 15.43 16.05 09027556 ......... ............ A Treat knee dislocation ................................... 14.87 NA NA 9.31 11.07 2.50 NA NA 26.68 28.44 09027557 ......... ............ A Treat knee dislocation ................................... 17.22 NA NA 10.58 12.49 2.97 NA NA 30.77 32.68 09027558 ......... ............ A Treat knee dislocation ................................... 17.93 NA NA 10.62 12.44 3.08 NA NA 31.63 33.45 09027560 ......... ............ A Treat kneecap dislocation ............................. 3.81 3.93 4.61 3.41 3.24 0.40 8.14 8.82 7.627.45 09027562 ......... ............ A Treat kneecap dislocation ............................. 5.78 NA NA 4.45 4.69 0.94 NA NA 11.17 11.41 09027566 ......... ............ A Treat kneecap dislocation ............................. 12.51 NA NA 7.85 8.95 2.12 NA NA 22.48 23.5809027570 ......... ............ A Fixation of knee joint ..................................... 1.74 NA NA 1.62 1.73 0.30 NA NA 3.66 3.77 01027580 ......... ............ A Fusion of knee ............................................... 20.82 NA NA 12.34 14.19 3.37 NA NA 36.53 38.38 09027590 ......... ............ A Amputate leg at thigh .................................... 13.27 NA NA 6.14 6.54 1.74 NA NA 21.15 21.55 09027591 ......... ............ A Amputate leg at thigh .................................... 13.74 NA NA 7.43 8.34 2.02 NA NA 23.19 24.10 09027592 ......... ............ A Amputate leg at thigh .................................... 10.78 NA NA 5.50 6.00 1.45 NA NA 17.73 18.23 09027594 ......... ............ 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 09027598 ......... ............ A Amputate lower leg at knee .......................... 10.99 NA NA 6.34 6.85 1.65 NA NA 18.98 19.49 09027599 ......... ............ C Leg surgery procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY27600 ......... ............ 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 13.179.69 9.89 09027604 ......... ............ A Drain lower leg bursa .................................... 4.46 6.47 6.18 3.42 3.83 0.69 11.62 11.338.57 8.98 09027605 ......... ............ 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 01027606 ......... ............ A Incision of achilles tendon ............................. 4.13 NA NA 2.67 3.19 0.69 NA NA 7.49 8.01 01027607 ......... ............ A Treat lower leg bone lesion ........................... 8.44 NA NA 5.76 6.07 1.31 NA NA 15.51 15.82 09027610 ......... ............ A Explore/treat ankle joint ................................. 8.93 NA NA 6.17 6.79 1.40 NA NA 16.50 17.12 09027612 ......... ............ A Exploration of ankle joint ............................... 7.92 NA NA 5.35 5.91 1.13 NA NA 14.40 14.96 09027613 ......... ............ A Biopsy lower leg soft tissue .......................... 2.17 3.81 3.38 1.72 1.78 0.20 6.18 5.75 4.094.15 01027614 ......... ............ 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 09027615 ......... ............ A Remove tumor, lower leg .............................. 12.84 NA NA 8.04 9.05 1.83 NA NA 22.71 23.72 09027618 ......... ............ 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 09027619 ......... ............ 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 09027620 ......... ............ A Explore/treat ankle joint ................................. 5.97 NA NA 4.61 5.25 0.97 NA NA 11.55 12.19 09027625 ......... ............ A Remove ankle joint lining .............................. 8.29 NA NA 5.59 6.24 1.28 NA NA 15.16 15.8109027626 ......... ............ A Remove ankle joint lining .............................. 8.90 NA NA 5.95 6.68 1.48 NA NA 16.33 17.0609027630 ......... ............ A Removal of tendon lesion ............................. 4.79 7.98 7.67 3.80 4.24 0.74 13.51 13.20 9.339.77 09027635 ......... ............ A Remove lower leg bone lesion ...................... 7.83 NA NA 5.67 6.47 1.31 NA NA 14.81 15.61 09027637 ......... ............ 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 09027641 ......... ............ A Partial removal of fibula ................................ 9.65 NA NA 6.78 7.95 1.46 NA NA 17.89 19.06 09027645 ......... ............ A Extensive lower leg surgery .......................... 14.69 NA NA 9.51 11.42 2.41 NA NA 26.61 28.5209027646 ......... ............ A Extensive lower leg surgery .......................... 13.12 NA NA 8.41 10.38 2.05 NA NA 23.58 25.5509027647 ......... ............ A Extensive ankle/heel surgery ........................ 12.76 NA NA 6.61 7.36 1.75 NA NA 21.12 21.87 09027648 ......... ............ 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



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# 49115 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules27650 ......... ............ A Repair achilles tendon ................................... 9.86 NA NA 6.30 7.21 1.59 NA NA 17.75 18.66 09027652 ......... ............ A Repair/graft achilles tendon .......................... 10.55 NA NA 6.45 7.64 1.71 NA NA 18.71 19.9009027654 ......... ............ A Repair of achilles tendon .............................. 10.24 NA NA 5.96 6.85 1.58 NA NA 17.78 18.6709027656 ......... ............ 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 09027658 ......... ............ A Repair of leg tendon, each ............................ 4.97 NA NA 3.91 4.40 0.79 NA NA 9.67 10.16 09027659 ......... ............ A Repair of leg tendon, each ............................ 6.92 NA NA 4.87 5.45 1.09 NA NA 12.88 13.46 09027664 ......... ............ 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 09027675 ......... ............ A Repair lower leg tendons .............................. 7.17 NA NA 4.75 5.49 1.11 NA NA 13.03 13.77 09027676 ......... ............ A Repair lower leg tendons .............................. 8.53 NA NA 5.79 6.51 1.37 NA NA 15.69 16.41 09027680 ......... ............ 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 09027685 ......... ............ 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 09027686 ......... ............ A Revise lower leg tendons .............................. 7.57 NA NA 5.38 6.21 1.24 NA NA 14.19 15.02 09027687 ......... ............ A Revision of calf tendon .................................. 6.23 NA NA 4.54 5.12 1.00 NA NA 11.77 12.35 09027690 ......... ............ A Revise lower leg tendon ................................ 8.88 NA NA 5.47 6.13 1.33 NA NA 15.68 16.3409027691 ......... ............ A Revise lower leg tendon ................................ 10.19 NA NA 6.72 7.50 1.64 NA NA 18.55 19.3309027692 ......... ............ A Revise additional leg tendon ......................... 1.87 NA NA 0.73 0.88 0.32 NA NA 2.92 3.07 ZZZ27695 ......... ............ A Repair of ankle ligament ............................... 6.50 NA NA 5.00 5.65 1.05 NA NA 12.55 13.2009027696 ......... ............ A Repair of ankle ligaments ............................. 8.38 NA NA 5.39 6.17 1.28 NA NA 15.05 15.83 09027698 ......... ............ A Repair of ankle ligament ............................... 9.41 NA NA 5.93 6.69 1.47 NA NA 16.81 17.5709027700 ......... ............ A Revision of ankle joint ................................... 9.46 NA NA 5.14 5.55 1.30 NA NA 15.90 16.31 09027702 ......... ............ A Reconstruct ankle joint .................................. 14.19 NA NA 8.73 10.03 2.37 NA NA 25.29 26.59 09027703 ......... ............ A Reconstruction, ankle joint ............................ 16.69 NA NA 9.89 10.90 2.76 NA NA 29.34 30.35 09027704 ......... ............ A Removal of ankle implant .............................. 7.61 NA NA 5.70 5.62 1.27 NA NA 14.58 14.50 09027705 ......... ............ A Incision of tibia .............................................. 10.66 NA NA 6.91 7.86 1.80 NA NA 19.37 20.32 09027707 ......... ............ A Incision of fibula ............................................ 4.60 NA NA 4.50 4.83 0.76 NA NA 9.8610.19 09027709 ......... ............ A Incision of tibia & fibula ................................. 17.24 NA NA 9.94 8.58 1.73 NA NA 28.91 27.55 09027712 ......... ............ A Realignment of lower leg .............................. 15.59 NA NA 9.18 10.35 2.47 NA NA 27.24 28.4109027715 ......... ............ A Revision of lower leg ..................................... 15.27 NA NA 9.07 10.35 2.49 NA NA 26.83 28.11 09027720 ......... ............ A Repair of tibia ................................................ 12.13 NA NA 7.97 9.04 2.04 NA NA 22.14 23.21 09027722 ......... ............ A Repair/graft of tibia ........................................ 12.22 NA NA 8.07 8.87 2.05 NA NA 22.3423.14 09027724 ......... ............ A Repair/graft of tibia ........................................ 19.12 NA NA 10.34 11.86 3.16 NA NA 32.62 34.14 09027725 ......... ............ A Repair of lower leg ........................................ 17.07 NA NA 10.61 11.59 2.71 NA NA 30.3931.37 09027727 ......... ............ A Repair of lower leg ........................................ 14.59 NA NA 8.59 9.90 2.43 NA NA 25.61 26.92 09027730 ......... ............ A Repair of tibia epiphysis ................................ 7.52 NA NA 5.30 6.14 1.72 NA NA 14.54 15.38 09027732 ......... ............ A Repair of fibula epiphysis .............................. 5.31 NA NA 4.68 4.87 0.77 NA NA 10.76 10.9509027734 ......... ............ A Repair lower leg epiphyses ........................... 8.65 NA NA 6.20 6.26 1.35 NA NA 16.20 16.26 09027740 ......... ............ A Repair of leg epiphyses ................................ 9.41 NA NA 6.65 7.66 1.62 NA NA 17.68 18.6909027742 ......... ............ A Repair of leg epiphyses ................................ 10.40 NA NA 5.20 5.47 1.79 NA NA 17.39 17.6609027745 ......... ............ A Reinforce tibia ............................................... 10.29 NA NA 7.01 7.88 1.75 NA NA 19.05 19.92 09027750 ......... ............ 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 09027752 ......... ............ 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 09027756 ......... ............ A Treatment of tibia fracture ............................. 7.25 NA NA 5.77 6.29 1.17 NA NA 14.19 14.7109027758 ......... ............ A Treatment of tibia fracture ............................. 12.31 NA NA 8.07 8.90 2.03 NA NA 22.41 23.24 09027759 ......... ............ A Treatment of tibia fracture ............................. 14.23 NA NA 8.73 9.92 2.38 NA NA 25.34 26.53 09027760 ......... ............ A Treatment of ankle fracture ........................... 3.01 4.29 4.58 3.68 3.61 0.48 7.78 8.07 7.177.10 09027762 ......... ............ 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 09027766 ......... ............ A Treatment of ankle fracture ........................... 8.65 NA NA 6.29 6.99 1.44 NA NA 16.38 17.08 09027780 ......... ............ A Treatment of fibula fracture ........................... 2.65 3.89 4.11 3.33 3.24 0.41 6.95 7.17 6.396.30 09027781 ......... ............ 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 09027784 ......... ............ A Treatment of fibula fracture ........................... 7.34 NA NA 5.62 6.26 1.23 NA NA 14.19 14.8309027786 ......... ............ A Treatment of ankle fracture ........................... 2.84 4.07 4.36 3.44 3.36 0.46 7.37 7.66 6.746.66 09027788 ......... ............ 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 09027792 ......... ............ A Treatment of ankle fracture ........................... 7.83 NA NA 5.95 6.71 1.32 NA NA 15.10 15.86 09027808 ......... ............ A Treatment of ankle fracture ........................... 2.83 4.40 4.70 3.70 3.70 0.46 7.69 7.99 6.996.99 09027810 ......... ............ 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 09027814 ......... ............ A Treatment of ankle fracture ........................... 11.02 NA NA 7.28 8.24 1.85 NA NA 20.15 21.1109027816 ......... ............ A Treatment of ankle fracture ........................... 2.89 4.03 4.29 3.36 3.40 0.43 7.35 7.61 6.686.72 09027818 ......... ............ 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 09027822 ......... ............ A Treatment of ankle fracture ........................... 12.04 NA NA 8.87 10.21 1.91 NA NA 22.82 24.1609027823 ......... ............ A Treatment of ankle fracture ........................... 14.18 NA NA 9.51 10.98 2.25 NA NA 25.94 27.4109027824 ......... ............ 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 09027825 ......... ............ A Treat lower leg fracture ................................. 6.54 5.88 6.42 4.84 5.25 1.02 13.44 13.9812.40 12.81 09027826 ......... ............ A Treat lower leg fracture ................................. 8.89 NA NA 7.01 8.37 1.47 NA NA 17.37 18.73 09027827 ......... ............ A Treat lower leg fracture ................................. 15.65 NA NA 10.82 12.28 2.43 NA NA 28.90 30.36 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00135 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49116 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal27828 ......... ............ A Treat lower leg fracture ................................. 18.07 NA NA 12.36 13.54 2.81 NA NA 33.24 34.42 09027829 ......... ............ A Treat lower leg joint ....................................... 5.60 NA NA 5.53 6.47 0.95 NA NA 12.08 13.02 09027830 ......... ............ A Treat lower leg dislocation ............................ 3.78 4.32 4.37 3.76 3.83 0.54 8.64 8.69 8.088.15 09027831 ......... ............ A Treat lower leg dislocation ............................ 4.55 NA NA 3.99 4.34 0.73 NA NA 9.27 9.62 09027832 ......... ............ A Treat lower leg dislocation ............................ 6.60 NA NA 4.75 5.82 1.03 NA NA 12.38 13.4509027840 ......... ............ A Treat ankle dislocation .................................. 4.57 NA NA 3.62 3.73 0.46 NA NA 8.65 8.7609027842 ......... ............ A Treat ankle dislocation .................................. 6.26 NA NA 4.90 5.07 1.00 NA NA 12.16 12.33 09027846 ......... ............ A Treat ankle dislocation .................................. 10.08 NA NA 6.87 7.67 1.70 NA NA 18.65 19.45 09027848 ......... ............ A Treat ankle dislocation .................................. 11.48 NA NA 7.72 9.21 1.94 NA NA 21.14 22.63 09027860 ......... ............ A Fixation of ankle joint .................................... 2.34 NA NA 1.70 1.91 0.39 NA NA 4.43 4.64 01027870 ......... ............ A Fusion of ankle joint, open ............................ 15.13 NA NA 9.19 10.19 2.36 NA NA 26.68 27.68 09027871 ......... ............ A Fusion of tibiofibular joint .............................. 9.34 NA NA 6.54 7.32 1.59 NA NA 17.47 18.25 09027880 ......... ............ A Amputation of lower leg ................................ 15.18 NA NA 6.78 7.04 1.75 NA NA 23.71 23.9709027881 ......... ............ A Amputation of lower leg ................................ 13.22 NA NA 7.45 8.49 1.98 NA NA 22.65 23.6909027882 ......... ............ A Amputation of lower leg ................................ 9.59 NA NA 5.55 6.25 1.29 NA NA 16.43 17.1309027884 ......... ............ 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 18.8409027889 ......... ............ A Amputation of foot at ankle ........................... 10.63 NA NA 5.35 6.19 1.46 NA NA 17.44 18.2809027892 ......... ............ A Decompression of leg ................................... 7.74 NA NA 4.88 5.41 1.10 NA NA 13.72 14.2509027893 ......... ............ A Decompression of leg ................................... 7.70 NA NA 5.14 5.38 1.10 NA NA 13.94 14.1809027894 ......... ............ A Decompression of leg ................................... 12.32 NA NA 7.36 7.67 1.65 NA NA 21.33 21.6409027899 ......... ............ 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 YYY28001 ......... ............ A Drainage of bursa of foot .............................. 2.73 4.04 3.25 1.63 1.87 0.33 7.10 6.31 4.694.93 01028002 ......... ............ 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 01028003 ......... ............ 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 09028005 ......... ............ A Treat foot bone lesion ................................... 9.21 NA NA 5.48 5.90 1.16 NA NA 15.85 16.27 09028008 ......... ............ A Incision of foot fascia .................................... 4.44 6.22 4.97 3.02 3.16 0.57 11.23 9.988.03 8.17 09028010 ......... ............ 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 09028011 ......... ............ 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 09028020 ......... ............ A Exploration of foot joint ................................. 5.00 7.57 6.40 3.68 4.02 0.72 13.29 12.129.40 9.74 09028022 ......... ............ A Exploration of foot joint ................................. 4.66 6.94 5.63 3.33 3.72 0.62 12.22 10.918.61 9.00 09028024 ......... ............ A Exploration of toe joint .................................. 4.37 6.71 5.59 3.19 3.74 0.58 11.66 10.548.14 8.69 09028030 ......... ............ A Removal of foot nerve ................................... 6.14 NA NA 3.47 3.61 0.74 NA NA 10.35 10.4909028035 ......... ............ 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 09028043 ......... ............ 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 09028045 ......... ............ A Excision of foot lesion ................................... 4.71 7.12 5.81 3.29 3.52 0.63 12.46 11.158.63 8.86 09028046 ......... ............ A Resection of tumor, foot ................................ 10.46 10.49 9.19 5.84 6.31 1.36 22.31 21.0117.66 18.13 09028050 ......... ............ A Biopsy of foot joint lining ............................... 4.24 6.93 5.40 3.28 3.51 0.60 11.77 10.248.12 8.35 09028052 ......... ............ A Biopsy of foot joint lining ............................... 3.93 6.49 5.31 2.96 3.31 0.53 10.95 9.777.42 7.77 09028054 ......... ............ A Biopsy of toe joint lining ................................ 3.44 6.25 5.10 2.78 3.12 0.46 10.15 9.006.68 7.02 09028060 ......... ............ 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 09028062 ......... ............ 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 09028070 ......... ............ 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 09028072 ......... ............ 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 09028080 ......... ............ 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 09028086 ......... ............ 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 09028088 ......... ............ 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 09028090 ......... ............ 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 09028092 ......... ............ 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 09028100 ......... ............ A Removal of ankle/heel lesion ........................ 5.65 8.29 8.04 4.10 4.54 0.82 14.76 14.51 10.5711.01 09028102 ......... ............ A Remove/graft foot lesion ............................... 7.72 NA NA 4.97 5.70 1.14 NA NA 13.83 14.5609028103 ......... ............ A Remove/graft foot lesion ............................... 6.49 NA NA 4.17 4.50 0.91 NA NA 11.57 11.9009028104 ......... ............ 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 09028106 ......... ............ A Remove/graft foot lesion ............................... 7.15 NA NA 4.46 4.44 0.97 NA NA 12.58 12.5609028107 ......... ............ 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



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# 49117 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules28108 ......... ............ 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 09028110 ......... ............ 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 09028111 ......... ............ 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 09028112 ......... ............ 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 09028113 ......... ............ 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 09028114 ......... ............ 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 09028116 ......... ............ A Revision of foot ............................................. 8.86 9.58 7.49 5.41 5.23 1.03 19.47 17.38 15.30 15.12 09028118 ......... ............ 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 09028119 ......... ............ 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 09028120 ......... ............ 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 09028122 ......... ............ 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 09028124 ......... ............ A Partial removal of toe .................................... 4.80 6.82 5.45 3.47 3.61 0.60 12.22 10.858.87 9.01 09028126 ......... ............ 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 09028130 ......... ............ A Removal of ankle bone ................................. 9.22 NA NA 5.91 6.51 1.26 NA NA 16.39 16.99 09028140 ......... ............ A Removal of metatarsal .................................. 6.96 7.91 7.39 4.16 4.61 0.92 15.79 15.27 12.04 12.49 09028150 ......... ............ A Removal of toe .............................................. 4.08 6.46 5.24 3.03 3.22 0.53 11.07 9.85 7.64 7.83 09028153 ......... ............ A Partial removal of toe .................................... 3.65 6.23 4.79 2.89 2.73 0.47 10.35 8.917.01 6.85 09028160 ......... ............ A Partial removal of toe .................................... 3.73 6.41 5.02 2.97 3.24 0.49 10.63 9.247.19 7.46 09028171 ......... ............ A Extensive foot surgery ................................... 9.77 NA NA 5.34 5.40 1.33 NA NA 16.44 16.50 09028173 ......... ............ A Extensive foot surgery ................................... 8.97 8.85 7.91 4.68 5.06 1.12 18.94 18.0014.77 15.15 09028175 ......... ............ A Extensive foot surgery ................................... 6.10 7.18 6.07 3.64 3.69 0.73 14.01 12.9010.47 10.52 09028190 ......... ............ 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 01028192 ......... ............ A Removal of foot foreign body ........................ 4.63 6.79 5.80 3.22 3.54 0.61 12.03 11.04 8.468.78 09028193 ......... ............ A Removal of foot foreign body ........................ 5.72 7.38 6.05 3.64 3.85 0.73 13.83 12.50 10.0910.30 09028200 ......... ............ A Repair of foot tendon .................................... 4.59 6.95 5.56 3.26 3.48 0.61 12.15 10.768.46 8.68 09028202 ......... ............ 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 09028208 ......... ............ A Repair of foot tendon .................................... 4.36 6.73 5.29 3.19 3.27 0.58 11.67 10.238.13 8.21 09028210 ......... ............ 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 09028220 ......... ............ 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 09028222 ......... ............ 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 09028225 ......... ............ 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 09028226 ......... ............ 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 09028230 ......... ............ 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 09028232 ......... ............ 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 09028234 ......... ............ A Incision of foot tendon ................................... 3.36 6.32 5.08 3.06 3.28 0.44 10.12 8.886.86 7.08 09028238 ......... ............ 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 09028240 ......... ............ 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 09028250 ......... ............ A Revision of foot fascia ................................... 5.91 7.49 6.09 3.78 4.04 0.82 14.22 12.8210.51 10.77 09028260 ......... ............ 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 09028261 ......... ............ A Revision of foot tendon ................................. 12.83 10.79 9.16 6.40 7.08 1.57 25.19 23.5620.80 21.48 09028262 ......... ............ A Revision of foot and ankle ............................ 16.93 15.68 14.08 9.83 10.64 2.59 35.20 33.6029.35 30.16 09028264 ......... ............ A Release of midfoot joint ................................ 10.45 10.45 8.41 6.03 6.97 1.54 22.44 20.4018.02 18.96 09028270 ......... ............ 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 09028272 ......... ............ 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 09028280 ......... ............ A Fusion of toes ................................................ 5.18 7.41 6.53 3.60 4.26 0.73 13.32 12.44 9.51 10.17 09028285 ......... ............ A Repair of hammertoe .................................... 4.58 6.77 5.34 3.37 3.41 0.59 11.94 10.51 8.54 8.58 09028286 ......... ............ A Repair of hammertoe .................................... 4.55 6.54 5.23 3.05 3.20 0.57 11.66 10.35 8.17 8.32 09028288 ......... ............ 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 09028289 ......... ............ A Repair hallux rigidus ...................................... 8.03 9.52 8.37 5.39 5.67 1.02 18.57 17.42 14.44 14.72 09028290 ......... ............ A Correction of bunion ...................................... 5.65 8.24 6.75 3.98 4.54 0.82 14.71 13.2210.45 11.01 09028292 ......... ............ A Correction of bunion ...................................... 8.60 10.42 8.20 6.19 5.70 0.91 19.93 17.71 15.70 15.21 09028293 ......... ............ A Correction of bunion ...................................... 10.96 14.60 11.71 6.97 6.32 1.13 26.69 23.80 19.06 18.41 09028294 ......... ............ A Correction of bunion ...................................... 8.55 9.19 7.87 4.61 4.69 1.09 18.83 17.5114.25 14.33 09028296 ......... ............ A Correction of bunion ...................................... 9.23 9.66 8.53 4.83 5.27 1.19 20.08 18.9515.25 15.69 09028297 ......... ............ A Correction of bunion ...................................... 9.23 10.54 9.34 5.36 6.03 1.32 21.09 19.89 15.91 16.58 09028298 ......... ............ A Correction of bunion ...................................... 7.93 9.30 7.73 4.58 4.90 1.05 18.28 16.7113.56 13.88 09028299 ......... ............ A Correction of bunion ...................................... 11.31 10.63 9.23 5.77 5.99 1.37 23.31 21.91 18.45 18.67 09028300 ......... ............ A Incision of heel bone ..................................... 9.53 NA NA 6.11 6.80 1.54 NA NA 17.18 17.87 09028302 ......... ............ A Incision of ankle bone ................................... 9.54 NA NA 5.72 6.59 1.42 NA NA 16.68 17.55 09028304 ......... ............ 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 09028305 ......... ............ A Incise/graft midfoot bones ............................. 10.54 NA NA 5.61 6.44 1.27 NA NA 17.42 18.2509028306 ......... ............ A Incision of metatarsal .................................... 5.85 8.39 7.22 3.87 4.10 0.84 15.08 13.9110.56 10.79 09028307 ......... ............ A Incision of metatarsal .................................... 6.32 9.57 10.66 4.48 5.08 0.90 16.79 17.88 11.70 12.30 09028308 ......... ............ A Incision of metatarsal .................................... 5.28 7.95 6.29 3.83 3.72 0.70 13.93 12.279.81 9.70 09028309 ......... ............ A Incision of metatarsals .................................. 13.88 NA NA 7.79 7.91 2.04 NA NA 23.71 23.83 09028310 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00137 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49118 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal28312 ......... ............ A Revision of toe .............................................. 4.54 7.41 5.93 3.24 3.53 0.63 12.58 11.10 8.41 8.70 09028313 ......... ............ A Repair deformity of toe .................................. 5.00 7.39 5.80 3.67 4.54 0.73 13.12 11.539.40 10.27 09028315 ......... ............ 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 09028320 ......... ............ A Repair of foot bones ...................................... 9.17 NA NA 5.78 6.48 1.43 NA NA 16.38 17.08 09028322 ......... ............ A Repair of metatarsals .................................... 8.33 10.03 9.39 5.48 6.12 1.27 19.63 18.9915.08 15.72 09028340 ......... ............ 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 09028341 ......... ............ A Resect enlarged toe ...................................... 8.52 8.70 7.37 4.47 4.73 1.01 18.23 16.9014.00 14.26 09028344 ......... ............ 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 09028345 ......... ............ 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 09028360 ......... ............ A Reconstruct cleft foot .................................... 14.57 NA NA 6.39 9.47 2.28 NA NA 23.24 26.32 09028400 ......... ............ A Treatment of heel fracture ............................. 2.16 3.39 3.57 2.93 3.02 0.35 5.90 6.08 5.445.53 09028405 ......... ............ 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 09028406 ......... ............ A Treatment of heel fracture ............................. 6.36 NA NA 5.69 6.52 1.11 NA NA 13.16 13.9909028415 ......... ............ A Treat heel fracture ......................................... 17.44 NA NA 10.92 12.69 2.66 NA NA 31.02 32.79 09028420 ......... ............ A Treat/graft heel fracture ................................. 16.98 NA NA 10.21 12.24 2.80 NA NA 29.9932.02 09028430 ......... ............ A Treatment of ankle fracture ........................... 2.09 3.15 3.33 2.59 2.57 0.31 5.55 5.73 4.994.97 09028435 ......... ............ A Treatment of ankle fracture ........................... 3.39 3.76 3.85 3.07 3.57 0.55 7.70 7.79 7.017.51 09028436 ......... ............ A Treatment of ankle fracture ........................... 4.70 NA NA 5.00 5.68 0.81 NA NA 10.51 11.19 09028445 ......... ............ A Treat ankle fracture ....................................... 16.99 NA NA 9.79 10.72 2.58 NA NA 29.3630.29 09028450 ......... ............ A Treat midfoot fracture, each .......................... 1.90 2.95 3.07 2.44 2.46 0.28 5.13 5.25 4.624.64 09028455 ......... ............ A Treat midfoot fracture, each .......................... 3.09 3.68 3.49 3.05 3.33 0.44 7.21 7.02 6.586.86 09028456 ......... ............ A Treat midfoot fracture .................................... 2.68 NA NA 3.63 4.02 0.44 NA NA 6.75 7.1409028465 ......... ............ A Treat midfoot fracture, each .......................... 7.06 NA NA 5.09 6.01 1.10 NA NA 13.25 14.17 09028470 ......... ............ A Treat metatarsal fracture ............................... 1.99 2.84 3.05 2.40 2.43 0.30 5.13 5.34 4.69 4.72 09028475 ......... ............ A Treat metatarsal fracture ............................... 2.97 3.18 3.29 2.56 3.05 0.44 6.59 6.70 5.97 6.46 09028476 ......... ............ A Treat metatarsal fracture ............................... 3.37 NA NA 4.35 4.82 0.54 NA NA 8.26 8.73 09028485 ......... ............ A Treat metatarsal fracture ............................... 5.70 NA NA 4.57 5.22 0.83 NA NA 11.10 11.7509028490 ......... ............ A Treat big toe fracture ..................................... 1.09 2.11 2.04 1.69 1.65 0.14 3.34 3.272.92 2.88 09028495 ......... ............ A Treat big toe fracture ..................................... 1.58 2.48 2.25 1.88 2.02 0.20 4.26 4.033.66 3.80 09028496 ......... ............ A Treat big toe fracture ..................................... 2.33 7.22 7.99 2.90 3.12 0.36 9.91 10.685.59 5.81 09028505 ......... ............ 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 09028510 ......... ............ A Treatment of toe fracture .............................. 1.09 1.68 1.57 1.61 1.55 0.14 2.91 2.80 2.842.78 09028515 ......... ............ A Treatment of toe fracture .............................. 1.46 2.25 1.98 1.84 1.88 0.18 3.89 3.62 3.483.52 09028525 ......... ............ A Treat toe fracture ........................................... 3.32 6.93 7.37 2.92 3.30 0.49 10.74 11.18 6.73 7.11 09028530 ......... ............ 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 09028531 ......... ............ 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 09028540 ......... ............ A Treat foot dislocation ..................................... 2.04 2.78 2.50 2.33 2.38 0.26 5.08 4.804.63 4.68 09028545 ......... ............ A Treat foot dislocation ..................................... 2.45 3.25 2.57 2.66 2.42 0.37 6.07 5.395.48 5.24 09028546 ......... ............ A Treat foot dislocation ..................................... 3.20 7.69 7.11 3.45 4.15 0.52 11.41 10.83 7.17 7.87 09028555 ......... ............ A Repair foot dislocation ................................... 6.35 9.82 9.88 4.96 5.49 1.04 17.21 17.2712.35 12.88 09028570 ......... ............ A Treat foot dislocation ..................................... 1.66 2.59 2.46 2.00 2.25 0.23 4.48 4.353.89 4.14 09028575 ......... ............ A Treat foot dislocation ..................................... 3.31 4.38 3.89 3.68 3.71 0.56 8.25 7.767.55 7.58 09028576 ......... ............ A Treat foot dislocation ..................................... 4.40 NA NA 4.01 4.13 0.69 NA NA 9.10 9.22 09028585 ......... ............ A Repair foot dislocation ................................... 8.10 9.98 7.99 5.29 5.70 1.25 19.33 17.3414.64 15.05 09028600 ......... ............ A Treat foot dislocation ..................................... 1.89 3.06 2.87 2.40 2.61 0.27 5.22 5.034.56 4.77 09028605 ......... ............ A Treat foot dislocation ..................................... 2.71 3.76 3.28 3.16 3.13 0.40 6.87 6.396.27 6.24 09028606 ......... ............ A Treat foot dislocation ..................................... 4.89 NA NA 4.31 4.60 0.82 NA NA 10.02 10.31 09028615 ......... ............ A Repair foot dislocation ................................... 8.88 NA NA 7.00 7.78 1.30 NA NA 17.18 17.96 09028630 ......... ............ A Treat toe dislocation ...................................... 1.70 1.96 1.67 0.95 0.99 0.20 3.86 3.572.85 2.89 01028635 ......... ............ A Treat toe dislocation ...................................... 1.91 2.27 2.08 1.33 1.48 0.26 4.44 4.253.50 3.65 01028636 ......... ............ A Treat toe dislocation ...................................... 2.77 4.38 4.00 2.05 2.48 0.43 7.58 7.205.25 5.68 01028645 ......... ............ A Repair toe dislocation .................................... 4.21 6.90 5.44 3.20 3.25 0.57 11.68 10.227.98 8.03 09028660 ......... ............ A Treat toe dislocation ...................................... 1.23 1.31 1.27 0.79 0.79 0.13 2.67 2.632.15 2.15 01028665 ......... ............ A Treat toe dislocation ...................................... 1.92 1.85 1.54 1.34 1.41 0.26 4.03 3.723.52 3.59 01028666 ......... ............ A Treat toe dislocation ...................................... 2.66 NA NA 1.92 2.42 0.43 NA NA 5.01 5.51 01028675 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00138 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49119 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules28705 ......... ............ A Fusion of foot bones ..................................... 20.04 NA NA 10.77 12.02 3.08 NA NA 33.89 35.14 09028715 ......... ............ A Fusion of foot bones ..................................... 14.32 NA NA 8.54 9.45 2.16 NA NA 25.02 25.93 09028725 ......... ............ A Fusion of foot bones ..................................... 11.89 NA NA 6.95 7.92 1.86 NA NA 20.70 21.67 09028730 ......... ............ A Fusion of foot bones ..................................... 12.11 NA NA 7.79 8.31 1.70 NA NA 21.60 22.12 09028735 ......... ............ A Fusion of foot bones ..................................... 11.95 NA NA 6.99 7.61 1.68 NA NA 20.62 21.24 09028737 ......... ............ A Revision of foot bones .................................. 10.75 NA NA 6.13 6.63 1.47 NA NA 18.35 18.85 09028740 ......... ............ 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 09028750 ......... ............ 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 09028755 ......... ............ 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 09028760 ......... ............ 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 09028800 ......... ............ A Amputation of midfoot ................................... 8.56 NA NA 5.08 5.61 1.15 NA NA 14.79 15.3209028805 ......... ............ A Amputation thru metatarsal ........................... 12.47 NA NA 6.02 5.74 1.18 NA NA 19.67 19.39 09028810 ......... ............ 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 09028825 ......... ............ 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 09028890 ......... ............ A High energy eswt, plantar f ........................... 3.30 4.65 5.45 2.31 2.14 0.41 8.36 9.16 6.025.85 09028899 ......... ............ 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 YYY29000 ......... ............ 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 00029010 ......... ............ 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 00029015 ......... ............ 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 00029020 ......... ............ 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 00029025 ......... ............ 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 00029035 ......... ............ 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 00029040 ......... ............ 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 00029044 ......... ............ 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 00029046 ......... ............ 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 00029049 ......... ............ 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 00029055 ......... ............ A Application of shoulder cast .......................... 1.78 2.92 2.97 1.31 1.43 0.30 5.00 5.05 3.393.51 00029058 ......... ............ A Application of shoulder cast .......................... 1.31 1.25 1.48 0.68 0.71 0.17 2.73 2.96 2.162.19 00029065 ......... ............ A Application of long arm cast .......................... 0.87 1.28 1.32 0.71 0.74 0.15 2.30 2.34 1.731.76 00029075 ......... ............ A Application of forearm cast ........................... 0.77 1.24 1.26 0.67 0.68 0.13 2.14 2.16 1.571.58 00029085 ......... ............ 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 00029086 ......... ............ A Apply finger cast ............................................ 0.62 1.03 0.98 0.53 0.50 0.07 1.72 1.67 1.22 1.19 00029105 ......... ............ 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 00029125 ......... ............ A Apply forearm splint ...................................... 0.59 0.97 1.01 0.43 0.40 0.07 1.63 1.67 1.09 1.06 00029126 ......... ............ A Apply forearm splint ...................................... 0.77 1.02 1.16 0.48 0.47 0.07 1.86 2.00 1.32 1.31 00029130 ......... ............ 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 00029131 ......... ............ 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 00029200 ......... ............ A Strapping of chest ......................................... 0.65 0.62 0.70 0.35 0.34 0.04 1.31 1.391.04 1.03 00029220 ......... ............ 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 00029240 ......... ............ A Strapping of shoulder .................................... 0.71 0.67 0.81 0.39 0.37 0.06 1.44 1.58 1.16 1.14 00029260 ......... ............ A Strapping of elbow or wrist ........................... 0.55 0.65 0.72 0.36 0.33 0.05 1.25 1.32 0.960.93 00029280 ......... ............ A Strapping of hand or finger ........................... 0.51 0.66 0.77 0.37 0.33 0.03 1.20 1.31 0.910.87 00029305 ......... ............ 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 00029325 ......... ............ 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 00029345 ......... ............ A Application of long leg cast ........................... 1.40 1.67 1.74 0.95 1.03 0.24 3.31 3.38 2.592.67 00029355 ......... ............ A Application of long leg cast ........................... 1.53 1.64 1.69 0.95 1.08 0.26 3.43 3.48 2.742.87 00029358 ......... ............ A Apply long leg cast brace .............................. 1.43 2.06 2.06 0.94 1.05 0.25 3.74 3.74 2.622.73 00029365 ......... ............ A Application of long leg cast ........................... 1.18 1.58 1.64 0.86 0.93 0.20 2.96 3.02 2.242.31 00029405 ......... ............ A Apply short leg cast ....................................... 0.86 1.21 1.22 0.66 0.70 0.14 2.21 2.221.66 1.70 00029425 ......... ............ A Apply short leg cast ....................................... 1.01 1.24 1.23 0.67 0.72 0.15 2.40 2.391.83 1.88 00029435 ......... ............ A Apply short leg cast ....................................... 1.18 1.54 1.56 0.82 0.90 0.20 2.92 2.942.20 2.28 00029440 ......... ............ 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 00029445 ......... ............ A Apply rigid leg cast ........................................ 1.78 1.62 1.76 0.93 0.95 0.27 3.67 3.812.98 3.00 00029450 ......... ............ 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 00029505 ......... ............ 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 00029515 ......... ............ 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 00029520 ......... ............ A Strapping of hip ............................................. 0.54 0.68 0.81 0.38 0.45 0.03 1.25 1.38 0.95 1.02 00029530 ......... ............ A Strapping of knee .......................................... 0.57 0.65 0.76 0.36 0.34 0.05 1.27 1.380.98 0.96 00029540 ......... ............ A Strapping of ankle and/or ft ........................... 0.51 0.55 0.45 0.31 0.31 0.06 1.12 1.02 0.880.88 00029550 ......... ............ A Strapping of toes ........................................... 0.47 0.57 0.46 0.30 0.29 0.06 1.10 0.990.83 0.82 00029580 ......... ............ 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 00029590 ......... ............ 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 00029700 ......... ............ A Removal/revision of cast ............................... 0.57 0.97 0.91 0.26 0.28 0.08 1.62 1.56 0.910.93 00029705 ......... ............ A Removal/revision of cast ............................... 0.76 0.77 0.81 0.37 0.38 0.13 1.66 1.70 1.261.27 00029710 ......... ............ A Removal/revision of cast ............................... 1.34 1.45 1.51 0.63 0.68 0.20 2.99 3.05 2.172.22 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00139 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49120 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal29715 ......... ............ A Removal/revision of cast ............................... 0.94 1.14 1.16 0.41 0.40 0.09 2.17 2.19 1.441.43 00029720 ......... ............ 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 00029730 ......... ............ A Windowing of cast ......................................... 0.75 0.76 0.80 0.35 0.35 0.12 1.63 1.67 1.22 1.22 00029740 ......... ............ A Wedging of cast ............................................ 1.12 1.05 1.13 0.49 0.49 0.18 2.35 2.431.79 1.79 00029750 ......... ............ A Wedging of clubfoot cast ............................... 1.26 0.91 1.02 0.44 0.55 0.21 2.38 2.49 1.912.02 00029799 ......... ............ C Casting/strapping procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY29800 ......... ............ A Jaw arthroscopy/surgery ............................... 6.67 NA NA 5.72 6.66 0.99 NA NA 13.38 14.32 09029804 ......... ............ A Jaw arthroscopy/surgery ............................... 8.63 NA NA 7.34 7.55 1.38 NA NA 17.35 17.56 09029805 ......... ............ A Shoulder arthroscopy, dx .............................. 5.88 NA NA 4.74 5.44 1.02 NA NA 11.64 12.34 09029806 ......... ............ A Shoulder arthroscopy/surgery ....................... 14.85 NA NA 9.41 10.72 2.49 NA NA 26.75 28.06 09029807 ......... ............ A Shoulder arthroscopy/surgery ....................... 14.38 NA NA 9.28 10.56 2.41 NA NA 26.07 27.35 09029819 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.61 NA NA 5.66 6.51 1.32 NA NA 14.59 15.44 09029820 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.06 NA NA 5.21 5.97 1.22 NA NA 13.49 14.25 09029821 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.71 NA NA 5.68 6.52 1.33 NA NA 14.72 15.56 09029822 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.42 NA NA 5.61 6.42 1.28 NA NA 14.31 15.12 09029823 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.16 NA NA 6.07 6.93 1.41 NA NA 15.64 16.50 09029824 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.74 NA NA 6.57 7.29 1.42 NA NA 16.73 17.45 09029825 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.61 NA NA 5.67 6.49 1.32 NA NA 14.60 15.42 09029826 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.98 NA NA 6.22 7.20 1.55 NA NA 16.75 17.73 09029827 ......... ............ A Arthroscop rotator cuff repr ........................... 15.34 NA NA 9.38 10.99 2.66 NA NA 27.38 28.99 09029830 ......... ............ A Elbow arthroscopy ......................................... 5.75 NA NA 4.52 5.14 0.99 NA NA 11.26 11.88 09029834 ......... ............ A Elbow arthroscopy/surgery ............................ 6.27 NA NA 4.87 5.59 1.08 NA NA 12.22 12.94 09029835 ......... ............ A Elbow arthroscopy/surgery ............................ 6.47 NA NA 4.99 5.66 1.13 NA NA 12.59 13.26 09029836 ......... ............ A Elbow arthroscopy/surgery ............................ 7.54 NA NA 5.59 6.49 1.22 NA NA 14.35 15.25 09029837 ......... ............ A Elbow arthroscopy/surgery ............................ 6.86 NA NA 5.15 5.89 1.19 NA NA 13.20 13.94 09029838 ......... ............ A Elbow arthroscopy/surgery ............................ 7.70 NA NA 5.70 6.59 1.30 NA NA 14.70 15.59 09029840 ......... ............ A Wrist arthroscopy .......................................... 5.53 NA NA 4.62 5.15 0.84 NA NA 10.99 11.52 09029843 ......... ............ A Wrist arthroscopy/surgery ............................. 6.00 NA NA 4.92 5.45 0.92 NA NA 11.84 12.37 09029844 ......... ............ A Wrist arthroscopy/surgery ............................. 6.36 NA NA 4.96 5.61 1.04 NA NA 12.36 13.01 09029845 ......... ............ A Wrist arthroscopy/surgery ............................. 7.51 NA NA 5.51 6.23 0.99 NA NA 14.01 14.73 09029846 ......... ............ A Wrist arthroscopy/surgery ............................. 6.74 NA NA 5.10 5.81 1.07 NA NA 12.91 13.62 09029847 ......... ............ A Wrist arthroscopy/surgery ............................. 7.07 NA NA 5.17 5.94 1.08 NA NA 13.32 14.09 09029848 ......... ............ A Wrist endoscopy/surgery ............................... 6.18 NA NA 5.29 5.52 0.86 NA NA 12.33 12.56 09029850 ......... ............ A Knee arthroscopy/surgery ............................. 8.18 NA NA 5.13 5.07 1.25 NA NA 14.56 14.50 09029851 ......... ............ A Knee arthroscopy/surgery ............................. 13.08 NA NA 8.32 9.42 2.34 NA NA 23.74 24.84 09029855 ......... ............ A Tibial arthroscopy/surgery ............................. 10.60 NA NA 7.39 8.42 1.84 NA NA 19.83 20.8609029856 ......... ............ A Tibial arthroscopy/surgery ............................. 14.12 NA NA 8.76 10.19 2.39 NA NA 25.27 26.70 09029860 ......... ............ A Hip arthroscopy, dx ....................................... 8.79 NA NA 6.23 6.77 1.36 NA NA 16.38 16.92 09029861 ......... ............ A Hip arthroscopy/surgery ................................ 9.89 NA NA 6.64 7.17 1.59 NA NA 18.12 18.6509029862 ......... ............ A Hip arthroscopy/surgery ................................ 10.89 NA NA 7.62 8.33 1.62 NA NA 20.13 20.8409029863 ......... ............ A Hip arthroscopy/surgery ................................ 10.89 NA NA 7.53 8.27 1.42 NA NA 19.84 20.5809029866 ......... ............ A Autgrft implnt, knee w/scope ......................... 14.38 NA NA 9.54 10.90 2.39 NA NA 26.31 27.6709029867 ......... ............ A Allgrft implnt, knee w/scope .......................... 18.08 NA NA 11.24 12.73 2.78 NA NA 32.10 33.59 09029868 ......... ............ A Meniscal trnspl, knee w/scpe ........................ 24.79 NA NA 13.94 16.08 4.35 NA NA 43.08 45.2209029870 ......... ............ A Knee arthroscopy, dx .................................... 5.06 NA NA 4.18 4.71 0.85 NA NA 10.09 10.6209029871 ......... ............ 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 09029874 ......... ............ A Knee arthroscopy/surgery ............................. 7.04 NA NA 5.18 5.85 1.11 NA NA 13.33 14.00 09029875 ......... ............ A Knee arthroscopy/surgery ............................. 6.30 NA NA 4.92 5.62 1.09 NA NA 12.31 13.01 09029876 ......... ............ A Knee arthroscopy/surgery ............................. 8.66 NA NA 6.23 6.82 1.37 NA NA 16.26 16.85 09029877 ......... ............ A Knee arthroscopy/surgery ............................. 8.09 NA NA 5.99 6.55 1.28 NA NA 15.36 15.92 09029879 ......... ............ A Knee arthroscopy/surgery ............................. 8.78 NA NA 6.28 6.91 1.39 NA NA 16.45 17.08 09029880 ......... ............ A Knee arthroscopy/surgery ............................. 9.24 NA NA 6.48 7.14 1.47 NA NA 17.19 17.85 09029881 ......... ............ A Knee arthroscopy/surgery ............................. 8.50 NA NA 6.18 6.77 1.34 NA NA 16.02 16.61 09029882 ......... ............ A Knee arthroscopy/surgery ............................. 9.39 NA NA 6.52 7.06 1.50 NA NA 17.41 17.95 09029883 ......... ............ A Knee arthroscopy/surgery ............................. 11.53 NA NA 7.65 8.71 1.92 NA NA 21.10 22.16 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00140 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49121 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules29884 ......... ............ A Knee arthroscopy/surgery ............................. 8.07 NA NA 6.01 6.53 1.27 NA NA 15.35 15.87 09029885 ......... ............ A Knee arthroscopy/surgery ............................. 9.96 NA NA 7.05 7.74 1.58 NA NA 18.58 19.28 09029886 ......... ............ A Knee arthroscopy/surgery ............................. 8.28 NA NA 6.08 6.66 1.30 NA NA 15.66 16.24 09029887 ......... ............ A Knee arthroscopy/surgery ............................. 9.91 NA NA 7.04 7.71 1.57 NA NA 18.52 19.19 09029888 ......... ............ A Knee arthroscopy/surgery ............................. 14.06 NA NA 8.34 9.74 2.41 NA NA 24.81 26.21 09029889 ......... ............ A Knee arthroscopy/surgery ............................. 17.05 NA NA 10.75 12.01 2.78 NA NA 30.58 31.8409029891 ......... ............ A Ankle arthroscopy/surgery ............................. 9.39 NA NA 6.69 7.31 1.39 NA NA 17.47 18.09 09029892 ......... ............ A Ankle arthroscopy/surgery ............................. 9.99 NA NA 6.58 7.45 1.41 NA NA 17.98 18.85 09029893 ......... ............ A Scope, plantar fasciotomy ............................. 5.96 8.86 6.93 4.67 4.16 0.63 15.45 13.52 11.26 10.75 09029894 ......... ............ A Ankle arthroscopy/surgery ............................. 7.20 NA NA 4.72 5.28 1.15 NA NA 13.07 13.63 09029895 ......... ............ A Ankle arthroscopy/surgery ............................. 6.98 NA NA 4.54 5.24 1.11 NA NA 12.63 13.33 09029897 ......... ............ A Ankle arthroscopy/surgery ............................. 7.17 NA NA 4.96 5.65 1.17 NA NA 13.30 13.99 09029898 ......... ............ A Ankle arthroscopy/surgery ............................. 8.31 NA NA 5.29 5.97 1.28 NA NA 14.88 15.56 09029899 ......... ............ A Ankle arthroscopy/surgery ............................. 15.13 NA NA 9.30 10.23 2.40 NA NA 26.83 27.7609029900 ......... ............ A Mcp joint arthroscopy, dx .............................. 5.66 NA NA 4.74 5.58 0.94 NA NA 11.34 12.1809029901 ......... ............ A Mcp joint arthroscopy, surg ........................... 6.37 NA NA 5.50 6.07 1.06 NA NA 12.93 13.50 09029902 ......... ............ A Mcp joint arthroscopy, surg ........................... 6.94 NA NA 3.68 5.83 1.12 NA NA 11.74 13.89 09029999 ......... ............ C Arthroscopy of joint ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 YYY30000 ......... ............ A Drainage of nose lesion ................................ 1.43 3.73 3.99 1.23 1.35 0.12 5.28 5.54 2.782.90 01030020 ......... ............ A Drainage of nose lesion ................................ 1.43 3.86 3.42 1.26 1.42 0.12 5.41 4.97 2.812.97 01030100 ......... ............ A Intranasal biopsy ........................................... 0.94 2.40 2.08 0.68 0.79 0.07 3.41 3.091.69 1.80 00030110 ......... ............ 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 01030115 ......... ............ A Removal of nose polyp(s) ............................. 4.34 NA NA 5.47 5.69 0.41 NA NA 10.22 10.44 09030117 ......... ............ 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 09030118 ......... ............ A Removal of intranasal lesion ......................... 9.74 NA NA 7.73 8.83 0.78 NA NA 18.25 19.35 09030120 ......... ............ A Revision of nose ............................................ 5.26 6.78 6.56 4.84 5.71 0.52 12.56 12.34 10.62 11.49 09030124 ......... ............ A Removal of nose lesion ................................. 3.10 NA NA 3.59 3.61 0.25 NA NA 6.94 6.96 09030125 ......... ............ A Removal of nose lesion ................................. 7.15 NA NA 7.00 7.99 0.63 NA NA 14.78 15.7709030130 ......... ............ A Excise inferior turbinate ................................. 3.37 NA NA 5.28 5.51 0.31 NA NA 8.96 9.1909030140 ......... ............ A Resect inferior turbinate ................................ 3.42 NA NA 6.54 6.28 0.35 NA NA 10.31 10.05 09030150 ......... ............ A Partial removal of nose ................................. 9.37 NA NA 8.50 10.38 0.93 NA NA 18.80 20.68 09030160 ......... ............ A Removal of nose ........................................... 9.81 NA NA 8.12 9.69 0.88 NA NA 18.81 20.38 09030200 ......... ............ A Injection treatment of nose ............................ 0.78 1.87 1.68 0.61 0.71 0.06 2.71 2.52 1.451.55 00030210 ......... ............ A Nasal sinus therapy ....................................... 1.08 2.31 2.15 1.15 1.27 0.09 3.48 3.32 2.32 2.44 01030220 ......... ............ 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 01030300 ......... ............ 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 01030310 ......... ............ A Remove nasal foreign body .......................... 1.96 NA NA 2.71 3.00 0.16 NA NA 4.83 5.12 01030320 ......... ............ A Remove nasal foreign body .......................... 4.51 NA NA 5.93 6.76 0.39 NA NA 10.83 11.66 09030400 ......... ............ R Reconstruction of nose ................................. 10.46 NA NA 13.64 15.03 1.04 NA NA 25.14 26.53 09030410 ......... ............ R Reconstruction of nose ................................. 13.60 NA NA 14.27 17.35 1.42 NA NA 29.29 32.37 09030420 ......... ............ R Reconstruction of nose ................................. 16.50 NA NA 14.69 17.11 1.46 NA NA 32.65 35.07 09030430 ......... ............ R Revision of nose ............................................ 7.84 NA NA 12.76 15.20 0.77 NA NA 21.3723.81 09030435 ......... ............ R Revision of nose ............................................ 12.33 NA NA 14.67 18.18 1.22 NA NA 28.22 31.73 09030450 ......... ............ R Revision of nose ............................................ 19.26 NA NA 16.12 20.45 1.96 NA NA 37.34 41.67 09030460 ......... ............ A Revision of nose ............................................ 10.20 NA NA 7.13 9.24 1.03 NA NA 18.3620.47 09030462 ......... ............ A Revision of nose ............................................ 20.04 NA NA 14.29 18.75 2.53 NA NA 36.86 41.32 09030465 ......... ............ A Repair nasal stenosis .................................... 12.12 NA NA 10.25 11.54 1.06 NA NA 23.43 24.72 09030520 ......... ............ A Repair of nasal septum ................................. 7.63 NA NA 7.58 6.89 0.46 NA NA 15.67 14.9809030540 ......... ............ A Repair nasal defect ....................................... 7.74 NA NA 7.01 8.71 0.67 NA NA 15.42 17.12 09030545 ......... ............ A Repair nasal defect ....................................... 11.42 NA NA 10.02 11.43 1.70 NA NA 23.1424.55 09030560 ......... ............ 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 01030580 ......... ............ 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 09030600 ......... ............ 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 09030620 ......... ............ A Intranasal reconstruction ............................... 5.96 NA NA 8.08 8.64 0.57 NA NA 14.61 15.1709030630 ......... ............ 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 01030802 ......... ............ A Cauterization, inner nose .............................. 2.03 4.60 4.61 2.30 2.35 0.16 6.79 6.80 4.494.54 01030901 ......... ............ A Control of nosebleed ..................................... 1.21 1.20 1.32 0.28 0.31 0.11 2.52 2.64 1.60 1.63 00030903 ......... ............ A Control of nosebleed ..................................... 1.54 3.07 2.80 0.38 0.47 0.13 4.74 4.47 2.05 2.14 00030905 ......... ............ A Control of nosebleed ..................................... 1.97 3.73 3.57 0.46 0.69 0.17 5.87 5.71 2.60 2.83 00030906 ......... ............ 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 00030915 ......... ............ A Ligation, nasal sinus artery ........................... 7.31 NA NA 5.80 6.47 0.58 NA NA 13.69 14.3609030920 ......... ............ A Ligation, upper jaw artery .............................. 10.97 NA NA 8.11 8.76 0.80 NA NA 19.88 20.53 09030930 ......... ............ A Ther fx, nasal inf turbinate ............................ 1.26 NA NA 1.52 1.60 0.12 NA NA 2.90 2.98 01030999 ......... ............ C Nasal surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY31000 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00141 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49122 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal31002 ......... ............ A Irrigation, sphenoid sinus .............................. 1.91 NA NA 2.51 3.06 0.15 NA NA 4.57 5.12 01031020 ......... ............ A Exploration, maxillary sinus ........................... 2.94 8.06 8.41 5.16 5.18 0.29 11.29 11.64 8.39 8.41 09031030 ......... ............ A Exploration, maxillary sinus ........................... 5.91 9.77 11.07 6.01 6.50 0.60 16.28 17.58 12.52 13.01 09031032 ......... ............ A Explore sinus, remove polyps ....................... 6.56 NA NA 6.46 7.04 0.59 NA NA 13.61 14.19 09031040 ......... ............ 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 09031051 ......... ............ A Sphenoid sinus surgery ................................. 7.10 NA NA 7.68 8.10 0.62 NA NA 15.40 15.8209031070 ......... ............ A Exploration of frontal sinus ............................ 4.27 NA NA 5.68 5.87 0.38 NA NA 10.33 10.5209031075 ......... ............ A Exploration of frontal sinus ............................ 9.33 NA NA 8.49 9.42 0.75 NA NA 18.57 19.5009031080 ......... ............ A Removal of frontal sinus ............................... 12.46 NA NA 10.39 12.75 1.23 NA NA 24.08 26.44 09031081 ......... ............ A Removal of frontal sinus ............................... 13.91 NA NA 14.59 14.15 2.46 NA NA 30.96 30.52 09031084 ......... ............ A Removal of frontal sinus ............................... 14.67 NA NA 11.82 13.08 1.19 NA NA 27.68 28.94 09031085 ......... ............ A Removal of frontal sinus ............................... 15.36 NA NA 12.90 13.70 1.72 NA NA 29.98 30.78 09031086 ......... ............ A Removal of frontal sinus ............................... 14.08 NA NA 11.66 12.88 1.07 NA NA 26.81 28.03 09031087 ......... ............ A Removal of frontal sinus ............................... 14.32 NA NA 10.69 12.07 1.44 NA NA 26.45 27.83 09031090 ......... ............ A Exploration of sinuses ................................... 10.78 NA NA 12.26 12.48 0.94 NA NA 23.98 24.20 09031200 ......... ............ A Removal of ethmoid sinus ............................. 4.96 NA NA 7.42 8.76 0.29 NA NA 12.67 14.01 09031201 ......... ............ A Removal of ethmoid sinus ............................. 8.42 NA NA 8.22 8.93 0.82 NA NA 17.46 18.17 09031205 ......... ............ A Removal of ethmoid sinus ............................. 10.40 NA NA 9.52 11.29 0.67 NA NA 20.59 22.3609031225 ......... ............ A Removal of upper jaw ................................... 26.34 NA NA 16.28 17.44 1.59 NA NA 44.21 45.37 09031230 ......... ............ A Removal of upper jaw ................................... 30.46 NA NA 16.95 18.76 1.77 NA NA 49.18 50.99 09031231 ......... ............ A Nasal endoscopy, dx ..................................... 1.10 3.34 3.37 0.69 0.83 0.09 4.53 4.56 1.88 2.02 00031233 ......... ............ 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 00031235 ......... ............ 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 00031237 ......... ............ 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 00031238 ......... ............ 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 00031239 ......... ............ A Nasal/sinus endoscopy, surg ........................ 9.19 NA NA 6.27 7.57 0.62 NA NA 16.08 17.38 01031240 ......... ............ A Nasal/sinus endoscopy, surg ........................ 2.61 NA NA 1.12 1.58 0.24 NA NA 3.97 4.43 00031254 ......... ............ 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 00031256 ......... ............ A Exploration maxillary sinus ............................ 3.29 NA NA 1.31 1.91 0.33 NA NA 4.93 5.53 00031267 ......... ............ A Endoscopy, maxillary sinus ........................... 5.45 NA NA 1.92 2.95 0.55 NA NA 7.92 8.95 00031276 ......... ............ A Sinus endoscopy, surgical ............................ 8.84 NA NA 2.87 4.56 0.92 NA NA 12.63 14.32 00031287 ......... ............ A Nasal/sinus endoscopy, surg ........................ 3.91 NA NA 1.48 2.21 0.39 NA NA 5.78 6.51 00031288 ......... ............ A Nasal/sinus endoscopy, surg ........................ 4.57 NA NA 1.67 2.53 0.46 NA NA 6.70 7.56 00031290 ......... ............ A Nasal/sinus endoscopy, surg ........................ 18.46 NA NA 7.99 11.04 1.40 NA NA 27.85 30.90 01031291 ......... ............ A Nasal/sinus endoscopy, surg ........................ 19.41 NA NA 8.60 11.50 1.68 NA NA 29.69 32.59 01031292 ......... ............ 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 01031294 ......... ............ A Nasal/sinus endoscopy, surg ........................ 20.16 NA NA 8.72 11.83 1.53 NA NA 30.41 33.52 01031299 ......... ............ C Sinus surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY31300 ......... ............ A Removal of larynx lesion ............................... 15.63 NA NA 13.43 14.59 1.17 NA NA 30.23 31.39 09031320 ......... ............ A Diagnostic incision, larynx ............................. 5.55 NA NA 9.17 10.02 0.46 NA NA 15.18 16.03 09031360 ......... ............ A Removal of larynx ......................................... 27.23 NA NA 17.39 16.89 1.38 NA NA 46.0045.50 09031365 ......... ............ A Removal of larynx ......................................... 34.85 NA NA 19.55 20.16 1.97 NA NA 56.3756.98 09031367 ......... ............ A Partial removal of larynx ............................... 27.11 NA NA 19.32 21.25 1.78 NA NA 48.21 50.14 09031368 ......... ............ A Partial removal of larynx ............................... 33.73 NA NA 22.12 24.65 2.20 NA NA 58.05 60.58 09031370 ......... ............ A Partial removal of larynx ............................... 27.11 NA NA 20.11 21.72 1.74 NA NA 48.96 50.57 09031375 ......... ............ A Partial removal of larynx ............................... 25.61 NA NA 19.22 20.09 1.63 NA NA 46.46 47.33 09031380 ......... ............ A Partial removal of larynx ............................... 25.11 NA NA 18.90 20.18 1.70 NA NA 45.71 46.99 09031382 ......... ............ A Partial removal of larynx ............................... 28.11 NA NA 20.41 21.31 1.67 NA NA 50.19 51.09 09031390 ......... ............ A Removal of larynx & pharynx ........................ 38.72 NA NA 22.29 23.86 2.23 NA NA 63.24 64.81 09031395 ......... ............ A Reconstruct larynx & pharynx ....................... 43.34 NA NA 25.53 27.61 2.48 NA NA 71.35 73.43 09031400 ......... ............ A Revision of larynx .......................................... 11.40 NA NA 11.42 13.18 0.83 NA NA 23.65 25.41 09031420 ......... ............ A Removal of epiglottis ..................................... 11.25 NA NA 7.82 9.11 0.83 NA NA 19.90 21.19 09031500 ......... ............ A Insert emergency airway ............................... 2.33 NA NA 0.43 0.52 0.17 NA NA 2.93 3.02 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00142 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49123 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules31502 ......... ............ A Change of windpipe airway ........................... 0.65 NA NA 0.20 0.26 0.05 NA NA 0.90 0.96 00031505 ......... ............ A Diagnostic laryngoscopy ............................... 0.61 1.33 1.42 0.54 0.59 0.05 1.99 2.08 1.201.25 00031510 ......... ............ A Laryngoscopy with biopsy ............................. 1.92 2.98 3.22 0.91 1.17 0.16 5.06 5.30 2.99 3.25 00031511 ......... ............ 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 00031512 ......... ............ A Removal of larynx lesion ............................... 2.07 2.73 3.08 0.95 1.26 0.18 4.98 5.33 3.203.51 00031513 ......... ............ A Injection into vocal cord ................................ 2.10 NA NA 0.97 1.34 0.17 NA NA 3.24 3.6100031515 ......... ............ A Laryngoscopy for aspiration .......................... 1.80 3.06 3.42 0.83 1.00 0.14 5.00 5.36 2.77 2.94 00031520 ......... ............ A Dx laryngoscopy, newborn ............................ 2.56 NA NA 1.09 1.44 0.20 NA NA 3.85 4.20 00031525 ......... ............ A Dx laryngoscopy excl nb ............................... 2.63 3.22 3.54 1.10 1.52 0.21 6.06 6.38 3.944.36 00031526 ......... ............ A Dx laryngoscopy w/oper scope ..................... 2.57 NA NA 1.10 1.57 0.21 NA NA 3.88 4.35 00031527 ......... ............ A Laryngoscopy for treatment .......................... 3.27 NA NA 1.29 1.73 0.26 NA NA 4.82 5.26 00031528 ......... ............ A Laryngoscopy and dilation ............................ 2.37 NA NA 0.97 1.34 0.19 NA NA 3.53 3.90 00031529 ......... ............ A Laryngoscopy and dilation ............................ 2.68 NA NA 1.09 1.56 0.22 NA NA 3.99 4.46 00031530 ......... ............ A Laryngoscopy w/fb removal .......................... 3.38 NA NA 1.29 1.79 0.29 NA NA 4.96 5.46 00031531 ......... ............ A Laryngoscopy w/fb & op scope ..................... 3.58 NA NA 1.39 2.05 0.29 NA NA 5.26 5.92 00031535 ......... ............ 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 00031540 ......... ............ A Laryngoscopy w/exc of tumor ....................... 4.12 NA NA 1.54 2.29 0.33 NA NA 5.99 6.74 00031541 ......... ............ A Larynscop w/tumr exc + scope ..................... 4.52 NA NA 1.66 2.50 0.37 NA NA 6.55 7.39 00031545 ......... ............ A Remove vc lesion w/scope ........................... 6.30 NA NA 2.19 3.15 0.37 NA NA 8.86 9.82 00031546 ......... ............ A Remove vc lesion scope/graft ....................... 9.73 NA NA 3.71 4.66 0.78 NA NA 14.22 15.17 00031560 ......... ............ A Laryngoscop w/arytenoidectom ..................... 5.45 NA NA 1.87 2.83 0.43 NA NA 7.75 8.71 00031561 ......... ............ A Larynscop, remve cart + scop ...................... 5.99 NA NA 2.02 3.03 0.49 NA NA 8.50 9.51 00031570 ......... ............ 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 00031571 ......... ............ A Laryngoscop w/vc inj + scope ....................... 4.26 NA NA 1.58 2.35 0.35 NA NA 6.19 6.96 00031575 ......... ............ A Diagnostic laryngoscopy ............................... 1.10 1.56 1.82 0.69 0.84 0.09 2.75 3.01 1.882.03 00031576 ......... ............ A Laryngoscopy with biopsy ............................. 1.97 3.26 3.56 0.94 1.20 0.14 5.37 5.67 3.05 3.31 00031577 ......... ............ 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 00031578 ......... ............ A Removal of larynx lesion ............................... 2.84 3.66 4.13 1.18 1.44 0.23 6.73 7.20 4.254.51 00031579 ......... ............ A Diagnostic laryngoscopy ............................... 2.26 2.63 3.49 1.02 1.37 0.18 5.07 5.93 3.463.81 00031580 ......... ............ A Revision of larynx .......................................... 14.38 NA NA 13.35 15.27 1.00 NA NA 28.73 30.65 09031582 ......... ............ A Revision of larynx .......................................... 22.73 NA NA 20.27 24.42 1.75 NA NA 44.75 48.90 09031584 ......... ............ A Treat larynx fracture ...................................... 20.27 NA NA 14.11 17.14 1.71 NA NA 36.0939.12 09031587 ......... ............ A Revision of larynx .......................................... 15.06 NA NA 7.88 8.92 0.97 NA NA 23.9124.95 09031588 ......... ............ A Revision of larynx .......................................... 14.48 NA NA 11.28 13.03 1.06 NA NA 26.82 28.57 09031590 ......... ............ A Reinnervate larynx ........................................ 7.53 NA NA 11.98 14.64 0.84 NA NA 20.35 23.01 09031595 ......... ............ A Larynx nerve surgery .................................... 8.69 NA NA 8.86 10.13 0.68 NA NA 18.23 19.50 09031599 ......... ............ C Larynx surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY31600 ......... ............ A Incision of windpipe ....................................... 7.17 NA NA 2.19 2.94 0.80 NA NA 10.16 10.91 00031601 ......... ............ A Incision of windpipe ....................................... 4.44 NA NA 1.61 2.20 0.40 NA NA 6.45 7.04 00031603 ......... ............ A Incision of windpipe ....................................... 4.14 NA NA 1.11 1.56 0.44 NA NA 5.69 6.14 00031605 ......... ............ A Incision of windpipe ....................................... 3.57 NA NA 0.82 1.10 0.40 NA NA 4.79 5.07 00031610 ......... ............ A Incision of windpipe ....................................... 9.23 NA NA 7.12 7.98 0.79 NA NA 17.14 18.00 09031611 ......... ............ A Surgery/speech prosthesis ............................ 5.87 NA NA 6.44 6.91 0.46 NA NA 12.77 13.24 09031612 ......... ............ A Puncture/clear windpipe ................................ 0.91 1.07 1.09 0.24 0.32 0.08 2.06 2.08 1.231.31 00031613 ......... ............ A Repair windpipe opening ............................... 4.58 NA NA 5.79 5.94 0.42 NA NA 10.79 10.94 09031614 ......... ............ A Repair windpipe opening ............................... 8.39 NA NA 8.81 8.74 0.58 NA NA 17.78 17.71 09031615 ......... ............ A Visualization of windpipe ............................... 2.09 2.21 2.50 0.95 1.14 0.16 4.46 4.75 3.20 3.39 00031620 ......... ............ 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 ZZZ31622 ......... ............ A Dx bronchoscope/wash ................................. 2.78 5.26 5.55 0.90 1.02 0.18 8.22 8.51 3.86 3.98 00031623 ......... ............ A Dx bronchoscope/brush ................................ 2.88 6.03 6.32 0.90 1.01 0.13 9.04 9.33 3.91 4.02 00031624 ......... ............ A Dx bronchoscope/lavage ............................... 2.88 5.38 5.67 0.90 1.01 0.13 8.39 8.68 3.91 4.02 00031625 ......... ............ 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 00031628 ......... ............ 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 00031629 ......... ............ 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 00031630 ......... ............ 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 00031632 ......... ............ 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 ZZZ31633 ......... ............ A Bronchoscopy/needle bx addIl ...................... 1.32 0.99 0.94 0.31 0.38 0.16 2.47 2.42 1.79 1.86ZZZ31635 ......... ............ 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 00031636 ......... ............ A Bronchoscopy, bronch stents ........................ 4.30 NA NA 1.37 1.66 0.31 NA NA 5.98 6.27 00031637 ......... ............ A Bronchoscopy, stent add-on ......................... 1.58 NA NA 0.42 0.53 0.13 NA NA 2.13 2.24 ZZZ31638 ......... ............ A Bronchoscopy, revise stent ........................... 4.88 NA NA 1.55 1.87 0.22 NA NA 6.65 6.97 00031640 ......... ............ A Bronchoscopy w/tumor excise ...................... 4.93 NA NA 1.52 1.93 0.46 NA NA 6.91 7.32 00031641 ......... ............ A Bronchoscopy, treat blockage ....................... 5.02 NA NA 1.49 1.78 0.35 NA NA 6.86 7.15 00031643 ......... ............ A Diag bronchoscope/catheter ......................... 3.49 NA NA 1.05 1.19 0.20 NA NA 4.74 4.88 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00143 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49124 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal31645 ......... ............ A Bronchoscopy, clear airways ........................ 3.16 4.77 5.05 0.97 1.08 0.16 8.09 8.37 4.29 4.40 00031646 ......... ............ A Bronchoscopy, reclear airway ....................... 2.72 4.48 4.77 0.86 0.97 0.14 7.34 7.63 3.72 3.83 00031656 ......... ............ A Bronchoscopy, inj for x-ray ........................... 2.17 5.31 6.80 0.65 0.79 0.15 7.63 9.12 2.973.11 00031700 ......... ............ A Insertion of airway catheter ........................... 1.34 2.30 2.19 0.68 0.68 0.08 3.72 3.61 2.102.10 00031708 ......... ............ A Instill airway contrast dye .............................. 1.41 NA NA 0.40 0.45 0.07 NA NA 1.88 1.9300031710 ......... ............ A Insertion of airway catheter ........................... 1.30 NA NA 0.42 0.41 0.12 NA NA 1.84 1.83 00031715 ......... ............ A Injection for bronchus x-ray ........................... 1.11 NA NA 0.29 0.33 0.07 NA NA 1.47 1.51 00031717 ......... ............ A Bronchial brush biopsy .................................. 2.12 5.86 7.65 0.76 0.78 0.14 8.12 9.91 3.02 3.04 00031720 ......... ............ A Clearance of airways ..................................... 1.06 NA NA 0.25 0.31 0.07 NA NA 1.38 1.4400031725 ......... ............ A Clearance of airways ..................................... 1.96 NA NA 0.45 0.55 0.14 NA NA 2.55 2.6500031730 ......... ............ A Intro, windpipe wire/tube ............................... 2.85 25.67 8.06 0.72 0.93 0.21 28.73 11.123.78 3.99 00031750 ......... ............ A Repair of windpipe ........................................ 15.11 NA NA 16.11 17.19 1.05 NA NA 32.2733.35 09031755 ......... ............ A Repair of windpipe ........................................ 17.05 NA NA 22.15 23.93 1.29 NA NA 40.4942.27 09031760 ......... ............ A Repair of windpipe ........................................ 23.28 NA NA 9.76 10.47 2.94 NA NA 35.98 36.69 09031766 ......... ............ A Reconstruction of windpipe ........................... 31.52 NA NA 11.44 13.10 4.52 NA NA 47.48 49.1409031770 ......... ............ A Repair/graft of bronchus ................................ 23.44 NA NA 8.83 9.89 2.83 NA NA 35.10 36.16 09031775 ......... ............ A Reconstruct bronchus ................................... 24.46 NA NA 9.07 11.11 3.01 NA NA 36.54 38.58 09031780 ......... ............ A Reconstruct windpipe .................................... 19.62 NA NA 7.98 10.28 1.65 NA NA 29.25 31.55 09031781 ......... ............ A Reconstruct windpipe .................................... 24.72 NA NA 9.17 11.38 2.24 NA NA 36.13 38.34 09031785 ......... ............ A Remove windpipe lesion ............................... 18.25 NA NA 5.49 9.01 1.59 NA NA 25.33 28.85 09031786 ......... ............ A Remove windpipe lesion ............................... 25.29 NA NA 9.74 12.25 3.29 NA NA 38.32 40.8309031800 ......... ............ A Repair of windpipe injury ............................... 8.05 NA NA 8.35 9.02 0.79 NA NA 17.19 17.8609031805 ......... ............ A Repair of windpipe injury ............................... 13.29 NA NA 6.24 6.97 1.82 NA NA 21.35 22.08 09031820 ......... ............ 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 09031825 ......... ............ 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 09031830 ......... ............ A Revise windpipe scar .................................... 4.49 5.60 5.72 3.33 3.82 0.44 10.53 10.65 8.26 8.75 09031899 ......... ............ C Airways surgical procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY32000 ......... ............ A Drainage of chest .......................................... 1.54 2.39 2.89 0.43 0.47 0.08 4.01 4.512.05 2.09 00032002 ......... ............ 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 00032005 ......... ............ A Treat lung lining chemically ........................... 2.19 5.11 6.12 0.59 0.67 0.23 7.53 8.54 3.013.09 00032019 ......... ............ A Insert pleural catheter ................................... 4.17 15.54 18.86 1.45 1.60 0.42 20.13 23.45 6.04 6.19 00032020 ......... ............ A Insertion of chest tube ................................... 3.97 NA NA 1.14 1.30 0.43 NA NA 5.54 5.7000032035 ......... ............ A Exploration of chest ....................................... 11.14 NA NA 6.11 5.92 1.26 NA NA 18.50 18.32 09032036 ......... ............ A Exploration of chest ....................................... 12.15 NA NA 6.43 6.43 1.43 NA NA 20.01 20.01 09032095 ......... ............ A Biopsy through chest wall ............................. 10.03 NA NA 5.22 5.33 1.22 NA NA 16.47 16.5809032100 ......... ............ A Exploration/biopsy of chest ........................... 16.04 NA NA 7.09 7.64 2.23 NA NA 25.36 25.9109032110 ......... ............ A Explore/repair chest ...................................... 25.11 NA NA 10.03 10.56 3.21 NA NA 38.3538.88 09032120 ......... ............ A Re-exploration of chest ................................. 14.24 NA NA 6.91 7.03 1.63 NA NA 22.78 22.90 09032124 ......... ............ A Explore chest free adhesions ........................ 15.30 NA NA 7.09 7.18 1.89 NA NA 24.28 24.37 09032140 ......... ............ A Removal of lung lesion(s) ............................. 16.51 NA NA 7.48 7.63 1.96 NA NA 25.95 26.1009032141 ......... ............ A Remove/treat lung lesions ............................. 17.14 NA NA 7.69 7.59 2.00 NA NA 26.83 26.7309032150 ......... ............ A Removal of lung lesion(s) ............................. 16.67 NA NA 7.54 7.59 2.00 NA NA 26.21 26.2609032151 ......... ............ A Remove lung foreign body ............................ 16.79 NA NA 8.73 8.18 2.03 NA NA 27.55 27.00 09032160 ......... ............ 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 09032201 ......... ............ A Drain, percut, lung lesion .............................. 3.99 19.87 20.49 1.26 1.29 0.24 24.10 24.725.49 5.52 00032215 ......... ............ A Treat chest lining ........................................... 12.90 NA NA 6.43 6.78 1.68 NA NA 21.0121.36 09032220 ......... ............ A Release of lung ............................................. 26.31 NA NA 12.11 12.74 3.56 NA NA 41.98 42.61 09032225 ......... ............ A Partial release of lung ................................... 16.60 NA NA 7.54 7.62 2.06 NA NA 26.20 26.28 09032310 ......... ............ A Removal of chest lining ................................. 15.13 NA NA 6.98 7.29 1.99 NA NA 24.10 24.41 09032320 ......... ............ A Free/remove chest lining ............................... 26.96 NA NA 11.63 12.02 3.51 NA NA 42.10 42.49 09032400 ......... ............ A Needle biopsy chest lining ............................ 1.76 2.12 2.12 0.52 0.54 0.10 3.98 3.98 2.382.40 00032402 ......... ............ A Open biopsy chest lining ............................... 8.86 NA NA 4.81 5.04 1.07 NA NA 14.74 14.9709032405 ......... ............ 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 00032420 ......... ............ A Puncture/clear lung ....................................... 2.18 NA NA 0.68 0.68 0.12 NA NA 2.98 2.9800032440 ......... ............ A Removal of lung ............................................ 27.11 NA NA 11.11 12.45 3.68 NA NA 41.9043.24 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00144 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49125 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules32442 ......... ............ A Sleeve pneumonectomy ................................ 37.74 NA NA 13.28 14.39 3.84 NA NA 54.86 55.9709032445 ......... ............ A Removal of lung ............................................ 40.73 NA NA 16.31 14.62 3.71 NA NA 60.7559.06 09032480 ......... ............ A Partial removal of lung .................................. 25.65 NA NA 10.37 11.64 3.49 NA NA 39.51 40.78 09032482 ......... ............ A Bilobectomy ................................................... 27.22 NA NA 11.22 12.49 3.66 NA NA 42.10 43.37 09032484 ......... ............ A Segmentectomy ............................................ 22.67 NA NA 8.92 10.77 3.03 NA NA 34.62 36.47 09032486 ......... ............ A Sleeve lobectomy .......................................... 31.72 NA NA 11.89 12.90 3.51 NA NA 47.1248.13 09032488 ......... ............ 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 09032500 ......... ............ A Partial removal of lung .................................. 24.42 NA NA 10.43 11.87 3.25 NA NA 38.10 39.54 09032501 ......... ............ 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 09032504 ......... ............ A Resect apical lung tum/chest ........................ 36.35 NA NA 13.73 15.94 5.07 NA NA 55.15 57.3609032540 ......... ............ A Removal of lung lesion .................................. 23.68 NA NA 10.25 9.79 2.07 NA NA 36.00 35.54 09032601 ......... ............ 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 00032604 ......... ............ A Thoracoscopy, diagnostic .............................. 8.77 NA NA 3.08 3.36 1.25 NA NA 13.10 13.38 00032605 ......... ............ A Thoracoscopy, diagnostic .............................. 6.92 NA NA 2.56 2.82 1.00 NA NA 10.48 10.74 00032606 ......... ............ A Thoracoscopy, diagnostic .............................. 8.39 NA NA 3.02 3.25 1.22 NA NA 12.63 12.86 00032650 ......... ............ A Thoracoscopy, surgical ................................. 10.73 NA NA 5.32 6.40 1.58 NA NA 17.63 18.7109032651 ......... ............ A Thoracoscopy, surgical ................................. 16.28 NA NA 7.09 7.20 1.86 NA NA 25.23 25.3409032652 ......... ............ A Thoracoscopy, surgical ................................. 23.34 NA NA 9.65 10.02 2.72 NA NA 35.71 36.08 09032653 ......... ............ A Thoracoscopy, surgical ................................. 19.86 NA NA 8.01 7.23 1.88 NA NA 29.75 28.9709032654 ......... ............ A Thoracoscopy, surgical ................................. 18.49 NA NA 7.47 7.52 1.63 NA NA 27.59 27.6409032655 ......... ............ A Thoracoscopy, surgical ................................. 14.95 NA NA 6.74 7.12 1.89 NA NA 23.58 23.9609032656 ......... ............ A Thoracoscopy, surgical ................................. 13.14 NA NA 6.04 7.47 1.89 NA NA 21.07 22.5009032657 ......... ............ A Thoracoscopy, surgical ................................. 14.54 NA NA 6.47 7.38 1.99 NA NA 23.00 23.9109032658 ......... ............ A Thoracoscopy, surgical ................................. 11.61 NA NA 5.64 6.92 1.69 NA NA 18.94 20.2209032659 ......... ............ A Thoracoscopy, surgical ................................. 11.82 NA NA 5.95 7.08 1.62 NA NA 19.39 20.5209032660 ......... ............ A Thoracoscopy, surgical ................................. 17.65 NA NA 7.52 8.99 2.08 NA NA 27.25 28.7209032661 ......... ............ A Thoracoscopy, surgical ................................. 13.23 NA NA 6.22 7.40 1.92 NA NA 21.37 22.5509032662 ......... ............ A Thoracoscopy, surgical ................................. 17.00 NA NA 7.23 8.42 2.17 NA NA 26.40 27.5909032663 ......... ............ A Thoracoscopy, surgical ................................. 19.96 NA NA 8.91 10.30 2.72 NA NA 31.59 32.98 09032664 ......... ............ A Thoracoscopy, surgical ................................. 14.18 NA NA 6.42 7.33 2.32 NA NA 22.92 23.8309032665 ......... ............ A Thoracoscopy, surgical ................................. 17.37 NA NA 7.66 8.01 2.15 NA NA 27.18 27.5309032800 ......... ............ A Repair lung hernia ......................................... 15.56 NA NA 7.13 7.34 1.98 NA NA 24.67 24.88 09032810 ......... ............ A Close chest after drainage ............................ 14.80 NA NA 7.12 7.42 1.93 NA NA 23.85 24.1509032815 ......... ............ A Close bronchial fistula ................................... 37.94 NA NA 15.43 12.09 3.27 NA NA 56.6453.30 09032820 ......... ............ A Reconstruct injured chest .............................. 22.27 NA NA 11.75 12.06 2.52 NA NA 36.54 36.85 09032851 ......... ............ A Lung transplant, single .................................. 40.72 NA NA 20.99 25.99 5.56 NA NA 67.27 72.27 09032852 ......... ............ A Lung transplant with bypass ......................... 44.37 NA NA 23.82 30.83 6.00 NA NA 74.19 81.2009032853 ......... ............ A Lung transplant, double ................................. 49.89 NA NA 23.39 29.66 7.05 NA NA 80.33 86.60 09032854 ......... ............ A Lung transplant with bypass ......................... 53.60 NA NA 26.62 32.70 7.20 NA NA 87.42 93.5009032855 ......... ............ C Prepare donor lung, single ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX32856 ......... ............ 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 XXX32900 ......... ............ A Removal of rib(s) ........................................... 23.66 NA NA 9.81 9.86 2.93 NA NA 36.4036.45 09032905 ......... ............ A Revise & repair chest wall ............................ 23.14 NA NA 9.64 10.01 3.15 NA NA 35.93 36.3009032906 ......... ............ A Revise & repair chest wall ............................ 29.15 NA NA 11.34 11.88 3.97 NA NA 44.46 45.00 09032940 ......... ............ A Revision of lung ............................................. 21.19 NA NA 8.66 9.27 2.88 NA NA 32.7333.34 09032960 ......... ............ A Therapeutic pneumothorax ........................... 1.84 1.59 1.70 0.67 0.59 0.16 3.59 3.70 2.67 2.59 00032997 ......... ............ A Total lung lavage ........................................... 5.99 NA NA 1.51 1.81 0.55 NA NA 8.05 8.35 00032999 ......... ............ C Chest surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY33010 ......... ............ A Drainage of heart sac .................................... 2.24 NA NA 1.02 0.84 0.14 NA NA 3.40 3.2200033011 ......... ............ A Repeat drainage of heart sac ....................... 2.24 NA NA 1.10 0.88 0.15 NA NA 3.49 3.27 00033015 ......... ............ A Incision of heart sac ...................................... 8.41 NA NA 5.08 4.98 0.65 NA NA 14.14 14.04 09033020 ......... ............ A Incision of heart sac ...................................... 14.85 NA NA 6.54 6.72 1.79 NA NA 23.18 23.36 09033025 ......... ............ A Incision of heart sac ...................................... 13.63 NA NA 5.98 6.26 1.80 NA NA 21.41 21.69 09033030 ......... ............ A Partial removal of heart sac .......................... 22.24 NA NA 9.26 9.46 2.83 NA NA 34.33 34.5309033031 ......... ............ A Partial removal of heart sac .......................... 25.28 NA NA 9.96 10.01 3.13 NA NA 38.37 38.4209033050 ......... ............ A Removal of heart sac lesion ......................... 16.82 NA NA 7.63 7.79 2.14 NA NA 26.59 26.75 09033120 ......... ............ A Removal of heart lesion ................................ 27.30 NA NA 10.79 11.38 3.69 NA NA 41.78 42.37 09033130 ......... ............ A Removal of heart lesion ................................ 24.02 NA NA 9.48 9.95 3.00 NA NA 36.50 36.9709033140 ......... ............ A Heart revascularize (tmr) ............................... 22.72 NA NA 10.09 10.68 2.85 NA NA 35.66 36.25 09033141 ......... ............ A Heart tmr w/other procedure ......................... 4.83 NA NA 1.52 1.57 0.69 NA NA 7.04 7.09 ZZZ33200 ......... ............ A Insertion of heart pacemaker ........................ 14.70 NA NA 7.45 6.99 1.70 NA NA 23.85 23.39 09033201 ......... ............ A Insertion of heart pacemaker ........................ 12.08 NA NA 6.40 6.54 1.36 NA NA 19.84 19.98 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00145 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49126 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal33206 ......... ............ 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 00033211 ......... ............ A Insertion of heart electrode ........................... 3.39 NA NA 1.67 1.40 0.21 NA NA 5.27 5.00 00033212 ......... ............ 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 09033214 ......... ............ A Upgrade of pacemaker system ..................... 7.74 NA NA 5.38 5.01 0.58 NA NA 13.70 13.33 09033215 ......... ............ A Reposition pacing-defib lead ......................... 4.87 NA NA 3.52 3.27 0.37 NA NA 8.76 8.51 09033216 ......... ............ A Insert lead pace-defib, one ........................... 5.77 NA NA 4.58 4.30 0.36 NA NA 10.71 10.43 09033217 ......... ............ A Insert lead pace-defib, dual ........................... 5.74 NA NA 4.50 4.30 0.39 NA NA 10.63 10.4309033218 ......... ............ A Repair lead pace-defib, one .......................... 5.93 NA NA 4.83 4.43 0.37 NA NA 11.13 10.73 09033220 ......... ............ A Repair lead pace-defib, dual ......................... 6.01 NA NA 4.89 4.43 0.37 NA NA 11.27 10.81 09033222 ......... ............ A Revise pocket, pacemaker ............................ 4.95 NA NA 4.33 4.30 0.42 NA NA 9.70 9.67 09033223 ......... ............ A Revise pocket, pacing-defib .......................... 6.45 NA NA 4.97 4.69 0.45 NA NA 11.87 11.59 09033224 ......... ............ 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 ZZZ33226 ......... ............ A Reposition l ventric lead ................................ 8.68 NA NA 4.87 4.08 0.59 NA NA 14.14 13.35 00033233 ......... ............ A Removal of pacemaker system ..................... 3.29 NA NA 3.29 3.28 0.22 NA NA 6.80 6.79 09033234 ......... ............ A Removal of pacemaker system ..................... 7.81 NA NA 5.52 5.06 0.56 NA NA 13.89 13.43 09033235 ......... ............ A Removal pacemaker electrode ..................... 9.85 NA NA 7.32 6.94 0.73 NA NA 17.90 17.52 09033236 ......... ............ A Remove electrode/thoracotomy .................... 12.58 NA NA 6.70 7.25 1.68 NA NA 20.96 21.51 09033237 ......... ............ A Remove electrode/thoracotomy .................... 13.69 NA NA 7.68 7.76 1.59 NA NA 22.96 23.04 09033238 ......... ............ A Remove electrode/thoracotomy .................... 15.20 NA NA 8.35 8.24 2.02 NA NA 25.57 25.46 09033240 ......... ............ A Insert pulse generator ................................... 7.59 NA NA 5.34 4.77 0.41 NA NA 13.34 12.77 09033241 ......... ............ A Remove pulse generator ............................... 3.24 NA NA 3.04 2.98 0.18 NA NA 6.46 6.40 09033243 ......... ............ A Remove eltrd/thoracotomy ............................ 23.36 NA NA 11.00 11.35 2.09 NA NA 36.45 36.8009033244 ......... ............ A Remove eltrd, transven ................................. 13.74 NA NA 9.53 9.05 0.99 NA NA 24.26 23.7809033245 ......... ............ A Insert epic eltrd pace-defib ............................ 16.82 NA NA 7.96 7.92 2.01 NA NA 26.79 26.75 09033246 ......... ............ A Insert epic eltrd/generator ............................. 23.11 NA NA 10.73 10.39 2.63 NA NA 36.47 36.13 09033249 ......... ............ A Eltrd/insert pace-defib ................................... 14.96 NA NA 10.33 8.85 0.77 NA NA 26.06 24.58 09033250 ......... ............ A Ablate heart dysrhythm focus ....................... 25.75 NA NA 10.16 10.81 3.18 NA NA 39.09 39.74 09033251 ......... ............ A Ablate heart dysrhythm focus ....................... 28.77 NA NA 11.15 11.53 3.59 NA NA 43.51 43.89 09033253 ......... ............ A Reconstruct atria ........................................... 31.33 NA NA 12.15 13.40 4.52 NA NA 48.00 49.25 09033261 ......... ............ A Ablate heart dysrhythm focus ....................... 28.77 NA NA 11.33 11.66 3.45 NA NA 43.55 43.88 09033282 ......... ............ 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 09033300 ......... ............ A Repair of heart wound ................................... 29.93 NA NA 11.14 9.71 2.65 NA NA 43.72 42.29 09033305 ......... ............ A Repair of heart wound ................................... 33.67 NA NA 12.24 11.02 3.12 NA NA 49.03 47.81 09033310 ......... ............ A Exploratory heart surgery .............................. 20.19 NA NA 8.83 9.39 2.58 NA NA 31.60 32.1609033315 ......... ............ A Exploratory heart surgery .............................. 26.02 NA NA 10.46 10.78 3.27 NA NA 39.75 40.07 09033320 ......... ............ A Repair major blood vessel(s) ........................ 18.43 NA NA 8.69 8.34 2.07 NA NA 29.19 28.84 09033321 ......... ............ A Repair major vessel ...................................... 20.67 NA NA 10.28 9.91 2.90 NA NA 33.85 33.48 09033322 ......... ............ A Repair major blood vessel(s) ........................ 24.27 NA NA 9.83 10.23 2.85 NA NA 36.95 37.35 09033330 ......... ............ A Insert major vessel graft ................................ 25.14 NA NA 9.80 10.15 2.81 NA NA 37.75 38.10 09033332 ......... ............ A Insert major vessel graft ................................ 24.42 NA NA 9.65 10.30 3.02 NA NA 37.09 37.74 09033335 ......... ............ A Insert major vessel graft ................................ 33.76 NA NA 12.97 13.24 4.27 NA NA 51.00 51.27 09033400 ......... ............ A Repair of aortic valve .................................... 39.23 NA NA 14.57 15.39 4.10 NA NA 57.9058.72 09033401 ......... ............ A Valvuloplasty, open ....................................... 24.33 NA NA 9.83 12.58 3.56 NA NA 37.72 40.47 09033403 ......... ............ A Valvuloplasty, w/cp bypass ........................... 25.31 NA NA 10.53 13.36 3.54 NA NA 39.38 42.2109033404 ......... ............ A Prepare heart-aorta conduit .......................... 31.22 NA NA 12.26 13.97 4.32 NA NA 47.80 49.5109033405 ......... ............ A Replacement of aortic valve .......................... 39.97 NA NA 15.12 17.50 5.31 NA NA 60.40 62.7809033406 ......... ............ A Replacement of aortic valve .......................... 48.87 NA NA 17.72 18.77 5.43 NA NA 72.02 73.0709033410 ......... ............ A Replacement of aortic valve .......................... 38.69 NA NA 14.63 16.09 4.68 NA NA 58.00 59.4609033411 ......... ............ A Replacement of aortic valve .......................... 57.11 NA NA 20.12 19.09 5.46 NA NA 82.69 81.6609033412 ......... ............ A Replacement of aortic valve .......................... 43.71 NA NA 16.57 19.44 6.37 NA NA 66.65 69.52090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00146 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49127 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules33413 ......... ............ A Replacement of aortic valve .......................... 55.27 NA NA 19.33 20.44 6.51 NA NA 81.11 82.2209033414 ......... ............ A Repair of aortic valve .................................... 39.27 NA NA 15.20 14.40 4.56 NA NA 59.0358.23 09033415 ......... ............ A Revision, subvalvular tissue .......................... 29.70 NA NA 11.14 11.80 4.13 NA NA 44.97 45.63 09033416 ......... ............ A Revise ventricle muscle ................................ 36.39 NA NA 13.63 13.53 4.56 NA NA 54.58 54.48 09033417 ......... ............ A Repair of aortic valve .................................... 29.13 NA NA 12.14 13.24 4.09 NA NA 45.3646.46 09033420 ......... ............ A Revision of mitral valve ................................. 25.64 NA NA 8.85 9.38 1.81 NA NA 36.30 36.83 09033422 ......... ............ A Revision of mitral valve ................................. 29.58 NA NA 12.50 13.36 3.93 NA NA 46.01 46.87 09033425 ......... ............ A Repair of mitral valve .................................... 38.37 NA NA 14.50 13.41 4.06 NA NA 56.9355.84 09033426 ......... ............ A Repair of mitral valve .................................... 41.28 NA NA 15.51 16.73 5.01 NA NA 61.8063.02 09033427 ......... ............ A Repair of mitral valve .................................... 42.78 NA NA 16.33 18.60 6.07 NA NA 65.1867.45 09033430 ......... ............ A Replacement of mitral valve .......................... 49.81 NA NA 18.75 17.66 5.08 NA NA 73.64 72.5509033460 ......... ............ A Revision of tricuspid valve ............................ 27.97 NA NA 10.98 11.22 3.44 NA NA 42.39 42.63 09033463 ......... ............ A Valvuloplasty, tricuspid .................................. 42.57 NA NA 15.50 13.56 3.86 NA NA 61.9359.99 09033464 ......... ............ A Valvuloplasty, tricuspid .................................. 30.93 NA NA 12.13 13.17 4.14 NA NA 47.2048.24 09033465 ......... ............ A Replace tricuspid valve ................................. 33.58 NA NA 12.60 12.87 4.38 NA NA 50.56 50.83 09033468 ......... ............ A Revision of tricuspid valve ............................ 32.79 NA NA 15.30 14.06 4.06 NA NA 52.15 50.91 09033470 ......... ............ A Revision of pulmonary valve ......................... 21.24 NA NA 8.74 10.20 1.03 NA NA 31.01 32.47 09033471 ......... ............ 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 09033474 ......... ............ A Revision of pulmonary valve ......................... 25.85 NA NA 12.10 11.19 3.21 NA NA 41.16 40.2509033475 ......... ............ 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 40.7009033478 ......... ............ A Revision of heart chamber ............................ 27.34 NA NA 11.04 12.55 3.88 NA NA 42.26 43.7709033496 ......... ............ A Repair, prosth valve clot ............................... 29.67 NA NA 11.51 12.43 4.12 NA NA 45.30 46.22 09033500 ......... ............ A Repair heart vessel fistula ............................. 27.79 NA NA 11.08 11.37 3.86 NA NA 42.73 43.02 09033501 ......... ............ A Repair heart vessel fistula ............................. 19.39 NA NA 8.25 8.27 1.90 NA NA 29.54 29.56 09033502 ......... ............ A Coronary artery correction ............................ 21.65 NA NA 9.32 10.63 2.99 NA NA 33.96 35.2709033503 ......... ............ A Coronary artery graft ..................................... 22.21 NA NA 10.61 9.95 1.77 NA NA 34.59 33.93 09033504 ......... ............ A Coronary artery graft ..................................... 25.26 NA NA 10.18 11.40 3.35 NA NA 38.7940.01 09033505 ......... ............ A Repair artery w/tunnel ................................... 38.33 NA NA 12.33 12.76 2.18 NA NA 52.84 53.27 09033506 ......... ............ A Repair artery, translocation ........................... 37.78 NA NA 15.51 14.80 4.65 NA NA 57.94 57.23 09033507 ......... ............ A Repair art, intramural .................................... 31.33 NA NA 11.78 13.18 4.05 NA NA 47.1648.56 09033508 ......... ............ 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 50.6653.30 09033511 ......... ............ A CABG, vein, two ............................................ 34.59 NA NA 13.37 16.15 4.55 NA NA 52.5155.29 09033512 ......... ............ A CABG, vein, three ......................................... 38.73 NA NA 14.72 16.88 4.66 NA NA 58.1160.27 09033513 ......... ............ A CABG, vein, four ........................................... 39.69 NA NA 15.13 17.12 4.87 NA NA 59.6961.68 09033514 ......... ............ A CABG, vein, five ............................................ 40.50 NA NA 15.38 17.38 4.76 NA NA 60.64 62.64 09033516 ......... ............ A Cabg, vein, six or more ................................. 41.96 NA NA 16.16 18.14 5.11 NA NA 63.23 65.21 09033517 ......... ............ A CABG, artery-vein, single .............................. 2.57 NA NA 0.79 0.83 0.39 NA NA 3.75 3.79 ZZZ33518 ......... ............ A CABG, artery-vein, two ................................. 4.84 NA NA 1.48 1.56 0.73 NA NA 7.05 7.13 ZZZ33519 ......... ............ A CABG, artery-vein, three ............................... 7.11 NA NA 2.18 2.29 1.04 NA NA 10.33 10.44ZZZ33521 ......... ............ A CABG, artery-vein, four ................................. 9.39 NA NA 2.89 3.03 1.37 NA NA 13.65 13.79ZZZ33522 ......... ............ A CABG, artery-vein, five ................................. 11.65 NA NA 3.56 3.75 1.77 NA NA 16.98 17.17 ZZZ33523 ......... ............ A Cabg, art-vein, six or more ........................... 13.93 NA NA 4.29 4.47 2.12 NA NA 20.34 20.52ZZZ33530 ......... ............ A Coronary artery, bypass/reop ........................ 5.85 NA NA 1.79 1.88 0.88 NA NA 8.52 8.61 ZZZ33533 ......... ............ A CABG, arterial, single .................................... 37.38 NA NA 14.00 15.85 4.55 NA NA 55.9357.78 09033534 ......... ............ A CABG, arterial, two ....................................... 38.81 NA NA 14.74 16.97 4.69 NA NA 58.2460.47 09033535 ......... ............ A CABG, arterial, three ..................................... 41.48 NA NA 15.68 17.52 5.01 NA NA 62.1764.01 09033536 ......... ............ A Cabg, arterial, four or more ........................... 40.79 NA NA 15.30 17.54 5.42 NA NA 61.51 63.75 09033542 ......... ............ A Removal of heart lesion ................................ 32.65 NA NA 12.64 12.90 4.37 NA NA 49.66 49.92 09033545 ......... ............ A Repair of heart damage ................................ 41.12 NA NA 15.46 15.58 5.19 NA NA 61.77 61.89 09033548 ......... ............ A Restore/remodel, ventricle ............................ 42.46 NA NA 16.52 18.60 5.51 NA NA 64.49 66.57 09033572 ......... ............ A Open coronary endarterectomy .................... 4.44 NA NA 1.34 1.42 0.65 NA NA 6.43 6.51 ZZZ33600 ......... ............ A Closure of valve ............................................ 30.11 NA NA 12.44 12.49 4.41 NA NA 46.96 47.01 09033602 ......... ............ A Closure of valve ............................................ 29.14 NA NA 13.30 12.66 3.81 NA NA 46.25 45.61 09033606 ......... ............ A Anastomosis/artery-aorta .............................. 31.33 NA NA 12.17 13.30 4.40 NA NA 47.90 49.03 09033608 ......... ............ A Repair anomaly w/conduit ............................. 31.68 NA NA 13.41 13.93 4.73 NA NA 49.82 50.3409033610 ......... ............ A Repair by enlargement .................................. 31.20 NA NA 11.20 13.00 4.55 NA NA 46.95 48.75 09033611 ......... ............ A Repair double ventricle ................................. 35.47 NA NA 12.37 13.69 4.36 NA NA 52.20 53.52 09033612 ......... ............ A Repair double ventricle ................................. 36.47 NA NA 12.97 14.61 5.28 NA NA 54.72 56.36 09033615 ......... ............ A Repair, modified fontan ................................. 35.72 NA NA 12.49 12.98 4.31 NA NA 52.52 53.01 09033617 ......... ............ A Repair single ventricle ................................... 38.92 NA NA 16.37 16.09 5.64 NA NA 60.9360.65 09033619 ......... ............ A Repair single ventricle ................................... 48.56 NA NA 18.36 20.19 6.44 NA NA 73.3675.19 09033641 ......... ............ A Repair heart septum defect ........................... 28.47 NA NA 10.73 9.86 3.22 NA NA 42.42 41.5509033645 ......... ............ A Revision of heart veins .................................. 27.95 NA NA 11.02 11.58 3.78 NA NA 42.75 43.31 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00147 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49128 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal33647 ......... ............ A Repair heart septum defects ......................... 29.33 NA NA 12.34 13.41 3.31 NA NA 44.98 46.0509033660 ......... ............ A Repair of heart defects .................................. 31.73 NA NA 11.49 12.98 4.48 NA NA 47.70 49.19 09033665 ......... ............ A Repair of heart defects .................................. 34.75 NA NA 12.45 13.49 3.99 NA NA 51.19 52.23 09033670 ......... ............ A Repair of heart chambers ............................. 36.56 NA NA 12.28 12.95 4.64 NA NA 53.48 54.1509033681 ......... ............ A Repair heart septum defect ........................... 32.10 NA NA 13.28 14.33 4.44 NA NA 49.82 50.8709033684 ......... ............ A Repair heart septum defect ........................... 34.27 NA NA 19.40 15.07 3.38 NA NA 57.05 52.7209033688 ......... ............ A Repair heart septum defect ........................... 34.65 NA NA 9.50 10.23 4.72 NA NA 48.87 49.6009033690 ......... ............ A Reinforce pulmonary artery ........................... 20.16 NA NA 8.63 9.78 1.96 NA NA 30.75 31.90 09033692 ......... ............ A Repair of heart defects .................................. 31.34 NA NA 9.29 12.76 4.57 NA NA 45.20 48.67 09033694 ......... ............ A Repair of heart defects .................................. 35.47 NA NA 10.16 13.21 5.26 NA NA 50.89 53.94 09033697 ......... ............ A Repair of heart defects .................................. 37.47 NA NA 21.66 16.57 4.08 NA NA 63.21 58.12 09033702 ......... ............ A Repair of heart defects .................................. 27.07 NA NA 11.48 12.29 3.67 NA NA 42.22 43.03 09033710 ......... ............ A Repair of heart defects .................................. 30.24 NA NA 11.69 13.39 4.42 NA NA 46.35 48.05 09033720 ......... ............ A Repair of heart defect ................................... 27.09 NA NA 11.17 12.00 3.83 NA NA 42.09 42.92 09033722 ......... ............ A Repair of heart defect ................................... 29.01 NA NA 8.75 12.58 1.30 NA NA 39.06 42.89 09033730 ......... ............ A Repair heart-vein defect(s) ............................ 35.97 NA NA 13.35 13.93 5.01 NA NA 54.33 54.91 09033732 ......... ............ A Repair heart-vein defect ................................ 28.76 NA NA 14.75 13.72 3.67 NA NA 47.18 46.15 09033735 ......... ............ A Revision of heart chamber ............................ 22.00 NA NA 9.50 9.09 1.91 NA NA 33.41 33.00 09033736 ......... ............ A Revision of heart chamber ............................ 24.12 NA NA 10.80 11.59 3.08 NA NA 38.00 38.7909033737 ......... ............ A Revision of heart chamber ............................ 22.30 NA NA 7.62 10.10 3.24 NA NA 33.16 35.6409033750 ......... ............ A Major vessel shunt ........................................ 22.02 NA NA 11.30 10.48 1.16 NA NA 34.4833.66 09033755 ......... ............ A Major vessel shunt ........................................ 22.40 NA NA 7.87 8.57 3.25 NA NA 33.52 34.22 09033762 ......... ............ A Major vessel shunt ........................................ 22.40 NA NA 7.21 9.42 3.13 NA NA 32.74 34.95 09033764 ......... ............ A Major vessel shunt & graft ............................ 22.40 NA NA 9.29 9.99 3.00 NA NA 34.69 35.3909033766 ......... ............ A Major vessel shunt ........................................ 23.37 NA NA 8.58 10.90 3.69 NA NA 35.64 37.96 09033767 ......... ............ A Major vessel shunt ........................................ 25.10 NA NA 9.47 11.16 3.81 NA NA 38.38 40.07 09033768 ......... ............ A Cavopulmonary shunting ............................... 8.00 NA NA 2.22 2.55 1.19 NA NA 11.41 11.74 ZZZ33770 ......... ............ A Repair great vessels defect .......................... 39.00 NA NA 10.67 13.68 5.72 NA NA 55.39 58.4009033771 ......... ............ A Repair great vessels defect .......................... 40.56 NA NA 10.65 11.95 5.66 NA NA 56.87 58.1709033774 ......... ............ A Repair great vessels defect .......................... 31.48 NA NA 12.45 14.11 4.80 NA NA 48.73 50.3909033775 ......... ............ A Repair great vessels defect .......................... 32.79 NA NA 10.21 13.80 4.98 NA NA 47.98 51.5709033776 ......... ............ A Repair great vessels defect .......................... 34.45 NA NA 13.39 15.20 5.07 NA NA 52.91 54.7209033777 ......... ............ A Repair great vessels defect .......................... 33.87 NA NA 10.02 14.21 5.47 NA NA 49.36 53.5509033778 ......... ............ A Repair great vessels defect .......................... 42.58 NA NA 15.26 16.48 6.18 NA NA 64.02 65.2409033779 ......... ............ A Repair great vessels defect .......................... 43.13 NA NA 11.48 14.40 2.91 NA NA 57.52 60.4409033780 ......... ............ A Repair great vessels defect .......................... 43.83 NA NA 11.79 17.26 3.67 NA NA 59.29 64.7609033781 ......... ............ A Repair great vessels defect .......................... 43.14 NA NA 14.18 13.54 5.95 NA NA 63.27 62.6309033786 ......... ............ A Repair arterial trunk ....................................... 41.70 NA NA 11.53 15.42 5.69 NA NA 58.92 62.81 09033788 ......... ............ A Revision of pulmonary artery ........................ 27.22 NA NA 9.69 11.39 4.02 NA NA 40.93 42.63 09033800 ......... ............ A Aortic suspension .......................................... 17.21 NA NA 7.32 7.91 2.45 NA NA 26.98 27.57 09033802 ......... ............ A Repair vessel defect ...................................... 18.20 NA NA 7.50 8.79 2.26 NA NA 27.96 29.25 09033803 ......... ............ A Repair vessel defect ...................................... 20.14 NA NA 7.95 9.31 3.19 NA NA 31.28 32.64 09033813 ......... ............ A Repair septal defect ...................................... 21.19 NA NA 9.00 10.43 3.12 NA NA 33.31 34.74 09033814 ......... ............ A Repair septal defect ...................................... 26.37 NA NA 10.48 12.10 3.84 NA NA 40.6942.31 09033820 ......... ............ A Revise major vessel ...................................... 16.59 NA NA 8.39 8.37 2.34 NA NA 27.32 27.30 09033822 ......... ............ A Revise major vessel ...................................... 17.61 NA NA 6.00 8.21 2.67 NA NA 26.28 28.49 09033824 ......... ............ A Revise major vessel ...................................... 20.06 NA NA 8.62 9.64 2.88 NA NA 31.56 32.58 09033840 ......... ............ A Remove aorta constriction ............................ 21.17 NA NA 8.99 9.97 2.15 NA NA 32.31 33.29 09033845 ......... ............ A Remove aorta constriction ............................ 22.73 NA NA 9.64 10.92 3.21 NA NA 35.58 36.8609033851 ......... ............ A Remove aorta constriction ............................ 21.81 NA NA 9.17 10.30 3.17 NA NA 34.15 35.2809033852 ......... ............ A Repair septal defect ...................................... 24.24 NA NA 9.90 11.00 2.15 NA NA 36.29 37.39 09033853 ......... ............ A Repair septal defect ...................................... 32.31 NA NA 13.03 14.37 4.47 NA NA 49.8151.15 09033860 ......... ............ A Ascending aortic graft ................................... 43.13 NA NA 15.73 16.27 5.74 NA NA 64.60 65.14 09033861 ......... ............ A Ascending aortic graft ................................... 43.88 NA NA 16.12 17.31 6.35 NA NA 66.35 67.54 09033863 ......... ............ A Ascending aortic graft ................................... 48.52 NA NA 17.69 18.44 6.57 NA NA 72.78 73.53 09033870 ......... ............ A Transverse aortic arch graft .......................... 45.87 NA NA 16.67 17.95 6.60 NA NA 69.14 70.42 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00148 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49129 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules33875 ......... ............ A Thoracic aortic graft ...................................... 35.64 NA NA 13.16 13.86 4.88 NA NA 53.6854.38 09033877 ......... ............ A Thoracoabdominal graft ................................ 57.75 NA NA 18.83 16.94 5.92 NA NA 82.50 80.61 09033880 ......... ............ A Endovasc taa repr incl subcl ......................... 34.44 NA NA 10.59 12.75 2.74 NA NA 47.77 49.9309033881 ......... ............ A Endovasc taa repr w/o subcl ......................... 29.44 NA NA 9.35 11.31 2.32 NA NA 41.11 43.07 09033883 ......... ............ A Insert endovasc prosth, taa ........................... 20.95 NA NA 7.01 8.64 2.10 NA NA 30.06 31.6909033884 ......... ............ A Endovasc prosth, taa, add-on ....................... 8.20 NA NA 2.01 2.43 0.86 NA NA 11.07 11.49 ZZZ33886 ......... ............ A Endovasc prosth, delayed ............................. 17.95 NA NA 6.25 7.74 1.79 NA NA 25.99 27.48 09033889 ......... ............ 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 00033910 ......... ............ A Remove lung artery emboli ........................... 29.56 NA NA 11.34 11.41 3.69 NA NA 44.59 44.6609033915 ......... ............ A Remove lung artery emboli ........................... 24.80 NA NA 10.04 9.73 1.44 NA NA 36.28 35.97 09033916 ......... ............ A Surgery of great vessel ................................. 28.27 NA NA 10.92 11.24 3.66 NA NA 42.85 43.17 09033917 ......... ............ A Repair pulmonary artery ................................ 25.10 NA NA 10.43 11.74 3.69 NA NA 39.22 40.53 09033920 ......... ............ A Repair pulmonary atresia .............................. 32.54 NA NA 11.39 13.21 4.37 NA NA 48.30 50.12 09033922 ......... ............ A Transect pulmonary artery ............................ 24.05 NA NA 11.44 11.04 3.09 NA NA 38.58 38.1809033924 ......... ............ A Remove pulmonary shunt ............................. 5.49 NA NA 2.12 1.91 0.82 NA NA 8.43 8.22 ZZZ33925 ......... ............ A Rpr pul art unifocal w/o cpb .......................... 31.23 NA NA 10.21 13.55 4.60 NA NA 46.04 49.38 09033926 ......... ............ A Repr pul art, unifocal w/cpb .......................... 44.66 NA NA 14.38 16.86 6.20 NA NA 65.24 67.72 09033933 ......... ............ C Prepare donor heart/lung .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX33935 ......... ............ R Transplantation, heart/lung ............................ 61.56 NA NA 23.37 27.42 9.03 NA NA 93.96 98.01 09033944 ......... ............ C Prepare donor heart ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX33945 ......... ............ R Transplantation of heart ................................ 50.14 NA NA 19.01 20.80 6.24 NA NA 75.39 77.18 09033960 ......... ............ A External circulation assist .............................. 19.33 NA NA 5.60 5.08 2.66 NA NA 27.59 27.07 00033961 ......... ............ A External circulation assist .............................. 10.91 NA NA 2.91 3.44 0.88 NA NA 14.70 15.23 ZZZ33967 ......... ............ A Insert ia percut device ................................... 4.84 NA NA 2.44 1.99 0.35 NA NA 7.63 7.1800033968 ......... ............ A Remove aortic assist device ......................... 0.64 NA NA 0.27 0.24 0.07 NA NA 0.98 0.95 00033970 ......... ............ A Aortic circulation assist .................................. 6.74 NA NA 2.54 2.35 0.82 NA NA 10.10 9.91 00033971 ......... ............ A Aortic circulation assist .................................. 11.89 NA NA 6.09 6.02 1.25 NA NA 19.23 19.16 09033973 ......... ............ A Insert balloon device ..................................... 9.75 NA NA 3.88 3.45 1.26 NA NA 14.89 14.46 00033974 ......... ............ A Remove intra-aortic balloon .......................... 14.89 NA NA 7.79 7.86 1.73 NA NA 24.41 24.48 09033975 ......... ............ A Implant ventricular device ............................. 20.97 NA NA 6.63 6.37 3.06 NA NA 30.66 30.40XXX33976 ......... ............ A Implant ventricular device ............................. 22.97 NA NA 7.92 7.64 3.25 NA NA 34.14 33.86XXX33977 ......... ............ A Remove ventricular device ............................ 19.99 NA NA 9.37 10.65 2.80 NA NA 32.16 33.4409033978 ......... ............ A Remove ventricular device ............................ 22.43 NA NA 10.52 11.44 3.30 NA NA 36.25 37.1709033979 ......... ............ A Insert intracorporeal device ........................... 45.93 NA NA 14.38 14.79 6.95 NA NA 67.26 67.67 XXX33980 ......... ............ A Remove intracorporeal device ...................... 64.76 NA NA 25.09 25.20 8.56 NA NA 98.41 98.52 09033999 ......... ............ C Cardiac surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY34001 ......... ............ A Removal of artery clot ................................... 17.74 NA NA 6.68 6.70 1.84 NA NA 26.26 26.28 09034051 ......... ............ A Removal of artery clot ................................... 16.86 NA NA 6.93 7.57 2.20 NA NA 25.99 26.63 09034101 ......... ............ A Removal of artery clot ................................... 10.81 NA NA 4.44 5.12 1.41 NA NA 16.66 17.34 09034111 ......... ............ A Removal of arm artery clot ............................ 10.81 NA NA 4.50 5.14 1.40 NA NA 16.71 17.3509034151 ......... ............ A Removal of artery clot ................................... 26.35 NA NA 8.87 10.02 3.55 NA NA 38.77 39.92 09034201 ......... ............ A Removal of artery clot ................................... 18.40 NA NA 6.57 5.70 1.45 NA NA 26.42 25.55 09034203 ......... ............ A Removal of leg artery clot ............................. 17.67 NA NA 6.57 7.69 2.35 NA NA 26.59 27.7109034401 ......... ............ A Removal of vein clot ...................................... 26.35 NA NA 9.64 10.41 3.09 NA NA 39.08 39.85 09034421 ......... ............ A Removal of vein clot ...................................... 13.25 NA NA 5.36 6.06 1.55 NA NA 20.16 20.86 09034451 ......... ............ A Removal of vein clot ...................................... 28.35 NA NA 9.71 11.01 3.83 NA NA 41.89 43.19 09034471 ......... ............ A Removal of vein clot ...................................... 20.94 NA NA 7.73 5.91 1.18 NA NA 29.85 28.03 09034490 ......... ............ A Removal of vein clot ...................................... 10.79 NA NA 4.54 5.20 1.41 NA NA 16.74 17.40 09034501 ......... ............ A Repair valve, femoral vein ............................ 16.68 NA NA 6.96 8.11 2.34 NA NA 25.98 27.1309034502 ......... ............ A Reconstruct vena cava .................................. 27.80 NA NA 10.78 11.91 3.62 NA NA 42.20 43.33 09034510 ......... ............ A Transposition of vein valve ........................... 19.74 NA NA 7.25 8.87 2.32 NA NA 29.31 30.9309034520 ......... ............ A Cross-over vein graft ..................................... 18.99 NA NA 9.19 8.64 2.28 NA NA 30.46 29.91 09034530 ......... ............ A Leg vein fusion .............................................. 17.69 NA NA 7.88 8.43 1.73 NA NA 27.3027.85 09034800 ......... ............ A Endovas aaa repr w/sm tube ........................ 21.42 NA NA 7.49 8.74 2.45 NA NA 31.36 32.61 09034802 ......... ............ 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 09034808 ......... ............ A Endovas iliac a device addon ....................... 4.12 NA NA 1.11 1.31 0.59 NA NA 5.82 6.02 ZZZ34812 ......... ............ A Xpose for endoprosth, femorl ........................ 6.74 NA NA 1.73 2.11 1.18 NA NA 9.65 10.03 00034813 ......... ............ A Femoral endovas graft add-on ...................... 4.79 NA NA 1.21 1.48 0.67 NA NA 6.67 6.94 ZZZ34820 ......... ............ A Xpose for endoprosth, iliac ........................... 9.74 NA NA 2.47 3.04 1.50 NA NA 13.71 14.28 00034825 ......... ............ A Endovasc extend prosth, init ......................... 12.68 NA NA 5.23 5.91 1.28 NA NA 19.19 19.87 09034826 ......... ............ A Endovasc exten prosth, addIl ........................ 4.12 NA NA 1.16 1.32 0.44 NA NA 5.72 5.88 ZZZ34830 ......... ............ A Open aortic tube prosth repr ......................... 35.04 NA NA 10.82 12.97 4.54 NA NA 50.40 52.55090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00149 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49130 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal34831 ......... ............ A Open aortoiliac prosth repr ........................... 37.79 NA NA 12.15 11.84 4.88 NA NA 54.82 54.51 09034832 ......... ............ A Open aortofemor prosth repr ........................ 37.79 NA NA 11.68 13.89 4.84 NA NA 54.31 56.52 09034833 ......... ............ A Xpose for endoprosth, iliac ........................... 11.98 NA NA 3.32 4.15 1.69 NA NA 16.99 17.8200034834 ......... ............ A Xpose, endoprosth, brachial ......................... 5.34 NA NA 1.62 2.05 0.76 NA NA 7.72 8.15 00034900 ......... ............ A Endovasc iliac repr w/graft ............................ 16.73 NA NA 6.34 7.27 1.99 NA NA 25.06 25.9909035001 ......... ............ A Repair defect of artery .................................. 20.63 NA NA 7.64 9.07 2.80 NA NA 31.07 32.50 09035002 ......... ............ A Repair artery rupture, neck ........................... 22.05 NA NA 7.82 9.22 2.99 NA NA 32.86 34.2609035005 ......... ............ A Repair defect of artery .................................. 19.11 NA NA 8.14 8.67 1.76 NA NA 29.01 29.54 09035011 ......... ............ A Repair defect of artery .................................. 18.46 NA NA 6.43 7.59 2.54 NA NA 27.43 28.59 09035013 ......... ............ A Repair artery rupture, arm ............................. 23.04 NA NA 7.96 9.24 3.09 NA NA 34.09 35.3709035021 ......... ............ A Repair defect of artery .................................. 22.04 NA NA 8.70 9.23 2.86 NA NA 33.60 34.13 09035022 ......... ............ A Repair artery rupture, chest .......................... 25.57 NA NA 9.50 9.76 3.16 NA NA 38.23 38.4909035045 ......... ............ A Repair defect of arm artery ........................... 17.91 NA NA 6.42 7.23 2.44 NA NA 26.77 27.5809035081 ......... ............ A Repair defect of artery .................................. 33.31 NA NA 11.10 11.37 4.00 NA NA 48.41 48.68 09035082 ......... ............ A Repair artery rupture, aorta ........................... 41.87 NA NA 13.19 14.77 5.42 NA NA 60.48 62.06 09035091 ......... ............ A Repair defect of artery .................................. 35.35 NA NA 10.46 12.79 5.12 NA NA 50.93 53.26 09035092 ......... ............ A Repair artery rupture, aorta ........................... 50.75 NA NA 15.09 17.00 6.38 NA NA 72.22 74.13 09035102 ......... ............ A Repair defect of artery .................................. 36.31 NA NA 11.68 12.18 4.47 NA NA 52.46 52.96 09035103 ......... ............ A Repair artery rupture, groin ........................... 43.43 NA NA 13.31 15.21 5.74 NA NA 62.48 64.38 09035111 ......... ............ A Repair defect of artery .................................. 26.11 NA NA 8.62 10.00 3.46 NA NA 38.19 39.57 09035112 ......... ............ A Repair artery rupture,spleen ......................... 32.38 NA NA 10.53 11.60 4.07 NA NA 46.98 48.0509035121 ......... ............ A Repair defect of artery .................................. 31.35 NA NA 10.51 11.90 4.29 NA NA 46.15 47.54 09035122 ......... ............ A Repair artery rupture, belly ........................... 37.70 NA NA 12.17 13.39 4.74 NA NA 54.61 55.83 09035131 ......... ............ A Repair defect of artery .................................. 26.23 NA NA 8.92 10.29 3.79 NA NA 38.94 40.31 09035132 ......... ............ A Repair artery rupture, groin ........................... 32.38 NA NA 10.33 11.86 4.29 NA NA 47.00 48.53 09035141 ......... ............ A Repair defect of artery .................................. 20.79 NA NA 7.15 8.47 2.89 NA NA 30.83 32.15 09035142 ......... ............ A Repair artery rupture, thigh ........................... 24.97 NA NA 8.46 9.89 3.35 NA NA 36.78 38.2109035151 ......... ............ A Repair defect of artery .................................. 23.55 NA NA 7.96 9.48 3.23 NA NA 34.74 36.26 09035152 ......... ............ A Repair artery rupture, knee ........................... 27.47 NA NA 9.15 10.82 3.60 NA NA 40.22 41.8909035180 ......... ............ A Repair blood vessel lesion ............................ 14.95 NA NA 6.15 6.74 1.00 NA NA 22.10 22.6909035182 ......... ............ A Repair blood vessel lesion ............................ 31.52 NA NA 11.82 12.55 4.35 NA NA 47.69 48.42 09035184 ......... ............ A Repair blood vessel lesion ............................ 18.67 NA NA 6.96 7.96 2.52 NA NA 28.15 29.1509035188 ......... ............ A Repair blood vessel lesion ............................ 14.98 NA NA 6.23 7.28 2.15 NA NA 23.36 24.4109035189 ......... ............ A Repair blood vessel lesion ............................ 29.79 NA NA 10.15 11.50 4.00 NA NA 43.94 45.29 09035190 ......... ............ A Repair blood vessel lesion ............................ 13.27 NA NA 5.34 6.19 1.79 NA NA 20.40 21.2509035201 ......... ............ A Repair blood vessel lesion ............................ 16.78 NA NA 6.45 7.61 2.33 NA NA 25.56 26.7209035206 ......... ............ A Repair blood vessel lesion ............................ 13.72 NA NA 5.42 6.27 1.86 NA NA 21.00 21.8509035207 ......... ............ A Repair blood vessel lesion ............................ 10.79 NA NA 6.60 7.16 1.48 NA NA 18.87 19.4309035211 ......... ............ A Repair blood vessel lesion ............................ 24.45 NA NA 10.11 10.49 3.19 NA NA 37.75 38.13 09035216 ......... ............ A Repair blood vessel lesion ............................ 36.43 NA NA 13.90 10.20 2.64 NA NA 52.97 49.27 09035221 ......... ............ A Repair blood vessel lesion ............................ 26.50 NA NA 8.59 9.60 3.36 NA NA 38.45 39.4609035226 ......... ............ A Repair blood vessel lesion ............................ 15.18 NA NA 5.91 7.05 2.01 NA NA 23.10 24.2409035231 ......... ............ A Repair blood vessel lesion ............................ 21.04 NA NA 7.70 9.25 2.88 NA NA 31.62 33.1709035236 ......... ............ A Repair blood vessel lesion ............................ 17.90 NA NA 6.50 7.54 2.42 NA NA 26.82 27.8609035241 ......... ............ A Repair blood vessel lesion ............................ 25.45 NA NA 9.97 10.83 3.52 NA NA 38.94 39.8009035246 ......... ............ A Repair blood vessel lesion ............................ 28.11 NA NA 11.95 11.55 3.85 NA NA 43.91 43.51 09035251 ......... ............ A Repair blood vessel lesion ............................ 31.79 NA NA 9.83 11.30 4.12 NA NA 45.74 47.2109035256 ......... ............ A Repair blood vessel lesion ............................ 18.94 NA NA 6.65 7.93 2.62 NA NA 28.21 29.4909035261 ......... ............ A Repair blood vessel lesion ............................ 18.84 NA NA 7.26 7.82 2.60 NA NA 28.70 29.2609035266 ......... ............ A Repair blood vessel lesion ............................ 15.71 NA NA 5.72 6.68 2.09 NA NA 23.52 24.4809035271 ......... ............ A Repair blood vessel lesion ............................ 24.45 NA NA 9.69 10.31 3.15 NA NA 37.29 37.9109035276 ......... ............ A Repair blood vessel lesion ............................ 25.67 NA NA 9.66 10.82 3.48 NA NA 38.81 39.9709035281 ......... ............ A Repair blood vessel lesion ............................ 29.87 NA NA 9.81 11.23 3.96 NA NA 43.64 45.0609035286 ......... ............ A Repair blood vessel lesion ............................ 17.00 NA NA 6.47 7.66 2.34 NA NA 25.81 27.0009035301 ......... ............ A Rechanneling of artery .................................. 19.49 NA NA 6.90 8.05 2.67 NA NA 29.06 30.21 09035311 ......... ............ A Rechanneling of artery .................................. 28.48 NA NA 9.69 11.23 3.41 NA NA 41.58 43.12 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00150 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49131 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules35321 ......... ............ A Rechanneling of artery .................................. 16.47 NA NA 6.00 7.04 2.24 NA NA 24.71 25.75 09035331 ......... ............ A Rechanneling of artery .................................. 27.55 NA NA 9.04 10.68 3.82 NA NA 40.41 42.05 09035341 ......... ............ A Rechanneling of artery .................................. 26.03 NA NA 8.58 10.29 3.77 NA NA 38.38 40.09 09035351 ......... ............ A Rechanneling of artery .................................. 24.49 NA NA 7.98 9.19 3.34 NA NA 35.81 37.02 09035355 ......... ............ A Rechanneling of artery .................................. 19.74 NA NA 6.57 7.70 2.66 NA NA 28.97 30.10 09035361 ......... ............ A Rechanneling of artery .................................. 30.05 NA NA 9.75 11.21 4.14 NA NA 43.94 45.40 09035363 ......... ............ A Rechanneling of artery .................................. 32.16 NA NA 10.60 12.09 4.32 NA NA 47.08 48.57 09035371 ......... ............ A Rechanneling of artery .................................. 15.19 NA NA 5.51 6.59 2.13 NA NA 22.83 23.91 09035372 ......... ............ A Rechanneling of artery .................................. 18.46 NA NA 6.33 7.61 2.62 NA NA 27.41 28.69 09035381 ......... ............ A Rechanneling of artery .................................. 16.63 NA NA 6.33 7.44 2.25 NA NA 25.21 26.32 09035390 ......... ............ A Reoperation, carotid add-on .......................... 3.19 NA NA 0.85 1.01 0.46 NA NA 4.50 4.66 ZZZ35400 ......... ............ A Angioscopy .................................................... 3.00 NA NA 0.75 1.02 0.43 NA NA 4.184.45 ZZZ35450 ......... ............ A Repair arterial blockage ................................ 10.05 NA NA 3.22 3.48 1.25 NA NA 14.52 14.78 00035452 ......... ............ A Repair arterial blockage ................................ 6.90 NA NA 2.12 2.48 0.94 NA NA 9.96 10.3200035454 ......... ............ A Repair arterial blockage ................................ 6.03 NA NA 1.83 2.19 0.87 NA NA 8.73 9.09 00035456 ......... ............ A Repair arterial blockage ................................ 7.34 NA NA 2.30 2.65 1.04 NA NA 10.68 11.0300035458 ......... ............ A Repair arterial blockage ................................ 9.48 NA NA 2.91 3.33 1.26 NA NA 13.65 14.0700035459 ......... ............ A Repair arterial blockage ................................ 8.62 NA NA 2.53 3.01 1.21 NA NA 12.36 12.8400035460 ......... ............ 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 91.4812.78 12.69 00035471 ......... ............ A Repair arterial blockage ................................ 10.05 66.97 91.94 4.70 4.14 0.67 77.69 102.7 15.42 14.86 00035472 ......... ............ A Repair arterial blockage ................................ 6.90 48.34 60.35 2.81 2.76 0.58 55.82 67.8310.29 10.24 00035473 ......... ............ A Repair arterial blockage ................................ 6.03 47.23 56.69 2.51 2.44 0.51 53.77 63.239.05 8.98 00035474 ......... ............ A Repair arterial blockage ................................ 7.35 61.24 81.11 3.00 2.92 0.57 69.16 89.0310.92 10.84 00035475 ......... ............ R Repair arterial blockage ................................ 9.48 49.26 54.39 3.40 3.52 0.62 59.36 64.4913.50 13.62 00035476 ......... ............ A Repair venous blockage ................................ 6.03 37.43 42.91 2.13 2.30 0.34 43.80 49.28 8.50 8.67 00035480 ......... ............ A Atherectomy, open ........................................ 11.06 NA NA 3.96 4.02 1.28 NA NA 16.30 16.36 00035481 ......... ............ A Atherectomy, open ........................................ 7.60 NA NA 2.50 2.78 1.13 NA NA 11.23 11.51 00035482 ......... ............ A Atherectomy, open ........................................ 6.64 NA NA 2.13 2.45 0.89 NA NA 9.66 9.9800035483 ......... ............ A Atherectomy, open ........................................ 8.09 NA NA 2.79 2.96 1.15 NA NA 12.03 12.20 00035484 ......... ............ A Atherectomy, open ........................................ 10.42 NA NA 3.08 3.60 1.27 NA NA 14.77 15.29 00035485 ......... ............ A Atherectomy, open ........................................ 9.48 NA NA 3.00 3.40 1.35 NA NA 13.83 14.23 00035490 ......... ............ 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 00035492 ......... ............ A Atherectomy, percutaneous .......................... 6.64 NA NA 3.63 3.30 0.43 NA NA 10.70 10.37 00035493 ......... ............ A Atherectomy, percutaneous .......................... 8.09 NA NA 4.15 3.89 0.56 NA NA 12.80 12.54 00035494 ......... ............ 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 00035500 ......... ............ A Harvest vein for bypass ................................ 6.44 NA NA 1.69 1.94 0.93 NA NA 9.06 9.31 ZZZ35501 ......... ............ A Artery bypass graft ........................................ 19.70 NA NA 7.29 8.17 2.80 NA NA 29.79 30.67 09035506 ......... ............ A Artery bypass graft ........................................ 25.19 NA NA 8.48 9.22 2.86 NA NA 36.53 37.27 09035507 ......... ............ A Artery bypass graft ........................................ 20.60 NA NA 7.54 8.95 2.84 NA NA 30.98 32.39 09035508 ......... ............ A Artery bypass graft ........................................ 25.95 NA NA 9.15 9.37 2.77 NA NA 37.87 38.09 09035509 ......... ............ A Artery bypass graft ........................................ 18.94 NA NA 6.78 8.27 2.61 NA NA 28.33 29.82 09035510 ......... ............ A Artery bypass graft ........................................ 24.25 NA NA 7.80 9.58 2.11 NA NA 34.16 35.94 09035511 ......... ............ A Artery bypass graft ........................................ 22.08 NA NA 7.33 8.85 2.90 NA NA 32.31 33.83 09035512 ......... ............ A Artery bypass graft ........................................ 23.75 NA NA 7.53 9.38 2.11 NA NA 33.39 35.24 09035515 ......... ............ A Artery bypass graft ........................................ 25.95 NA NA 8.45 9.07 2.77 NA NA 37.17 37.79 09035516 ......... ............ A Artery bypass graft ........................................ 24.07 NA NA 7.80 7.05 2.33 NA NA 34.20 33.45 09035518 ......... ............ A Artery bypass graft ........................................ 22.53 NA NA 7.54 8.61 3.02 NA NA 33.09 34.16 09035521 ......... ............ A Artery bypass graft ........................................ 23.94 NA NA 8.15 9.41 3.12 NA NA 35.21 36.47 09035522 ......... ............ A Artery bypass graft ........................................ 23.01 NA NA 7.51 9.19 2.11 NA NA 32.63 34.31 09035525 ......... ............ A Artery bypass graft ........................................ 21.55 NA NA 7.19 8.83 2.11 NA NA 30.85 32.49 09035526 ......... ............ A Artery bypass graft ........................................ 31.43 NA NA 18.22 13.93 3.62 NA NA 53.2748.98 09035531 ......... ............ A Artery bypass graft ........................................ 38.92 NA NA 11.95 13.84 5.16 NA NA 56.0357.92 09035533 ......... ............ A Artery bypass graft ........................................ 29.73 NA NA 9.99 11.29 3.84 NA NA 43.5644.86 09035536 ......... ............ A Artery bypass graft ........................................ 33.54 NA NA 10.69 12.38 4.61 NA NA 48.8450.53 09035541 ......... ............ A Artery bypass graft ........................................ 26.90 NA NA 9.26 10.72 3.70 NA NA 39.8641.32 09035546 ......... ............ A Artery bypass graft ........................................ 26.40 NA NA 9.07 10.41 3.69 NA NA 39.1640.50 09035548 ......... ............ A Artery bypass graft ........................................ 22.50 NA NA 7.97 9.06 2.97 NA NA 33.44 34.53 09035549 ......... ............ A Artery bypass graft ........................................ 24.27 NA NA 9.18 10.07 3.29 NA NA 36.7437.63 09035551 ......... ............ A Artery bypass graft ........................................ 27.65 NA NA 9.90 11.09 3.74 NA NA 41.2942.48 09035556 ......... ............ A Artery bypass graft ........................................ 26.56 NA NA 8.93 9.52 3.09 NA NA 38.58 39.17 09035558 ......... ............ A Artery bypass graft ........................................ 22.94 NA NA 8.09 9.18 2.99 NA NA 34.02 35.11 09035560 ......... ............ A Artery bypass graft ........................................ 33.84 NA NA 10.79 12.68 4.74 NA NA 49.3751.26 09035563 ......... ............ A Artery bypass graft ........................................ 25.93 NA NA 8.62 10.05 3.51 NA NA 38.0639.49 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00151 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49132 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal35565 ......... ............ A Artery bypass graft ........................................ 24.94 NA NA 8.51 9.73 3.29 NA NA 36.74 37.96 09035566 ......... ............ A Artery bypass graft ........................................ 32.16 NA NA 10.20 11.09 3.82 NA NA 46.1847.07 09035571 ......... ............ A Artery bypass graft ........................................ 25.33 NA NA 8.45 10.24 3.42 NA NA 37.2038.99 09035572 ......... ............ A Harvest femoropopliteal vein ......................... 6.81 NA NA 1.88 2.15 0.99 NA NA 9.68 9.95 ZZZ35583 ......... ............ A Vein bypass graft .......................................... 27.56 NA NA 9.01 9.87 3.16 NA NA 39.73 40.59 09035585 ......... ............ A Vein bypass graft .......................................... 32.16 NA NA 10.15 11.70 4.01 NA NA 46.3247.87 09035587 ......... ............ A Vein bypass graft .......................................... 26.02 NA NA 8.69 10.76 3.51 NA NA 38.2240.29 09035600 ......... ............ A Harvest artery for cabg ................................. 4.94 NA NA 1.54 1.60 0.73 NA NA 7.21 7.27 ZZZ35601 ......... ............ A Artery bypass graft ........................................ 18.31 NA NA 6.63 8.12 2.49 NA NA 27.43 28.92 09035606 ......... ............ A Artery bypass graft ........................................ 22.32 NA NA 7.68 8.68 2.69 NA NA 32.69 33.69 09035612 ......... ............ A Artery bypass graft ........................................ 16.64 NA NA 6.40 7.51 2.08 NA NA 25.12 26.23 09035616 ......... ............ A Artery bypass graft ........................................ 21.70 NA NA 7.14 7.86 2.19 NA NA 31.03 31.75 09035621 ......... ............ A Artery bypass graft ........................................ 20.91 NA NA 7.04 8.26 2.91 NA NA 30.86 32.08 09035623 ......... ............ A Bypass graft, not vein ................................... 25.73 NA NA 8.65 10.03 3.45 NA NA 37.83 39.21 09035626 ......... ............ A Artery bypass graft ........................................ 29.02 NA NA 10.25 11.54 4.07 NA NA 43.3444.63 09035631 ......... ............ A Artery bypass graft ........................................ 35.84 NA NA 11.04 13.13 4.95 NA NA 51.8353.92 09035636 ......... ............ A Artery bypass graft ........................................ 31.56 NA NA 9.94 11.70 4.09 NA NA 45.5947.35 09035641 ......... ............ A Artery bypass graft ........................................ 26.24 NA NA 9.23 10.60 3.53 NA NA 39.0040.37 09035642 ......... ............ A Artery bypass graft ........................................ 18.79 NA NA 7.70 8.44 2.27 NA NA 28.76 29.50 09035645 ......... ............ A Artery bypass graft ........................................ 18.28 NA NA 7.32 8.03 2.49 NA NA 28.09 28.80 09035646 ......... ............ A Artery bypass graft ........................................ 32.78 NA NA 10.78 12.52 4.43 NA NA 47.9949.73 09035647 ......... ............ A Artery bypass graft ........................................ 29.56 NA NA 9.79 11.28 3.98 NA NA 43.3344.82 09035650 ......... ............ A Artery bypass graft ........................................ 20.04 NA NA 6.80 7.97 2.71 NA NA 29.55 30.72 09035651 ......... ............ A Artery bypass graft ........................................ 25.90 NA NA 8.84 10.25 3.35 NA NA 38.0939.50 09035654 ......... ............ A Artery bypass graft ........................................ 26.11 NA NA 8.59 10.14 3.52 NA NA 38.2239.77 09035656 ......... ............ A Artery bypass graft ........................................ 20.35 NA NA 7.05 8.21 2.79 NA NA 30.19 31.35 09035661 ......... ............ A Artery bypass graft ........................................ 20.16 NA NA 7.30 8.52 2.71 NA NA 30.17 31.39 09035663 ......... ............ A Artery bypass graft ........................................ 23.74 NA NA 8.13 9.51 3.10 NA NA 34.97 36.35 09035665 ......... ............ A Artery bypass graft ........................................ 22.16 NA NA 7.65 8.99 3.00 NA NA 32.81 34.15 09035666 ......... ............ A Artery bypass graft ........................................ 23.47 NA NA 8.78 10.18 3.15 NA NA 35.4036.80 09035671 ......... ............ A Artery bypass graft ........................................ 20.58 NA NA 7.98 9.02 2.77 NA NA 31.33 32.37 09035681 ......... ............ 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 ZZZ35683 ......... ............ A Composite bypass graft ................................ 8.49 NA NA 2.12 2.65 1.20 NA NA 11.81 12.34 ZZZ35685 ......... ............ A Bypass graft patency/patch ........................... 4.04 NA NA 1.01 1.27 0.58 NA NA 5.63 5.89 ZZZ35686 ......... ............ 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 27.1728.72 09035693 ......... ............ A Arterial transposition ...................................... 15.58 NA NA 6.09 7.31 2.21 NA NA 23.8825.10 09035694 ......... ............ A Arterial transposition ...................................... 19.13 NA NA 6.59 8.10 2.69 NA NA 28.4129.92 09035695 ......... ............ A Arterial transposition ...................................... 19.91 NA NA 6.64 8.07 2.73 NA NA 29.2830.71 09035697 ......... ............ A Reimplant artery each ................................... 3.00 NA NA 0.77 0.96 0.41 NA NA 4.18 4.37 ZZZ35700 ......... ............ 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 15.1209035721 ......... ............ A Exploration, femoral artery ............................ 7.62 NA NA 3.76 4.26 1.03 NA NA 12.41 12.9109035741 ......... ............ A Exploration popliteal artery ............................ 8.57 NA NA 3.98 4.49 1.12 NA NA 13.67 14.1809035761 ......... ............ A Exploration of artery/vein .............................. 5.78 NA NA 3.49 3.88 0.75 NA NA 10.02 10.4109035800 ......... ............ A Explore neck vessels .................................... 7.94 NA NA 3.96 4.48 0.95 NA NA 12.85 13.3709035820 ......... ............ A Explore chest vessels ................................... 30.08 NA NA 11.17 8.19 1.94 NA NA 43.19 40.21 09035840 ......... ............ A Explore abdominal vessels ........................... 10.81 NA NA 4.89 5.18 1.34 NA NA 17.04 17.33 09035860 ......... ............ A Explore limb vessels ..................................... 6.67 NA NA 3.49 3.90 0.78 NA NA 10.94 11.35 09035870 ......... ............ A Repair vessel graft defect ............................. 24.32 NA NA 8.25 9.38 3.00 NA NA 35.57 36.7009035875 ......... ............ A Removal of clot in graft ................................. 10.60 NA NA 4.43 4.99 1.41 NA NA 16.44 17.00 09035876 ......... ............ A Removal of clot in graft ................................. 17.70 NA NA 6.16 7.17 2.39 NA NA 26.25 27.26 09035879 ......... ............ A Revise graft w/vein ........................................ 17.24 NA NA 6.17 7.31 2.27 NA NA 25.68 26.82 09035881 ......... ............ A Revise graft w/vein ........................................ 19.16 NA NA 6.72 8.18 2.55 NA NA 28.43 29.89 09035901 ......... ............ A Excision, graft, neck ...................................... 8.18 NA NA 4.32 5.06 1.15 NA NA 13.65 14.39 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00152 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49133 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules35903 ......... ............ A Excision, graft, extremity ............................... 9.38 NA NA 4.72 5.79 1.30 NA NA 15.40 16.47 09035905 ......... ............ A Excision, graft, thorax .................................... 33.33 NA NA 10.76 12.58 4.43 NA NA 48.5250.34 09035907 ......... ............ A Excision, graft, abdomen ............................... 37.08 NA NA 11.35 13.46 4.91 NA NA 53.34 55.45 09036000 ......... ............ 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 XXX36002 ......... ............ A Pseudoaneurysm injection trt ........................ 1.96 2.23 2.70 0.82 0.93 0.17 4.36 4.83 2.95 3.06 00036005 ......... ............ A Injection ext venography ............................... 0.95 8.54 7.87 0.37 0.33 0.05 9.54 8.87 1.371.33 00036010 ......... ............ 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 XXX36011 ......... ............ 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 XXX36012 ......... ............ 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 XXX36013 ......... ............ 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 XXX36014 ......... ............ 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 XXX36015 ......... ............ 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 XXX36100 ......... ............ A Establish access to artery ............................. 3.02 11.30 11.88 1.20 1.13 0.26 14.58 15.164.48 4.41 XXX36120 ......... ............ 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 XXX36140 ......... ............ A Establish access to artery ............................. 2.01 10.55 12.22 0.70 0.66 0.16 12.72 14.392.87 2.83 XXX36145 ......... ............ 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 XXX36160 ......... ............ A Establish access to aorta .............................. 2.52 11.88 13.08 0.76 0.82 0.26 14.66 15.863.54 3.60 XXX36200 ......... ............ 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 XXX36215 ......... ............ 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 XXX36216 ......... ............ 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 XXX36217 ......... ............ 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 XXX36218 ......... ............ 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 ZZZ36245 ......... ............ 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 XXX36246 ......... ............ 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 XXX36247 ......... ............ 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 XXX36248 ......... ............ 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 ZZZ36260 ......... ............ A Insertion of infusion pump ............................. 9.76 NA NA 4.86 4.88 1.29 NA NA 15.91 15.9309036261 ......... ............ 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 09036299 ......... ............ C Vessel injection procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY36400 ......... ............ A Bl draw < 3 yrs fem/jugular ........................... 0.38 0.33 0.29 0.11 0.10 0.03 0.74 0.70 0.520.51 XXX36405 ......... ............ A Bl draw < 3 yrs scalp vein ............................ 0.31 0.29 0.27 0.08 0.08 0.03 0.63 0.61 0.420.42 XXX36406 ......... ............ A Bl draw < 3 yrs other vein ............................. 0.18 0.30 0.29 0.08 0.06 0.01 0.49 0.48 0.270.25 XXX36410 ......... ............ 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 XXX36420 ......... ............ A Vein access cutdown < 1 yr .......................... 1.01 NA NA 0.21 0.26 0.07 NA NA 1.29 1.34 XXX36425 ......... ............ A Vein access cutdown > 1 yr .......................... 0.76 NA NA 0.22 0.22 0.06 NA NA 1.04 1.04 XXX36430 ......... ............ A Blood transfusion service .............................. 0.00 0.93 0.99 0.00 0.76 0.06 0.99 1.05 0.060.82 XXX36440 ......... ............ 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 XXX36460 ......... ............ A Transfusion service, fetal .............................. 6.58 NA NA 1.70 2.11 0.79 NA NA 9.07 9.48 XXX36470 ......... ............ 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 01036471 ......... ............ 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 01036475 ......... ............ A Endovenous rf, 1st vein ................................ 6.72 36.90 47.77 1.97 2.39 0.37 43.99 54.869.06 9.48 00036476 ......... ............ 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 ZZZ36478 ......... ............ 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 00036479 ......... ............ 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 ZZZ36481 ......... ............ A Insertion of catheter, vein .............................. 6.98 NA NA 2.14 2.48 0.55 NA NA 9.67 10.0100036500 ......... ............ A Insertion of catheter, vein .............................. 3.51 NA NA 1.25 1.34 0.20 NA NA 4.96 5.0500036510 ......... ............ 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 00036511 ......... ............ A Apheresis wbc ............................................... 1.74 NA NA 0.58 0.69 0.08 NA NA 2.40 2.51 00036512 ......... ............ A Apheresis rbc ................................................ 1.74 NA NA 0.61 0.71 0.08 NA NA 2.43 2.53 00036513 ......... ............ A Apheresis platelets ........................................ 1.74 NA NA 0.52 0.68 0.17 NA NA 2.43 2.59 00036514 ......... ............ A Apheresis plasma .......................................... 1.74 10.54 15.36 0.53 0.67 0.08 12.36 17.18 2.35 2.49 00036515 ......... ............ A Apheresis, adsorp/reinfuse ............................ 1.74 45.31 61.05 0.51 0.62 0.08 47.13 62.87 2.33 2.44 00036516 ......... ............ A Apheresis, selective ...................................... 1.22 49.90 75.51 0.38 0.46 0.08 51.20 76.81 1.68 1.76 00036522 ......... ............ A Photopheresis ............................................... 1.67 35.02 33.03 0.85 0.93 0.13 36.82 34.83 2.65 2.73 00036550 ......... ............ A Declot vascular device .................................. 0.00 0.33 0.38 0.06 0.31 0.37 0.70 0.75 0.43 0.68 XXX36555 ......... ............ 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 00036556 ......... ............ 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 00036557 ......... ............ 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 01036558 ......... ............ 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 01036560 ......... ............ 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 01036561 ......... ............ 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 01036563 ......... ............ 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 01036565 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00153 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49134 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal36566 ......... ............ 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 01036568 ......... ............ A Insert picc cath .............................................. 1.92 5.73 7.08 0.57 0.58 0.11 7.76 9.11 2.60 2.61 00036569 ......... ............ A Insert picc cath .............................................. 1.82 4.46 6.62 0.61 0.58 0.19 6.47 8.63 2.62 2.59 00036570 ......... ............ A Insert picvad cath .......................................... 5.31 23.19 30.68 2.34 2.63 0.57 29.07 36.56 8.22 8.51 01036571 ......... ............ A Insert picvad cath .......................................... 5.29 25.04 31.19 2.42 2.64 0.57 30.90 37.05 8.28 8.50 01036575 ......... ............ A Repair tunneled cv cath ................................ 0.67 3.33 3.87 0.23 0.25 0.20 4.20 4.74 1.101.12 00036576 ......... ............ 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 01036578 ......... ............ 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 01036580 ......... ............ A Replace cvad cath ......................................... 1.31 3.99 6.20 0.41 0.41 0.19 5.49 7.70 1.91 1.91 00036581 ......... ............ 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 01036582 ......... ............ 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 01036583 ......... ............ 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 01036584 ......... ............ A Replace picc cath .......................................... 1.20 3.97 6.22 0.57 0.56 0.19 5.36 7.611.96 1.95 00036585 ......... ............ A Replace picvad cath ...................................... 4.79 22.75 26.55 2.30 2.62 0.19 27.73 31.53 7.28 7.60 01036589 ......... ............ 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 01036590 ......... ............ 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 01036595 ......... ............ A Mech remov tunneled cv cath ....................... 3.59 10.85 15.65 1.31 1.42 0.21 14.65 19.45 5.115.22 00036596 ......... ............ A Mech remov tunneled cv cath ....................... 0.75 2.59 3.42 0.42 0.48 0.05 3.39 4.22 1.22 1.2800036597 ......... ............ A Reposition venous catheter ........................... 1.21 2.02 2.31 0.42 0.44 0.07 3.30 3.59 1.70 1.72 00036598 ......... ............ 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 00036600 ......... ............ A Withdrawal of arterial blood .......................... 0.32 0.50 0.49 0.08 0.09 0.02 0.84 0.83 0.420.43 XXX36620 ......... ............ A Insertion catheter, artery ............................... 1.15 NA NA 0.17 0.22 0.07 NA NA 1.39 1.4400036625 ......... ............ A Insertion catheter, artery ............................... 2.11 NA NA 0.49 0.52 0.26 NA NA 2.86 2.8900036640 ......... ............ A Insertion catheter, artery ............................... 2.10 NA NA 0.91 1.01 0.21 NA NA 3.22 3.3200036660 ......... ............ A Insertion catheter, artery ............................... 1.40 NA NA 0.20 0.38 0.14 NA NA 1.74 1.9200036680 ......... ............ A Insert needle, bone cavity ............................. 1.20 NA NA 0.33 0.45 0.11 NA NA 1.64 1.76 00036800 ......... ............ A Insertion of cannula ....................................... 2.43 NA NA 1.55 1.74 0.25 NA NA 4.23 4.42 00036810 ......... ............ A Insertion of cannula ....................................... 3.96 NA NA 1.36 1.60 0.45 NA NA 5.77 6.01 00036815 ......... ............ A Insertion of cannula ....................................... 2.62 NA NA 1.04 1.14 0.35 NA NA 4.01 4.11 00036818 ......... ............ A Av fuse, uppr arm, cephalic .......................... 11.77 NA NA 4.88 5.74 1.89 NA NA 18.54 19.40 09036819 ......... ............ A Av fuse, uppr arm, basilic ............................. 14.35 NA NA 5.26 6.09 1.95 NA NA 21.56 22.3909036820 ......... ............ A Av fusion/forearm vein .................................. 14.35 NA NA 5.34 6.12 1.94 NA NA 21.63 22.41 09036821 ......... ............ A Av fusion direct any site ................................ 9.10 NA NA 4.04 4.50 1.23 NA NA 14.37 14.83 09036822 ......... ............ A Insertion of cannula(s) ................................... 5.47 NA NA 3.82 4.24 0.79 NA NA 10.08 10.50 09036823 ......... ............ A Insertion of cannula(s) ................................... 22.74 NA NA 8.91 9.26 2.88 NA NA 34.53 34.88 09036825 ......... ............ A Artery-vein autograft ...................................... 9.95 NA NA 4.34 4.87 1.35 NA NA 15.64 16.17 09036830 ......... ............ A Artery-vein nonautograft ................................ 11.98 NA NA 4.25 4.99 1.66 NA NA 17.89 18.63 09036831 ......... ............ A Open thrombect av fistula ............................. 7.99 NA NA 3.28 3.78 1.09 NA NA 12.36 12.86 09036832 ......... ............ A Av fistula revision, open ................................ 10.48 NA NA 3.87 4.51 1.44 NA NA 15.79 16.43 09036833 ......... ............ A Av fistula revision .......................................... 11.93 NA NA 4.25 4.96 1.65 NA NA 17.8318.54 09036834 ......... ............ A Repair A-V aneurysm .................................... 11.07 NA NA 4.35 4.68 1.37 NA NA 16.79 17.1209036835 ......... ............ A Artery to vein shunt ....................................... 7.38 NA NA 3.90 4.22 0.98 NA NA 12.26 12.58 09036838 ......... ............ A Dist revas ligation, hemo ............................... 21.55 NA NA 7.14 8.82 3.01 NA NA 31.70 33.38 09036860 ......... ............ A External cannula declotting ........................... 2.01 3.35 2.17 0.62 0.67 0.11 5.47 4.29 2.742.79 00036861 ......... ............ A Cannula declotting ......................................... 2.52 NA NA 1.25 1.43 0.27 NA NA 4.04 4.22 00036870 ......... ............ 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 09037140 ......... ............ A Revision of circulation ................................... 25.05 NA NA 9.04 10.12 2.01 NA NA 36.10 37.18 09037145 ......... ............ A Revision of circulation ................................... 26.06 NA NA 9.10 10.42 3.25 NA NA 38.41 39.73 09037160 ......... ............ A Revision of circulation ................................... 23.06 NA NA 8.16 8.98 2.81 NA NA 34.03 34.85 09037180 ......... ............ A Revision of circulation ................................... 26.06 NA NA 9.00 9.97 3.34 NA NA 38.40 39.37 09037181 ......... ............ A Splice spleen/kidney veins ............................ 28.19 NA NA 9.34 10.59 3.40 NA NA 40.92 42.1709037182 ......... ............ A Insert hepatic shunt (tips) .............................. 16.97 NA NA 5.73 5.98 1.00 NA NA 23.70 23.95 00037183 ......... ............ 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 12.2112.47 00037185 ......... ............ A Prim art m-thrombect add-on ........................ 3.28 16.20 21.21 1.02 1.09 0.21 19.69 24.70 4.514.58 ZZZ37186 ......... ............ A Sec art m-thrombect add-on ......................... 4.92 34.21 45.60 1.53 1.63 0.32 39.45 50.84 6.776.87 ZZZ



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00154 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49135 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules37187 ......... ............ A Venous mech thrombectomy ........................ 8.03 48.71 64.81 2.81 3.06 0.51 57.25 73.35 11.35 11.60 00037188 ......... ............ A Venous m-thrombectomy add-on .................. 5.71 42.51 57.11 2.09 2.29 0.37 48.59 63.19 8.17 8.3700037195 ......... ............ C Thrombolytic therapy, stroke ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX37200 ......... ............ A Transcatheter biopsy ..................................... 4.55 NA NA 1.49 1.50 0.27 NA NA 6.31 6.3200037201 ......... ............ A Transcatheter therapy infuse ........................ 4.99 NA NA 2.25 2.47 0.33 NA NA 7.57 7.79 00037202 ......... ............ A Transcatheter therapy infuse ........................ 5.67 NA NA 3.40 3.12 0.43 NA NA 9.50 9.22 00037203 ......... ............ A Transcatheter retrieval .................................. 5.02 30.34 32.24 1.95 2.01 0.29 35.65 37.55 7.26 7.32 00037204 ......... ............ A Transcatheter occlusion ................................ 18.11 NA NA 5.79 5.87 1.48 NA NA 25.38 25.4600037205 ......... ............ A Transcath iv stent, percut .............................. 8.27 NA NA 3.90 3.79 0.60 NA NA 12.77 12.6600037206 ......... ............ 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 12.4200037208 ......... ............ A Transcath iv stent/open addl ......................... 4.12 NA NA 1.05 1.30 0.59 NA NA 5.76 6.01 ZZZ37209 ......... ............ A Change iv cath at thromb tx .......................... 2.27 NA NA 0.73 0.74 0.15 NA NA 3.15 3.16 00037215 ......... ............ R Transcath stent, cca w/eps ........................... 19.54 NA NA 10.12 9.35 1.09 NA NA 30.75 29.9809037216 ......... ............ N Transcath stent, cca w/o eps ........................ 18.81 NA NA 8.74 8.79 1.04 NA NA 28.59 28.64 09037250 ......... ............ A Iv us first vessel add-on ................................ 2.10 NA NA 0.81 0.77 0.21 NA NA 3.12 3.08ZZZ37251 ......... ............ A Iv us each add vessel add-on ....................... 1.60 NA NA 0.52 0.54 0.19 NA NA 2.31 2.33 ZZZ37500 ......... ............ A Endoscopy ligate perf veins .......................... 11.48 NA NA 5.46 6.50 1.54 NA NA 18.48 19.52 09037501 ......... ............ C Vascular endoscopy procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY37565 ......... ............ A Ligation of neck vein ..................................... 11.93 NA NA 5.10 5.49 1.33 NA NA 18.36 18.75 09037600 ......... ............ A Ligation of neck artery ................................... 12.30 NA NA 4.80 6.17 1.41 NA NA 18.51 19.88 09037605 ......... ............ A Ligation of neck artery ................................... 14.16 NA NA 5.57 6.57 1.98 NA NA 21.71 22.71 09037606 ......... ............ A Ligation of neck artery ................................... 8.66 NA NA 4.87 4.64 1.23 NA NA 14.76 14.53 09037607 ......... ............ A Ligation of a-v fistula ..................................... 6.15 NA NA 3.11 3.45 0.85 NA NA 10.11 10.45 09037609 ......... ............ A Temporal artery procedure ............................ 3.00 4.24 4.44 1.84 1.93 0.36 7.60 7.80 5.20 5.29 01037615 ......... ............ A Ligation of neck artery ................................... 7.67 NA NA 3.98 4.08 0.68 NA NA 12.33 12.43 09037616 ......... ............ A Ligation of chest artery .................................. 18.84 NA NA 7.94 8.05 2.32 NA NA 29.10 29.21 09037617 ......... ............ A Ligation of abdomen artery ........................... 23.67 NA NA 7.92 8.86 2.97 NA NA 34.56 35.50 09037618 ......... ............ A Ligation of extremity artery ............................ 5.90 NA NA 3.40 3.56 0.67 NA NA 9.97 10.1309037620 ......... ............ A Revision of major vein ................................... 11.44 NA NA 5.24 5.59 0.91 NA NA 17.59 17.94 09037650 ......... ............ A Revision of major vein ................................... 8.37 NA NA 4.22 4.57 1.01 NA NA 13.60 13.95 09037660 ......... ............ A Revision of major vein ................................... 22.16 NA NA 8.13 8.82 2.48 NA NA 32.77 33.46 09037700 ......... ............ A Revise leg vein .............................................. 3.72 NA NA 2.45 2.71 0.53 NA NA 6.70 6.96 09037718 ......... ............ A Ligate/strip short leg vein .............................. 7.01 NA NA 3.53 3.93 0.14 NA NA 10.68 11.08 09037722 ......... ............ A Ligate/strip long leg vein ............................... 8.04 NA NA 3.80 4.26 0.86 NA NA 12.70 13.16 09037735 ......... ............ A Removal of leg veins/lesion .......................... 10.75 NA NA 4.67 5.29 1.48 NA NA 16.90 17.52 09037760 ......... ............ A Ligation, leg veins, open ............................... 10.63 NA NA 4.55 5.14 1.44 NA NA 16.62 17.21 09037765 ......... ............ A Phleb veins—extrem—to 20 ......................... 7.59 NA NA 3.60 4.37 0.48 NA NA 11.67 12.44 09037766 ......... ............ A Phleb veins—extrem 20+ .............................. 9.54 NA NA 4.15 5.03 0.48 NA NA 14.17 15.05 09037780 ......... ............ A Revision of leg vein ....................................... 3.83 NA NA 2.50 2.76 0.53 NA NA 6.86 7.12 09037785 ......... ............ 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 09037788 ......... ............ A Revascularization, penis ............................... 23.13 NA NA 11.95 9.80 2.25 NA NA 37.33 35.18 09037790 ......... ............ A Penile venous occlusion ................................ 8.33 NA NA 5.09 4.55 0.59 NA NA 14.01 13.4709037799 ......... ............ C Vascular surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY38100 ......... ............ A Removal of spleen, total ............................... 19.43 NA NA 6.94 6.36 1.91 NA NA 28.28 27.7009038101 ......... ............ A Removal of spleen, partial ............................ 19.43 NA NA 7.36 6.73 2.04 NA NA 28.83 28.2009038102 ......... ............ A Removal of spleen, total ............................... 4.79 NA NA 1.27 1.55 0.63 NA NA 6.69 6.97 ZZZ38115 ......... ............ A Repair of ruptured spleen ............................. 21.76 NA NA 7.59 6.88 2.08 NA NA 31.43 30.7209038120 ......... ............ A Laparoscopy, splenectomy ............................ 16.97 NA NA 7.00 7.29 2.24 NA NA 26.21 26.50 09038129 ......... ............ C Laparoscope proc, spleen ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY38200 ......... ............ A Injection for spleen x-ray ............................... 2.64 NA NA 1.00 0.92 0.14 NA NA 3.78 3.7000038205 ......... ............ R Harvest allogenic stem cells ......................... 1.50 NA NA 0.54 0.64 0.07 NA NA 2.11 2.21 00038206 ......... ............ R Harvest auto stem cells ................................. 1.50 NA NA 0.54 0.64 0.07 NA NA 2.11 2.21 00038220 ......... ............ A Bone marrow aspiration ................................ 1.08 2.67 3.46 0.44 0.50 0.05 3.80 4.59 1.571.63 XXX38221 ......... ............ A Bone marrow biopsy ..................................... 1.37 2.79 3.65 0.57 0.63 0.07 4.23 5.09 2.012.07 XXX38230 ......... ............ R Bone marrow collection ................................. 4.78 NA NA 2.76 3.11 0.48 NA NA 8.02 8.37 01038240 ......... ............ R Bone marrow/stem transplant ....................... 2.24 NA NA 0.93 1.01 0.11 NA NA 3.28 3.36 XXX38241 ......... ............ R Bone marrow/stem transplant ....................... 2.24 NA NA 0.93 1.01 0.11 NA NA 3.28 3.36 XXX38242 ......... ............ A Lymphocyte infuse transplant ....................... 1.71 NA NA 0.69 0.76 0.08 NA NA 2.48 2.55 00038300 ......... ............ 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 01038305 ......... ............ A Drainage, lymph node lesion ........................ 6.49 NA NA 3.42 4.19 0.88 NA NA 10.79 11.56 09038308 ......... ............ A Incision of lymph channels ............................ 6.69 NA NA 3.59 3.70 0.85 NA NA 11.13 11.24 09038380 ......... ............ A Thoracic duct procedure ............................... 8.26 NA NA 4.64 5.42 0.74 NA NA 13.64 14.42 09038381 ......... ............ A Thoracic duct procedure ............................... 13.28 NA NA 6.11 6.69 1.84 NA NA 21.23 21.8109038382 ......... ............ A Thoracic duct procedure ............................... 10.42 NA NA 5.47 5.68 1.37 NA NA 17.26 17.4709038500 ......... ............ A Biopsy/removal, lymph nodes ....................... 3.74 3.78 3.71 2.04 2.07 0.49 8.01 7.94 6.27 6.30010



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00155 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49136 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal38505 ......... ............ 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 00038510 ......... ............ 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 01038520 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.91 NA NA 3.71 3.97 0.84 NA NA 11.46 11.72 09038525 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.31 NA NA 3.50 3.34 0.80 NA NA 10.61 10.45 09038530 ......... ............ A Biopsy/removal, lymph nodes ....................... 8.22 NA NA 4.12 4.32 1.12 NA NA 13.46 13.66 09038542 ......... ............ 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 09038562 ......... ............ A Removal, pelvic lymph nodes ....................... 10.83 NA NA 5.77 5.77 1.20 NA NA 17.80 17.80 09038564 ......... ............ A Removal, abdomen lymph nodes ................. 11.23 NA NA 5.25 5.24 1.32 NA NA 17.80 17.79 09038570 ......... ............ A Laparoscopy, lymph node biop ..................... 9.24 NA NA 3.98 3.97 1.13 NA NA 14.35 14.34 01038571 ......... ............ A Laparoscopy, lymphadenectomy ................... 14.66 NA NA 6.86 5.95 1.15 NA NA 22.67 21.76 01038572 ......... ............ A Laparoscopy, lymphadenectomy ................... 16.82 NA NA 6.16 6.84 1.90 NA NA 24.88 25.56 01038589 ......... ............ C Laparoscope proc, lymphatic ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY38700 ......... ............ A Removal of lymph nodes, neck ..................... 12.62 NA NA 5.91 6.15 0.72 NA NA 19.25 19.49 09038720 ......... ............ A Removal of lymph nodes, neck ..................... 21.64 NA NA 9.21 9.32 1.20 NA NA 32.05 32.16 09038724 ......... ............ A Removal of lymph nodes, neck ..................... 23.64 NA NA 9.79 9.82 1.28 NA NA 34.71 34.74 09038740 ......... ............ A Remove armpit lymph nodes ........................ 10.51 NA NA 5.07 4.97 1.32 NA NA 16.90 16.80 09038745 ......... ............ A Remove armpit lymph nodes ........................ 13.65 NA NA 6.12 6.08 1.73 NA NA 21.50 21.46 09038746 ......... ............ A Remove thoracic lymph nodes ...................... 4.88 NA NA 1.45 1.57 0.72 NA NA 7.05 7.17 ZZZ38747 ......... ............ A Remove abdominal lymph nodes .................. 4.88 NA NA 1.28 1.57 0.64 NA NA 6.80 7.09 ZZZ38760 ......... ............ A Remove groin lymph nodes .......................... 13.43 NA NA 6.01 6.09 1.71 NA NA 21.15 21.23 09038765 ......... ............ A Remove groin lymph nodes .......................... 21.72 NA NA 8.72 8.78 2.47 NA NA 32.91 32.97 09038770 ......... ............ A Remove pelvis lymph nodes ......................... 13.93 NA NA 6.91 6.03 1.40 NA NA 22.24 21.36 09038780 ......... ............ A Remove abdomen lymph nodes ................... 17.47 NA NA 8.00 8.15 1.88 NA NA 27.35 27.50 09038790 ......... ............ A Inject for lymphatic x-ray ............................... 1.29 NA NA 0.73 0.75 0.13 NA NA 2.15 2.1700038792 ......... ............ A Identify sentinel node .................................... 0.52 NA NA 0.48 0.45 0.06 NA NA 1.06 1.0300038794 ......... ............ A Access thoracic lymph duct .......................... 4.44 NA NA 3.04 3.35 0.32 NA NA 7.80 8.11 09038999 ......... ............ C Blood/lymph system procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY39000 ......... ............ A Exploration of chest ....................................... 7.46 NA NA 4.36 4.58 0.89 NA NA 12.71 12.93 09039010 ......... ............ A Exploration of chest ....................................... 13.08 NA NA 6.17 7.20 1.75 NA NA 21.00 22.03 09039200 ......... ............ A Removal chest lesion .................................... 15.02 NA NA 6.29 7.22 2.02 NA NA 23.33 24.26 09039220 ......... ............ A Removal chest lesion .................................... 18.42 NA NA 7.64 8.93 2.45 NA NA 28.51 29.80 09039400 ......... ............ A Visualization of chest .................................... 5.97 NA NA 3.62 4.54 0.82 NA NA 10.41 11.33 01039499 ......... ............ C Chest procedure ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 YYY39501 ......... ............ A Repair diaphragm laceration ......................... 13.83 NA NA 5.93 6.32 1.77 NA NA 21.53 21.92 09039502 ......... ............ A Repair paraesophageal hernia ...................... 17.03 NA NA 6.66 7.02 2.16 NA NA 25.85 26.21 09039503 ......... ............ A Repair of diaphragm hernia .......................... 108.57 NA NA 30.95 32.77 10.95 NA NA 150.47 152.29 09039520 ......... ............ A Repair of diaphragm hernia .......................... 16.56 NA NA 6.93 7.76 2.23 NA NA 25.72 26.55 09039530 ......... ............ A Repair of diaphragm hernia .......................... 16.17 NA NA 6.43 6.96 2.10 NA NA 24.70 25.23 09039531 ......... ............ A Repair of diaphragm hernia .......................... 17.18 NA NA 6.63 7.19 2.21 NA NA 26.02 26.58 09039540 ......... ............ A Repair of diaphragm hernia .......................... 14.47 NA NA 5.65 6.08 1.79 NA NA 21.91 22.34 09039541 ......... ............ A Repair of diaphragm hernia .......................... 15.62 NA NA 6.21 6.49 1.92 NA NA 23.75 24.03 09039545 ......... ............ A Revision of diaphragm .................................. 14.52 NA NA 7.23 7.46 1.83 NA NA 23.58 23.8109039560 ......... ............ A Resect diaphragm, simple ............................. 12.91 NA NA 5.58 6.11 1.59 NA NA 20.08 20.61 09039561 ......... ............ 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 0.00YYY40490 ......... ............ A Biopsy of lip ................................................... 1.22 2.02 1.73 0.55 0.60 0.05 3.293.00 1.82 1.87 00040500 ......... ............ 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 09040510 ......... ............ 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 09040520 ......... ............ 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 09040525 ......... ............ A Reconstruct lip with flap ................................ 7.54 NA NA 5.23 6.03 0.85 NA NA 13.62 14.42 09040527 ......... ............ A Reconstruct lip with flap ................................ 9.12 NA NA 5.84 6.97 0.97 NA NA 15.93 17.06 09040530 ......... ............ 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 09040650 ......... ............ A Repair lip ....................................................... 3.63 5.91 6.57 3.12 3.25 0.38 9.9210.58 7.13 7.26 09040652 ......... ............ A Repair lip ....................................................... 4.25 6.97 7.55 3.94 4.18 0.52 11.74 12.32 8.71 8.95 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00156 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49137 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules40654 ......... ............ A Repair lip ....................................................... 5.30 7.98 8.45 4.60 4.85 0.60 13.88 14.35 10.50 10.75 09040700 ......... ............ A Repair cleft lip/nasal ...................................... 13.89 NA NA 9.13 9.09 0.95 NA NA 23.9723.93 09040701 ......... ............ A Repair cleft lip/nasal ...................................... 16.95 NA NA 11.13 11.28 1.65 NA NA 29.73 29.88 09040702 ......... ............ A Repair cleft lip/nasal ...................................... 14.02 NA NA 7.21 7.99 1.23 NA NA 22.4623.24 09040720 ......... ............ A Repair cleft lip/nasal ...................................... 14.47 NA NA 9.01 9.67 1.79 NA NA 25.2725.93 09040761 ......... ............ A Repair cleft lip/nasal ...................................... 15.63 NA NA 8.82 9.91 1.93 NA NA 26.3827.47 09040799 ......... ............ C Lip surgery procedure ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY40800 ......... ............ A Drainage of mouth lesion .............................. 1.17 3.84 3.18 1.88 1.80 0.13 5.14 4.48 3.183.10 01040801 ......... ............ A Drainage of mouth lesion .............................. 2.53 4.85 4.23 2.55 2.69 0.31 7.69 7.07 5.395.53 01040804 ......... ............ A Removal, foreign body, mouth ...................... 1.24 3.63 3.45 1.75 1.83 0.11 4.98 4.80 3.10 3.1801040805 ......... ............ A Removal, foreign body, mouth ...................... 2.69 5.04 4.62 2.56 2.75 0.32 8.05 7.63 5.57 5.7601040806 ......... ............ 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 00040808 ......... ............ 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 01040810 ......... ............ A Excision of mouth lesion ............................... 1.31 3.57 3.05 1.66 1.66 0.13 5.01 4.49 3.103.10 01040812 ......... ............ A Excise/repair mouth lesion ............................ 2.31 4.51 3.92 2.26 2.37 0.28 7.10 6.51 4.854.96 01040814 ......... ............ A Excise/repair mouth lesion ............................ 3.41 5.62 5.11 3.64 3.83 0.41 9.44 8.93 7.467.65 09040816 ......... ............ A Excision of mouth lesion ............................... 3.66 5.79 5.33 3.68 3.92 0.40 9.85 9.39 7.747.98 09040818 ......... ............ 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 09040819 ......... ............ 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 09040820 ......... ............ 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 01040830 ......... ............ A Repair mouth laceration ................................ 1.76 4.11 3.82 2.02 2.07 0.19 6.06 5.77 3.974.02 01040831 ......... ............ A Repair mouth laceration ................................ 2.46 5.33 4.83 2.73 2.97 0.30 8.09 7.59 5.495.73 01040840 ......... ............ R Reconstruction of mouth ............................... 8.97 9.99 9.83 5.53 6.61 1.08 20.04 19.88 15.58 16.66 09040842 ......... ............ R Reconstruction of mouth ............................... 8.97 9.71 9.97 5.32 6.42 1.08 19.76 20.02 15.37 16.47 09040843 ......... ............ R Reconstruction of mouth ............................... 12.56 11.76 11.90 6.01 7.36 1.39 25.71 25.8519.96 21.31 09040844 ......... ............ R Reconstruction of mouth ............................... 16.47 14.78 15.52 8.75 10.86 1.99 33.24 33.9827.21 29.32 09040845 ......... ............ R Reconstruction of mouth ............................... 19.03 15.15 16.58 9.55 12.30 2.00 36.18 37.6130.58 33.33 09040899 ......... ............ C Mouth surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY41000 ......... ............ A Drainage of mouth lesion .............................. 1.30 2.49 2.36 1.29 1.38 0.12 3.91 3.78 2.712.80 01041005 ......... ............ A Drainage of mouth lesion .............................. 1.26 4.23 3.56 1.71 1.72 0.12 5.61 4.94 3.093.10 01041006 ......... ............ A Drainage of mouth lesion .............................. 3.24 5.29 4.92 2.73 3.06 0.35 8.88 8.51 6.326.65 09041007 ......... ............ A Drainage of mouth lesion .............................. 3.10 5.33 5.19 2.71 2.94 0.31 8.74 8.60 6.126.35 09041008 ......... ............ A Drainage of mouth lesion .............................. 3.36 5.41 4.86 2.78 3.10 0.42 9.19 8.64 6.566.88 09041009 ......... ............ A Drainage of mouth lesion .............................. 3.58 5.80 5.18 3.11 3.46 0.47 9.85 9.23 7.167.51 09041010 ......... ............ 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 01041015 ......... ............ 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 09041016 ......... ............ 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 09041017 ......... ............ 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 09041018 ......... ............ 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 09041100 ......... ............ A Biopsy of tongue ........................................... 1.37 2.57 2.46 1.11 1.34 0.15 4.09 3.982.63 2.86 01041105 ......... ............ A Biopsy of tongue ........................................... 1.42 2.56 2.37 1.13 1.27 0.13 4.11 3.922.68 2.82 01041108 ......... ............ 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 01041110 ......... ............ A Excision of tongue lesion .............................. 1.51 3.46 3.10 1.54 1.62 0.13 5.10 4.74 3.183.26 01041112 ......... ............ A Excision of tongue lesion .............................. 2.73 5.11 4.63 3.14 3.20 0.28 8.12 7.64 6.156.21 09041113 ......... ............ A Excision of tongue lesion .............................. 3.19 5.38 4.90 3.29 3.43 0.34 8.91 8.43 6.826.96 09041114 ......... ............ A Excision of tongue lesion .............................. 8.64 NA NA 5.94 6.88 0.83 NA NA 15.41 16.3509041115 ......... ............ 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 01041116 ......... ............ A Excision of mouth lesion ............................... 2.44 5.31 4.59 2.65 2.76 0.23 7.98 7.26 5.325.43 09041120 ......... ............ A Partial removal of tongue .............................. 10.83 NA NA 13.22 14.79 0.79 NA NA 24.84 26.41 09041130 ......... ............ A Partial removal of tongue .............................. 15.43 NA NA 14.55 15.78 0.93 NA NA 30.91 32.14 09041135 ......... ............ A Tongue and neck surgery ............................. 29.71 NA NA 19.86 22.38 1.88 NA NA 51.45 53.9709041140 ......... ............ A Removal of tongue ........................................ 28.69 NA NA 21.36 25.34 2.26 NA NA 52.31 56.29 09041145 ......... ............ 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 09041153 ......... ............ A Tongue, mouth, neck surgery ....................... 33.16 NA NA 21.82 24.22 2.00 NA NA 56.98 59.38 09041155 ......... ............ A Tongue, jaw, & neck surgery ........................ 39.84 NA NA 23.98 26.10 2.33 NA NA 66.15 68.27 09041250 ......... ............ A Repair tongue laceration ............................... 1.91 3.79 3.00 1.58 1.28 0.18 5.88 5.09 3.673.37 01041251 ......... ............ A Repair tongue laceration ............................... 2.27 3.15 3.24 1.63 1.57 0.22 5.64 5.73 4.124.06 01041252 ......... ............ A Repair tongue laceration ............................... 2.97 4.34 4.00 1.96 2.18 0.29 7.60 7.26 5.225.44 01041500 ......... ............ A Fixation of tongue .......................................... 3.70 NA NA 6.54 7.22 0.30 NA NA 10.54 11.22 09041510 ......... ............ A Tongue to lip surgery .................................... 3.41 NA NA 7.02 7.70 0.20 NA NA 10.63 11.31 09041520 ......... ............ A Reconstruction, tongue fold .......................... 2.73 5.71 4.89 3.20 3.52 0.27 8.71 7.89 6.20 6.52 09041599 ......... ............ 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 YYY41800 ......... ............ A Drainage of gum lesion ................................. 1.17 4.76 3.13 2.09 1.48 0.12 6.05 4.42 3.382.77 01041805 ......... ............ 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 01041806 ......... ............ A Removal foreign body,jawbone ..................... 2.69 5.91 4.16 3.39 3.12 0.37 8.97 7.22 6.45 6.18010



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# 49138 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal41822 ......... ............ 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 01041823 ......... ............ 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 09041825 ......... ............ 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 01041826 ......... ............ 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 01041827 ......... ............ 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 09041828 ......... ............ 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 01041830 ......... ............ R Removal of gum tissue ................................. 3.34 6.03 5.23 3.13 3.50 0.44 9.81 9.01 6.917.28 01041872 ......... ............ R Repair gum .................................................... 2.84 5.87 5.23 3.25 3.41 0.30 9.01 8.37 6.39 6.55 09041874 ......... ............ R Repair tooth socket ....................................... 3.09 5.76 5.07 2.76 3.07 0.45 9.30 8.61 6.30 6.61 09041899 ......... ............ C Dental surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY42000 ......... ............ 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 01042100 ......... ............ 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 01042104 ......... ............ A Excision lesion, mouth roof ........................... 1.64 3.43 2.76 1.58 1.56 0.16 5.23 4.56 3.383.36 01042106 ......... ............ A Excision lesion, mouth roof ........................... 2.10 4.41 3.52 2.04 2.34 0.25 6.76 5.87 4.394.69 01042107 ......... ............ 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 09042120 ......... ............ A Remove palate/lesion .................................... 11.62 NA NA 11.41 11.68 0.52 NA NA 23.55 23.82 09042140 ......... ............ A Excision of uvula ........................................... 1.62 4.22 3.85 1.93 2.05 0.13 5.97 5.603.68 3.80 09042145 ......... ............ 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 01042180 ......... ............ A Repair palate ................................................. 2.50 3.21 3.11 1.76 2.02 0.21 5.92 5.82 4.47 4.73 01042182 ......... ............ A Repair palate ................................................. 3.82 4.01 3.91 2.36 2.86 0.40 8.23 8.13 6.58 7.08 01042200 ......... ............ A Reconstruct cleft palate ................................. 12.35 NA NA 8.11 9.69 1.27 NA NA 21.73 23.31 09042205 ......... ............ A Reconstruct cleft palate ................................. 13.51 NA NA 7.46 9.42 1.58 NA NA 22.55 24.51 09042210 ......... ............ A Reconstruct cleft palate ................................. 14.85 NA NA 9.72 11.03 2.16 NA NA 26.73 28.04 09042215 ......... ............ A Reconstruct cleft palate ................................. 8.81 NA NA 7.21 8.61 1.31 NA NA 17.33 18.73 09042220 ......... ............ A Reconstruct cleft palate ................................. 7.01 NA NA 6.71 6.76 0.73 NA NA 14.45 14.50 09042225 ......... ............ A Reconstruct cleft palate ................................. 9.59 NA NA 12.00 15.80 0.86 NA NA 22.45 26.25 09042226 ......... ............ A Lengthening of palate .................................... 10.17 NA NA 11.33 13.86 1.01 NA NA 22.51 25.04 09042227 ......... ............ A Lengthening of palate .................................... 9.75 NA NA 9.68 14.08 0.98 NA NA 20.41 24.81 09042235 ......... ............ A Repair palate ................................................. 7.86 NA NA 10.27 11.46 0.72 NA NA 18.85 20.04 09042260 ......... ............ 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 09042280 ......... ............ A Preparation, palate mold ............................... 1.54 2.25 2.03 0.84 1.07 0.19 3.98 3.76 2.572.80 01042281 ......... ............ A Insertion, palate prosthesis ........................... 1.93 2.82 2.68 1.56 1.79 0.17 4.92 4.78 3.663.89 01042299 ......... ............ C Palate/uvula surgery ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY42300 ......... ............ A Drainage of salivary gland ............................ 1.93 2.92 2.85 1.59 1.76 0.16 5.01 4.94 3.683.85 01042305 ......... ............ A Drainage of salivary gland ............................ 6.18 NA NA 3.65 4.45 0.51 NA NA 10.34 11.14 09042310 ......... ............ A Drainage of salivary gland ............................ 1.56 2.18 2.24 1.31 1.48 0.13 3.87 3.93 3.003.17 01042320 ......... ............ A Drainage of salivary gland ............................ 2.35 3.54 3.34 1.76 2.01 0.21 6.10 5.90 4.324.57 01042330 ......... ............ A Removal of salivary stone ............................. 2.21 3.19 3.15 1.59 1.78 0.19 5.59 5.55 3.994.18 01042335 ......... ............ A Removal of salivary stone ............................. 3.31 5.43 5.03 2.65 3.02 0.29 9.03 8.63 6.256.62 09042340 ......... ............ 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 09042400 ......... ............ 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 00042405 ......... ............ 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 01042408 ......... ............ A Excision of salivary cyst ................................ 4.53 6.07 5.95 3.05 3.47 0.45 11.05 10.938.03 8.45 09042409 ......... ............ 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 09042410 ......... ............ A Excise parotid gland/lesion ........................... 9.39 NA NA 4.90 5.89 0.91 NA NA 15.20 16.19 09042415 ......... ............ A Excise parotid gland/lesion ........................... 17.92 NA NA 7.69 10.07 1.43 NA NA 27.04 29.4209042420 ......... ............ A Excise parotid gland/lesion ........................... 20.80 NA NA 8.50 11.40 1.65 NA NA 30.95 33.8509042425 ......... ............ A Excise parotid gland/lesion ........................... 13.24 NA NA 6.03 7.97 1.05 NA NA 20.32 22.2609042426 ......... ............ A Excise parotid gland/lesion ........................... 22.46 NA NA 8.77 11.95 1.80 NA NA 33.03 36.2109042440 ......... ............ A Excise submaxillary gland ............................. 7.02 NA NA 3.46 4.46 0.59 NA NA 11.07 12.07 09042450 ......... ............ A Excise sublingual gland ................................. 4.61 5.87 5.89 3.66 4.10 0.42 10.90 10.92 8.69 9.13 09042500 ......... ............ A Repair salivary duct ....................................... 4.29 5.79 5.71 3.62 4.04 0.41 10.49 10.41 8.32 8.74 09042505 ......... ............ A Repair salivary duct ....................................... 6.17 6.73 7.02 4.32 5.10 0.55 13.45 13.74 11.04 11.82 09042507 ......... ............ A Parotid duct diversion .................................... 6.10 NA NA 5.90 6.37 0.49 NA NA 12.49 12.96 09042508 ......... ............ A Parotid duct diversion .................................... 9.15 NA NA 7.50 8.13 1.04 NA NA 17.69 18.32 090



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# 49139 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules42509 ......... ............ A Parotid duct diversion .................................... 11.58 NA NA 8.70 9.82 0.93 NA NA 21.21 22.33 09042510 ......... ............ A Parotid duct diversion .................................... 8.20 NA NA 6.33 7.43 0.66 NA NA 15.19 16.29 09042550 ......... ............ 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 00042600 ......... ............ A Closure of salivary fistula .............................. 4.81 6.46 6.55 3.32 3.92 0.43 11.70 11.798.56 9.16 09042650 ......... ............ 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 00042660 ......... ............ 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 00042665 ......... ............ 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 09042699 ......... ............ C Salivary surgery procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY42700 ......... ............ A Drainage of tonsil abscess ............................ 1.62 2.74 2.67 1.51 1.65 0.13 4.49 4.42 3.263.40 01042720 ......... ............ A Drainage of throat abscess ........................... 6.31 4.28 4.69 2.84 3.55 0.44 11.03 11.44 9.5910.30 01042725 ......... ............ A Drainage of throat abscess ........................... 12.22 NA NA 6.56 7.81 0.91 NA NA 19.69 20.94 09042800 ......... ............ A Biopsy of throat ............................................. 1.39 2.27 2.20 1.17 1.34 0.11 3.77 3.70 2.67 2.84 01042802 ......... ............ A Biopsy of throat ............................................. 1.54 3.83 4.53 1.52 1.93 0.12 5.49 6.19 3.18 3.59 01042804 ......... ............ 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 01042806 ......... ............ 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 01042808 ......... ............ A Excise pharynx lesion ................................... 2.30 2.96 3.06 1.44 1.81 0.19 5.45 5.55 3.93 4.30 01042809 ......... ............ A Remove pharynx foreign body ...................... 1.81 2.12 2.28 1.25 1.31 0.16 4.09 4.25 3.22 3.2801042810 ......... ............ 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 09042815 ......... ............ A Excision of neck cyst ..................................... 7.18 NA NA 5.70 6.23 0.61 NA NA 13.49 14.02 09042820 ......... ............ A Remove tonsils and adenoids ....................... 4.15 NA NA 2.53 3.10 0.31 NA NA 6.99 7.56 09042821 ......... ............ A Remove tonsils and adenoids ....................... 4.28 NA NA 2.68 3.30 0.35 NA NA 7.31 7.93 09042825 ......... ............ A Removal of tonsils ......................................... 3.41 NA NA 2.42 2.98 0.25 NA NA 6.08 6.64 09042826 ......... ............ A Removal of tonsils ......................................... 3.37 NA NA 2.42 2.88 0.27 NA NA 6.06 6.52 09042830 ......... ............ A Removal of adenoids .................................... 2.57 NA NA 2.19 2.47 0.20 NA NA 4.96 5.24 09042831 ......... ............ A Removal of adenoids .................................... 2.71 NA NA 2.41 2.73 0.22 NA NA 5.34 5.66 09042835 ......... ............ A Removal of adenoids .................................... 2.30 NA NA 1.79 2.29 0.21 NA NA 4.30 4.80 09042836 ......... ............ A Removal of adenoids .................................... 3.18 NA NA 2.40 2.82 0.26 NA NA 5.84 6.26 09042842 ......... ............ A Extensive surgery of throat ........................... 11.94 NA NA 10.96 10.98 0.71 NA NA 23.61 23.63 09042844 ......... ............ A Extensive surgery of throat ........................... 17.49 NA NA 13.99 15.67 1.16 NA NA 32.64 34.32 09042845 ......... ............ A Extensive surgery of throat ........................... 32.27 NA NA 19.00 22.14 1.98 NA NA 53.25 56.39 09042860 ......... ............ A Excision of tonsil tags ................................... 2.22 NA NA 2.10 2.33 0.18 NA NA 4.50 4.7309042870 ......... ............ A Excision of lingual tonsil ................................ 5.39 NA NA 7.97 8.42 0.44 NA NA 13.80 14.25 09042890 ......... ............ A Partial removal of pharynx ............................ 18.84 NA NA 13.79 14.06 1.05 NA NA 33.68 33.95 09042892 ......... ............ A Revision of pharyngeal walls ........................ 25.67 NA NA 17.34 17.21 1.28 NA NA 44.29 44.1609042894 ......... ............ A Revision of pharyngeal walls ........................ 33.49 NA NA 21.04 21.78 1.86 NA NA 56.39 57.1309042900 ......... ............ A Repair throat wound ...................................... 5.24 NA NA 2.70 3.42 0.50 NA NA 8.44 9.1601042950 ......... ............ A Reconstruction of throat ................................ 8.09 NA NA 10.21 11.46 0.72 NA NA 19.02 20.27 09042953 ......... ............ A Repair throat, esophagus .............................. 9.25 NA NA 12.87 16.22 0.88 NA NA 23.00 26.3509042955 ......... ............ A Surgical opening of throat ............................. 7.86 NA NA 9.37 10.35 0.80 NA NA 18.03 19.0109042960 ......... ............ A Control throat bleeding .................................. 2.33 NA NA 1.59 1.87 0.19 NA NA 4.11 4.3901042961 ......... ............ A Control throat bleeding .................................. 5.64 NA NA 4.08 4.74 0.45 NA NA 10.17 10.83 09042962 ......... ............ A Control throat bleeding .................................. 7.25 NA NA 4.69 5.61 0.58 NA NA 12.52 13.44 09042970 ......... ............ 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 09042972 ......... ............ A Control nose/throat bleeding ......................... 7.49 NA NA 4.42 5.38 0.62 NA NA 12.53 13.49 09042999 ......... ............ C Throat surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY43020 ......... ............ A Incision of esophagus ................................... 8.08 NA NA 4.32 5.14 0.87 NA NA 13.27 14.0909043030 ......... ............ A Throat muscle surgery .................................. 7.86 NA NA 4.13 5.15 0.70 NA NA 12.69 13.7109043045 ......... ............ A Incision of esophagus ................................... 21.63 NA NA 10.07 10.54 2.58 NA NA 34.28 34.75 09043100 ......... ............ 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 09043107 ......... ............ A Removal of esophagus ................................. 43.89 NA NA 16.66 17.86 5.22 NA NA 65.77 66.9709043108 ......... ............ A Removal of esophagus ................................. 63.23 NA NA 20.50 15.78 4.07 NA NA 87.80 83.0809043112 ......... ............ A Removal of esophagus ................................. 47.21 NA NA 17.15 18.81 5.79 NA NA 70.15 71.8109043113 ......... ............ A Removal of esophagus ................................. 46.95 NA NA 17.99 15.83 4.42 NA NA 69.36 67.2009043116 ......... ............ A Partial removal of esophagus ....................... 71.39 NA NA 22.74 18.20 3.05 NA NA 97.18 92.64 09043117 ......... ............ A Partial removal of esophagus ....................... 43.46 NA NA 15.40 16.80 5.17 NA NA 64.03 65.43 09043118 ......... ............ A Partial removal of esophagus ....................... 52.07 NA NA 17.39 14.68 4.10 NA NA 73.56 70.85 09043121 ......... ............ A Partial removal of esophagus ....................... 46.35 NA NA 17.01 14.51 3.90 NA NA 67.26 64.76 09043122 ......... ............ A Partial removal of esophagus ....................... 43.89 NA NA 15.83 17.00 5.40 NA NA 65.12 66.29 09043123 ......... ............ A Partial removal of esophagus ....................... 63.83 NA NA 21.00 15.83 4.15 NA NA 88.98 83.81 09043124 ......... ............ A Removal of esophagus ................................. 64.63 NA NA 22.76 15.50 3.73 NA NA 91.12 83.8609043130 ......... ............ A Removal of esophagus pouch ...................... 12.33 NA NA 5.93 7.15 1.16 NA NA 19.42 20.64 09043135 ......... ............ A Removal of esophagus pouch ...................... 22.37 NA NA 8.93 8.30 2.33 NA NA 33.63 33.00 09043200 ......... ............ A Esophagus endoscopy .................................. 1.59 3.53 3.98 0.91 1.03 0.13 5.25 5.70 2.63 2.75 00043201 ......... ............ A Esoph scope w/submucous inj ...................... 2.09 5.56 4.86 1.18 1.12 0.15 7.80 7.10 3.42 3.36000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00159 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49140 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal43202 ......... ............ A Esophagus endoscopy, biopsy ..................... 1.89 5.13 5.44 0.97 0.95 0.15 7.17 7.48 3.01 2.99 00043204 ......... ............ A Esoph scope w/sclerosis inj .......................... 3.76 NA NA 1.93 1.62 0.30 NA NA 5.99 5.68 00043205 ......... ............ A Esophagus endoscopy/ligation ...................... 3.78 NA NA 2.02 1.65 0.28 NA NA 6.08 5.71 00043215 ......... ............ A Esophagus endoscopy .................................. 2.60 NA NA 1.25 1.21 0.22 NA NA 4.07 4.03 00043216 ......... ............ A Esophagus endoscopy/lesion ........................ 2.40 3.00 1.55 1.21 1.10 0.20 5.60 4.15 3.81 3.7000043217 ......... ............ A Esophagus endoscopy .................................. 2.90 6.58 6.86 1.40 1.24 0.26 9.74 10.02 4.564.40 00043219 ......... ............ A Esophagus endoscopy .................................. 2.80 NA NA 1.53 1.40 0.24 NA NA 4.57 4.44 00043220 ......... ............ A Esoph endoscopy, dilation ............................ 2.10 NA NA 1.12 1.01 0.17 NA NA 3.39 3.28 00043226 ......... ............ A Esoph endoscopy, dilation ............................ 2.34 NA NA 1.27 1.09 0.19 NA NA 3.80 3.62 00043227 ......... ............ A Esoph endoscopy, repair .............................. 3.59 NA NA 1.81 1.54 0.28 NA NA 5.68 5.41 00043228 ......... ............ A Esoph endoscopy, ablation ........................... 3.76 NA NA 1.84 1.62 0.34 NA NA 5.94 5.72 00043231 ......... ............ A Esoph endoscopy w/us exam ....................... 3.19 NA NA 1.72 1.41 0.23 NA NA 5.14 4.83 00043232 ......... ............ A Esoph endoscopy w/us fn bx ........................ 4.47 NA NA 2.34 1.94 0.34 NA NA 7.15 6.75 00043234 ......... ............ A Upper GI endoscopy, exam .......................... 2.01 4.98 5.24 1.01 0.91 0.17 7.16 7.42 3.19 3.0900043235 ......... ............ 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 00043236 ......... ............ 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 00043237 ......... ............ A Endoscopic us exam, esoph ......................... 3.98 NA NA 2.12 1.72 0.43 NA NA 6.53 6.13 00043238 ......... ............ A Uppr gi endoscopy w/us fn bx ...................... 5.02 NA NA 2.52 2.10 0.43 NA NA 7.97 7.55 00043239 ......... ............ 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 00043240 ......... ............ A Esoph endoscope w/drain cyst ..................... 6.85 NA NA 3.41 2.80 0.56 NA NA 10.82 10.21 00043241 ......... ............ A Upper GI endoscopy with tube ..................... 2.59 NA NA 1.40 1.18 0.21 NA NA 4.20 3.98 00043242 ......... ............ A Uppr gi endoscopy w/us fn bx ...................... 7.30 NA NA 3.65 2.96 0.53 NA NA 11.48 10.79 00043243 ......... ............ A Upper gi endoscopy & inject ......................... 4.56 NA NA 2.34 1.93 0.33 NA NA 7.23 6.82 00043244 ......... ............ A Upper GI endoscopy/ligation ......................... 5.04 NA NA 2.62 2.13 0.37 NA NA 8.03 7.54 00043245 ......... ............ A Uppr gi scope dilate strictr ............................ 3.18 NA NA 1.62 1.38 0.26 NA NA 5.06 4.82 00043246 ......... ............ A Place gastrostomy tube ................................. 4.32 NA NA 2.10 1.79 0.34 NA NA 6.76 6.45 00043247 ......... ............ A Operative upper GI endoscopy ..................... 3.38 NA NA 1.77 1.47 0.27 NA NA 5.42 5.12 00043248 ......... ............ A Uppr gi endoscopy/guide wire ....................... 3.15 NA NA 1.76 1.42 0.23 NA NA 5.14 4.80 00043249 ......... ............ A Esoph endoscopy, dilation ............................ 2.90 NA NA 1.61 1.31 0.22 NA NA 4.73 4.43 00043250 ......... ............ A Upper GI endoscopy/tumor ........................... 3.20 NA NA 1.62 1.39 0.26 NA NA 5.08 4.85 00043251 ......... ............ A Operative upper GI endoscopy ..................... 3.69 NA NA 1.91 1.59 0.29 NA NA 5.89 5.57 00043255 ......... ............ A Operative upper GI endoscopy ..................... 4.81 NA NA 2.50 2.04 0.35 NA NA 7.66 7.20 00043256 ......... ............ A Uppr gi endoscopy w/stent ............................ 4.34 NA NA 2.23 1.84 0.32 NA NA 6.89 6.50 00043257 ......... ............ A Uppr gi scope w/thrml txmnt ......................... 5.50 NA NA 2.05 2.16 0.36 NA NA 7.91 8.02 00043258 ......... ............ A Operative upper GI endoscopy ..................... 4.54 NA NA 2.36 1.93 0.33 NA NA 7.23 6.80 00043259 ......... ............ A Endoscopic ultrasound exam ........................ 5.19 NA NA 2.66 2.16 0.35 NA NA 8.20 7.70 00043260 ......... ............ A Endo cholangiopancreatograph .................... 5.95 NA NA 3.04 2.47 0.43 NA NA 9.42 8.85 00043261 ......... ............ A Endo cholangiopancreatograph .................... 6.26 NA NA 3.19 2.59 0.46 NA NA 9.91 9.31 00043262 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.69 3.01 0.54 NA NA 11.61 10.93 00043263 ......... ............ A Endo cholangiopancreatograph .................... 7.28 NA NA 3.70 3.00 0.54 NA NA 11.52 10.82 00043264 ......... ............ A Endo cholangiopancreatograph .................... 8.89 NA NA 4.41 3.59 0.65 NA NA 13.95 13.13 00043265 ......... ............ A Endo cholangiopancreatograph .................... 10.00 NA NA 4.90 3.99 0.73 NA NA 15.63 14.72 00043267 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.60 2.99 0.54 NA NA 11.52 10.91 00043268 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.85 3.12 0.54 NA NA 11.77 11.04 00043269 ......... ............ A Endo cholangiopancreatograph .................... 8.20 NA NA 4.07 3.32 0.60 NA NA 12.87 12.12 00043271 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.70 3.01 0.54 NA NA 11.62 10.93 00043272 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.77 3.03 0.54 NA NA 11.69 10.95 00043280 ......... ............ A Laparoscopy, fundoplasty ............................. 17.96 NA NA 6.73 7.14 2.27 NA NA 26.96 27.37 09043289 ......... ............ C Laparoscope proc, esoph .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY43300 ......... ............ A Repair of esophagus ..................................... 9.13 NA NA 5.17 6.07 1.12 NA NA 15.42 16.3209043305 ......... ............ 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 09043312 ......... ............ A Repair esophagus and fistula ....................... 29.22 NA NA 9.96 11.41 4.00 NA NA 43.18 44.63 09043313 ......... ............ A Esophagoplasty congenital ........................... 48.07 NA NA 17.38 18.45 5.45 NA NA 70.90 71.9709043314 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00160 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49141 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules43324 ......... ............ A Revise esophagus & stomach ...................... 22.80 NA NA 8.42 8.68 2.75 NA NA 33.97 34.23 09043325 ......... ............ A Revise esophagus & stomach ...................... 22.41 NA NA 8.39 8.68 2.59 NA NA 33.39 33.68 09043326 ......... ............ A Revise esophagus & stomach ...................... 22.09 NA NA 9.37 9.31 2.84 NA NA 34.30 34.24 09043330 ......... ............ A Repair of esophagus ..................................... 22.00 NA NA 8.27 8.47 2.62 NA NA 32.89 33.09 09043331 ......... ............ A Repair of esophagus ..................................... 22.87 NA NA 9.58 9.73 2.93 NA NA 35.38 35.53 09043340 ......... ............ A Fuse esophagus & intestine .......................... 22.80 NA NA 9.09 8.99 2.45 NA NA 34.34 34.24 09043341 ......... ............ A Fuse esophagus & intestine .......................... 24.04 NA NA 10.12 10.04 2.91 NA NA 37.07 36.9909043350 ......... ............ 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 60.5960.04 09043361 ......... ............ A Gastrointestinal repair ................................... 45.42 NA NA 16.89 16.88 4.49 NA NA 66.8066.79 09043400 ......... ............ A Ligate esophagus veins ................................ 25.41 NA NA 13.74 10.51 1.95 NA NA 41.10 37.87 09043401 ......... ............ 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 37.0909043410 ......... ............ 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 09043420 ......... ............ 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 09043450 ......... ............ A Dilate esophagus ........................................... 1.38 2.66 2.64 0.92 0.75 0.11 4.15 4.132.41 2.24 00043453 ......... ............ A Dilate esophagus ........................................... 1.51 6.29 6.12 1.00 0.80 0.11 7.91 7.742.62 2.42 00043456 ......... ............ A Dilate esophagus ........................................... 2.57 12.99 13.55 1.45 1.19 0.20 15.76 16.32 4.22 3.96 00043458 ......... ............ A Dilate esophagus ........................................... 3.06 6.93 6.72 1.61 1.36 0.24 10.23 10.02 4.91 4.66 00043460 ......... ............ A Pressure treatment esophagus ..................... 3.79 NA NA 1.70 1.54 0.31 NA NA 5.80 5.64 00043496 ......... ............ 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 09043499 ......... ............ C Esophagus surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY43500 ......... ............ A Surgical opening of stomach ......................... 12.67 NA NA 5.27 5.05 1.45 NA NA 19.39 19.17 09043501 ......... ............ A Surgical repair of stomach ............................ 22.41 NA NA 8.18 8.27 2.64 NA NA 33.23 33.3209043502 ......... ............ A Surgical repair of stomach ............................ 25.50 NA NA 9.04 9.35 3.09 NA NA 37.63 37.9409043510 ......... ............ A Surgical opening of stomach ......................... 14.95 NA NA 6.89 6.66 1.48 NA NA 23.32 23.09 09043520 ......... ............ A Incision of pyloric muscle .............................. 11.17 NA NA 4.89 5.16 1.36 NA NA 17.42 17.69 09043600 ......... ............ A Biopsy of stomach ......................................... 1.91 NA NA 0.80 0.70 0.14 NA NA 2.85 2.7500043605 ......... ............ A Biopsy of stomach ......................................... 13.60 NA NA 5.46 5.33 1.58 NA NA 20.64 20.51 09043610 ......... ............ A Excision of stomach lesion ............................ 16.22 NA NA 6.11 6.13 1.93 NA NA 24.26 24.2809043611 ......... ............ A Excision of stomach lesion ............................ 20.19 NA NA 7.61 7.57 2.35 NA NA 30.15 30.1109043620 ......... ............ A Removal of stomach ..................................... 33.85 NA NA 11.16 11.63 3.95 NA NA 48.96 49.43 09043621 ......... ............ A Removal of stomach ..................................... 39.34 NA NA 12.57 12.12 4.03 NA NA 55.94 55.49 09043622 ......... ............ A Removal of stomach ..................................... 39.84 NA NA 12.71 12.61 4.29 NA NA 56.84 56.74 09043631 ......... ............ A Removal of stomach, partial ......................... 24.32 NA NA 8.68 9.03 2.98 NA NA 35.98 36.33 09043632 ......... ............ A Removal of stomach, partial ......................... 34.95 NA NA 11.43 9.72 2.98 NA NA 49.36 47.65 09043633 ......... ............ A Removal of stomach, partial ......................... 32.95 NA NA 10.92 9.72 3.05 NA NA 46.92 45.72 09043634 ......... ............ A Removal of stomach, partial ......................... 36.45 NA NA 11.97 10.55 3.32 NA NA 51.74 50.3209043635 ......... ............ A Removal of stomach, partial ......................... 2.06 NA NA 0.53 0.66 0.27 NA NA 2.86 2.99 ZZZ43640 ......... ............ A Vagotomy & pylorus repair ............................ 19.37 NA NA 7.42 7.29 2.25 NA NA 29.04 28.91 09043641 ......... ............ A Vagotomy & pylorus repair ............................ 19.62 NA NA 7.72 7.45 2.24 NA NA 29.58 29.31 09043644 ......... ............ A Lap gastric bypass/roux-en-y ........................ 29.18 NA NA 10.29 10.98 3.15 NA NA 42.62 43.3109043645 ......... ............ A Lap gastr bypass incl smll i ........................... 31.31 NA NA 11.27 11.83 3.53 NA NA 46.11 46.67 09043651 ......... ............ A Laparoscopy, vagus nerve ............................ 10.13 NA NA 4.67 4.74 1.33 NA NA 16.13 16.20 09043652 ......... ............ A Laparoscopy, vagus nerve ............................ 12.13 NA NA 5.23 5.62 1.55 NA NA 18.91 19.30 09043653 ......... ............ 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 0.000.00 YYY43750 ......... ............ A Place gastrostomy tube ................................. 4.60 NA NA 1.96 2.13 0.43 NA NA 6.99 7.16 01043752 ......... ............ A Nasal/orogastric w/stent ................................ 0.81 NA NA 0.24 0.26 0.02 NA NA 1.07 1.09 00043760 ......... ............ A Change gastrostomy tube ............................. 1.10 13.09 4.83 0.39 0.44 0.09 14.28 6.02 1.581.63 00043761 ......... ............ A Reposition gastrostomy tube ......................... 2.01 0.98 1.12 0.64 0.66 0.13 3.12 3.26 2.78 2.80 00043770 ......... ............ A Lap, place gastr adjust band ......................... 17.79 NA NA 7.57 7.68 2.18 NA NA 27.54 27.65 09043771 ......... ............ A Lap, revise adjust gast band ......................... 20.58 NA NA 8.22 8.50 2.54 NA NA 31.34 31.62 09043772 ......... ............ A Lap, remove adjust gast band ...................... 15.58 NA NA 6.03 6.32 1.92 NA NA 23.53 23.82 09043773 ......... ............ 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 23.0209043810 ......... ............ A Fusion of stomach and bowel ....................... 16.76 NA NA 6.28 6.20 1.93 NA NA 24.97 24.89 09043820 ......... ............ A Fusion of stomach and bowel ....................... 22.34 NA NA 8.19 6.85 2.03 NA NA 32.56 31.22 09043825 ......... ............ A Fusion of stomach and bowel ....................... 21.57 NA NA 7.96 8.00 2.53 NA NA 32.06 32.10 09043830 ......... ............ A Place gastrostomy tube ................................. 10.71 NA NA 5.22 4.94 1.25 NA NA 17.18 16.9009043831 ......... ............ A Place gastrostomy tube ................................. 8.31 NA NA 5.17 4.68 1.03 NA NA 14.51 14.02090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00161 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49142 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal43832 ......... ............ A Place gastrostomy tube ................................. 17.22 NA NA 7.15 6.92 1.97 NA NA 26.34 26.1109043840 ......... ............ A Repair of stomach lesion .............................. 22.64 NA NA 8.26 7.14 2.05 NA NA 32.95 31.8309043842 ......... ............ N V-band gastroplasty ...................................... 20.84 NA NA 7.81 7.80 2.44 NA NA 31.09 31.08 09043843 ......... ............ A Gastroplasty w/o v-band ............................... 21.02 NA NA 7.88 7.79 2.45 NA NA 31.35 31.2609043845 ......... ............ A Gastroplasty duodenal switch ....................... 33.04 NA NA 12.63 11.24 4.05 NA NA 49.72 48.33 09043846 ......... ............ A Gastric bypass for obesity ............................. 27.15 NA NA 10.09 10.04 3.18 NA NA 40.42 40.37 09043847 ......... ............ A Gastric bypass incl small i ............................ 30.02 NA NA 10.72 10.85 3.55 NA NA 44.29 44.42 09043848 ......... ............ A Revision gastroplasty .................................... 32.49 NA NA 11.41 11.71 3.87 NA NA 47.77 48.07 09043850 ......... ............ A Revise stomach-bowel fusion ....................... 27.39 NA NA 9.48 9.73 3.27 NA NA 40.14 40.39 09043855 ......... ............ 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 09043865 ......... ............ A Revise stomach-bowel fusion ....................... 28.86 NA NA 10.17 10.42 3.50 NA NA 42.53 42.78 09043870 ......... ............ A Repair stomach opening ............................... 11.32 NA NA 5.05 4.65 1.27 NA NA 17.64 17.24 09043880 ......... ............ A Repair stomach-bowel fistula ........................ 26.99 NA NA 9.42 9.77 3.26 NA NA 39.67 40.02 09043886 ......... ............ A Revise gastric port, open .............................. 4.50 NA NA 3.45 3.21 0.25 NA NA 8.20 7.96 09043887 ......... ............ A Remove gastric port, open ............................ 4.20 NA NA 3.00 2.83 0.51 NA NA 7.71 7.54 09043888 ......... ............ A Change gastric port, open ............................. 6.30 NA NA 3.94 3.81 0.70 NA NA 10.94 10.81 09043999 ......... ............ C Stomach surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY44005 ......... ............ A Freeing of bowel adhesion ............................ 18.34 NA NA 6.67 6.70 2.14 NA NA 27.15 27.18 09044010 ......... ............ A Incision of small bowel .................................. 14.14 NA NA 5.58 5.48 1.64 NA NA 21.36 21.26 09044015 ......... ............ A Insert needle cath bowel ............................... 2.62 NA NA 0.69 0.83 0.35 NA NA 3.66 3.80 ZZZ44020 ......... ............ A Explore small intestine .................................. 16.10 NA NA 6.06 5.96 1.85 NA NA 24.01 23.91 09044021 ......... ............ A Decompress small bowel .............................. 16.19 NA NA 6.33 6.05 1.86 NA NA 24.38 24.10 09044025 ......... ............ A Incision of large bowel .................................. 16.39 NA NA 6.19 6.06 1.89 NA NA 24.47 24.34 09044050 ......... ............ A Reduce bowel obstruction ............................. 15.40 NA NA 5.89 5.94 1.85 NA NA 23.14 23.19 09044055 ......... ............ A Correct malrotation of bowel ......................... 25.49 NA NA 8.60 8.69 2.90 NA NA 36.99 37.08 09044100 ......... ............ A Biopsy of bowel ............................................. 2.01 NA NA 0.88 0.75 0.17 NA NA 3.06 2.93 00044110 ......... ............ A Excise intestine lesion(s) ............................... 13.92 NA NA 5.58 5.31 1.55 NA NA 21.05 20.78 09044111 ......... ............ A Excision of bowel lesion(s) ............................ 16.40 NA NA 6.20 6.13 1.86 NA NA 24.46 24.3909044120 ......... ............ A Removal of small intestine ............................ 20.70 NA NA 7.24 7.11 2.24 NA NA 30.18 30.0509044121 ......... ............ 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 29.3609044126 ......... ............ A Enterectomy w/o taper, cong ........................ 41.94 NA NA 13.97 14.08 4.68 NA NA 60.59 60.70 09044127 ......... ............ A Enterectomy w/taper, cong ........................... 49.01 NA NA 14.84 15.49 5.75 NA NA 69.60 70.2509044128 ......... ............ A Enterectomy cong, add-on ............................ 4.44 NA NA 1.07 1.42 0.61 NA NA 6.12 6.47 ZZZ44130 ......... ............ A Bowel to bowel fusion ................................... 21.92 NA NA 8.05 6.67 1.87 NA NA 31.84 30.46 09044137 ......... ............ C Remove intestinal allograft ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX44139 ......... ............ A Mobilization of colon ...................................... 2.23 NA NA 0.56 0.71 0.28 NA NA 3.07 3.22 ZZZ44140 ......... ............ A Partial removal of colon ................................ 22.40 NA NA 8.17 8.52 2.70 NA NA 33.27 33.62 09044141 ......... ............ A Partial removal of colon ................................ 29.69 NA NA 11.96 10.52 2.52 NA NA 44.17 42.73 09044143 ......... ............ A Partial removal of colon ................................ 27.57 NA NA 10.40 10.61 3.04 NA NA 41.01 41.22 09044144 ......... ............ A Partial removal of colon ................................ 29.69 NA NA 10.75 9.90 2.85 NA NA 43.29 42.44 09044145 ......... ............ A Partial removal of colon ................................ 28.39 NA NA 9.58 10.50 3.28 NA NA 41.25 42.17 09044146 ......... ............ A Partial removal of colon ................................ 35.08 NA NA 13.46 13.00 3.40 NA NA 51.94 51.48 09044147 ......... ............ A Partial removal of colon ................................ 33.50 NA NA 11.06 9.28 2.55 NA NA 47.11 45.33 09044150 ......... ............ A Removal of colon .......................................... 29.91 NA NA 12.74 12.20 3.03 NA NA 45.6845.14 09044151 ......... ............ A Removal of colon/ileostomy .......................... 34.65 NA NA 14.19 13.59 3.48 NA NA 52.32 51.7209044152 ......... ............ A Removal of colon/ileostomy .......................... 29.91 NA NA 10.53 11.33 3.51 NA NA 43.95 44.7509044153 ......... ............ A Removal of colon/ileostomy .......................... 33.18 NA NA 14.40 14.38 3.54 NA NA 51.12 51.1009044155 ......... ............ A Removal of colon/ileostomy .......................... 34.15 NA NA 13.59 13.37 3.27 NA NA 51.01 50.7909044156 ......... ............ A Removal of colon/ileostomy .......................... 37.15 NA NA 14.84 14.98 3.94 NA NA 55.93 56.0709044160 ......... ............ A Removal of colon .......................................... 20.72 NA NA 7.60 7.71 2.36 NA NA 30.68 30.79 09044180 ......... ............ A Lap, enterolysis ............................................. 15.15 NA NA 5.87 6.14 1.85 NA NA 22.8723.14 09044186 ......... ............ A Lap, jejunostomy ........................................... 10.26 NA NA 4.63 4.75 1.27 NA NA 16.16 16.28 09044187 ......... ............ A Lap, ileo/jejuno-stomy ................................... 17.21 NA NA 8.25 8.27 1.95 NA NA 27.41 27.43 09044188 ......... ............ A Lap, colostomy .............................................. 19.14 NA NA 8.82 8.84 2.23 NA NA 30.1930.21 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00162 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49143 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules44202 ......... ............ A Lap, enterectomy ........................................... 23.20 NA NA 8.41 8.79 2.84 NA NA 34.45 34.83 09044203 ......... ............ A Lap resect s/intestine, addl ........................... 4.44 NA NA 1.14 1.41 0.57 NA NA 6.15 6.42 ZZZ44204 ......... ............ A Laparo partial colectomy ............................... 26.23 NA NA 9.00 9.71 3.10 NA NA 38.33 39.0409044205 ......... ............ A Lap colectomy part w/ileum .......................... 22.80 NA NA 7.89 8.60 2.74 NA NA 33.43 34.14 09044206 ......... ............ A Lap part colectomy w/stoma ......................... 29.57 NA NA 10.60 11.09 3.45 NA NA 43.62 44.11 09044207 ......... ............ A L colectomy/coloproctostomy ........................ 31.73 NA NA 10.22 11.17 3.66 NA NA 45.61 46.56 09044208 ......... ............ A L colectomy/coloproctostomy ........................ 33.80 NA NA 12.15 12.89 3.87 NA NA 49.82 50.56 09044210 ......... ............ A Laparo total proctocolectomy ........................ 29.80 NA NA 11.27 11.72 3.41 NA NA 44.48 44.9309044211 ......... ............ A Laparo total proctocolectomy ........................ 36.79 NA NA 13.90 14.48 4.16 NA NA 54.85 55.4309044212 ......... ............ A Laparo total proctocolectomy ........................ 34.29 NA NA 13.27 13.58 3.77 NA NA 51.33 51.6409044213 ......... ............ 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 09044238 ......... ............ C Laparoscope proc, intestine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY44300 ......... ............ A Open bowel to skin ....................................... 13.61 NA NA 5.63 5.52 1.60 NA NA 20.84 20.73 09044310 ......... ............ A Ileostomy/jejunostomy ................................... 17.45 NA NA 6.46 6.63 1.98 NA NA 25.89 26.06 09044312 ......... ............ A Revision of ileostomy .................................... 9.29 NA NA 4.66 4.16 0.92 NA NA 14.87 14.37 09044314 ......... ............ A Revision of ileostomy .................................... 16.55 NA NA 6.88 6.63 1.74 NA NA 25.17 24.92 09044316 ......... ............ A Devise bowel pouch ...................................... 23.40 NA NA 9.34 8.74 2.37 NA NA 35.11 34.51 09044320 ......... ............ A Colostomy ...................................................... 19.69 NA NA 7.69 7.66 2.25 NA NA 29.63 29.60 09044322 ......... ............ A Colostomy with biopsies ................................ 13.04 NA NA 9.47 8.80 1.54 NA NA 24.05 23.3809044340 ......... ............ A Revision of colostomy ................................... 9.06 NA NA 4.99 4.44 0.99 NA NA 15.04 14.4909044345 ......... ............ A Revision of colostomy ................................... 17.00 NA NA 6.98 6.91 1.96 NA NA 25.94 25.87 09044346 ......... ............ A Revision of colostomy ................................... 19.41 NA NA 7.60 7.44 2.12 NA NA 29.13 28.97 09044360 ......... ............ A Small bowel endoscopy ................................ 2.59 NA NA 1.50 1.20 0.19 NA NA 4.28 3.98 00044361 ......... ............ A Small bowel endoscopy/biopsy ..................... 2.87 NA NA 1.63 1.31 0.21 NA NA 4.71 4.39 00044363 ......... ............ A Small bowel endoscopy ................................ 3.49 NA NA 1.92 1.52 0.27 NA NA 5.68 5.28 00044364 ......... ............ A Small bowel endoscopy ................................ 3.73 NA NA 2.00 1.62 0.27 NA NA 6.00 5.62 00044365 ......... ............ A Small bowel endoscopy ................................ 3.31 NA NA 1.77 1.46 0.24 NA NA 5.32 5.01 00044366 ......... ............ A Small bowel endoscopy ................................ 4.40 NA NA 2.37 1.89 0.32 NA NA 7.09 6.61 00044369 ......... ............ A Small bowel endoscopy ................................ 4.51 NA NA 2.40 1.90 0.33 NA NA 7.24 6.74 00044370 ......... ............ A Small bowel endoscopy/stent ........................ 4.79 NA NA 2.53 2.11 0.37 NA NA 7.69 7.27 00044372 ......... ............ A Small bowel endoscopy ................................ 4.40 NA NA 2.12 1.83 0.35 NA NA 6.87 6.58 00044373 ......... ............ A Small bowel endoscopy ................................ 3.49 NA NA 1.73 1.50 0.27 NA NA 5.49 5.26 00044376 ......... ............ A Small bowel endoscopy ................................ 5.25 NA NA 2.44 2.13 0.42 NA NA 8.11 7.80 00044377 ......... ............ A Small bowel endoscopy/biopsy ..................... 5.52 NA NA 2.77 2.29 0.40 NA NA 8.69 8.21 00044378 ......... ............ A Small bowel endoscopy ................................ 7.12 NA NA 3.52 2.90 0.52 NA NA 11.16 10.54 00044379 ......... ............ A S bowel endoscope w/stent .......................... 7.46 NA NA 3.28 3.00 0.62 NA NA 11.36 11.08 00044380 ......... ............ A Small bowel endoscopy ................................ 1.05 NA NA 0.75 0.60 0.08 NA NA 1.88 1.73 00044382 ......... ............ A Small bowel endoscopy ................................ 1.27 NA NA 0.79 0.67 0.12 NA NA 2.18 2.06 00044383 ......... ............ A Ileoscopy w/stent ........................................... 2.94 NA NA 1.63 1.36 0.21 NA NA 4.78 4.51 00044385 ......... ............ 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 00044386 ......... ............ A Endoscopy, bowel pouch/biop ...................... 2.12 6.75 6.67 1.04 0.92 0.20 9.07 8.99 3.36 3.2400044388 ......... ............ A Colonoscopy .................................................. 2.82 6.11 5.34 1.34 1.20 0.26 9.19 8.42 4.42 4.28 00044389 ......... ............ A Colonoscopy with biopsy ............................... 3.13 7.07 6.73 1.56 1.34 0.27 10.47 10.13 4.96 4.74 00044390 ......... ............ 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 00044391 ......... ............ A Colonoscopy for bleeding .............................. 4.31 8.93 8.77 2.19 1.82 0.34 13.58 13.42 6.84 6.47 00044392 ......... ............ A Colonoscopy & polypectomy ......................... 3.81 7.38 6.78 1.71 1.55 0.34 11.53 10.93 5.86 5.70 00044393 ......... ............ A Colonoscopy, lesion removal ........................ 4.83 7.89 7.15 2.04 1.91 0.42 13.14 12.40 7.29 7.16 00044394 ......... ............ A Colonoscopy w/snare .................................... 4.42 8.47 7.98 2.05 1.80 0.38 13.27 12.78 6.85 6.60 00044397 ......... ............ A Colonoscopy w/stent ..................................... 4.70 NA NA 2.28 1.91 0.39 NA NA 7.37 7.00 00044500 ......... ............ A Intro, gastrointestinal tube ............................. 0.49 NA NA 0.15 0.16 0.03 NA NA 0.67 0.6800044602 ......... ............ A Suture, small intestine ................................... 24.60 NA NA 7.73 6.73 2.11 NA NA 34.44 33.44 09044603 ......... ............ A Suture, small intestine ................................... 27.97 NA NA 9.10 7.73 2.41 NA NA 39.48 38.11 09044604 ......... ............ A Suture, large intestine ................................... 18.02 NA NA 6.14 6.37 2.11 NA NA 26.27 26.50 09044605 ......... ............ A Repair of bowel lesion ................................... 21.96 NA NA 7.98 8.29 2.51 NA NA 32.45 32.76 09044615 ......... ............ A Intestinal stricturoplasty ................................. 18.04 NA NA 6.64 6.66 2.06 NA NA 26.74 26.76 09044620 ......... ............ A Repair bowel opening ................................... 14.31 NA NA 5.55 5.38 1.51 NA NA 21.37 21.2009044625 ......... ............ A Repair bowel opening ................................... 17.16 NA NA 6.22 6.28 1.85 NA NA 25.23 25.2909044626 ......... ............ A Repair bowel opening ................................... 27.78 NA NA 9.02 9.61 3.26 NA NA 40.06 40.6509044640 ......... ............ A Repair bowel-skin fistula ............................... 24.08 NA NA 8.15 8.47 2.77 NA NA 35.00 35.32 09044650 ......... ............ A Repair bowel fistula ....................................... 25.00 NA NA 8.40 8.76 2.92 NA NA 36.32 36.68 09044660 ......... ............ A Repair bowel-bladder fistula .......................... 23.79 NA NA 9.72 8.69 2.13 NA NA 35.64 34.6109044661 ......... ............ A Repair bowel-bladder fistula .......................... 27.23 NA NA 9.46 9.53 2.80 NA NA 39.49 39.5609044680 ......... ............ A Surgical revision, intestine ............................ 17.84 NA NA 6.64 6.49 1.99 NA NA 26.47 26.32 09044700 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00163 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49144 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal44715 ......... ............ C Prepare donor intestine ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX44720 ......... ............ A Prep donor intestine/venous ......................... 5.00 NA NA 1.25 1.60 0.37 NA NA 6.62 6.97 XXX44721 ......... ............ A Prep donor intestine/artery ............................ 7.00 NA NA 1.81 2.25 0.97 NA NA 9.78 10.22 XXX44799 ......... ............ C Unlisted procedure intestine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY44800 ......... ............ A Excision of bowel pouch ............................... 11.87 NA NA 5.56 5.43 1.47 NA NA 18.90 18.7709044820 ......... ............ A Excision of mesentery lesion ........................ 13.59 NA NA 5.66 5.53 1.59 NA NA 20.84 20.71 09044850 ......... ............ A Repair of mesentery ...................................... 11.99 NA NA 5.06 5.02 1.39 NA NA 18.44 18.40 09044899 ......... ............ C Bowel surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY44900 ......... ............ A Drain app abscess, open .............................. 12.38 NA NA 5.07 4.79 1.33 NA NA 18.78 18.50 09044901 ......... ............ 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 00044950 ......... ............ A Appendectomy ............................................... 10.48 NA NA 4.09 4.26 1.31 NA NA 15.88 16.05 09044955 ......... ............ A Appendectomy add-on .................................. 1.53 NA NA 0.40 0.51 0.20 NA NA 2.13 2.24 ZZZ44960 ......... ............ A Appendectomy ............................................... 14.33 NA NA 5.47 5.37 1.63 NA NA 21.43 21.33 09044970 ......... ............ A Laparoscopy, appendectomy ........................ 9.31 NA NA 4.24 4.12 1.14 NA NA 14.69 14.57 09044979 ......... ............ C Laparoscope proc, app ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY45000 ......... ............ 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 01045020 ......... ............ A Drainage of rectal abscess ........................... 8.37 NA NA 4.58 3.60 0.55 NA NA 13.50 12.52 09045100 ......... ............ A Biopsy of rectum ........................................... 3.92 NA NA 2.84 2.48 0.44 NA NA 7.20 6.84 09045108 ......... ............ A Removal of anorectal lesion .......................... 5.00 NA NA 3.08 2.85 0.59 NA NA 8.67 8.44 09045110 ......... ............ A Removal of rectum ........................................ 30.49 NA NA 11.98 12.29 3.35 NA NA 45.82 46.13 09045111 ......... ............ A Partial removal of rectum .............................. 17.81 NA NA 7.08 7.14 2.06 NA NA 26.95 27.0109045112 ......... ............ A Removal of rectum ........................................ 32.99 NA NA 10.39 11.42 3.42 NA NA 46.80 47.83 09045113 ......... ............ A Partial proctectomy ........................................ 33.03 NA NA 11.60 12.34 3.48 NA NA 48.1148.85 09045114 ......... ............ A Partial removal of rectum .............................. 30.57 NA NA 10.45 10.77 3.35 NA NA 44.37 44.69 09045116 ......... ............ A Partial removal of rectum .............................. 27.50 NA NA 9.50 9.89 2.87 NA NA 39.87 40.2609045119 ......... ............ A Remove rectum w/reservoir .......................... 33.29 NA NA 11.71 12.27 3.35 NA NA 48.35 48.91 09045120 ......... ............ A Removal of rectum ........................................ 26.15 NA NA 9.44 9.95 2.89 NA NA 38.48 38.99 09045121 ......... ............ A Removal of rectum and colon ....................... 28.83 NA NA 10.34 10.91 3.24 NA NA 42.41 42.98 09045123 ......... ............ A Partial proctectomy ........................................ 18.64 NA NA 7.07 6.91 1.85 NA NA 27.56 27.40 09045126 ......... ............ A Pelvic exenteration ........................................ 48.81 NA NA 17.39 18.75 4.32 NA NA 70.5271.88 09045130 ......... ............ A Excision of rectal prolapse ............................ 18.31 NA NA 6.73 6.75 1.79 NA NA 26.83 26.8509045135 ......... ............ A Excision of rectal prolapse ............................ 22.07 NA NA 9.28 8.63 2.35 NA NA 33.70 33.0509045136 ......... ............ A Excise ileoanal reservior ............................... 30.55 NA NA 11.86 12.35 2.81 NA NA 45.22 45.71 09045150 ......... ............ A Excision of rectal stricture ............................. 5.72 NA NA 3.40 3.07 0.61 NA NA 9.73 9.4009045160 ......... ............ A Excision of rectal lesion ................................ 16.11 NA NA 6.59 6.63 1.67 NA NA 24.37 24.41 09045170 ......... ............ A Excision of rectal lesion ................................ 12.42 NA NA 5.41 5.28 1.35 NA NA 19.18 19.05 09045190 ......... ............ A Destruction, rectal tumor ............................... 10.23 NA NA 5.55 4.85 1.13 NA NA 16.91 16.21 09045300 ......... ............ A Proctosigmoidoscopy dx ............................... 0.38 2.00 1.65 0.35 0.30 0.04 2.42 2.07 0.77 0.72 00045303 ......... ............ A Proctosigmoidoscopy dilate ........................... 0.44 19.63 18.92 0.38 0.34 0.05 20.12 19.41 0.87 0.83 00045305 ......... ............ A Proctosigmoidoscopy w/bx ............................ 1.01 3.31 2.80 0.53 0.51 0.11 4.43 3.92 1.65 1.63 00045307 ......... ............ A Proctosigmoidoscopy fb ................................ 0.94 3.52 3.15 0.51 0.49 0.11 4.57 4.20 1.561.54 00045308 ......... ............ A Proctosigmoidoscopy removal ...................... 0.83 3.30 2.32 0.49 0.45 0.09 4.22 3.24 1.41 1.3700045309 ......... ............ A Proctosigmoidoscopy removal ...................... 2.01 3.73 3.04 0.83 0.84 0.22 5.96 5.27 3.06 3.0700045315 ......... ............ A Proctosigmoidoscopy removal ...................... 1.40 3.74 3.08 0.65 0.64 0.15 5.29 4.63 2.20 2.1900045317 ......... ............ A Proctosigmoidoscopy bleed .......................... 1.50 3.83 2.78 0.66 0.66 0.15 5.48 4.43 2.31 2.31 00045320 ......... ............ A Proctosigmoidoscopy ablate ......................... 1.58 4.49 3.31 0.75 0.72 0.16 6.23 5.05 2.49 2.46 00045321 ......... ............ A Proctosigmoidoscopy volvul .......................... 1.17 NA NA 0.65 0.58 0.13 NA NA 1.95 1.88 00045327 ......... ............ A Proctosigmoidoscopy w/stent ........................ 1.65 NA NA 0.83 0.73 0.16 NA NA 2.64 2.54 00045330 ......... ............ A Diagnostic sigmoidoscopy ............................. 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 00045331 ......... ............ A Sigmoidoscopy and biopsy ........................... 1.15 3.24 3.11 0.78 0.64 0.09 4.48 4.35 2.02 1.88 00045332 ......... ............ A Sigmoidoscopy w/fb removal ........................ 1.79 5.62 5.16 1.02 0.86 0.16 7.57 7.11 2.97 2.8100045333 ......... ............ A Sigmoidoscopy & polypectomy ..................... 1.79 5.63 5.06 0.98 0.85 0.15 7.57 7.00 2.92 2.79 00045334 ......... ............ A Sigmoidoscopy for bleeding .......................... 2.73 NA NA 1.52 1.24 0.20 NA NA 4.45 4.17 00045335 ......... ............ A Sigmoidoscopy w/submuc inj ........................ 1.46 5.32 3.74 0.90 0.74 0.11 6.89 5.31 2.47 2.3100045337 ......... ............ A Sigmoidoscopy & decompress ...................... 2.36 NA NA 1.23 1.06 0.21 NA NA 3.80 3.63 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00164 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49145 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules45338 ......... ............ 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 00045339 ......... ............ A Sigmoidoscopy w/ablate tumr ....................... 3.14 5.73 4.03 1.66 1.38 0.26 9.13 7.43 5.06 4.7800045340 ......... ............ A Sig w/balloon dilation .................................... 1.89 10.25 7.19 1.03 0.88 0.15 12.29 9.233.07 2.92 00045341 ......... ............ A Sigmoidoscopy w/ultrasound ......................... 2.60 NA NA 1.45 1.17 0.19 NA NA 4.24 3.96 00045342 ......... ............ A Sigmoidoscopy w/us guide bx ....................... 4.05 NA NA 2.15 1.69 0.30 NA NA 6.50 6.04 00045345 ......... ............ A Sigmoidoscopy w/stent .................................. 2.92 NA NA 1.53 1.25 0.23 NA NA 4.68 4.40 00045355 ......... ............ A Surgical colonoscopy .................................... 3.51 NA NA 1.55 1.42 0.36 NA NA 5.42 5.29 00045378 ......... ............ A Diagnostic colonoscopy ................................. 3.69 6.36 6.20 1.81 1.56 0.30 10.35 10.19 5.80 5.55 00045378 ......... 53 ....... A Diagnostic colonoscopy ................................. 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 00045379 ......... ............ A Colonoscopy w/fb removal ............................ 4.68 8.14 7.78 2.20 1.91 0.39 13.21 12.85 7.276.98 00045380 ......... ............ A Colonoscopy and biopsy ............................... 4.43 7.71 7.32 2.22 1.85 0.35 12.49 12.10 7.006.63 00045381 ......... ............ A Colonoscopy, submucous inj ........................ 4.19 7.68 7.25 2.14 1.77 0.30 12.17 11.74 6.63 6.26 00045382 ......... ............ A Colonoscopy/control bleeding ....................... 5.68 10.31 10.03 2.87 2.35 0.41 16.40 16.12 8.968.44 00045383 ......... ............ A Lesion removal colonoscopy ......................... 5.86 8.54 8.08 2.63 2.32 0.48 14.88 14.42 8.97 8.66 00045384 ......... ............ A Lesion remove colonoscopy .......................... 4.69 7.20 6.90 2.19 1.91 0.38 12.27 11.97 7.26 6.98 00045385 ......... ............ A Lesion removal colonoscopy ......................... 5.30 8.33 7.93 2.57 2.17 0.42 14.05 13.65 8.29 7.89 00045386 ......... ............ A Colonoscopy dilate stricture .......................... 4.57 12.31 12.38 2.16 1.88 0.39 17.27 17.34 7.12 6.84 00045387 ......... ............ A Colonoscopy w/stent ..................................... 5.90 NA NA 2.89 2.47 0.48 NA NA 9.27 8.85 00045391 ......... ............ A Colonoscopy w/endoscope us ...................... 5.09 NA NA 2.54 2.11 0.42 NA NA 8.05 7.62 00045392 ......... ............ A Colonoscopy w/endoscopic fnb ..................... 6.54 NA NA 3.10 2.64 0.42 NA NA 10.06 9.60 00045395 ......... ............ A Lap, removal of rectum ................................. 32.71 NA NA 13.06 13.52 3.62 NA NA 49.39 49.85 09045397 ......... ............ A Lap, remove rectum w/pouch ........................ 36.21 NA NA 13.59 14.09 3.66 NA NA 53.46 53.96 09045400 ......... ............ A Laparoscopic proctopexy .............................. 19.25 NA NA 7.18 7.67 2.02 NA NA 28.45 28.94 09045402 ......... ............ A Lap proctopexy w/sig resect ......................... 26.32 NA NA 8.87 9.70 2.81 NA NA 38.00 38.83 09045499 ......... ............ C Laparoscope proc, rectum ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY45500 ......... ............ A Repair of rectum ............................................ 7.58 NA NA 4.35 3.74 0.75 NA NA 12.68 12.07 09045505 ......... ............ A Repair of rectum ............................................ 8.14 NA NA 5.11 4.17 0.86 NA NA 14.11 13.17 09045520 ......... ............ 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 00045540 ......... ............ A Correct rectal prolapse .................................. 17.98 NA NA 5.89 6.57 1.84 NA NA 25.71 26.39 09045541 ......... ............ A Correct rectal prolapse .................................. 14.66 NA NA 6.59 6.10 1.55 NA NA 22.80 22.31 09045550 ......... ............ A Repair rectum/remove sigmoid ..................... 24.61 NA NA 9.02 9.16 2.61 NA NA 36.24 36.38 09045560 ......... ............ A Repair of rectocele ........................................ 11.38 NA NA 5.52 5.17 1.13 NA NA 18.03 17.68 09045562 ......... ............ A Exploration/repair of rectum .......................... 17.74 NA NA 8.17 7.28 1.83 NA NA 27.74 26.8509045563 ......... ............ A Exploration/repair of rectum .......................... 26.14 NA NA 10.97 10.63 3.10 NA NA 40.21 39.87 09045800 ......... ............ A Repair rect/bladder fistula ............................. 20.12 NA NA 9.23 7.87 1.85 NA NA 31.20 29.84 09045805 ......... ............ A Repair fistula w/colostomy ............................ 23.13 NA NA 9.26 9.44 2.02 NA NA 34.41 34.5909045820 ......... ............ A Repair rectourethral fistula ............................ 20.18 NA NA 9.29 8.04 1.58 NA NA 31.05 29.80 09045825 ......... ............ A Repair fistula w/colostomy ............................ 23.93 NA NA 10.94 10.09 2.31 NA NA 37.18 36.33 09045900 ......... ............ A Reduction of rectal prolapse ......................... 2.94 NA NA 1.70 1.55 0.30 NA NA 4.94 4.79 01045905 ......... ............ A Dilation of anal sphincter ............................... 2.30 NA NA 1.65 1.49 0.27 NA NA 4.22 4.0601045910 ......... ............ A Dilation of rectal narrowing ........................... 2.80 NA NA 1.80 1.70 0.30 NA NA 4.90 4.80 01045915 ......... ............ A Remove rectal obstruction ............................ 3.14 4.26 4.31 2.04 2.08 0.30 7.70 7.75 5.48 5.52 01045990 ......... ............ 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 YYY46020 ......... ............ A Placement of seton ....................................... 2.90 3.29 2.57 2.37 1.98 0.31 6.50 5.78 5.58 5.19 01046030 ......... ............ A Removal of rectal marker .............................. 1.23 1.90 1.49 0.81 0.74 0.14 3.27 2.86 2.182.11 01046040 ......... ............ 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 09046045 ......... ............ A Incision of rectal abscess .............................. 5.75 NA NA 3.93 3.15 0.54 NA NA 10.22 9.4409046050 ......... ............ 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 01046060 ......... ............ A Incision of rectal abscess .............................. 6.18 NA NA 3.99 3.43 0.67 NA NA 10.84 10.2809046070 ......... ............ A Incision of anal septum ................................. 2.71 NA NA 2.35 1.96 0.36 NA NA 5.42 5.03 09046080 ......... ............ 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 01046083 ......... ............ A Incise external hemorrhoid ............................ 1.40 2.36 2.48 0.95 0.93 0.15 3.91 4.03 2.502.48 01046200 ......... ............ 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 09046210 ......... ............ 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 09046211 ......... ............ 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 09046220 ......... ............ 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 01046221 ......... ............ A Ligation of hemorrhoid(s) .............................. 2.29 3.75 2.92 2.00 1.81 0.23 6.27 5.44 4.524.33 01046230 ......... ............ 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 01046250 ......... ............ A Hemorrhoidectomy ........................................ 4.13 6.02 5.48 2.86 2.67 0.48 10.63 10.09 7.47 7.28 09046255 ......... ............ A Hemorrhoidectomy ........................................ 4.84 6.44 5.98 3.12 2.90 0.58 11.86 11.40 8.54 8.32 09046257 ......... ............ A Remove hemorrhoids & fissure ..................... 5.64 NA NA 3.80 3.10 0.64 NA NA 10.08 9.38 09046258 ......... ............ A Remove hemorrhoids & fistula ...................... 6.22 NA NA 4.01 3.46 0.68 NA NA 10.91 10.36 09046260 ......... ............ A Hemorrhoidectomy ........................................ 6.61 NA NA 4.06 3.40 0.76 NA NA 11.43 10.7709046261 ......... ............ A Remove hemorrhoids & fissure ..................... 7.57 NA NA 4.32 3.78 0.79 NA NA 12.68 12.14 09046262 ......... ............ A Remove hemorrhoids & fistula ...................... 7.74 NA NA 4.68 3.97 0.83 NA NA 13.25 12.54 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00165 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49146 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal46270 ......... ............ A Removal of anal fistula .................................. 4.75 6.33 5.33 3.91 3.10 0.46 11.54 10.549.12 8.31 09046275 ......... ............ A Removal of anal fistula .................................. 5.25 6.66 5.14 4.00 3.23 0.52 12.43 10.919.77 9.00 09046280 ......... ............ A Removal of anal fistula .................................. 6.22 NA NA 4.26 3.50 0.66 NA NA 11.14 10.38 09046285 ......... ............ A Removal of anal fistula .................................. 5.25 6.54 4.46 3.95 3.04 0.44 12.23 10.159.64 8.73 09046288 ......... ............ A Repair anal fistula ......................................... 7.62 NA NA 4.67 3.92 0.79 NA NA 13.08 12.33 09046320 ......... ............ 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 01046500 ......... ............ A Injection into hemorrhoid(s) ........................... 1.61 3.61 2.49 1.25 1.18 0.16 5.38 4.26 3.022.95 01046505 ......... ............ A Chemodenervation anal musc ...................... 3.11 3.30 3.11 2.31 2.05 0.14 6.55 6.36 5.56 5.30 01046600 ......... ............ A Diagnostic anoscopy ..................................... 0.50 1.48 1.54 0.37 0.35 0.05 2.03 2.09 0.92 0.90 00046604 ......... ............ A Anoscopy and dilation ................................... 1.31 12.65 10.00 0.58 0.61 0.12 14.08 11.432.01 2.04 00046606 ......... ............ A Anoscopy and biopsy .................................... 0.81 4.02 3.84 0.48 0.44 0.09 4.92 4.74 1.381.34 00046608 ......... ............ 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 00046610 ......... ............ A Anoscopy, remove lesion .............................. 1.32 4.29 4.10 0.66 0.62 0.15 5.76 5.57 2.13 2.09 00046611 ......... ............ A Anoscopy ....................................................... 1.81 2.88 3.22 0.72 0.77 0.19 4.88 5.22 2.72 2.77 00046612 ......... ............ A Anoscopy, remove lesions ............................ 2.34 5.51 5.26 0.95 0.97 0.28 8.13 7.88 3.57 3.59 00046614 ......... ............ A Anoscopy, control bleeding ........................... 2.01 2.78 2.44 0.82 0.84 0.20 4.99 4.65 3.03 3.05 00046615 ......... ............ A Anoscopy ....................................................... 2.68 2.43 2.47 0.97 1.05 0.33 5.44 5.48 3.98 4.06 00046700 ......... ............ A Repair of anal stricture .................................. 9.62 NA NA 4.72 4.33 0.94 NA NA 15.28 14.89 09046705 ......... ............ A Repair of anal stricture .................................. 7.25 NA NA 4.08 3.78 0.91 NA NA 12.24 11.94 09046706 ......... ............ A Repr of anal fistula w/glue ............................ 2.39 NA NA 1.45 1.30 0.28 NA NA 4.12 3.97 01046710 ......... ............ 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 09046715 ......... ............ A Rep perf anoper fistu .................................... 7.49 NA NA 3.77 3.62 0.92 NA NA 12.18 12.03 09046716 ......... ............ A Rep perf anoper/vestib fistu .......................... 17.04 NA NA 9.66 8.39 1.58 NA NA 28.28 27.0109046730 ......... ............ A Construction of absent anus ......................... 30.05 NA NA 11.66 11.93 2.46 NA NA 44.17 44.4409046735 ......... ............ A Construction of absent anus ......................... 35.54 NA NA 13.36 13.50 3.20 NA NA 52.10 52.2409046740 ......... ............ A Construction of absent anus ......................... 33.30 NA NA 14.66 13.58 2.41 NA NA 50.37 49.2909046742 ......... ............ A Repair of imperforated anus ......................... 39.54 NA NA 16.19 17.08 3.19 NA NA 58.92 59.8109046744 ......... ............ A Repair of cloacal anomaly ............................. 58.34 NA NA 21.08 21.10 6.38 NA NA 85.80 85.82 09046746 ......... ............ A Repair of cloacal anomaly ............................. 64.79 NA NA 19.85 23.82 7.68 NA NA 92.32 96.29 09046748 ......... ............ A Repair of cloacal anomaly ............................. 70.77 NA NA 21.25 23.04 3.36 NA NA 95.38 97.17 09046750 ......... ............ A Repair of anal sphincter ................................ 11.96 NA NA 5.81 5.24 1.10 NA NA 18.87 18.30 09046751 ......... ............ A Repair of anal sphincter ................................ 9.12 NA NA 4.45 5.17 0.94 NA NA 14.51 15.2309046753 ......... ............ A Reconstruction of anus ................................. 8.77 NA NA 4.61 4.03 0.94 NA NA 14.32 13.7409046754 ......... ............ 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 01046760 ......... ............ A Repair of anal sphincter ................................ 17.11 NA NA 8.26 7.38 1.59 NA NA 26.96 26.08 09046761 ......... ............ A Repair of anal sphincter ................................ 15.10 NA NA 6.45 6.11 1.43 NA NA 22.98 22.64 09046762 ......... ............ A Implant artificial sphincter .............................. 14.58 NA NA 6.79 5.83 1.24 NA NA 22.61 21.65 09046900 ......... ............ 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 01046910 ......... ............ 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 01046916 ......... ............ A Cryosurgery, anal lesion(s) ........................... 1.86 3.70 3.29 1.54 1.43 0.11 5.67 5.26 3.513.40 01046917 ......... ............ 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 01046922 ......... ............ 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 01046924 ......... ............ 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 01046934 ......... ............ A Destruction of hemorrhoids ........................... 3.75 5.41 5.16 2.80 2.91 0.32 9.48 9.23 6.87 6.98 09046935 ......... ............ A Destruction of hemorrhoids ........................... 2.43 3.70 3.52 1.08 1.18 0.23 6.36 6.18 3.74 3.84 01046936 ......... ............ A Destruction of hemorrhoids ........................... 3.68 6.16 5.19 2.60 2.52 0.34 10.18 9.21 6.626.54 09046937 ......... ............ A Cryotherapy of rectal lesion .......................... 2.69 4.01 3.08 1.80 1.37 0.14 6.84 5.91 4.634.20 01046938 ......... ............ A Cryotherapy of rectal lesion .......................... 4.65 5.85 4.46 3.66 3.20 0.58 11.08 9.69 8.898.43 09046940 ......... ............ A Treatment of anal fissure .............................. 2.32 2.85 2.21 1.04 1.08 0.23 5.40 4.76 3.593.63 01046942 ......... ............ A Treatment of anal fissure .............................. 2.04 2.80 2.07 0.95 1.00 0.19 5.03 4.30 3.183.23 01046945 ......... ............ A Ligation of hemorrhoids ................................. 2.09 4.83 3.65 3.00 2.60 0.19 7.11 5.93 5.28 4.88 09046946 ......... ............ A Ligation of hemorrhoids ................................. 2.58 4.65 3.95 2.66 2.46 0.27 7.50 6.80 5.51 5.31 09046947 ......... ............ A Hemorrhoidopexy by stapling ........................ 5.45 NA NA 3.12 2.81 0.75 NA NA 9.32 9.01 09046999 ......... ............ C Anus surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY47000 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00166 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49147 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules47001 ......... ............ A Needle biopsy, liver add-on .......................... 1.90 NA NA 0.49 0.61 0.25 NA NA 2.64 2.76 ZZZ47010 ......... ............ A Open drainage, liver lesion ........................... 19.21 NA NA 8.34 8.38 1.80 NA NA 29.35 29.3909047011 ......... ............ A Percut drain, liver lesion ................................ 3.69 NA NA 1.18 1.20 0.22 NA NA 5.09 5.1100047015 ......... ............ A Inject/aspirate liver cyst ................................. 18.31 NA NA 7.92 7.59 1.83 NA NA 28.06 27.73 09047100 ......... ............ A Wedge biopsy of liver .................................... 12.72 NA NA 6.39 6.12 1.53 NA NA 20.64 20.37 09047120 ......... ............ A Partial removal of liver .................................. 38.74 NA NA 14.23 14.91 4.65 NA NA 57.6258.30 09047122 ......... ............ A Extensive removal of liver ............................. 59.29 NA NA 19.03 20.84 7.19 NA NA 85.51 87.32 09047125 ......... ............ A Partial removal of liver .................................. 52.85 NA NA 17.27 18.94 6.45 NA NA 76.5778.24 09047130 ......... ............ A Partial removal of liver .................................. 57.00 NA NA 18.28 20.29 6.94 NA NA 82.2284.23 09047135 ......... ............ R Transplantation of liver .................................. 83.15 NA NA 28.01 30.63 9.93 NA NA 121.09123.71 09047136 ......... ............ R Transplantation of liver .................................. 70.25 NA NA 23.80 26.21 8.41 NA NA 102.46104.87 09047140 ......... ............ A Partial removal, donor liver ........................... 59.14 NA NA 21.89 22.18 5.17 NA NA 86.20 86.49 09047141 ......... ............ A Partial removal, donor liver ........................... 71.17 NA NA 25.67 26.59 5.17 NA NA 102.01 102.93 09047142 ......... ............ A Partial removal, donor liver ........................... 79.11 NA NA 27.72 29.03 5.17 NA NA 112.00 113.31 09047143 ......... ............ 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 XXX47144 ......... ............ 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 09047145 ......... ............ 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 09047146 ......... ............ A Prep donor liver/venous ................................ 6.00 NA NA 1.54 1.92 0.83 NA NA 8.37 8.75 XXX47147 ......... ............ A Prep donor liver/arterial ................................. 7.00 NA NA 1.80 2.24 0.97 NA NA 9.77 10.21 XXX47300 ......... ............ A Surgery for liver lesion .................................. 17.95 NA NA 7.71 7.34 1.98 NA NA 27.64 27.27 09047350 ......... ............ A Repair liver wound ........................................ 22.30 NA NA 8.95 8.88 2.58 NA NA 33.83 33.76 09047360 ......... ............ A Repair liver wound ........................................ 31.12 NA NA 11.51 11.56 3.37 NA NA 46.0046.05 09047361 ......... ............ A Repair liver wound ........................................ 52.41 NA NA 16.93 18.12 5.85 NA NA 75.1976.38 09047362 ......... ............ A Repair liver wound ........................................ 23.35 NA NA 9.35 8.87 2.50 NA NA 35.20 34.72 09047370 ......... ............ A Laparo ablate liver tumor rf ........................... 20.61 NA NA 7.75 8.04 2.55 NA NA 30.91 31.2009047371 ......... ............ A Laparo ablate liver cryosurg .......................... 20.61 NA NA 8.16 8.15 2.60 NA NA 31.37 31.3609047379 ......... ............ C Laparoscope procedure, liver ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY47380 ......... ............ A Open ablate liver tumor rf ............................. 24.37 NA NA 8.69 9.19 2.86 NA NA 35.92 36.4209047381 ......... ............ A Open ablate liver tumor cryo ......................... 24.64 NA NA 9.23 9.49 2.84 NA NA 36.71 36.97 09047382 ......... ............ A Percut ablate liver rf ...................................... 15.17 NA NA 5.68 5.97 0.96 NA NA 21.8122.10 01047399 ......... ............ C Liver surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY47400 ......... ............ A Incision of liver duct ...................................... 36.17 NA NA 13.24 13.38 3.07 NA NA 52.48 52.62 09047420 ......... ............ A Incision of bile duct ....................................... 21.86 NA NA 8.69 8.74 2.62 NA NA 33.1733.22 09047425 ......... ............ A Incision of bile duct ....................................... 22.14 NA NA 8.70 8.78 2.61 NA NA 33.4533.53 09047460 ......... ............ A Incise bile duct sphincter ............................... 20.35 NA NA 9.06 8.54 2.20 NA NA 31.61 31.09 09047480 ......... ............ A Incision of gallbladder ................................... 13.06 NA NA 6.72 6.11 1.42 NA NA 21.20 20.59 09047490 ......... ............ A Incision of gallbladder ................................... 8.00 NA NA 5.02 5.43 0.43 NA NA 13.45 13.86 09047500 ......... ............ A Injection for liver x-rays ................................. 1.96 NA NA 0.64 0.64 0.12 NA NA 2.72 2.72 00047505 ......... ............ A Injection for liver x-rays ................................. 0.76 NA NA 0.25 0.25 0.04 NA NA 1.05 1.05 00047510 ......... ............ A Insert catheter, bile duct ................................ 7.88 NA NA 4.35 4.85 0.46 NA NA 12.69 13.19 09047511 ......... ............ A Insert bile duct drain ...................................... 10.72 NA NA 4.67 4.98 0.62 NA NA 16.0116.32 09047525 ......... ............ 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 01047530 ......... ............ 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 09047550 ......... ............ A Bile duct endoscopy add-on .......................... 3.02 NA NA 0.79 0.96 0.40 NA NA 4.21 4.38 ZZZ47552 ......... ............ 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 00047555 ......... ............ A Biliary endoscopy thru skin ........................... 7.55 NA NA 2.50 2.47 0.45 NA NA 10.50 10.47 00047556 ......... ............ A Biliary endoscopy thru skin ........................... 8.55 NA NA 2.77 2.78 0.50 NA NA 11.82 11.83 00047560 ......... ............ A Laparoscopy w/cholangio .............................. 4.88 NA NA 1.26 1.57 0.65 NA NA 6.79 7.10 00047561 ......... ............ A Laparo w/cholangio/biopsy ............................ 5.17 NA NA 1.57 1.83 0.66 NA NA 7.40 7.66 00047562 ......... ............ A Laparoscopic cholecystectomy ..................... 11.57 NA NA 5.32 5.07 1.46 NA NA 18.35 18.10 09047563 ......... ............ A Laparo cholecystectomy/graph ..................... 11.98 NA NA 5.13 5.25 1.58 NA NA 18.69 18.81 09047564 ......... ............ 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 09047579 ......... ............ C Laparoscope proc, biliary .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY47600 ......... ............ A Removal of gallbladder ................................. 15.44 NA NA 6.82 6.30 1.79 NA NA 24.05 23.5309047605 ......... ............ A Removal of gallbladder ................................. 15.86 NA NA 6.46 6.48 1.94 NA NA 24.26 24.2809047610 ......... ............ A Removal of gallbladder ................................. 20.80 NA NA 7.78 7.89 2.48 NA NA 31.06 31.1709047612 ......... ............ A Removal of gallbladder ................................. 21.09 NA NA 7.78 7.85 2.47 NA NA 31.34 31.4109047620 ......... ............ A Removal of gallbladder ................................. 22.95 NA NA 8.29 8.46 2.73 NA NA 33.97 34.1409047630 ......... ............ A Remove bile duct stone ................................ 9.52 NA NA 4.55 4.80 0.65 NA NA 14.72 14.97 09047700 ......... ............ A Exploration of bile ducts ................................ 16.32 NA NA 7.33 7.38 2.06 NA NA 25.71 25.76 09047701 ......... ............ A Bile duct revision ........................................... 28.55 NA NA 10.18 11.15 3.67 NA NA 42.40 43.37 09047711 ......... ............ A Excision of bile duct tumor ............................ 25.71 NA NA 9.68 9.85 3.04 NA NA 38.43 38.6009047712 ......... ............ A Excision of bile duct tumor ............................ 33.53 NA NA 11.69 12.22 3.92 NA NA 49.14 49.67 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00167 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49148 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal47715 ......... ............ A Excision of bile duct cyst ............................... 21.36 NA NA 8.64 8.48 2.48 NA NA 32.48 32.32 09047716 ......... ............ A Fusion of bile duct cyst ................................. 19.01 NA NA 7.99 7.86 2.14 NA NA 29.14 29.01 09047720 ......... ............ A Fuse gallbladder & bowel .............................. 18.15 NA NA 7.80 7.55 2.10 NA NA 28.05 27.8009047721 ......... ............ A Fuse upper gi structures ............................... 21.80 NA NA 8.69 8.59 2.52 NA NA 33.01 32.9109047740 ......... ............ A Fuse gallbladder & bowel .............................. 21.04 NA NA 8.56 8.41 2.41 NA NA 32.01 31.8609047741 ......... ............ A Fuse gallbladder & bowel .............................. 24.02 NA NA 9.33 9.29 2.82 NA NA 36.17 36.1309047760 ......... ............ A Fuse bile ducts and bowel ............................ 38.08 NA NA 13.24 11.43 3.41 NA NA 54.73 52.9209047765 ......... ............ A Fuse liver ducts & bowel ............................... 51.95 NA NA 17.09 12.36 3.29 NA NA 72.33 67.60 09047780 ......... ............ A Fuse bile ducts and bowel ............................ 42.08 NA NA 14.27 11.96 3.49 NA NA 59.84 57.5309047785 ......... ............ A Fuse bile ducts and bowel ............................ 55.95 NA NA 18.09 14.19 4.09 NA NA 78.13 74.2309047800 ......... ............ A Reconstruction of bile ducts .......................... 25.98 NA NA 9.84 9.99 3.07 NA NA 38.89 39.0409047801 ......... ............ A Placement, bile duct support ......................... 17.41 NA NA 8.19 8.15 1.16 NA NA 26.76 26.72 09047802 ......... ............ A Fuse liver duct & intestine ............................. 24.74 NA NA 9.64 9.65 2.85 NA NA 37.23 37.24 09047900 ......... ............ A Suture bile duct injury ................................... 22.25 NA NA 8.82 8.84 2.64 NA NA 33.71 33.73 09047999 ......... ............ C Bile tract surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY48000 ......... ............ A Drainage of abdomen .................................... 31.76 NA NA 11.07 11.39 3.47 NA NA 46.30 46.62 09048001 ......... ............ A Placement of drain, pancreas ....................... 39.50 NA NA 12.81 13.60 4.68 NA NA 56.99 57.78 09048005 ......... ............ A Resect/debride pancreas .............................. 48.97 NA NA 16.10 16.43 5.54 NA NA 70.61 70.9409048020 ......... ............ 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 09048102 ......... ............ A Needle biopsy, pancreas ............................... 4.67 9.57 8.36 1.74 1.89 0.28 14.52 13.31 6.69 6.84 01048120 ......... ............ A Removal of pancreas lesion .......................... 18.29 NA NA 6.98 6.88 2.09 NA NA 27.36 27.26 09048140 ......... ............ A Partial removal of pancreas .......................... 26.13 NA NA 9.48 9.51 3.02 NA NA 38.63 38.66 09048145 ......... ............ A Partial removal of pancreas .......................... 27.20 NA NA 9.83 9.82 3.17 NA NA 40.20 40.19 09048146 ......... ............ A Pancreatectomy ............................................ 30.34 NA NA 12.02 11.98 3.49 NA NA 45.8545.81 09048148 ......... ............ A Removal of pancreatic duct .......................... 20.20 NA NA 8.14 7.73 2.29 NA NA 30.63 30.22 09048150 ......... ............ A Partial removal of pancreas .......................... 52.55 NA NA 18.29 19.18 6.30 NA NA 77.14 78.0309048152 ......... ............ A Pancreatectomy ............................................ 48.39 NA NA 16.84 17.85 5.78 NA NA 71.0172.02 09048153 ......... ............ A Pancreatectomy ............................................ 52.53 NA NA 18.15 19.18 6.29 NA NA 76.9778.00 09048154 ......... ............ A Pancreatectomy ............................................ 48.62 NA NA 17.15 17.95 5.82 NA NA 71.5972.39 09048155 ......... ............ A Removal of pancreas .................................... 29.19 NA NA 12.09 11.76 3.26 NA NA 44.54 44.21 09048180 ......... ............ A Fuse pancreas and bowel ............................. 27.90 NA NA 10.01 10.11 3.27 NA NA 41.18 41.2809048400 ......... ............ A Injection, intraop add-on ................................ 1.95 NA NA 0.84 0.69 0.15 NA NA 2.94 2.79ZZZ48500 ......... ............ A Surgery of pancreatic cyst ............................ 17.97 NA NA 8.12 7.52 2.02 NA NA 28.11 27.5109048510 ......... ............ A Drain pancreatic pseudocyst ......................... 17.00 NA NA 7.64 7.48 1.82 NA NA 26.46 26.30 09048511 ......... ............ A Drain pancreatic pseudocyst ......................... 3.99 20.24 20.73 1.27 1.30 0.24 24.47 24.96 5.50 5.53 00048520 ......... ............ A Fuse pancreas cyst and bowel ..................... 18.03 NA NA 6.85 6.73 2.05 NA NA 26.93 26.81 09048540 ......... ............ A Fuse pancreas cyst and bowel ..................... 21.82 NA NA 7.81 8.03 2.60 NA NA 32.23 32.45 09048545 ......... ............ A Pancreatorrhaphy .......................................... 22.04 NA NA 8.16 8.02 2.37 NA NA 32.57 32.43 09048547 ......... ............ A Duodenal exclusion ....................................... 30.19 NA NA 10.36 10.44 3.41 NA NA 43.96 44.04 09048551 ......... ............ C Prep donor pancreas ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX48552 ......... ............ A Prep donor pancreas/venous ........................ 4.30 NA NA 1.14 1.38 0.31 NA NA 5.75 5.99 XXX48554 ......... ............ R Transpl allograft pancreas ............................. 36.77 NA NA 20.69 18.86 4.18 NA NA 61.64 59.81 09048556 ......... ............ A Removal, allograft pancreas ......................... 19.16 NA NA 9.48 8.42 2.07 NA NA 30.71 29.65 09048999 ......... ............ C Pancreas surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY49000 ......... ............ A Exploration of abdomen ................................ 12.40 NA NA 5.25 5.34 1.52 NA NA 19.17 19.2609049002 ......... ............ A Reopening of abdomen ................................. 17.51 NA NA 6.47 5.38 1.37 NA NA 25.35 24.26 09049010 ......... ............ A Exploration behind abdomen ........................ 15.94 NA NA 6.36 6.01 1.51 NA NA 23.81 23.46 09049020 ......... ............ A Drain abdominal abscess .............................. 26.38 NA NA 9.95 10.12 2.84 NA NA 39.17 39.3409049021 ......... ............ A Drain abdominal abscess .............................. 3.37 19.73 20.72 1.08 1.10 0.20 23.30 24.29 4.65 4.67 00049040 ......... ............ A Drain, open, abdom abscess ........................ 16.35 NA NA 6.57 6.45 1.69 NA NA 24.61 24.49 09049041 ......... ............ A Drain, percut, abdom abscess ...................... 3.99 19.97 19.63 1.28 1.30 0.24 24.20 23.86 5.515.53 00049060 ......... ............ A Drain, open, retrop abscess .......................... 18.36 NA NA 7.30 7.39 1.74 NA NA 27.40 27.49 09049061 ......... ............ 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 00049062 ......... ............ A Drain to peritoneal cavity .............................. 12.08 NA NA 5.26 5.38 1.39 NA NA 18.73 18.85 09049080 ......... ............ A Puncture, peritoneal cavity ............................ 1.35 2.72 3.67 0.44 0.46 0.08 4.15 5.10 1.871.89 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00168 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49149 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules49081 ......... ............ 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 00049085 ......... ............ A Remove abdomen foreign body .................... 13.97 NA NA 5.61 5.52 1.62 NA NA 21.20 21.11 09049180 ......... ............ A Biopsy, abdominal mass ............................... 1.73 2.43 2.93 0.55 0.57 0.10 4.26 4.76 2.38 2.40 00049200 ......... ............ 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 09049215 ......... ............ A Excise sacral spine tumor ............................. 37.60 NA NA 12.80 13.73 4.37 NA NA 54.77 55.70 09049220 ......... ............ A Multiple surgery, abdomen ............................ 15.64 NA NA 6.30 6.54 1.88 NA NA 23.82 24.06 09049250 ......... ............ A Excision of umbilicus ..................................... 8.88 NA NA 4.32 4.28 1.08 NA NA 14.28 14.24 09049255 ......... ............ A Removal of omentum .................................... 12.35 NA NA 5.68 5.62 1.43 NA NA 19.46 19.4009049320 ......... ............ 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 01049322 ......... ............ A Laparoscopy, aspiration ................................ 5.94 NA NA 2.66 2.91 0.71 NA NA 9.31 9.56 01049323 ......... ............ A Laparo drain lymphocele ............................... 10.09 NA NA 4.72 4.55 1.20 NA NA 16.01 15.8409049329 ......... ............ C Laparo proc, abdm/per/oment ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY49400 ......... ............ A Air injection into abdomen ............................. 1.88 2.44 2.91 0.57 0.61 0.15 4.47 4.94 2.602.64 00049419 ......... ............ A Insrt abdom cath for chemotx ....................... 7.01 NA NA 3.49 3.54 0.81 NA NA 11.31 11.36 09049420 ......... ............ 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 01049423 ......... ............ A Exchange drainage catheter ......................... 1.46 13.26 13.87 0.51 0.52 0.09 14.81 15.42 2.062.07 00049424 ......... ............ A Assess cyst, contrast inject ........................... 0.76 3.09 3.56 0.28 0.29 0.04 3.89 4.36 1.081.09 00049425 ......... ............ A Insert abdomen-venous drain ....................... 12.07 NA NA 5.32 5.52 1.54 NA NA 18.93 19.13 09049426 ......... ............ A Revise abdomen-venous shunt ..................... 10.28 NA NA 4.55 4.71 1.28 NA NA 16.11 16.27 09049427 ......... ............ 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 10.6311.26 01049429 ......... ............ A Removal of shunt .......................................... 7.39 NA NA 3.01 3.32 1.02 NA NA 11.42 11.73 01049491 ......... ............ A Rpr hern preemie reduc ................................ 12.36 NA NA 5.47 5.16 1.40 NA NA 19.23 18.9209049492 ......... ............ A Rpr ing hern premie, blocked ........................ 15.26 NA NA 5.86 6.04 1.80 NA NA 22.92 23.10 09049495 ......... ............ A Rpr ing hernia baby, reduc ........................... 6.13 NA NA 3.00 2.96 0.74 NA NA 9.87 9.83 09049496 ......... ............ 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 9.6709049501 ......... ............ A Rpr ing hernia, init blocked ........................... 9.24 NA NA 4.28 4.22 1.12 NA NA 14.64 14.5809049505 ......... ............ A Prp i/hern init reduc >5 yr ............................. 7.84 NA NA 3.92 3.79 1.03 NA NA 12.79 12.6609049507 ......... ............ A Prp i/hern init block >5 yr .............................. 9.93 NA NA 4.50 4.46 1.27 NA NA 15.70 15.66 09049520 ......... ............ A Rerepair ing hernia, reduce .......................... 9.87 NA NA 4.42 4.43 1.28 NA NA 15.57 15.58 09049521 ......... ............ A Rerepair ing hernia, blocked ......................... 12.32 NA NA 5.04 5.18 1.59 NA NA 18.95 19.09 09049525 ......... ............ A Repair ing hernia, sliding .............................. 8.81 NA NA 4.17 4.10 1.13 NA NA 14.11 14.0409049540 ......... ............ A Repair lumbar hernia ..................................... 10.62 NA NA 4.67 4.72 1.37 NA NA 16.66 16.71 09049550 ......... ............ A Rpr rem hernia, init, reduce .......................... 8.87 NA NA 4.15 4.13 1.14 NA NA 14.16 14.14 09049553 ......... ............ A Rpr fem hernia, init blocked .......................... 9.80 NA NA 4.45 4.42 1.24 NA NA 15.49 15.46 09049555 ......... ............ 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 09049560 ......... ............ A Rpr ventral hern init, reduc ........................... 11.80 NA NA 4.93 5.09 1.52 NA NA 18.25 18.4109049561 ......... ............ A Rpr ventral hern init, block ............................ 15.26 NA NA 5.86 6.00 1.88 NA NA 23.00 23.14 09049565 ......... ............ A Rerepair ventrl hern, reduce ......................... 12.25 NA NA 5.17 5.20 1.52 NA NA 18.94 18.97 09049566 ......... ............ A Rerepair ventrl hern, block ............................ 15.41 NA NA 5.92 6.07 1.90 NA NA 23.23 23.3809049568 ......... ............ A Hernia repair w/mesh .................................... 4.88 NA NA 1.26 1.57 0.64 NA NA 6.78 7.09 ZZZ49570 ......... ............ A Rpr epigastric hern, reduce ........................... 5.93 NA NA 3.36 3.21 0.75 NA NA 10.04 9.89 09049572 ......... ............ A Rpr epigastric hern, blocked ......................... 7.75 NA NA 3.87 3.56 0.88 NA NA 12.50 12.19 09049580 ......... ............ A Rpr umbil hern, reduc < 5 yr ......................... 4.35 NA NA 3.03 2.70 0.54 NA NA 7.92 7.59 09049582 ......... ............ A Rpr umbil hern, block < 5 yr ......................... 7.01 NA NA 3.64 3.51 0.88 NA NA 11.53 11.40 09049585 ......... ............ A Rpr umbil hern, reduc > 5 yr ......................... 6.47 NA NA 3.54 3.35 0.82 NA NA 10.83 10.64 09049587 ......... ............ A Rpr umbil hern, block > 5 yr ......................... 7.92 NA NA 3.90 3.77 0.99 NA NA 12.81 12.68 09049590 ......... ............ A Repair spigelian hernia ................................. 8.78 NA NA 4.14 4.10 1.13 NA NA 14.05 14.0109049600 ......... ............ A Repair umbilical lesion .................................. 11.42 NA NA 5.20 5.29 1.32 NA NA 17.94 18.03 09049605 ......... ............ A Repair umbilical lesion .................................. 86.79 NA NA 26.58 28.02 9.36 NA NA 122.73124.17 09049606 ......... ............ A Repair umbilical lesion .................................. 18.87 NA NA 6.66 7.43 2.45 NA NA 27.98 28.75 09049610 ......... ............ A Repair umbilical lesion .................................. 10.78 NA NA 4.73 5.08 1.07 NA NA 16.58 16.93 09049611 ......... ............ A Repair umbilical lesion .................................. 9.21 NA NA 3.66 6.14 0.78 NA NA 13.65 16.13 09049650 ......... ............ A Laparo hernia repair initial ............................ 6.26 NA NA 3.37 3.24 0.93 NA NA 10.56 10.4309049651 ......... ............ A Laparo hernia repair recur ............................ 8.23 NA NA 4.26 4.10 1.14 NA NA 13.63 13.47 09049659 ......... ............ C Laparo proc, hernia repair ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY49900 ......... ............ A Repair of abdominal wall ............................... 12.26 NA NA 6.35 6.25 1.62 NA NA 20.23 20.1309049904 ......... ............ A Omental flap, extra-abdom ............................ 22.06 NA NA 12.17 14.45 2.69 NA NA 36.92 39.2009049905 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00169 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49150 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal49999 ......... ............ C Abdomen surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY50010 ......... ............ A Exploration of kidney ..................................... 12.07 NA NA 6.90 5.63 0.93 NA NA 19.90 18.63 09050020 ......... ............ A Renal abscess, open drain ........................... 17.80 NA NA 8.63 7.96 1.34 NA NA 27.77 27.10 09050021 ......... ............ 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 00050040 ......... ............ A Drainage of kidney ........................................ 16.40 NA NA 8.91 7.33 1.03 NA NA 26.34 24.76 09050045 ......... ............ A Exploration of kidney ..................................... 16.61 NA NA 8.55 7.08 1.24 NA NA 26.40 24.93 09050060 ......... ............ A Removal of kidney stone ............................... 20.74 NA NA 11.10 8.64 1.36 NA NA 33.20 30.7409050065 ......... ............ A Incision of kidney ........................................... 22.11 NA NA 11.69 7.48 1.59 NA NA 35.39 31.18 09050070 ......... ............ A Incision of kidney ........................................... 21.64 NA NA 11.49 9.03 1.44 NA NA 34.57 32.11 09050075 ......... ............ A Removal of kidney stone ............................... 26.84 NA NA 13.79 10.87 1.80 NA NA 42.43 39.51 09050080 ......... ............ A Removal of kidney stone ............................... 15.56 NA NA 8.64 6.86 1.04 NA NA 25.24 23.4609050081 ......... ............ A Removal of kidney stone ............................... 23.25 NA NA 12.32 9.64 1.54 NA NA 37.11 34.4309050100 ......... ............ A Revise kidney blood vessels ......................... 17.24 NA NA 7.34 7.67 2.06 NA NA 26.64 26.97 09050120 ......... ............ A Exploration of kidney ..................................... 17.00 NA NA 8.80 7.27 1.21 NA NA 27.01 25.48 09050125 ......... ............ A Explore and drain kidney .............................. 17.61 NA NA 9.85 7.68 1.43 NA NA 28.89 26.7209050130 ......... ............ A Removal of kidney stone ............................... 18.61 NA NA 10.12 7.90 1.22 NA NA 29.95 27.7309050135 ......... ............ A Exploration of kidney ..................................... 20.38 NA NA 10.81 8.53 1.33 NA NA 32.52 30.24 09050200 ......... ............ A Biopsy of kidney ............................................ 2.63 NA NA 1.13 1.25 0.16 NA NA 3.92 4.04 00050205 ......... ............ A Biopsy of kidney ............................................ 12.15 NA NA 5.62 5.16 1.30 NA NA 19.0718.61 09050220 ......... ............ A Remove kidney, open ................................... 18.47 NA NA 9.64 7.83 1.35 NA NA 29.46 27.6509050225 ......... ............ A Removal kidney open, complex .................... 21.67 NA NA 11.14 8.89 1.50 NA NA 34.31 32.06 09050230 ......... ............ A Removal kidney open, radical ....................... 23.63 NA NA 11.81 9.38 1.55 NA NA 36.99 34.56 09050234 ......... ............ A Removal of kidney & ureter .......................... 23.84 NA NA 12.20 9.67 1.59 NA NA 37.63 35.10 09050236 ......... ............ A Removal of kidney & ureter .......................... 26.66 NA NA 14.10 11.21 1.76 NA NA 42.52 39.6309050240 ......... ............ A Partial removal of kidney ............................... 23.93 NA NA 12.78 9.95 1.55 NA NA 38.26 35.43 09050250 ......... ............ A Cryoablate renal mass open ......................... 21.98 NA NA 11.01 9.62 1.39 NA NA 34.38 32.99 09050280 ......... ............ A Removal of kidney lesion .............................. 16.88 NA NA 9.35 7.35 1.19 NA NA 27.42 25.4209050290 ......... ............ A Removal of kidney lesion .............................. 15.94 NA NA 8.19 6.89 1.41 NA NA 25.54 24.2409050320 ......... ............ A Remove kidney, living donor ......................... 22.18 NA NA 12.52 11.12 2.35 NA NA 37.05 35.6509050323 ......... ............ C Prep cadaver renal allograft .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX50325 ......... ............ 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 XXX50327 ......... ............ A Prep renal graft/venous ................................. 4.00 NA NA 1.10 1.29 0.29 NA NA 5.39 5.58 XXX50328 ......... ............ A Prep renal graft/arterial ................................. 3.50 NA NA 0.98 1.13 0.26 NA NA 4.74 4.89XXX50329 ......... ............ A Prep renal graft/ureteral ................................ 3.34 NA NA 0.97 1.09 0.25 NA NA 4.56 4.68XXX50340 ......... ............ A Removal of kidney ......................................... 13.79 NA NA 7.70 6.79 1.65 NA NA 23.14 22.23 09050360 ......... ............ A Transplantation of kidney .............................. 40.27 NA NA 18.95 16.34 3.81 NA NA 63.03 60.42 09050365 ......... ............ A Transplantation of kidney .............................. 45.50 NA NA 19.63 18.55 4.42 NA NA 69.55 68.47 09050370 ......... ............ 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 09050382 ......... ............ 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 00050384 ......... ............ 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 00050387 ......... ............ A Change ext/int ureter stent ............................ 2.00 12.75 16.85 0.66 0.67 0.12 14.87 18.972.78 2.79 00050389 ......... ............ A Remove renal tube w/fluoro .......................... 1.10 6.75 11.24 0.36 0.37 0.07 7.92 12.41 1.531.54 00050390 ......... ............ A Drainage of kidney lesion .............................. 1.96 NA NA 0.64 0.64 0.12 NA NA 2.72 2.72 00050391 ......... ............ 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 00050392 ......... ............ A Insert kidney drain ......................................... 3.37 NA NA 1.40 1.49 0.20 NA NA 4.97 5.06 00050393 ......... ............ A Insert ureteral tube ........................................ 4.15 NA NA 1.66 1.75 0.25 NA NA 6.06 6.15 00050394 ......... ............ 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 00050395 ......... ............ A Create passage to kidney ............................. 3.37 NA NA 1.48 1.50 0.21 NA NA 5.06 5.08 00050396 ......... ............ A Measure kidney pressure .............................. 2.09 NA NA 1.02 1.07 0.13 NA NA 3.24 3.29 00050398 ......... ............ A Change kidney tube ...................................... 1.46 11.99 15.23 0.52 0.52 0.09 13.54 16.782.07 2.07 00050400 ......... ............ A Revision of kidney/ureter ............................... 21.06 NA NA 11.12 8.68 1.38 NA NA 33.56 31.12 09050405 ......... ............ A Revision of kidney/ureter ............................... 25.61 NA NA 13.16 10.06 1.78 NA NA 40.55 37.45 09050500 ......... ............ A Repair of kidney wound ................................ 21.01 NA NA 9.29 8.61 2.01 NA NA 32.31 31.6309050520 ......... ............ A Close kidney-skin fistula ................................ 18.67 NA NA 9.40 7.92 1.49 NA NA 29.56 28.08 09050525 ......... ............ A Repair renal-abdomen fistula ........................ 24.14 NA NA 10.99 9.49 1.83 NA NA 36.96 35.46 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00170 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49151 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules50526 ......... ............ A Repair renal-abdomen fistula ........................ 26.06 NA NA 8.23 9.45 1.96 NA NA 36.25 37.47 09050540 ......... ............ A Revision of horseshoe kidney ....................... 20.89 NA NA 10.79 8.94 1.36 NA NA 33.04 31.19 09050541 ......... ............ A Laparo ablate renal cyst ................................ 16.72 NA NA 8.81 7.06 1.13 NA NA 26.66 24.91 09050542 ......... ............ A Laparo ablate renal mass ............................. 21.12 NA NA 11.24 8.91 1.39 NA NA 33.75 31.4209050543 ......... ............ A Laparo partial nephrectomy .......................... 27.10 NA NA 14.20 11.19 1.80 NA NA 43.10 40.0909050544 ......... ............ A Laparoscopy, pyeloplasty .............................. 23.23 NA NA 11.51 9.27 1.58 NA NA 36.32 34.0809050545 ......... ............ A Laparo radical nephrectomy .......................... 24.89 NA NA 12.35 9.97 1.70 NA NA 38.94 36.56 09050546 ......... ............ A Laparoscopic nephrectomy ........................... 21.63 NA NA 11.39 9.12 1.57 NA NA 34.59 32.32 09050547 ......... ............ A Laparo removal donor kidney ....................... 26.20 NA NA 12.68 11.50 2.76 NA NA 41.64 40.46 09050548 ......... ............ A Laparo remove w/ureter ................................ 25.22 NA NA 12.27 9.95 1.72 NA NA 39.21 36.8909050549 ......... ............ C Laparoscope proc, renal ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY50551 ......... ............ A Kidney endoscopy ......................................... 5.59 4.61 4.26 2.66 2.14 0.40 10.60 10.258.65 8.13 00050553 ......... ............ A Kidney endoscopy ......................................... 5.98 4.45 4.38 2.55 2.27 0.39 10.82 10.758.92 8.64 00050555 ......... ............ A Kidney endoscopy & biopsy .......................... 6.52 5.12 4.89 3.03 2.51 0.45 12.09 11.86 10.009.48 00050557 ......... ............ A Kidney endoscopy & treatment ..................... 6.61 5.28 4.76 3.07 2.49 0.47 12.36 11.84 10.15 9.57 00050561 ......... ............ A Kidney endoscopy & treatment ..................... 7.58 5.80 5.26 3.42 2.84 0.54 13.92 13.38 11.54 10.96 00050562 ......... ............ 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 00050572 ......... ............ A Kidney endoscopy ......................................... 10.33 NA NA 4.60 3.78 0.85 NA NA 15.78 14.96 00050574 ......... ............ 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 00050576 ......... ............ A Kidney endoscopy & treatment ..................... 10.97 NA NA 4.86 3.96 0.78 NA NA 16.61 15.71 00050580 ......... ............ A Kidney endoscopy & treatment ..................... 11.84 NA NA 5.17 4.26 0.83 NA NA 17.84 16.93 00050590 ......... ............ 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 09050592 ......... ............ A Perc rf ablate renal tumor ............................. 6.75 77.05 131.0 2.81 2.94 0.43 84.23 138.29.99 10.12 01050600 ......... ............ A Exploration of ureter ...................................... 16.99 NA NA 8.60 7.15 1.13 NA NA 26.72 25.27 09050605 ......... ............ A Insert ureteral support ................................... 16.61 NA NA 8.00 7.05 1.45 NA NA 26.06 25.11 09050610 ......... ............ A Removal of ureter stone ................................ 17.07 NA NA 9.12 7.50 1.43 NA NA 27.62 26.0009050620 ......... ............ A Removal of ureter stone ................................ 16.25 NA NA 8.97 6.99 1.07 NA NA 26.29 24.3109050630 ......... ............ A Removal of ureter stone ................................ 16.03 NA NA 8.30 6.78 1.09 NA NA 25.42 23.9009050650 ......... ............ A Removal of ureter .......................................... 18.61 NA NA 10.15 7.95 1.23 NA NA 29.9927.79 09050660 ......... ............ A Removal of ureter .......................................... 20.81 NA NA 10.87 8.68 1.38 NA NA 33.0630.87 09050684 ......... ............ 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 00050686 ......... ............ A Measure ureter pressure ............................... 1.51 2.07 3.10 0.71 0.79 0.11 3.69 4.72 2.332.41 00050688 ......... ............ A Change of ureter tube/stent .......................... 1.17 NA NA 0.92 1.03 0.07 NA NA 2.16 2.27 01050690 ......... ............ 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 00050700 ......... ............ A Revision of ureter .......................................... 16.48 NA NA 8.46 7.45 1.27 NA NA 26.2125.20 09050715 ......... ............ A Release of ureter ........................................... 20.43 NA NA 8.65 8.71 2.13 NA NA 31.2131.27 09050722 ......... ............ A Release of ureter ........................................... 17.74 NA NA 8.02 7.86 1.90 NA NA 27.6627.50 09050725 ......... ............ A Release/revise ureter .................................... 19.99 NA NA 9.70 8.46 1.52 NA NA 31.21 29.97 09050727 ......... ............ A Revise ureter ................................................. 8.17 NA NA 5.78 4.65 0.61 NA NA 14.5613.43 09050728 ......... ............ A Revise ureter ................................................. 12.00 NA NA 7.21 5.97 1.00 NA NA 20.21 18.97 09050740 ......... ............ A Fusion of ureter & kidney .............................. 19.86 NA NA 9.03 8.06 1.96 NA NA 30.85 29.8809050750 ......... ............ A Fusion of ureter & kidney .............................. 21.01 NA NA 9.84 8.45 1.38 NA NA 32.23 30.8409050760 ......... ............ A Fusion of ureters ........................................... 19.86 NA NA 9.84 8.21 1.55 NA NA 31.2529.62 09050770 ......... ............ A Splicing of ureters ......................................... 21.01 NA NA 10.70 8.65 1.45 NA NA 33.1631.11 09050780 ......... ............ A Reimplant ureter in bladder ........................... 19.74 NA NA 10.14 8.22 1.51 NA NA 31.39 29.4709050782 ......... ............ A Reimplant ureter in bladder ........................... 19.51 NA NA 8.30 8.65 1.61 NA NA 29.42 29.7709050783 ......... ............ A Reimplant ureter in bladder ........................... 20.52 NA NA 10.07 8.68 1.98 NA NA 32.57 31.1809050785 ......... ............ A Reimplant ureter in bladder ........................... 22.02 NA NA 11.19 9.02 1.45 NA NA 34.66 32.4909050800 ......... ............ A Implant ureter in bowel .................................. 16.16 NA NA 9.32 7.18 1.19 NA NA 26.67 24.53 09050810 ......... ............ A Fusion of ureter & bowel ............................... 22.29 NA NA 9.65 9.22 2.31 NA NA 34.25 33.8209050815 ......... ............ A Urine shunt to intestine ................................. 21.98 NA NA 11.63 9.24 1.54 NA NA 35.15 32.76 09050820 ......... ............ A Construct bowel bladder ............................... 23.82 NA NA 12.00 9.47 1.89 NA NA 37.71 35.1809050825 ......... ............ A Construct bowel bladder ............................... 30.40 NA NA 15.09 12.11 2.07 NA NA 47.56 44.58 09050830 ......... ............ A Revise urine flow ........................................... 33.49 NA NA 15.92 13.10 2.37 NA NA 51.78 48.96 09050840 ......... ............ A Replace ureter by bowel ............................... 22.11 NA NA 11.93 9.30 1.47 NA NA 35.51 32.8809050845 ......... ............ A Appendico-vesicostomy ................................. 22.11 NA NA 12.42 9.77 1.57 NA NA 36.10 33.4509050860 ......... ............ A Transplant ureter to skin ............................... 16.87 NA NA 9.05 7.22 1.29 NA NA 27.21 25.38 09050900 ......... ............ A Repair of ureter ............................................. 14.83 NA NA 8.10 6.62 1.14 NA NA 24.0722.59 09050920 ......... ............ A Closure ureter/skin fistula .............................. 15.60 NA NA 8.54 7.06 1.01 NA NA 25.15 23.67 09050930 ......... ............ A Closure ureter/bowel fistula ........................... 19.98 NA NA 10.29 8.54 1.28 NA NA 31.55 29.80 09050940 ......... ............ A Release of ureter ........................................... 15.72 NA NA 8.27 6.86 1.26 NA NA 25.2523.84 09050945 ......... ............ 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 38.1209050948 ......... ............ A Laparo new ureter/bladder ............................ 23.65 NA NA 12.02 9.52 1.70 NA NA 37.37 34.87090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00171 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49152 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal50949 ......... ............ C Laparoscope proc, ureter .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY50951 ......... ............ A Endoscopy of ureter ...................................... 5.83 4.87 4.44 2.79 2.24 0.41 11.11 10.689.03 8.48 00050953 ......... ............ A Endoscopy of ureter ...................................... 6.23 5.05 4.56 3.31 2.60 0.43 11.71 11.229.97 9.26 00050955 ......... ............ A Ureter endoscopy & biopsy ........................... 6.74 5.28 6.13 3.52 2.89 0.48 12.50 13.35 10.7410.11 00050957 ......... ............ A Ureter endoscopy & treatment ...................... 6.78 5.37 4.76 3.15 2.57 0.48 12.63 12.02 10.41 9.83 00050961 ......... ............ A Ureter endoscopy & treatment ...................... 6.04 4.85 4.48 2.82 2.34 0.41 11.30 10.93 9.27 8.79 00050970 ......... ............ A Ureter endoscopy .......................................... 7.13 NA NA 3.30 2.67 0.52 NA NA 10.95 10.32 00050972 ......... ............ A Ureter endoscopy & catheter ........................ 6.88 NA NA 3.14 2.63 0.49 NA NA 10.51 10.00 00050974 ......... ............ 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 00050980 ......... ............ A Ureter endoscopy & treatment ...................... 6.84 NA NA 3.13 2.56 0.48 NA NA 10.45 9.88 00051000 ......... ............ A Drainage of bladder ....................................... 0.78 0.94 1.69 0.28 0.25 0.05 1.77 2.52 1.11 1.08 00051005 ......... ............ A Drainage of bladder ....................................... 1.02 2.43 4.13 0.30 0.33 0.10 3.55 5.25 1.42 1.45 00051010 ......... ............ A Drainage of bladder ....................................... 4.25 4.78 5.40 2.38 2.00 0.28 9.31 9.93 6.91 6.53 01051020 ......... ............ A Incise & treat bladder .................................... 7.51 NA NA 5.35 4.23 0.47 NA NA 13.33 12.21 09051030 ......... ............ A Incise & treat bladder .................................... 7.63 NA NA 4.80 4.18 0.58 NA NA 13.01 12.39 09051040 ......... ............ A Incise & drain bladder ................................... 4.39 NA NA 3.72 3.00 0.31 NA NA 8.42 7.7009051045 ......... ............ A Incise bladder/drain ureter ............................ 7.63 NA NA 5.23 4.25 0.52 NA NA 13.38 12.4009051050 ......... ............ A Removal of bladder stone ............................. 7.83 NA NA 5.38 4.08 0.49 NA NA 13.70 12.40 09051060 ......... ............ A Removal of ureter stone ................................ 9.77 NA NA 6.42 4.98 0.62 NA NA 16.81 15.3709051065 ......... ............ A Remove ureter calculus ................................ 9.77 NA NA 6.35 4.85 0.63 NA NA 16.75 15.25 09051080 ......... ............ A Drainage of bladder abscess ........................ 6.57 NA NA 4.35 3.74 0.43 NA NA 11.35 10.74 09051500 ......... ............ A Removal of bladder cyst ............................... 10.87 NA NA 5.85 5.21 1.03 NA NA 17.75 17.1109051520 ......... ............ A Removal of bladder lesion ............................ 10.03 NA NA 6.51 5.13 0.69 NA NA 17.23 15.85 09051525 ......... ............ A Removal of bladder lesion ............................ 15.24 NA NA 8.66 6.76 0.99 NA NA 24.89 22.99 09051530 ......... ............ A Removal of bladder lesion ............................ 13.53 NA NA 7.33 6.14 1.05 NA NA 21.91 20.72 09051535 ......... ............ A Repair of ureter lesion ................................... 13.72 NA NA 7.54 6.46 1.23 NA NA 22.49 21.41 09051550 ......... ............ A Partial removal of bladder ............................. 17.05 NA NA 8.91 7.27 1.31 NA NA 27.27 25.6309051555 ......... ............ A Partial removal of bladder ............................. 22.97 NA NA 11.51 9.37 1.69 NA NA 36.17 34.03 09051565 ......... ............ A Revise bladder & ureter(s) ............................ 23.43 NA NA 12.07 9.73 1.63 NA NA 37.13 34.7909051570 ......... ............ A Removal of bladder ....................................... 27.25 NA NA 13.39 10.65 1.71 NA NA 42.35 39.61 09051575 ......... ............ A Removal of bladder & nodes ........................ 33.93 NA NA 16.79 13.21 2.16 NA NA 52.88 49.30 09051580 ......... ............ A Remove bladder/revise tract ......................... 35.05 NA NA 17.64 13.77 2.24 NA NA 54.93 51.0609051585 ......... ............ A Removal of bladder & nodes ........................ 39.32 NA NA 19.63 15.18 2.48 NA NA 61.43 56.98 09051590 ......... ............ A Remove bladder/revise tract ......................... 36.08 NA NA 17.47 13.82 2.27 NA NA 55.82 52.1709051595 ......... ............ A Remove bladder/revise tract ......................... 41.04 NA NA 19.79 15.54 2.59 NA NA 63.42 59.1709051596 ......... ............ 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 61.4709051600 ......... ............ 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 00051605 ......... ............ A Preparation for bladder xray ......................... 0.64 NA NA 0.42 0.37 0.04 NA NA 1.10 1.05 00051610 ......... ............ 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 00051700 ......... ............ A Irrigation of bladder ....................................... 0.88 1.52 1.58 0.34 0.30 0.06 2.46 2.521.28 1.24 00051701 ......... ............ A Insert bladder catheter .................................. 0.50 1.05 1.45 0.25 0.21 0.04 1.59 1.99 0.79 0.75 00051702 ......... ............ A Insert temp bladder cath ............................... 0.50 1.54 1.95 0.34 0.27 0.04 2.08 2.49 0.880.81 00051703 ......... ............ 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 00051705 ......... ............ A Change of bladder tube ................................ 1.02 2.04 2.21 0.85 0.67 0.07 3.13 3.30 1.941.76 01051710 ......... ............ A Change of bladder tube ................................ 1.49 2.75 3.19 1.19 0.88 0.11 4.35 4.79 2.792.48 01051715 ......... ............ A Endoscopic injection/implant ......................... 3.73 4.47 4.04 1.76 1.45 0.29 8.49 8.06 5.78 5.47 00051720 ......... ............ 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 00051725 ......... ............ A Simple cystometrogram ................................. 1.51 4.32 5.27 4.32 5.27 0.16 5.99 6.94 5.996.94 00051725 ......... 26 ....... A Simple cystometrogram ................................. 1.51 0.57 0.51 0.57 0.51 0.12 2.20 2.14 2.20 2.14 00051725 ......... TC ...... A Simple cystometrogram ................................. 0.00 3.75 4.76 3.75 4.76 0.04 3.79 4.80 3.79 4.8000051726 ......... ............ A Complex cystometrogram ............................. 1.71 7.18 7.42 7.18 7.42 0.18 9.07 9.31 9.07 9.31 00051726 ......... 26 ....... A Complex cystometrogram ............................. 1.71 0.65 0.58 0.65 0.58 0.13 2.49 2.42 2.49 2.42 00051726 ......... TC ...... A Complex cystometrogram ............................. 0.00 6.53 6.84 6.53 6.84 0.05 6.58 6.89 6.58 6.89 00051736 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00172 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49153 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules51736 ......... 26 ....... A Urine flow measurement ............................... 0.61 0.23 0.21 0.23 0.21 0.05 0.89 0.87 0.89 0.8700051736 ......... TC ...... A Urine flow measurement ............................... 0.00 0.68 0.46 0.68 0.46 0.01 0.69 0.47 0.69 0.4700051741 ......... ............ A Electro-uroflowmetry, first .............................. 1.14 1.27 0.91 1.27 0.91 0.11 2.52 2.16 2.52 2.16 00051741 ......... 26 ....... A Electro-uroflowmetry, first .............................. 1.14 0.44 0.39 0.44 0.39 0.09 1.67 1.62 1.671.62 00051741 ......... 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 00051772 ......... ............ A Urethra pressure profile ................................ 1.61 5.09 5.45 5.09 5.45 0.20 6.90 7.26 6.90 7.26 00051772 ......... 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 00051772 ......... 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 00051784 ......... ............ A Anal/urinary muscle study ............................. 1.53 3.85 3.95 3.85 3.95 0.16 5.54 5.64 5.545.64 00051784 ......... 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 00051784 ......... TC ...... A Anal/urinary muscle study ............................. 0.00 3.33 3.44 3.33 3.44 0.04 3.37 3.48 3.37 3.4800051785 ......... ............ A Anal/urinary muscle study ............................. 1.53 4.54 4.47 4.54 4.47 0.15 6.22 6.15 6.226.15 00051785 ......... 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 00051785 ......... TC ...... A Anal/urinary muscle study ............................. 0.00 3.97 3.95 3.97 3.95 0.04 4.01 3.99 4.01 3.9900051792 ......... ............ A Urinary reflex study ....................................... 1.10 5.01 5.75 5.01 5.75 0.20 6.31 7.056.31 7.05 00051792 ......... 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 00051792 ......... TC ...... A Urinary reflex study ....................................... 0.00 4.61 5.34 4.61 5.34 0.13 4.74 5.47 4.745.47 00051795 ......... ............ 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 00051795 ......... 26 ....... A Urine voiding pressure study ........................ 1.53 0.58 0.52 0.58 0.52 0.12 2.23 2.17 2.23 2.1700051795 ......... 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 00051797 ......... ............ A Intraabdominal pressure test ......................... 1.60 4.88 5.56 4.88 5.56 0.17 6.65 7.33 6.65 7.33 00051797 ......... 26 ....... A Intraabdominal pressure test ......................... 1.60 0.60 0.55 0.60 0.55 0.12 2.32 2.27 2.32 2.2700051797 ......... TC ...... A Intraabdominal pressure test ......................... 0.00 4.28 5.01 4.28 5.01 0.05 4.33 5.06 4.33 5.0600051798 ......... ............ A Us urine capacity measure ........................... 0.00 0.60 0.41 NA NA 0.08 0.68 0.49 NA NA XXX51800 ......... ............ A Revision of bladder/urethra ........................... 18.68 NA NA 10.11 8.20 1.32 NA NA 30.11 28.2009051820 ......... ............ A Revision of urinary tract ................................ 19.34 NA NA 10.54 8.85 1.74 NA NA 31.62 29.93 09051840 ......... ............ A Attach bladder/urethra ................................... 11.23 NA NA 5.81 5.62 1.06 NA NA 18.10 17.91 09051841 ......... ............ A Attach bladder/urethra ................................... 13.55 NA NA 6.85 6.49 1.24 NA NA 21.64 21.28 09051845 ......... ............ A Repair bladder neck ...................................... 10.02 NA NA 5.88 5.03 0.79 NA NA 16.69 15.84 09051860 ......... ............ A Repair of bladder wound ............................... 12.42 NA NA 6.83 6.02 1.16 NA NA 20.41 19.6009051865 ......... ............ A Repair of bladder wound ............................... 15.62 NA NA 8.47 7.12 1.23 NA NA 25.32 23.9709051880 ......... ............ A Repair of bladder opening ............................. 7.77 NA NA 4.73 4.15 0.72 NA NA 13.22 12.64 09051900 ......... ............ A Repair bladder/vagina lesion ......................... 14.42 NA NA 8.04 6.56 1.21 NA NA 23.67 22.19 09051920 ......... ............ A Close bladder-uterus fistula .......................... 13.20 NA NA 7.77 6.17 1.18 NA NA 22.15 20.5509051925 ......... ............ A Hysterectomy/bladder repair ......................... 17.28 NA NA 10.27 9.03 2.03 NA NA 29.58 28.34 09051940 ......... ............ A Correction of bladder defect .......................... 30.41 NA NA 11.41 11.91 2.14 NA NA 43.96 44.46 09051960 ......... ............ A Revision of bladder & bowel ......................... 25.12 NA NA 13.18 10.52 1.63 NA NA 39.93 37.2709051980 ......... ............ A Construct bladder opening ............................ 12.39 NA NA 7.29 5.85 0.86 NA NA 20.54 19.10 09051990 ......... ............ A Laparo urethral suspension ........................... 13.22 NA NA 5.99 6.10 1.39 NA NA 20.60 20.71 09051992 ......... ............ A Laparo sling operation ................................... 14.73 NA NA 6.65 6.31 1.41 NA NA 22.79 22.45 09051999 ......... ............ C Laparoscope proc, bladder ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY52000 ......... ............ A Cystoscopy .................................................... 2.23 3.70 3.40 1.33 0.90 0.14 6.07 5.77 3.70 3.27 00052001 ......... ............ A Cystoscopy, removal of clots ........................ 5.44 5.14 5.09 2.62 2.05 0.39 10.97 10.92 8.457.88 00052005 ......... ............ A Cystoscopy & ureter catheter ........................ 2.37 5.79 5.62 1.39 1.02 0.17 8.33 8.16 3.93 3.56 00052007 ......... ............ A Cystoscopy and biopsy ................................. 3.02 10.83 15.04 1.64 1.27 0.22 14.07 18.28 4.88 4.51 00052010 ......... ............ A Cystoscopy & duct catheter .......................... 3.02 8.20 10.11 1.65 1.28 0.21 11.43 13.34 4.884.51 00052204 ......... ............ A Cystoscopy .................................................... 2.59 8.39 12.98 1.40 1.03 0.17 11.1515.74 4.16 3.79 00052214 ......... ............ A Cystoscopy and treatment ............................ 3.70 20.07 33.59 1.86 1.46 0.26 24.03 37.55 5.82 5.42 00052224 ......... ............ A Cystoscopy and treatment ............................ 3.14 19.25 32.15 1.63 1.27 0.22 22.61 35.51 4.99 4.63 00052234 ......... ............ A Cystoscopy and treatment ............................ 4.62 NA NA 2.31 1.82 0.33 NA NA 7.26 6.77 00052235 ......... ............ A Cystoscopy and treatment ............................ 5.44 NA NA 2.68 2.12 0.39 NA NA 8.51 7.95 00052240 ......... ............ 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 00052260 ......... ............ A Cystoscopy and treatment ............................ 3.91 NA NA 1.97 1.56 0.28 NA NA 6.16 5.75 00052265 ......... ............ A Cystoscopy and treatment ............................ 2.94 7.74 11.94 1.53 1.22 0.22 10.90 15.10 4.694.38 00052270 ......... ............ A Cystoscopy & revise urethra ......................... 3.36 7.08 10.04 1.77 1.37 0.24 10.68 13.64 5.374.97 00052275 ......... ............ A Cystoscopy & revise urethra ......................... 4.69 9.39 14.01 2.31 1.82 0.33 14.41 19.03 7.336.84 00052276 ......... ............ A Cystoscopy and treatment ............................ 4.99 NA NA 2.48 1.96 0.35 NA NA 7.82 7.30 00052277 ......... ............ A Cystoscopy and treatment ............................ 6.16 NA NA 2.91 2.39 0.44 NA NA 9.51 8.99 00052281 ......... ............ A Cystoscopy and treatment ............................ 2.80 5.34 6.65 1.56 1.20 0.20 8.34 9.65 4.56 4.20 00052282 ......... ............ 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 00052285 ......... ............ A Cystoscopy and treatment ............................ 3.60 4.40 4.11 1.87 1.47 0.26 8.26 7.97 5.73 5.33 00052290 ......... ............ A Cystoscopy and treatment ............................ 4.58 NA NA 2.30 1.81 0.32 NA NA 7.20 6.71 00052300 ......... ............ A Cystoscopy and treatment ............................ 5.30 NA NA 2.65 2.09 0.38 NA NA 8.33 7.77 00052301 ......... ............ A Cystoscopy and treatment ............................ 5.50 NA NA 2.13 2.02 0.46 NA NA 8.09 7.98 000



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# 49154 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal52305 ......... ............ A Cystoscopy and treatment ............................ 5.30 NA NA 2.53 2.02 0.38 NA NA 8.21 7.70 00052310 ......... ............ A Cystoscopy and treatment ............................ 2.81 4.05 4.53 1.45 1.14 0.20 7.06 7.54 4.46 4.15 00052315 ......... ............ A Cystoscopy and treatment ............................ 5.20 6.70 8.17 2.51 2.00 0.37 12.27 13.74 8.087.57 00052317 ......... ............ A Remove bladder stone .................................. 6.71 17.25 26.02 3.04 2.47 0.48 24.44 33.21 10.23 9.66 00052318 ......... ............ A Remove bladder stone .................................. 9.18 NA NA 4.11 3.35 0.65 NA NA 13.94 13.18 00052320 ......... ............ A Cystoscopy and treatment ............................ 4.69 NA NA 2.24 1.78 0.33 NA NA 7.26 6.80 00052325 ......... ............ A Cystoscopy, stone removal ........................... 6.15 NA NA 2.86 2.30 0.44 NA NA 9.45 8.89 00052327 ......... ............ A Cystoscopy, inject material ........................... 5.18 17.98 28.35 2.36 1.95 0.37 23.53 33.90 7.91 7.50 00052330 ......... ............ A Cystoscopy and treatment ............................ 5.03 20.61 34.27 2.38 1.91 0.36 26.00 39.66 7.77 7.30 00052332 ......... ............ A Cystoscopy and treatment ............................ 2.83 12.54 7.44 1.58 1.18 0.21 15.58 10.48 4.624.22 00052334 ......... ............ A Create passage to kidney ............................. 4.82 NA NA 2.34 1.88 0.35 NA NA 7.51 7.05 00052341 ......... ............ A Cysto w/ureter stricture tx ............................. 5.99 NA NA 3.04 2.42 0.43 NA NA 9.46 8.84 00052342 ......... ............ A Cysto w/up stricture tx ................................... 6.49 NA NA 3.26 2.57 0.46 NA NA 10.21 9.52 00052343 ......... ............ A Cysto w/renal stricture tx ............................... 7.19 NA NA 3.54 2.82 0.51 NA NA 11.24 10.52 00052344 ......... ............ A Cysto/uretero, stricture tx .............................. 7.69 NA NA 3.91 3.07 0.55 NA NA 12.15 11.31 00052345 ......... ............ A Cysto/uretero w/up stricture .......................... 8.19 NA NA 4.12 3.24 0.58 NA NA 12.89 12.01 00052346 ......... ............ A Cystouretero w/renal strict ............................ 9.22 NA NA 4.52 3.59 0.65 NA NA 14.39 13.4600052351 ......... ............ A Cystouretero & or pyeloscope ....................... 5.85 NA NA 3.00 2.36 0.41 NA NA 9.26 8.62 00052352 ......... ............ A Cystouretero w/stone remove ....................... 6.87 NA NA 3.52 2.76 0.49 NA NA 10.88 10.12 00052353 ......... ............ A Cystouretero w/lithotripsy .............................. 7.96 NA NA 3.96 3.13 0.57 NA NA 12.49 11.6600052354 ......... ............ A Cystouretero w/biopsy ................................... 7.33 NA NA 3.71 2.93 0.52 NA NA 11.56 10.7800052355 ......... ............ 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 09052402 ......... ............ A Cystourethro cut ejacul duct ......................... 5.27 NA NA 2.20 1.83 0.40 NA NA 7.87 7.50 00052450 ......... ............ A Incision of prostate ........................................ 7.63 NA NA 5.56 4.14 0.54 NA NA 13.73 12.31 09052500 ......... ............ A Revision of bladder neck ............................... 9.33 NA NA 6.24 4.50 0.60 NA NA 16.17 14.4309052510 ......... ............ A Dilation prostatic urethra ............................... 7.45 NA NA 4.95 3.57 0.48 NA NA 12.88 11.50 09052601 ......... ............ A Prostatectomy (TURP) .................................. 15.07 NA NA 8.54 5.96 0.87 NA NA 24.48 21.9009052606 ......... ............ A Control postop bleeding ................................ 8.80 NA NA 5.57 4.06 0.57 NA NA 14.94 13.4309052612 ......... ............ A Prostatectomy, first stage .............................. 9.02 NA NA 5.94 4.28 0.56 NA NA 15.52 13.8609052614 ......... ............ A Prostatectomy, second stage ........................ 7.76 NA NA 5.44 3.87 0.48 NA NA 13.68 12.11 09052620 ......... ............ A Remove residual prostate ............................. 7.16 NA NA 4.64 3.40 0.47 NA NA 12.27 11.03 09052630 ......... ............ 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 09052647 ......... ............ A Laser surgery of prostate .............................. 11.09 42.33 66.04 6.97 5.14 0.73 54.15 77.8618.79 16.96 09052648 ......... ............ A Laser surgery of prostate .............................. 11.94 42.86 66.17 7.30 5.42 0.79 55.59 78.9020.03 18.15 09052700 ......... ............ A Drainage of prostate abscess ....................... 7.35 NA NA 5.00 3.64 0.48 NA NA 12.83 11.47 09053000 ......... ............ A Incision of urethra .......................................... 2.28 NA NA 1.81 1.61 0.16 NA NA 4.25 4.05 01053010 ......... ............ A Incision of urethra .......................................... 4.31 NA NA 3.83 3.14 0.24 NA NA 8.38 7.69 09053020 ......... ............ A Incision of urethra .......................................... 1.77 NA NA 0.96 0.74 0.13 NA NA 2.86 2.64 00053025 ......... ............ A Incision of urethra .......................................... 1.13 NA NA 0.68 0.55 0.08 NA NA 1.89 1.76 00053040 ......... ............ 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 01053080 ......... ............ A Drainage of urinary leakage .......................... 6.78 NA NA 4.94 5.70 0.52 NA NA 12.24 13.00 09053085 ......... ............ A Drainage of urinary leakage .......................... 11.00 NA NA 4.54 6.69 0.92 NA NA 16.46 18.60 09053200 ......... ............ A Biopsy of urethra ........................................... 2.59 1.71 1.42 1.30 1.06 0.20 4.50 4.214.09 3.85 00053210 ......... ............ A Removal of urethra ........................................ 13.54 NA NA 7.80 6.32 0.89 NA NA 22.23 20.75 09053215 ......... ............ A Removal of urethra ........................................ 16.67 NA NA 9.22 7.27 1.10 NA NA 26.99 25.04 09053220 ......... ............ A Treatment of urethra lesion ........................... 7.49 NA NA 5.04 4.04 0.49 NA NA 13.02 12.02 09053230 ......... ............ A Removal of urethra lesion ............................. 10.26 NA NA 6.49 5.16 0.73 NA NA 17.48 16.1509053235 ......... ............ A Removal of urethra lesion ............................. 10.81 NA NA 6.96 5.42 0.72 NA NA 18.49 16.9509053240 ......... ............ A Surgery for urethra pouch ............................. 6.94 NA NA 4.80 3.84 0.52 NA NA 12.26 11.30 09053250 ......... ............ A Removal of urethra gland .............................. 6.38 NA NA 4.72 3.65 0.49 NA NA 11.59 10.52 09053260 ......... ............ A Treatment of urethra lesion ........................... 2.98 2.48 2.30 1.86 1.53 0.25 5.71 5.53 5.094.76 01053265 ......... ............ A Treatment of urethra lesion ........................... 3.12 2.98 2.78 2.02 1.57 0.24 6.34 6.14 5.384.93 01053270 ......... ............ A Removal of urethra gland .............................. 3.09 2.31 2.23 1.72 1.59 0.30 5.70 5.62 5.114.98 010



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# 49155 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules53275 ......... ............ A Repair of urethra defect ................................ 4.52 NA NA 2.79 2.39 0.32 NA NA 7.63 7.23 01053400 ......... ............ A Revise urethra, stage 1 ................................. 13.92 NA NA 8.23 6.57 0.98 NA NA 23.13 21.47 09053405 ......... ............ A Revise urethra, stage 2 ................................. 15.45 NA NA 8.96 6.97 1.10 NA NA 25.51 23.52 09053410 ......... ............ A Reconstruction of urethra .............................. 17.47 NA NA 9.84 7.75 1.16 NA NA 28.47 26.3809053415 ......... ............ A Reconstruction of urethra .............................. 20.49 NA NA 11.00 8.25 1.37 NA NA 32.86 30.11 09053420 ......... ............ A Reconstruct urethra, stage 1 ......................... 14.99 NA NA 6.51 6.34 0.96 NA NA 22.46 22.29 09053425 ......... ............ A Reconstruct urethra, stage 2 ......................... 16.89 NA NA 9.30 7.49 1.13 NA NA 27.32 25.51 09053430 ......... ............ A Reconstruction of urethra .............................. 17.25 NA NA 8.73 7.43 1.15 NA NA 27.13 25.8309053431 ......... ............ A Reconstruct urethra/bladder .......................... 20.97 NA NA 11.08 8.81 1.41 NA NA 33.46 31.1909053440 ......... ............ A Male sling procedure ..................................... 15.33 NA NA 9.31 6.81 0.96 NA NA 25.60 23.10 09053442 ......... ............ A Remove/revise male sling ............................. 13.28 NA NA 8.50 6.20 0.82 NA NA 22.60 20.30 09053444 ......... ............ A Insert tandem cuff ......................................... 14.00 NA NA 8.09 6.43 0.94 NA NA 23.03 21.37 09053445 ......... ............ A Insert uro/ves nck sphincter .......................... 15.15 NA NA 8.86 7.53 0.99 NA NA 25.00 23.6709053446 ......... ............ A Remove uro sphincter ................................... 10.83 NA NA 7.10 5.68 0.72 NA NA 18.65 17.2309053447 ......... ............ 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 09053450 ......... ............ A Revision of urethra ........................................ 6.63 NA NA 4.81 3.67 0.43 NA NA 11.87 10.73 09053460 ......... ............ A Revision of urethra ........................................ 7.61 NA NA 5.17 4.06 0.50 NA NA 13.28 12.17 09053500 ......... ............ A Urethrlys, transvag w/scope .......................... 12.81 NA NA 7.47 6.52 0.90 NA NA 21.18 20.23 09053502 ......... ............ A Repair of urethra injury ................................. 8.12 NA NA 5.06 4.25 0.62 NA NA 13.80 12.99 09053505 ......... ............ A Repair of urethra injury ................................. 8.12 NA NA 5.45 4.26 0.54 NA NA 14.11 12.92 09053510 ......... ............ A Repair of urethra injury ................................. 10.78 NA NA 6.78 5.57 0.74 NA NA 18.30 17.08 09053515 ......... ............ A Repair of urethra injury ................................. 14.04 NA NA 7.89 6.41 1.05 NA NA 22.98 21.50 09053520 ......... ............ A Repair of urethra defect ................................ 9.30 NA NA 6.17 4.90 0.61 NA NA 16.08 14.8109053600 ......... ............ A Dilate urethra stricture ................................... 1.21 1.16 1.15 0.57 0.47 0.09 2.46 2.451.87 1.77 00053601 ......... ............ A Dilate urethra stricture ................................... 0.98 1.38 1.30 0.53 0.41 0.07 2.43 2.351.58 1.46 00053605 ......... ............ A Dilate urethra stricture ................................... 1.28 NA NA 0.52 0.44 0.09 NA NA 1.89 1.81 00053620 ......... ............ A Dilate urethra stricture ................................... 1.62 1.72 1.92 0.84 0.65 0.11 3.45 3.652.57 2.38 00053621 ......... ............ A Dilate urethra stricture ................................... 1.35 1.83 2.01 0.68 0.54 0.10 3.28 3.462.13 1.99 00053660 ......... ............ A Dilation of urethra .......................................... 0.71 1.33 1.32 0.46 0.35 0.05 2.09 2.08 1.22 1.11 00053661 ......... ............ A Dilation of urethra .......................................... 0.72 1.31 1.30 0.42 0.32 0.05 2.08 2.07 1.19 1.09 00053665 ......... ............ A Dilation of urethra .......................................... 0.76 NA NA 0.27 0.26 0.06 NA NA 1.09 1.08 00053850 ......... ............ A Prostatic microwave thermotx ....................... 9.94 49.68 82.97 5.94 4.44 0.67 60.29 93.58 16.55 15.05 09053852 ......... ............ A Prostatic rf thermotx ...................................... 10.62 46.82 78.28 6.74 4.96 0.70 58.14 89.60 18.06 16.28 09053853 ......... ............ A Prostatic water thermother ............................ 5.48 29.37 48.85 4.39 3.24 0.37 35.22 54.70 10.24 9.09 09053899 ......... ............ C Urology surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY54000 ......... ............ A Slitting of prepuce ......................................... 1.54 2.72 2.86 1.49 1.07 0.11 4.37 4.513.14 2.72 01054001 ......... ............ A Slitting of prepuce ......................................... 2.19 3.07 3.15 1.67 1.25 0.15 5.41 5.494.01 3.59 01054015 ......... ............ A Drain penis lesion .......................................... 5.31 NA NA 3.22 2.72 0.38 NA NA 8.91 8.41 01054050 ......... ............ A Destruction, penis lesion(s) ........................... 1.24 2.05 1.76 1.35 1.11 0.08 3.37 3.08 2.672.43 01054055 ......... ............ A Destruction, penis lesion(s) ........................... 1.22 1.97 1.67 1.23 0.91 0.08 3.27 2.97 2.532.21 01054056 ......... ............ 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 01054057 ......... ............ A Laser surg, penis lesion(s) ............................ 1.24 2.61 2.31 1.36 0.96 0.09 3.94 3.64 2.692.29 01054060 ......... ............ A Excision of penis lesion(s) ............................ 1.93 3.11 3.10 1.64 1.21 0.13 5.17 5.16 3.703.27 01054065 ......... ............ A Destruction, penis lesion(s) ........................... 2.42 3.22 2.78 1.94 1.41 0.13 5.77 5.33 4.493.96 01054100 ......... ............ A Biopsy of penis .............................................. 1.90 3.30 2.93 1.34 0.95 0.10 5.30 4.93 3.34 2.95 00054105 ......... ............ A Biopsy of penis .............................................. 3.49 4.03 4.22 2.47 2.07 0.25 7.77 7.96 6.21 5.81 01054110 ......... ............ A Treatment of penis lesion .............................. 10.74 NA NA 6.58 5.21 0.72 NA NA 18.03 16.6709054111 ......... ............ A Treat penis lesion, graft ................................ 14.24 NA NA 8.13 6.35 0.96 NA NA 23.33 21.55 09054112 ......... ............ A Treat penis lesion, graft ................................ 16.77 NA NA 9.42 7.45 1.11 NA NA 27.30 25.33 09054115 ......... ............ 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 09054120 ......... ............ A Partial removal of penis ................................ 10.83 NA NA 6.81 5.21 0.68 NA NA 18.32 16.72 09054125 ......... ............ A Removal of penis .......................................... 14.38 NA NA 8.25 6.43 0.95 NA NA 23.58 21.76 09054130 ......... ............ A Remove penis & nodes ................................. 21.59 NA NA 11.40 8.98 1.52 NA NA 34.51 32.0909054135 ......... ............ A Remove penis & nodes ................................. 27.92 NA NA 14.31 11.20 1.87 NA NA 44.10 40.9909054150 ......... ............ A Circumcision .................................................. 1.81 2.56 3.90 0.57 0.67 0.16 4.53 5.87 2.54 2.64 00054152 ......... ............ A Circumcision .................................................. 2.31 NA NA 1.72 1.33 0.19 NA NA 4.223.83 01054160 ......... ............ A Circumcision .................................................. 2.48 3.69 4.03 1.45 1.18 0.19 6.36 6.70 4.12 3.85 01054161 ......... ............ A Circumcision .................................................. 3.27 NA NA 2.22 1.73 0.23 NA NA 5.725.23 01054162 ......... ............ 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 01054163 ......... ............ A Repair of circumcision ................................... 3.25 NA NA 2.89 2.22 0.21 NA NA 6.35 5.6801054164 ......... ............ A Frenulotomy of penis ..................................... 2.75 NA NA 2.65 2.04 0.18 NA NA 5.58 4.9701054200 ......... ............ A Treatment of penis lesion .............................. 1.06 2.03 1.85 1.31 1.06 0.08 3.17 2.99 2.452.20 01054205 ......... ............ A Treatment of penis lesion .............................. 8.79 NA NA 6.12 5.04 0.56 NA NA 15.47 14.3909054220 ......... ............ A Treatment of penis lesion .............................. 2.42 3.35 3.72 1.37 1.06 0.17 5.94 6.31 3.963.65 000



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# 49156 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal54230 ......... ............ A Prepare penis study ...................................... 1.34 1.41 1.16 0.91 0.70 0.09 2.84 2.59 2.34 2.13 00054231 ......... ............ A Dynamic cavernosometry .............................. 2.04 1.87 1.50 1.18 0.95 0.16 4.07 3.70 3.38 3.15 00054235 ......... ............ A Penile injection .............................................. 1.19 1.40 1.07 0.90 0.66 0.08 2.67 2.34 2.17 1.93 00054240 ......... ............ A Penis study .................................................... 1.31 1.55 1.16 1.55 1.16 0.17 3.03 2.64 3.03 2.64 00054240 ......... 26 ....... A Penis study .................................................... 1.31 0.50 0.45 0.50 0.45 0.11 1.92 1.871.92 1.87 00054240 ......... TC ...... A Penis study .................................................... 0.00 1.05 0.71 1.05 0.71 0.06 1.11 0.771.11 0.77 00054250 ......... ............ A Penis study .................................................... 2.22 1.25 1.00 1.25 1.00 0.18 3.65 3.40 3.65 3.40 00054250 ......... 26 ....... A Penis study .................................................... 2.22 0.88 0.75 0.88 0.75 0.16 3.26 3.133.26 3.13 00054250 ......... TC ...... A Penis study .................................................... 0.00 0.37 0.24 0.37 0.24 0.02 0.39 0.260.39 0.26 00054300 ......... ............ A Revision of penis ........................................... 11.02 NA NA 6.80 5.87 0.76 NA NA 18.5817.65 09054304 ......... ............ A Revision of penis ........................................... 13.10 NA NA 7.89 6.71 0.88 NA NA 21.8720.69 09054308 ......... ............ A Reconstruction of urethra .............................. 12.44 NA NA 7.58 6.36 0.84 NA NA 20.86 19.6409054312 ......... ............ A Reconstruction of urethra .............................. 14.30 NA NA 8.58 7.38 1.24 NA NA 24.12 22.9209054316 ......... ............ A Reconstruction of urethra .............................. 17.84 NA NA 10.07 8.47 1.21 NA NA 29.12 27.52 09054318 ......... ............ A Reconstruction of urethra .............................. 12.22 NA NA 6.25 5.90 1.39 NA NA 19.86 19.5109054322 ......... ............ A Reconstruction of urethra .............................. 13.80 NA NA 7.94 6.82 0.92 NA NA 22.66 21.5409054324 ......... ............ A Reconstruction of urethra .............................. 17.34 NA NA 9.83 8.42 1.14 NA NA 28.31 26.9009054326 ......... ............ A Reconstruction of urethra .............................. 16.81 NA NA 9.65 8.24 1.11 NA NA 27.57 26.1609054328 ......... ............ A Revise penis/urethra ..................................... 16.68 NA NA 9.73 7.86 0.98 NA NA 27.39 25.52 09054332 ......... ............ A Revise penis/urethra ..................................... 18.16 NA NA 10.20 8.34 1.21 NA NA 29.57 27.71 09054336 ......... ............ A Revise penis/urethra ..................................... 21.37 NA NA 11.88 10.68 2.20 NA NA 35.45 34.25 09054340 ......... ............ A Secondary urethral surgery ........................... 9.53 NA NA 6.43 5.38 0.63 NA NA 16.58 15.54 09054344 ......... ............ A Secondary urethral surgery ........................... 16.85 NA NA 9.79 8.25 1.54 NA NA 28.18 26.64 09054348 ......... ............ A Secondary urethral surgery ........................... 18.11 NA NA 6.40 7.86 1.23 NA NA 25.74 27.20 09054352 ......... ............ A Reconstruct urethra/penis ............................. 25.88 NA NA 13.72 11.81 2.24 NA NA 41.84 39.93 09054360 ......... ............ A Penis plastic surgery ..................................... 12.60 NA NA 7.54 6.40 0.84 NA NA 20.98 19.84 09054380 ......... ............ A Repair penis .................................................. 13.97 NA NA 5.59 6.35 0.93 NA NA 20.49 21.25 09054385 ......... ............ A Repair penis .................................................. 16.31 NA NA 8.37 8.28 0.86 NA NA 25.54 25.45 09054390 ......... ............ A Repair penis and bladder .............................. 22.52 NA NA 7.49 8.92 1.54 NA NA 31.55 32.9809054400 ......... ............ A Insert semi-rigid prosthesis ........................... 9.04 NA NA 5.80 4.71 0.64 NA NA 15.48 14.3909054401 ......... ............ A Insert self-contd prosthesis ........................... 10.26 NA NA 8.26 6.36 0.73 NA NA 19.25 17.3509054405 ......... ............ A Insert multi-comp penis pros ......................... 14.34 NA NA 8.22 6.49 0.95 NA NA 23.51 21.78 09054406 ......... ............ A Remove muti-comp penis pros ..................... 12.70 NA NA 7.70 5.98 0.86 NA NA 21.26 19.54 09054408 ......... ............ 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 09054411 ......... ............ A Remov/replc penis pros, comp ..................... 18.06 NA NA 10.50 7.90 1.13 NA NA 29.69 27.09 09054415 ......... ............ A Remove self-contd penis pros ...................... 8.69 NA NA 6.06 4.66 0.58 NA NA 15.33 13.93 09054416 ......... ............ 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 20.6319.08 09054430 ......... ............ A Revision of penis ........................................... 10.88 NA NA 6.99 5.57 0.72 NA NA 18.5817.17 09054435 ......... ............ A Revision of penis ........................................... 6.67 NA NA 4.98 3.95 0.43 NA NA 12.08 11.05 09054440 ......... ............ C Repair of penis .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09054450 ......... ............ A Preputial stretching ........................................ 1.12 0.86 0.93 0.49 0.45 0.08 2.06 2.131.69 1.65 00054500 ......... ............ A Biopsy of testis .............................................. 1.31 NA NA 0.80 0.62 0.10 NA NA 2.212.03 00054505 ......... ............ A Biopsy of testis .............................................. 3.45 NA NA 2.41 2.04 0.27 NA NA 6.135.76 01054512 ......... ............ A Excise lesion testis ........................................ 9.19 NA NA 5.72 4.52 0.67 NA NA 15.58 14.38 09054520 ......... ............ A Removal of testis ........................................... 5.22 NA NA 3.76 3.03 0.50 NA NA 9.48 8.75 09054522 ......... ............ A Orchiectomy, partial ...................................... 10.11 NA NA 5.80 5.10 0.89 NA NA 16.80 16.10 09054530 ......... ............ A Removal of testis ........................................... 9.26 NA NA 6.13 4.71 0.66 NA NA 16.05 14.63 09054535 ......... ............ A Extensive testis surgery ................................ 13.01 NA NA 7.59 6.05 0.95 NA NA 21.55 20.01 09054550 ......... ............ A Exploration for testis ...................................... 8.27 NA NA 5.38 4.20 0.59 NA NA 14.24 13.06 09054560 ......... ............ A Exploration for testis ...................................... 11.92 NA NA 6.32 5.44 0.90 NA NA 19.1418.26 09054600 ......... ............ A Reduce testis torsion ..................................... 7.50 NA NA 5.18 3.95 0.51 NA NA 13.19 11.96 09054620 ......... ............ A Suspension of testis ...................................... 5.14 NA NA 3.28 2.64 0.37 NA NA 8.79 8.1501054640 ......... ............ A Suspension of testis ...................................... 7.53 NA NA 5.50 4.17 0.62 NA NA 13.65 12.32 090



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# 49157 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules54650 ......... ............ A Orchiopexy (Fowler-Stephens) ...................... 12.18 NA NA 7.72 5.97 1.16 NA NA 21.06 19.31 09054660 ......... ............ A Revision of testis ........................................... 5.60 NA NA 4.44 3.35 0.44 NA NA 10.489.39 09054670 ......... ............ A Repair testis injury ......................................... 6.52 NA NA 4.84 3.86 0.47 NA NA 11.8310.85 09054680 ......... ............ A Relocation of testis(es) .................................. 13.86 NA NA 7.78 6.55 1.16 NA NA 22.80 21.57 09054690 ......... ............ A Laparoscopy, orchiectomy ............................ 11.56 NA NA 6.20 5.25 1.02 NA NA 18.78 17.83 09054692 ......... ............ A Laparoscopy, orchiopexy .............................. 13.60 NA NA 7.66 5.98 1.30 NA NA 22.56 20.88 09054699 ......... ............ C Laparoscope proc, testis ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY54700 ......... ............ A Drainage of scrotum ...................................... 3.42 NA NA 2.40 2.05 0.28 NA NA 6.10 5.7501054800 ......... ............ A Biopsy of epididymis ..................................... 2.33 NA NA 1.00 0.93 0.23 NA NA 3.56 3.4900054820 ......... ............ A Exploration of epididymis .............................. 5.63 NA NA 4.32 3.28 0.40 NA NA 10.35 9.31 09054830 ......... ............ A Remove epididymis lesion ............................ 5.87 NA NA 4.48 3.38 0.41 NA NA 10.76 9.66 09054840 ......... ............ A Remove epididymis lesion ............................ 5.19 NA NA 3.84 3.04 0.37 NA NA 9.40 8.60 09054860 ......... ............ A Removal of epididymis .................................. 6.81 NA NA 4.92 3.71 0.45 NA NA 12.18 10.9709054861 ......... ............ A Removal of epididymis .................................. 9.52 NA NA 6.32 4.81 0.63 NA NA 16.47 14.9609054900 ......... ............ A Fusion of spermatic ducts ............................. 13.99 NA NA 5.29 5.66 0.93 NA NA 20.21 20.5809054901 ......... ............ A Fusion of spermatic ducts ............................. 18.85 NA NA 6.64 7.29 1.82 NA NA 27.31 27.9609055000 ......... ............ A Drainage of hydrocele ................................... 1.43 1.86 2.01 0.92 0.72 0.11 3.40 3.55 2.46 2.26 00055040 ......... ............ A Removal of hydrocele ................................... 5.35 NA NA 3.98 3.16 0.43 NA NA 9.76 8.94 09055041 ......... ............ A Removal of hydroceles .................................. 8.36 NA NA 5.74 4.41 0.60 NA NA 14.70 13.3709055060 ......... ............ A Repair of hydrocele ....................................... 6.01 NA NA 4.47 3.42 0.46 NA NA 10.94 9.89 09055100 ......... ............ A Drainage of scrotum abscess ....................... 2.38 3.52 3.63 2.12 1.70 0.17 6.07 6.18 4.67 4.2501055110 ......... ............ A Explore scrotum ............................................ 6.19 NA NA 4.52 3.47 0.43 NA NA 11.14 10.09 09055120 ......... ............ 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 12.7709055175 ......... ............ A Revision of scrotum ....................................... 5.73 NA NA 4.38 3.35 0.37 NA NA 10.48 9.45 09055180 ......... ............ A Revision of scrotum ....................................... 11.57 NA NA 7.32 5.84 0.90 NA NA 19.79 18.31 09055200 ......... ............ A Incision of sperm duct ................................... 4.48 8.27 11.30 3.38 2.62 0.33 13.08 16.118.19 7.43 09055250 ......... ............ 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 09055300 ......... ............ A Prepare, sperm duct x-ray ............................ 3.50 NA NA 1.63 1.39 0.25 NA NA 5.38 5.14 00055400 ......... ............ A Repair of sperm duct ..................................... 8.48 NA NA 5.50 4.41 0.64 NA NA 14.62 13.53 09055450 ......... ............ A Ligation of sperm duct ................................... 4.36 6.00 6.74 2.86 2.11 0.29 10.65 11.397.51 6.76 01055500 ......... ............ A Removal of hydrocele ................................... 6.08 NA NA 4.26 3.38 0.55 NA NA 10.89 10.0109055520 ......... ............ A Removal of sperm cord lesion ...................... 6.52 NA NA 3.86 3.40 0.75 NA NA 11.13 10.67 09055530 ......... ............ A Revise spermatic cord veins ......................... 5.65 NA NA 4.16 3.29 0.45 NA NA 10.26 9.39 09055535 ......... ............ 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 09055550 ......... ............ A Laparo ligate spermatic vein ......................... 7.06 NA NA 4.58 3.61 0.57 NA NA 12.21 11.24 09055559 ......... ............ 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 YYY55600 ......... ............ A Incise sperm duct pouch ............................... 6.87 NA NA 4.95 3.73 0.62 NA NA 12.44 11.22 09055605 ......... ............ A Incise sperm duct pouch ............................... 8.58 NA NA 4.94 4.45 0.64 NA NA 14.16 13.67 09055650 ......... ............ A Remove sperm duct pouch ........................... 12.47 NA NA 7.31 5.77 0.92 NA NA 20.70 19.16 09055680 ......... ............ A Remove sperm pouch lesion ........................ 5.56 NA NA 3.90 3.20 0.47 NA NA 9.93 9.23 09055700 ......... ............ A Biopsy of prostate ......................................... 2.58 3.75 4.08 1.34 0.82 0.11 6.44 6.774.03 3.51 00055705 ......... ............ A Biopsy of prostate ......................................... 4.56 NA NA 2.89 2.44 0.32 NA NA 7.77 7.32 01055720 ......... ............ A Drainage of prostate abscess ....................... 7.63 NA NA 4.84 4.07 0.95 NA NA 13.42 12.65 09055725 ......... ............ A Drainage of prostate abscess ....................... 9.84 NA NA 6.41 4.96 0.70 NA NA 16.95 15.50 09055801 ......... ............ A Removal of prostate ...................................... 19.55 NA NA 10.68 8.37 1.34 NA NA 31.57 29.26 09055810 ......... ............ A Extensive prostate surgery ............................ 24.08 NA NA 12.49 9.81 1.60 NA NA 38.17 35.4909055812 ......... ............ A Extensive prostate surgery ............................ 29.61 NA NA 15.07 11.99 2.04 NA NA 46.72 43.64 09055815 ......... ............ A Extensive prostate surgery ............................ 32.67 NA NA 16.50 13.03 2.16 NA NA 51.33 47.86 09055821 ......... ............ A Removal of prostate ...................................... 15.58 NA NA 8.79 6.84 1.01 NA NA 25.38 23.43 09055831 ......... ............ A Removal of prostate ...................................... 17.01 NA NA 9.37 7.32 1.10 NA NA 27.48 25.43 09055840 ......... ............ A Extensive prostate surgery ............................ 24.38 NA NA 12.82 10.15 1.61 NA NA 38.81 36.14 09055842 ......... ............ A Extensive prostate surgery ............................ 26.24 NA NA 13.67 10.78 1.72 NA NA 41.63 38.74 09055845 ......... ............ A Extensive prostate surgery ............................ 30.46 NA NA 14.90 11.91 2.02 NA NA 47.38 44.39 09055859 ......... ............ A Percut/needle insert, pros ............................. 13.25 NA NA 7.90 6.35 0.89 NA NA 22.04 20.4909055860 ......... ............ A Surgical exposure, prostate .......................... 15.66 NA NA 8.73 6.98 1.02 NA NA 25.41 23.66 09055862 ......... ............ A Extensive prostate surgery ............................ 19.83 NA NA 10.84 8.58 1.49 NA NA 32.16 29.9009055865 ......... ............ A Extensive prostate surgery ............................ 24.32 NA NA 12.97 10.17 1.63 NA NA 38.92 36.12 09055866 ......... ............ A Laparo radical prostatectomy ........................ 32.17 NA NA 16.15 12.81 2.16 NA NA 50.48 47.1409055870 ......... ............ A Electroejaculation .......................................... 2.58 2.47 1.77 1.44 1.17 0.16 5.21 4.514.18 3.91 00055873 ......... ............ A Cryoablate prostate ....................................... 20.19 NA NA 11.44 9.56 1.38 NA NA 33.01 31.13 09055899 ......... ............ C Genital surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY56405 ......... ............ A I & D of vulva/perineum ................................ 1.44 1.18 1.29 1.16 1.15 0.17 2.79 2.90 2.772.76 01056420 ......... ............ 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 01056440 ......... ............ A Surgery for vulva lesion ................................ 2.84 NA NA 1.54 1.67 0.34 NA NA 4.72 4.85 010



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00177 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49158 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal56441 ......... ............ A Lysis of labial lesion(s) .................................. 1.97 1.71 1.79 1.56 1.45 0.20 3.88 3.963.73 3.62 01056501 ......... ............ A Destroy, vulva lesions, sim ........................... 1.53 1.64 1.75 1.22 1.24 0.18 3.35 3.46 2.932.95 01056515 ......... ............ 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 01056605 ......... ............ A Biopsy of vulva/perineum .............................. 1.10 0.91 1.03 0.35 0.43 0.13 2.14 2.26 1.581.66 00056606 ......... ............ A Biopsy of vulva/perineum .............................. 0.55 0.36 0.46 0.16 0.21 0.07 0.98 1.08 0.780.83 ZZZ56620 ......... ............ A Partial removal of vulva ................................. 8.39 NA NA 4.41 4.70 0.90 NA NA 13.70 13.99 09056625 ......... ............ 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 22.8009056631 ......... ............ A Extensive vulva surgery ................................ 18.75 NA NA 7.74 8.54 1.95 NA NA 28.44 29.2409056632 ......... ............ A Extensive vulva surgery ................................ 21.51 NA NA 9.30 9.46 2.38 NA NA 33.19 33.3509056633 ......... ............ A Extensive vulva surgery ................................ 19.41 NA NA 7.79 8.39 1.97 NA NA 29.17 29.7709056634 ......... ............ A Extensive vulva surgery ................................ 20.42 NA NA 8.18 9.11 2.16 NA NA 30.76 31.6909056637 ......... ............ A Extensive vulva surgery ................................ 24.51 NA NA 9.20 10.60 2.60 NA NA 36.31 37.71 09056640 ......... ............ A Extensive vulva surgery ................................ 24.60 NA NA 9.07 10.23 2.88 NA NA 36.55 37.71 09056700 ......... ............ 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 00056740 ......... ............ A Remove vagina gland lesion ......................... 4.81 NA NA 2.32 2.50 0.56 NA NA 7.69 7.87 01056800 ......... ............ A Repair of vagina ............................................ 3.88 NA NA 2.00 2.14 0.44 NA NA 6.32 6.46 01056805 ......... ............ A Repair clitoris ................................................. 19.69 NA NA 9.28 9.38 2.14 NA NA 31.11 31.21 09056810 ......... ............ A Repair of perineum ........................................ 4.24 NA NA 2.06 2.23 0.49 NA NA 6.79 6.9601056820 ......... ............ A Exam of vulva w/scope ................................. 1.50 1.20 1.28 0.53 0.62 0.18 2.88 2.96 2.212.30 00056821 ......... ............ 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 3.1600057000 ......... ............ A Exploration of vagina ..................................... 2.97 NA NA 1.72 1.72 0.31 NA NA 5.00 5.0001057010 ......... ............ A Drainage of pelvic abscess ........................... 6.70 NA NA 3.85 3.81 0.71 NA NA 11.26 11.22 09057020 ......... ............ 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 00057022 ......... ............ A I & d vaginal hematoma, pp .......................... 2.68 NA NA 1.44 1.48 0.26 NA NA 4.38 4.42 01057023 ......... ............ A I & d vag hematoma, non-ob ........................ 5.11 NA NA 2.40 2.53 0.58 NA NA 8.09 8.22 01057061 ......... ............ 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 01057065 ......... ............ 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 01057100 ......... ............ A Biopsy of vagina ............................................ 1.20 0.93 1.04 0.37 0.45 0.14 2.27 2.381.71 1.79 00057105 ......... ............ A Biopsy of vagina ............................................ 1.69 1.59 1.74 1.34 1.40 0.20 3.48 3.633.23 3.29 01057106 ......... ............ A Remove vagina wall, partial .......................... 7.29 NA NA 4.26 4.20 0.73 NA NA 12.28 12.22 09057107 ......... ............ A Remove vagina tissue, part .......................... 24.37 NA NA 9.11 10.12 2.71 NA NA 36.19 37.20 09057109 ......... ............ A Vaginectomy partial w/nodes ........................ 28.19 NA NA 10.34 11.02 3.21 NA NA 41.74 42.42 09057110 ......... ............ A Remove vagina wall, complete ..................... 15.34 NA NA 6.27 7.02 1.73 NA NA 23.34 24.09 09057111 ......... ............ A Remove vagina tissue, compl ....................... 28.19 NA NA 10.26 12.02 3.17 NA NA 41.62 43.38 09057112 ......... ............ 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 09057130 ......... ............ A Remove vagina lesion ................................... 2.43 1.99 2.11 1.49 1.53 0.29 4.71 4.83 4.214.25 01057135 ......... ............ A Remove vagina lesion ................................... 2.67 2.03 2.20 1.54 1.62 0.31 5.01 5.18 4.524.60 01057150 ......... ............ A Treat vagina infection .................................... 0.55 0.58 0.97 0.16 0.20 0.07 1.20 1.59 0.78 0.82 00057155 ......... ............ A Insert uteri tandems/ovoids ........................... 6.75 NA NA 3.11 4.20 0.43 NA NA 10.29 11.38 09057160 ......... ............ A Insert pessary/other device ........................... 0.89 1.05 1.02 0.26 0.32 0.10 2.04 2.01 1.251.31 00057170 ......... ............ 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 00057180 ......... ............ A Treat vaginal bleeding ................................... 1.58 1.85 2.08 0.92 1.18 0.19 3.62 3.85 2.69 2.95 01057200 ......... ............ A Repair of vagina ............................................ 4.31 NA NA 2.95 2.91 0.46 NA NA 7.72 7.68 09057210 ......... ............ 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 09057230 ......... ............ A Repair of urethral lesion ................................ 6.19 NA NA 3.78 3.50 0.54 NA NA 10.51 10.23 09057240 ......... ............ A Repair bladder & vagina ............................... 11.38 NA NA 5.47 4.23 0.62 NA NA 17.47 16.2309057250 ......... ............ A Repair rectum & vagina ................................ 11.38 NA NA 5.04 3.94 0.65 NA NA 17.07 15.9709057260 ......... ............ A Repair of vagina ............................................ 14.32 NA NA 5.86 5.09 0.97 NA NA 21.1520.38 09057265 ......... ............ A Extensive repair of vagina ............................. 15.82 NA NA 6.33 6.11 1.32 NA NA 23.47 23.2509057267 ......... ............ 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 12.4409057270 ......... ............ A Repair of bowel pouch .................................. 13.53 NA NA 5.71 6.11 1.42 NA NA 20.66 21.06090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00178 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49159 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules57280 ......... ............ A Suspension of vagina .................................... 16.58 NA NA 7.02 7.28 1.67 NA NA 25.27 25.53 09057282 ......... ............ A Colpopexy, extraperitoneal ............................ 7.79 NA NA 4.43 4.48 1.02 NA NA 13.24 13.29 09057283 ......... ............ A Colpopexy, intraperitoneal ............................. 11.54 NA NA 5.24 5.74 1.02 NA NA 17.80 18.3009057284 ......... ............ A Repair paravaginal defect ............................. 13.43 NA NA 6.77 7.05 1.41 NA NA 21.61 21.8909057287 ......... ............ A Revise/remove sling repair ............................ 11.43 NA NA 6.47 5.72 0.90 NA NA 18.80 18.0509057288 ......... ............ A Repair bladder defect .................................... 13.95 NA NA 7.09 6.20 1.12 NA NA 22.16 21.27 09057289 ......... ............ A Repair bladder & vagina ............................... 12.63 NA NA 6.23 6.08 1.21 NA NA 20.07 19.9209057291 ......... ............ A Construction of vagina .................................. 8.50 NA NA 4.39 4.79 0.93 NA NA 13.82 14.2209057292 ......... ............ A Construct vagina with graft ........................... 13.87 NA NA 5.99 6.70 1.58 NA NA 21.44 22.1509057295 ......... ............ A Change vaginal graft ..................................... 7.70 NA NA 3.77 4.27 0.91 NA NA 12.38 12.88 09057300 ......... ............ A Repair rectum-vagina fistula ......................... 8.53 NA NA 4.48 4.33 0.87 NA NA 13.88 13.73 09057305 ......... ............ A Repair rectum-vagina fistula ......................... 15.18 NA NA 6.20 6.25 1.72 NA NA 23.10 23.15 09057307 ......... ............ A Fistula repair & colostomy ............................. 16.96 NA NA 7.04 7.00 2.01 NA NA 26.01 25.9709057308 ......... ............ A Fistula repair, transperine ............................. 10.42 NA NA 4.88 5.04 1.14 NA NA 16.44 16.60 09057310 ......... ............ A Repair urethrovaginal lesion ......................... 7.51 NA NA 5.05 4.14 0.54 NA NA 13.10 12.19 09057311 ......... ............ A Repair urethrovaginal lesion ......................... 8.77 NA NA 5.16 4.37 0.65 NA NA 14.58 13.79 09057320 ......... ............ 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 09057335 ......... ............ A Repair vagina ................................................ 19.81 NA NA 8.80 8.97 1.91 NA NA 30.5230.69 09057400 ......... ............ A Dilation of vagina ........................................... 2.27 NA NA 0.99 1.08 0.26 NA NA 3.52 3.61 00057410 ......... ............ A Pelvic examination ........................................ 1.75 NA NA 0.92 0.90 0.18 NA NA 2.85 2.8300057415 ......... ............ A Remove vaginal foreign body ....................... 2.42 NA NA 1.51 1.44 0.24 NA NA 4.17 4.10 01057420 ......... ............ 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 00057421 ......... ............ 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 3.3700057425 ......... ............ A Laparoscopy, surg, colpopexy ...................... 16.89 NA NA 7.00 6.72 1.75 NA NA 25.64 25.36 09057452 ......... ............ A Exam of cervix w/scope ................................ 1.50 1.19 1.26 0.75 0.76 0.18 2.87 2.94 2.432.44 00057454 ......... ............ A Bx/curett of cervix w/scope ........................... 2.33 1.41 1.58 0.97 1.11 0.28 4.02 4.19 3.583.72 00057455 ......... ............ A Biopsy of cervix w/scope ............................... 1.99 1.51 1.67 0.67 0.82 0.24 3.74 3.90 2.903.05 00057456 ......... ............ 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 00057460 ......... ............ A Bx of cervix w/scope, leep ............................ 2.83 4.33 5.46 1.11 1.31 0.34 7.50 8.63 4.284.48 00057461 ......... ............ 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 00057500 ......... ............ A Biopsy of cervix ............................................. 1.20 2.03 2.41 0.65 0.64 0.12 3.35 3.73 1.97 1.96 00057505 ......... ............ A Endocervical curettage .................................. 1.14 1.32 1.43 1.07 1.09 0.14 2.60 2.71 2.35 2.37 01057510 ......... ............ A Cauterization of cervix ................................... 1.90 1.32 1.50 0.91 1.01 0.23 3.45 3.63 3.04 3.14 01057511 ......... ............ A Cryocautery of cervix .................................... 1.90 1.61 1.77 1.27 1.35 0.23 3.74 3.90 3.40 3.48 01057513 ......... ............ 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 01057520 ......... ............ A Conization of cervix ....................................... 4.03 3.39 3.80 2.52 2.78 0.49 7.91 8.327.04 7.30 09057522 ......... ............ A Conization of cervix ....................................... 3.60 2.79 3.06 2.27 2.41 0.41 6.80 7.076.28 6.42 09057530 ......... ............ A Removal of cervix .......................................... 5.16 NA NA 3.12 3.32 0.58 NA NA 8.86 9.06 09057531 ......... ............ A Removal of cervix, radical ............................. 29.71 NA NA 10.66 12.54 3.34 NA NA 43.71 45.59 09057540 ......... ............ A Removal of residual cervix ............................ 13.15 NA NA 5.61 6.08 1.49 NA NA 20.25 20.7209057545 ......... ............ A Remove cervix/repair pelvis .......................... 13.96 NA NA 6.23 6.56 1.52 NA NA 21.71 22.04 09057550 ......... ............ A Removal of residual cervix ............................ 6.20 NA NA 3.65 3.78 0.67 NA NA 10.52 10.65 09057555 ......... ............ 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 09057720 ......... ............ A Revision of cervix .......................................... 4.50 NA NA 2.92 3.06 0.49 NA NA 7.91 8.05 09057800 ......... ............ 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 00057820 ......... ............ 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 01058100 ......... ............ 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 00058110 ......... ............ 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 1.15ZZZ58120 ......... ............ A Dilation and curettage ................................... 3.52 2.72 2.41 1.67 1.82 0.39 6.63 6.32 5.58 5.73 01058140 ......... ............ A Myomectomy abdom method ........................ 15.65 NA NA 6.25 6.89 1.81 NA NA 23.71 24.35 09058145 ......... ............ A Myomectomy vag method ............................. 8.77 NA NA 4.28 4.66 0.97 NA NA 14.02 14.40 09058146 ......... ............ A Myomectomy abdom complex ...................... 20.20 NA NA 7.36 8.59 2.32 NA NA 29.88 31.11 09058150 ......... ............ A Total hysterectomy ........................................ 17.17 NA NA 6.59 7.26 1.84 NA NA 25.60 26.27 09058152 ......... ............ A Total hysterectomy ........................................ 21.68 NA NA 8.18 9.43 2.47 NA NA 32.33 33.58 09058180 ......... ............ A Partial hysterectomy ...................................... 16.46 NA NA 6.38 7.18 1.64 NA NA 24.48 25.28 09058200 ......... ............ A Extensive hysterectomy ................................ 22.96 NA NA 8.15 9.53 2.54 NA NA 33.65 35.0309058210 ......... ............ A Extensive hysterectomy ................................ 30.70 NA NA 10.71 12.57 3.37 NA NA 44.78 46.64 09058240 ......... ............ A Removal of pelvis contents ........................... 43.13 NA NA 15.92 17.19 4.22 NA NA 63.27 64.5409058260 ......... ............ A Vaginal hysterectomy .................................... 13.98 NA NA 5.83 6.48 1.57 NA NA 21.38 22.03 09058262 ......... ............ A Vag hyst including t/o .................................... 15.77 NA NA 6.31 7.11 1.79 NA NA 23.87 24.67 09058263 ......... ............ A Vag hyst w/t/o & vag repair ........................... 17.06 NA NA 6.67 7.58 1.94 NA NA 25.67 26.5809058267 ......... ............ A Vag hyst w/urinary repair .............................. 18.18 NA NA 7.06 8.04 2.06 NA NA 27.30 28.2809058270 ......... ............ A Vag hyst w/enterocele repair ........................ 15.16 NA NA 5.99 6.79 1.73 NA NA 22.88 23.68 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00179 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49160 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal58275 ......... ............ A Hysterectomy/revise vagina .......................... 16.85 NA NA 6.70 7.50 1.91 NA NA 25.46 26.26 09058280 ......... ............ A Hysterectomy/revise vagina .......................... 18.15 NA NA 7.08 7.96 2.06 NA NA 27.28 28.17 09058285 ......... ............ A Extensive hysterectomy ................................ 23.26 NA NA 7.96 9.45 2.70 NA NA 33.92 35.4109058290 ......... ............ A Vag hyst complex .......................................... 20.13 NA NA 7.44 8.70 2.29 NA NA 29.86 31.12 09058291 ......... ............ A Vag hyst incl t/o, complex ............................. 21.92 NA NA 7.87 9.37 2.52 NA NA 32.31 33.8109058292 ......... ............ A Vag hyst t/o & repair, compl ......................... 23.21 NA NA 8.34 9.86 2.67 NA NA 34.22 35.74 09058293 ......... ............ A Vag hyst w/uro repair, compl ........................ 24.19 NA NA 8.55 10.13 2.78 NA NA 35.52 37.10 09058294 ......... ............ 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 XXX58301 ......... ............ A Remove intrauterine device .......................... 1.27 1.06 1.26 0.35 0.45 0.15 2.48 2.68 1.77 1.87 00058321 ......... ............ A Artificial insemination ..................................... 0.92 0.98 1.11 0.25 0.34 0.10 2.00 2.131.27 1.36 00058322 ......... ............ A Artificial insemination ..................................... 1.10 1.05 1.16 0.31 0.39 0.13 2.28 2.391.54 1.62 00058323 ......... ............ A Sperm washing .............................................. 0.23 0.15 0.44 0.07 0.09 0.03 0.41 0.700.33 0.35 00058340 ......... ............ A Catheter for hysterography ........................... 0.88 2.17 2.91 0.57 0.63 0.09 3.14 3.88 1.54 1.60 00058345 ......... ............ A Reopen fallopian tube ................................... 4.65 NA NA 2.08 2.34 0.41 NA NA 7.14 7.40 01058346 ......... ............ A Insert heyman uteri capsule .......................... 7.44 NA NA 3.34 3.78 0.56 NA NA 11.34 11.78 09058350 ......... ............ A Reopen fallopian tube ................................... 1.01 1.34 1.45 0.87 0.91 0.12 2.47 2.58 2.00 2.04 01058353 ......... ............ A Endometr ablate, thermal .............................. 3.55 23.12 32.53 1.72 1.97 0.43 27.10 36.51 5.70 5.95 01058356 ......... ............ A Endometrial cryoablation ............................... 6.36 43.78 57.02 1.86 2.48 0.82 50.96 64.209.04 9.66 01058400 ......... ............ A Suspension of uterus .................................... 7.03 NA NA 3.85 3.91 0.75 NA NA 11.63 11.6909058410 ......... ............ A Suspension of uterus .................................... 13.66 NA NA 5.91 6.30 1.45 NA NA 21.02 21.41 09058520 ......... ............ A Repair of ruptured uterus .............................. 13.34 NA NA 5.48 5.89 1.47 NA NA 20.29 20.7009058540 ......... ............ A Revision of uterus ......................................... 15.57 NA NA 6.25 6.78 1.78 NA NA 23.60 24.13 09058545 ......... ............ A Laparoscopic myomectomy ........................... 15.65 NA NA 6.03 6.89 1.77 NA NA 23.45 24.31 09058546 ......... ............ A Laparo-myomectomy, complex ..................... 20.20 NA NA 7.26 8.50 2.30 NA NA 29.76 31.00 09058550 ......... ............ A Laparo-asst vag hysterectomy ...................... 14.91 NA NA 6.20 7.02 1.72 NA NA 22.83 23.65 09058552 ......... ............ A Laparo-vag hyst incl t/o ................................. 16.23 NA NA 6.49 7.63 1.72 NA NA 24.44 25.58 09058553 ......... ............ A Laparo-vag hyst, complex ............................. 20.13 NA NA 7.24 8.49 2.30 NA NA 29.67 30.92 09058554 ......... ............ A Laparo-vag hyst w/t/o, compl ........................ 23.13 NA NA 8.41 9.90 2.27 NA NA 33.81 35.30 09058555 ......... ............ 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 00058558 ......... ............ A Hysteroscopy, biopsy .................................... 4.74 3.63 2.54 1.68 2.05 0.57 8.94 7.85 6.99 7.36 00058559 ......... ............ A Hysteroscopy, lysis ........................................ 6.16 NA NA 2.07 2.57 0.74 NA NA 8.97 9.47 00058560 ......... ............ A Hysteroscopy, resect septum ........................ 6.99 NA NA 2.31 2.89 0.84 NA NA 10.14 10.72 00058561 ......... ............ A Hysteroscopy, remove myoma ...................... 9.99 NA NA 3.16 4.00 1.21 NA NA 14.36 15.20 00058562 ......... ............ A Hysteroscopy, remove fb .............................. 5.20 3.53 2.65 1.78 2.21 0.63 9.36 8.48 7.61 8.04 00058563 ......... ............ A Hysteroscopy, ablation .................................. 6.16 37.70 51.57 2.08 2.58 0.74 44.60 58.478.98 9.48 00058565 ......... ............ A Hysteroscopy, sterilization ............................. 7.02 34.73 45.85 3.39 3.77 1.19 42.94 54.0611.60 11.98 09058578 ......... ............ C Laparo proc, uterus ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY58579 ......... ............ C Hysteroscope procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY58600 ......... ............ A Division of fallopian tube ............................... 5.84 NA NA 2.94 3.23 0.66 NA NA 9.44 9.7309058605 ......... ............ A Division of fallopian tube ............................... 5.23 NA NA 2.69 3.01 0.59 NA NA 8.51 8.8309058611 ......... ............ A Ligate oviduct(s) add-on ................................ 1.45 NA NA 0.40 0.53 0.18 NA NA 2.03 2.16 ZZZ58615 ......... ............ A Occlude fallopian tube(s) .............................. 3.89 NA NA 2.00 2.53 0.47 NA NA 6.36 6.89 01058660 ......... ............ A Laparoscopy, lysis ......................................... 11.52 NA NA 4.56 5.08 1.40 NA NA 17.48 18.00 09058661 ......... ............ A Laparoscopy, remove adnexa ....................... 11.28 NA NA 4.04 4.85 1.34 NA NA 16.66 17.47 01058662 ......... ............ A Laparoscopy, excise lesions ......................... 12.06 NA NA 4.83 5.54 1.43 NA NA 18.32 19.03 09058670 ......... ............ A Laparoscopy, tubal cautery ........................... 5.84 NA NA 2.98 3.20 0.67 NA NA 9.49 9.71 09058671 ......... ............ 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 20.2909058673 ......... ............ 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 0.000.00 YYY58700 ......... ............ A Removal of fallopian tube ............................. 12.80 NA NA 5.56 5.88 1.51 NA NA 19.87 20.1909058720 ......... ............ A Removal of ovary/tube(s) .............................. 12.04 NA NA 5.13 5.61 1.39 NA NA 18.56 19.0409058740 ......... ............ A Revise fallopian tube(s) ................................. 14.75 NA NA 6.11 6.88 1.71 NA NA 22.57 23.34 09058750 ......... ............ A Repair oviduct ............................................... 15.52 NA NA 6.14 7.06 1.84 NA NA 23.5024.42 09058752 ......... ............ A Revise ovarian tube(s) .................................. 15.52 NA NA 6.04 6.72 1.80 NA NA 23.36 24.04 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00180 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49161 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules58760 ......... ............ A Remove tubal obstruction ............................. 13.81 NA NA 5.66 6.45 1.79 NA NA 21.26 22.05 09058770 ......... ............ A Create new tubal opening ............................. 14.65 NA NA 5.81 6.63 1.73 NA NA 22.19 23.01 09058800 ......... ............ A Drainage of ovarian cyst(s) ........................... 4.51 3.20 3.53 2.68 2.85 0.43 8.14 8.47 7.627.79 09058805 ......... ............ A Drainage of ovarian cyst(s) ........................... 6.31 NA NA 3.49 3.50 0.69 NA NA 10.49 10.50 09058820 ......... ............ A Drain ovary abscess, open ........................... 4.59 NA NA 2.89 3.19 0.52 NA NA 8.00 8.30 09058822 ......... ............ A Drain ovary abscess, percut ......................... 11.67 NA NA 5.18 5.20 1.16 NA NA 18.01 18.03 09058823 ......... ............ 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 00058825 ......... ............ A Transposition, ovary(s) .................................. 11.66 NA NA 4.98 5.59 1.32 NA NA 17.96 18.57 09058900 ......... ............ A Biopsy of ovary(s) ......................................... 6.48 NA NA 3.49 3.55 0.69 NA NA 10.66 10.72 09058920 ......... ............ A Partial removal of ovary(s) ............................ 11.84 NA NA 5.24 5.49 1.43 NA NA 18.51 18.7609058925 ......... ............ A Removal of ovarian cyst(s) ........................... 12.29 NA NA 5.31 5.59 1.41 NA NA 19.01 19.29 09058940 ......... ............ A Removal of ovary(s) ...................................... 8.08 NA NA 4.07 4.09 0.91 NA NA 13.06 13.08 09058943 ......... ............ A Removal of ovary(s) ...................................... 19.38 NA NA 7.25 8.29 2.22 NA NA 28.85 29.89 09058950 ......... ............ A Resect ovarian malignancy ........................... 18.18 NA NA 7.29 8.12 2.04 NA NA 27.51 28.34 09058951 ......... ............ A Resect ovarian malignancy ........................... 24.11 NA NA 8.61 9.98 2.63 NA NA 35.35 36.72 09058952 ......... ............ A Resect ovarian malignancy ........................... 27.09 NA NA 9.81 11.27 3.02 NA NA 39.92 41.38 09058953 ......... ............ A Tah, rad dissect for debulk ........................... 33.91 NA NA 11.63 13.81 3.83 NA NA 49.37 51.55 09058954 ......... ............ 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 09058960 ......... ............ A Exploration of abdomen ................................ 15.64 NA NA 6.29 7.09 1.79 NA NA 23.72 24.5209058970 ......... ............ A Retrieval of oocyte ........................................ 3.52 1.83 2.19 1.26 1.43 0.43 5.78 6.145.21 5.38 00058974 ......... ............ C Transfer of embryo ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00058976 ......... ............ A Transfer of embryo ........................................ 3.82 1.96 2.50 1.22 1.67 0.47 6.25 6.79 5.51 5.96 00058999 ......... ............ C Genital surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY59000 ......... ............ A Amniocentesis, diagnostic ............................. 1.30 1.75 1.99 0.56 0.64 0.31 3.36 3.60 2.172.25 00059001 ......... ............ A Amniocentesis, therapeutic ........................... 3.00 NA NA 1.09 1.33 0.71 NA NA 4.80 5.04 00059012 ......... ............ A Fetal cord puncture,prenatal ......................... 3.44 NA NA 1.16 1.45 0.82 NA NA 5.42 5.71 00059015 ......... ............ A Chorion biopsy .............................................. 2.20 1.43 1.52 0.81 0.98 0.52 4.15 4.243.53 3.70 00059020 ......... ............ 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 00059020 ......... 26 ....... A Fetal contract stress test ............................... 0.66 0.19 0.24 0.19 0.24 0.16 1.01 1.06 1.011.06 00059020 ......... 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 00059025 ......... ............ A Fetal non-stress test ...................................... 0.53 0.63 0.49 0.63 0.49 0.15 1.31 1.171.31 1.17 00059025 ......... 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 00059025 ......... TC ...... A Fetal non-stress test ...................................... 0.00 0.49 0.30 0.49 0.30 0.02 0.51 0.32 0.510.32 00059030 ......... ............ 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 1.43XXX59051 ......... ............ A Fetal monitor/interpret only ........................... 0.74 NA NA 0.21 0.27 0.17 NA NA 1.12 1.18 XXX59070 ......... ............ 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 00059072 ......... ............ A Umbilical cord occlud w/us ............................ 8.99 NA NA 2.88 3.06 0.16 NA NA 12.03 12.21 00059074 ......... ............ 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 00059076 ......... ............ 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 22.4509059120 ......... ............ A Treat ectopic pregnancy ................................ 12.52 NA NA 5.47 6.05 2.72 NA NA 20.71 21.2909059121 ......... ............ A Treat ectopic pregnancy ................................ 12.60 NA NA 5.42 6.10 2.78 NA NA 20.80 21.4809059130 ......... ............ A Treat ectopic pregnancy ................................ 14.94 NA NA 6.09 5.12 3.38 NA NA 24.41 23.4409059135 ......... ............ A Treat ectopic pregnancy ................................ 14.78 NA NA 5.12 6.70 3.30 NA NA 23.20 24.7809059136 ......... ............ A Treat ectopic pregnancy ................................ 14.11 NA NA 5.77 6.39 3.13 NA NA 23.01 23.6309059140 ......... ............ A Treat ectopic pregnancy ................................ 5.83 NA NA 2.91 2.39 1.29 NA NA 10.03 9.51 09059150 ......... ............ A Treat ectopic pregnancy ................................ 12.15 NA NA 5.26 5.81 2.78 NA NA 20.19 20.7409059151 ......... ............ A Treat ectopic pregnancy ................................ 11.97 NA NA 4.93 5.77 2.73 NA NA 19.63 20.4709059160 ......... ............ A D & c after delivery ....................................... 2.71 2.00 2.97 1.19 1.90 0.64 5.35 6.324.54 5.25 01059200 ......... ............ A Insert cervical dilator ..................................... 0.79 0.95 1.13 0.22 0.28 0.19 1.93 2.111.20 1.26 00059300 ......... ............ A Episiotomy or vaginal repair .......................... 2.41 2.21 2.18 1.03 0.98 0.57 5.19 5.16 4.013.96 00059320 ......... ............ A Revision of cervix .......................................... 2.48 NA NA 1.02 1.19 0.59 NA NA 4.09 4.26 00059325 ......... ............ A Revision of cervix .......................................... 4.06 NA NA 1.24 1.73 0.88 NA NA 6.18 6.67 00059350 ......... ............ A Repair of uterus ............................................. 4.94 NA NA 1.41 1.76 1.17 NA NA 7.52 7.87 00059400 ......... ............ A Obstetrical care ............................................. 26.53 NA NA 14.36 15.08 5.48 NA NA 46.37 47.09 MMM59409 ......... ............ A Obstetrical care ............................................. 13.48 NA NA 3.76 4.92 3.21 NA NA 20.4521.61 MMM59410 ......... ............ A Obstetrical care ............................................. 15.26 NA NA 4.97 5.97 3.51 NA NA 23.7424.74 MMM59412 ......... ............ A Antepartum manipulation .............................. 1.71 NA NA 0.65 0.77 0.40 NA NA 2.76 2.88 MMM59414 ......... ............ A Deliver placenta ............................................. 1.61 NA NA 0.44 0.59 0.38 NA NA 2.43 2.58 MMM59425 ......... ............ A Antepartum care only .................................... 6.12 4.25 4.21 1.68 1.81 1.14 11.51 11.47 8.94 9.07 MMM59426 ......... ............ A Antepartum care only .................................... 10.84 7.82 7.61 2.97 3.16 1.97 20.63 20.4215.78 15.97 MMM59430 ......... ............ A Care after delivery ......................................... 2.13 1.04 1.18 0.66 0.87 0.50 3.67 3.813.29 3.50 MMM59510 ......... ............ A Cesarean delivery ......................................... 30.05 NA NA 16.03 16.95 6.23 NA NA 52.3153.23 MMM59514 ......... ............ A Cesarean delivery only .................................. 15.95 NA NA 4.51 5.79 3.79 NA NA 24.25 25.53 MMM



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00181 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49162 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal59515 ......... ............ A Cesarean delivery ......................................... 18.21 NA NA 6.25 7.44 4.12 NA NA 28.58 29.77 MMM59525 ......... ............ A Remove uterus after cesarean ...................... 8.53 NA NA 2.40 3.08 1.94 NA NA 12.87 13.55 ZZZ59610 ......... ............ A Vbac delivery ................................................. 27.95 NA NA 14.66 15.56 5.85 NA NA 48.46 49.36 MMM59612 ......... ............ A Vbac delivery only ......................................... 15.04 NA NA 4.28 5.61 3.58 NA NA 22.90 24.23 MMM59614 ......... ............ A Vbac care after delivery ................................ 16.57 NA NA 5.19 6.50 3.88 NA NA 25.64 26.95 MMM59618 ......... ............ A Attempted vbac delivery ................................ 31.48 NA NA 16.38 17.77 6.59 NA NA 54.45 55.84 MMM59620 ......... ............ A Attempted vbac delivery only ........................ 17.50 NA NA 4.80 6.27 4.16 NA NA 26.46 27.93 MMM59622 ......... ............ A Attempted vbac after care ............................. 19.64 NA NA 6.69 8.15 4.49 NA NA 30.82 32.28MMM59812 ......... ............ A Treatment of miscarriage .............................. 4.37 3.12 2.69 2.38 2.50 0.95 8.44 8.01 7.707.82 09059820 ......... ............ A Care of miscarriage ....................................... 4.64 4.10 4.34 3.49 3.54 0.95 9.69 9.93 9.08 9.13 09059821 ......... ............ A Treatment of miscarriage .............................. 4.94 3.85 4.17 3.19 3.35 1.06 9.85 10.17 9.199.35 09059830 ......... ............ A Treat uterus infection .................................... 6.48 NA NA 3.47 3.85 1.44 NA NA 11.39 11.77 09059840 ......... ............ R Abortion ......................................................... 3.01 2.04 2.10 1.81 2.04 0.71 5.765.82 5.53 5.76 01059841 ......... ............ R Abortion ......................................................... 5.55 3.19 3.42 2.61 2.88 1.24 9.9810.21 9.40 9.67 01059850 ......... ............ R Abortion ......................................................... 5.90 NA NA 2.66 3.10 1.28 NA NA 9.84 10.28 09059851 ......... ............ R Abortion ......................................................... 5.92 NA NA 3.33 3.64 1.28 NA NA 10.53 10.84 09059852 ......... ............ R Abortion ......................................................... 8.23 NA NA 3.84 4.74 1.80 NA NA 13.87 14.77 09059855 ......... ............ R Abortion ......................................................... 6.36 NA NA 3.00 3.41 1.45 NA NA 10.81 11.22 09059856 ......... ............ R Abortion ......................................................... 7.72 NA NA 3.85 4.01 1.78 NA NA 13.35 13.51 09059857 ......... ............ R Abortion ......................................................... 9.28 NA NA 3.17 4.33 2.01 NA NA 14.46 15.62 09059866 ......... ............ R Abortion (mpr) ............................................... 3.99 NA NA 1.26 1.73 0.87 NA NA 6.12 6.59 00059870 ......... ............ A Evacuate mole of uterus ............................... 6.32 NA NA 4.31 4.44 1.42 NA NA 12.05 12.18 09059871 ......... ............ A Remove cerclage suture ............................... 2.13 NA NA 0.94 1.08 0.50 NA NA 3.57 3.71 00059897 ......... ............ 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 YYY59898 ......... ............ 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 YYY59899 ......... ............ C Maternity care procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY60000 ......... ............ A Drain thyroid/tongue cyst .............................. 1.76 2.06 1.96 1.67 1.70 0.15 3.97 3.87 3.583.61 01060001 ......... ............ 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 00060100 ......... ............ A Biopsy of thyroid ............................................ 1.56 1.27 1.37 0.47 0.52 0.10 2.93 3.03 2.13 2.18 00060200 ......... ............ A Remove thyroid lesion ................................... 9.84 NA NA 5.20 5.79 1.01 NA NA 16.05 16.6409060210 ......... ............ A Partial thyroid excision .................................. 11.11 NA NA 5.04 5.48 1.23 NA NA 17.38 17.82 09060212 ......... ............ A Partial thyroid excision .................................. 16.26 NA NA 6.55 7.39 1.94 NA NA 24.75 25.59 09060220 ......... ............ A Partial removal of thyroid .............................. 12.25 NA NA 5.37 5.95 1.32 NA NA 18.94 19.52 09060225 ......... ............ A Partial removal of thyroid .............................. 14.59 NA NA 6.65 7.21 1.64 NA NA 22.88 23.44 09060240 ......... ............ A Removal of thyroid ........................................ 16.16 NA NA 6.14 7.22 1.85 NA NA 24.15 25.23 09060252 ......... ............ A Removal of thyroid ........................................ 21.82 NA NA 8.38 9.66 2.29 NA NA 32.49 33.77 09060254 ......... ............ A Extensive thyroid surgery .............................. 28.23 NA NA 10.28 13.18 2.60 NA NA 41.11 44.01 09060260 ......... ............ A Repeat thyroid surgery .................................. 18.14 NA NA 6.96 8.22 1.93 NA NA 27.03 28.29 09060270 ......... ............ A Removal of thyroid ........................................ 23.01 NA NA 8.90 10.06 2.32 NA NA 34.23 35.39 09060271 ......... ............ A Removal of thyroid ........................................ 17.50 NA NA 6.77 8.13 1.74 NA NA 26.01 27.37 09060280 ......... ............ A Remove thyroid duct lesion ........................... 5.98 NA NA 4.07 4.51 0.54 NA NA 10.59 11.03 09060281 ......... ............ A Remove thyroid duct lesion ........................... 8.64 NA NA 4.63 5.53 0.73 NA NA 14.00 14.90 09060500 ......... ............ A Explore parathyroid glands ........................... 16.63 NA NA 6.74 7.24 2.00 NA NA 25.37 25.87 09060502 ......... ............ A Re-explore parathyroids ................................ 20.92 NA NA 8.47 9.13 2.53 NA NA 31.92 32.5809060505 ......... ............ A Explore parathyroid glands ........................... 22.81 NA NA 9.23 10.50 2.64 NA NA 34.68 35.9509060512 ......... ............ 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 09060521 ......... ............ A Removal of thymus gland ............................. 19.09 NA NA 8.31 9.23 2.81 NA NA 30.21 31.13 09060522 ......... ............ A Removal of thymus gland ............................. 23.31 NA NA 9.80 10.90 3.26 NA NA 36.37 37.47 09060540 ......... ............ A Explore adrenal gland ................................... 17.84 NA NA 8.14 7.72 1.74 NA NA 27.72 27.30 09060545 ......... ............ A Explore adrenal gland ................................... 20.75 NA NA 8.92 8.63 2.07 NA NA 31.74 31.45 09060600 ......... ............ A Remove carotid body lesion .......................... 24.95 NA NA 8.78 10.42 2.19 NA NA 35.92 37.56 09060605 ......... ............ A Remove carotid body lesion .......................... 31.82 NA NA 12.29 12.26 2.49 NA NA 46.60 46.5709060650 ......... ............ A Laparoscopy adrenalectomy ......................... 20.59 NA NA 8.20 8.04 2.28 NA NA 31.07 30.91 09060659 ......... ............ C Laparo proc, endocrine ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY60699 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00182 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49163 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules61000 ......... ............ 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 00061026 ......... ............ A Injection into brain canal ............................... 1.69 NA NA 1.49 1.42 0.33 NA NA 3.51 3.4400061050 ......... ............ 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 3.6600061070 ......... ............ A Brain canal shunt procedure ......................... 0.89 NA NA 1.17 1.05 0.17 NA NA 2.23 2.11 00061105 ......... ............ A Twist drill hole ............................................... 5.38 NA NA 4.89 4.17 1.32 NA NA 11.59 10.87 09061107 ......... ............ A Drill skull for implantation .............................. 4.99 NA NA 1.85 2.36 1.29 NA NA 8.13 8.6400061108 ......... ............ A Drill skull for drainage ................................... 11.46 NA NA 8.43 7.46 2.63 NA NA 22.52 21.55 09061120 ......... ............ A Burr hole for puncture ................................... 9.49 NA NA 6.69 6.17 2.09 NA NA 18.27 17.75 09061140 ......... ............ A Pierce skull for biopsy ................................... 17.05 NA NA 10.39 10.01 4.11 NA NA 31.5531.17 09061150 ......... ............ A Pierce skull for drainage ............................... 18.76 NA NA 10.73 10.46 4.31 NA NA 33.80 33.53 09061151 ......... ............ A Pierce skull for drainage ............................... 13.38 NA NA 8.49 7.98 3.00 NA NA 24.87 24.36 09061154 ......... ............ A Pierce skull & remove clot ............................ 16.86 NA NA 10.76 9.80 4.20 NA NA 31.82 30.8609061156 ......... ............ A Pierce skull for drainage ............................... 17.34 NA NA 9.88 9.84 4.22 NA NA 31.44 31.40 09061210 ......... ............ A Pierce skull, implant device ........................... 5.83 NA NA 2.18 2.73 1.50 NA NA 9.51 10.06 00061215 ......... ............ A Insert brain-fluid device ................................. 5.74 NA NA 5.44 4.36 1.26 NA NA 12.44 11.36 09061250 ......... ............ A Pierce skull & explore ................................... 11.38 NA NA 7.49 7.01 2.76 NA NA 21.63 21.15 09061253 ......... ............ A Pierce skull & explore ................................... 13.38 NA NA 7.80 7.74 2.61 NA NA 23.79 23.73 09061304 ......... ............ A Open skull for exploration ............................. 23.27 NA NA 12.61 12.78 5.61 NA NA 41.49 41.66 09061305 ......... ............ A Open skull for exploration ............................. 28.46 NA NA 15.07 15.25 6.07 NA NA 49.60 49.78 09061312 ......... ............ A Open skull for drainage ................................. 30.03 NA NA 15.34 15.12 6.34 NA NA 51.71 51.49 09061313 ......... ............ A Open skull for drainage ................................. 27.88 NA NA 15.48 14.97 6.43 NA NA 49.79 49.28 09061314 ......... ............ A Open skull for drainage ................................. 25.72 NA NA 14.22 13.33 6.26 NA NA 46.20 45.31 09061315 ......... ............ A Open skull for drainage ................................. 29.47 NA NA 15.56 15.90 7.14 NA NA 52.17 52.51 09061316 ......... ............ A Implt cran bone flap to abdo ......................... 1.39 NA NA 0.52 0.58 0.35 NA NA 2.26 2.32 ZZZ61320 ......... ............ A Open skull for drainage ................................. 27.28 NA NA 14.29 14.64 6.60 NA NA 48.17 48.52 09061321 ......... ............ A Open skull for drainage ................................. 30.35 NA NA 14.29 15.66 7.12 NA NA 51.76 53.13 09061322 ......... ............ A Decompressive craniotomy ........................... 34.00 NA NA 17.78 16.19 7.61 NA NA 59.39 57.80 09061323 ......... ............ A Decompressive lobectomy ............................ 34.87 NA NA 17.00 16.31 8.01 NA NA 59.88 59.19 09061330 ......... ............ A Decompress eye socket ................................ 25.12 NA NA 11.88 13.26 2.31 NA NA 39.31 40.6909061332 ......... ............ A Explore/biopsy eye socket ............................ 28.46 NA NA 13.45 15.06 4.82 NA NA 46.73 48.3409061333 ......... ............ A Explore orbit/remove lesion ........................... 29.13 NA NA 13.31 15.01 3.91 NA NA 46.35 48.05 09061334 ......... ............ A Explore orbit/remove object .......................... 19.46 NA NA 9.11 10.25 1.74 NA NA 30.31 31.4509061340 ......... ............ A Subtemporal decompression ......................... 19.97 NA NA 11.40 11.19 4.83 NA NA 36.20 35.99 09061343 ......... ............ A Incise skull (press relief) ............................... 31.68 NA NA 16.14 16.64 7.62 NA NA 55.4455.94 09061345 ......... ............ A Relieve cranial pressure ................................ 29.05 NA NA 15.24 15.35 7.02 NA NA 51.31 51.42 09061440 ......... ............ A Incise skull for surgery .................................. 28.48 NA NA 14.06 14.17 6.88 NA NA 49.4249.53 09061450 ......... ............ A Incise skull for surgery .................................. 27.55 NA NA 12.70 13.89 5.77 NA NA 46.0247.21 09061458 ......... ............ A Incise skull for brain wound .......................... 28.66 NA NA 15.01 15.39 7.01 NA NA 50.68 51.06 09061460 ......... ............ A Incise skull for surgery .................................. 30.06 NA NA 15.14 16.09 6.02 NA NA 51.2252.17 09061470 ......... ............ A Incise skull for surgery .................................. 27.48 NA NA 13.11 13.67 5.88 NA NA 46.4747.03 09061480 ......... ............ A Incise skull for surgery .................................. 27.91 NA NA 8.23 13.51 6.71 NA NA 42.85 48.13 09061490 ......... ............ A Incise skull for surgery .................................. 27.08 NA NA 14.34 14.33 6.90 NA NA 48.3248.31 09061500 ......... ............ A Removal of skull lesion ................................. 19.00 NA NA 10.64 10.76 4.10 NA NA 33.74 33.86 09061501 ......... ............ A Remove infected skull bone .......................... 16.17 NA NA 9.52 9.28 3.21 NA NA 28.90 28.66 09061510 ......... ............ A Removal of brain lesion ................................ 30.55 NA NA 17.08 16.79 7.33 NA NA 54.96 54.67 09061512 ......... ............ A Remove brain lining lesion ............................ 36.93 NA NA 18.56 19.39 9.05 NA NA 64.54 65.37 09061514 ......... ............ A Removal of brain abscess ............................. 27.05 NA NA 14.53 14.46 6.52 NA NA 48.10 48.0309061516 ......... ............ A Removal of brain lesion ................................ 26.40 NA NA 14.28 14.27 6.33 NA NA 47.01 47.00 09061517 ......... ............ A Implt brain chemotx add-on .......................... 1.38 NA NA 0.51 0.61 0.35 NA NA 2.24 2.34 ZZZ61518 ......... ............ A Removal of brain lesion ................................ 39.61 NA NA 20.45 20.93 9.62 NA NA 69.68 70.16 09061519 ......... ............ A Remove brain lining lesion ............................ 43.22 NA NA 20.82 22.19 10.60 NA NA 74.64 76.01 09061520 ......... ............ A Removal of brain lesion ................................ 56.81 NA NA 25.64 29.15 11.18 NA NA 93.63 97.14 09061521 ......... ............ A Removal of brain lesion ................................ 46.78 NA NA 22.16 23.70 11.36 NA NA 80.30 81.84 09061522 ......... ............ A Removal of brain abscess ............................. 31.36 NA NA 15.56 16.20 7.60 NA NA 54.52 55.1609061524 ......... ............ A Removal of brain lesion ................................ 29.71 NA NA 15.78 15.69 7.14 NA NA 52.63 52.54 09061526 ......... ............ A Removal of brain lesion ................................ 53.84 NA NA 21.66 27.53 7.05 NA NA 82.55 88.42 09061530 ......... ............ A Removal of brain lesion ................................ 45.38 NA NA 18.18 23.33 6.13 NA NA 69.69 74.84 09061531 ......... ............ A Implant brain electrodes ................................ 16.24 NA NA 10.26 9.41 3.78 NA NA 30.28 29.43 09061533 ......... ............ A Implant brain electrodes ................................ 21.32 NA NA 11.76 11.59 5.10 NA NA 38.18 38.01 09061534 ......... ............ A Removal of brain lesion ................................ 22.83 NA NA 13.21 12.36 5.42 NA NA 41.46 40.61 09061535 ......... ............ A Remove brain electrodes .............................. 13.01 NA NA 8.93 7.80 3.01 NA NA 24.95 23.82 09061536 ......... ............ A Removal of brain lesion ................................ 37.54 NA NA 18.46 19.45 9.18 NA NA 65.18 66.17 09061537 ......... ............ A Removal of brain tissue ................................ 36.31 NA NA 17.52 15.44 6.92 NA NA 60.75 58.67 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00183 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49164 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal61538 ......... ............ A Removal of brain tissue ................................ 39.31 NA NA 18.80 16.18 6.92 NA NA 65.03 62.41 09061539 ......... ............ A Removal of brain tissue ................................ 34.10 NA NA 15.51 17.20 8.30 NA NA 57.91 59.60 09061540 ......... ............ A Removal of brain tissue ................................ 31.24 NA NA 15.91 16.91 8.30 NA NA 55.45 56.45 09061541 ......... ............ A Incision of brain tissue .................................. 30.76 NA NA 16.10 16.18 6.58 NA NA 53.4453.52 09061542 ......... ............ A Removal of brain tissue ................................ 32.98 NA NA 16.23 17.42 8.01 NA NA 57.22 58.41 09061543 ......... ............ A Removal of brain tissue ................................ 31.13 NA NA 16.35 16.37 7.54 NA NA 55.02 55.04 09061544 ......... ............ A Remove & treat brain lesion ......................... 27.22 NA NA 14.39 13.96 5.95 NA NA 47.56 47.1309061545 ......... ............ A Excision of brain tumor ................................. 46.15 NA NA 22.36 23.75 10.60 NA NA 79.11 80.50 09061546 ......... ............ A Removal of pituitary gland ............................ 33.26 NA NA 16.62 17.27 7.65 NA NA 57.53 58.17 09061548 ......... ............ A Removal of pituitary gland ............................ 23.23 NA NA 11.37 12.43 3.42 NA NA 38.02 39.08 09061550 ......... ............ A Release of skull seams ................................. 15.38 NA NA 5.70 6.62 0.98 NA NA 22.06 22.9809061552 ......... ............ A Release of skull seams ................................. 20.22 NA NA 6.71 8.51 1.06 NA NA 27.99 29.7809061556 ......... ............ A Incise skull/sutures ........................................ 23.96 NA NA 12.76 11.71 4.64 NA NA 41.36 40.31 09061557 ......... ............ A Incise skull/sutures ........................................ 23.10 NA NA 13.73 13.65 5.78 NA NA 42.61 42.53 09061558 ......... ............ A Excision of skull/sutures ................................ 26.29 NA NA 8.24 12.70 1.36 NA NA 35.89 40.35 09061559 ......... ............ A Excision of skull/sutures ................................ 33.74 NA NA 18.83 19.19 8.48 NA NA 61.05 61.41 09061563 ......... ............ A Excision of skull tumor .................................. 28.31 NA NA 14.31 15.01 5.15 NA NA 47.77 48.47 09061564 ......... ............ A Excision of skull tumor .................................. 34.53 NA NA 16.25 17.77 8.75 NA NA 59.53 61.05 09061566 ......... ............ A Removal of brain tissue ................................ 32.26 NA NA 16.65 17.49 6.92 NA NA 55.83 56.67 09061567 ......... ............ A Incision of brain tissue .................................. 36.76 NA NA 16.84 19.71 6.52 NA NA 60.1262.99 09061570 ......... ............ A Remove foreign body, brain .......................... 26.33 NA NA 14.16 13.97 5.86 NA NA 46.35 46.1609061571 ......... ............ A Incise skull for brain wound .......................... 28.24 NA NA 15.21 15.16 6.77 NA NA 50.22 50.17 09061575 ......... ............ A Skull base/brainstem surgery ........................ 36.38 NA NA 15.53 18.61 5.32 NA NA 57.23 60.3109061576 ......... ............ A Skull base/brainstem surgery ........................ 55.03 NA NA 25.88 32.52 5.56 NA NA 86.47 93.1109061580 ......... ............ A Craniofacial approach, skull .......................... 34.26 NA NA 20.69 24.36 3.36 NA NA 58.31 61.98 09061581 ......... ............ A Craniofacial approach, skull .......................... 38.78 NA NA 24.86 23.80 3.91 NA NA 67.55 66.49 09061582 ......... ............ A Craniofacial approach, skull .......................... 34.83 NA NA 30.37 28.07 7.19 NA NA 72.39 70.09 09061583 ......... ............ A Craniofacial approach, skull .......................... 38.37 NA NA 25.79 25.28 9.18 NA NA 73.34 72.83 09061584 ......... ............ A Orbitocranial approach/skull .......................... 37.57 NA NA 25.56 24.78 8.16 NA NA 71.29 70.51 09061585 ......... ............ A Orbitocranial approach/skull .......................... 42.40 NA NA 24.83 26.08 7.01 NA NA 74.24 75.49 09061586 ......... ............ A Resect nasopharynx, skull ............................ 27.20 NA NA 23.97 22.93 4.36 NA NA 55.53 54.4909061590 ......... ............ A Infratemporal approach/skull ......................... 46.79 NA NA 23.16 27.26 5.29 NA NA 75.24 79.3409061591 ......... ............ A Infratemporal approach/skull ......................... 46.81 NA NA 23.73 28.07 5.64 NA NA 76.18 80.5209061592 ......... ............ A Orbitocranial approach/skull .......................... 42.94 NA NA 27.58 26.77 10.04 NA NA 80.56 79.75 09061595 ......... ............ A Transtemporal approach/skull ....................... 33.49 NA NA 19.29 21.59 3.97 NA NA 56.75 59.05 09061596 ......... ............ A Transcochlear approach/skull ....................... 39.25 NA NA 18.52 22.96 3.39 NA NA 61.16 65.60 09061597 ......... ............ A Transcondylar approach/skull ....................... 40.67 NA NA 22.86 22.96 8.81 NA NA 72.34 72.44 09061598 ......... ............ A Transpetrosal approach/skull ........................ 36.35 NA NA 20.81 22.63 5.68 NA NA 62.84 64.6609061600 ......... ............ A Resect/excise cranial lesion .......................... 29.76 NA NA 18.31 19.41 3.78 NA NA 51.85 52.95 09061601 ......... ............ A Resect/excise cranial lesion .......................... 31.00 NA NA 22.32 20.95 6.61 NA NA 59.93 58.56 09061605 ......... ............ A Resect/excise cranial lesion .......................... 32.32 NA NA 17.57 20.86 2.85 NA NA 52.74 56.03 09061606 ......... ............ A Resect/excise cranial lesion .......................... 41.88 NA NA 24.31 24.94 8.94 NA NA 75.13 75.76 09061607 ......... ............ A Resect/excise cranial lesion .......................... 40.76 NA NA 20.51 22.96 6.88 NA NA 68.15 70.60 09061608 ......... ............ A Resect/excise cranial lesion .......................... 45.39 NA NA 26.51 26.56 10.72 NA NA 82.62 82.67 09061609 ......... ............ A Transect artery, sinus .................................... 9.88 NA NA 3.73 4.57 2.55 NA NA 16.16 17.00 ZZZ61610 ......... ............ A Transect artery, sinus .................................... 29.63 NA NA 11.19 12.65 7.66 NA NA 48.4849.94 ZZZ61611 ......... ............ A Transect artery, sinus .................................... 7.41 NA NA 2.80 3.57 1.88 NA NA 12.09 12.86 ZZZ61612 ......... ............ A Transect artery, sinus .................................... 27.84 NA NA 8.15 12.02 4.30 NA NA 40.29 44.16 ZZZ61613 ......... ............ A Remove aneurysm, sinus .............................. 44.88 NA NA 27.54 26.58 8.42 NA NA 80.84 79.8809061615 ......... ............ A Resect/excise lesion, skull ............................ 35.57 NA NA 19.35 21.88 4.72 NA NA 59.64 62.17 09061616 ......... ............ A Resect/excise lesion, skull ............................ 46.54 NA NA 26.45 28.10 8.24 NA NA 81.23 82.88 09061618 ......... ............ A Repair dura .................................................... 18.52 NA NA 10.11 10.36 3.71 NA NA 32.34 32.59 09061619 ......... ............ A Repair dura .................................................... 21.95 NA NA 10.97 11.92 3.94 NA NA 36.86 37.81 09061623 ......... ............ A Endovasc tempory vessel occl ...................... 9.95 NA NA 3.40 3.91 1.05 NA NA 14.40 14.91 00061624 ......... ............ A Transcath occlusion, cns ............................... 20.12 NA NA 6.80 6.87 1.95 NA NA 28.87 28.9400061626 ......... ............ A Transcath occlusion, non-cns ....................... 16.60 NA NA 5.43 5.49 1.24 NA NA 23.27 23.33 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00184 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49165 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules61630 ......... ............ N Intracranial angioplasty ................................. 22.03 NA NA 6.50 10.99 2.01 NA NA 30.54 35.03 09061635 ......... ............ N Intracran angioplsty w/stent .......................... 24.24 NA NA 7.02 11.91 2.20 NA NA 33.46 38.3509061680 ......... ............ A Intracranial vessel surgery ............................ 32.34 NA NA 16.85 17.29 7.93 NA NA 57.12 57.56 09061682 ......... ............ A Intracranial vessel surgery ............................ 63.27 NA NA 27.31 30.99 15.85 NA NA 106.43 110.11 09061684 ......... ............ A Intracranial vessel surgery ............................ 41.43 NA NA 20.46 21.62 10.28 NA NA 72.17 73.33 09061686 ......... ............ A Intracranial vessel surgery ............................ 67.26 NA NA 30.29 33.61 16.66 NA NA 114.21 117.53 09061690 ......... ............ A Intracranial vessel surgery ............................ 31.14 NA NA 15.88 16.51 6.92 NA NA 53.94 54.57 09061692 ......... ............ A Intracranial vessel surgery ............................ 54.39 NA NA 24.71 26.78 13.39 NA NA 92.49 94.56 09061697 ......... ............ A Brain aneurysm repr, complx ........................ 63.16 NA NA 28.85 28.22 12.81 NA NA 104.82 104.19 09061698 ......... ............ A Brain aneurysm repr, complx ........................ 69.39 NA NA 30.92 27.75 12.50 NA NA 112.81 109.64 09061700 ......... ............ A Brain aneurysm repr, simple ......................... 50.44 NA NA 24.03 26.86 12.98 NA NA 87.45 90.2809061702 ......... ............ A Inner skull vessel surgery ............................. 59.80 NA NA 27.94 26.51 10.76 NA NA 98.50 97.07 09061703 ......... ............ A Clamp neck artery ......................................... 18.66 NA NA 10.84 10.56 4.05 NA NA 33.5533.27 09061705 ......... ............ A Revise circulation to head ............................. 37.92 NA NA 17.61 18.84 8.84 NA NA 64.37 65.60 09061708 ......... ............ A Revise circulation to head ............................. 37.02 NA NA 13.19 14.66 2.50 NA NA 52.71 54.18 09061710 ......... ............ A Revise circulation to head ............................. 31.15 NA NA 13.35 13.57 4.51 NA NA 49.01 49.23 09061711 ......... ............ A Fusion of skull arteries .................................. 38.05 NA NA 18.57 19.49 9.39 NA NA 66.0166.93 09061720 ......... ............ A Incise skull/brain surgery ............................... 17.48 NA NA 8.13 9.51 2.78 NA NA 28.39 29.77 09061735 ......... ............ A Incise skull/brain surgery ............................... 22.17 NA NA 11.32 11.95 2.72 NA NA 36.21 36.84 09061750 ......... ............ A Incise skull/brain biopsy ................................ 19.69 NA NA 10.97 10.70 4.71 NA NA 35.37 35.10 09061751 ......... ............ A Brain biopsy w/ct/mr guide ............................ 18.58 NA NA 11.42 10.97 4.55 NA NA 34.55 34.10 09061760 ......... ............ A Implant brain electrodes ................................ 22.24 NA NA 11.94 9.52 5.40 NA NA 39.58 37.16 09061770 ......... ............ A Incise skull for treatment ............................... 23.05 NA NA 9.87 11.66 3.54 NA NA 36.46 38.25 09061790 ......... ............ A Treat trigeminal nerve ................................... 11.46 NA NA 7.79 6.38 2.81 NA NA 22.06 20.65 09061791 ......... ............ A Treat trigeminal tract ..................................... 15.27 NA NA 7.61 8.59 3.39 NA NA 26.27 27.25 09061793 ......... ............ A Focus radiation beam .................................... 17.71 NA NA 9.79 10.04 4.45 NA NA 31.95 32.20 09061795 ......... ............ A Brain surgery using computer ....................... 4.03 NA NA 1.37 1.87 0.79 NA NA 6.19 6.69 ZZZ61850 ......... ............ A Implant neuroelectrodes ................................ 13.23 NA NA 5.56 7.14 3.21 NA NA 22.00 23.5809061860 ......... ............ A Implant neuroelectrodes ................................ 22.12 NA NA 11.19 11.84 4.94 NA NA 38.25 38.90 09061863 ......... ............ A Implant neuroelectrode .................................. 20.50 NA NA 12.48 11.95 5.41 NA NA 38.39 37.86 09061864 ......... ............ A Implant neuroelectrde, addl ........................... 4.49 NA NA 1.70 2.14 5.41 NA NA 11.60 12.04 ZZZ61867 ......... ............ A Implant neuroelectrode .................................. 32.82 NA NA 16.69 17.69 5.41 NA NA 54.92 55.92 09061868 ......... ............ A Implant neuroelectrde, addIl .......................... 7.91 NA NA 2.96 3.75 5.41 NA NA 16.28 17.07 ZZZ61870 ......... ............ A Implant neuroelectrodes ................................ 16.20 NA NA 8.63 9.43 3.86 NA NA 28.69 29.4909061875 ......... ............ A Implant neuroelectrodes ................................ 16.32 NA NA 5.38 7.77 2.94 NA NA 24.64 27.0309061880 ......... ............ A Revise/remove neuroelectrode ..................... 6.84 NA NA 5.47 4.80 1.66 NA NA 13.97 13.30 09061885 ......... ............ A Insrt/redo neurostim 1 array .......................... 7.29 NA NA 7.42 5.83 1.59 NA NA 16.30 14.71 09061886 ......... ............ A Implant neurostim arrays ............................... 9.65 NA NA 8.74 6.95 1.96 NA NA 20.35 18.5609061888 ......... ............ A Revise/remove neuroreceiver ....................... 5.18 NA NA 3.59 3.65 1.33 NA NA 10.10 10.16 01062000 ......... ............ A Treat skull fracture ........................................ 13.79 NA NA 7.21 5.94 1.06 NA NA 22.0620.79 09062005 ......... ............ A Treat skull fracture ........................................ 17.49 NA NA 9.47 8.96 3.86 NA NA 30.8230.31 09062010 ......... ............ A Treatment of head injury ............................... 21.25 NA NA 11.91 11.76 5.12 NA NA 38.28 38.13 09062100 ......... ............ A Repair brain fluid leakage ............................. 23.35 NA NA 11.84 12.55 4.83 NA NA 40.02 40.73 09062115 ......... ............ A Reduction of skull defect ............................... 22.63 NA NA 13.97 12.22 5.49 NA NA 42.09 40.34 09062116 ......... ............ A Reduction of skull defect ............................... 24.82 NA NA 13.12 13.30 6.09 NA NA 44.03 44.21 09062117 ......... ............ A Reduction of skull defect ............................... 28.20 NA NA 14.69 15.20 4.52 NA NA 47.41 47.92 09062120 ......... ............ A Repair skull cavity lesion ............................... 24.31 NA NA 15.76 17.80 2.99 NA NA 43.06 45.10 09062121 ......... ............ A Incise skull repair .......................................... 22.89 NA NA 14.03 15.10 4.16 NA NA 41.08 42.15 09062140 ......... ............ A Repair of skull defect .................................... 14.41 NA NA 8.60 8.39 3.46 NA NA 26.47 26.26 09062141 ......... ............ A Repair of skull defect .................................... 15.93 NA NA 9.30 9.11 3.75 NA NA 28.98 28.79 09062142 ......... ............ A Remove skull plate/flap ................................. 11.69 NA NA 7.72 7.17 2.72 NA NA 22.13 21.58 09062143 ......... ............ A Replace skull plate/flap ................................. 14.01 NA NA 8.79 8.23 3.36 NA NA 26.16 25.60 09062145 ......... ............ A Repair of skull & brain ................................... 19.95 NA NA 10.20 10.72 4.49 NA NA 34.6435.16 09062146 ......... ............ A Repair of skull with graft ............................... 17.14 NA NA 9.04 9.48 3.61 NA NA 29.79 30.23 09062147 ......... ............ A Repair of skull with graft ............................... 20.53 NA NA 10.59 11.12 4.31 NA NA 35.43 35.96 09062148 ......... ............ A Retr bone flap to fix skull .............................. 2.00 NA NA 0.76 0.84 0.48 NA NA 3.24 3.32ZZZ62160 ......... ............ A Neuroendoscopy add-on ............................... 3.00 NA NA 1.12 1.43 0.77 NA NA 4.89 5.20 ZZZ62161 ......... ............ A Dissect brain w/scope ................................... 21.04 NA NA 12.12 12.10 5.17 NA NA 38.33 38.31 09062162 ......... ............ A Remove colloid cyst w/scope ........................ 26.61 NA NA 13.85 14.60 5.89 NA NA 46.35 47.10 09062163 ......... ............ 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 09062180 ......... ............ A Establish brain cavity shunt .......................... 22.41 NA NA 12.00 12.21 4.97 NA NA 39.38 39.59 09062190 ......... ............ A Establish brain cavity shunt .......................... 12.03 NA NA 7.67 7.23 2.79 NA NA 22.49 22.0509062192 ......... ............ A Establish brain cavity shunt .......................... 13.21 NA NA 8.40 7.82 3.01 NA NA 24.62 24.0409062194 ......... ............ A Replace/irrigate catheter ............................... 5.64 NA NA 3.81 2.78 0.92 NA NA 10.37 9.34010



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00185 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49166 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal62200 ......... ............ A Establish brain cavity shunt .......................... 19.15 NA NA 10.69 10.80 4.64 NA NA 34.48 34.59 09062201 ......... ............ A Brain cavity shunt w/scope ........................... 15.83 NA NA 10.52 9.71 3.67 NA NA 30.02 29.2109062220 ......... ............ A Establish brain cavity shunt .......................... 13.96 NA NA 8.39 8.08 3.34 NA NA 25.69 25.3809062223 ......... ............ A Establish brain cavity shunt .......................... 13.84 NA NA 9.42 8.54 3.13 NA NA 26.39 25.5109062225 ......... ............ A Replace/irrigate catheter ............................... 6.08 NA NA 5.49 4.44 1.39 NA NA 12.96 11.9109062230 ......... ............ A Replace/revise brain shunt ............................ 11.32 NA NA 7.28 6.68 2.70 NA NA 21.30 20.7009062252 ......... ............ A Csf shunt reprogram ..................................... 0.74 1.78 1.55 NA NA 0.21 2.73 2.50 NA NA XXX62252 ......... 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 XXX62252 ......... TC ...... A Csf shunt reprogram ..................................... 0.00 1.51 1.20 NA NA 0.02 1.53 1.22 NA NA XXX62256 ......... ............ A Remove brain cavity shunt ............................ 7.27 NA NA 5.88 4.99 1.71 NA NA 14.86 13.97 09062258 ......... ............ A Replace brain cavity shunt ............................ 15.50 NA NA 9.25 8.85 3.73 NA NA 28.48 28.0809062263 ......... ............ 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 01062264 ......... ............ 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 01062268 ......... ............ 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 00062269 ......... ............ 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 00062270 ......... ............ 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 00062272 ......... ............ 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 00062273 ......... ............ A Inject epidural patch ...................................... 2.15 1.70 2.46 0.58 0.68 0.13 3.98 4.742.86 2.96 00062280 ......... ............ 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 01062281 ......... ............ 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 01062282 ......... ............ 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 01062284 ......... ............ A Injection for myelogram ................................. 1.54 3.79 4.67 0.67 0.68 0.13 5.46 6.34 2.34 2.35 00062287 ......... ............ 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 00062291 ......... ............ 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 00062292 ......... ............ A Injection into disk lesion ................................ 9.10 NA NA 3.19 4.15 0.82 NA NA 13.11 14.07 09062294 ......... ............ A Injection into spinal artery ............................. 12.73 NA NA 5.63 5.59 1.24 NA NA 19.60 19.56 09062310 ......... ............ 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 00062311 ......... ............ 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 00062318 ......... ............ A Inject spine w/cath, c/t ................................... 2.04 3.24 5.10 0.48 0.61 0.12 5.40 7.262.64 2.77 00062319 ......... ............ 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 00062350 ......... ............ A Implant spinal canal cath .............................. 7.96 NA NA 4.19 4.00 1.02 NA NA 13.17 12.9809062351 ......... ............ A Implant spinal canal cath .............................. 11.46 NA NA 7.73 7.27 2.24 NA NA 21.43 20.9709062355 ......... ............ A Remove spinal canal catheter ....................... 6.54 NA NA 3.61 3.27 0.71 NA NA 10.86 10.52 09062360 ......... ............ A Insert spine infusion device ........................... 3.60 NA NA 3.46 2.88 0.34 NA NA 7.40 6.82 09062361 ......... ............ 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 09062367 ......... ............ 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 XXX62368 ......... ............ 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 XXX63001 ......... ............ A Removal of spinal lamina .............................. 17.47 NA NA 9.89 9.61 3.76 NA NA 31.12 30.8409063003 ......... ............ A Removal of spinal lamina .............................. 17.60 NA NA 9.80 9.85 3.72 NA NA 31.12 31.1709063005 ......... ............ A Removal of spinal lamina .............................. 16.22 NA NA 9.78 9.92 3.34 NA NA 29.34 29.4809063011 ......... ............ A Removal of spinal lamina .............................. 15.73 NA NA 9.22 8.51 3.37 NA NA 28.32 27.6109063012 ......... ............ A Removal of spinal lamina .............................. 16.67 NA NA 9.84 10.05 3.48 NA NA 29.99 30.2009063015 ......... ............ A Removal of spinal lamina .............................. 20.64 NA NA 12.01 11.91 4.75 NA NA 37.40 37.30 09063016 ......... ............ A Removal of spinal lamina .............................. 21.85 NA NA 11.95 11.82 4.58 NA NA 38.38 38.25 09063017 ......... ............ A Removal of spinal lamina .............................. 17.12 NA NA 10.43 10.40 3.63 NA NA 31.18 31.15 09063020 ......... ............ A Neck spine disk surgery ................................ 15.99 NA NA 9.99 9.75 3.71 NA NA 29.69 29.4509063030 ......... ............ A Low back disk surgery .................................. 12.97 NA NA 8.67 8.48 3.00 NA NA 24.64 24.4509063035 ......... ............ A Spinal disk surgery add-on ........................... 3.15 NA NA 1.21 1.50 0.79 NA NA 5.15 5.44 ZZZ63040 ......... ............ A Laminotomy, single cervical .......................... 20.13 NA NA 11.08 11.40 4.67 NA NA 35.88 36.2009063042 ......... ............ A Laminotomy, single lumbar ........................... 18.55 NA NA 10.68 11.18 4.25 NA NA 33.48 33.9809063043 ......... ............ C Laminotomy, addIl cervical ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 ZZZ63044 ......... ............ C Laminotomy, addIl lumbar ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ63045 ......... ............ A Removal of spinal lamina .............................. 17.77 NA NA 10.41 10.37 3.98 NA NA 32.16 32.12 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00186 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49167 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules63046 ......... ............ A Removal of spinal lamina .............................. 17.07 NA NA 9.88 10.11 3.55 NA NA 30.50 30.7309063047 ......... ............ A Removal of spinal lamina .............................. 15.16 NA NA 9.41 9.77 3.23 NA NA 27.80 28.1609063048 ......... ............ A Remove spinal lamina add-on ...................... 3.26 NA NA 1.25 1.56 0.72 NA NA 5.23 5.54 ZZZ63050 ......... ............ A Cervical laminoplasty .................................... 21.82 NA NA 8.87 11.10 4.66 NA NA 35.35 37.58 09063051 ......... ............ A C-laminoplasty w/graft/plate .......................... 25.32 NA NA 11.71 13.03 4.66 NA NA 41.69 43.01 09063055 ......... ............ A Decompress spinal cord ................................ 23.37 NA NA 12.40 12.95 5.27 NA NA 41.04 41.59 09063056 ......... ............ A Decompress spinal cord ................................ 21.68 NA NA 11.41 12.27 4.75 NA NA 37.84 38.70 09063057 ......... ............ A Decompress spine cord add-on .................... 5.25 NA NA 1.97 2.47 1.22 NA NA 8.44 8.94 ZZZ63064 ......... ............ A Decompress spinal cord ................................ 26.04 NA NA 13.41 14.17 5.69 NA NA 45.14 45.90 09063066 ......... ............ A Decompress spine cord add-on .................... 3.26 NA NA 1.24 1.56 0.69 NA NA 5.19 5.51 ZZZ63075 ......... ............ A Neck spine disk surgery ................................ 19.41 NA NA 11.11 11.84 4.62 NA NA 35.14 35.87 09063076 ......... ............ A Neck spine disk surgery ................................ 4.04 NA NA 1.53 1.92 0.96 NA NA 6.53 6.92 ZZZ63077 ......... ............ A Spine disk surgery, thorax ............................ 22.70 NA NA 11.20 12.39 3.98 NA NA 37.88 39.07 09063078 ......... ............ 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 45.6109063082 ......... ............ A Remove vertebral body add-on ..................... 4.36 NA NA 1.66 2.08 1.02 NA NA 7.04 7.46 ZZZ63085 ......... ............ A Removal of vertebral body ............................ 29.29 NA NA 13.77 15.05 4.48 NA NA 47.54 48.8209063086 ......... ............ A Remove vertebral body add-on ..................... 3.19 NA NA 1.17 1.49 0.59 NA NA 4.95 5.27 ZZZ63087 ......... ............ A Removal of vertebral body ............................ 37.32 NA NA 16.85 18.80 6.20 NA NA 60.37 62.3209063088 ......... ............ A Remove vertebral body add-on ..................... 4.32 NA NA 1.64 2.04 0.82 NA NA 6.78 7.18 ZZZ63090 ......... ............ A Removal of vertebral body ............................ 30.72 NA NA 14.16 15.56 4.21 NA NA 49.09 50.4909063091 ......... ............ A Remove vertebral body add-on ..................... 3.03 NA NA 1.13 1.38 0.48 NA NA 4.64 4.89 ZZZ63101 ......... ............ A Removal of vertebral body ............................ 33.84 NA NA 17.18 18.75 5.69 NA NA 56.71 58.2809063102 ......... ............ A Removal of vertebral body ............................ 33.84 NA NA 16.90 18.68 5.69 NA NA 56.43 58.2109063103 ......... ............ A Remove vertebral body add-on ..................... 4.82 NA NA 1.78 2.32 0.69 NA NA 7.29 7.83 ZZZ63170 ......... ............ A Incise spinal cord tract(s) .............................. 22.03 NA NA 12.64 12.06 4.86 NA NA 39.53 38.95 09063172 ......... ............ A Drainage of spinal cyst .................................. 19.62 NA NA 11.31 10.81 4.48 NA NA 35.41 34.91 09063173 ......... ............ A Drainage of spinal cyst .................................. 24.13 NA NA 13.38 12.95 5.68 NA NA 43.19 42.76 09063180 ......... ............ A Revise spinal cord ligaments ........................ 20.35 NA NA 10.94 10.97 3.95 NA NA 35.24 35.2709063182 ......... ............ A Revise spinal cord ligaments ........................ 22.64 NA NA 7.25 10.03 5.30 NA NA 35.19 37.97 09063185 ......... ............ A Incise spinal column/nerves .......................... 16.31 NA NA 10.11 8.60 2.79 NA NA 29.21 27.7009063190 ......... ............ A Incise spinal column/nerves .......................... 18.71 NA NA 10.16 10.14 3.24 NA NA 32.11 32.0909063191 ......... ............ A Incise spinal column/nerves .......................... 18.74 NA NA 10.78 10.55 6.34 NA NA 35.86 35.6309063194 ......... ............ A Incise spinal column & cord .......................... 21.92 NA NA 8.65 10.95 3.26 NA NA 33.83 36.1309063195 ......... ............ A Incise spinal column & cord .......................... 21.50 NA NA 12.18 11.33 4.87 NA NA 38.55 37.7009063196 ......... ............ A Incise spinal column & cord .......................... 25.09 NA NA 13.88 13.51 5.76 NA NA 44.73 44.3609063197 ......... ............ A Incise spinal column & cord .......................... 23.90 NA NA 13.43 12.51 5.36 NA NA 42.69 41.7709063198 ......... ............ A Incise spinal column & cord .......................... 29.69 NA NA 9.01 8.58 6.43 NA NA 45.13 44.70 09063199 ......... ............ A Incise spinal column & cord .......................... 31.26 NA NA 9.38 13.62 1.40 NA NA 42.04 46.2809063200 ......... ............ A Release of spinal cord .................................. 21.26 NA NA 11.74 11.40 4.96 NA NA 37.96 37.62 09063250 ......... ............ A Revise spinal cord vessels ............................ 43.68 NA NA 21.09 20.21 9.01 NA NA 73.78 72.90 09063251 ......... ............ A Revise spinal cord vessels ............................ 44.43 NA NA 21.36 22.28 10.41 NA NA 76.20 77.12 09063252 ......... ............ A Revise spinal cord vessels ............................ 44.42 NA NA 21.41 22.03 10.64 NA NA 76.47 77.09 09063265 ......... ............ A Excise intraspinal lesion ................................ 23.64 NA NA 13.10 12.85 5.43 NA NA 42.17 41.92 09063266 ......... ............ A Excise intraspinal lesion ................................ 24.50 NA NA 13.27 13.20 5.54 NA NA 43.31 43.24 09063267 ......... ............ A Excise intraspinal lesion ................................ 19.27 NA NA 11.22 11.11 4.37 NA NA 34.86 34.75 09063268 ......... ............ A Excise intraspinal lesion ................................ 19.84 NA NA 10.84 10.48 3.69 NA NA 34.37 34.01 09063270 ......... ............ A Excise intraspinal lesion ................................ 29.62 NA NA 15.73 15.53 6.82 NA NA 52.17 51.97 09063271 ......... ............ A Excise intraspinal lesion ................................ 29.74 NA NA 15.34 15.51 6.90 NA NA 51.98 52.15 09063272 ......... ............ A Excise intraspinal lesion ................................ 27.32 NA NA 14.33 14.59 6.18 NA NA 47.83 48.09 09063273 ......... ............ A Excise intraspinal lesion ................................ 26.29 NA NA 13.84 14.21 5.74 NA NA 45.87 46.24 09063275 ......... ............ A Biopsy/excise spinal tumor ............................ 25.68 NA NA 13.51 13.70 5.80 NA NA 44.99 45.18 09063276 ......... ............ A Biopsy/excise spinal tumor ............................ 25.51 NA NA 13.73 13.69 5.83 NA NA 45.07 45.03 09063277 ......... ............ A Biopsy/excise spinal tumor ............................ 22.21 NA NA 12.17 12.43 5.01 NA NA 39.39 39.65 09063278 ......... ............ A Biopsy/excise spinal tumor ............................ 21.94 NA NA 12.07 12.30 4.55 NA NA 38.56 38.79 09063280 ......... ............ A Biopsy/excise spinal tumor ............................ 30.08 NA NA 16.02 16.23 7.27 NA NA 53.37 53.58 09063281 ......... ............ A Biopsy/excise spinal tumor ............................ 29.78 NA NA 15.82 16.08 7.17 NA NA 52.77 53.03 09063282 ......... ............ A Biopsy/excise spinal tumor ............................ 27.94 NA NA 15.14 15.28 6.76 NA NA 49.84 49.98 09063283 ......... ............ A Biopsy/excise spinal tumor ............................ 26.55 NA NA 14.20 14.54 6.26 NA NA 47.01 47.35 09063285 ......... ............ A Biopsy/excise spinal tumor ............................ 37.84 NA NA 19.05 19.71 9.18 NA NA 66.07 66.73 09063286 ......... ............ A Biopsy/excise spinal tumor ............................ 37.41 NA NA 18.80 19.62 9.21 NA NA 65.42 66.24 09063287 ......... ............ A Biopsy/excise spinal tumor ............................ 39.87 NA NA 19.48 20.18 9.39 NA NA 68.74 69.43 09063290 ......... ............ A Biopsy/excise spinal tumor ............................ 40.61 NA NA 20.06 20.45 9.02 NA NA 69.68 70.07 09063295 ......... ............ A Repair of laminectomy defect ....................... 5.25 NA NA 1.33 1.94 1.03 NA NA 7.61 8.22 ZZZ63300 ......... ............ A Removal of vertebral body ............................ 26.62 NA NA 13.54 14.10 5.97 NA NA 46.13 46.6909063301 ......... ............ A Removal of vertebral body ............................ 31.36 NA NA 15.06 15.42 5.39 NA NA 51.81 52.17090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00187 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49168 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal63302 ......... ............ A Removal of vertebral body ............................ 30.94 NA NA 14.83 15.59 5.53 NA NA 51.30 52.0609063303 ......... ............ A Removal of vertebral body ............................ 33.37 NA NA 14.68 16.35 4.68 NA NA 52.73 54.4009063304 ......... ............ A Removal of vertebral body ............................ 33.64 NA NA 17.05 17.21 6.41 NA NA 57.10 57.2609063305 ......... ............ A Removal of vertebral body ............................ 36.03 NA NA 17.60 17.93 5.71 NA NA 59.34 59.6709063306 ......... ............ A Removal of vertebral body ............................ 35.34 NA NA 15.77 17.29 8.33 NA NA 59.43 60.9609063307 ......... ............ A Removal of vertebral body ............................ 34.75 NA NA 17.66 17.02 4.46 NA NA 56.87 56.2309063308 ......... ............ A Remove vertebral body add-on ..................... 5.24 NA NA 1.93 2.43 1.29 NA NA 8.46 8.96 ZZZ63600 ......... ............ A Remove spinal cord lesion ............................ 14.98 NA NA 4.61 5.20 1.52 NA NA 21.11 21.70 09063610 ......... ............ A Stimulation of spinal cord .............................. 8.72 14.20 48.31 1.58 2.08 0.86 23.78 57.8911.16 11.66 00063615 ......... ............ A Remove lesion of spinal cord ........................ 17.18 NA NA 5.98 8.44 2.84 NA NA 26.00 28.46 09063650 ......... ............ A Implant neuroelectrodes ................................ 7.53 NA NA 2.98 3.12 0.53 NA NA 11.04 11.1809063655 ......... ............ A Implant neuroelectrodes ................................ 11.38 NA NA 7.84 7.13 2.43 NA NA 21.65 20.9409063660 ......... ............ A Revise/remove neuroelectrode ..................... 6.83 NA NA 3.36 3.55 0.78 NA NA 10.97 11.16 09063685 ......... ............ A Insrt/redo spine n generator .......................... 7.83 NA NA 3.74 4.04 1.05 NA NA 12.62 12.92 09063688 ......... ............ A Revise/remove neuroreceiver ....................... 6.06 NA NA 3.60 3.56 0.89 NA NA 10.55 10.51 09063700 ......... ............ A Repair of spinal herniation ............................ 17.26 NA NA 9.78 10.17 3.52 NA NA 30.56 30.95 09063702 ......... ............ A Repair of spinal herniation ............................ 19.20 NA NA 10.93 11.01 4.12 NA NA 34.25 34.33 09063704 ......... ............ A Repair of spinal herniation ............................ 22.15 NA NA 12.60 12.83 4.57 NA NA 39.32 39.55 09063706 ......... ............ A Repair of spinal herniation ............................ 25.07 NA NA 15.07 13.95 6.23 NA NA 46.37 45.25 09063707 ......... ............ A Repair spinal fluid leakage ............................ 12.47 NA NA 7.90 7.75 2.51 NA NA 22.88 22.7309063709 ......... ............ A Repair spinal fluid leakage ............................ 15.47 NA NA 9.06 9.31 3.09 NA NA 27.62 27.8709063710 ......... ............ A Graft repair of spine defect ........................... 15.22 NA NA 9.26 9.09 3.40 NA NA 27.88 27.7109063740 ......... ............ A Install spinal shunt ......................................... 12.45 NA NA 8.25 7.57 2.93 NA NA 23.6322.95 09063741 ......... ............ A Install spinal shunt ......................................... 8.98 NA NA 4.85 4.78 1.66 NA NA 15.4915.42 09063744 ......... ............ A Revision of spinal shunt ................................ 8.83 NA NA 6.06 5.45 1.89 NA NA 16.78 16.1709063746 ......... ............ A Removal of spinal shunt ................................ 7.22 NA NA 4.75 4.02 1.53 NA NA 13.50 12.7709064400 ......... ............ A N block inj, trigeminal .................................... 1.11 1.41 1.77 0.45 0.44 0.07 2.59 2.951.63 1.62 00064402 ......... ............ 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 00064405 ......... ............ A N block inj, occipital ...................................... 1.32 1.17 1.39 0.51 0.47 0.08 2.57 2.791.91 1.87 00064408 ......... ............ A N block inj, vagus .......................................... 1.41 1.45 1.55 0.70 0.81 0.10 2.96 3.062.21 2.32 00064410 ......... ............ A N block inj, phrenic ........................................ 1.43 1.82 2.33 0.52 0.48 0.09 3.34 3.852.04 2.00 00064412 ......... ............ A N block inj, spinal accessor .......................... 1.18 2.05 2.50 0.55 0.46 0.08 3.31 3.76 1.811.72 00064413 ......... ............ 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 00064415 ......... ............ A N block inj, brachial plexus ........................... 1.48 1.50 2.48 0.34 0.43 0.09 3.07 4.05 1.912.00 00064416 ......... ............ A N block cont infuse, b plex ............................ 3.85 NA NA 0.57 0.74 0.31 NA NA 4.73 4.90 01064417 ......... ............ 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 00064418 ......... ............ A N block inj, suprascapular ............................. 1.32 1.90 2.44 0.52 0.46 0.07 3.29 3.83 1.911.85 00064420 ......... ............ 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 00064421 ......... ............ 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 00064425 ......... ............ 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 00064430 ......... ............ 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 00064435 ......... ............ 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 00064445 ......... ............ 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 00064446 ......... ............ A N blk inj, sciatic, cont inf ............................... 3.61 NA NA 0.59 0.90 0.20 NA NA 4.40 4.71 01064447 ......... ............ A N block inj fem, single ................................... 1.50 NA NA 0.21 0.38 0.09 NA NA 1.80 1.9700064448 ......... ............ A N block inj fem, cont inf ................................ 3.36 NA NA 0.47 0.73 0.18 NA NA 4.01 4.2701064449 ......... ............ A N block inj, lumbar plexus ............................. 3.24 NA NA 0.49 0.84 0.15 NA NA 3.88 4.23 01064450 ......... ............ 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 00064470 ......... ............ A Inj paravertebral c/t ....................................... 1.85 3.87 6.39 0.71 0.71 0.11 5.83 8.352.67 2.67 00064472 ......... ............ A Inj paravertebral c/t add-on ........................... 1.29 1.23 2.06 0.34 0.34 0.08 2.60 3.43 1.711.71 ZZZ64475 ......... ............ 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 00064476 ......... ............ A Inj paravertebral l/s add-on ........................... 0.98 1.12 1.87 0.23 0.24 0.07 2.17 2.92 1.281.29 ZZZ64479 ......... ............ 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 00064480 ......... ............ 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 ZZZ64483 ......... ............ 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 00064484 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00188 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49169 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules64505 ......... ............ 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 00064508 ......... ............ 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 00064510 ......... ............ 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 00064517 ......... ............ A N block inj, hypogas plxs .............................. 2.20 1.70 2.47 0.67 0.82 0.11 4.01 4.78 2.983.13 00064520 ......... ............ 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 00064530 ......... ............ 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 00064550 ......... ............ A Apply neurostimulator .................................... 0.18 0.20 0.26 0.06 0.05 0.01 0.39 0.45 0.25 0.24 00064553 ......... ............ A Implant neuroelectrodes ................................ 2.31 2.50 2.75 1.35 1.73 0.18 4.99 5.24 3.844.22 01064555 ......... ............ A Implant neuroelectrodes ................................ 2.27 2.57 2.97 1.36 1.23 0.19 5.03 5.43 3.823.69 01064560 ......... ............ A Implant neuroelectrodes ................................ 2.36 2.49 2.60 1.33 1.29 0.22 5.07 5.18 3.913.87 01064561 ......... ............ A Implant neuroelectrodes ................................ 7.05 20.04 27.55 3.87 3.05 0.51 27.60 35.1111.43 10.61 01064565 ......... ............ A Implant neuroelectrodes ................................ 1.76 2.47 3.08 1.28 1.27 0.13 4.36 4.97 3.173.16 01064573 ......... ............ A Implant neuroelectrodes ................................ 8.11 NA NA 5.44 5.29 1.60 NA NA 15.15 15.0009064575 ......... ............ A Implant neuroelectrodes ................................ 4.34 NA NA 2.00 2.50 0.61 NA NA 6.95 7.45 09064577 ......... ............ A Implant neuroelectrodes ................................ 4.61 NA NA 2.87 3.18 1.04 NA NA 8.52 8.83 09064580 ......... ............ A Implant neuroelectrodes ................................ 4.11 NA NA 2.69 3.34 0.36 NA NA 7.16 7.81 09064581 ......... ............ A Implant neuroelectrodes ................................ 14.13 NA NA 6.72 5.71 1.05 NA NA 21.90 20.8909064585 ......... ............ A Revise/remove neuroelectrode ..................... 2.06 5.79 9.91 2.24 2.16 0.20 8.05 12.17 4.50 4.4201064590 ......... ............ 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 01064595 ......... ............ A Revise/remove neuroreceiver ....................... 1.73 6.52 9.42 2.20 1.99 0.19 8.44 11.34 4.12 3.91 01064600 ......... ............ A Injection treatment of nerve .......................... 3.44 5.28 8.33 1.58 1.63 0.34 9.06 12.11 5.365.41 01064605 ......... ............ 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 01064610 ......... ............ 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 01064612 ......... ............ 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 01064613 ......... ............ 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 01064614 ......... ............ 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 01064620 ......... ............ A Injection treatment of nerve .......................... 2.84 3.44 4.66 1.17 1.29 0.20 6.48 7.70 4.214.33 01064622 ......... ............ 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 01064623 ......... ............ 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 ZZZ64626 ......... ............ A Destr paravertebrl nerve c/t .......................... 3.78 4.74 7.02 1.87 1.94 0.20 8.72 11.00 5.855.92 01064627 ......... ............ 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 ZZZ64630 ......... ............ A Injection treatment of nerve .......................... 3.00 2.81 2.75 1.88 1.53 0.22 6.03 5.97 5.104.75 01064640 ......... ............ A Injection treatment of nerve .......................... 2.76 2.45 3.75 1.44 1.74 0.29 5.50 6.80 4.494.79 01064650 ......... ............ A Chemodenerv eccrine glands ....................... 0.70 0.78 0.85 0.18 0.27 0.06 1.54 1.61 0.94 1.0300064653 ......... ............ A Chemodenerv eccrine glands ....................... 0.88 0.83 0.90 0.22 0.34 0.08 1.79 1.86 1.18 1.3000064680 ......... ............ A Injection treatment of nerve .......................... 2.62 4.01 6.04 1.09 1.35 0.18 6.81 8.84 3.894.15 01064681 ......... ............ A Injection treatment of nerve .......................... 3.78 4.92 8.20 1.32 1.88 0.28 8.98 12.26 5.385.94 01064702 ......... ............ A Revise finger/toe nerve ................................. 6.02 NA NA 5.27 4.21 0.61 NA NA 11.90 10.8409064704 ......... ............ A Revise hand/foot nerve ................................. 4.56 NA NA 3.20 3.28 0.61 NA NA 8.37 8.45 09064708 ......... ............ A Revise arm/leg nerve .................................... 6.17 NA NA 4.29 4.72 0.96 NA NA 11.42 11.8509064712 ......... ............ A Revision of sciatic nerve ............................... 7.92 NA NA 4.55 4.86 0.95 NA NA 13.42 13.7309064713 ......... ............ A Revision of arm nerve(s) ............................... 11.22 NA NA 6.47 6.02 1.82 NA NA 19.51 19.0609064714 ......... ............ A Revise low back nerve(s) .............................. 10.37 NA NA 4.91 4.38 1.19 NA NA 16.47 15.9409064716 ......... ............ A Revision of cranial nerve ............................... 6.80 NA NA 5.15 5.77 0.63 NA NA 12.58 13.2009064718 ......... ............ 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 09064721 ......... ............ A Carpal tunnel surgery .................................... 4.78 4.72 5.20 4.66 5.19 0.73 10.23 10.7110.17 10.70 09064722 ......... ............ A Relieve pressure on nerve(s) ........................ 4.69 NA NA 2.83 2.99 0.48 NA NA 8.00 8.16 09064726 ......... ............ A Release foot/toe nerve .................................. 4.17 NA NA 2.73 2.78 0.54 NA NA 7.44 7.49 09064727 ......... ............ A Internal nerve revision ................................... 3.10 NA NA 1.23 1.43 0.48 NA NA 4.81 5.01ZZZ64732 ......... ............ A Incision of brow nerve ................................... 4.78 NA NA 4.27 3.69 0.98 NA NA 10.03 9.4509064734 ......... ............ A Incision of cheek nerve ................................. 5.41 NA NA 4.64 4.20 0.89 NA NA 10.94 10.5009064736 ......... ............ A Incision of chin nerve .................................... 5.09 NA NA 3.87 3.98 0.52 NA NA 9.48 9.5909064738 ......... ............ A Incision of jaw nerve ..................................... 6.22 NA NA 4.22 4.51 1.08 NA NA 11.52 11.81 09064740 ......... ............ A Incision of tongue nerve ................................ 6.08 NA NA 4.41 4.94 0.69 NA NA 11.18 11.7109064742 ......... ............ A Incision of facial nerve .................................. 6.71 NA NA 4.35 4.61 0.73 NA NA 11.79 12.05 09064744 ......... ............ A Incise nerve, back of head ............................ 5.61 NA NA 4.59 3.98 1.16 NA NA 11.36 10.75 09064746 ......... ............ A Incise diaphragm nerve ................................. 6.42 NA NA 3.88 4.35 0.82 NA NA 11.12 11.5909064752 ......... ............ A Incision of vagus nerve ................................. 7.55 NA NA 4.06 4.23 0.93 NA NA 12.54 12.7109064755 ......... ............ A Incision of stomach nerves ........................... 14.93 NA NA 5.84 5.68 1.83 NA NA 22.60 22.44 09064760 ......... ............ A Incision of vagus nerve ................................. 7.45 NA NA 3.85 3.55 0.81 NA NA 12.11 11.8109064761 ......... ............ A Incision of pelvis nerve .................................. 6.90 NA NA 3.99 3.64 0.53 NA NA 11.42 11.07 09064763 ......... ............ A Incise hip/thigh nerve .................................... 7.42 NA NA 5.07 5.16 0.94 NA NA 13.43 13.52 09064766 ......... ............ A Incise hip/thigh nerve .................................... 9.29 NA NA 5.31 5.26 1.06 NA NA 15.66 15.61 09064771 ......... ............ A Sever cranial nerve ....................................... 7.97 NA NA 5.28 5.48 1.23 NA NA 14.48 14.68 09064772 ......... ............ A Incision of spinal nerve ................................. 7.70 NA NA 5.32 5.02 1.40 NA NA 14.42 14.12 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00189 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49170 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal64774 ......... ............ A Remove skin nerve lesion ............................. 5.66 NA NA 3.97 3.87 0.74 NA NA 10.37 10.27 09064776 ......... ............ 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 09064783 ......... ............ A Limb nerve surgery add-on ........................... 3.71 NA NA 1.41 1.73 0.51 NA NA 5.63 5.95 ZZZ64784 ......... ............ A Remove nerve lesion .................................... 10.44 NA NA 6.20 6.49 1.38 NA NA 18.01 18.3009064786 ......... ............ A Remove sciatic nerve lesion ......................... 16.07 NA NA 8.97 9.62 2.60 NA NA 27.64 28.29 09064787 ......... ............ A Implant nerve end ......................................... 4.29 NA NA 1.60 1.99 0.58 NA NA 6.47 6.86ZZZ64788 ......... ............ A Remove skin nerve lesion ............................. 5.10 NA NA 3.87 3.56 0.73 NA NA 9.70 9.39 09064790 ......... ............ A Removal of nerve lesion ............................... 11.92 NA NA 6.81 7.10 2.10 NA NA 20.83 21.1209064792 ......... ............ A Removal of nerve lesion ............................... 15.65 NA NA 8.40 8.72 2.48 NA NA 26.53 26.8509064795 ......... ............ A Biopsy of nerve ............................................. 3.01 NA NA 1.44 1.53 0.52 NA NA 4.97 5.06 00064802 ......... ............ A Remove sympathetic nerves ......................... 10.19 NA NA 4.22 4.90 1.29 NA NA 15.70 16.38 09064804 ......... ............ A Remove sympathetic nerves ......................... 15.73 NA NA 6.10 6.90 2.14 NA NA 23.97 24.77 09064809 ......... ............ A Remove sympathetic nerves ......................... 14.57 NA NA 6.60 5.97 1.50 NA NA 22.67 22.04 09064818 ......... ............ A Remove sympathetic nerves ......................... 11.20 NA NA 4.36 5.05 1.33 NA NA 16.89 17.58 09064820 ......... ............ A Remove sympathetic nerves ......................... 10.60 NA NA 7.04 7.10 1.49 NA NA 19.13 19.19 09064821 ......... ............ A Remove sympathetic nerves ......................... 9.11 NA NA 6.64 7.17 1.24 NA NA 16.99 17.52 09064822 ......... ............ A Remove sympathetic nerves ......................... 9.11 NA NA 6.45 7.04 1.30 NA NA 16.86 17.45 09064823 ......... ............ A Remove sympathetic nerves ......................... 10.72 NA NA 7.11 7.88 1.57 NA NA 19.40 20.17 09064831 ......... ............ A Repair of digit nerve ...................................... 10.18 NA NA 6.67 6.97 1.41 NA NA 18.26 18.56 09064832 ......... ............ A Repair nerve add-on ..................................... 5.65 NA NA 2.36 2.79 0.85 NA NA 8.86 9.29 ZZZ64834 ......... ............ A Repair of hand or foot nerve ......................... 10.67 NA NA 6.57 6.96 1.54 NA NA 18.78 19.17 09064835 ......... ............ A Repair of hand or foot nerve ......................... 11.55 NA NA 7.32 7.60 1.73 NA NA 20.60 20.88 09064836 ......... ............ A Repair of hand or foot nerve ......................... 11.55 NA NA 7.04 7.51 1.67 NA NA 20.26 20.73 09064837 ......... ............ A Repair nerve add-on ..................................... 6.25 NA NA 2.67 3.09 0.97 NA NA 9.89 10.31ZZZ64840 ......... ............ A Repair of leg nerve ........................................ 13.81 NA NA 5.07 7.46 1.37 NA NA 20.25 22.64 09064856 ......... ............ A Repair/transpose nerve ................................. 14.89 NA NA 8.60 9.04 2.12 NA NA 25.61 26.0509064857 ......... ............ A Repair arm/leg nerve ..................................... 15.64 NA NA 8.93 9.46 2.21 NA NA 26.78 27.31 09064858 ......... ............ A Repair sciatic nerve ....................................... 17.64 NA NA 10.15 10.62 3.33 NA NA 31.1231.58 09064859 ......... ............ A Nerve surgery ................................................ 4.25 NA NA 1.88 2.11 0.67 NA NA 6.80 7.03 ZZZ64861 ......... ............ A Repair of arm nerves .................................... 20.68 NA NA 10.04 11.34 4.08 NA NA 34.80 36.10 09064862 ......... ............ A Repair of low back nerves ............................ 20.88 NA NA 6.83 10.66 4.31 NA NA 32.02 35.8509064864 ......... ............ A Repair of facial nerve .................................... 13.27 NA NA 7.03 8.33 1.26 NA NA 21.56 22.86 09064865 ......... ............ A Repair of facial nerve .................................... 15.91 NA NA 9.89 12.61 1.50 NA NA 27.30 30.02 09064866 ......... ............ A Fusion of facial/other nerve ........................... 16.65 NA NA 12.27 12.94 2.04 NA NA 30.96 31.63 09064868 ......... ............ A Fusion of facial/other nerve ........................... 14.76 NA NA 9.07 10.84 1.43 NA NA 25.26 27.03 09064870 ......... ............ A Fusion of facial/other nerve ........................... 16.90 NA NA 8.42 8.65 1.30 NA NA 26.62 26.8509064872 ......... ............ A Subsequent repair of nerve ........................... 1.99 NA NA 0.81 1.01 0.29 NA NA 3.09 3.29 ZZZ64874 ......... ............ A Repair & revise nerve add-on ....................... 2.98 NA NA 1.21 1.45 0.42 NA NA 4.61 4.85 ZZZ64876 ......... ............ A Repair nerve/shorten bone ............................ 3.37 NA NA 0.78 1.50 0.47 NA NA 4.62 5.34 ZZZ64885 ......... ............ A Nerve graft, head or neck ............................. 17.50 NA NA 8.84 10.91 1.63 NA NA 27.97 30.0409064886 ......... ............ A Nerve graft, head or neck ............................. 20.72 NA NA 9.68 12.58 2.08 NA NA 32.48 35.3809064890 ......... ............ A Nerve graft, hand or foot ............................... 16.06 NA NA 9.05 9.76 2.29 NA NA 27.40 28.11 09064891 ......... ............ A Nerve graft, hand or foot ............................... 17.17 NA NA 9.87 8.15 1.63 NA NA 28.67 26.95 09064892 ......... ............ A Nerve graft, arm or leg .................................. 15.56 NA NA 8.95 8.88 2.47 NA NA 26.98 26.91 09064893 ......... ............ A Nerve graft, arm or leg .................................. 16.69 NA NA 9.67 9.81 2.61 NA NA 28.97 29.11 09064895 ......... ............ A Nerve graft, hand or foot ............................... 20.21 NA NA 10.02 9.74 2.57 NA NA 32.80 32.52 09064896 ......... ............ A Nerve graft, hand or foot ............................... 21.75 NA NA 11.89 11.21 3.16 NA NA 36.80 36.12 09064897 ......... ............ A Nerve graft, arm or leg .................................. 19.20 NA NA 10.43 10.63 2.54 NA NA 32.17 32.37 09064898 ......... ............ A Nerve graft, arm or leg .................................. 20.76 NA NA 11.28 11.66 2.77 NA NA 34.81 35.19 09064901 ......... ............ A Nerve graft add-on ........................................ 10.20 NA NA 3.82 4.90 1.37 NA NA 15.39 16.47 ZZZ64902 ......... ............ A Nerve graft add-on ........................................ 11.81 NA NA 4.25 5.53 1.55 NA NA 17.61 18.89 ZZZ64905 ......... ............ A Nerve pedicle transfer ................................... 14.93 NA NA 6.84 8.08 2.00 NA NA 23.77 25.01 09064907 ......... ............ A Nerve pedicle transfer ................................... 19.85 NA NA 6.41 10.99 3.16 NA NA 29.42 34.00 09064999 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00190 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49171 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules65091 ......... ............ A Revise eye ..................................................... 7.08 NA NA 6.91 7.99 0.32 NA NA 14.31 15.39 09065093 ......... ............ A Revise eye with implant ................................ 6.86 NA NA 7.00 8.28 0.34 NA NA 14.20 15.4809065101 ......... ............ A Removal of eye ............................................. 8.02 NA NA 8.15 9.18 0.35 NA NA 16.52 17.55 09065103 ......... ............ A Remove eye/insert implant ............................ 8.56 NA NA 8.37 9.39 0.37 NA NA 17.30 18.32 09065105 ......... ............ A Remove eye/attach implant ........................... 9.61 NA NA 9.06 10.11 0.42 NA NA 19.09 20.14 09065110 ......... ............ A Removal of eye ............................................. 15.31 NA NA 11.58 13.15 0.81 NA NA 27.7029.27 09065112 ......... ............ A Remove eye/revise socket ............................ 18.05 NA NA 13.05 15.36 1.30 NA NA 32.40 34.7109065114 ......... ............ A Remove eye/revise socket ............................ 19.19 NA NA 13.69 15.68 1.02 NA NA 33.90 35.8909065125 ......... ............ A Revise ocular implant .................................... 3.12 6.82 8.31 3.18 3.50 0.19 10.13 11.626.49 6.81 09065130 ......... ............ A Insert ocular implant ...................................... 8.14 NA NA 7.92 8.85 0.35 NA NA 16.41 17.34 09065135 ......... ............ A Insert ocular implant ...................................... 8.32 NA NA 7.97 8.98 0.36 NA NA 16.65 17.66 09065140 ......... ............ A Attach ocular implant ..................................... 9.14 NA NA 8.59 9.55 0.40 NA NA 18.13 19.09 09065150 ......... ............ A Revise ocular implant .................................... 6.25 NA NA 6.47 7.60 0.31 NA NA 13.03 14.16 09065155 ......... ............ A Reinsert ocular implant ................................. 9.78 NA NA 8.85 10.07 0.50 NA NA 19.13 20.35 09065175 ......... ............ A Removal of ocular implant ............................ 7.15 NA NA 7.27 8.18 0.31 NA NA 14.73 15.64 09065205 ......... ............ A Remove foreign body from eye ..................... 0.71 0.59 0.63 0.33 0.30 0.03 1.33 1.37 1.07 1.0400065210 ......... ............ A Remove foreign body from eye ..................... 0.84 0.74 0.79 0.41 0.39 0.04 1.62 1.67 1.29 1.2700065220 ......... ............ A Remove foreign body from eye ..................... 0.71 0.60 0.63 0.29 0.28 0.05 1.36 1.39 1.05 1.0400065222 ......... ............ A Remove foreign body from eye ..................... 0.93 0.81 0.87 0.43 0.39 0.04 1.78 1.84 1.40 1.3600065235 ......... ............ A Remove foreign body from eye ..................... 8.69 NA NA 6.99 6.80 0.37 NA NA 16.05 15.86 09065260 ......... ............ A Remove foreign body from eye ..................... 12.19 NA NA 9.03 9.50 0.57 NA NA 21.79 22.26 09065265 ......... ............ A Remove foreign body from eye ..................... 13.95 NA NA 9.90 10.44 0.62 NA NA 24.47 25.01 09065270 ......... ............ 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 01065272 ......... ............ 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 09065273 ......... ............ A Repair of eye wound ..................................... 4.98 NA NA 3.43 3.54 0.22 NA NA 8.63 8.74 09065275 ......... ............ 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 09065280 ......... ............ A Repair of eye wound ..................................... 8.78 NA NA 6.02 6.18 0.38 NA NA 15.18 15.3409065285 ......... ............ A Repair of eye wound ..................................... 14.32 NA NA 8.70 9.08 0.64 NA NA 23.66 24.04 09065286 ......... ............ A Repair of eye wound ..................................... 6.38 8.96 10.60 4.53 4.60 0.27 15.61 17.2511.18 11.25 09065290 ......... ............ A Repair of eye socket wound ......................... 6.28 NA NA 4.55 4.69 0.31 NA NA 11.14 11.28 09065400 ......... ............ 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 09065410 ......... ............ A Biopsy of cornea ........................................... 1.47 1.72 2.01 0.90 0.95 0.07 3.26 3.552.44 2.49 00065420 ......... ............ 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 09065426 ......... ............ 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 09065430 ......... ............ A Corneal smear ............................................... 1.47 1.13 1.25 0.90 0.96 0.07 2.67 2.792.44 2.50 00065435 ......... ............ A Curette/treat cornea ...................................... 0.92 0.89 0.97 0.67 0.70 0.04 1.85 1.93 1.63 1.66 00065436 ......... ............ A Curette/treat cornea ...................................... 4.68 3.88 4.04 3.55 3.64 0.21 8.77 8.93 8.44 8.53 09065450 ......... ............ 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 09065600 ......... ............ A Revision of cornea ........................................ 4.02 4.58 4.90 3.51 3.39 0.17 8.77 9.09 7.70 7.58 09065710 ......... ............ A Corneal transplant ......................................... 13.97 NA NA 10.49 11.02 0.61 NA NA 25.0725.60 09065730 ......... ............ A Corneal transplant ......................................... 15.87 NA NA 11.29 11.84 0.70 NA NA 27.8628.41 09065750 ......... ............ A Corneal transplant ......................................... 16.48 NA NA 11.00 11.73 0.74 NA NA 28.2228.95 09065755 ......... ............ A Corneal transplant ......................................... 16.37 NA NA 10.97 11.66 0.73 NA NA 28.0728.76 09065770 ......... ............ A Revise cornea with implant ........................... 19.28 NA NA 12.09 12.92 0.87 NA NA 32.24 33.0709065772 ......... ............ A Correction of astigmatism ............................. 4.91 4.99 5.40 4.04 4.11 0.21 10.11 10.52 9.16 9.23 09065775 ......... ............ A Correction of astigmatism ............................. 6.66 NA NA 5.46 5.83 0.28 NA NA 12.40 12.77 09065780 ......... ............ A Ocular reconst, transplant ............................. 10.23 NA NA 9.18 10.01 0.44 NA NA 19.85 20.68 09065781 ......... ............ A Ocular reconst, transplant ............................. 17.64 NA NA 11.94 13.24 0.44 NA NA 30.02 31.32 09065782 ......... ............ A Ocular reconst, transplant ............................. 14.98 NA NA 10.53 11.63 0.44 NA NA 25.95 27.05 09065800 ......... ............ A Drainage of eye ............................................. 1.91 1.45 1.71 1.07 1.15 0.09 3.45 3.713.07 3.15 00065805 ......... ............ A Drainage of eye ............................................. 1.91 1.76 2.07 1.07 1.16 0.09 3.76 4.073.07 3.16 00065810 ......... ............ A Drainage of eye ............................................. 5.61 NA NA 4.82 4.73 0.24 NA NA 10.67 10.58 09065815 ......... ............ A Drainage of eye ............................................. 5.79 8.14 9.54 4.72 4.79 0.25 14.18 15.58 10.76 10.83 09065820 ......... ............ A Relieve inner eye pressure ........................... 8.62 NA NA 7.88 8.76 0.40 NA NA 16.90 17.78 09065850 ......... ............ A Incision of eye ............................................... 11.14 NA NA 7.56 8.22 0.52 NA NA 19.22 19.88 09065855 ......... ............ 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 01065860 ......... ............ 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 09065865 ......... ............ A Incise inner eye adhesions ........................... 5.59 NA NA 4.84 5.43 0.28 NA NA 10.71 11.30 09065870 ......... ............ A Incise inner eye adhesions ........................... 7.14 NA NA 5.88 6.28 0.31 NA NA 13.33 13.73 09065875 ......... ............ A Incise inner eye adhesions ........................... 7.53 NA NA 6.33 6.68 0.32 NA NA 14.18 14.53 09065880 ......... ............ A Incise inner eye adhesions ........................... 8.08 NA NA 6.54 6.91 0.35 NA NA 14.97 15.34 09065900 ......... ............ A Remove eye lesion ........................................ 12.16 NA NA 9.15 9.98 0.54 NA NA 21.85 22.68 09065920 ......... ............ A Remove implant of eye ................................. 9.64 NA NA 7.72 8.06 0.41 NA NA 17.77 18.11 09065930 ......... ............ A Remove blood clot from eye ......................... 8.18 NA NA 5.98 6.62 0.37 NA NA 14.53 15.17 09066020 ......... ............ 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 01066030 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00191 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49172 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal66130 ......... ............ A Remove eye lesion ........................................ 7.68 7.75 9.15 5.04 5.47 0.38 15.81 17.2113.10 13.53 09066150 ......... ............ A Glaucoma surgery ......................................... 10.04 NA NA 9.04 9.31 0.46 NA NA 19.54 19.81 09066155 ......... ............ A Glaucoma surgery ......................................... 10.03 NA NA 9.02 9.27 0.41 NA NA 19.46 19.71 09066160 ......... ............ A Glaucoma surgery ......................................... 11.90 NA NA 9.78 10.09 0.50 NA NA 22.18 22.49 09066165 ......... ............ A Glaucoma surgery ......................................... 9.75 NA NA 8.97 9.17 0.40 NA NA 19.12 19.32 09066170 ......... ............ A Glaucoma surgery ......................................... 14.39 NA NA 11.90 12.14 0.60 NA NA 26.89 27.13 09066172 ......... ............ A Incision of eye ............................................... 18.02 NA NA 15.09 15.17 0.74 NA NA 33.85 33.93 09066180 ......... ............ A Implant eye shunt .......................................... 15.91 NA NA 10.05 10.58 0.71 NA NA 26.6727.20 09066185 ......... ............ A Revise eye shunt ........................................... 9.26 NA NA 7.28 7.36 0.40 NA NA 16.94 17.01 09066220 ......... ............ A Repair eye lesion .......................................... 8.89 NA NA 7.21 7.13 0.40 NA NA 16.50 16.42 09066225 ......... ............ A Repair/graft eye lesion .................................. 12.28 NA NA 8.41 8.65 0.55 NA NA 21.24 21.48 09066250 ......... ............ 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 09066500 ......... ............ A Incision of iris ................................................ 3.70 NA NA 4.07 4.50 0.18 NA NA 7.95 8.38 09066505 ......... ............ A Incision of iris ................................................ 4.07 NA NA 4.43 4.85 0.20 NA NA 8.70 9.12 09066600 ......... ............ A Remove iris and lesion .................................. 9.80 NA NA 8.55 8.30 0.43 NA NA 18.78 18.5309066605 ......... ............ A Removal of iris .............................................. 13.90 NA NA 9.43 9.87 0.77 NA NA 24.1024.54 09066625 ......... ............ A Removal of iris .............................................. 5.12 NA NA 4.34 4.63 0.26 NA NA 9.72 10.01 09066630 ......... ............ A Removal of iris .............................................. 7.03 NA NA 5.52 5.66 0.31 NA NA 12.8613.00 09066635 ......... ............ A Removal of iris .............................................. 7.12 NA NA 5.55 5.69 0.31 NA NA 12.9813.12 09066680 ......... ............ A Repair iris & ciliary body ............................... 6.18 NA NA 5.23 5.26 0.27 NA NA 11.68 11.71 09066682 ......... ............ A Repair iris & ciliary body ............................... 7.08 NA NA 6.92 6.69 0.31 NA NA 14.31 14.08 09066700 ......... ............ A Destruction, ciliary body ................................ 5.02 4.96 5.17 3.73 3.88 0.24 10.22 10.438.99 9.14 09066710 ......... ............ A Ciliary transsleral therapy .............................. 5.02 4.73 5.06 3.71 3.81 0.23 9.98 10.31 8.96 9.06 09066711 ......... ............ A Ciliary endoscopic ablation ........................... 7.60 NA NA 6.49 6.48 0.30 NA NA 14.39 14.38 09066720 ......... ............ A Destruction, ciliary body ................................ 4.77 5.47 5.71 4.40 4.64 0.26 10.50 10.749.43 9.67 09066740 ......... ............ A Destruction, ciliary body ................................ 5.02 4.68 4.99 3.73 3.91 0.23 9.93 10.24 8.98 9.16 09066761 ......... ............ A Revision of iris ............................................... 4.81 5.17 5.49 4.32 4.31 0.20 10.1810.50 9.33 9.32 09066762 ......... ............ A Revision of iris ............................................... 5.20 5.26 5.55 4.20 4.27 0.23 10.6910.98 9.63 9.70 09066770 ......... ............ A Removal of inner eye lesion ......................... 5.92 5.71 5.99 4.74 4.79 0.26 11.89 12.17 10.9210.97 09066820 ......... ............ 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 6.906.98 09066825 ......... ............ A Reposition intraocular lens ............................ 8.72 NA NA 8.01 8.80 0.40 NA NA 17.13 17.9209066830 ......... ............ A Removal of lens lesion .................................. 9.19 NA NA 6.57 6.86 0.36 NA NA 16.12 16.4109066840 ......... ............ A Removal of lens material .............................. 8.90 NA NA 6.51 6.77 0.39 NA NA 15.80 16.06 09066850 ......... ............ A Removal of lens material .............................. 10.23 NA NA 7.31 7.56 0.45 NA NA 17.99 18.2409066852 ......... ............ A Removal of lens material .............................. 11.09 NA NA 7.65 7.99 0.49 NA NA 19.23 19.5709066920 ......... ............ A Extraction of lens ........................................... 9.85 NA NA 6.87 7.19 0.44 NA NA 17.1617.48 09066930 ......... ............ A Extraction of lens ........................................... 11.29 NA NA 7.73 8.04 0.49 NA NA 19.5119.82 09066940 ......... ............ A Extraction of lens ........................................... 10.05 NA NA 7.25 7.51 0.43 NA NA 17.7317.99 09066982 ......... ............ A Cataract surgery, complex ............................ 14.73 NA NA 9.28 9.72 0.63 NA NA 24.64 25.08 09066983 ......... ............ A Cataract surg w/iol, 1 stage .......................... 10.11 NA NA 6.30 6.16 0.14 NA NA 16.55 16.4109066984 ......... ............ A Cataract surg w/iol, 1 stage .......................... 10.28 NA NA 6.62 7.22 0.39 NA NA 17.29 17.8909066985 ......... ............ A Insert lens prosthesis .................................... 9.63 NA NA 7.33 7.42 0.36 NA NA 17.32 17.41 09066986 ......... ............ A Exchange lens prosthesis ............................. 12.26 NA NA 8.38 8.97 0.60 NA NA 21.24 21.83 09066990 ......... ............ A Ophthalmic endoscope add-on ..................... 1.51 NA NA 0.57 0.66 0.07 NA NA 2.15 2.24 ZZZ66999 ......... ............ C Eye surgery procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY67005 ......... ............ A Partial removal of eye fluid ........................... 5.69 NA NA 4.72 4.83 0.28 NA NA 10.69 10.8009067010 ......... ............ A Partial removal of eye fluid ........................... 6.86 NA NA 5.16 5.35 0.34 NA NA 12.36 12.5509067015 ......... ............ A Release of eye fluid ...................................... 6.91 NA NA 5.88 6.31 0.34 NA NA 13.13 13.56 09067025 ......... ............ A Replace eye fluid ........................................... 7.83 8.11 8.94 6.11 6.19 0.34 16.28 17.11 14.28 14.36 09067027 ......... ............ A Implant eye drug system ............................... 11.33 NA NA 7.61 7.90 0.54 NA NA 19.48 19.7709067028 ......... ............ A Injection eye drug .......................................... 2.52 2.23 2.58 1.30 1.42 0.12 4.87 5.223.94 4.06 00067030 ......... ............ A Incise inner eye strands ................................ 5.83 NA NA 5.77 5.83 0.24 NA NA 11.84 11.9009067031 ......... ............ 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 09067036 ......... ............ A Removal of inner eye fluid ............................ 13.00 NA NA 8.35 8.93 0.58 NA NA 21.93 22.5109067038 ......... ............ A Strip retinal membrane .................................. 23.15 NA NA 13.97 15.11 1.04 NA NA 38.16 39.30 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00192 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49173 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules67039 ......... ............ A Laser treatment of retina ............................... 16.25 NA NA 11.08 11.91 0.71 NA NA 28.04 28.87 09067040 ......... ............ A Laser treatment of retina ............................... 19.08 NA NA 12.45 13.37 0.85 NA NA 32.38 33.30 09067101 ......... ............ A Repair detached retina .................................. 8.52 8.75 9.03 6.38 6.49 0.37 17.64 17.92 15.27 15.38 09067105 ......... ............ A Repair detached retina .................................. 8.28 7.65 7.97 5.99 6.11 0.37 16.30 16.62 14.64 14.75 09067107 ......... ............ A Repair detached retina .................................. 16.26 NA NA 10.74 11.16 0.73 NA NA 27.73 28.15 09067108 ......... ............ A Repair detached retina .................................. 22.39 NA NA 13.45 14.18 1.02 NA NA 36.86 37.59 09067110 ......... ............ A Repair detached retina .................................. 9.93 9.22 9.98 7.20 7.34 0.44 19.59 20.35 17.57 17.71 09067112 ......... ............ A Rerepair detached retina ............................... 18.33 NA NA 11.27 11.68 0.83 NA NA 30.43 30.84 09067115 ......... ............ A Release encircling material ........................... 5.86 NA NA 5.07 5.08 0.25 NA NA 11.18 11.19 09067120 ......... ............ 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 09067121 ......... ............ A Remove eye implant material ....................... 11.90 NA NA 8.25 8.46 0.53 NA NA 20.68 20.89 09067141 ......... ............ A Treatment of retina ........................................ 5.94 5.59 5.79 4.81 4.85 0.26 11.79 11.99 11.01 11.05 09067145 ......... ............ A Treatment of retina ........................................ 6.11 5.51 5.67 4.87 4.92 0.27 11.89 12.05 11.25 11.30 09067208 ......... ............ 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 09067210 ......... ............ 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 09067218 ......... ............ A Treatment of retinal lesion ............................ 20.14 NA NA 11.08 11.88 0.92 NA NA 32.14 32.94 09067220 ......... ............ 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 09067221 ......... ............ R Ocular photodynamic ther ............................. 3.45 3.03 4.01 1.45 1.71 0.20 6.68 7.66 5.10 5.36 00067225 ......... ............ A Eye photodynamic ther add-on ..................... 0.47 0.24 0.25 0.18 0.20 0.02 0.73 0.74 0.67 0.69ZZZ67227 ......... ............ 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 09067228 ......... ............ A Treatment of retinal lesion ............................ 13.60 10.27 11.18 7.98 8.40 0.63 24.50 25.4122.21 22.63 09067250 ......... ............ A Reinforce eye wall ......................................... 9.40 NA NA 7.90 8.85 0.47 NA NA 17.77 18.72 09067255 ......... ............ A Reinforce/graft eye wall ................................. 9.89 NA NA 8.71 9.60 0.44 NA NA 19.04 19.93 09067299 ......... ............ C Eye surgery procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY67311 ......... ............ A Revise eye muscle ........................................ 7.52 NA NA 5.68 5.94 0.37 NA NA 13.57 13.83 09067312 ......... ............ A Revise two eye muscles ............................... 9.41 NA NA 6.42 6.67 0.43 NA NA 16.26 16.51 09067314 ......... ............ A Revise eye muscle ........................................ 8.51 NA NA 6.37 6.51 0.39 NA NA 15.27 15.41 09067316 ......... ............ A Revise two eye muscles ............................... 10.65 NA NA 7.18 7.42 0.49 NA NA 18.32 18.56 09067318 ......... ............ A Revise eye muscle(s) .................................... 8.84 NA NA 6.76 6.89 0.41 NA NA 16.01 16.1409067320 ......... ............ A Revise eye muscle(s) add-on ....................... 4.32 NA NA 1.62 1.87 0.22 NA NA 6.16 6.41 ZZZ67331 ......... ............ A Eye surgery follow-up add-on ....................... 4.05 NA NA 1.51 1.75 0.21 NA NA 5.77 6.01 ZZZ67332 ......... ............ A Rerevise eye muscles add-on ....................... 4.48 NA NA 1.68 1.94 0.23 NA NA 6.39 6.65 ZZZ67334 ......... ............ A Revise eye muscle w/suture ......................... 3.97 NA NA 1.48 1.71 0.20 NA NA 5.65 5.88 ZZZ67335 ......... ............ 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 ZZZ67343 ......... ............ A Release eye tissue ........................................ 8.22 NA NA 6.25 6.45 0.37 NA NA 14.84 15.04 09067345 ......... ............ 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 01067350 ......... ............ A Biopsy eye muscle ........................................ 2.87 NA NA 1.69 1.83 0.15 NA NA 4.71 4.8500067399 ......... ............ C Eye muscle surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00YYY67400 ......... ............ A Explore/biopsy eye socket ............................ 10.88 NA NA 9.71 10.87 0.56 NA NA 21.15 22.3109067405 ......... ............ A Explore/drain eye socket ............................... 8.92 NA NA 8.48 9.45 0.44 NA NA 17.84 18.8109067412 ......... ............ A Explore/treat eye socket ................................ 10.12 NA NA 8.81 10.40 0.48 NA NA 19.41 21.00 09067413 ......... ............ A Explore/treat eye socket ................................ 9.99 NA NA 8.94 10.31 0.50 NA NA 19.43 20.80 09067414 ......... ............ A Explr/decompress eye socket ....................... 17.72 NA NA 11.99 12.03 0.65 NA NA 30.36 30.40 09067415 ......... ............ A Aspiration, orbital contents ............................ 1.76 NA NA 0.63 0.73 0.09 NA NA 2.48 2.58 00067420 ......... ............ A Explore/treat eye socket ................................ 21.52 NA NA 14.59 16.69 1.15 NA NA 37.26 39.36 09067430 ......... ............ A Explore/treat eye socket ................................ 14.87 NA NA 12.66 14.33 0.86 NA NA 28.39 30.06 09067440 ......... ............ A Explore/drain eye socket ............................... 14.45 NA NA 12.12 13.73 0.70 NA NA 27.27 28.88 09067445 ......... ............ A Explr/decompress eye socket ....................... 18.90 NA NA 12.58 13.58 0.90 NA NA 32.38 33.38 09067450 ......... ............ A Explore/biopsy eye socket ............................ 14.99 NA NA 12.63 14.18 0.68 NA NA 28.30 29.8509067500 ......... ............ 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 00067505 ......... ............ 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 00067515 ......... ............ 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 00067550 ......... ............ A Insert eye socket implant .............................. 11.42 NA NA 10.04 10.99 0.72 NA NA 22.18 23.13 09067560 ......... ............ A Revise eye socket implant ............................ 11.83 NA NA 10.07 11.05 0.60 NA NA 22.50 23.4809067570 ......... ............ A Decompress optic nerve ............................... 14.13 NA NA 11.33 13.02 0.68 NA NA 26.14 27.8309067599 ......... ............ C Orbit surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY67700 ......... ............ 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 01067710 ......... ............ A Incision of eyelid ............................................ 1.02 3.79 4.98 1.10 1.18 0.05 4.86 6.05 2.17 2.25 01067715 ......... ............ A Incision of eyelid fold ..................................... 1.22 3.91 5.01 1.18 1.26 0.06 5.19 6.292.46 2.54 01067800 ......... ............ A Remove eyelid lesion .................................... 1.38 1.44 1.58 0.93 1.01 0.07 2.89 3.03 2.38 2.46 01067801 ......... ............ A Remove eyelid lesions .................................. 1.88 1.73 1.90 1.12 1.23 0.09 3.70 3.87 3.093.20 01067805 ......... ............ A Remove eyelid lesions .................................. 2.22 2.25 2.45 1.46 1.60 0.11 4.58 4.78 3.793.93 01067808 ......... ............ A Remove eyelid lesion(s) ................................ 4.42 NA NA 3.70 3.75 0.19 NA NA 8.31 8.36 09067810 ......... ............ A Biopsy of eyelid ............................................. 1.48 3.87 3.47 0.66 0.68 0.06 5.41 5.01 2.20 2.22 00067820 ......... ............ A Revise eyelashes .......................................... 0.71 0.45 0.56 0.52 0.55 0.04 1.20 1.31 1.27 1.30 000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00193 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49174 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal67825 ......... ............ A Revise eyelashes .......................................... 1.38 1.44 1.66 1.30 1.38 0.07 2.89 3.11 2.75 2.83 01067830 ......... ............ A Revise eyelashes .......................................... 1.70 4.10 5.17 1.36 1.47 0.08 5.88 6.95 3.14 3.25 01067835 ......... ............ A Revise eyelashes .......................................... 5.55 NA NA 4.18 4.51 0.28 NA NA 10.01 10.34 09067840 ......... ............ A Remove eyelid lesion .................................... 2.04 4.01 5.11 1.50 1.61 0.10 6.15 7.25 3.64 3.75 01067850 ......... ............ A Treat eyelid lesion ......................................... 1.69 3.26 3.34 1.43 1.46 0.07 5.02 5.103.19 3.22 01067875 ......... ............ A Closure of eyelid by suture ........................... 1.35 2.45 3.09 0.86 0.92 0.07 3.87 4.51 2.282.34 00067880 ......... ............ A Revision of eyelid .......................................... 4.42 5.58 6.35 3.67 3.77 0.19 10.19 10.96 8.28 8.38 09067882 ......... ............ A Revision of eyelid .......................................... 5.81 6.56 7.36 4.62 4.76 0.25 12.62 13.42 10.68 10.82 09067900 ......... ............ A Repair brow defect ........................................ 6.63 7.52 8.68 4.72 5.12 0.38 14.53 15.6911.73 12.13 09067901 ......... ............ A Repair eyelid defect ...................................... 7.39 9.25 6.36 5.46 5.42 0.54 17.18 14.2913.39 13.35 09067902 ......... ............ A Repair eyelid defect ...................................... 9.60 NA NA 6.58 5.74 0.60 NA NA 16.78 15.94 09067903 ......... ............ A Repair eyelid defect ...................................... 6.36 6.82 8.88 4.48 5.25 0.47 13.65 15.7111.31 12.08 09067904 ......... ............ A Repair eyelid defect ...................................... 7.75 8.47 9.34 5.54 5.31 0.41 16.63 17.5013.70 13.47 09067906 ......... ............ A Repair eyelid defect ...................................... 6.78 NA NA 4.63 4.93 0.46 NA NA 11.87 12.17 09067908 ......... ............ A Repair eyelid defect ...................................... 5.12 5.71 6.40 4.25 5.07 0.28 11.11 11.809.65 10.47 09067909 ......... ............ A Revise eyelid defect ...................................... 5.39 6.39 7.62 4.31 4.79 0.31 12.09 13.3210.01 10.49 09067911 ......... ............ A Revise eyelid defect ...................................... 7.30 NA NA 5.21 4.89 0.31 NA NA 12.82 12.50 09067912 ......... ............ 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 09067914 ......... ............ A Repair eyelid defect ...................................... 3.67 4.88 5.98 2.76 2.98 0.19 8.74 9.84 6.62 6.84 09067915 ......... ............ A Repair eyelid defect ...................................... 3.18 4.54 5.62 2.57 2.74 0.16 7.88 8.96 5.91 6.08 09067916 ......... ............ A Repair eyelid defect ...................................... 5.30 6.53 7.67 4.26 4.64 0.28 12.11 13.259.84 10.22 09067917 ......... ............ A Repair eyelid defect ...................................... 6.01 6.91 8.07 4.54 4.94 0.36 13.28 14.4410.91 11.31 09067921 ......... ............ A Repair eyelid defect ...................................... 3.39 4.75 5.83 2.64 2.83 0.17 8.31 9.39 6.20 6.39 09067922 ......... ............ A Repair eyelid defect ...................................... 3.06 4.44 5.54 2.51 2.69 0.15 7.65 8.75 5.72 5.90 09067923 ......... ............ A Repair eyelid defect ...................................... 5.87 6.63 7.75 4.46 4.84 0.30 12.80 13.9210.63 11.01 09067924 ......... ............ A Repair eyelid defect ...................................... 5.78 7.11 8.47 4.19 4.56 0.30 13.19 14.5510.27 10.64 09067930 ......... ............ A Repair eyelid wound ...................................... 3.60 4.50 5.41 1.85 2.09 0.19 8.29 9.20 5.64 5.88 01067935 ......... ............ A Repair eyelid wound ...................................... 6.21 6.95 8.13 3.70 4.23 0.39 13.55 14.7310.30 10.83 09067938 ......... ............ 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 01067950 ......... ............ A Revision of eyelid .......................................... 5.81 6.80 8.17 4.47 5.03 0.36 12.97 14.34 10.64 11.20 09067961 ......... ............ A Revision of eyelid .......................................... 5.68 7.00 8.26 4.43 4.88 0.33 13.01 14.27 10.44 10.89 09067966 ......... ............ A Revision of eyelid .......................................... 8.75 8.29 8.92 5.93 5.65 0.37 17.41 18.04 15.05 14.77 09067971 ......... ............ A Reconstruction of eyelid ................................ 9.78 NA NA 6.40 7.06 0.53 NA NA 16.71 17.3709067973 ......... ............ A Reconstruction of eyelid ................................ 12.85 NA NA 8.02 8.99 0.75 NA NA 21.62 22.59 09067974 ......... ............ A Reconstruction of eyelid ................................ 12.82 NA NA 8.04 8.93 0.75 NA NA 21.61 22.50 09067975 ......... ............ A Reconstruction of eyelid ................................ 9.12 NA NA 6.16 6.75 0.50 NA NA 15.78 16.3709067999 ......... ............ C Revision of eyelid .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 YYY68020 ......... ............ 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 01068040 ......... ............ A Treatment of eyelid lesions ........................... 0.85 0.62 0.69 0.37 0.42 0.04 1.51 1.58 1.261.31 00068100 ......... ............ 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 00068110 ......... ............ 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 01068115 ......... ............ 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 01068130 ......... ............ A Remove eyelid lining lesion .......................... 4.92 6.84 8.24 4.16 4.49 0.24 12.00 13.40 9.329.65 09068135 ......... ............ 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 01068200 ......... ............ 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 00068320 ......... ............ A Revise/graft eyelid lining ............................... 6.36 9.42 10.82 5.47 5.51 0.27 16.05 17.4512.10 12.14 09068325 ......... ............ A Revise/graft eyelid lining ............................... 8.35 NA NA 6.16 6.45 0.44 NA NA 14.95 15.24 09068326 ......... ............ A Revise/graft eyelid lining ............................... 8.14 NA NA 6.12 6.34 0.35 NA NA 14.61 14.83 09068328 ......... ............ A Revise/graft eyelid lining ............................... 9.17 NA NA 6.66 7.13 0.54 NA NA 16.37 16.84 09068330 ......... ............ A Revise eyelid lining ....................................... 5.57 7.64 8.97 4.59 4.69 0.24 13.45 14.78 10.40 10.50 09068335 ......... ............ A Revise/graft eyelid lining ............................... 8.18 NA NA 6.13 6.32 0.36 NA NA 14.67 14.86 09068340 ......... ............ A Separate eyelid adhesions ............................ 4.79 7.07 8.42 3.99 4.07 0.21 12.07 13.42 8.999.07 09068360 ......... ............ A Revise eyelid lining ....................................... 4.99 6.60 7.68 4.07 4.15 0.22 11.81 12.89 9.28 9.36 09068362 ......... ............ A Revise eyelid lining ....................................... 8.33 NA NA 6.18 6.35 0.36 NA NA 14.87 15.04 09068371 ......... ............ 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 0.000.00 0.00 YYY



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# 49175 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules68400 ......... ............ 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 01068420 ......... ............ A Incise/drain tear sac ...................................... 2.30 4.70 5.82 1.46 1.94 0.11 7.11 8.233.87 4.35 01068440 ......... ............ 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 01068500 ......... ............ A Removal of tear gland ................................... 12.38 NA NA 8.97 9.54 0.55 NA NA 21.90 22.47 09068505 ......... ............ A Partial removal, tear gland ............................ 12.30 NA NA 9.11 10.27 0.55 NA NA 21.96 23.12 09068510 ......... ............ A Biopsy of tear gland ...................................... 4.60 5.37 6.84 2.11 2.10 0.23 10.20 11.676.94 6.93 00068520 ......... ............ A Removal of tear sac ...................................... 8.50 NA NA 6.68 7.24 0.37 NA NA 15.55 16.11 09068525 ......... ............ A Biopsy of tear sac ......................................... 4.42 NA NA 1.64 1.93 0.22 NA NA 6.28 6.57 00068530 ......... ............ 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 01068540 ......... ............ A Remove tear gland lesion ............................. 11.83 NA NA 8.71 9.22 0.52 NA NA 21.06 21.57 09068550 ......... ............ A Remove tear gland lesion ............................. 14.74 NA NA 10.52 11.14 0.80 NA NA 26.06 26.6809068700 ......... ............ A Repair tear ducts ........................................... 7.59 NA NA 5.74 5.92 0.32 NA NA 13.65 13.83 09068705 ......... ............ A Revise tear duct opening .............................. 2.06 3.12 3.91 1.63 1.75 0.10 5.28 6.07 3.793.91 01068720 ......... ............ A Create tear sac drain .................................... 9.70 NA NA 7.10 7.67 0.44 NA NA 17.24 17.81 09068745 ......... ............ A Create tear duct drain ................................... 9.62 NA NA 7.45 7.76 0.52 NA NA 17.59 17.90 09068750 ......... ............ A Create tear duct drain ................................... 9.78 NA NA 7.64 8.11 0.43 NA NA 17.85 18.32 09068760 ......... ............ A Close tear duct opening ................................ 1.73 2.66 3.32 1.50 1.60 0.09 4.48 5.14 3.323.42 01068761 ......... ............ A Close tear duct opening ................................ 1.36 1.88 2.17 1.28 1.31 0.06 3.30 3.59 2.702.73 01068770 ......... ............ A Close tear system fistula ............................... 8.01 NA NA 5.88 3.86 0.35 NA NA 14.24 12.2209068801 ......... ............ 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 01068810 ......... ............ A Probe nasolacrimal duct ................................ 2.59 3.49 3.62 2.76 2.69 0.10 6.18 6.31 5.455.38 01068811 ......... ............ A Probe nasolacrimal duct ................................ 2.35 NA NA 2.17 2.35 0.13 NA NA 4.65 4.83 01068815 ......... ............ A Probe nasolacrimal duct ................................ 3.20 6.57 7.82 2.49 2.73 0.17 9.94 11.19 5.86 6.10 01068840 ......... ............ 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 01068850 ......... ............ 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 00068899 ......... ............ 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 YYY69000 ......... ............ 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 01069005 ......... ............ 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 01069020 ......... ............ A Drain outer ear canal lesion .......................... 1.48 3.84 3.95 1.76 1.99 0.12 5.44 5.55 3.363.59 01069100 ......... ............ 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 00069105 ......... ............ 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 00069110 ......... ............ A Remove external ear, partial ......................... 3.43 7.50 6.93 4.23 4.41 0.30 11.23 10.66 7.968.14 09069120 ......... ............ A Removal of external ear ................................ 4.04 NA NA 5.09 5.91 0.38 NA NA 9.51 10.33 09069140 ......... ............ A Remove ear canal lesion(s) .......................... 7.96 NA NA 12.30 13.04 0.65 NA NA 20.91 21.65 09069145 ......... ............ 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 09069150 ......... ............ A Extensive ear canal surgery .......................... 13.41 NA NA 10.55 12.69 1.22 NA NA 25.18 27.3209069155 ......... ............ A Extensive ear/neck surgery ........................... 22.96 NA NA 15.01 18.41 1.92 NA NA 39.89 43.2909069200 ......... ............ 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 00069205 ......... ............ A Clear outer ear canal .................................... 1.20 NA NA 1.14 1.31 0.10 NA NA 2.44 2.6101069210 ......... ............ A Remove impacted ear wax ........................... 0.61 0.55 0.61 0.16 0.21 0.05 1.21 1.27 0.82 0.8700069220 ......... ............ A Clean out mastoid cavity ............................... 0.83 2.37 2.36 0.61 0.70 0.07 3.27 3.26 1.511.60 00069222 ......... ............ A Clean out mastoid cavity ............................... 1.40 3.66 3.80 1.73 1.98 0.12 5.18 5.32 3.253.50 01069300 ......... ............ R Revise external ear ....................................... 6.35 9.61 5.57 4.51 4.29 0.72 16.68 12.6411.58 11.36 YYY69310 ......... ............ A Rebuild outer ear canal ................................. 10.77 NA NA 14.19 15.76 0.85 NA NA 25.81 27.38 09069320 ......... ............ A Rebuild outer ear canal ................................. 16.93 NA NA 18.16 20.92 1.37 NA NA 36.46 39.22 09069399 ......... ............ 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 YYY69400 ......... ............ 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 00069401 ......... ............ 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 00069405 ......... ............ 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 01069420 ......... ............ A Incision of eardrum ........................................ 1.33 3.05 3.13 1.41 1.55 0.11 4.49 4.572.85 2.99 01069421 ......... ............ A Incision of eardrum ........................................ 1.73 NA NA 1.68 2.04 0.15 NA NA 3.56 3.92 01069424 ......... ............ A Remove ventilating tube ................................ 0.85 2.18 2.18 0.62 0.67 0.07 3.10 3.10 1.541.59 00069433 ......... ............ A Create eardrum opening ............................... 1.52 3.06 3.08 1.44 1.59 0.13 4.71 4.73 3.09 3.24 01069436 ......... ............ A Create eardrum opening ............................... 1.96 NA NA 1.72 2.15 0.19 NA NA 3.87 4.30 01069440 ......... ............ A Exploration of middle ear .............................. 7.56 NA NA 8.31 8.66 0.61 NA NA 16.48 16.8309069450 ......... ............ A Eardrum revision ........................................... 5.56 NA NA 6.96 7.01 0.45 NA NA 12.97 13.02 09069501 ......... ............ A Mastoidectomy .............................................. 9.06 NA NA 7.80 8.70 0.73 NA NA 17.59 18.49 09069502 ......... ............ A Mastoidectomy .............................................. 12.36 NA NA 10.02 11.20 1.00 NA NA 23.3824.56 09069505 ......... ............ A Remove mastoid structures .......................... 12.97 NA NA 14.81 16.60 1.05 NA NA 28.83 30.62 09069511 ......... ............ A Extensive mastoid surgery ............................ 13.50 NA NA 14.89 16.83 1.09 NA NA 29.48 31.4209069530 ......... ............ A Extensive mastoid surgery ............................ 20.15 NA NA 17.97 20.72 1.54 NA NA 39.66 42.4109069535 ......... ............ 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 01069550 ......... ............ A Remove ear lesion ........................................ 10.97 NA NA 13.06 14.41 0.89 NA NA 24.92 26.27 09069552 ......... ............ A Remove ear lesion ........................................ 19.61 NA NA 16.55 19.64 1.59 NA NA 37.75 40.84 09069554 ......... ............ A Remove ear lesion ........................................ 35.63 NA NA 22.41 28.35 2.91 NA NA 60.95 66.89 090



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00195 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49176 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal69601 ......... ............ A Mastoid surgery revision ............................... 13.22 NA NA 10.84 12.21 1.07 NA NA 25.13 26.50 09069602 ......... ............ A Mastoid surgery revision ............................... 13.56 NA NA 11.56 12.81 1.10 NA NA 26.22 27.47 09069603 ......... ............ A Mastoid surgery revision ............................... 14.00 NA NA 15.03 17.53 1.14 NA NA 30.17 32.67 09069604 ......... ............ A Mastoid surgery revision ............................... 14.00 NA NA 11.67 13.19 1.14 NA NA 26.81 28.33 09069605 ......... ............ A Mastoid surgery revision ............................... 18.46 NA NA 17.50 20.09 1.50 NA NA 37.46 40.05 09069610 ......... ............ A Repair of eardrum ......................................... 4.42 4.47 5.28 2.30 3.03 0.36 9.25 10.067.08 7.81 01069620 ......... ............ A Repair of eardrum ......................................... 5.88 10.04 10.85 5.29 6.04 0.48 16.40 17.21 11.65 12.40 09069631 ......... ............ A Repair eardrum structures ............................ 9.85 NA NA 10.50 11.03 0.80 NA NA 21.15 21.6809069632 ......... ............ A Rebuild eardrum structures ........................... 12.73 NA NA 12.08 13.12 1.03 NA NA 25.84 26.8809069633 ......... ............ A Rebuild eardrum structures ........................... 12.08 NA NA 11.91 12.77 0.98 NA NA 24.97 25.8309069635 ......... ............ A Repair eardrum structures ............................ 13.31 NA NA 14.83 16.26 1.08 NA NA 29.22 30.6509069636 ......... ............ A Rebuild eardrum structures ........................... 15.20 NA NA 16.60 18.63 1.23 NA NA 33.03 35.0609069637 ......... ............ A Rebuild eardrum structures ........................... 15.09 NA NA 16.58 18.56 1.22 NA NA 32.89 34.8709069641 ......... ............ A Revise middle ear & mastoid ........................ 12.69 NA NA 11.31 12.41 1.03 NA NA 25.03 26.13 09069642 ......... ............ A Revise middle ear & mastoid ........................ 16.81 NA NA 14.05 15.72 1.36 NA NA 32.22 33.89 09069643 ......... ............ A Revise middle ear & mastoid ........................ 15.36 NA NA 12.81 14.32 1.24 NA NA 29.41 30.92 09069644 ......... ............ A Revise middle ear & mastoid ........................ 17.00 NA NA 17.09 19.57 1.37 NA NA 35.46 37.94 09069645 ......... ............ A Revise middle ear & mastoid ........................ 16.48 NA NA 17.01 19.27 1.33 NA NA 34.82 37.08 09069646 ......... ............ A Revise middle ear & mastoid ........................ 18.14 NA NA 17.42 19.93 1.46 NA NA 37.02 39.53 09069650 ......... ............ A Release middle ear bone .............................. 9.65 NA NA 8.64 9.59 0.78 NA NA 19.07 20.02 09069660 ......... ............ A Revise middle ear bone ................................ 11.88 NA NA 9.52 10.77 0.96 NA NA 22.36 23.6109069661 ......... ............ A Revise middle ear bone ................................ 15.72 NA NA 12.17 14.07 1.27 NA NA 29.16 31.06 09069662 ......... ............ A Revise middle ear bone ................................ 15.42 NA NA 11.29 13.14 1.25 NA NA 27.96 29.81 09069666 ......... ............ A Repair middle ear structures ......................... 9.74 NA NA 8.92 9.71 0.79 NA NA 19.45 20.24 09069667 ......... ............ A Repair middle ear structures ......................... 9.75 NA NA 8.83 9.69 0.79 NA NA 19.37 20.23 09069670 ......... ............ A Remove mastoid air cells .............................. 11.55 NA NA 10.15 11.32 0.93 NA NA 22.63 23.80 09069676 ......... ............ A Remove middle ear nerve ............................. 9.51 NA NA 9.63 10.47 0.81 NA NA 19.95 20.79 09069700 ......... ............ A Close mastoid fistula ..................................... 8.22 NA NA 7.65 8.84 0.67 NA NA 16.54 17.73 09069711 ......... ............ A Remove/repair hearing aid ............................ 10.42 NA NA 9.42 10.45 0.83 NA NA 20.67 21.7009069714 ......... ............ A Implant temple bone w/stimul ....................... 14.23 NA NA 10.56 12.14 1.13 NA NA 25.92 27.50 09069715 ......... ............ A Temple bne implnt w/stimulat ....................... 18.72 NA NA 11.94 14.26 1.48 NA NA 32.14 34.46 09069717 ......... ............ A Temple bone implant revision ....................... 15.21 NA NA 11.31 13.68 0.90 NA NA 27.42 29.79 09069718 ......... ............ A Revise temple bone implant .......................... 18.97 NA NA 20.26 16.54 3.21 NA NA 42.44 38.7209069720 ......... ............ A Release facial nerve ...................................... 14.48 NA NA 12.75 14.08 1.16 NA NA 28.3929.72 09069725 ......... ............ A Release facial nerve ...................................... 27.36 NA NA 16.30 19.17 2.44 NA NA 46.1048.97 09069740 ......... ............ A Repair facial nerve ........................................ 16.12 NA NA 11.17 12.85 1.27 NA NA 28.5630.24 09069745 ......... ............ A Repair facial nerve ........................................ 16.84 NA NA 11.87 14.20 1.14 NA NA 29.8532.18 09069799 ......... ............ 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 YYY69801 ......... ............ A Incise inner ear .............................................. 8.55 NA NA 8.75 9.28 0.69 NA NA 17.9918.52 09069802 ......... ............ A Incise inner ear .............................................. 13.32 NA NA 10.54 11.88 1.06 NA NA 24.92 26.26 09069805 ......... ............ A Explore inner ear ........................................... 14.49 NA NA 9.80 11.36 1.12 NA NA 25.4126.97 09069806 ......... ............ A Explore inner ear ........................................... 12.45 NA NA 9.37 10.62 1.00 NA NA 22.8224.07 09069820 ......... ............ A Establish inner ear window ........................... 10.32 NA NA 9.83 10.87 0.90 NA NA 21.05 22.0909069840 ......... ............ A Revise inner ear window ............................... 10.24 NA NA 11.67 12.80 0.79 NA NA 22.70 23.83 09069905 ......... ............ A Remove inner ear .......................................... 11.08 NA NA 10.08 11.03 0.90 NA NA 22.0623.01 09069910 ......... ............ 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 09069930 ......... ............ A Implant cochlear device ................................ 17.54 NA NA 11.81 14.02 1.36 NA NA 30.71 32.92 09069949 ......... ............ 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 YYY69950 ......... ............ A Incise inner ear nerve ................................... 27.38 NA NA 15.12 17.96 2.28 NA NA 44.78 47.62 09069955 ......... ............ A Release facial nerve ...................................... 29.14 NA NA 17.30 20.36 2.48 NA NA 48.9251.98 09069960 ......... ............ A Release inner ear canal ................................ 29.14 NA NA 15.41 18.89 2.17 NA NA 46.72 50.20 09069970 ......... ............ A Remove inner ear lesion ............................... 32.13 NA NA 17.78 21.90 2.41 NA NA 52.32 56.44 09069979 ......... ............ C Temporal bone surgery ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 YYY69990 ......... ............ R Microsurgery add-on ..................................... 3.46 NA NA 1.29 1.67 0.89 NA NA 5.64 6.02 ZZZ70010 ......... ............ A Contrast x-ray of brain .................................. 1.19 2.77 4.23 NA NA 0.27 4.23 5.69 NA NAXXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00196 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49177 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules70010 ......... 26 ....... A Contrast x-ray of brain .................................. 1.19 0.37 0.39 0.37 0.39 0.05 1.61 1.63 1.611.63 XXX70010 ......... TC ...... A Contrast x-ray of brain .................................. 0.00 2.40 3.85 NA NA 0.22 2.62 4.07 NA NA XXX70015 ......... ............ A Contrast x-ray of brain .................................. 1.19 2.85 2.01 NA NA 0.16 4.20 3.36 NA NAXXX70015 ......... 26 ....... A Contrast x-ray of brain .................................. 1.19 0.38 0.39 0.38 0.39 0.08 1.65 1.66 1.651.66 XXX70015 ......... TC ...... A Contrast x-ray of brain .................................. 0.00 2.47 1.63 NA NA 0.08 2.55 1.71 NA NA XXX70030 ......... ............ 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 XXX70030 ......... TC ...... A X-ray eye for foreign body ............................ 0.00 0.55 0.45 NA NA 0.02 0.57 0.47 NA NA XXX70100 ......... ............ A X-ray exam of jaw ......................................... 0.18 0.63 0.59 NA NA 0.03 0.84 0.80 NA NAXXX70100 ......... 26 ....... A X-ray exam of jaw ......................................... 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.240.25 XXX70100 ......... 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 NAXXX70110 ......... 26 ....... A X-ray exam of jaw ......................................... 0.25 0.08 0.08 0.08 0.08 0.01 0.34 0.34 0.340.34 XXX70110 ......... 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 XXX70120 ......... TC ...... A X-ray exam of mastoids ................................ 0.00 0.64 0.63 NA NA 0.04 0.68 0.67 NA NA XXX70130 ......... ............ 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 XXX70130 ......... TC ...... A X-ray exam of mastoids ................................ 0.00 1.06 0.85 NA NA 0.05 1.11 0.90 NA NA XXX70134 ......... ............ 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 XXX70134 ......... TC ...... A X-ray exam of middle ear .............................. 0.00 0.82 0.75 NA NA 0.05 0.87 0.80 NA NA XXX70140 ......... ............ A X-ray exam of facial bones ........................... 0.19 0.55 0.65 NA NA 0.05 0.79 0.89 NA NA XXX70140 ......... 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 0.26XXX70140 ......... TC ...... A X-ray exam of facial bones ........................... 0.00 0.50 0.59 NA NA 0.04 0.54 0.63 NA NA XXX70150 ......... ............ A X-ray exam of facial bones ........................... 0.26 0.85 0.86 NA NA 0.06 1.17 1.18 NA NA XXX70150 ......... 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 0.35XXX70150 ......... TC ...... A X-ray exam of facial bones ........................... 0.00 0.77 0.78 NA NA 0.05 0.82 0.83 NA NA XXX70160 ......... ............ A X-ray exam of nasal bones ........................... 0.17 0.70 0.61 NA NA 0.03 0.90 0.81 NA NA XXX70160 ......... 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 0.24XXX70160 ......... TC ...... A X-ray exam of nasal bones ........................... 0.00 0.65 0.55 NA NA 0.02 0.67 0.57 NA NA XXX70170 ......... ............ A X-ray exam of tear duct ................................ 0.30 NA NA NA NA 0.07 NA NA NA NA XXX70170 ......... 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 XXX70170 ......... TC ...... A X-ray exam of tear duct ................................ 0.00 NA NA NA NA 0.06 NA NA NA NA XXX70190 ......... ............ A X-ray exam of eye sockets ........................... 0.21 0.72 0.70 NA NA 0.05 0.98 0.96 NA NA XXX70190 ......... 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 0.29XXX70190 ......... TC ...... A X-ray exam of eye sockets ........................... 0.00 0.66 0.63 NA NA 0.04 0.70 0.67 NA NA XXX70200 ......... ............ A X-ray exam of eye sockets ........................... 0.28 0.87 0.87 NA NA 0.06 1.21 1.21 NA NA XXX70200 ......... 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 0.38XXX70200 ......... TC ...... A X-ray exam of eye sockets ........................... 0.00 0.79 0.78 NA NA 0.05 0.84 0.83 NA NA XXX70210 ......... ............ A X-ray exam of sinuses .................................. 0.17 0.57 0.65 NA NA 0.05 0.79 0.87 NA NA XXX70210 ......... 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 XXX70210 ......... TC ...... A X-ray exam of sinuses .................................. 0.00 0.52 0.60 NA NA 0.04 0.56 0.64 NA NA XXX70220 ......... ............ A X-ray exam of sinuses .................................. 0.25 0.72 0.83 NA NA 0.06 1.03 1.14 NA NA XXX70220 ......... 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 XXX70220 ......... TC ...... A X-ray exam of sinuses .................................. 0.00 0.65 0.75 NA NA 0.05 0.70 0.80 NA NA XXX70240 ......... ............ A X-ray exam, pituitary saddle ......................... 0.19 0.61 0.51 NA NA 0.03 0.83 0.73 NA NA XXX70240 ......... 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 0.26XXX70240 ......... TC ...... A X-ray exam, pituitary saddle ......................... 0.00 0.55 0.45 NA NA 0.02 0.57 0.47 NA NA XXX70250 ......... ............ A X-ray exam of skull ....................................... 0.24 0.70 0.70 NA NA 0.05 0.99 0.99 NA NAXXX70250 ......... 26 ....... A X-ray exam of skull ....................................... 0.24 0.07 0.08 0.07 0.08 0.01 0.32 0.33 0.320.33 XXX70250 ......... 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 NAXXX70260 ......... 26 ....... A X-ray exam of skull ....................................... 0.34 0.10 0.11 0.10 0.11 0.02 0.46 0.47 0.460.47 XXX70260 ......... 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 NAXXX70300 ......... 26 ....... A X-ray exam of teeth ....................................... 0.10 0.03 0.05 0.03 0.05 0.01 0.14 0.16 0.140.16 XXX70300 ......... 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 NAXXX70310 ......... 26 ....... A X-ray exam of teeth ....................................... 0.16 0.05 0.07 0.05 0.07 0.01 0.22 0.24 0.220.24 XXX70310 ......... 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 XXX70320 ......... 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 XXX70320 ......... TC ...... A Full mouth x-ray of teeth ............................... 0.00 0.91 0.81 NA NA 0.05 0.96 0.86 NA NA XXX70328 ......... ............ A X-ray exam of jaw joint ................................. 0.18 0.62 0.57 NA NA 0.03 0.83 0.78 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00197 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49178 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal70328 ......... 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 XXX70328 ......... TC ...... A X-ray exam of jaw joint ................................. 0.00 0.57 0.51 NA NA 0.02 0.59 0.53 NA NA XXX70330 ......... ............ A X-ray exam of jaw joints ................................ 0.24 1.01 0.94 NA NA 0.06 1.31 1.24 NA NA XXX70330 ......... 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 XXX70330 ......... TC ...... A X-ray exam of jaw joints ................................ 0.00 0.94 0.87 NA NA 0.05 0.99 0.92 NA NA XXX70332 ......... ............ A X-ray exam of jaw joint ................................. 0.54 1.46 2.09 NA NA 0.14 2.14 2.77 NA NA XXX70332 ......... 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 XXX70332 ......... TC ...... A X-ray exam of jaw joint ................................. 0.00 1.30 1.90 NA NA 0.12 1.42 2.02 NA NA XXX70336 ......... ............ A Magnetic image, jaw joint .............................. 1.48 12.60 11.92 NA NA 0.66 14.74 14.06 NA NA XXX70336 ......... 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 XXX70336 ......... TC ...... A Magnetic image, jaw joint .............................. 0.00 12.10 11.43 NA NA 0.59 12.69 12.02 NA NA XXX70350 ......... ............ 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 XXX70350 ......... TC ...... A X-ray head for orthodontia ............................ 0.00 0.27 0.35 NA NA 0.02 0.29 0.37 NA NA XXX70355 ......... ............ A Panoramic x-ray of jaws ................................ 0.20 0.30 0.56 NA NA 0.05 0.55 0.81 NA NA XXX70355 ......... 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 XXX70355 ......... TC ...... A Panoramic x-ray of jaws ................................ 0.00 0.24 0.49 NA NA 0.04 0.28 0.53 NA NA XXX70360 ......... ............ A X-ray exam of neck ....................................... 0.17 0.58 0.51 NA NA 0.03 0.78 0.71 NA NAXXX70360 ......... 26 ....... A X-ray exam of neck ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.230.24 XXX70360 ......... TC ...... A X-ray exam of neck ....................................... 0.00 0.52 0.45 NA NA 0.02 0.54 0.47 NA NA XXX70370 ......... ............ 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 XXX70370 ......... TC ...... A Throat x-ray & fluoroscopy ............................ 0.00 1.56 1.37 NA NA 0.07 1.63 1.44 NA NA XXX70371 ......... ............ A Speech evaluation, complex ......................... 0.84 1.50 2.16 NA NA 0.16 2.50 3.16 NA NA XXX70371 ......... 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 XXX70371 ......... TC ...... A Speech evaluation, complex ......................... 0.00 1.24 1.89 NA NA 0.12 1.36 2.01 NA NA XXX70373 ......... ............ A Contrast x-ray of larynx ................................. 0.44 1.71 1.87 NA NA 0.13 2.28 2.44 NA NAXXX70373 ......... 26 ....... A Contrast x-ray of larynx ................................. 0.44 0.13 0.14 0.13 0.14 0.02 0.59 0.60 0.590.60 XXX70373 ......... TC ...... A Contrast x-ray of larynx ................................. 0.00 1.58 1.73 NA NA 0.11 1.69 1.84 NA NA XXX70380 ......... ............ A X-ray exam of salivary gland ........................ 0.17 0.82 0.75 NA NA 0.05 1.04 0.97 NA NA XXX70380 ......... 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 0.24XXX70380 ......... TC ...... A X-ray exam of salivary gland ........................ 0.00 0.76 0.69 NA NA 0.04 0.80 0.73 NA NA XXX70390 ......... ............ A X-ray exam of salivary duct .......................... 0.38 2.34 2.01 NA NA 0.13 2.85 2.52 NA NA XXX70390 ......... 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 0.52XXX70390 ......... TC ...... A X-ray exam of salivary duct .......................... 0.00 2.22 1.89 NA NA 0.11 2.33 2.00 NA NA XXX70450 ......... ............ A Ct head/brain w/o dye ................................... 0.85 4.90 4.98 NA NA 0.29 6.04 6.12 NA NA XXX70450 ......... 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 XXX70450 ......... TC ...... A Ct head/brain w/o dye ................................... 0.00 4.64 4.70 NA NA 0.25 4.89 4.95 NA NA XXX70460 ......... ............ A Ct head/brain w/dye ...................................... 1.13 6.52 6.15 NA NA 0.35 8.00 7.63 NA NAXXX70460 ......... 26 ....... A Ct head/brain w/dye ...................................... 1.13 0.36 0.37 0.36 0.37 0.05 1.54 1.55 1.541.55 XXX70460 ......... TC ...... A Ct head/brain w/dye ...................................... 0.00 6.16 5.79 NA NA 0.30 6.46 6.09 NA NA XXX70470 ......... ............ A Ct head/brain w/o & w/dye ............................ 1.27 7.96 7.61 NA NA 0.43 9.66 9.31 NA NA XXX70470 ......... 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 1.75XXX70470 ......... 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 XXX70480 ......... ............ A Ct orbit/ear/fossa w/o dye ............................. 1.28 8.52 5.99 NA NA 0.31 10.11 7.58 NA NA XXX70480 ......... 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 XXX70480 ......... 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 XXX70481 ......... ............ A Ct orbit/ear/fossa w/dye ................................ 1.38 10.04 7.09 NA NA 0.36 11.78 8.83 NA NAXXX70481 ......... 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 XXX70481 ......... TC ...... A Ct orbit/ear/fossa w/dye ................................ 0.00 9.60 6.65 NA NA 0.30 9.90 6.95 NA NA XXX70482 ......... ............ 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 XXX70482 ......... 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 1.99XXX70482 ......... 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 XXX70486 ......... ............ A Ct maxillofacial w/o dye ................................ 1.14 6.81 5.52 NA NA 0.30 8.25 6.96 NA NA XXX70486 ......... 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 XXX70486 ......... TC ...... A Ct maxillofacial w/o dye ................................ 0.00 6.44 5.15 NA NA 0.25 6.69 5.40 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00198 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49179 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules70487 ......... ............ A Ct maxillofacial w/dye .................................... 1.30 8.39 6.67 NA NA 0.36 10.05 8.33 NA NA XXX70487 ......... 26 ....... A Ct maxillofacial w/dye .................................... 1.30 0.42 0.43 0.42 0.43 0.06 1.78 1.79 1.781.79 XXX70487 ......... 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 XXX70488 ......... 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 1.94XXX70488 ......... TC ...... A Ct maxillofacial w/o & w/dye ......................... 0.00 10.03 7.81 NA NA 0.37 10.40 8.18 NA NA XXX70490 ......... ............ 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 XXX70490 ......... 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 XXX70491 ......... ............ A Ct soft tissue neck w/dye .............................. 1.38 8.06 6.60 NA NA 0.36 9.80 8.34 NA NA XXX70491 ......... 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 XXX70491 ......... TC ...... A Ct soft tissue neck w/dye .............................. 0.00 7.62 6.15 NA NA 0.30 7.92 6.45 NA NA XXX70492 ......... ............ 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 XXX70492 ......... 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 1.98XXX70492 ......... 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 XXX70496 ......... ............ A Ct angiography, head .................................... 1.75 17.16 12.67 NA NA 0.66 19.57 15.08 NANA XXX70496 ......... 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 XXX70496 ......... TC ...... A Ct angiography, head .................................... 0.00 16.59 12.10 NA NA 0.58 17.17 12.68 NA NA XXX70498 ......... ............ A Ct angiography, neck .................................... 1.75 17.26 12.69 NA NA 0.66 19.67 15.10 NANA XXX70498 ......... 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 XXX70498 ......... TC ...... A Ct angiography, neck .................................... 0.00 16.68 12.12 NA NA 0.58 17.26 12.70 NA NA XXX70540 ......... ............ A Mri orbit/face/neck w/o dye ........................... 1.35 14.58 12.38 NA NA 0.45 16.38 14.18 NA NAXXX70540 ......... 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 XXX70540 ......... 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 XXX70542 ......... 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 XXX70542 ......... TC ...... A Mri orbit/face/neck w/dye .............................. 0.00 15.00 13.83 NA NA 0.47 15.47 14.30 NA NA XXX70543 ......... ............ A Mri orbt/fac/nck w/o & w/dye ......................... 2.15 19.26 24.01 NA NA 0.94 22.35 27.10 NA NAXXX70543 ......... 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 2.96XXX70543 ......... 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 XXX70544 ......... ............ A Mr angiography head w/o dye ...................... 1.20 16.05 12.71 NA NA 0.64 17.89 14.55 NA NA XXX70544 ......... 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 XXX70545 ......... ............ A Mr angiography head w/dye .......................... 1.20 15.97 12.69 NA NA 0.64 17.81 14.53 NA NA XXX70545 ......... 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 XXX70545 ......... TC ...... A Mr angiography head w/dye .......................... 0.00 15.59 12.30 NA NA 0.59 16.18 12.89 NA NA XXX70546 ......... ............ A Mr angiograph head w/o&w/dye ................... 1.80 24.49 23.37 NA NA 0.67 26.96 25.84 NA NA XXX70546 ......... 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 XXX70546 ......... 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 XXX70547 ......... ............ 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 XXX70547 ......... TC ...... A Mr angiography neck w/o dye ....................... 0.00 15.70 12.33 NA NA 0.59 16.29 12.92 NA NA XXX70548 ......... ............ A Mr angiography neck w/dye .......................... 1.20 16.79 12.89 NA NA 0.64 18.63 14.73 NA NA XXX70548 ......... 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 XXX70548 ......... TC ...... A Mr angiography neck w/dye .......................... 0.00 16.41 12.50 NA NA 0.59 17.00 13.09 NA NA XXX70549 ......... ............ A Mr angiograph neck w/o&w/dye .................... 1.80 24.41 23.35 NA NA 0.67 26.88 25.82 NA NA XXX70549 ......... 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 XXX70549 ......... 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 XXX70551 ......... ............ A Mri brain w/o dye ........................................... 1.48 14.69 12.44 NA NA 0.66 16.83 14.58NA NA XXX70551 ......... 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 XXX70551 ......... TC ...... A Mri brain w/o dye ........................................... 0.00 14.22 11.96 NA NA 0.59 14.81 12.55 NANA XXX70552 ......... ............ A Mri brain w/dye .............................................. 1.78 15.73 14.46 NA NA 0.78 18.29 17.02 NA NA XXX70552 ......... 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 XXX70552 ......... TC ...... A Mri brain w/dye .............................................. 0.00 15.16 13.87 NA NA 0.70 15.86 14.57 NANA XXX70553 ......... ............ A Mri brain w/o & w/dye ................................... 2.36 18.37 23.84 NA NA 1.41 22.14 27.61 NANA XXX70553 ......... 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 XXX70553 ......... TC ...... A Mri brain w/o & w/dye ................................... 0.00 17.61 23.06 NA NA 1.31 18.92 24.37 NA NA XXX70557 ......... ............ C Mri brain w/o dye ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX70557 ......... 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 XXX70557 ......... 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 XXX70558 ......... ............ 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 XXX70558 ......... 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 XXX70558 ......... 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 XXX70559 ......... ............ 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 XXX70559 ......... 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 XXX70559 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00199 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49180 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal71010 ......... ............ A Chest x-ray .................................................... 0.18 0.43 0.51 NA NA 0.03 0.64 0.72NA NA XXX71010 ......... 26 ....... A Chest x-ray .................................................... 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.250.24 0.25 XXX71010 ......... TC ...... A Chest x-ray .................................................... 0.00 0.37 0.45 NA NA 0.02 0.39 0.47 NA NA XXX71015 ......... ............ A Chest x-ray .................................................... 0.21 0.57 0.59 NA NA 0.03 0.81 0.83NA NA XXX71015 ......... 26 ....... A Chest x-ray .................................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.290.29 0.29 XXX71015 ......... TC ...... A Chest x-ray .................................................... 0.00 0.51 0.52 NA NA 0.02 0.53 0.54 NA NA XXX71020 ......... ............ A Chest x-ray .................................................... 0.22 0.57 0.66 NA NA 0.05 0.84 0.93NA NA XXX71020 ......... 26 ....... A Chest x-ray .................................................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.300.30 0.30 XXX71020 ......... TC ...... A Chest x-ray .................................................... 0.00 0.50 0.59 NA NA 0.04 0.54 0.63 NA NA XXX71021 ......... ............ A Chest x-ray .................................................... 0.27 0.71 0.79 NA NA 0.06 1.04 1.12NA NA XXX71021 ......... 26 ....... A Chest x-ray .................................................... 0.27 0.08 0.09 0.08 0.09 0.01 0.36 0.370.36 0.37 XXX71021 ......... TC ...... A Chest x-ray .................................................... 0.00 0.63 0.71 NA NA 0.05 0.68 0.76 NA NA XXX71022 ......... ............ A Chest x-ray .................................................... 0.31 0.89 0.85 NA NA 0.06 1.26 1.22NA NA XXX71022 ......... 26 ....... A Chest x-ray .................................................... 0.31 0.09 0.10 0.09 0.10 0.01 0.41 0.420.41 0.42 XXX71022 ......... TC ...... A Chest x-ray .................................................... 0.00 0.80 0.75 NA NA 0.05 0.85 0.80 NA NA XXX71023 ......... ............ A Chest x-ray and fluoroscopy ......................... 0.38 1.57 1.08 NA NA 0.06 2.01 1.52 NA NA XXX71023 ......... 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 0.52XXX71023 ......... TC ...... A Chest x-ray and fluoroscopy ......................... 0.00 1.42 0.94 NA NA 0.05 1.47 0.99 NA NA XXX71030 ......... ............ A Chest x-ray .................................................... 0.31 0.91 0.89 NA NA 0.06 1.28 1.26NA NA XXX71030 ......... 26 ....... A Chest x-ray .................................................... 0.31 0.09 0.10 0.09 0.10 0.01 0.41 0.420.41 0.42 XXX71030 ......... TC ...... A Chest x-ray .................................................... 0.00 0.82 0.79 NA NA 0.05 0.87 0.84 NA NA XXX71034 ......... ............ A Chest x-ray and fluoroscopy ......................... 0.46 2.04 1.71 NA NA 0.10 2.60 2.27 NA NA XXX71034 ......... 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 0.65XXX71034 ......... TC ...... A Chest x-ray and fluoroscopy ......................... 0.00 1.86 1.55 NA NA 0.08 1.94 1.63 NA NA XXX71035 ......... ............ A Chest x-ray .................................................... 0.18 0.77 0.63 NA NA 0.03 0.98 0.84NA NA XXX71035 ......... 26 ....... A Chest x-ray .................................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.250.25 0.25 XXX71035 ......... TC ...... A Chest x-ray .................................................... 0.00 0.72 0.57 NA NA 0.02 0.74 0.59 NA NA XXX71040 ......... ............ A Contrast x-ray of bronchi ............................... 0.58 2.08 1.76 NA NA 0.11 2.77 2.45 NA NA XXX71040 ......... 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 XXX71040 ......... TC ...... A Contrast x-ray of bronchi ............................... 0.00 1.92 1.58 NA NA 0.08 2.00 1.66 NA NA XXX71060 ......... ............ A Contrast x-ray of bronchi ............................... 0.74 3.07 2.60 NA NA 0.16 3.97 3.50 NA NA XXX71060 ......... 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 XXX71060 ......... TC ...... A Contrast x-ray of bronchi ............................... 0.00 2.84 2.36 NA NA 0.13 2.97 2.49 NA NA XXX71090 ......... ............ A X-ray & pacemaker insertion ......................... 0.54 NA NA NA NA 0.13 NA NA NA NA XXX71090 ......... 26 ....... A X-ray & pacemaker insertion ......................... 0.54 0.28 0.23 0.28 0.23 0.02 0.84 0.79 0.84 0.79XXX71090 ......... TC ...... A X-ray & pacemaker insertion ......................... 0.00 NA NA NA NA 0.11 NA NA NA NA XXX71100 ......... ............ A X-ray exam of ribs ......................................... 0.22 0.62 0.64 NA NA 0.05 0.89 0.91 NA NA XXX71100 ......... 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 XXX71100 ......... TC ...... A X-ray exam of ribs ......................................... 0.00 0.55 0.57 NA NA 0.04 0.59 0.61 NA NA XXX71101 ......... ............ A X-ray exam of ribs/chest ............................... 0.27 0.76 0.76 NA NA 0.05 1.08 1.08 NA NA XXX71101 ......... 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 XXX71101 ......... TC ...... A X-ray exam of ribs/chest ............................... 0.00 0.68 0.67 NA NA 0.04 0.72 0.71 NA NA XXX71110 ......... ............ A X-ray exam of ribs ......................................... 0.27 0.78 0.85 NA NA 0.06 1.11 1.18 NA NA XXX71110 ......... 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 XXX71110 ......... TC ...... A X-ray exam of ribs ......................................... 0.00 0.70 0.76 NA NA 0.05 0.75 0.81 NA NA XXX71111 ......... ............ A X-ray exam of ribs/chest ............................... 0.32 1.06 1.01 NA NA 0.07 1.45 1.40 NA NA XXX71111 ......... 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 XXX71111 ......... TC ...... A X-ray exam of ribs/chest ............................... 0.00 0.97 0.91 NA NA 0.06 1.03 0.97 NA NA XXX71120 ......... ............ A X-ray exam of breastbone ............................. 0.20 0.62 0.70 NA NA 0.05 0.87 0.95 NA NA XXX71120 ......... 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 0.28XXX71120 ......... TC ...... A X-ray exam of breastbone ............................. 0.00 0.56 0.63 NA NA 0.04 0.60 0.67 NA NA XXX71130 ......... ............ A X-ray exam of breastbone ............................. 0.22 0.75 0.77 NA NA 0.05 1.02 1.04 NA NA XXX71130 ......... 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 0.30XXX71130 ......... TC ...... A X-ray exam of breastbone ............................. 0.00 0.68 0.70 NA NA 0.04 0.72 0.74 NA NA XXX71250 ......... ............ A Ct thorax w/o dye .......................................... 1.16 6.47 6.34 NA NA 0.36 7.99 7.86 NA NA XXX71250 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00200 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49181 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules71250 ......... TC ...... A Ct thorax w/o dye .......................................... 0.00 6.10 5.96 NA NA 0.31 6.41 6.27 NA NA XXX71260 ......... ............ A Ct thorax w/dye ............................................. 1.24 8.01 7.61 NA NA 0.42 9.67 9.27 NANA XXX71260 ......... 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 XXX71260 ......... TC ...... A Ct thorax w/dye ............................................. 0.00 7.61 7.21 NA NA 0.37 7.98 7.58 NA NA XXX71270 ......... ............ A Ct thorax w/o & w/dye ................................... 1.38 10.15 9.51 NA NA 0.52 12.05 11.41 NA NA XXX71270 ......... 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 XXX71270 ......... TC ...... A Ct thorax w/o & w/dye ................................... 0.00 9.71 9.07 NA NA 0.46 10.17 9.53 NA NA XXX71275 ......... ............ A Ct angiography, chest ................................... 1.92 11.77 12.70 NA NA 0.48 14.17 15.10 NANA XXX71275 ......... 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 XXX71275 ......... TC ...... A Ct angiography, chest ................................... 0.00 11.14 12.07 NA NA 0.39 11.53 12.46 NA NA XXX71550 ......... ............ A Mri chest w/o dye .......................................... 1.46 16.75 12.95 NA NA 0.51 18.72 14.92NA NA XXX71550 ......... 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 XXX71550 ......... TC ...... A Mri chest w/o dye .......................................... 0.00 16.27 12.47 NA NA 0.45 16.72 12.92 NA NA XXX71551 ......... ............ A Mri chest w/dye ............................................. 1.73 18.16 15.05 NA NA 0.60 20.49 17.38NA NA XXX71551 ......... 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 XXX71551 ......... TC ...... A Mri chest w/dye ............................................. 0.00 17.59 14.48 NA NA 0.52 18.11 15.00 NANA XXX71552 ......... ............ A Mri chest w/o & w/dye ................................... 2.26 22.91 24.94 NA NA 0.78 25.95 27.98 NANA XXX71552 ......... 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 XXX71552 ......... TC ...... A Mri chest w/o & w/dye ................................... 0.00 22.16 24.20 NA NA 0.68 22.84 24.88 NA NA XXX71555 ......... ............ 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 XXX71555 ......... 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 2.50XXX71555 ......... 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 XXX72010 ......... ............ A X-ray exam of spine ...................................... 0.45 1.45 1.24 NA NA 0.08 1.98 1.77 NA NAXXX72010 ......... 26 ....... A X-ray exam of spine ...................................... 0.45 0.13 0.15 0.13 0.15 0.02 0.60 0.62 0.600.62 XXX72010 ......... TC ...... A X-ray exam of spine ...................................... 0.00 1.32 1.10 NA NA 0.06 1.38 1.16 NA NA XXX72020 ......... ............ A X-ray exam of spine ...................................... 0.15 0.46 0.47 NA NA 0.03 0.64 0.65 NA NAXXX72020 ......... 26 ....... A X-ray exam of spine ...................................... 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.210.21 XXX72020 ......... TC ...... A X-ray exam of spine ...................................... 0.00 0.42 0.42 NA NA 0.02 0.44 0.44 NA NA XXX72040 ......... ............ A X-ray exam of neck spine ............................. 0.22 0.77 0.70 NA NA 0.05 1.04 0.97 NA NA XXX72040 ......... 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 0.30XXX72040 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 0.70 0.63 NA NA 0.04 0.74 0.67 NA NA XXX72050 ......... ............ A X-ray exam of neck spine ............................. 0.31 1.07 1.01 NA NA 0.07 1.45 1.39 NA NA XXX72050 ......... 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 0.42XXX72050 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 0.97 0.91 NA NA 0.06 1.03 0.97 NA NA XXX72052 ......... ............ A X-ray exam of neck spine ............................. 0.36 1.39 1.29 NA NA 0.08 1.83 1.73 NA NA XXX72052 ......... 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 0.50XXX72052 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 1.27 1.17 NA NA 0.06 1.33 1.23 NA NA XXX72069 ......... ............ 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 XXX72069 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.69 0.54 NA NA 0.02 0.71 0.56 NA NA XXX72070 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.64 0.70 NA NA 0.05 0.91 0.97 NA NA XXX72070 ......... 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 0.30XXX72070 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.57 0.63 NA NA 0.04 0.61 0.67 NA NA XXX72072 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.77 0.79 NA NA 0.06 1.05 1.07 NA NA XXX72072 ......... 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 0.30XXX72072 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.70 0.72 NA NA 0.05 0.75 0.77 NA NA XXX72074 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.95 0.97 NA NA 0.07 1.24 1.26 NA NA XXX72074 ......... 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 0.30XXX72074 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.88 0.90 NA NA 0.06 0.94 0.96 NA NA XXX72080 ......... ............ 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 XXX72080 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.62 0.66 NA NA 0.04 0.66 0.70 NA NA XXX72090 ......... ............ 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 XXX72090 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.92 0.73 NA NA 0.04 0.96 0.77 NA NA XXX72100 ......... ............ A X-ray exam of lower spine ............................ 0.22 0.81 0.76 NA NA 0.05 1.08 1.03 NA NA XXX72100 ......... 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 0.30XXX72100 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 0.74 0.69 NA NA 0.04 0.78 0.73 NA NA XXX72110 ......... ............ A X-ray exam of lower spine ............................ 0.31 1.14 1.04 NA NA 0.07 1.52 1.42 NA NA XXX72110 ......... 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 0.42XXX72110 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.04 0.94 NA NA 0.06 1.10 1.00 NA NA XXX72114 ......... ............ A X-ray exam of lower spine ............................ 0.36 1.57 1.38 NA NA 0.08 2.01 1.82 NA NA XXX72114 ......... 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 0.50XXX72114 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.45 1.26 NA NA 0.06 1.51 1.32 NA NA XXX72120 ......... ............ A X-ray exam of lower spine ............................ 0.22 1.07 0.99 NA NA 0.07 1.36 1.28 NA NA XXX72120 ......... 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 0.30XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00201 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49182 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal72120 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.00 0.92 NA NA 0.06 1.06 0.98 NA NA XXX72125 ......... ............ A Ct neck spine w/o dye ................................... 1.16 6.46 6.33 NA NA 0.36 7.98 7.85 NA NA XXX72125 ......... 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 XXX72125 ......... TC ...... A Ct neck spine w/o dye ................................... 0.00 6.09 5.96 NA NA 0.31 6.40 6.27 NA NA XXX72126 ......... ............ A Ct neck spine w/dye ...................................... 1.22 8.04 7.61 NA NA 0.42 9.68 9.25 NA NAXXX72126 ......... 26 ....... A Ct neck spine w/dye ...................................... 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.661.67 XXX72126 ......... TC ...... A Ct neck spine w/dye ...................................... 0.00 7.65 7.22 NA NA 0.37 8.02 7.59 NA NA XXX72127 ......... ............ A Ct neck spine w/o & w/dye ........................... 1.27 10.17 9.50 NA NA 0.52 11.96 11.29 NA NA XXX72127 ......... 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 1.75XXX72127 ......... 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 XXX72128 ......... ............ A Ct chest spine w/o dye .................................. 1.16 6.47 6.34 NA NA 0.36 7.99 7.86 NA NA XXX72128 ......... 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 XXX72128 ......... TC ...... A Ct chest spine w/o dye .................................. 0.00 6.10 5.96 NA NA 0.31 6.41 6.27 NA NA XXX72129 ......... ............ A Ct chest spine w/dye ..................................... 1.22 8.03 7.61 NA NA 0.42 9.67 9.25 NA NAXXX72129 ......... 26 ....... A Ct chest spine w/dye ..................................... 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.661.67 XXX72129 ......... TC ...... A Ct chest spine w/dye ..................................... 0.00 7.64 7.21 NA NA 0.37 8.01 7.58 NA NA XXX72130 ......... ............ A Ct chest spine w/o & w/dye .......................... 1.27 10.14 9.49 NA NA 0.52 11.93 11.28 NA NA XXX72130 ......... 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 1.75XXX72130 ......... 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 XXX72131 ......... ............ 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 XXX72131 ......... TC ...... A Ct lumbar spine w/o dye ............................... 0.00 6.10 5.96 NA NA 0.31 6.41 6.27 NA NA XXX72132 ......... ............ A Ct lumbar spine w/dye .................................. 1.22 8.03 7.61 NA NA 0.42 9.67 9.25 NA NA XXX72132 ......... 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 XXX72132 ......... TC ...... A Ct lumbar spine w/dye .................................. 0.00 7.64 7.21 NA NA 0.37 8.01 7.58 NA NA XXX72133 ......... ............ 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 XXX72133 ......... 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 XXX72141 ......... ............ A Mri neck spine w/o dye ................................. 1.60 12.80 12.00 NA NA 0.66 15.06 14.26 NA NA XXX72141 ......... 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 XXX72141 ......... TC ...... A Mri neck spine w/o dye ................................. 0.00 12.26 11.47 NA NA 0.59 12.85 12.06 NA NA XXX72142 ......... ............ A Mri neck spine w/dye .................................... 1.92 15.86 14.53 NA NA 0.79 18.57 17.24 NANA XXX72142 ......... 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 XXX72142 ......... TC ...... A Mri neck spine w/dye .................................... 0.00 15.24 13.89 NA NA 0.70 15.94 14.59 NA NA XXX72146 ......... ............ A Mri chest spine w/o dye ................................ 1.60 12.77 12.92 NA NA 0.71 15.08 15.23 NA NA XXX72146 ......... 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 XXX72146 ......... TC ...... A Mri chest spine w/o dye ................................ 0.00 12.24 12.39 NA NA 0.64 12.88 13.03 NA NA XXX72147 ......... ............ A Mri chest spine w/dye ................................... 1.92 13.70 13.98 NA NA 0.79 16.41 16.69 NANA XXX72147 ......... 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 XXX72147 ......... TC ...... A Mri chest spine w/dye ................................... 0.00 13.08 13.35 NA NA 0.70 13.78 14.05 NA NA XXX72148 ......... ............ A Mri lumbar spine w/o dye .............................. 1.48 12.77 12.89 NA NA 0.71 14.96 15.08 NA NAXXX72148 ......... 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 XXX72148 ......... 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 XXX72149 ......... 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 XXX72149 ......... TC ...... A Mri lumbar spine w/dye ................................. 0.00 15.25 13.89 NA NA 0.70 15.95 14.59 NA NA XXX72156 ......... ............ A Mri neck spine w/o & w/dye .......................... 2.57 18.13 23.83 NA NA 1.42 22.12 27.82 NA NA XXX72156 ......... 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 3.53XXX72156 ......... 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 XXX72157 ......... ............ A Mri chest spine w/o & w/dye ......................... 2.57 16.43 23.40 NA NA 1.42 20.42 27.39 NA NA XXX72157 ......... 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 3.52XXX72157 ......... 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 XXX72158 ......... ............ A Mri lumbar spine w/o & w/dye ....................... 2.36 18.10 23.77 NA NA 1.41 21.87 27.54 NA NA XXX72158 ......... 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 XXX72158 ......... 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 XXX72159 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00202 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49183 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules72159 ......... 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 2.52XXX72159 ......... 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 XXX72170 ......... ............ A X-ray exam of pelvis ..................................... 0.17 0.50 0.56 NA NA 0.03 0.70 0.76 NA NAXXX72170 ......... 26 ....... A X-ray exam of pelvis ..................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.240.24 XXX72170 ......... TC ...... A X-ray exam of pelvis ..................................... 0.00 0.44 0.50 NA NA 0.02 0.46 0.52 NA NA XXX72190 ......... ............ A X-ray exam of pelvis ..................................... 0.21 0.85 0.77 NA NA 0.05 1.11 1.03 NA NAXXX72190 ......... 26 ....... A X-ray exam of pelvis ..................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.290.29 XXX72190 ......... TC ...... A X-ray exam of pelvis ..................................... 0.00 0.78 0.70 NA NA 0.04 0.82 0.74 NA NA XXX72191 ......... ............ A Ct angiograph pelv w/o&w/dye ..................... 1.81 11.43 12.32 NA NA 0.47 13.71 14.60 NA NA XXX72191 ......... 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 XXX72192 ......... ............ A Ct pelvis w/o dye ........................................... 1.09 6.02 6.21 NA NA 0.36 7.47 7.66 NANA XXX72192 ......... 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 XXX72192 ......... TC ...... A Ct pelvis w/o dye ........................................... 0.00 5.68 5.85 NA NA 0.31 5.99 6.16 NA NA XXX72193 ......... ............ A Ct pelvis w/dye .............................................. 1.16 7.55 7.30 NA NA 0.41 9.12 8.87 NANA XXX72193 ......... 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 XXX72193 ......... TC ...... A Ct pelvis w/dye .............................................. 0.00 7.18 6.93 NA NA 0.36 7.54 7.29 NA NAXXX72194 ......... ............ A Ct pelvis w/o & w/dye .................................... 1.22 10.18 9.21 NA NA 0.48 11.88 10.91 NANA XXX72194 ......... 26 ....... A Ct pelvis w/o & w/dye .................................... 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.661.67 XXX72194 ......... 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 14.42NA NA XXX72195 ......... 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 XXX72195 ......... TC ...... A Mri pelvis w/o dye ......................................... 0.00 14.25 11.96 NA NA 0.45 14.70 12.41 NA NA XXX72196 ......... ............ A Mri pelvis w/dye ............................................. 1.73 15.67 14.43 NA NA 0.60 18.00 16.76 NA NA XXX72196 ......... 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 XXX72196 ......... TC ...... A Mri pelvis w/dye ............................................. 0.00 15.11 13.86 NA NA 0.52 15.63 14.38 NANA XXX72197 ......... ............ A Mri pelvis w/o & w/dye .................................. 2.26 19.28 24.04 NA NA 1.02 22.56 27.32 NANA XXX72197 ......... 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 XXX72197 ......... TC ...... A Mri pelvis w/o & w/dye .................................. 0.00 18.54 23.30 NA NA 0.92 19.46 24.22 NA NA XXX72198 ......... ............ A Mr angio pelvis w/o & w/dye ......................... 1.80 15.34 12.68 NA NA 0.67 17.81 15.15 NA NA XXX72198 ......... 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 2.47XXX72198 ......... 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 XXX72200 ......... ............ 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 XXX72200 ......... TC ...... A X-ray exam sacroiliac joints .......................... 0.00 0.55 0.53 NA NA 0.02 0.57 0.55 NA NA XXX72202 ......... ............ 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 XXX72202 ......... TC ...... A X-ray exam sacroiliac joints .......................... 0.00 0.68 0.64 NA NA 0.04 0.72 0.68 NA NA XXX72220 ......... ............ A X-ray exam of tailbone .................................. 0.17 0.58 0.62 NA NA 0.05 0.80 0.84 NA NA XXX72220 ......... 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 XXX72220 ......... TC ...... A X-ray exam of tailbone .................................. 0.00 0.53 0.56 NA NA 0.04 0.57 0.60 NA NA XXX72240 ......... ............ A Contrast x-ray of neck spine ......................... 0.91 2.53 4.41 NA NA 0.29 3.73 5.61 NA NA XXX72240 ......... 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 1.24XXX72240 ......... TC ...... A Contrast x-ray of neck spine ......................... 0.00 2.25 4.13 NA NA 0.25 2.50 4.38 NA NA XXX72255 ......... ............ 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 XXX72255 ......... TC ...... A Contrast x-ray, thorax spine .......................... 0.00 2.00 3.75 NA NA 0.22 2.22 3.97 NA NA XXX72265 ......... ............ 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 XXX72265 ......... TC ...... A Contrast x-ray, lower spine ........................... 0.00 2.24 3.61 NA NA 0.22 2.46 3.83 NA NA XXX72270 ......... ............ A Contrast x-ray, spine ..................................... 1.33 3.95 5.88 NA NA 0.39 5.67 7.60 NA NAXXX72270 ......... 26 ....... A Contrast x-ray, spine ..................................... 1.33 0.43 0.42 0.43 0.42 0.06 1.82 1.81 1.821.81 XXX72270 ......... 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 NANA XXX72275 ......... 26 ....... A Epidurography ............................................... 0.76 0.19 0.20 0.19 0.20 0.04 0.99 1.00 0.99 1.00 XXX72275 ......... TC ...... A Epidurography ............................................... 0.00 1.52 1.96 NA NA 0.22 1.74 2.18 NA NA XXX72285 ......... ............ A X-ray c/t spine disk ........................................ 1.16 1.42 6.90 NA NA 0.50 3.08 8.56 NANA XXX72285 ......... 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 XXX72285 ......... TC ...... A X-ray c/t spine disk ........................................ 0.00 1.13 6.57 NA NA 0.43 1.56 7.00 NA NA XXX72295 ......... ............ A X-ray of lower spine disk ............................... 0.83 1.41 6.45 NA NA 0.46 2.70 7.74 NA NA XXX72295 ......... 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 XXX72295 ......... TC ...... A X-ray of lower spine disk ............................... 0.00 1.18 6.19 NA NA 0.40 1.58 6.59 NA NA XXX73000 ......... ............ 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 XXX73000 ......... TC ...... A X-ray exam of collar bone ............................. 0.00 0.50 0.52 NA NA 0.02 0.52 0.54 NA NA XXX73010 ......... ............ A X-ray exam of shoulder blade ....................... 0.17 0.58 0.58 NA NA 0.03 0.78 0.78 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00203 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49184 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal73010 ......... 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 XXX73010 ......... TC ...... A X-ray exam of shoulder blade ....................... 0.00 0.53 0.52 NA NA 0.02 0.55 0.54 NA NA XXX73020 ......... ............ A X-ray exam of shoulder ................................. 0.15 0.45 0.50 NA NA 0.03 0.63 0.68 NA NA XXX73020 ......... 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 XXX73020 ......... TC ...... A X-ray exam of shoulder ................................. 0.00 0.40 0.45 NA NA 0.02 0.42 0.47 NA NA XXX73030 ......... ............ A X-ray exam of shoulder ................................. 0.18 0.57 0.62 NA NA 0.05 0.80 0.85 NA NA XXX73030 ......... 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 XXX73030 ......... TC ...... A X-ray exam of shoulder ................................. 0.00 0.51 0.56 NA NA 0.04 0.55 0.60 NA NA XXX73040 ......... ............ A Contrast x-ray of shoulder ............................. 0.54 2.24 2.27 NA NA 0.14 2.92 2.95 NA NA XXX73040 ......... 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 XXX73040 ......... TC ...... A Contrast x-ray of shoulder ............................. 0.00 2.06 2.09 NA NA 0.12 2.18 2.21 NA NA XXX73050 ......... ............ 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 XXX73050 ......... TC ...... A X-ray exam of shoulders ............................... 0.00 0.66 0.67 NA NA 0.04 0.70 0.71 NA NA XXX73060 ......... ............ 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 XXX73060 ......... TC ...... A X-ray exam of humerus ................................. 0.00 0.52 0.56 NA NA 0.04 0.56 0.60 NA NA XXX73070 ......... ............ A X-ray exam of elbow ..................................... 0.15 0.56 0.57 NA NA 0.03 0.74 0.75 NA NA XXX73070 ......... 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 XXX73070 ......... TC ...... A X-ray exam of elbow ..................................... 0.00 0.51 0.52 NA NA 0.02 0.53 0.54 NA NA XXX73080 ......... ............ A X-ray exam of elbow ..................................... 0.17 0.75 0.66 NA NA 0.05 0.97 0.88 NA NA XXX73080 ......... 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 XXX73080 ......... TC ...... A X-ray exam of elbow ..................................... 0.00 0.70 0.60 NA NA 0.04 0.74 0.64 NA NA XXX73085 ......... ............ A Contrast x-ray of elbow ................................. 0.54 1.82 2.17 NA NA 0.14 2.50 2.85 NA NA XXX73085 ......... 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 XXX73085 ......... TC ...... A Contrast x-ray of elbow ................................. 0.00 1.65 1.99 NA NA 0.12 1.77 2.11 NA NA XXX73090 ......... ............ A X-ray exam of forearm .................................. 0.16 0.55 0.57 NA NA 0.03 0.74 0.76 NA NA XXX73090 ......... 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 XXX73090 ......... TC ...... A X-ray exam of forearm .................................. 0.00 0.50 0.52 NA NA 0.02 0.52 0.54 NA NA XXX73092 ......... ............ 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 XXX73092 ......... TC ...... A X-ray exam of arm, infant ............................. 0.00 0.54 0.50 NA NA 0.02 0.56 0.52 NA NA XXX73100 ......... ............ A X-ray exam of wrist ....................................... 0.16 0.61 0.56 NA NA 0.03 0.80 0.75 NA NAXXX73100 ......... 26 ....... A X-ray exam of wrist ....................................... 0.16 0.06 0.05 0.06 0.05 0.01 0.23 0.22 0.230.22 XXX73100 ......... 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 NAXXX73110 ......... 26 ....... A X-ray exam of wrist ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.230.24 XXX73110 ......... 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 NAXXX73115 ......... 26 ....... A Contrast x-ray of wrist ................................... 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.740.74 XXX73115 ......... 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 NAXXX73120 ......... 26 ....... A X-ray exam of hand ....................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.220.22 XXX73120 ......... TC ...... A X-ray exam of hand ....................................... 0.00 0.51 0.50 NA NA 0.02 0.53 0.52 NA NA XXX73130 ......... ............ A X-ray exam of hand ....................................... 0.17 0.66 0.61 NA NA 0.03 0.86 0.81 NA NAXXX73130 ......... 26 ....... A X-ray exam of hand ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.230.24 XXX73130 ......... TC ...... A X-ray exam of hand ....................................... 0.00 0.61 0.55 NA NA 0.02 0.63 0.57 NA NA XXX73140 ......... ............ A X-ray exam of finger(s) ................................. 0.13 0.68 0.52 NA NA 0.03 0.84 0.68 NA NA XXX73140 ......... 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 XXX73140 ......... TC ...... A X-ray exam of finger(s) ................................. 0.00 0.64 0.48 NA NA 0.02 0.66 0.50 NA NA XXX73200 ......... ............ A Ct upper extremity w/o dye ........................... 1.09 6.45 5.60 NA NA 0.30 7.84 6.99 NA NA XXX73200 ......... 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 1.50XXX73200 ......... TC ...... A Ct upper extremity w/o dye ........................... 0.00 6.10 5.25 NA NA 0.25 6.35 5.50 NA NA XXX73201 ......... ............ 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 XXX73201 ......... TC ...... A Ct upper extremity w/dye .............................. 0.00 7.60 6.33 NA NA 0.31 7.91 6.64 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00204 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49185 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules73202 ......... ............ 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 XXX73202 ......... 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 XXX73206 ......... ............ 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 XXX73206 ......... 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 XXX73218 ......... ............ A Mri upper extremity w/o dye .......................... 1.35 15.03 12.49 NA NA 0.45 16.83 14.29 NA NAXXX73218 ......... 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 1.85XXX73218 ......... TC ...... A Mri upper extremity w/o dye .......................... 0.00 14.58 12.05 NA NA 0.39 14.97 12.44 NA NA XXX73219 ......... ............ A Mri upper extremity w/dye ............................. 1.62 15.68 14.41 NA NA 0.54 17.84 16.57 NA NAXXX73219 ......... 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 XXX73219 ......... 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 XXX73220 ......... 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 XXX73220 ......... 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 XXX73221 ......... ............ A Mri joint upr extrem w/o dye ......................... 1.35 13.95 12.22 NA NA 0.45 15.75 14.02 NA NAXXX73221 ......... 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 1.86XXX73221 ......... 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 XXX73222 ......... ............ A Mri joint upr extrem w/dye ............................. 1.62 14.71 14.16 NA NA 0.54 16.87 16.32 NA NA XXX73222 ......... 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 XXX73222 ......... TC ...... A Mri joint upr extrem w/dye ............................. 0.00 14.16 13.62 NA NA 0.47 14.63 14.09 NA NA XXX73223 ......... ............ A Mri joint upr extr w/o&w/dye .......................... 2.15 18.04 23.70 NA NA 0.94 21.13 26.79 NA NAXXX73223 ......... 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 XXX73223 ......... 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 XXX73225 ......... 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 XXX73225 ......... 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 XXX73500 ......... ............ A X-ray exam of hip .......................................... 0.17 0.49 0.52 NA NA 0.03 0.69 0.72 NA NA XXX73500 ......... 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 XXX73500 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.43 0.46 NA NA 0.02 0.45 0.48 NA NA XXX73510 ......... ............ A X-ray exam of hip .......................................... 0.21 0.78 0.68 NA NA 0.05 1.04 0.94 NA NA XXX73510 ......... 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 XXX73510 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.71 0.61 NA NA 0.04 0.75 0.65 NA NA XXX73520 ......... ............ A X-ray exam of hips ........................................ 0.26 0.79 0.77 NA NA 0.05 1.10 1.08 NA NAXXX73520 ......... 26 ....... A X-ray exam of hips ........................................ 0.26 0.08 0.09 0.08 0.09 0.01 0.35 0.36 0.350.36 XXX73520 ......... 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 XXX73525 ......... 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 XXX73525 ......... TC ...... A Contrast x-ray of hip ...................................... 0.00 1.62 1.98 NA NA 0.12 1.74 2.10 NA NA XXX73530 ......... ............ A X-ray exam of hip .......................................... 0.29 NA NA NA NA 0.03 NA NA NA NA XXX73530 ......... 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 XXX73530 ......... TC ...... A X-ray exam of hip .......................................... 0.00 NA NA NA NA 0.02 NA NA NA NA XXX73540 ......... ............ A X-ray exam of pelvis & hips .......................... 0.20 0.80 0.68 NA NA 0.05 1.05 0.93 NA NA XXX73540 ......... 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 0.28XXX73540 ......... TC ...... A X-ray exam of pelvis & hips .......................... 0.00 0.73 0.61 NA NA 0.04 0.77 0.65 NA NA XXX73542 ......... ............ A X-ray exam, sacroiliac joint ........................... 0.59 1.12 1.98 NA NA 0.15 1.86 2.72 NA NA XXX73542 ......... 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 XXX73542 ......... TC ...... A X-ray exam, sacroiliac joint ........................... 0.00 0.98 1.82 NA NA 0.12 1.10 1.94 NA NA XXX73550 ......... ............ A X-ray exam of thigh ....................................... 0.17 0.54 0.61 NA NA 0.05 0.76 0.83 NA NAXXX73550 ......... 26 ....... A X-ray exam of thigh ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.230.24 XXX73550 ......... 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 XXX73560 ......... 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 0.24XXX73560 ......... 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 XXX73562 ......... ............ A X-ray exam of knee, 3 ................................... 0.18 0.73 0.66 NA NA 0.05 0.96 0.89 NA NA XXX73562 ......... 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 XXX73562 ......... TC ...... A X-ray exam of knee, 3 ................................... 0.00 0.67 0.60 NA NA 0.04 0.71 0.64 NA NA XXX73564 ......... ............ A X-ray exam, knee, 4 or more ........................ 0.22 0.87 0.74 NA NA 0.05 1.14 1.01 NA NA XXX73564 ......... 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 XXX73564 ......... 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 XXX73565 ......... ............ A X-ray exam of knees ..................................... 0.17 0.65 0.58 NA NA 0.03 0.85 0.78 NA NA XXX73565 ......... 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 XXX73565 ......... TC ...... A X-ray exam of knees ..................................... 0.00 0.59 0.52 NA NA 0.02 0.61 0.54 NA NA XXX73580 ......... ............ A Contrast x-ray of knee joint ........................... 0.54 2.40 2.69 NA NA 0.17 3.11 3.40 NA NA XXX73580 ......... 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 XXX73580 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00205 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49186 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal73590 ......... ............ A X-ray exam of lower leg ................................ 0.17 0.54 0.57 NA NA 0.03 0.74 0.77 NA NA XXX73590 ......... 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 XXX73590 ......... TC ...... A X-ray exam of lower leg ................................ 0.00 0.49 0.51 NA NA 0.02 0.51 0.53 NA NA XXX73592 ......... ............ A X-ray exam of leg, infant ............................... 0.16 0.60 0.56 NA NA 0.03 0.79 0.75 NA NA XXX73592 ......... 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 XXX73592 ......... TC ...... A X-ray exam of leg, infant ............................... 0.00 0.55 0.51 NA NA 0.02 0.57 0.53 NA NA XXX73600 ......... ............ A X-ray exam of ankle ...................................... 0.16 0.57 0.55 NA NA 0.03 0.76 0.74 NA NAXXX73600 ......... 26 ....... A X-ray exam of ankle ...................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.220.22 XXX73600 ......... TC ...... A X-ray exam of ankle ...................................... 0.00 0.51 0.50 NA NA 0.02 0.53 0.52 NA NA XXX73610 ......... ............ A X-ray exam of ankle ...................................... 0.17 0.67 0.61 NA NA 0.03 0.87 0.81 NA NAXXX73610 ......... 26 ....... A X-ray exam of ankle ...................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.230.24 XXX73610 ......... TC ...... A X-ray exam of ankle ...................................... 0.00 0.62 0.55 NA NA 0.02 0.64 0.57 NA NA XXX73615 ......... ............ A Contrast x-ray of ankle .................................. 0.54 1.89 2.18 NA NA 0.15 2.58 2.87 NA NAXXX73615 ......... 26 ....... A Contrast x-ray of ankle .................................. 0.54 0.17 0.18 0.17 0.18 0.03 0.74 0.75 0.740.75 XXX73615 ......... TC ...... A Contrast x-ray of ankle .................................. 0.00 1.72 2.01 NA NA 0.12 1.84 2.13 NA NA XXX73620 ......... ............ A X-ray exam of foot ......................................... 0.16 0.53 0.54 NA NA 0.03 0.72 0.73 NA NA XXX73620 ......... 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 XXX73620 ......... TC ...... A X-ray exam of foot ......................................... 0.00 0.49 0.49 NA NA 0.02 0.51 0.51 NA NA XXX73630 ......... ............ A X-ray exam of foot ......................................... 0.17 0.66 0.61 NA NA 0.03 0.86 0.81 NA NA XXX73630 ......... 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 XXX73630 ......... TC ...... A X-ray exam of foot ......................................... 0.00 0.60 0.55 NA NA 0.02 0.62 0.57 NA NA XXX73650 ......... ............ A X-ray exam of heel ........................................ 0.16 0.56 0.53 NA NA 0.03 0.75 0.72 NA NAXXX73650 ......... 26 ....... A X-ray exam of heel ........................................ 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.220.22 XXX73650 ......... 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 NAXXX73660 ......... 26 ....... A X-ray exam of toe(s) ..................................... 0.13 0.04 0.04 0.04 0.04 0.01 0.18 0.18 0.180.18 XXX73660 ......... TC ...... A X-ray exam of toe(s) ..................................... 0.00 0.60 0.47 NA NA 0.02 0.62 0.49 NA NA XXX73700 ......... ............ 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 XXX73700 ......... TC ...... A Ct lower extremity w/o dye ............................ 0.00 6.09 5.24 NA NA 0.25 6.34 5.49 NA NA XXX73701 ......... ............ A Ct lower extremity w/dye ............................... 1.16 7.95 6.71 NA NA 0.36 9.47 8.23 NA NA XXX73701 ......... 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 XXX73701 ......... TC ...... A Ct lower extremity w/dye ............................... 0.00 7.59 6.33 NA NA 0.31 7.90 6.64 NA NA XXX73702 ......... ............ A Ct lwr extremity w/o&w/dye ........................... 1.22 10.81 8.57 NA NA 0.44 12.47 10.23 NA NA XXX73702 ......... 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 1.67XXX73702 ......... 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 XXX73706 ......... ............ 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 XXX73706 ......... 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 2.61XXX73706 ......... 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 XXX73718 ......... ............ A Mri lower extremity w/o dye .......................... 1.35 14.74 12.42 NA NA 0.45 16.54 14.22 NA NAXXX73718 ......... 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 1.86XXX73718 ......... TC ...... A Mri lower extremity w/o dye .......................... 0.00 14.28 11.97 NA NA 0.39 14.67 12.36 NA NA XXX73719 ......... ............ A Mri lower extremity w/dye ............................. 1.62 15.59 14.38 NA NA 0.54 17.75 16.54 NA NAXXX73719 ......... 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 XXX73719 ......... 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 XXX73720 ......... 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 2.95XXX73720 ......... 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 XXX73721 ......... ............ A Mri jnt of lwr extre w/o dye ............................ 1.35 14.27 12.30 NA NA 0.45 16.07 14.10 NANA XXX73721 ......... 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 XXX73721 ......... 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 XXX73722 ......... ............ A Mri joint of lwr extr w/dye .............................. 1.62 14.86 14.19 NA NA 0.54 17.02 16.35 NANA XXX73722 ......... 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 2.232.22 XXX73722 ......... TC ...... A Mri joint of lwr extr w/dye .............................. 0.00 14.32 13.66 NA NA 0.47 14.79 14.13 NA NAXXX73723 ......... ............ A Mri joint lwr extr w/o&w/dye .......................... 2.15 17.91 23.67 NA NA 0.94 21.00 26.76 NA NAXXX73723 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00206 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49187 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules73723 ......... 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 XXX73725 ......... 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 2.50XXX73725 ......... 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 XXX74000 ......... ............ A X-ray exam of abdomen ................................ 0.18 0.46 0.55 NA NA 0.03 0.67 0.76 NA NA XXX74000 ......... 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 0.25XXX74000 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.40 0.49 NA NA 0.02 0.42 0.51 NA NA XXX74010 ......... ............ A X-ray exam of abdomen ................................ 0.23 0.79 0.69 NA NA 0.05 1.07 0.97 NA NA XXX74010 ......... 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 0.32XXX74010 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.72 0.61 NA NA 0.04 0.76 0.65 NA NA XXX74020 ......... ............ A X-ray exam of abdomen ................................ 0.27 0.80 0.73 NA NA 0.05 1.12 1.05 NA NA XXX74020 ......... 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 0.37XXX74020 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.71 0.64 NA NA 0.04 0.75 0.68 NA NA XXX74022 ......... ............ A X-ray exam series, abdomen ........................ 0.32 0.97 0.87 NA NA 0.06 1.35 1.25 NA NA XXX74022 ......... 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 XXX74022 ......... TC ...... A X-ray exam series, abdomen ........................ 0.00 0.87 0.77 NA NA 0.05 0.92 0.82 NA NA XXX74150 ......... ............ A Ct abdomen w/o dye ..................................... 1.19 6.06 6.05 NA NA 0.35 7.60 7.59 NA NA XXX74150 ......... 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 XXX74150 ......... TC ...... A Ct abdomen w/o dye ..................................... 0.00 5.68 5.67 NA NA 0.30 5.98 5.97 NA NA XXX74160 ......... ............ A Ct abdomen w/dye ........................................ 1.27 8.83 7.65 NA NA 0.42 10.52 9.34 NA NAXXX74160 ......... 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 XXX74160 ......... TC ...... A Ct abdomen w/dye ........................................ 0.00 8.43 7.24 NA NA 0.36 8.79 7.60 NA NA XXX74170 ......... ............ A Ct abdomen w/o & w/dye .............................. 1.40 12.27 9.77 NA NA 0.49 14.16 11.66 NA NA XXX74170 ......... 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 1.92XXX74170 ......... TC ...... A Ct abdomen w/o & w/dye .............................. 0.00 11.82 9.32 NA NA 0.43 12.25 9.75 NA NA XXX74175 ......... ............ 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 XXX74175 ......... 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 XXX74181 ......... ............ A Mri abdomen w/o dye .................................... 1.46 12.60 11.91 NA NA 0.51 14.57 13.88 NA NA XXX74181 ......... 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 XXX74181 ......... TC ...... A Mri abdomen w/o dye .................................... 0.00 12.13 11.43 NA NA 0.45 12.58 11.88 NA NA XXX74182 ......... ............ A Mri abdomen w/dye ....................................... 1.73 17.59 14.91 NA NA 0.60 19.92 17.24 NANA XXX74182 ......... 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 XXX74182 ......... TC ...... A Mri abdomen w/dye ....................................... 0.00 17.04 14.34 NA NA 0.52 17.56 14.86 NA NA XXX74183 ......... ............ A Mri abdomen w/o & w/dye ............................ 2.26 19.27 24.03 NA NA 1.02 22.55 27.31 NA NA XXX74183 ......... 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 XXX74183 ......... TC ...... A Mri abdomen w/o & w/dye ............................ 0.00 18.54 23.30 NA NA 0.92 19.46 24.22 NA NA XXX74185 ......... ............ 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 XXX74185 ......... 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 XXX74190 ......... ............ A X-ray exam of peritoneum ............................. 0.48 NA NA NA NA 0.09 NA NA NA NA XXX74190 ......... 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 0.66XXX74190 ......... TC ...... A X-ray exam of peritoneum ............................. 0.00 NA NA NA NA 0.07 NA NA NA NA XXX74210 ......... ............ A Contrst x-ray exam of throat ......................... 0.36 1.76 1.42 NA NA 0.08 2.20 1.86 NA NA XXX74210 ......... 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 0.50XXX74210 ......... TC ...... A Contrst x-ray exam of throat ......................... 0.00 1.65 1.31 NA NA 0.06 1.71 1.37 NA NA XXX74220 ......... ............ A Contrast x-ray, esophagus ............................ 0.46 2.01 1.51 NA NA 0.08 2.55 2.05 NA NA XXX74220 ......... 26 ....... A Contrast x-ray, esophagus ............................ 0.46 0.14 0.15 0.14 0.15 0.02 0.62 0.63 0.62 0.63XXX74220 ......... TC ...... A Contrast x-ray, esophagus ............................ 0.00 1.87 1.36 NA NA 0.06 1.93 1.42 NA NA XXX74230 ......... ............ 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 XXX74230 ......... TC ...... A Cine/vid x-ray, throat/esoph .......................... 0.00 1.76 1.42 NA NA 0.07 1.83 1.49 NA NA XXX74235 ......... ............ C Remove esophagus obstruction .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX74235 ......... 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 XXX74235 ......... 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 XXX74240 ......... ............ 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 XXX74240 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 2.07 1.61 NA NA 0.08 2.15 1.69 NA NA XXX74241 ......... ............ 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 XXX74241 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 2.34 1.70 NA NA 0.08 2.42 1.78 NA NA XXX74245 ......... ............ 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 XXX74245 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 3.65 2.70 NA NA 0.13 3.78 2.83 NA NA XXX74246 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.69 2.78 2.09 NA NA 0.13 3.60 2.91 NA NA XXX74246 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00207 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49188 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal74246 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 2.57 1.87 NA NA 0.10 2.67 1.97 NA NA XXX74247 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.69 3.21 2.23 NA NA 0.14 4.04 3.06 NA NA XXX74247 ......... 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 XXX74247 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 2.99 2.01 NA NA 0.11 3.10 2.12 NA NA XXX74249 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.91 4.33 3.24 NA NA 0.18 5.42 4.33 NA NA XXX74249 ......... 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 XXX74249 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 4.05 2.94 NA NA 0.14 4.19 3.08 NA NA XXX74250 ......... ............ A X-ray exam of small bowel ............................ 0.47 2.48 1.72 NA NA 0.09 3.04 2.28 NA NA XXX74250 ......... 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 0.64XXX74250 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 2.33 1.57 NA NA 0.07 2.40 1.64 NA NA XXX74251 ......... ............ A X-ray exam of small bowel ............................ 0.69 10.01 3.66 NA NA 0.10 10.80 4.45 NA NA XXX74251 ......... 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 0.95XXX74251 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 9.80 3.43 NA NA 0.07 9.87 3.50 NA NA XXX74260 ......... ............ A X-ray exam of small bowel ............................ 0.50 8.32 3.32 NA NA 0.10 8.92 3.92 NA NA XXX74260 ......... 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 0.68XXX74260 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 8.17 3.16 NA NA 0.08 8.25 3.24 NA NA XXX74270 ......... ............ A Contrast x-ray exam of colon ........................ 0.69 3.57 2.33 NA NA 0.14 4.40 3.16 NA NA XXX74270 ......... 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 0.95XXX74270 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 3.35 2.11 NA NA 0.11 3.46 2.22 NA NA XXX74280 ......... ............ A Contrast x-ray exam of colon ........................ 0.99 4.94 3.15 NA NA 0.17 6.10 4.31 NA NA XXX74280 ......... 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 1.35XXX74280 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 4.63 2.83 NA NA 0.13 4.76 2.96 NA NA XXX74283 ......... ............ A Contrast x-ray exam of colon ........................ 2.02 3.42 3.27 NA NA 0.23 5.67 5.52 NA NA XXX74283 ......... 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 2.76XXX74283 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 2.80 2.62 NA NA 0.14 2.94 2.76 NA NA XXX74290 ......... ............ A Contrast x-ray, gallbladder ............................ 0.32 1.56 1.01 NA NA 0.06 1.94 1.39 NA NA XXX74290 ......... 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 XXX74290 ......... TC ...... A Contrast x-ray, gallbladder ............................ 0.00 1.46 0.91 NA NA 0.05 1.51 0.96 NA NA XXX74291 ......... ............ 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 XXX74291 ......... TC ...... A Contrast x-rays, gallbladder .......................... 0.00 1.54 0.70 NA NA 0.02 1.56 0.72 NA NA XXX74300 ......... ............ C X-ray bile ducts/pancreas .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX74300 ......... 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 XXX74300 ......... 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 XXX74301 ......... ............ C X-rays at surgery add-on .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 ZZZ74301 ......... 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 ZZZ74301 ......... 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 0.00ZZZ74305 ......... ............ A X-ray bile ducts/pancreas .............................. 0.42 NA NA NA NA 0.07 NA NA NA NA XXX74305 ......... 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 XXX74305 ......... TC ...... A X-ray bile ducts/pancreas .............................. 0.00 NA NA NA NA 0.05 NA NA NA NA XXX74320 ......... ............ A Contrast x-ray of bile ducts ........................... 0.54 2.13 3.03 NA NA 0.19 2.86 3.76 NA NA XXX74320 ......... 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 XXX74320 ......... TC ...... A Contrast x-ray of bile ducts ........................... 0.00 1.95 2.85 NA NA 0.17 2.12 3.02 NA NA XXX74327 ......... ............ A X-ray bile stone removal ............................... 0.70 2.99 2.24 NA NA 0.14 3.83 3.08 NA NA XXX74327 ......... 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 XXX74327 ......... TC ...... A X-ray bile stone removal ............................... 0.00 2.76 2.01 NA NA 0.11 2.87 2.12 NA NA XXX74328 ......... ............ A X-ray bile duct endoscopy ............................. 0.70 NA NA NA NA 0.20 NA NA NA NA XXX74328 ......... 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 XXX74328 ......... TC ...... A X-ray bile duct endoscopy ............................. 0.00 NA NA NA NA 0.17 NA NA NA NA XXX74329 ......... ............ C X-ray for pancreas endoscopy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX74329 ......... 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 XXX74329 ......... 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 XXX74330 ......... 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 1.23XXX74330 ......... TC ...... A X-ray bile/panc endoscopy ............................ 0.00 NA NA NA NA 0.17 NA NA NA NA XXX74340 ......... ............ A X-ray guide for GI tube ................................. 0.54 NA NA NA NA 0.16 NA NA NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00208 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49189 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules74340 ......... 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 XXX74340 ......... TC ...... A X-ray guide for GI tube ................................. 0.00 NA NA NA NA 0.14 NA NA NA NA XXX74350 ......... ............ A X-ray guide, stomach tube ............................ 0.76 2.22 3.11 NA NA 0.20 3.18 4.07 NA NA XXX74350 ......... 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 1.04XXX74350 ......... TC ...... A X-ray guide, stomach tube ............................ 0.00 1.97 2.86 NA NA 0.17 2.14 3.03 NA NA XXX74355 ......... ............ A X-ray guide, intestinal tube ........................... 0.76 NA NA NA NA 0.17 NA NA NA NA XXX74355 ......... 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 XXX74355 ......... TC ...... A X-ray guide, intestinal tube ........................... 0.00 NA NA NA NA 0.14 NA NA NA NA XXX74360 ......... ............ A X-ray guide, GI dilation ................................. 0.54 NA NA NA NA 0.19 NA NA NA NA XXX74360 ......... 26 ....... A X-ray guide, GI dilation ................................. 0.54 0.24 0.20 0.24 0.20 0.02 0.80 0.76 0.800.76 XXX74360 ......... TC ...... A X-ray guide, GI dilation ................................. 0.00 NA NA NA NA 0.17 NA NA NA NA XXX74363 ......... ............ C X-ray, bile duct dilation .................................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX74363 ......... 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 XXX74363 ......... TC ...... C X-ray, bile duct dilation .................................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX74400 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 2.60 2.02 NA NA 0.13 3.22 2.64 NA NA XXX74400 ......... 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 XXX74400 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 2.44 1.87 NA NA 0.11 2.55 1.98 NA NA XXX74410 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 2.73 2.27 NA NA 0.13 3.35 2.89 NA NA XXX74410 ......... 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 XXX74410 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 2.56 2.10 NA NA 0.11 2.67 2.21 NA NA XXX74415 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 3.29 2.53 NA NA 0.14 3.92 3.16 NA NA XXX74415 ......... 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 XXX74415 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 3.13 2.37 NA NA 0.12 3.25 2.49 NA NA XXX74420 ......... ............ A Contrst x-ray, urinary tract ............................ 0.36 NA NA NA NA 0.16 NA NA NA NA XXX74420 ......... 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 XXX74420 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 NA NA NA NA 0.14 NA NA NA NA XXX74425 ......... ............ A Contrst x-ray, urinary tract ............................ 0.36 NA NA NA NA 0.09 NA NA NA NA XXX74425 ......... 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 XXX74425 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 NA NA NA NA 0.07 NA NA NA NA XXX74430 ......... ............ A Contrast x-ray, bladder .................................. 0.32 1.96 1.35 NA NA 0.08 2.36 1.75 NA NAXXX74430 ......... 26 ....... A Contrast x-ray, bladder .................................. 0.32 0.11 0.10 0.11 0.10 0.02 0.45 0.44 0.450.44 XXX74430 ......... TC ...... A Contrast x-ray, bladder .................................. 0.00 1.85 1.25 NA NA 0.06 1.91 1.31 NA NA XXX74440 ......... ............ A X-ray, male genital tract ................................ 0.38 2.20 1.49 NA NA 0.08 2.66 1.95 NA NAXXX74440 ......... 26 ....... A X-ray, male genital tract ................................ 0.38 0.15 0.13 0.15 0.13 0.02 0.55 0.53 0.550.53 XXX74440 ......... TC ...... A X-ray, male genital tract ................................ 0.00 2.06 1.36 NA NA 0.06 2.12 1.42 NA NA XXX74445 ......... ............ A X-ray exam of penis ...................................... 1.14 NA NA NA NA 0.13 NA NA NA NA XXX74445 ......... 26 ....... A X-ray exam of penis ...................................... 1.14 0.44 0.39 0.44 0.39 0.07 1.65 1.60 1.651.60 XXX74445 ......... TC ...... A X-ray exam of penis ...................................... 0.00 NA NA NA NA 0.06 NA NA NA NA XXX74450 ......... ............ A X-ray, urethra/bladder ................................... 0.33 NA NA NA NA 0.10 NA NA NA NA XXX74450 ......... 26 ....... A X-ray, urethra/bladder ................................... 0.33 0.11 0.11 0.11 0.11 0.02 0.46 0.46 0.460.46 XXX74450 ......... TC ...... A X-ray, urethra/bladder ................................... 0.00 NA NA NA NA 0.08 NA NA NA NA XXX74455 ......... ............ A X-ray, urethra/bladder ................................... 0.33 2.18 1.81 NA NA 0.12 2.63 2.26 NA NAXXX74455 ......... 26 ....... A X-ray, urethra/bladder ................................... 0.33 0.12 0.11 0.12 0.11 0.02 0.47 0.46 0.470.46 XXX74455 ......... TC ...... A X-ray, urethra/bladder ................................... 0.00 2.06 1.70 NA NA 0.10 2.16 1.80 NA NA XXX74470 ......... ............ A X-ray exam of kidney lesion .......................... 0.54 NA NA NA NA 0.09 NA NA NA NA XXX74470 ......... 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 0.74XXX74470 ......... TC ...... A X-ray exam of kidney lesion .......................... 0.00 NA NA NA NA 0.07 NA NA NA NA XXX74475 ......... ............ A X-ray control, cath insert ............................... 0.54 2.12 3.72 NA NA 0.24 2.90 4.50 NA NAXXX74475 ......... 26 ....... A X-ray control, cath insert ............................... 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.740.74 XXX74475 ......... TC ...... A X-ray control, cath insert ............................... 0.00 1.94 3.54 NA NA 0.22 2.16 3.76 NA NA XXX74480 ......... ............ A X-ray control, cath insert ............................... 0.54 2.13 3.72 NA NA 0.24 2.91 4.50 NA NAXXX74480 ......... 26 ....... A X-ray control, cath insert ............................... 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.740.74 XXX74480 ......... TC ...... A X-ray control, cath insert ............................... 0.00 1.95 3.54 NA NA 0.22 2.17 3.76 NA NA XXX74485 ......... ............ A X-ray guide, GU dilation ................................ 0.54 2.29 3.06 NA NA 0.20 3.03 3.80 NA NA XXX74485 ......... 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 XXX74485 ......... TC ...... A X-ray guide, GU dilation ................................ 0.00 2.10 2.89 NA NA 0.17 2.27 3.06 NA NA XXX74710 ......... ............ A X-ray measurement of pelvis ........................ 0.34 0.64 1.03 NA NA 0.08 1.06 1.45 NA NA XXX74710 ......... 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 XXX74710 ......... TC ...... A X-ray measurement of pelvis ........................ 0.00 0.53 0.92 NA NA 0.06 0.59 0.98 NA NA XXX74740 ......... ............ A X-ray, female genital tract ............................. 0.38 1.77 1.52 NA NA 0.09 2.24 1.99 NA NA XXX74740 ......... 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 XXX74740 ......... TC ...... A X-ray, female genital tract ............................. 0.00 1.65 1.40 NA NA 0.07 1.72 1.47 NA NA XXX74742 ......... ............ C X-ray, fallopian tube ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX74742 ......... 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 XXX74742 ......... TC ...... C X-ray, fallopian tube ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX74775 ......... ............ A X-ray exam of perineum ................................ 0.62 NA NA NA NA 0.11 NA NA NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00209 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49190 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal74775 ......... 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 XXX74775 ......... TC ...... A X-ray exam of perineum ................................ 0.00 NA NA NA NA 0.08 NA NA NA NA XXX75552 ......... ............ A Heart mri for morph w/o dye ......................... 1.60 19.30 13.62 NA NA 0.66 21.56 15.88 NA NA XXX75552 ......... 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 2.21XXX75552 ......... 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 XXX75553 ......... ............ A Heart mri for morph w/dye ............................ 2.00 24.28 14.96 NA NA 0.66 26.94 17.62 NA NAXXX75553 ......... 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 2.79XXX75553 ......... TC ...... A Heart mri for morph w/dye ............................ 0.00 23.34 14.24 NA NA 0.59 23.93 14.83 NA NA XXX75554 ......... ............ A Cardiac MRI/function ..................................... 1.83 27.20 15.68 NA NA 0.66 29.69 18.17 NANA XXX75554 ......... 26 ....... A Cardiac MRI/function ..................................... 1.83 0.79 0.68 0.79 0.68 0.07 2.69 2.58 2.692.58 XXX75554 ......... TC ...... A Cardiac MRI/function ..................................... 0.00 26.41 15.00 NA NA 0.59 27.00 15.59 NA NAXXX75555 ......... ............ A Cardiac MRI/limited study ............................. 1.74 27.64 15.79 NA NA 0.66 30.04 18.19 NA NAXXX75555 ......... 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 XXX75555 ......... 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 0.72XXX75600 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 6.24 11.01 NA NA 0.65 6.89 11.66 NA NA XXX75605 ......... ............ 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 1.62XXX75605 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 3.13 10.23 NA NA 0.65 3.78 10.88 NA NA XXX75625 ......... ............ 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 1.59XXX75625 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 2.96 10.19 NA NA 0.65 3.61 10.84 NA NA XXX75630 ......... ............ A X-ray aorta, leg arteries ................................ 1.79 3.80 11.26 NA NA 0.80 6.39 13.85 NA NA XXX75630 ......... 26 ....... A X-ray aorta, leg arteries ................................ 1.79 0.72 0.64 0.72 0.64 0.11 2.62 2.54 2.622.54 XXX75630 ......... TC ...... A X-ray aorta, leg arteries ................................ 0.00 3.08 10.62 NA NA 0.69 3.77 11.31 NA NA XXX75635 ......... ............ A Ct angio abdominal arteries .......................... 2.40 12.87 15.74 NA NA 0.50 15.77 18.64 NA NAXXX75635 ......... 26 ....... A Ct angio abdominal arteries .......................... 2.40 0.83 0.80 0.83 0.80 0.11 3.34 3.31 3.34 3.31XXX75635 ......... TC ...... A Ct angio abdominal arteries .......................... 0.00 12.04 14.94 NA NA 0.39 12.43 15.33 NA NA XXX75650 ......... ............ A Artery x-rays, head & neck ........................... 1.49 3.53 10.70 NA NA 0.72 5.74 12.91 NA NA XXX75650 ......... 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 2.07XXX75650 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 2.97 10.19 NA NA 0.65 3.62 10.84 NA NA XXX75658 ......... ............ A Artery x-rays, arm .......................................... 1.31 3.86 10.77 NA NA 0.72 5.89 12.80 NA NA XXX75658 ......... 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 XXX75658 ......... TC ...... A Artery x-rays, arm .......................................... 0.00 3.37 10.29 NA NA 0.65 4.02 10.94 NA NAXXX75660 ......... ............ A Artery x-rays, head & neck ........................... 1.31 3.94 10.77 NA NA 0.71 5.96 12.79 NA NA XXX75660 ......... 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 1.82XXX75660 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.45 10.31 NA NA 0.65 4.10 10.96 NA NA XXX75662 ......... ............ A Artery x-rays, head & neck ........................... 1.66 5.11 11.17 NA NA 0.71 7.48 13.54 NA NA XXX75662 ......... 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 2.34XXX75662 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 4.39 10.55 NA NA 0.65 5.04 11.20 NA NA XXX75665 ......... ............ A Artery x-rays, head & neck ........................... 1.31 4.10 10.81 NA NA 0.74 6.15 12.86 NA NA XXX75665 ......... 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 1.85XXX75665 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.64 10.36 NA NA 0.65 4.29 11.01 NA NA XXX75671 ......... ............ A Artery x-rays, head & neck ........................... 1.66 5.09 11.14 NA NA 0.72 7.47 13.52 NA NA XXX75671 ......... 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 2.30XXX75671 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 4.48 10.57 NA NA 0.65 5.13 11.22 NA NA XXX75676 ......... ............ A Artery x-rays, neck ........................................ 1.31 3.86 10.75 NA NA 0.72 5.89 12.78 NANA XXX75676 ......... 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 XXX75676 ......... TC ...... A Artery x-rays, neck ........................................ 0.00 3.40 10.30 NA NA 0.65 4.05 10.95 NA NAXXX75680 ......... ............ A Artery x-rays, neck ........................................ 1.66 4.61 11.02 NA NA 0.72 6.99 13.40 NANA XXX75680 ......... 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 XXX75680 ......... TC ...... A Artery x-rays, neck ........................................ 0.00 3.98 10.45 NA NA 0.65 4.63 11.10 NA NAXXX75685 ......... ............ A Artery x-rays, spine ....................................... 1.31 3.90 10.75 NA NA 0.71 5.92 12.77 NANA XXX75685 ......... 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 XXX75685 ......... TC ...... A Artery x-rays, spine ....................................... 0.00 3.41 10.30 NA NA 0.65 4.06 10.95 NA NAXXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00210 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49191 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules75705 ......... ............ A Artery x-rays, spine ....................................... 2.18 4.07 11.02 NA NA 0.78 7.03 13.98 NANA XXX75705 ......... 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 XXX75705 ......... TC ...... A Artery x-rays, spine ....................................... 0.00 3.35 10.29 NA NA 0.65 4.00 10.94 NA NAXXX75710 ......... ............ A Artery x-rays, arm/leg .................................... 1.14 3.99 10.74 NA NA 0.72 5.85 12.60 NANA XXX75710 ......... 26 ....... A Artery x-rays, arm/leg .................................... 1.14 0.42 0.40 0.42 0.40 0.07 1.63 1.61 1.631.61 XXX75710 ......... TC ...... A Artery x-rays, arm/leg .................................... 0.00 3.57 10.34 NA NA 0.65 4.22 10.99 NA NA XXX75716 ......... ............ A Artery x-rays, arms/legs ................................ 1.31 4.94 11.01 NA NA 0.72 6.97 13.04 NA NAXXX75716 ......... 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 XXX75716 ......... 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 NANA XXX75722 ......... 26 ....... A Artery x-rays, kidney ..................................... 1.14 0.47 0.42 0.47 0.42 0.05 1.66 1.61 1.661.61 XXX75722 ......... TC ...... A Artery x-rays, kidney ..................................... 0.00 3.42 10.31 NA NA 0.65 4.07 10.96 NA NA XXX75724 ......... ............ A Artery x-rays, kidneys .................................... 1.49 5.20 11.17 NA NA 0.70 7.39 13.36 NANA XXX75724 ......... 26 ....... A Artery x-rays, kidneys .................................... 1.49 0.75 0.61 0.75 0.61 0.05 2.29 2.15 2.292.15 XXX75724 ......... TC ...... A Artery x-rays, kidneys .................................... 0.00 4.44 10.56 NA NA 0.65 5.09 11.21 NA NA XXX75726 ......... ............ A Artery x-rays, abdomen ................................. 1.14 3.73 10.66 NA NA 0.70 5.57 12.50 NA NAXXX75726 ......... 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 XXX75726 ......... TC ...... A Artery x-rays, abdomen ................................. 0.00 3.35 10.29 NA NA 0.65 4.00 10.94 NA NA XXX75731 ......... ............ A Artery x-rays, adrenal gland .......................... 1.14 3.90 10.70 NA NA 0.71 5.75 12.55 NA NA XXX75731 ......... 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 XXX75731 ......... TC ...... A Artery x-rays, adrenal gland .......................... 0.00 3.48 10.32 NA NA 0.65 4.13 10.97 NA NA XXX75733 ......... ............ A Artery x-rays, adrenals .................................. 1.31 5.27 11.10 NA NA 0.71 7.29 13.12 NA NA XXX75733 ......... 26 ....... A Artery x-rays, adrenals .................................. 1.31 0.59 0.48 0.59 0.48 0.06 1.96 1.85 1.961.85 XXX75733 ......... TC ...... A Artery x-rays, adrenals .................................. 0.00 4.68 10.62 NA NA 0.65 5.33 11.27 NA NA XXX75736 ......... ............ A Artery x-rays, pelvis ....................................... 1.14 3.87 10.70 NA NA 0.71 5.72 12.55 NA NA XXX75736 ......... 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 XXX75736 ......... TC ...... A Artery x-rays, pelvis ....................................... 0.00 3.46 10.32 NA NA 0.65 4.11 10.97 NA NAXXX75741 ......... ............ A Artery x-rays, lung ......................................... 1.31 3.14 10.56 NA NA 0.71 5.16 12.58 NA NA XXX75741 ......... 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 XXX75741 ......... TC ...... A Artery x-rays, lung ......................................... 0.00 2.70 10.13 NA NA 0.65 3.35 10.78 NA NAXXX75743 ......... ............ A Artery x-rays, lungs ....................................... 1.66 3.53 10.74 NA NA 0.72 5.91 13.12 NANA XXX75743 ......... 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 XXX75743 ......... TC ...... A Artery x-rays, lungs ....................................... 0.00 2.96 10.19 NA NA 0.65 3.61 10.84 NA NAXXX75746 ......... ............ A Artery x-rays, lung ......................................... 1.14 3.46 10.60 NA NA 0.70 5.30 12.44 NA NA XXX75746 ......... 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 XXX75746 ......... TC ...... A Artery x-rays, lung ......................................... 0.00 3.10 10.23 NA NA 0.65 3.75 10.88 NA NAXXX75756 ......... ............ A Artery x-rays, chest ....................................... 1.14 4.45 10.90 NA NA 0.69 6.28 12.73 NANA XXX75756 ......... 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 XXX75756 ......... TC ...... A Artery x-rays, chest ....................................... 0.00 3.84 10.41 NA NA 0.65 4.49 11.06 NA NAXXX75774 ......... ............ 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 ZZZ75774 ......... 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 ZZZ75774 ......... TC ...... A Artery x-ray, each vessel .............................. 0.00 2.40 10.05 2.40 10.05 0.65 3.05 10.70 3.0510.70 ZZZ75790 ......... ............ A Visualize A-V shunt ....................................... 1.84 3.11 2.23 NA NA 0.17 5.12 4.24 NA NAXXX75790 ......... 26 ....... A Visualize A-V shunt ....................................... 1.84 0.57 0.59 0.57 0.59 0.09 2.50 2.52 2.502.52 XXX75790 ......... 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 XXX75801 ......... 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 1.15XXX75801 ......... TC ...... A Lymph vessel x-ray, arm/leg ......................... 0.00 NA NA NA NA 0.29 NA NA NA NA XXX75803 ......... ............ A Lymph vessel x-ray,arms/legs ....................... 1.17 NA NA NA NA 0.34 NA NA NA NA XXX75803 ......... 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 XXX75803 ......... TC ...... A Lymph vessel x-ray,arms/legs ....................... 0.00 NA NA NA NA 0.29 NA NA NA NA XXX75805 ......... ............ A Lymph vessel x-ray, trunk ............................. 0.81 NA NA NA NA 0.38 NA NA NA NA XXX75805 ......... 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 XXX75805 ......... TC ...... A Lymph vessel x-ray, trunk ............................. 0.00 NA NA NA NA 0.33 NA NA NA NA XXX75807 ......... ............ C Lymph vessel x-ray, trunk ............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75807 ......... 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 XXX75807 ......... TC ...... C Lymph vessel x-ray, trunk ............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75809 ......... ............ 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 XXX75809 ......... TC ...... A Nonvascular shunt, x-ray .............................. 0.00 2.03 1.09 NA NA 0.05 2.08 1.14 NA NA XXX75810 ......... ............ A Vein x-ray, spleen/liver .................................. 1.14 NA NA NA NA 0.70 NA NA NA NA XXX75810 ......... 26 ....... A Vein x-ray, spleen/liver .................................. 1.14 0.39 0.38 0.39 0.38 0.05 1.58 1.57 1.581.57 XXX75810 ......... TC ...... A Vein x-ray, spleen/liver .................................. 0.00 NA NA NA NA 0.65 NA NA NA NA XXX75820 ......... ............ A Vein x-ray, arm/leg ........................................ 0.70 3.02 1.64 NA NA 0.09 3.81 2.43 NA NA XXX75820 ......... 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 XXX75820 ......... TC ...... A Vein x-ray, arm/leg ........................................ 0.00 2.74 1.40 NA NA 0.06 2.80 1.46 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00211 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49192 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal75822 ......... ............ A Vein x-ray, arms/legs .................................... 1.06 3.18 2.16 NA NA 0.13 4.37 3.35 NA NAXXX75822 ......... 26 ....... A Vein x-ray, arms/legs .................................... 1.06 0.35 0.35 0.35 0.35 0.05 1.46 1.46 1.461.46 XXX75822 ......... TC ...... A Vein x-ray, arms/legs .................................... 0.00 2.83 1.82 NA NA 0.08 2.91 1.90 NA NA XXX75825 ......... ............ A Vein x-ray, trunk ............................................ 1.14 2.93 10.46 NA NA 0.72 4.79 12.32NA NA XXX75825 ......... 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 XXX75825 ......... TC ...... A Vein x-ray, trunk ............................................ 0.00 2.57 10.09 NA NA 0.65 3.22 10.74 NA NA XXX75827 ......... ............ A Vein x-ray, chest ........................................... 1.14 2.98 10.47 NA NA 0.70 4.82 12.31 NA NA XXX75827 ......... 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 XXX75827 ......... TC ...... A Vein x-ray, chest ........................................... 0.00 2.61 10.10 NA NA 0.65 3.26 10.75 NA NAXXX75831 ......... ............ A Vein x-ray, kidney .......................................... 1.14 3.05 10.49 NA NA 0.71 4.90 12.34 NA NA XXX75831 ......... 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 XXX75831 ......... TC ...... A Vein x-ray, kidney .......................................... 0.00 2.69 10.12 NA NA 0.65 3.34 10.77 NA NAXXX75833 ......... ............ A Vein x-ray, kidneys ........................................ 1.49 3.71 10.75 NA NA 0.74 5.94 12.98 NANA XXX75833 ......... 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 XXX75833 ......... TC ...... A Vein x-ray, kidneys ........................................ 0.00 3.23 10.26 NA NA 0.65 3.88 10.91 NA NAXXX75840 ......... ............ A Vein x-ray, adrenal gland .............................. 1.14 3.29 10.56 NA NA 0.72 5.15 12.42 NA NAXXX75840 ......... 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 XXX75840 ......... TC ...... A Vein x-ray, adrenal gland .............................. 0.00 2.84 10.16 NA NA 0.65 3.49 10.81 NA NA XXX75842 ......... ............ A Vein x-ray, adrenal glands ............................ 1.49 3.68 10.73 NA NA 0.72 5.89 12.94 NA NA XXX75842 ......... 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 XXX75842 ......... TC ...... A Vein x-ray, adrenal glands ............................ 0.00 3.19 10.25 NA NA 0.65 3.84 10.90 NA NA XXX75860 ......... ............ A Vein x-ray, neck ............................................ 1.14 3.45 10.61 NA NA 0.69 5.28 12.44 NA NA XXX75860 ......... 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 XXX75860 ......... TC ...... A Vein x-ray, neck ............................................ 0.00 2.96 10.19 NA NA 0.65 3.61 10.84 NA NAXXX75870 ......... ............ A Vein x-ray, skull ............................................. 1.14 3.23 10.55 NA NA 0.70 5.07 12.39NA NA XXX75870 ......... 26 ....... A Vein x-ray, skull ............................................. 1.14 0.39 0.39 0.39 0.39 0.05 1.58 1.581.58 1.58 XXX75870 ......... TC ...... A Vein x-ray, skull ............................................. 0.00 2.84 10.16 NA NA 0.65 3.49 10.81 NANA XXX75872 ......... ............ A Vein x-ray, skull ............................................. 1.14 3.91 10.71 NA NA 0.79 5.84 12.64NA NA XXX75872 ......... 26 ....... A Vein x-ray, skull ............................................. 1.14 0.42 0.38 0.42 0.38 0.14 1.70 1.661.70 1.66 XXX75872 ......... TC ...... A Vein x-ray, skull ............................................. 0.00 3.48 10.32 NA NA 0.65 4.13 10.97 NANA XXX75880 ......... ............ A Vein x-ray, eye socket ................................... 0.70 2.99 1.63 NA NA 0.09 3.78 2.42 NA NAXXX75880 ......... 26 ....... A Vein x-ray, eye socket ................................... 0.70 0.23 0.23 0.23 0.23 0.03 0.96 0.96 0.960.96 XXX75880 ......... TC ...... A Vein x-ray, eye socket ................................... 0.00 2.76 1.40 NA NA 0.06 2.82 1.46 NA NA XXX75885 ......... ............ A Vein x-ray, liver ............................................. 1.44 3.17 10.60 NA NA 0.71 5.32 12.75NA NA XXX75885 ......... 26 ....... A Vein x-ray, liver ............................................. 1.44 0.47 0.47 0.47 0.47 0.06 1.97 1.971.97 1.97 XXX75885 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.70 10.13 NA NA 0.65 3.35 10.78 NANA XXX75887 ......... ............ A Vein x-ray, liver ............................................. 1.44 3.35 10.64 NA NA 0.71 5.50 12.79NA NA XXX75887 ......... 26 ....... A Vein x-ray, liver ............................................. 1.44 0.51 0.48 0.51 0.48 0.06 2.01 1.982.01 1.98 XXX75887 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.84 10.16 NA NA 0.65 3.49 10.81 NANA XXX75889 ......... ............ A Vein x-ray, liver ............................................. 1.14 3.07 10.50 NA NA 0.70 4.91 12.34NA NA XXX75889 ......... 26 ....... A Vein x-ray, liver ............................................. 1.14 0.38 0.37 0.38 0.37 0.05 1.57 1.561.57 1.56 XXX75889 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.70 10.13 NA NA 0.65 3.35 10.78 NANA XXX75891 ......... ............ A Vein x-ray, liver ............................................. 1.14 3.05 10.49 NA NA 0.70 4.89 12.33NA NA XXX75891 ......... 26 ....... A Vein x-ray, liver ............................................. 1.14 0.37 0.37 0.37 0.37 0.05 1.56 1.561.56 1.56 XXX75891 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.68 10.12 NA NA 0.65 3.33 10.77 NANA XXX75893 ......... ............ A Venous sampling by catheter ........................ 0.54 2.87 10.30 NA NA 0.67 4.08 11.51 NA NA XXX75893 ......... 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 XXX75893 ......... TC ...... A Venous sampling by catheter ........................ 0.00 2.69 10.12 NA NA 0.65 3.34 10.77 NA NA XXX75894 ......... ............ A X-rays, transcath therapy .............................. 1.31 NA NA NA NA 1.35 NA NA NA NA XXX75894 ......... 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 XXX75894 ......... TC ...... A X-rays, transcath therapy .............................. 0.00 NA NA NA NA 1.27 NA NA NA NA XXX75896 ......... ............ A X-rays, transcath therapy .............................. 1.31 NA NA NA NA 1.15 NA NA NA NA XXX75896 ......... 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 XXX75896 ......... TC ...... A X-rays, transcath therapy .............................. 0.00 NA NA NA NA 1.10 NA NA NA NA XXX75898 ......... ............ A Follow-up angiography .................................. 1.65 NA NA NA NA 0.13 NA NA NA NA XXX75898 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00212 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49193 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules75898 ......... TC ...... A Follow-up angiography .................................. 0.00 NA NA NA NA 0.06 NA NA NA NA XXX75900 ......... ............ C Intravascular cath exchange ......................... 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75900 ......... 26 ....... A Intravascular cath exchange ......................... 0.49 0.16 0.16 0.16 0.16 0.03 0.68 0.68 0.68 0.68XXX75900 ......... TC ...... C Intravascular cath exchange ......................... 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75901 ......... ............ A Remove cva device obstruct ......................... 0.49 4.20 2.15 NA NA 0.85 5.54 3.49 NA NA XXX75901 ......... 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 XXX75901 ......... TC ...... A Remove cva device obstruct ......................... 0.00 4.04 1.99 NA NA 0.83 4.87 2.82 NA NA XXX75902 ......... ............ A Remove cva lumen obstruct ......................... 0.39 1.64 1.49 NA NA 0.85 2.88 2.73 NA NA XXX75902 ......... 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 XXX75902 ......... TC ...... A Remove cva lumen obstruct ......................... 0.00 1.52 1.36 NA NA 0.83 2.35 2.19 NA NA XXX75940 ......... ............ A X-ray placement, vein filter ........................... 0.54 NA NA NA NA 0.69 NA NA NA NA XXX75940 ......... 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 XXX75940 ......... TC ...... A X-ray placement, vein filter ........................... 0.00 NA NA NA NA 0.65 NA NA NA NA XXX75945 ......... ............ A Intravascular us ............................................. 0.40 NA NA NA NA 0.28 NA NA NA NA XXX75945 ......... 26 ....... A Intravascular us ............................................. 0.40 0.15 0.14 0.15 0.14 0.04 0.59 0.58 0.59 0.58 XXX75945 ......... TC ...... A Intravascular us ............................................. 0.00 NA NA NA NA 0.24 NA NA NA NA XXX75946 ......... ............ 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 ZZZ75946 ......... 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 ZZZ75946 ......... 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 ZZZ75952 ......... ............ C Endovasc repair abdom aorta ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX75952 ......... 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 XXX75952 ......... 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 XXX75953 ......... 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 XXX75953 ......... 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 XXX75954 ......... ............ 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 XXX75954 ......... 26 ....... A Iliac aneurysm endovas rpr ........................... 2.25 0.66 0.75 0.66 0.75 0.15 3.06 3.15 3.06 3.15XXX75954 ......... TC ...... C Iliac aneurysm endovas rpr ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX75956 ......... ............ 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 XXX75956 ......... 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 XXX75956 ......... 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 XXX75957 ......... ............ 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 XXX75957 ......... 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 8.67XXX75957 ......... 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 XXX75958 ......... ............ C Xray, place prox ext thor ao .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX75958 ......... 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 XXX75958 ......... 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 0.00XXX75959 ......... ............ C Xray, place dist ext thor ao ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX75959 ......... 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 XXX75959 ......... 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 XXX75960 ......... ............ A Transcath iv stent rs&i .................................. 0.82 NA NA NA NA 0.82 NA NA NA NA XXX75960 ......... 26 ....... A Transcath iv stent rs&i .................................. 0.82 0.32 0.29 0.32 0.29 0.05 1.19 1.16 1.191.16 XXX75960 ......... TC ...... A Transcath iv stent rs&i .................................. 0.00 NA NA NA NA 0.77 NA NA NA NA XXX75961 ......... ............ A Retrieval, broken catheter ............................. 4.24 4.59 10.07 NA NA 0.73 9.56 15.04 NA NAXXX75961 ......... 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 XXX75961 ......... TC ...... A Retrieval, broken catheter ............................. 0.00 3.20 8.68 NA NA 0.55 3.75 9.23 NA NA XXX75962 ......... ............ A Repair arterial blockage ................................ 0.54 3.54 12.83 NA NA 0.86 4.94 14.23 NA NAXXX75962 ......... 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 XXX75962 ......... 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 ZZZ75964 ......... 26 ....... A Repair artery blockage, each ........................ 0.36 0.13 0.12 0.13 0.12 0.03 0.52 0.51 0.52 0.51ZZZ75964 ......... 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 ZZZ75966 ......... ............ A Repair arterial blockage ................................ 1.31 4.21 13.20 NA NA 0.89 6.41 15.40 NA NAXXX75966 ......... 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 XXX75966 ......... 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 ZZZ75968 ......... 26 ....... A Repair artery blockage, each ........................ 0.36 0.16 0.14 0.16 0.14 0.02 0.54 0.52 0.54 0.52ZZZ75968 ......... 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 ZZZ75970 ......... ............ A Vascular biopsy ............................................. 0.83 NA NA NA NA 0.64 NA NA NA NA XXX75970 ......... 26 ....... A Vascular biopsy ............................................. 0.83 0.28 0.28 0.28 0.28 0.04 1.15 1.15 1.15 1.15 XXX75970 ......... TC ...... A Vascular biopsy ............................................. 0.00 NA NA NA NA 0.60 NA NA NA NA XXX75978 ......... ............ A Repair venous blockage ................................ 0.54 3.27 12.76 NA NA 0.85 4.66 14.15 NA NA XXX75978 ......... 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 XXX75978 ......... TC ...... A Repair venous blockage ................................ 0.00 3.11 12.58 NA NA 0.83 3.94 13.41 NA NA XXX75980 ......... ............ A Contrast xray exam bile duct ........................ 1.44 NA NA NA NA 0.35 NA NA NA NA XXX75980 ......... 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 1.97XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00213 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49194 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal75980 ......... TC ...... A Contrast xray exam bile duct ........................ 0.00 NA NA NA NA 0.29 NA NA NA NA XXX75982 ......... ............ C Contrast xray exam bile duct ........................ 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75982 ......... 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 1.97XXX75982 ......... TC ...... C Contrast xray exam bile duct ........................ 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75984 ......... ............ A Xray control catheter change ........................ 0.72 2.31 2.21 NA NA 0.14 3.17 3.07 NA NA XXX75984 ......... 26 ....... A Xray control catheter change ........................ 0.72 0.24 0.23 0.24 0.23 0.03 0.99 0.98 0.99 0.98XXX75984 ......... TC ...... A Xray control catheter change ........................ 0.00 2.08 1.98 NA NA 0.11 2.19 2.09 NA NA XXX75989 ......... ............ A Abscess drainage under x-ray ...................... 1.19 2.21 3.21 NA NA 0.22 3.62 4.62 NA NA XXX75989 ......... 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 XXX75989 ......... TC ...... A Abscess drainage under x-ray ...................... 0.00 1.83 2.82 NA NA 0.17 2.00 2.99 NA NA XXX75992 ......... ............ A Atherectomy, x-ray exam .............................. 0.54 NA NA NA NA 0.86 NA NA NA NA XXX75992 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.54 0.23 0.20 0.23 0.20 0.03 0.80 0.77 0.80 0.77XXX75992 ......... TC ...... A Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.83 NA NA NA NA XXX75993 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ75993 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.36 0.15 0.14 0.15 0.14 0.02 0.53 0.52 0.53 0.52ZZZ75993 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ75994 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75994 ......... 26 ....... A Atherectomy, x-ray exam .............................. 1.31 0.62 0.50 0.62 0.50 0.07 2.00 1.88 2.00 1.88XXX75994 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75995 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75995 ......... 26 ....... A Atherectomy, x-ray exam .............................. 1.31 0.51 0.48 0.51 0.48 0.05 1.87 1.84 1.87 1.84XXX75995 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX75996 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ75996 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.36 0.15 0.13 0.15 0.13 0.02 0.53 0.51 0.53 0.51ZZZ75996 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ75998 ......... ............ 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 ZZZ75998 ......... TC ...... A Fluoroguide for vein device ........................... 0.00 2.61 1.64 NA NA 0.10 2.71 1.74 NA NA ZZZ76000 ......... ............ A Fluoroscope examination .............................. 0.17 2.75 1.71 NA NA 0.08 3.00 1.96 NA NA XXX76000 ......... 26 ....... A Fluoroscope examination .............................. 0.17 0.06 0.05 0.06 0.05 0.01 0.24 0.23 0.24 0.23XXX76000 ......... TC ...... A Fluoroscope examination .............................. 0.00 2.70 1.66 NA NA 0.07 2.77 1.73 NA NA XXX76001 ......... ............ A Fluoroscope exam, extensive ....................... 0.67 NA NA NA NA 0.19 NA NA NA NA XXX76001 ......... 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 XXX76001 ......... TC ...... A Fluoroscope exam, extensive ....................... 0.00 NA NA NA NA 0.14 NA NA NA NA XXX76003 ......... ............ 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 XXX76003 ......... TC ...... A Needle localization by x-ray .......................... 0.00 1.06 1.25 NA NA 0.07 1.13 1.32 NA NA XXX76005 ......... ............ A Fluoroguide for spine inject ........................... 0.60 0.76 1.29 NA NA 0.10 1.46 1.99 NA NA XXX76005 ......... 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 XXX76005 ......... TC ...... A Fluoroguide for spine inject ........................... 0.00 0.62 1.14 NA NA 0.07 0.69 1.21 NA NA XXX76006 ......... ............ A X-ray stress view ........................................... 0.41 0.77 0.33 0.77 0.33 0.06 1.24 0.801.24 0.80 XXX76010 ......... ............ A X-ray, nose to rectum .................................... 0.18 0.55 0.57 NA NA 0.03 0.76 0.78 NA NAXXX76010 ......... 26 ....... A X-ray, nose to rectum .................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.250.25 XXX76010 ......... TC ...... A X-ray, nose to rectum .................................... 0.00 0.49 0.51 NA NA 0.02 0.51 0.53 NA NA XXX76012 ......... ............ C Percut vertebroplasty fluor ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX76012 ......... 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 XXX76012 ......... 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 XXX76013 ......... ............ C Percut vertebroplasty, ct ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76013 ......... 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 XXX76013 ......... 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 XXX76020 ......... ............ A X-rays for bone age ...................................... 0.19 0.42 0.54 NA NA 0.03 0.64 0.76 NA NAXXX76020 ......... 26 ....... A X-rays for bone age ...................................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.260.26 XXX76020 ......... TC ...... A X-rays for bone age ...................................... 0.00 0.36 0.48 NA NA 0.02 0.38 0.50 NA NA XXX76040 ......... ............ A X-rays, bone evaluation ................................ 0.27 0.67 0.82 NA NA 0.06 1.00 1.15 NA NA XXX76040 ......... 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 XXX76040 ......... TC ...... A X-rays, bone evaluation ................................ 0.00 0.57 0.73 NA NA 0.05 0.62 0.78 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00214 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49195 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules76061 ......... ............ A X-rays, bone survey ...................................... 0.45 1.43 1.22 NA NA 0.08 1.96 1.75 NA NAXXX76061 ......... 26 ....... A X-rays, bone survey ...................................... 0.45 0.14 0.15 0.14 0.15 0.02 0.61 0.62 0.610.62 XXX76061 ......... TC ...... A X-rays, bone survey ...................................... 0.00 1.28 1.07 NA NA 0.06 1.34 1.13 NA NA XXX76062 ......... ............ A X-rays, bone survey ...................................... 0.54 2.28 1.79 NA NA 0.10 2.92 2.43 NA NAXXX76062 ......... 26 ....... A X-rays, bone survey ...................................... 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.730.74 XXX76062 ......... TC ...... A X-rays, bone survey ...................................... 0.00 2.10 1.61 NA NA 0.08 2.18 1.69 NA NA XXX76065 ......... ............ A X-rays, bone evaluation ................................ 0.70 2.01 1.22 NA NA 0.08 2.79 2.00 NA NA XXX76065 ......... 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 XXX76065 ......... TC ...... A X-rays, bone evaluation ................................ 0.00 1.81 1.00 NA NA 0.05 1.86 1.05 NA NA XXX76066 ......... ............ A Joint survey, single view ............................... 0.31 0.65 1.07 NA NA 0.08 1.04 1.46 NA NA XXX76066 ......... 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 XXX76066 ......... TC ...... A Joint survey, single view ............................... 0.00 0.55 0.97 NA NA 0.06 0.61 1.03 NA NA XXX76070 ......... ............ A Ct bone density, axial .................................... 0.25 4.78 3.47 NA NA 0.17 5.20 3.89 NA NAXXX76070 ......... 26 ....... A Ct bone density, axial .................................... 0.25 0.08 0.08 0.08 0.08 0.01 0.34 0.34 0.340.34 XXX76070 ......... 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 XXX76071 ......... TC ...... A Ct bone density, peripheral ........................... 0.00 0.71 2.39 NA NA 0.05 0.76 2.44 NA NA XXX76075 ......... ............ A Dxa bone density, axial ................................. 0.20 0.53 2.53 NA NA 0.18 0.91 2.91 NA NA XXX76075 ......... 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 XXX76075 ......... TC ...... A Dxa bone density, axial ................................. 0.00 0.47 2.44 NA NA 0.17 0.64 2.61 NA NA XXX76076 ......... ............ A Dxa bone density/peripheral ......................... 0.22 0.57 0.77 NA NA 0.06 0.85 1.05 NA NA XXX76076 ......... 26 ....... A Dxa bone density/peripheral ......................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31XXX76076 ......... TC ...... A Dxa bone density/peripheral ......................... 0.00 0.50 0.69 NA NA 0.05 0.55 0.74 NA NA XXX76077 ......... ............ A Dxa bone density/v-fracture .......................... 0.17 0.41 0.71 NA NA 0.06 0.64 0.94 NA NA XXX76077 ......... 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 0.24XXX76077 ......... TC ...... A Dxa bone density/v-fracture .......................... 0.00 0.36 0.65 NA NA 0.05 0.41 0.70 NA NA XXX76078 ......... ............ A Radiographic absorptiometry ........................ 0.20 0.38 0.71 NA NA 0.06 0.64 0.97 NA NA XXX76078 ......... 26 ....... A Radiographic absorptiometry ........................ 0.20 0.05 0.07 0.05 0.07 0.01 0.26 0.28 0.26 0.28 XXX76078 ......... TC ...... A Radiographic absorptiometry ........................ 0.00 0.33 0.65 NA NA 0.05 0.38 0.70 NA NA XXX76080 ......... ............ A X-ray exam of fistula ..................................... 0.54 1.08 1.19 NA NA 0.08 1.70 1.81 NA NAXXX76080 ......... 26 ....... A X-ray exam of fistula ..................................... 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.730.74 XXX76080 ......... 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 ZZZ76082 ......... 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 ZZZ76082 ......... 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 ZZZ76083 ......... ............ 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 ZZZ76083 ......... 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 ZZZ76083 ......... 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 ZZZ76086 ......... ............ 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 XXX76086 ......... TC ...... A X-ray of mammary duct ................................. 0.00 1.11 2.24 NA NA 0.14 1.25 2.38 NA NA XXX76088 ......... ............ A X-ray of mammary ducts ............................... 0.45 1.66 3.27 NA NA 0.21 2.32 3.93 NA NA XXX76088 ......... 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 0.62XXX76088 ......... TC ...... A X-ray of mammary ducts ............................... 0.00 1.52 3.13 NA NA 0.19 1.71 3.32 NA NA XXX76090 ......... ............ A Mammogram, one breast .............................. 0.70 1.62 1.37 NA NA 0.09 2.41 2.16 NA NA XXX76090 ......... 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 XXX76090 ......... TC ...... A Mammogram, one breast .............................. 0.00 1.40 1.14 NA NA 0.06 1.46 1.20 NA NA XXX76091 ......... ............ A Mammogram, both breasts ........................... 0.87 2.11 1.72 NA NA 0.11 3.09 2.70 NA NA XXX76091 ......... 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 XXX76091 ......... TC ...... A Mammogram, both breasts ........................... 0.00 1.84 1.44 NA NA 0.07 1.91 1.51 NA NA XXX76092 ......... ............ A Mammogram, screening ................................ 0.70 1.42 1.45 NA NA 0.10 2.22 2.25 NA NA XXX76092 ......... 26 ....... A Mammogram, screening ................................ 0.70 0.22 0.23 0.22 0.23 0.03 0.95 0.96 0.95 0.96XXX76092 ......... TC ...... A Mammogram, screening ................................ 0.00 1.20 1.22 NA NA 0.07 1.27 1.29 NA NA XXX76093 ......... ............ A Magnetic image, breast ................................. 1.63 22.03 19.12 NA NA 0.99 24.65 21.74 NA NA XXX76093 ......... 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 XXX76093 ......... TC ...... A Magnetic image, breast ................................. 0.00 21.50 18.59 NA NA 0.92 22.42 19.51 NA NA XXX76094 ......... ............ A Magnetic image, both breasts ....................... 1.63 22.03 23.84 NA NA 1.31 24.97 26.78 NA NA XXX76094 ......... 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 XXX76094 ......... TC ...... A Magnetic image, both breasts ....................... 0.00 21.50 23.31 NA NA 1.24 22.74 24.55 NA NA XXX76095 ......... ............ A Stereotactic breast biopsy ............................. 1.59 1.82 6.22 NA NA 0.46 3.87 8.27 NA NA XXX76095 ......... 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 XXX76095 ......... TC ...... A Stereotactic breast biopsy ............................. 0.00 1.34 5.71 NA NA 0.37 1.71 6.08 NA NA XXX76096 ......... ............ 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 XXX76096 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00215 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49196 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal76098 ......... ............ A X-ray exam, breast specimen ....................... 0.16 0.32 0.43 NA NA 0.03 0.51 0.62 NA NA XXX76098 ......... 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 XXX76098 ......... TC ...... A X-ray exam, breast specimen ....................... 0.00 0.27 0.38 NA NA 0.02 0.29 0.40 NA NA XXX76100 ......... ............ A X-ray exam of body section .......................... 0.58 3.54 1.97 NA NA 0.10 4.22 2.65 NA NA XXX76100 ......... 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 0.80XXX76100 ......... TC ...... A X-ray exam of body section .......................... 0.00 3.35 1.78 NA NA 0.07 3.42 1.85 NA NA XXX76101 ......... ............ A Complex body section x-ray .......................... 0.58 5.35 2.55 NA NA 0.11 6.04 3.24 NA NA XXX76101 ......... 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 0.80XXX76101 ......... TC ...... A Complex body section x-ray .......................... 0.00 5.16 2.36 NA NA 0.08 5.24 2.44 NA NA XXX76102 ......... ............ A Complex body section x-rays ........................ 0.58 7.74 3.38 NA NA 0.14 8.46 4.10 NA NA XXX76102 ......... 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 XXX76102 ......... TC ...... A Complex body section x-rays ........................ 0.00 7.56 3.19 NA NA 0.11 7.67 3.30 NA NA XXX76120 ......... ............ A Cine/video x-rays ........................................... 0.38 2.00 1.39 NA NA 0.08 2.46 1.85 NANA XXX76120 ......... 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 XXX76120 ......... TC ...... A Cine/video x-rays ........................................... 0.00 1.85 1.25 NA NA 0.06 1.91 1.31 NA NA XXX76125 ......... ............ A Cine/video x-rays add-on .............................. 0.27 NA NA NA NA 0.06 NA NA NA NA ZZZ76125 ......... 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 ZZZ76125 ......... TC ...... A Cine/video x-rays add-on .............................. 0.00 NA NA NA NA 0.05 NA NA NA NA ZZZ76150 ......... ............ 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 0.000.00 XXX76355 ......... ............ A Ct scan for localization .................................. 1.21 20.46 11.60 NA NA 0.47 22.14 13.28 NA NA XXX76355 ......... 26 ....... A Ct scan for localization .................................. 1.21 0.37 0.39 0.37 0.39 0.05 1.63 1.65 1.631.65 XXX76355 ......... TC ...... A Ct scan for localization .................................. 0.00 20.09 11.22 NA NA 0.42 20.51 11.64 NA NAXXX76360 ......... ............ 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 XXX76360 ......... TC ...... A Ct scan for needle biopsy ............................. 0.00 1.93 6.68 NA NA 0.42 2.35 7.10 NA NA XXX76362 ......... ............ A Ct guide for tissue ablation ........................... 3.99 NA NA NA NA 1.64 NA NA NA NA XXX76362 ......... 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 XXX76362 ......... TC ...... A Ct guide for tissue ablation ........................... 0.00 NA NA NA NA 1.46 NA NA NA NA XXX76370 ......... ............ A Ct scan for therapy guide .............................. 0.85 4.43 3.53 NA NA 0.20 5.48 4.58 NA NA XXX76370 ......... 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 XXX76370 ......... TC ...... A Ct scan for therapy guide .............................. 0.00 4.19 3.26 NA NA 0.16 4.35 3.42 NA NA XXX76376 ......... ............ A 3d render w/o postprocess ............................ 0.20 1.40 2.97 NA NA 0.10 1.70 3.27 NA NA XXX76376 ......... 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 0.29XXX76376 ......... TC ...... A 3d render w/o postprocess ............................ 0.00 1.34 2.90 NA NA 0.08 1.42 2.98 NA NA XXX76377 ......... ............ A 3d rendering w/postprocess .......................... 0.79 1.38 3.11 NA NA 0.39 2.56 4.29 NA NA XXX76377 ......... 26 ....... A 3d rendering w/postprocess .......................... 0.79 0.25 0.27 0.25 0.27 0.08 1.12 1.14 1.12 1.14XXX76377 ......... TC ...... A 3d rendering w/postprocess .......................... 0.00 1.13 2.85 NA NA 0.31 1.44 3.16 NA NA XXX76380 ......... ............ A CAT scan follow-up study ............................. 0.98 4.72 4.05 NA NA 0.22 5.92 5.25 NA NA XXX76380 ......... 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 1.34XXX76380 ......... TC ...... A CAT scan follow-up study ............................. 0.00 4.42 3.73 NA NA 0.18 4.60 3.91 NA NA XXX76390 ......... ............ N Mr spectroscopy ............................................ 1.40 9.51 10.99 NA NA 0.66 11.57 13.05 NA NA XXX76390 ......... 26 ....... N Mr spectroscopy ............................................ 1.40 0.33 0.44 0.33 0.44 0.07 1.80 1.91 1.80 1.91 XXX76390 ......... TC ...... N Mr spectroscopy ............................................ 0.00 9.19 10.56 NA NA 0.59 9.78 11.15 NA NAXXX76393 ......... ............ 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 XXX76393 ......... TC ...... A Mr guidance for needle place ....................... 0.00 9.34 10.74 NA NA 0.55 9.89 11.29 NA NA XXX76394 ......... ............ A Mri for tissue ablation .................................... 4.24 NA NA NA NA 1.81 NA NA NA NA XXX76394 ......... 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 XXX76394 ......... TC ...... A Mri for tissue ablation .................................... 0.00 NA NA NA NA 1.57 NA NA NA NA XXX76400 ......... ............ A Magnetic image, bone marrow ...................... 1.60 14.85 12.50 NA NA 0.66 17.11 14.76 NA NA XXX76400 ......... 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 XXX76496 ......... ............ C Fluoroscopic procedure ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX76496 ......... 26 ....... C Fluoroscopic procedure ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76496 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00216 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49197 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules76497 ......... ............ C Ct procedure .................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76497 ......... 26 ....... C Ct procedure .................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX76497 ......... TC ...... C Ct procedure .................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76498 ......... ............ C Mri procedure ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76498 ......... 26 ....... C Mri procedure ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76498 ......... TC ...... C Mri procedure ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76499 ......... ............ C Radiographic procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX76499 ......... 26 ....... C Radiographic procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX76499 ......... TC ...... C Radiographic procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX76506 ......... ............ A Echo exam of head ....................................... 0.63 2.83 1.95 NA NA 0.14 3.60 2.72 NA NA XXX76506 ......... 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 XXX76506 ......... TC ...... A Echo exam of head ....................................... 0.00 2.63 1.72 NA NA 0.08 2.71 1.80 NA NA XXX76510 ......... ............ A Ophth us, b & quant a ................................... 1.55 2.31 2.72 NA NA 0.10 3.96 4.37 NA NA XXX76510 ......... 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 XXX76510 ......... TC ...... A Ophth us, b & quant a ................................... 0.00 1.73 2.07 NA NA 0.07 1.80 2.14 NA NA XXX76511 ......... ............ A Ophth us, quant a only .................................. 0.94 1.39 2.17 NA NA 0.10 2.43 3.21 NA NA XXX76511 ......... 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 XXX76511 ......... TC ...... A Ophth us, quant a only .................................. 0.00 1.05 1.79 NA NA 0.07 1.12 1.86 NA NA XXX76512 ......... ............ A Ophth us, b w/non-quant a ........................... 0.94 1.19 1.97 NA NA 0.12 2.25 3.03 NA NA XXX76512 ......... 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 1.36XXX76512 ......... 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 XXX76513 ......... ............ A Echo exam of eye, water bath ...................... 0.66 1.58 1.75 NA NA 0.12 2.36 2.53 NA NA XXX76513 ......... 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 XXX76513 ......... TC ...... A Echo exam of eye, water bath ...................... 0.00 1.33 1.47 NA NA 0.10 1.43 1.57 NA NA XXX76514 ......... ............ A Echo exam of eye, thickness ........................ 0.17 0.17 0.14 NA NA 0.02 0.36 0.33 NA NA XXX76514 ......... 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 XXX76514 ......... TC ...... A Echo exam of eye, thickness ........................ 0.00 0.11 0.07 NA NA 0.01 0.12 0.08 NA NA XXX76516 ......... ............ A Echo exam of eye ......................................... 0.54 1.19 1.39 NA NA 0.08 1.81 2.01 NA NAXXX76516 ......... 26 ....... A Echo exam of eye ......................................... 0.54 0.19 0.23 0.19 0.23 0.01 0.74 0.78 0.740.78 XXX76516 ......... TC ...... A Echo exam of eye ......................................... 0.00 1.00 1.17 NA NA 0.07 1.07 1.24 NA NA XXX76519 ......... ............ A Echo exam of eye ......................................... 0.54 1.33 1.50 NA NA 0.08 1.95 2.12 NA NAXXX76519 ......... 26 ....... A Echo exam of eye ......................................... 0.54 0.20 0.23 0.20 0.23 0.01 0.75 0.78 0.750.78 XXX76519 ......... TC ...... A Echo exam of eye ......................................... 0.00 1.12 1.26 NA NA 0.07 1.19 1.33 NA NA XXX76529 ......... ............ A Echo exam of eye ......................................... 0.57 1.19 1.33 NA NA 0.10 1.86 2.00 NA NAXXX76529 ......... 26 ....... A Echo exam of eye ......................................... 0.57 0.21 0.23 0.21 0.23 0.02 0.80 0.82 0.800.82 XXX76529 ......... TC ...... A Echo exam of eye ......................................... 0.00 0.98 1.09 NA NA 0.08 1.06 1.17 NA NA XXX76536 ......... ............ A Us exam of head and neck ........................... 0.56 2.69 1.87 NA NA 0.10 3.35 2.53 NA NA XXX76536 ......... 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 XXX76536 ......... TC ...... A Us exam of head and neck ........................... 0.00 2.52 1.70 NA NA 0.08 2.60 1.78 NA NA XXX76604 ......... ............ 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 XXX76604 ......... TC ...... A Us exam, chest, b-scan ................................ 0.00 1.64 1.39 NA NA 0.07 1.71 1.46 NA NA XXX76645 ......... ............ A Us exam, breast(s) ........................................ 0.54 2.11 1.45 NA NA 0.08 2.73 2.07 NA NAXXX76645 ......... 26 ....... A Us exam, breast(s) ........................................ 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.730.74 XXX76645 ......... 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 XXX76700 ......... 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 XXX76700 ......... TC ...... A Us exam, abdom, complete .......................... 0.00 2.78 2.17 NA NA 0.11 2.89 2.28 NA NA XXX76705 ......... ............ A Echo exam of abdomen ................................ 0.59 2.34 1.79 NA NA 0.11 3.04 2.49 NA NA XXX76705 ......... 26 ....... A Echo exam of abdomen ................................ 0.59 0.19 0.19 0.19 0.19 0.03 0.81 0.81 0.81 0.81XXX76705 ......... TC ...... A Echo exam of abdomen ................................ 0.00 2.16 1.61 NA NA 0.08 2.24 1.69 NA NA XXX76770 ......... ............ A Us exam abdo back wall, comp .................... 0.74 2.94 2.39 NA NA 0.14 3.82 3.27 NA NA XXX76770 ......... 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 XXX76770 ......... TC ...... A Us exam abdo back wall, comp .................... 0.00 2.70 2.15 NA NA 0.11 2.81 2.26 NA NA XXX76775 ......... ............ A Us exam abdo back wall, lim ........................ 0.58 2.42 1.81 NA NA 0.11 3.11 2.50 NA NA XXX76775 ......... 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 XXX76775 ......... TC ...... A Us exam abdo back wall, lim ........................ 0.00 2.23 1.62 NA NA 0.08 2.31 1.70 NA NA XXX76778 ......... ............ A Us exam kidney transplant ............................ 0.74 3.21 2.46 NA NA 0.14 4.09 3.34 NA NA XXX76778 ......... 26 ....... A Us exam kidney transplant ............................ 0.74 0.23 0.24 0.23 0.24 0.03 1.00 1.01 1.00 1.01XXX76778 ......... TC ...... A Us exam kidney transplant ............................ 0.00 2.98 2.22 NA NA 0.11 3.09 2.33 NA NA XXX76800 ......... ............ A Us exam, spinal canal ................................... 1.13 2.34 1.90 NA NA 0.13 3.60 3.16 NA NA XXX76800 ......... 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 XXX76800 ......... TC ...... A Us exam, spinal canal ................................... 0.00 2.04 1.58 NA NA 0.08 2.12 1.66 NA NA XXX76801 ......... ............ A Ob us < 14 wks, single fetus ........................ 0.99 2.46 2.45 NA NA 0.16 3.61 3.60 NA NA XXX76801 ......... 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 1.36XXX76801 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00217 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49198 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal76802 ......... ............ 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 ZZZ76802 ......... 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 1.15ZZZ76802 ......... 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 1.09ZZZ76805 ......... ............ A Ob us >/= 14 wks, sngl fetus ........................ 0.99 3.05 2.59 NA NA 0.16 4.20 3.74 NA NA XXX76805 ......... 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 1.36XXX76805 ......... TC ...... A Ob us >/= 14 wks, sngl fetus ........................ 0.00 2.75 2.26 NA NA 0.12 2.87 2.38 NA NA XXX76810 ......... ............ 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 ZZZ76810 ......... 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 1.35ZZZ76810 ......... 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 ZZZ76811 ......... ............ A Ob us, detailed, sngl fetus ............................ 1.90 3.07 3.95 NA NA 0.52 5.49 6.37 NA NA XXX76811 ......... 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 XXX76811 ......... TC ...... A Ob us, detailed, sngl fetus ............................ 0.00 2.53 3.28 NA NA 0.43 2.96 3.71 NA NA XXX76812 ......... ............ A Ob us, detailed, addl fetus ............................ 1.78 3.98 2.28 3.98 2.28 0.49 6.25 4.55 6.254.55 ZZZ76812 ......... 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 ZZZ76812 ......... 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 ZZZ76815 ......... ............ A Ob us, limited, fetus(s) .................................. 0.65 1.80 1.69 NA NA 0.11 2.56 2.45 NA NAXXX76815 ......... 26 ....... A Ob us, limited, fetus(s) .................................. 0.65 0.19 0.22 0.19 0.22 0.03 0.87 0.90 0.870.90 XXX76815 ......... 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 XXX76816 ......... 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 XXX76816 ......... TC ...... A Ob us, follow-up, per fetus ............................ 0.00 2.15 1.37 NA NA 0.06 2.21 1.43 NA NA XXX76817 ......... ............ A Transvaginal us, obstetric ............................. 0.75 2.02 1.83 NA NA 0.09 2.86 2.67 NA NA XXX76817 ......... 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 XXX76817 ......... TC ...... A Transvaginal us, obstetric ............................. 0.00 1.80 1.59 NA NA 0.06 1.86 1.65 NA NA XXX76818 ......... ............ A Fetal biophys profile w/nst ............................ 1.05 2.22 2.05 NA NA 0.15 3.42 3.25 NA NA XXX76818 ......... 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 XXX76818 ......... TC ...... A Fetal biophys profile w/nst ............................ 0.00 1.92 1.69 NA NA 0.10 2.02 1.79 NA NA XXX76819 ......... ............ A Fetal biophys profil w/o nst ........................... 0.77 1.63 1.82 NA NA 0.13 2.53 2.72 NA NA XXX76819 ......... 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 XXX76819 ......... TC ...... A Fetal biophys profil w/o nst ........................... 0.00 1.41 1.56 NA NA 0.10 1.51 1.66 NA NA XXX76820 ......... ............ A Umbilical artery echo ..................................... 0.50 0.57 1.49 NA NA 0.15 1.22 2.14 NA NAXXX76820 ......... 26 ....... A Umbilical artery echo ..................................... 0.50 0.14 0.18 0.14 0.18 0.03 0.67 0.71 0.670.71 XXX76820 ......... 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 XXX76821 ......... 26 ....... A Middle cerebral artery echo .......................... 0.70 0.20 0.25 0.20 0.25 0.03 0.93 0.98 0.93 0.98XXX76821 ......... TC ...... A Middle cerebral artery echo .......................... 0.00 1.68 1.63 NA NA 0.12 1.80 1.75 NA NA XXX76825 ......... ............ A Echo exam of fetal heart ............................... 1.67 4.37 3.02 NA NA 0.18 6.22 4.87 NA NA XXX76825 ......... 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 XXX76825 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 3.88 2.45 NA NA 0.11 3.99 2.56 NA NA XXX76826 ......... ............ A Echo exam of fetal heart ............................... 0.83 2.75 1.44 NA NA 0.08 3.66 2.35 NA NA XXX76826 ......... 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 XXX76826 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 2.51 1.16 NA NA 0.05 2.56 1.21 NA NA XXX76827 ......... ............ A Echo exam of fetal heart ............................... 0.58 1.07 1.71 NA NA 0.14 1.79 2.43 NA NA XXX76827 ......... 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 XXX76827 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 0.90 1.52 NA NA 0.12 1.02 1.64 NA NA XXX76828 ......... ............ A Echo exam of fetal heart ............................... 0.56 0.64 1.16 NA NA 0.11 1.31 1.83 NA NA XXX76828 ......... 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 XXX76828 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 0.48 0.95 NA NA 0.08 0.56 1.03 NA NA XXX76830 ......... ............ A Transvaginal us, non-ob ................................ 0.69 2.77 2.00 NA NA 0.13 3.59 2.82 NA NA XXX76830 ......... 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 XXX76830 ......... TC ...... A Transvaginal us, non-ob ................................ 0.00 2.56 1.78 NA NA 0.10 2.66 1.88 NA NA XXX76831 ......... ............ A Echo exam, uterus ........................................ 0.72 2.76 2.01 NA NA 0.13 3.61 2.86 NA NAXXX76831 ......... 26 ....... A Echo exam, uterus ........................................ 0.72 0.21 0.24 0.21 0.24 0.03 0.96 0.99 0.960.99 XXX76831 ......... TC ...... A Echo exam, uterus ........................................ 0.00 2.55 1.78 NA NA 0.10 2.65 1.88 NA NA XXX76856 ......... ............ A Us exam, pelvic, complete ............................ 0.69 2.81 2.01 NA NA 0.13 3.63 2.83 NA NA XXX76856 ......... 26 ....... A Us exam, pelvic, complete ............................ 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00218 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49199 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules76856 ......... TC ...... A Us exam, pelvic, complete ............................ 0.00 2.59 1.79 NA NA 0.10 2.69 1.89 NA NA XXX76857 ......... ............ A Us exam, pelvic, limited ................................ 0.38 2.53 2.00 NA NA 0.08 2.99 2.46 NA NA XXX76857 ......... 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 XXX76857 ......... TC ...... A Us exam, pelvic, limited ................................ 0.00 2.38 1.88 NA NA 0.06 2.44 1.94 NA NA XXX76870 ......... ............ A Us exam, scrotum ......................................... 0.64 2.83 2.00 NA NA 0.13 3.60 2.77 NA NAXXX76870 ......... 26 ....... A Us exam, scrotum ......................................... 0.64 0.21 0.21 0.21 0.21 0.03 0.88 0.88 0.880.88 XXX76870 ......... TC ...... A Us exam, scrotum ......................................... 0.00 2.62 1.80 NA NA 0.10 2.72 1.90 NA NA XXX76872 ......... ............ A Us, transrectal ............................................... 0.69 3.43 2.54 NA NA 0.14 4.26 3.37 NA NA XXX76872 ......... 26 ....... A Us, transrectal ............................................... 0.69 0.27 0.23 0.27 0.23 0.04 1.00 0.961.00 0.96 XXX76872 ......... TC ...... A Us, transrectal ............................................... 0.00 3.16 2.31 NA NA 0.10 3.26 2.41 NA NAXXX76873 ......... ............ A Echograp trans r, pros study ......................... 1.55 3.39 2.80 NA NA 0.25 5.19 4.60 NA NA XXX76873 ......... 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 2.14XXX76873 ......... TC ...... A Echograp trans r, pros study ......................... 0.00 2.87 2.29 NA NA 0.16 3.03 2.45 NA NA XXX76880 ......... ............ A Us exam, extremity ....................................... 0.59 3.19 2.01 NA NA 0.11 3.89 2.71 NA NAXXX76880 ......... 26 ....... A Us exam, extremity ....................................... 0.59 0.18 0.19 0.18 0.19 0.03 0.80 0.81 0.800.81 XXX76880 ......... TC ...... A Us exam, extremity ....................................... 0.00 3.01 1.82 NA NA 0.08 3.09 1.90 NA NA XXX76885 ......... ............ A Us exam infant hips, dynamic ....................... 0.74 3.21 2.12 NA NA 0.13 4.08 2.99 NA NA XXX76885 ......... 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 XXX76885 ......... TC ...... A Us exam infant hips, dynamic ....................... 0.00 2.99 1.89 NA NA 0.10 3.09 1.99 NA NA XXX76886 ......... ............ A Us exam infant hips, static ............................ 0.62 2.30 1.79 NA NA 0.11 3.03 2.52 NA NA XXX76886 ......... 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 XXX76886 ......... TC ...... A Us exam infant hips, static ............................ 0.00 2.12 1.60 NA NA 0.08 2.20 1.68 NA NA XXX76930 ......... ............ A Echo guide, cardiocentesis ........................... 0.67 2.11 1.85 NA NA 0.12 2.90 2.64 NA NA XXX76930 ......... 26 ....... A Echo guide, cardiocentesis ........................... 0.67 0.34 0.27 0.34 0.27 0.02 1.03 0.96 1.03 0.96XXX76930 ......... TC ...... A Echo guide, cardiocentesis ........................... 0.00 1.76 1.58 NA NA 0.10 1.86 1.68 NA NA XXX76932 ......... ............ A Echo guide for heart biopsy .......................... 0.67 NA NA NA NA 0.12 NA NA NA NA XXX76932 ......... 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 0.97XXX76932 ......... TC ...... A Echo guide for heart biopsy .......................... 0.00 NA NA NA NA 0.10 NA NA NA NA XXX76936 ......... ............ 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 XXX76936 ......... TC ...... A Echo guide for artery repair .......................... 0.00 5.38 6.06 NA NA 0.34 5.72 6.40 NA NA XXX76937 ......... ............ 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 ZZZ76937 ......... 26 ....... A Us guide, vascular access ............................ 0.30 0.09 0.10 0.09 0.10 0.03 0.42 0.43 0.42 0.43ZZZ76937 ......... TC ...... A Us guide, vascular access ............................ 0.00 0.52 0.42 0.52 0.42 0.10 0.62 0.52 0.62 0.52ZZZ76940 ......... ............ A Us guide, tissue ablation ............................... 2.00 NA NA NA NA 0.60 NA NA NA NA XXX76940 ......... 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 XXX76940 ......... TC ...... A Us guide, tissue ablation ............................... 0.00 NA NA NA NA 0.29 NA NA NA NA XXX76941 ......... ............ A Echo guide for transfusion ............................ 1.34 NA NA NA NA 0.15 NA NA NA NA XXX76941 ......... 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 XXX76941 ......... TC ...... A Echo guide for transfusion ............................ 0.00 NA NA NA NA 0.08 NA NA NA NA XXX76942 ......... ............ A Echo guide for biopsy ................................... 0.67 4.83 3.48 NA NA 0.13 5.63 4.28 NA NA XXX76942 ......... 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 XXX76942 ......... TC ...... A Echo guide for biopsy ................................... 0.00 4.60 3.26 NA NA 0.10 4.70 3.36 NA NA XXX76945 ......... ............ A Echo guide, villus sampling ........................... 0.67 NA NA NA NA 0.11 NA NA NA NA XXX76945 ......... 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 XXX76945 ......... TC ...... A Echo guide, villus sampling ........................... 0.00 NA NA NA NA 0.08 NA NA NA NA XXX76946 ......... ............ A Echo guide for amniocentesis ....................... 0.38 0.45 1.36 NA NA 0.12 0.95 1.86 NA NA XXX76946 ......... 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 XXX76946 ......... TC ...... A Echo guide for amniocentesis ....................... 0.00 0.34 1.23 NA NA 0.10 0.44 1.33 NA NA XXX76948 ......... ............ 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 XXX76948 ......... TC ...... A Echo guide, ova aspiration ............................ 0.00 0.34 1.23 NA NA 0.10 0.44 1.33 NA NA XXX76950 ......... ............ A Echo guidance radiotherapy ......................... 0.58 1.16 1.42 NA NA 0.10 1.84 2.10 NA NA XXX76950 ......... 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 XXX76950 ......... TC ...... A Echo guidance radiotherapy ......................... 0.00 1.00 1.23 NA NA 0.07 1.07 1.30 NA NA XXX76965 ......... ............ A Echo guidance radiotherapy ......................... 1.34 1.18 4.80 NA NA 0.37 2.89 6.51 NA NA XXX76965 ......... 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 XXX76965 ......... TC ...... A Echo guidance radiotherapy ......................... 0.00 0.70 4.35 NA NA 0.29 0.99 4.64 NA NA XXX76970 ......... ............ A Ultrasound exam follow-up ............................ 0.40 2.14 1.42 NA NA 0.08 2.62 1.90 NA NA XXX76970 ......... 26 ....... A Ultrasound exam follow-up ............................ 0.40 0.11 0.13 0.11 0.13 0.02 0.53 0.55 0.53 0.55XXX76970 ......... TC ...... A Ultrasound exam follow-up ............................ 0.00 2.03 1.30 NA NA 0.06 2.09 1.36 NA NA XXX76975 ......... ............ A GI endoscopic ultrasound ............................. 0.81 NA NA NA NA 0.14 NA NA NA NA XXX76975 ......... 26 ....... A GI endoscopic ultrasound ............................. 0.81 0.29 0.28 0.29 0.28 0.04 1.14 1.13 1.14 1.13XXX76975 ......... TC ...... A GI endoscopic ultrasound ............................. 0.00 NA NA NA NA 0.10 NA NA NA NA XXX76977 ......... ............ A Us bone density measure ............................. 0.05 0.11 0.66 NA NA 0.06 0.22 0.77 NA NA XXX76977 ......... 26 ....... A Us bone density measure ............................. 0.05 0.01 0.02 0.01 0.02 0.01 0.07 0.08 0.07 0.08XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00219 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49200 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal76977 ......... TC ...... A Us bone density measure ............................. 0.00 0.09 0.64 NA NA 0.05 0.14 0.69 NA NA XXX76986 ......... ............ A Ultrasound guide intraoper ............................ 1.20 NA NA NA NA 0.27 NA NA NA NA XXX76986 ......... 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 XXX76986 ......... TC ...... A Ultrasound guide intraoper ............................ 0.00 NA NA NA NA 0.14 NA NA NA NA XXX76999 ......... ............ C Echo examination procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX76999 ......... 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 XXX76999 ......... 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 XXX77262 ......... ............ A Radiation therapy planning ........................... 2.11 0.58 0.71 0.58 0.71 0.11 2.80 2.93 2.80 2.93 XXX77263 ......... ............ A Radiation therapy planning ........................... 3.14 0.86 1.05 0.86 1.05 0.16 4.16 4.35 4.16 4.35 XXX77280 ......... ............ A Set radiation therapy field ............................. 0.70 4.35 3.86 NA NA 0.22 5.27 4.78 NA NA XXX77280 ......... 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 XXX77280 ......... TC ...... A Set radiation therapy field ............................. 0.00 4.16 3.64 NA NA 0.18 4.34 3.82 NA NA XXX77285 ......... ............ A Set radiation therapy field ............................. 1.05 7.91 6.41 NA NA 0.35 9.31 7.81 NA NA XXX77285 ......... 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 XXX77285 ......... TC ...... A Set radiation therapy field ............................. 0.00 7.62 6.08 NA NA 0.30 7.92 6.38 NA NA XXX77290 ......... ............ A Set radiation therapy field ............................. 1.56 13.23 8.57 NA NA 0.43 15.22 10.56 NA NA XXX77290 ......... 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 XXX77290 ......... 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 XXX77295 ......... 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 XXX77295 ......... 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 XXX77299 ......... 26 ....... C Radiation therapy planning ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX77299 ......... TC ...... C Radiation therapy planning ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX77300 ......... ............ A Radiation therapy dose plan ......................... 0.62 1.08 1.43 NA NA 0.10 1.80 2.15 NA NA XXX77300 ......... 26 ....... A Radiation therapy dose plan ......................... 0.62 0.17 0.19 0.17 0.19 0.03 0.82 0.84 0.82 0.84XXX77300 ......... TC ...... A Radiation therapy dose plan ......................... 0.00 0.91 1.23 NA NA 0.07 0.98 1.30 NA NA XXX77301 ......... ............ A Radiotherapy dose plan, imrt ........................ 7.99 53.43 36.23 NA NA 1.88 63.30 46.10 NA NA XXX77301 ......... 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 XXX77301 ......... TC ...... A Radiotherapy dose plan, imrt ........................ 0.00 51.24 33.76 NA NA 1.48 52.72 35.24 NA NA XXX77305 ......... ............ 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 XXX77305 ......... TC ...... A Teletx isodose plan simple ............................ 0.00 0.65 1.56 NA NA 0.11 0.76 1.67 NA NA XXX77310 ......... ............ A Teletx isodose plan intermed ........................ 1.05 1.17 2.30 NA NA 0.18 2.40 3.53 NA NA XXX77310 ......... 26 ....... A Teletx isodose plan intermed ........................ 1.05 0.28 0.33 0.28 0.33 0.05 1.38 1.43 1.38 1.43XXX77310 ......... TC ...... A Teletx isodose plan intermed ........................ 0.00 0.89 1.97 NA NA 0.13 1.02 2.10 NA NA XXX77315 ......... ............ A Teletx isodose plan complex ......................... 1.56 1.97 2.86 NA NA 0.22 3.75 4.64 NA NA XXX77315 ......... 26 ....... A Teletx isodose plan complex ......................... 1.56 0.43 0.48 0.43 0.48 0.08 2.07 2.12 2.07 2.12XXX77315 ......... TC ...... A Teletx isodose plan complex ......................... 0.00 1.54 2.38 NA NA 0.14 1.68 2.52 NA NA XXX77321 ......... ............ A Special teletx port plan .................................. 0.95 1.38 3.60 NA NA 0.26 2.59 4.81 NA NAXXX77321 ......... 26 ....... A Special teletx port plan .................................. 0.95 0.26 0.29 0.26 0.29 0.05 1.26 1.29 1.261.29 XXX77321 ......... 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 XXX77326 ......... 26 ....... A Brachytx isodose calc simp ........................... 0.93 0.25 0.29 0.25 0.29 0.05 1.23 1.27 1.23 1.27XXX77326 ......... TC ...... A Brachytx isodose calc simp ........................... 0.00 2.53 2.40 NA NA 0.13 2.66 2.53 NA NA XXX77327 ......... ............ A Brachytx isodose calc interm ........................ 1.39 3.84 3.89 NA NA 0.25 5.48 5.53 NA NA XXX77327 ......... 26 ....... A Brachytx isodose calc interm ........................ 1.39 0.38 0.43 0.38 0.43 0.07 1.84 1.89 1.84 1.89XXX77327 ......... TC ...... A Brachytx isodose calc interm ........................ 0.00 3.46 3.47 NA NA 0.18 3.64 3.65 NA NA XXX77328 ......... ............ A Brachytx isodose plan compl ........................ 2.09 4.93 5.45 NA NA 0.36 7.38 7.90 NA NA XXX77328 ......... 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 XXX77328 ......... TC ...... A Brachytx isodose plan compl ........................ 0.00 4.36 4.81 NA NA 0.25 4.61 5.06 NA NA XXX77331 ......... ............ 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 XXX77331 ......... TC ...... A Special radiation dosimetry ........................... 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX77332 ......... ............ A Radiation treatment aid(s) ............................. 0.54 1.52 1.51 NA NA 0.10 2.16 2.15 NA NA XXX



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# 49201 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules77332 ......... 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 XXX77332 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 1.37 1.35 NA NA 0.07 1.44 1.42 NA NA XXX77333 ......... ............ A Radiation treatment aid(s) ............................. 0.84 0.46 1.74 NA NA 0.15 1.45 2.73 NA NA XXX77333 ......... 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 XXX77333 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 0.23 1.48 NA NA 0.11 0.34 1.59 NA NA XXX77334 ......... ............ A Radiation treatment aid(s) ............................. 1.24 2.61 3.39 NA NA 0.23 4.08 4.86 NA NA XXX77334 ......... 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 XXX77334 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 2.27 3.01 NA NA 0.17 2.44 3.18 NA NA XXX77336 ......... ............ A Radiation physics consult .............................. 0.00 0.92 2.47 NA NA 0.16 1.08 2.63 NA NA XXX77370 ......... ............ A Radiation physics consult .............................. 0.00 2.33 3.20 NA NA 0.18 2.51 3.38 NA NA XXX77399 ......... ............ C External radiation dosimetry .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX77399 ......... 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 XXX77399 ......... TC ...... C External radiation dosimetry .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX77401 ......... ............ A Radiation treatment delivery ......................... 0.00 0.49 1.45 NA NA 0.11 0.60 1.56 NA NA XXX77402 ......... ............ A Radiation treatment delivery ......................... 0.00 4.15 2.37 NA NA 0.11 4.26 2.48 NA NA XXX77403 ......... ............ A Radiation treatment delivery ......................... 0.00 3.73 2.26 NA NA 0.11 3.84 2.37 NA NA XXX77404 ......... ............ A Radiation treatment delivery ......................... 0.00 4.19 2.38 NA NA 0.11 4.30 2.49 NA NA XXX77406 ......... ............ A Radiation treatment delivery ......................... 0.00 4.18 2.37 NA NA 0.11 4.29 2.48 NA NA XXX77407 ......... ............ A Radiation treatment delivery ......................... 0.00 5.39 2.92 NA NA 0.12 5.51 3.04 NA NA XXX77408 ......... ............ A Radiation treatment delivery ......................... 0.00 5.18 2.86 NA NA 0.12 5.30 2.98 NA NA XXX77409 ......... ............ A Radiation treatment delivery ......................... 0.00 5.78 3.01 NA NA 0.12 5.90 3.13 NA NA XXX77411 ......... ............ A Radiation treatment delivery ......................... 0.00 5.68 2.99 NA NA 0.12 5.80 3.11 NA NA XXX77412 ......... ............ A Radiation treatment delivery ......................... 0.00 6.78 3.44 NA NA 0.13 6.91 3.57 NA NA XXX77413 ......... ............ A Radiation treatment delivery ......................... 0.00 6.80 3.45 NA NA 0.13 6.93 3.58 NA NA XXX77414 ......... ............ A Radiation treatment delivery ......................... 0.00 7.66 3.66 NA NA 0.13 7.79 3.79 NA NA XXX77416 ......... ............ A Radiation treatment delivery ......................... 0.00 7.65 3.66 NA NA 0.13 7.78 3.79 NA NA XXX77417 ......... ............ A Radiology port film(s) .................................... 0.00 0.35 0.53 NA NA 0.04 0.39 0.57 NA NAXXX77418 ......... ............ A Radiation tx delivery, imrt .............................. 0.00 13.02 16.77 NA NA 0.13 13.15 16.90 NANA XXX77421 ......... ............ A Stereoscopic x-ray guidance ......................... 0.39 1.95 3.10 NA NA 0.12 2.46 3.61 NA NA XXX77421 ......... 26 ....... A Stereoscopic x-ray guidance ......................... 0.39 0.11 0.13 0.11 0.13 0.02 0.52 0.54 0.52 0.54XXX77421 ......... TC ...... A Stereoscopic x-ray guidance ......................... 0.00 1.84 2.97 NA NA 0.10 1.94 3.07 NA NA XXX77422 ......... ............ A Neutron beam tx, simple ............................... 0.00 11.79 4.23 NA NA 0.13 11.92 4.36 NA NA XXX77423 ......... ............ A Neutron beam tx, complex ............................ 0.00 7.83 3.65 NA NA 0.13 7.96 3.78 NA NA XXX77427 ......... ............ A Radiation tx management, x5 ....................... 3.31 1.08 1.07 1.08 1.07 0.17 4.56 4.55 4.56 4.55XXX77431 ......... ............ A Radiation therapy management .................... 1.81 0.68 0.68 0.68 0.68 0.09 2.58 2.58 2.58 2.58 XXX77432 ......... ............ A Stereotactic radiation trmt ............................. 7.92 2.17 2.72 2.17 2.72 0.41 10.50 11.05 10.50 11.05 XXX77470 ......... ............ A Special radiation treatment ........................... 2.09 1.76 9.31 NA NA 0.70 4.55 12.10 NA NA XXX77470 ......... 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 XXX77470 ......... TC ...... A Special radiation treatment ........................... 0.00 1.19 8.66 NA NA 0.59 1.78 9.25 NA NA XXX77499 ......... ............ C Radiation therapy management .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX77499 ......... 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 XXX77499 ......... 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 XXX77520 ......... ............ 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 XXX77522 ......... ............ 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 XXX77523 ......... ............ C Proton trmt, intermediate ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX77525 ......... ............ C Proton treatment, complex ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX77600 ......... ............ R Hyperthermia treatment ................................. 1.56 9.32 4.99 NA NA 0.24 11.12 6.79 NA NA XXX77600 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.35 0.46 0.35 0.46 0.08 1.99 2.10 1.99 2.10 XXX77600 ......... TC ...... R Hyperthermia treatment ................................. 0.00 8.97 4.53 NA NA 0.16 9.13 4.69 NA NA XXX77605 ......... ............ R Hyperthermia treatment ................................. 2.09 16.90 7.77 NA NA 0.38 19.37 10.24 NA NAXXX77605 ......... 26 ....... R Hyperthermia treatment ................................. 2.09 0.53 0.63 0.53 0.63 0.16 2.78 2.88 2.78 2.88 XXX77605 ......... TC ...... R Hyperthermia treatment ................................. 0.00 16.36 7.14 NA NA 0.22 16.58 7.36 NA NA XXX77610 ......... ............ R Hyperthermia treatment ................................. 1.56 16.54 6.81 NA NA 0.24 18.34 8.61 NA NAXXX77610 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.43 0.49 0.43 0.49 0.08 2.07 2.13 2.07 2.13 XXX77610 ......... TC ...... R Hyperthermia treatment ................................. 0.00 16.12 6.32 NA NA 0.16 16.28 6.48 NA NA XXX77615 ......... ............ R Hyperthermia treatment ................................. 2.09 24.51 9.67 NA NA 0.33 26.93 12.09 NA NAXXX77615 ......... 26 ....... R Hyperthermia treatment ................................. 2.09 0.55 0.63 0.55 0.63 0.11 2.75 2.83 2.75 2.83 XXX77615 ......... TC ...... R Hyperthermia treatment ................................. 0.00 23.95 9.03 NA NA 0.22 24.17 9.25 NA NA XXX77620 ......... ............ R Hyperthermia treatment ................................. 1.56 9.58 5.07 NA NA 0.36 11.50 6.99 NA NA XXX77620 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.41 0.49 0.41 0.49 0.20 2.17 2.25 2.17 2.25 XXX77620 ......... TC ...... R Hyperthermia treatment ................................. 0.00 9.18 4.58 NA NA 0.16 9.34 4.74 NA NA XXX77750 ......... ............ A Infuse radioactive materials .......................... 4.90 4.19 3.22 4.19 3.22 0.32 9.41 8.44 9.418.44 09077750 ......... 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 09077750 ......... TC ...... A Infuse radioactive materials .......................... 0.00 2.84 1.71 2.84 1.71 0.07 2.91 1.78 2.91 1.7809077761 ......... ............ A Apply intrcav radiat simple ............................ 3.80 5.59 4.09 5.59 4.09 0.33 9.72 8.22 9.728.22 09077761 ......... 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



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# 49202 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal77761 ......... 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 09077762 ......... ............ 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 09077762 ......... 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 09077762 ......... 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 09077763 ......... ............ 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 09077763 ......... 26 ....... A Apply intrcav radiat compl ............................. 8.56 2.33 2.64 2.33 2.64 0.43 11.32 11.63 11.3211.63 09077763 ......... 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 09077776 ......... ............ 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 09077776 ......... 26 ....... A Apply interstit radiat simpl ............................. 4.65 1.54 1.10 1.54 1.10 0.44 6.63 6.19 6.636.19 09077776 ......... 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 09077777 ......... ............ A Apply interstit radiat inter .............................. 7.47 6.93 6.68 6.93 6.68 0.61 15.01 14.7615.01 14.76 09077777 ......... 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 09077778 ......... ............ A Apply interstit radiat compl ............................ 11.17 9.61 8.92 9.61 8.92 0.84 21.62 20.9321.62 20.93 09077778 ......... 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 09077778 ......... 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 09077781 ......... ............ A High intensity brachytherapy ......................... 1.21 4.23 16.68 NA NA 1.14 6.58 19.03 NA NA XXX77781 ......... 26 ....... A High intensity brachytherapy ......................... 1.21 0.33 0.48 0.33 0.48 0.08 1.62 1.77 1.62 1.77XXX77781 ......... TC ...... A High intensity brachytherapy ......................... 0.00 3.90 16.20 NA NA 1.06 4.96 17.26 NA NA XXX77782 ......... ............ A High intensity brachytherapy ......................... 2.04 12.03 18.83 NA NA 1.19 15.26 22.06 NA NAXXX77782 ......... 26 ....... A High intensity brachytherapy ......................... 2.04 0.55 0.74 0.55 0.74 0.13 2.72 2.91 2.72 2.91XXX77782 ......... TC ...... A High intensity brachytherapy ......................... 0.00 11.48 18.10 NA NA 1.06 12.54 19.16 NA NA XXX77783 ......... ............ A High intensity brachytherapy ......................... 3.27 23.55 22.01 NA NA 1.25 28.07 26.53 NA NAXXX77783 ......... 26 ....... A High intensity brachytherapy ......................... 3.27 0.89 1.12 0.89 1.12 0.19 4.35 4.58 4.35 4.58XXX77783 ......... TC ...... A High intensity brachytherapy ......................... 0.00 22.67 20.89 NA NA 1.06 23.73 21.95 NA NA XXX77784 ......... ............ A High intensity brachytherapy ......................... 5.15 44.52 27.71 NA NA 1.35 51.02 34.21 NA NAXXX77784 ......... 26 ....... A High intensity brachytherapy ......................... 5.15 1.40 1.69 1.40 1.69 0.29 6.84 7.13 6.84 7.13XXX77784 ......... TC ...... A High intensity brachytherapy ......................... 0.00 43.12 26.01 NA NA 1.06 44.18 27.07 NA NA XXX77789 ......... ............ A Apply surface radiation .................................. 1.12 1.95 1.10 1.95 1.10 0.08 3.15 2.30 3.15 2.30 00077789 ......... 26 ....... A Apply surface radiation .................................. 1.12 0.35 0.37 0.35 0.37 0.06 1.53 1.55 1.531.55 00077789 ......... 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 00077790 ......... ............ A Radiation handling ......................................... 1.05 1.16 0.92 NA NA 0.07 2.28 2.04 NA NA XXX77790 ......... 26 ....... A Radiation handling ......................................... 1.05 0.29 0.33 0.29 0.33 0.05 1.39 1.43 1.39 1.43 XXX77790 ......... TC ...... A Radiation handling ......................................... 0.00 0.87 0.59 NA NA 0.02 0.89 0.61 NA NA XXX77799 ......... ............ C Radium/radioisotope therapy ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX77799 ......... 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 XXX77799 ......... 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 XXX78000 ......... ............ A Thyroid, single uptake ................................... 0.19 1.85 1.24 NA NA 0.07 2.11 1.50 NA NAXXX78000 ......... 26 ....... A Thyroid, single uptake ................................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.260.26 XXX78000 ......... TC ...... A Thyroid, single uptake ................................... 0.00 1.79 1.18 NA NA 0.06 1.85 1.24 NA NA XXX78001 ......... ............ A Thyroid, multiple uptakes .............................. 0.26 2.27 1.62 NA NA 0.08 2.61 1.96 NA NA XXX78001 ......... 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 XXX78001 ......... TC ...... A Thyroid, multiple uptakes .............................. 0.00 2.19 1.53 NA NA 0.07 2.26 1.60 NA NA XXX78003 ......... ............ A Thyroid suppress/stimul ................................ 0.33 1.89 1.28 NA NA 0.07 2.29 1.68 NA NA XXX78003 ......... 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 XXX78003 ......... TC ...... A Thyroid suppress/stimul ................................ 0.00 1.78 1.17 NA NA 0.06 1.84 1.23 NA NA XXX78006 ......... ............ A Thyroid imaging with uptake ......................... 0.49 6.24 3.47 NA NA 0.15 6.88 4.11 NA NA XXX78006 ......... 26 ....... A Thyroid imaging with uptake ......................... 0.49 0.15 0.16 0.15 0.16 0.02 0.66 0.67 0.66 0.67XXX78006 ......... TC ...... A Thyroid imaging with uptake ......................... 0.00 6.08 3.31 NA NA 0.13 6.21 3.44 NA NA XXX78007 ......... ............ A Thyroid image, mult uptakes ......................... 0.50 3.02 2.81 NA NA 0.16 3.68 3.47 NA NA XXX78007 ......... 26 ....... A Thyroid image, mult uptakes ......................... 0.50 0.16 0.17 0.16 0.17 0.02 0.68 0.69 0.68 0.69XXX78007 ......... TC ...... A Thyroid image, mult uptakes ......................... 0.00 2.86 2.64 NA NA 0.14 3.00 2.78 NA NA XXX78010 ......... ............ A Thyroid imaging ............................................. 0.39 4.20 2.51 NA NA 0.13 4.72 3.03 NANA XXX78010 ......... 26 ....... A Thyroid imaging ............................................. 0.39 0.12 0.13 0.12 0.13 0.02 0.53 0.54 0.53 0.54 XXX78010 ......... TC ...... A Thyroid imaging ............................................. 0.00 4.08 2.39 NA NA 0.11 4.19 2.50 NA NA XXX78011 ......... ............ A Thyroid imaging with flow .............................. 0.45 4.55 3.06 NA NA 0.15 5.15 3.66 NA NA XXX78011 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00222 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49203 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules78011 ......... TC ...... A Thyroid imaging with flow .............................. 0.00 4.41 2.91 NA NA 0.13 4.54 3.04 NA NA XXX78015 ......... ............ A Thyroid met imaging ...................................... 0.67 5.43 3.46 NA NA 0.17 6.27 4.30 NA NAXXX78015 ......... 26 ....... A Thyroid met imaging ...................................... 0.67 0.21 0.23 0.21 0.23 0.03 0.91 0.93 0.910.93 XXX78015 ......... TC ...... A Thyroid met imaging ...................................... 0.00 5.22 3.23 NA NA 0.14 5.36 3.37 NA NA XXX78016 ......... ............ A Thyroid met imaging/studies ......................... 0.82 8.63 4.98 NA NA 0.21 9.66 6.01 NA NA XXX78016 ......... 26 ....... A Thyroid met imaging/studies ......................... 0.82 0.26 0.28 0.26 0.28 0.03 1.11 1.13 1.11 1.13XXX78016 ......... TC ...... A Thyroid met imaging/studies ......................... 0.00 8.37 4.70 NA NA 0.18 8.55 4.88 NA NA XXX78018 ......... ............ A Thyroid met imaging, body ............................ 0.86 7.96 6.28 NA NA 0.33 9.15 7.47 NA NA XXX78018 ......... 26 ....... A Thyroid met imaging, body ............................ 0.86 0.27 0.29 0.27 0.29 0.04 1.17 1.19 1.17 1.19XXX78018 ......... TC ...... A Thyroid met imaging, body ............................ 0.00 7.69 5.99 NA NA 0.29 7.98 6.28 NA NA XXX78020 ......... ............ A Thyroid met uptake ....................................... 0.60 1.79 1.59 1.79 1.59 0.16 2.55 2.35 2.55 2.35 ZZZ78020 ......... 26 ....... A Thyroid met uptake ....................................... 0.60 0.18 0.20 0.18 0.20 0.02 0.80 0.82 0.800.82 ZZZ78020 ......... 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 ZZZ78070 ......... ............ A Parathyroid nuclear imaging ......................... 0.82 3.43 4.27 NA NA 0.15 4.40 5.24 NA NA XXX78070 ......... 26 ....... A Parathyroid nuclear imaging ......................... 0.82 0.26 0.28 0.26 0.28 0.04 1.12 1.14 1.12 1.14XXX78070 ......... TC ...... A Parathyroid nuclear imaging ......................... 0.00 3.17 4.00 NA NA 0.11 3.28 4.11 NA NA XXX78075 ......... ............ A Adrenal nuclear imaging ............................... 0.74 11.67 7.18 NA NA 0.32 12.73 8.24 NA NA XXX78075 ......... 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 XXX78075 ......... TC ...... A Adrenal nuclear imaging ............................... 0.00 11.44 6.93 NA NA 0.29 11.73 7.22 NA NA XXX78099 ......... ............ C Endocrine nuclear procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78099 ......... 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 XXX78099 ......... 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 XXX78102 ......... ............ A Bone marrow imaging, ltd ............................. 0.55 4.17 2.72 NA NA 0.14 4.86 3.41 NA NA XXX78102 ......... 26 ....... A Bone marrow imaging, ltd ............................. 0.55 0.17 0.19 0.17 0.19 0.02 0.74 0.76 0.74 0.76XXX78102 ......... TC ...... A Bone marrow imaging, ltd ............................. 0.00 4.00 2.53 NA NA 0.12 4.12 2.65 NA NA XXX78103 ......... ............ A Bone marrow imaging, mult .......................... 0.75 5.43 3.93 NA NA 0.20 6.38 4.88 NA NA XXX78103 ......... 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 XXX78103 ......... TC ...... A Bone marrow imaging, mult .......................... 0.00 5.20 3.68 NA NA 0.17 5.37 3.85 NA NA XXX78104 ......... ............ A Bone marrow imaging, body ......................... 0.80 6.30 4.83 NA NA 0.25 7.35 5.88 NA NA XXX78104 ......... 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 XXX78104 ......... TC ...... A Bone marrow imaging, body ......................... 0.00 6.02 4.56 NA NA 0.22 6.24 4.78 NA NA XXX78110 ......... ............ A Plasma volume, single .................................. 0.19 2.16 1.31 NA NA 0.07 2.42 1.57 NA NA XXX78110 ......... 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 XXX78110 ......... TC ...... A Plasma volume, single .................................. 0.00 2.10 1.24 NA NA 0.06 2.16 1.30 NA NA XXX78111 ......... ............ 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 XXX78111 ......... TC ...... A Plasma volume, multiple ............................... 0.00 2.09 2.45 NA NA 0.14 2.23 2.59 NA NA XXX78120 ......... ............ A Red cell mass, single .................................... 0.23 2.09 1.88 NA NA 0.12 2.44 2.23 NA NAXXX78120 ......... 26 ....... A Red cell mass, single .................................... 0.23 0.07 0.08 0.07 0.08 0.01 0.31 0.32 0.310.32 XXX78120 ......... TC ...... A Red cell mass, single .................................... 0.00 2.02 1.80 NA NA 0.11 2.13 1.91 NA NA XXX78121 ......... ............ A Red cell mass, multiple ................................. 0.32 2.19 2.81 NA NA 0.15 2.66 3.28 NA NA XXX78121 ......... 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 XXX78121 ......... TC ...... A Red cell mass, multiple ................................. 0.00 2.10 2.71 NA NA 0.14 2.24 2.85 NA NA XXX78122 ......... ............ A Blood volume ................................................. 0.45 2.25 4.13 NA NA 0.26 2.96 4.84 NANA XXX78122 ......... 26 ....... A Blood volume ................................................. 0.45 0.14 0.16 0.14 0.16 0.02 0.61 0.63 0.61 0.63 XXX78122 ......... TC ...... A Blood volume ................................................. 0.00 2.11 3.98 NA NA 0.24 2.35 4.22 NA NAXXX78130 ......... ............ A Red cell survival study .................................. 0.61 3.55 3.18 NA NA 0.17 4.33 3.96 NA NAXXX78130 ......... 26 ....... A Red cell survival study .................................. 0.61 0.20 0.21 0.20 0.21 0.03 0.84 0.85 0.840.85 XXX78130 ......... TC ...... A Red cell survival study .................................. 0.00 3.35 2.98 NA NA 0.14 3.49 3.12 NA NA XXX78135 ......... ............ A Red cell survival kinetics ............................... 0.64 8.59 5.97 NA NA 0.28 9.51 6.89 NA NAXXX78135 ......... 26 ....... A Red cell survival kinetics ............................... 0.64 0.20 0.22 0.20 0.22 0.03 0.87 0.89 0.870.89 XXX78135 ......... TC ...... A Red cell survival kinetics ............................... 0.00 8.39 5.75 NA NA 0.25 8.64 6.00 NA NA XXX78140 ......... ............ A Red cell sequestration ................................... 0.61 2.87 3.82 NA NA 0.24 3.72 4.67 NA NAXXX78140 ......... 26 ....... A Red cell sequestration ................................... 0.61 0.19 0.20 0.19 0.20 0.03 0.83 0.84 0.830.84 XXX78140 ......... TC ...... A Red cell sequestration ................................... 0.00 2.68 3.62 NA NA 0.21 2.89 3.83 NA NA XXX78185 ......... ............ A Spleen imaging .............................................. 0.40 5.22 3.18 NA NA 0.15 5.77 3.73 NANA XXX78185 ......... 26 ....... A Spleen imaging .............................................. 0.40 0.12 0.14 0.12 0.14 0.02 0.54 0.56 0.54 0.56 XXX78185 ......... TC ...... A Spleen imaging .............................................. 0.00 5.10 3.05 NA NA 0.13 5.23 3.18 NA NA XXX78190 ......... ............ A Platelet survival, kinetics ............................... 1.09 9.05 6.84 NA NA 0.38 10.52 8.31 NA NA XXX78190 ......... 26 ....... A Platelet survival, kinetics ............................... 1.09 0.34 0.38 0.34 0.38 0.08 1.51 1.55 1.511.55 XXX78190 ......... 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 XXX78191 ......... 26 ....... A Platelet survival ............................................. 0.61 0.19 0.20 0.19 0.20 0.03 0.83 0.840.83 0.84 XXX78191 ......... TC ...... A Platelet survival ............................................. 0.00 3.24 6.32 NA NA 0.37 3.61 6.69 NA NAXXX78195 ......... ............ 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 1.66XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00223 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49204 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal78195 ......... TC ...... A Lymph system imaging ................................. 0.00 8.29 5.13 NA NA 0.22 8.51 5.35 NA NA XXX78199 ......... ............ 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 XXX78199 ......... 26 ....... C Blood/lymph nuclear exam ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78199 ......... 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 XXX78201 ......... ............ A Liver imaging ................................................. 0.44 4.75 3.07 NA NA 0.15 5.34 3.66 NA NA XXX78201 ......... 26 ....... A Liver imaging ................................................. 0.44 0.13 0.15 0.13 0.15 0.02 0.59 0.610.59 0.61 XXX78201 ......... TC ...... A Liver imaging ................................................. 0.00 4.61 2.92 NA NA 0.13 4.74 3.05 NA NAXXX78202 ......... ............ A Liver imaging with flow .................................. 0.51 5.34 3.62 NA NA 0.16 6.01 4.29 NA NAXXX78202 ......... 26 ....... A Liver imaging with flow .................................. 0.51 0.16 0.17 0.16 0.17 0.02 0.69 0.70 0.690.70 XXX78202 ......... TC ...... A Liver imaging with flow .................................. 0.00 5.19 3.46 NA NA 0.14 5.33 3.60 NA NA XXX78205 ......... ............ A Liver imaging (3D) ......................................... 0.71 5.26 5.93 NA NA 0.34 6.31 6.98 NA NA XXX78205 ......... 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 XXX78205 ......... TC ...... A Liver imaging (3D) ......................................... 0.00 5.04 5.69 NA NA 0.31 5.35 6.00 NA NA XXX78206 ......... ............ A Liver image (3d) with flow ............................. 0.96 14.57 8.32 NA NA 0.15 15.68 9.43 NA NAXXX78206 ......... 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 XXX78206 ......... TC ...... A Liver image (3d) with flow ............................. 0.00 14.26 8.00 NA NA 0.11 14.37 8.11 NA NA XXX78215 ......... ............ 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 XXX78215 ......... TC ...... A Liver and spleen imaging .............................. 0.00 4.66 3.37 NA NA 0.14 4.80 3.51 NA NA XXX78216 ......... ............ 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 XXX78216 ......... TC ...... A Liver & spleen image/flow ............................. 0.00 2.64 3.27 NA NA 0.18 2.82 3.45 NA NA XXX78220 ......... ............ A Liver function study ....................................... 0.49 3.04 3.67 NA NA 0.21 3.74 4.37 NA NA XXX78220 ......... 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 XXX78220 ......... TC ...... A Liver function study ....................................... 0.00 2.89 3.51 NA NA 0.19 3.08 3.70 NA NA XXX78223 ......... ............ A Hepatobiliary imaging .................................... 0.84 8.49 5.08 NA NA 0.23 9.56 6.15 NA NAXXX78223 ......... 26 ....... A Hepatobiliary imaging .................................... 0.84 0.26 0.28 0.26 0.28 0.04 1.14 1.16 1.141.16 XXX78223 ......... TC ...... A Hepatobiliary imaging .................................... 0.00 8.23 4.80 NA NA 0.19 8.42 4.99 NA NA XXX78230 ......... ............ A Salivary gland imaging .................................. 0.45 4.16 2.79 NA NA 0.15 4.76 3.39 NA NA XXX78230 ......... 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 XXX78230 ......... TC ...... A Salivary gland imaging .................................. 0.00 4.02 2.64 NA NA 0.13 4.15 2.77 NA NA XXX78231 ......... ............ A Serial salivary imaging .................................. 0.52 2.81 3.22 NA NA 0.19 3.52 3.93 NA NAXXX78231 ......... 26 ....... A Serial salivary imaging .................................. 0.52 0.16 0.18 0.16 0.18 0.02 0.70 0.72 0.700.72 XXX78231 ......... TC ...... A Serial salivary imaging .................................. 0.00 2.64 3.04 NA NA 0.17 2.81 3.21 NA NA XXX78232 ......... ............ A Salivary gland function exam ........................ 0.47 2.78 3.47 NA NA 0.20 3.45 4.14 NA NA XXX78232 ......... 26 ....... A Salivary gland function exam ........................ 0.47 0.15 0.16 0.15 0.16 0.02 0.64 0.65 0.64 0.65XXX78232 ......... TC ...... A Salivary gland function exam ........................ 0.00 2.64 3.32 NA NA 0.18 2.82 3.50 NA NA XXX78258 ......... ............ 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 XXX78258 ......... TC ...... A Esophageal motility study ............................. 0.00 5.56 3.55 NA NA 0.14 5.70 3.69 NA NA XXX78261 ......... ............ 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 XXX78261 ......... TC ...... A Gastric mucosa imaging ................................ 0.00 5.85 4.54 NA NA 0.22 6.07 4.76 NA NA XXX78262 ......... ............ A Gastroesophageal reflux exam ..................... 0.68 5.94 4.85 NA NA 0.25 6.87 5.78 NA NA XXX78262 ......... 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 XXX78264 ......... ............ A Gastric emptying study .................................. 0.78 7.16 5.08 NA NA 0.25 8.19 6.11 NA NA XXX78264 ......... 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 XXX78264 ......... TC ...... A Gastric emptying study .................................. 0.00 6.91 4.83 NA NA 0.22 7.13 5.05 NA NA XXX78270 ......... ............ 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 XXX78270 ......... TC ...... A Vit B-12 absorption exam .............................. 0.00 1.88 1.63 NA NA 0.10 1.98 1.73 NA NA XXX78271 ......... ............ 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 XXX78271 ......... 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 XXX78272 ......... ............ A Vit B-12 absorp, combined ............................ 0.27 2.02 2.31 NA NA 0.14 2.43 2.72 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00224 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49205 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules78272 ......... 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 0.37XXX78272 ......... TC ...... A Vit B-12 absorp, combined ............................ 0.00 1.95 2.23 NA NA 0.13 2.08 2.36 NA NA XXX78278 ......... ............ A Acute GI blood loss imaging ......................... 0.99 8.57 6.04 NA NA 0.29 9.85 7.32 NA NA XXX78278 ......... 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 1.36XXX78278 ......... TC ...... A Acute GI blood loss imaging ......................... 0.00 8.26 5.72 NA NA 0.25 8.51 5.97 NA NA XXX78282 ......... ............ 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 XXX78282 ......... 26 ....... A GI protein loss exam ..................................... 0.38 0.12 0.13 0.12 0.13 0.02 0.52 0.53 0.520.53 XXX78282 ......... 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 XXX78290 ......... ............ A MeckelIs divert exam .................................... 0.68 8.46 4.58 NA NA 0.19 9.33 5.45 NA NA XXX78290 ......... 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 XXX78290 ......... TC ...... A MeckelIs divert exam .................................... 0.00 8.25 4.35 NA NA 0.16 8.41 4.51 NA NA XXX78291 ......... ............ A Leveen/shunt patency exam ......................... 0.88 6.17 4.06 NA NA 0.20 7.25 5.14 NA NA XXX78291 ......... 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 XXX78291 ......... TC ...... A Leveen/shunt patency exam ......................... 0.00 5.90 3.77 NA NA 0.16 6.06 3.93 NA NA XXX78299 ......... ............ C GI nuclear procedure .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78299 ......... 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 XXX78299 ......... 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 XXX78300 ......... ............ A Bone imaging, limited area ........................... 0.62 4.20 3.07 NA NA 0.17 4.99 3.86 NA NA XXX78300 ......... 26 ....... A Bone imaging, limited area ........................... 0.62 0.19 0.21 0.19 0.21 0.03 0.84 0.86 0.84 0.86XXX78300 ......... TC ...... A Bone imaging, limited area ........................... 0.00 4.01 2.86 NA NA 0.14 4.15 3.00 NA NA XXX78305 ......... ............ A Bone imaging, multiple areas ........................ 0.83 5.46 4.32 NA NA 0.23 6.52 5.38 NA NA XXX78305 ......... 26 ....... A Bone imaging, multiple areas ........................ 0.83 0.26 0.28 0.26 0.28 0.04 1.13 1.15 1.13 1.15XXX78305 ......... TC ...... A Bone imaging, multiple areas ........................ 0.00 5.20 4.05 NA NA 0.19 5.39 4.24 NA NA XXX78306 ......... ............ A Bone imaging, whole body ............................ 0.86 6.05 4.93 NA NA 0.26 7.17 6.05 NA NA XXX78306 ......... 26 ....... A Bone imaging, whole body ............................ 0.86 0.27 0.29 0.27 0.29 0.04 1.17 1.19 1.17 1.19XXX78306 ......... TC ...... A Bone imaging, whole body ............................ 0.00 5.78 4.65 NA NA 0.22 6.00 4.87 NA NA XXX78315 ......... ............ 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 XXX78315 ......... TC ...... A Bone imaging, 3 phase ................................. 0.00 8.27 5.65 NA NA 0.25 8.52 5.90 NA NA XXX78320 ......... ............ A Bone imaging (3D) ........................................ 1.04 5.36 6.04 NA NA 0.35 6.75 7.43 NA NAXXX78320 ......... 26 ....... A Bone imaging (3D) ........................................ 1.04 0.33 0.35 0.33 0.35 0.04 1.41 1.43 1.411.43 XXX78320 ......... TC ...... A Bone imaging (3D) ........................................ 0.00 5.03 5.69 NA NA 0.31 5.34 6.00 NA NA XXX78350 ......... ............ A Bone mineral, single photon ......................... 0.22 0.56 0.76 NA NA 0.06 0.84 1.04 NA NA XXX78350 ......... 26 ....... A Bone mineral, single photon ......................... 0.22 0.06 0.07 0.06 0.07 0.01 0.29 0.30 0.29 0.30XXX78350 ......... TC ...... A Bone mineral, single photon ......................... 0.00 0.49 0.69 NA NA 0.05 0.54 0.74 NA NA XXX78351 ......... ............ 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 XXX78399 ......... ............ C Musculoskeletal nuclear exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78399 ......... 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 XXX78399 ......... 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 XXX78414 ......... 26 ....... A Non-imaging heart function ........................... 0.45 0.14 0.16 0.14 0.16 0.02 0.61 0.63 0.61 0.63XXX78414 ......... TC ...... C Non-imaging heart function ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78428 ......... ............ A Cardiac shunt imaging .................................. 0.78 5.36 3.25 NA NA 0.16 6.30 4.19 NA NA XXX78428 ......... 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 XXX78428 ......... TC ...... A Cardiac shunt imaging .................................. 0.00 4.98 2.93 NA NA 0.13 5.11 3.06 NA NA XXX78445 ......... ............ A Vascular flow imaging ................................... 0.49 4.63 2.68 NA NA 0.13 5.25 3.30 NA NA XXX78445 ......... 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 XXX78445 ......... TC ...... A Vascular flow imaging ................................... 0.00 4.45 2.51 NA NA 0.11 4.56 2.62 NA NA XXX78456 ......... ............ A Acute venous thrombus image ..................... 1.00 10.04 5.75 NA NA 0.33 11.37 7.08 NA NA XXX78456 ......... 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 XXX78456 ......... TC ...... A Acute venous thrombus image ..................... 0.00 9.54 5.37 NA NA 0.29 9.83 5.66 NA NA XXX78457 ......... ............ A Venous thrombosis imaging .......................... 0.77 4.73 3.38 NA NA 0.17 5.67 4.32 NA NA XXX78457 ......... 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 XXX78457 ......... TC ...... A Venous thrombosis imaging .......................... 0.00 4.49 3.12 NA NA 0.14 4.63 3.26 NA NA XXX78458 ......... ............ A Ven thrombosis images, bilat ........................ 0.90 4.59 4.40 NA NA 0.25 5.74 5.55 NA NA XXX78458 ......... 26 ....... A Ven thrombosis images, bilat ........................ 0.90 0.28 0.31 0.28 0.31 0.04 1.22 1.25 1.22 1.25XXX78458 ......... TC ...... A Ven thrombosis images, bilat ........................ 0.00 4.31 4.09 NA NA 0.21 4.52 4.30 NA NA XXX78459 ......... ............ 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 XXX78459 ......... 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 XXX78459 ......... 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 XXX78460 ......... ............ 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 XXX78460 ......... TC ...... A Heart muscle blood, single ............................ 0.00 4.39 2.87 NA NA 0.13 4.52 3.00 NA NA XXX78461 ......... ............ A Heart muscle blood, multiple ......................... 1.23 4.01 4.87 NA NA 0.30 5.54 6.40 NA NA XXX78461 ......... 26 ....... A Heart muscle blood, multiple ......................... 1.23 0.42 0.43 0.42 0.43 0.05 1.70 1.71 1.70 1.71XXX78461 ......... TC ...... A Heart muscle blood, multiple ......................... 0.00 3.59 4.44 NA NA 0.25 3.84 4.69 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00225 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49206 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal78464 ......... ............ A Heart image (3d), single ................................ 1.09 5.91 7.07 NA NA 0.41 7.41 8.57 NA NA XXX78464 ......... 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 XXX78464 ......... TC ...... A Heart image (3d), single ................................ 0.00 5.42 6.66 NA NA 0.37 5.79 7.03 NA NA XXX78465 ......... ............ A Heart image (3d), multiple ............................. 1.46 11.58 12.12 NA NA 0.67 13.71 14.25 NA NA XXX78465 ......... 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 XXX78465 ......... TC ...... A Heart image (3d), multiple ............................. 0.00 10.87 11.56 NA NA 0.62 11.49 12.18 NA NA XXX78466 ......... ............ A Heart infarct image ........................................ 0.69 4.52 3.28 NA NA 0.17 5.38 4.14 NA NA XXX78466 ......... 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 XXX78466 ......... TC ...... A Heart infarct image ........................................ 0.00 4.27 3.03 NA NA 0.14 4.41 3.17 NA NA XXX78468 ......... ............ A Heart infarct image (ef) ................................. 0.80 6.06 4.46 NA NA 0.22 7.08 5.48 NA NAXXX78468 ......... 26 ....... A Heart infarct image (ef) ................................. 0.80 0.42 0.31 0.42 0.31 0.03 1.25 1.14 1.251.14 XXX78468 ......... TC ...... A Heart infarct image (ef) ................................. 0.00 5.64 4.16 NA NA 0.19 5.83 4.35 NA NA XXX78469 ......... ............ A Heart infarct image (3D) ................................ 0.92 6.29 5.72 NA NA 0.31 7.52 6.95 NA NA XXX78469 ......... 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 XXX78469 ......... TC ...... A Heart infarct image (3D) ................................ 0.00 5.85 5.38 NA NA 0.28 6.13 5.66 NA NA XXX78472 ......... ............ A Gated heart, planar, single ............................ 0.98 6.15 5.93 NA NA 0.34 7.47 7.25 NA NA XXX78472 ......... 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 XXX78472 ......... TC ...... A Gated heart, planar, single ............................ 0.00 5.75 5.57 NA NA 0.30 6.05 5.87 NA NA XXX78473 ......... ............ A Gated heart, multiple ..................................... 1.47 7.79 8.52 NA NA 0.48 9.74 10.47 NA NA XXX78473 ......... 26 ....... A Gated heart, multiple ..................................... 1.47 0.62 0.54 0.62 0.54 0.06 2.15 2.07 2.152.07 XXX78473 ......... 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 XXX78478 ......... TC ...... A Heart wall motion add-on .............................. 0.00 0.57 1.31 NA NA 0.10 0.67 1.41 NA NA XXX78480 ......... ............ A Heart function add-on .................................... 0.30 0.71 1.51 NA NA 0.12 1.13 1.93 NA NAXXX78480 ......... 26 ....... A Heart function add-on .................................... 0.30 0.15 0.20 0.15 0.20 0.02 0.47 0.52 0.470.52 XXX78480 ......... TC ...... A Heart function add-on .................................... 0.00 0.57 1.31 NA NA 0.10 0.67 1.41 NA NA XXX78481 ......... ............ A Heart first pass, single .................................. 0.98 5.12 5.47 NA NA 0.31 6.41 6.76 NA NAXXX78481 ......... 26 ....... A Heart first pass, single .................................. 0.98 0.49 0.39 0.49 0.39 0.03 1.50 1.40 1.501.40 XXX78481 ......... 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 NAXXX78483 ......... 26 ....... A Heart first pass, multiple ............................... 1.47 0.79 0.60 0.79 0.60 0.05 2.31 2.12 2.312.12 XXX78483 ......... TC ...... A Heart first pass, multiple ............................... 0.00 6.14 7.44 NA NA 0.41 6.55 7.85 NA NA XXX78491 ......... ............ 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 XXX78491 ......... 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 XXX78491 ......... 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 XXX78492 ......... ............ C Heart image (pet), multiple ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX78492 ......... 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 XXX78492 ......... 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 XXX78494 ......... ............ A Heart image, spect ........................................ 1.19 6.30 7.19 NA NA 0.35 7.84 8.73 NA NAXXX78494 ......... 26 ....... A Heart image, spect ........................................ 1.19 0.54 0.45 0.54 0.45 0.05 1.78 1.69 1.781.69 XXX78494 ......... 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 ZZZ78496 ......... 26 ....... A Heart first pass add-on .................................. 0.50 0.25 0.20 0.25 0.20 0.02 0.77 0.72 0.770.72 ZZZ78496 ......... 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 ZZZ78499 ......... ............ C Cardiovascular nuclear exam ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78499 ......... 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 XXX78499 ......... 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 XXX78580 ......... ............ A Lung perfusion imaging ................................. 0.74 5.12 4.04 NA NA 0.21 6.07 4.99 NA NA XXX78580 ......... 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 XXX78580 ......... TC ...... A Lung perfusion imaging ................................. 0.00 4.88 3.79 NA NA 0.18 5.06 3.97 NA NA XXX78584 ......... ............ A Lung V/Q image single breath ...................... 0.99 2.93 3.38 NA NA 0.21 4.13 4.58 NA NA XXX78584 ......... 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 XXX78584 ......... TC ...... A Lung V/Q image single breath ...................... 0.00 2.62 3.06 NA NA 0.17 2.79 3.23 NA NA XXX78585 ......... ............ A Lung V/Q imaging ......................................... 1.09 8.60 6.65 NA NA 0.35 10.04 8.09 NA NAXXX78585 ......... 26 ....... A Lung V/Q imaging ......................................... 1.09 0.34 0.36 0.34 0.36 0.05 1.48 1.50 1.481.50 XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00226 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49207 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules78585 ......... TC ...... A Lung V/Q imaging ......................................... 0.00 8.26 6.30 NA NA 0.30 8.56 6.60 NA NA XXX78586 ......... ............ 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 XXX78586 ......... TC ...... A Aerosol lung image, single ............................ 0.00 4.01 2.95 NA NA 0.14 4.15 3.09 NA NA XXX78587 ......... ............ A Aerosol lung image, multiple ......................... 0.49 5.43 3.59 NA NA 0.16 6.08 4.24 NA NA XXX78587 ......... 26 ....... A Aerosol lung image, multiple ......................... 0.49 0.15 0.17 0.15 0.17 0.02 0.66 0.68 0.66 0.68XXX78587 ......... TC ...... A Aerosol lung image, multiple ......................... 0.00 5.27 3.42 NA NA 0.14 5.41 3.56 NA NA XXX78588 ......... ............ A Perfusion lung image .................................... 1.09 8.63 4.83 NA NA 0.23 9.95 6.15 NA NA XXX78588 ......... 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 XXX78588 ......... TC ...... A Perfusion lung image .................................... 0.00 8.29 4.47 NA NA 0.18 8.47 4.65 NA NA XXX78591 ......... ............ A Vent image, 1 breath, 1 proj ......................... 0.40 4.12 3.27 NA NA 0.16 4.68 3.83 NA NA XXX78591 ......... 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 0.55XXX78591 ......... TC ...... A Vent image, 1 breath, 1 proj ......................... 0.00 4.00 3.14 NA NA 0.14 4.14 3.28 NA NA XXX78593 ......... ............ A Vent image, 1 proj, gas ................................. 0.49 4.79 3.91 NA NA 0.20 5.48 4.60 NA NA XXX78593 ......... 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 XXX78593 ......... TC ...... A Vent image, 1 proj, gas ................................. 0.00 4.64 3.75 NA NA 0.18 4.82 3.93 NA NA XXX78594 ......... ............ 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 XXX78594 ......... TC ...... A Vent image, mult proj, gas ............................ 0.00 5.13 5.02 NA NA 0.25 5.38 5.27 NA NA XXX78596 ......... ............ A Lung differential function ............................... 1.27 8.73 7.80 NA NA 0.42 10.42 9.49 NA NAXXX78596 ......... 26 ....... A Lung differential function ............................... 1.27 0.37 0.41 0.37 0.41 0.05 1.69 1.73 1.691.73 XXX78596 ......... TC ...... A Lung differential function ............................... 0.00 8.36 7.39 NA NA 0.37 8.73 7.76 NA NA XXX78599 ......... ............ C Respiratory nuclear exam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78599 ......... 26 ....... C Respiratory nuclear exam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78599 ......... TC ...... C Respiratory nuclear exam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78600 ......... ............ A Brain imaging, ltd static ................................. 0.44 7.30 4.10 NA NA 0.16 7.90 4.70 NA NAXXX78600 ......... 26 ....... A Brain imaging, ltd static ................................. 0.44 0.14 0.15 0.14 0.15 0.02 0.60 0.61 0.600.61 XXX78600 ......... 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 XXX78601 ......... 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 XXX78601 ......... TC ...... A Brain imaging, ltd w/flow ............................... 0.00 5.19 3.85 NA NA 0.18 5.37 4.03 NA NA XXX78605 ......... ............ A Brain imaging, complete ................................ 0.53 4.75 3.87 NA NA 0.20 5.48 4.60 NA NA XXX78605 ......... 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 XXX78605 ......... TC ...... A Brain imaging, complete ................................ 0.00 4.59 3.70 NA NA 0.18 4.77 3.88 NA NA XXX78606 ......... ............ A Brain imaging, compl w/flow ......................... 0.64 8.54 5.20 NA NA 0.24 9.42 6.08 NA NA XXX78606 ......... 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 0.88XXX78606 ......... TC ...... A Brain imaging, compl w/flow ......................... 0.00 8.34 4.99 NA NA 0.21 8.55 5.20 NA NA XXX78607 ......... ............ A Brain imaging (3D) ........................................ 1.23 15.23 9.04 NA NA 0.40 16.86 10.67 NANA XXX78607 ......... 26 ....... A Brain imaging (3D) ........................................ 1.23 0.38 0.42 0.38 0.42 0.05 1.66 1.70 1.661.70 XXX78607 ......... TC ...... A Brain imaging (3D) ........................................ 0.00 14.85 8.63 NA NA 0.35 15.20 8.98 NA NA XXX78608 ......... ............ C Brain imaging (PET) ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78608 ......... 26 ....... A Brain imaging (PET) ...................................... 1.50 0.47 0.50 0.47 0.50 0.06 2.03 2.06 2.032.06 XXX78608 ......... 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 XXX78609 ......... ............ C Brain imaging (PET) ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78609 ......... 26 ....... A Brain imaging (PET) ...................................... 1.50 0.47 0.50 0.47 0.50 0.06 2.03 2.06 2.032.06 XXX78609 ......... 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 XXX78610 ......... ............ A Brain flow imaging only ................................. 0.30 4.44 2.38 NA NA 0.11 4.85 2.79 NA NA XXX78610 ......... 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 XXX78610 ......... TC ...... A Brain flow imaging only ................................. 0.00 4.35 2.27 NA NA 0.10 4.45 2.37 NA NA XXX78615 ......... ............ A Cerebral vascular flow image ........................ 0.42 5.34 4.34 NA NA 0.23 5.99 4.99 NA NA XXX78615 ......... 26 ....... A Cerebral vascular flow image ........................ 0.42 0.13 0.15 0.13 0.15 0.02 0.57 0.59 0.57 0.59XXX78615 ......... TC ...... A Cerebral vascular flow image ........................ 0.00 5.21 4.19 NA NA 0.21 5.42 4.40 NA NA XXX78630 ......... ............ A Cerebrospinal fluid scan ................................ 0.68 8.61 6.10 NA NA 0.30 9.59 7.08 NA NA XXX78630 ......... 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 XXX78630 ......... TC ...... A Cerebrospinal fluid scan ................................ 0.00 8.40 5.88 NA NA 0.27 8.67 6.15 NA NA XXX78635 ......... ............ A CSF ventriculography .................................... 0.61 8.54 4.21 NA NA 0.16 9.31 4.98 NA NA XXX78635 ......... 26 ....... A CSF ventriculography .................................... 0.61 0.19 0.22 0.19 0.22 0.02 0.82 0.85 0.82 0.85 XXX78635 ......... TC ...... A CSF ventriculography .................................... 0.00 8.35 3.99 NA NA 0.14 8.49 4.13 NA NA XXX78645 ......... ............ A CSF shunt evaluation .................................... 0.57 8.43 4.82 NA NA 0.20 9.20 5.59 NA NA XXX78645 ......... 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 XXX78645 ......... TC ...... A CSF shunt evaluation .................................... 0.00 8.25 4.64 NA NA 0.18 8.43 4.82 NA NA XXX78647 ......... ............ A Cerebrospinal fluid scan ................................ 0.90 14.31 8.24 NA NA 0.35 15.56 9.49 NA NAXXX78647 ......... 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 XXX78647 ......... 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 XXX78650 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00227 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49208 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal78650 ......... TC ...... A CSF leakage imaging .................................... 0.00 8.43 5.59 NA NA 0.24 8.67 5.83 NA NA XXX78660 ......... ............ 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 XXX78660 ......... TC ...... A Nuclear exam of tear flow ............................. 0.00 4.07 2.61 NA NA 0.12 4.19 2.73 NA NA XXX78699 ......... ............ C Nervous system nuclear exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78699 ......... 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 XXX78700 ......... ............ A Kidney imaging, static ................................... 0.45 4.47 3.52 NA NA 0.18 5.10 4.15 NA NAXXX78700 ......... 26 ....... A Kidney imaging, static ................................... 0.45 0.15 0.15 0.15 0.15 0.02 0.62 0.62 0.620.62 XXX78700 ......... TC ...... A Kidney imaging, static ................................... 0.00 4.32 3.37 NA NA 0.16 4.48 3.53 NA NA XXX78701 ......... ............ A Kidney imaging with flow ............................... 0.49 5.36 4.13 NA NA 0.20 6.05 4.82 NA NA XXX78701 ......... 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 XXX78701 ......... TC ...... A Kidney imaging with flow ............................... 0.00 5.21 3.97 NA NA 0.18 5.39 4.15 NA NA XXX78704 ......... ............ A Imaging renogram ......................................... 0.74 5.42 4.51 NA NA 0.24 6.40 5.49 NA NAXXX78704 ......... 26 ....... A Imaging renogram ......................................... 0.74 0.23 0.25 0.23 0.25 0.03 1.00 1.02 1.001.02 XXX78704 ......... TC ...... A Imaging renogram ......................................... 0.00 5.19 4.26 NA NA 0.21 5.40 4.47 NA NA XXX78707 ......... ............ A Kidney flow/function image ........................... 0.96 5.48 4.96 NA NA 0.27 6.71 6.19 NA NA XXX78707 ......... 26 ....... A Kidney flow/function image ........................... 0.96 0.30 0.32 0.30 0.32 0.04 1.30 1.32 1.30 1.32XXX78707 ......... TC ...... A Kidney flow/function image ........................... 0.00 5.18 4.65 NA NA 0.23 5.41 4.88 NA NA XXX78708 ......... ............ A Kidney flow/function image ........................... 1.21 3.41 4.51 NA NA 0.28 4.90 6.00 NA NA XXX78708 ......... 26 ....... A Kidney flow/function image ........................... 1.21 0.38 0.40 0.38 0.40 0.05 1.64 1.66 1.64 1.66XXX78708 ......... TC ...... A Kidney flow/function image ........................... 0.00 3.03 4.11 NA NA 0.23 3.26 4.34 NA NA XXX78709 ......... ............ 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 1.94XXX78709 ......... TC ...... A Kidney flow/function image ........................... 0.00 8.43 5.46 NA NA 0.23 8.66 5.69 NA NA XXX78710 ......... ............ A Kidney imaging (3D) ...................................... 0.66 5.29 5.92 NA NA 0.34 6.29 6.92 NA NAXXX78710 ......... 26 ....... A Kidney imaging (3D) ...................................... 0.66 0.21 0.22 0.21 0.22 0.03 0.90 0.91 0.900.91 XXX78710 ......... TC ...... A Kidney imaging (3D) ...................................... 0.00 5.08 5.70 NA NA 0.31 5.39 6.01 NA NA XXX78715 ......... ............ A Renal vascular flow exam ............................. 0.30 4.82 2.47 NA NA 0.11 5.23 2.88 NA NA XXX78715 ......... 26 ....... A Renal vascular flow exam ............................. 0.30 0.13 0.12 0.13 0.12 0.01 0.44 0.43 0.44 0.43XXX78715 ......... TC ...... A Renal vascular flow exam ............................. 0.00 4.69 2.36 NA NA 0.10 4.79 2.46 NA NA XXX78725 ......... ............ A Kidney function study .................................... 0.38 2.35 2.02 NA NA 0.13 2.86 2.53 NA NAXXX78725 ......... 26 ....... A Kidney function study .................................... 0.38 0.12 0.13 0.12 0.13 0.02 0.52 0.53 0.520.53 XXX78725 ......... TC ...... A Kidney function study .................................... 0.00 2.23 1.89 NA NA 0.11 2.34 2.00 NA NA XXX78730 ......... ............ A Urinary bladder retention ............................... 0.36 1.85 1.65 1.85 1.65 0.10 2.31 2.11 2.31 2.11 XXX78730 ......... 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 XXX78730 ......... 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 XXX78740 ......... ............ A Ureteral reflux study ...................................... 0.57 5.48 3.10 NA NA 0.15 6.20 3.82 NA NA XXX78740 ......... 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 XXX78740 ......... TC ...... A Ureteral reflux study ...................................... 0.00 5.30 2.92 NA NA 0.12 5.42 3.04 NA NA XXX78760 ......... ............ A Testicular imaging ......................................... 0.66 4.52 3.31 NA NA 0.17 5.35 4.14 NA NA XXX78760 ......... 26 ....... A Testicular imaging ......................................... 0.66 0.22 0.22 0.22 0.22 0.03 0.91 0.91 0.91 0.91 XXX78760 ......... TC ...... A Testicular imaging ......................................... 0.00 4.30 3.09 NA NA 0.14 4.44 3.23 NA NA XXX78761 ......... ............ A Testicular imaging/flow .................................. 0.71 4.96 3.82 NA NA 0.20 5.87 4.73 NA NAXXX78761 ......... 26 ....... A Testicular imaging/flow .................................. 0.71 0.23 0.24 0.23 0.24 0.03 0.97 0.98 0.970.98 XXX78761 ......... TC ...... A Testicular imaging/flow .................................. 0.00 4.72 3.58 NA NA 0.17 4.89 3.75 NA NA XXX78799 ......... ............ C Genitourinary nuclear exam .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX78799 ......... 26 ....... C Genitourinary nuclear exam .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78799 ......... 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 XXX78800 ......... ............ A Tumor imaging, limited area ......................... 0.66 4.29 3.79 NA NA 0.22 5.17 4.67 NA NA XXX78800 ......... 26 ....... A Tumor imaging, limited area ......................... 0.66 0.20 0.22 0.20 0.22 0.04 0.90 0.92 0.90 0.92XXX78800 ......... TC ...... A Tumor imaging, limited area ......................... 0.00 4.09 3.57 NA NA 0.18 4.27 3.75 NA NA XXX78801 ......... ............ A Tumor imaging, mult areas ........................... 0.79 6.10 4.89 NA NA 0.27 7.16 5.95 NA NA XXX78801 ......... 26 ....... A Tumor imaging, mult areas ........................... 0.79 0.24 0.26 0.24 0.26 0.05 1.08 1.10 1.08 1.10XXX78801 ......... TC ...... A Tumor imaging, mult areas ........................... 0.00 5.86 4.63 NA NA 0.22 6.08 4.85 NA NA XXX78802 ......... ............ A Tumor imaging, whole body .......................... 0.86 8.17 6.41 NA NA 0.34 9.37 7.61 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00228 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49209 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules78802 ......... 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 XXX78802 ......... TC ...... A Tumor imaging, whole body .......................... 0.00 7.90 6.12 NA NA 0.30 8.20 6.42 NA NA XXX78803 ......... ............ A Tumor imaging (3D) ...................................... 1.09 15.02 8.95 NA NA 0.40 16.51 10.44 NA NA XXX78803 ......... 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 XXX78803 ......... 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 XXX78804 ......... 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 XXX78804 ......... TC ...... A Tumor imaging, whole body .......................... 0.00 14.58 11.94 NA NA 0.30 14.88 12.24 NA NA XXX78805 ......... ............ 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 XXX78805 ......... TC ...... A Abscess imaging, ltd area ............................. 0.00 3.97 3.54 NA NA 0.18 4.15 3.72 NA NA XXX78806 ......... ............ A Abscess imaging, whole body ....................... 0.86 8.35 7.13 NA NA 0.39 9.60 8.38 NA NA XXX78806 ......... 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 XXX78806 ......... TC ...... A Abscess imaging, whole body ....................... 0.00 8.08 6.84 NA NA 0.35 8.43 7.19 NA NA XXX78807 ......... ............ A Nuclear localization/abscess ......................... 1.09 14.28 8.78 NA NA 0.39 15.76 10.26 NA NA XXX78807 ......... 26 ....... A Nuclear localization/abscess ......................... 1.09 0.34 0.38 0.34 0.38 0.04 1.47 1.51 1.47 1.51XXX78807 ......... TC ...... A Nuclear localization/abscess ......................... 0.00 13.94 8.40 NA NA 0.35 14.29 8.75 NA NA XXX78811 ......... ............ 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 XXX78811 ......... 26 ....... A Tumor imaging (pet), limited ......................... 1.54 0.48 0.52 0.48 0.52 0.11 2.13 2.17 2.13 2.17XXX78811 ......... TC ...... C Tumor imaging (pet), limited ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX78812 ......... ............ 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 XXX78812 ......... 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 2.69XXX78812 ......... 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 XXX78813 ......... ............ 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 XXX78813 ......... 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 2.78XXX78813 ......... 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 0.00XXX78814 ......... ............ C Tumor image pet/ct, limited ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX78814 ......... 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 XXX78814 ......... 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 0.00XXX78815 ......... ............ 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 XXX78815 ......... 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 3.37XXX78815 ......... 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 XXX78816 ......... ............ 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 XXX78816 ......... 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 3.45XXX78816 ......... 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 XXX78890 ......... ............ B Nuclear medicine data proc .......................... 0.05 0.39 1.10 NA NA 0.07 0.51 1.22 NA NA XXX78890 ......... 26 ....... B Nuclear medicine data proc .......................... 0.05 0.01 0.02 0.01 0.02 0.01 0.07 0.08 0.07 0.08XXX78890 ......... TC ...... B Nuclear medicine data proc .......................... 0.00 0.38 1.08 NA NA 0.06 0.44 1.14 NA NA XXX78891 ......... ............ B Nuclear med data proc .................................. 0.10 0.89 2.22 NA NA 0.14 1.13 2.46 NA NA XXX78891 ......... 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 XXX78891 ......... TC ...... B Nuclear med data proc .................................. 0.00 0.86 2.18 NA NA 0.13 0.99 2.31 NA NA XXX78999 ......... ............ C Nuclear diagnostic exam ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX78999 ......... 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 XXX78999 ......... TC ...... C Nuclear diagnostic exam ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX79005 ......... ............ A Nuclear rx, oral admin ................................... 1.80 1.78 2.86 NA NA 0.22 3.80 4.88 NA NAXXX79005 ......... 26 ....... A Nuclear rx, oral admin ................................... 1.80 0.53 0.58 0.53 0.58 0.08 2.41 2.46 2.412.46 XXX79005 ......... TC ...... A Nuclear rx, oral admin ................................... 0.00 1.25 2.28 NA NA 0.14 1.39 2.42 NA NA XXX79101 ......... ............ A Nuclear rx, iv admin ...................................... 1.96 2.10 2.99 NA NA 0.22 4.28 5.17 NA NAXXX79101 ......... 26 ....... A Nuclear rx, iv admin ...................................... 1.96 0.68 0.67 0.68 0.67 0.08 2.72 2.71 2.722.71 XXX79101 ......... 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 XXX79200 ......... TC ...... A Nuclear rx, intracav admin ............................ 0.00 1.60 2.37 NA NA 0.14 1.74 2.51 NA NA XXX79300 ......... ............ C Nuclr rx, interstit colloid ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX79300 ......... 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 XXX79300 ......... 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 XXX79403 ......... ............ A Hematopoietic nuclear tx ............................... 2.25 2.83 4.58 NA NA 0.24 5.32 7.07 NA NA XXX79403 ......... 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 XXX79403 ......... TC ...... A Hematopoietic nuclear tx ............................... 0.00 2.15 3.74 NA NA 0.14 2.29 3.88 NA NA XXX79440 ......... ............ A Nuclear rx, intra-articular ............................... 1.99 1.77 2.95 NA NA 0.22 3.98 5.16 NA NAXXX79440 ......... 26 ....... A Nuclear rx, intra-articular ............................... 1.99 0.61 0.69 0.61 0.69 0.08 2.68 2.76 2.682.76 XXX79440 ......... 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 0.000.00 0.00 XXX79445 ......... 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 XXX79445 ......... TC ...... C Nuclear rx, intra-arterial ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX79999 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00229 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49210 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal79999 ......... 26 ....... C Nuclear medicine therapy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX79999 ......... TC ...... C Nuclear medicine therapy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX80500 ......... ............ A Lab pathology consultation ........................... 0.37 0.20 0.21 0.11 0.15 0.01 0.58 0.59 0.49 0.53 XXX80502 ......... ............ A Lab pathology consultation ........................... 1.33 0.31 0.48 0.25 0.47 0.04 1.68 1.85 1.62 1.84 XXX83020 ......... 26 ....... A Hemoglobin electrophoresis .......................... 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52XXX83912 ......... 26 ....... A Genetic examination ...................................... 0.37 0.11 0.12 0.11 0.12 0.01 0.49 0.50 0.490.50 XXX84165 ......... 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 XXX84166 ......... 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 XXX84181 ......... 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 XXX84182 ......... 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 XXX85060 ......... ............ A Blood smear interpretation ............................ 0.45 0.14 0.17 0.14 0.17 0.02 0.61 0.64 0.610.64 XXX85097 ......... ............ A Bone marrow interpretation ........................... 0.94 1.30 1.76 0.28 0.38 0.04 2.28 2.74 1.26 1.36 XXX85390 ......... 26 ....... A Fibrinolysins screen ....................................... 0.37 0.12 0.13 0.12 0.13 0.01 0.50 0.51 0.50 0.51 XXX85396 ......... ............ A Clotting assay, whole blood .......................... 0.37 NA NA 0.05 0.13 0.04 NA NA 0.46 0.54 XXX85576 ......... 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 XXX86077 ......... ............ 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 XXX86078 ......... ............ 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 XXX86079 ......... ............ 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 XXX86255 ......... 26 ....... A Fluorescent antibody, screen ........................ 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52XXX86256 ......... 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 XXX86320 ......... 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 XXX86327 ......... 26 ....... A Immunoelectrophoresis assay ....................... 0.42 0.13 0.17 0.13 0.17 0.02 0.57 0.61 0.57 0.61 XXX86334 ......... 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 XXX86335 ......... 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 0.52XXX86485 ......... ............ C Skin test, candida .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX86490 ......... ............ A Coccidioidomycosis skin test ........................ 0.00 0.12 0.25 NA NA 0.02 0.14 0.27 NA NA XXX86510 ......... ............ A Histoplasmosis skin test ................................ 0.00 0.14 0.28 NA NA 0.02 0.16 0.30 NA NA XXX86580 ......... ............ A TB intradermal test ........................................ 0.00 0.16 0.23 NA NA 0.02 0.18 0.25 NA NA XXX87164 ......... 26 ....... A Dark field examination ................................... 0.37 0.12 0.12 0.12 0.12 0.01 0.50 0.50 0.500.50 XXX87207 ......... 26 ....... A Smear, special stain ...................................... 0.37 0.11 0.15 0.11 0.15 0.01 0.49 0.53 0.490.53 XXX88104 ......... ............ A Cytopathology, fluids ..................................... 0.56 1.16 0.93 NA NA 0.04 1.76 1.53 NA NAXXX88104 ......... 26 ....... A Cytopathology, fluids ..................................... 0.56 0.16 0.22 0.16 0.22 0.02 0.74 0.80 0.740.80 XXX88104 ......... 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 NAXXX88106 ......... 26 ....... A Cytopathology, fluids ..................................... 0.56 0.15 0.22 0.15 0.22 0.02 0.73 0.80 0.730.80 XXX88106 ......... 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 NAXXX88107 ......... 26 ....... A Cytopathology, fluids ..................................... 0.76 0.23 0.31 0.23 0.31 0.03 1.02 1.10 1.021.10 XXX88107 ......... 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 XXX88108 ......... 26 ....... A Cytopath, concentrate tech ........................... 0.56 0.16 0.22 0.16 0.22 0.02 0.74 0.80 0.74 0.80XXX88108 ......... TC ...... A Cytopath, concentrate tech ........................... 0.00 1.33 1.06 NA NA 0.02 1.35 1.08 NA NA XXX88112 ......... ............ A Cytopath, cell enhance tech .......................... 1.18 1.53 1.85 NA NA 0.04 2.75 3.07 NA NA XXX88112 ......... 26 ....... A Cytopath, cell enhance tech .......................... 1.18 0.31 0.46 0.31 0.46 0.02 1.51 1.66 1.51 1.66XXX88112 ......... TC ...... A Cytopath, cell enhance tech .......................... 0.00 1.22 1.40 NA NA 0.02 1.24 1.42 NA NA XXX88125 ......... ............ A Forensic cytopathology ................................. 0.26 0.25 0.27 NA NA 0.02 0.53 0.55 NA NA XXX88125 ......... 26 ....... A Forensic cytopathology ................................. 0.26 0.06 0.10 0.06 0.10 0.01 0.33 0.37 0.33 0.37 XXX88125 ......... TC ...... A Forensic cytopathology ................................. 0.00 0.20 0.17 NA NA 0.01 0.21 0.18 NA NA XXX88141 ......... ............ 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 XXX88160 ......... ............ A Cytopath smear, other source ....................... 0.50 0.91 0.85 NA NA 0.04 1.45 1.39 NA NA XXX88160 ......... 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 XXX88160 ......... TC ...... A Cytopath smear, other source ....................... 0.00 0.78 0.66 NA NA 0.02 0.80 0.68 NA NA XXX88161 ......... ............ A Cytopath smear, other source ....................... 0.50 1.13 0.99 NA NA 0.04 1.67 1.53 NA NA XXX88161 ......... 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 XXX88161 ......... TC ...... A Cytopath smear, other source ....................... 0.00 0.98 0.79 NA NA 0.02 1.00 0.81 NA NA XXX



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# 49211 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules88162 ......... ............ A Cytopath smear, other source ....................... 0.76 1.18 1.06 NA NA 0.05 1.99 1.87 NA NA XXX88162 ......... 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 XXX88162 ......... TC ...... A Cytopath smear, other source ....................... 0.00 1.01 0.77 NA NA 0.02 1.03 0.79 NA NA XXX88172 ......... ............ 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 XXX88172 ......... TC ...... A Cytopathology eval of fna ............................. 0.00 0.68 0.52 NA NA 0.02 0.70 0.54 NA NA XXX88173 ......... ............ A Cytopath eval, fna, report .............................. 1.39 2.33 2.18 NA NA 0.07 3.79 3.64 NA NA XXX88173 ......... 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 XXX88173 ......... TC ...... A Cytopath eval, fna, report .............................. 0.00 1.93 1.65 NA NA 0.02 1.95 1.67 NA NA XXX88182 ......... ............ A Cell marker study .......................................... 0.77 1.97 1.97 NA NA 0.07 2.81 2.81 NA NA XXX88182 ......... 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 XXX88182 ......... TC ...... A Cell marker study .......................................... 0.00 1.85 1.70 NA NA 0.04 1.89 1.74 NA NA XXX88184 ......... ............ A Flowcytometry/tc, 1 marker ........................... 0.00 2.51 1.62 NA NA 0.02 2.53 1.64 NA NA XXX88185 ......... ............ 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 1.761.81 XXX88188 ......... ............ A Flowcytometry/read, 9-15 .............................. 1.69 0.44 0.54 0.44 0.54 0.01 2.14 2.24 2.142.24 XXX88189 ......... ............ A Flowcytometry/read, 16 & > .......................... 2.23 0.49 0.69 0.49 0.69 0.01 2.73 2.93 2.73 2.93 XXX88199 ......... ............ C Cytopathology procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX88199 ......... 26 ....... C Cytopathology procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX88199 ......... TC ...... C Cytopathology procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX88291 ......... ............ A Cyto/molecular report .................................... 0.52 0.28 0.20 0.28 0.20 0.02 0.82 0.74 0.82 0.74 XXX88299 ......... ............ C Cytogenetic study .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX88300 ......... ............ A Surgical path, gross ...................................... 0.08 0.60 0.49 NA NA 0.02 0.70 0.59 NA NAXXX88300 ......... 26 ....... A Surgical path, gross ...................................... 0.08 0.02 0.03 0.02 0.03 0.01 0.11 0.12 0.110.12 XXX88300 ......... 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 XXX88302 ......... 26 ....... A Tissue exam by pathologist .......................... 0.13 0.04 0.06 0.04 0.06 0.01 0.18 0.20 0.18 0.20XXX88302 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.27 1.05 NA NA 0.02 1.29 1.07 NA NA XXX88304 ......... ............ A Tissue exam by pathologist .......................... 0.22 1.57 1.38 NA NA 0.03 1.82 1.63 NA NA XXX88304 ......... 26 ....... A Tissue exam by pathologist .......................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31XXX88304 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.50 1.30 NA NA 0.02 1.52 1.32 NA NA XXX88305 ......... ............ A Tissue exam by pathologist .......................... 0.75 2.20 1.98 NA NA 0.07 3.02 2.80 NA NA XXX88305 ......... 26 ....... A Tissue exam by pathologist .......................... 0.75 0.21 0.30 0.21 0.30 0.03 0.99 1.08 0.99 1.08XXX88305 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.99 1.68 NA NA 0.04 2.03 1.72 NA NA XXX88307 ......... ............ A Tissue exam by pathologist .......................... 1.59 4.54 3.50 NA NA 0.12 6.25 5.21 NA NA XXX88307 ......... 26 ....... A Tissue exam by pathologist .......................... 1.59 0.48 0.63 0.48 0.63 0.06 2.13 2.28 2.13 2.28XXX88307 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 4.06 2.87 NA NA 0.06 4.12 2.93 NA NA XXX88309 ......... ............ A Tissue exam by pathologist .......................... 2.80 6.37 4.89 NA NA 0.14 9.31 7.83 NA NA XXX88309 ......... 26 ....... A Tissue exam by pathologist .......................... 2.80 0.84 0.94 0.84 0.94 0.08 3.72 3.82 3.72 3.82XXX88309 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 5.52 3.95 NA NA 0.06 5.58 4.01 NA NA XXX88311 ......... ............ A Decalcify tissue ............................................. 0.24 0.26 0.24 NA NA 0.02 0.52 0.50 NANA XXX88311 ......... 26 ....... A Decalcify tissue ............................................. 0.24 0.07 0.09 0.07 0.09 0.01 0.32 0.34 0.32 0.34 XXX88311 ......... TC ...... A Decalcify tissue ............................................. 0.00 0.18 0.14 NA NA 0.01 0.19 0.15 NA NAXXX88312 ......... ............ A Special stains ................................................ 0.54 2.51 1.77 NA NA 0.03 3.08 2.34 NA NA XXX88312 ......... 26 ....... A Special stains ................................................ 0.54 0.15 0.21 0.15 0.21 0.02 0.71 0.770.71 0.77 XXX88312 ......... TC ...... A Special stains ................................................ 0.00 2.36 1.56 NA NA 0.01 2.37 1.57 NA NAXXX88313 ......... ............ A Special stains ................................................ 0.24 1.96 1.43 NA NA 0.02 2.22 1.69 NA NA XXX88313 ......... 26 ....... A Special stains ................................................ 0.24 0.06 0.09 0.06 0.09 0.01 0.31 0.340.31 0.34 XXX88313 ......... TC ...... A Special stains ................................................ 0.00 1.90 1.34 NA NA 0.01 1.91 1.35 NA NAXXX88314 ......... ............ A Histochemical stain ....................................... 0.45 1.96 2.04 NA NA 0.04 2.45 2.53 NA NAXXX88314 ......... 26 ....... A Histochemical stain ....................................... 0.45 0.14 0.18 0.14 0.18 0.02 0.61 0.65 0.610.65 XXX88314 ......... 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 XXX88318 ......... TC ...... A Chemical histochemistry ............................... 0.00 2.89 1.83 NA NA 0.01 2.90 1.84 NA NA XXX88319 ......... ............ 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 XXX88319 ......... TC ...... A Enzyme histochemistry ................................. 0.00 3.14 3.18 NA NA 0.02 3.16 3.20 NA NA XXX88321 ......... ............ A Microslide consultation .................................. 1.63 0.74 0.78 0.48 0.54 0.05 2.42 2.46 2.16 2.22 XXX88323 ......... ............ A Microslide consultation .................................. 1.83 2.23 1.89 NA NA 0.07 4.13 3.79 NA NAXXX88323 ......... 26 ....... A Microslide consultation .................................. 1.83 0.47 0.55 0.47 0.55 0.05 2.35 2.43 2.352.43 XXX88323 ......... TC ...... A Microslide consultation .................................. 0.00 1.77 1.35 NA NA 0.02 1.79 1.37 NA NA XXX88325 ......... ............ A Comprehensive review of data ..................... 2.50 2.27 2.77 0.63 0.87 0.07 4.84 5.34 3.20 3.44XXX88329 ......... ............ A Path consult introp ........................................ 0.67 0.69 0.66 0.21 0.27 0.02 1.38 1.350.90 0.96 XXX88331 ......... ............ 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



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# 49212 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal88331 ......... TC ...... A Path consult intraop, 1 bloc .......................... 0.00 0.88 0.66 NA NA 0.04 0.92 0.70 NA NA XXX88332 ......... ............ A Path consult intraop, addIl ............................ 0.59 0.48 0.47 NA NA 0.04 1.11 1.10 NA NA XXX88332 ......... 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 XXX88332 ......... TC ...... A Path consult intraop, addIl ............................ 0.00 0.30 0.23 NA NA 0.02 0.32 0.25 NA NA XXX88333 ......... ............ A Intraop cyto path consult, 1 ........................... 1.20 1.36 1.15 NA NA 0.08 2.64 2.43 NA NA XXX88333 ......... 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 XXX88333 ......... TC ...... A Intraop cyto path consult, 1 ........................... 0.00 0.98 0.66 NA NA 0.04 1.02 0.70 NA NA XXX88334 ......... ............ A Intraop cyto path consult, 2 ........................... 0.59 0.75 0.64 NA NA 0.04 1.38 1.27 NA NA XXX88334 ......... 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 XXX88334 ......... TC ...... A Intraop cyto path consult, 2 ........................... 0.00 0.57 0.40 NA NA 0.02 0.59 0.42 NA NA XXX88342 ......... ............ A Immunohistochemistry ................................... 0.85 2.05 1.61 NA NA 0.05 2.95 2.51 NA NA XXX88342 ......... 26 ....... A Immunohistochemistry ................................... 0.85 0.23 0.33 0.23 0.33 0.03 1.11 1.21 1.11 1.21 XXX88342 ......... TC ...... A Immunohistochemistry ................................... 0.00 1.82 1.28 NA NA 0.02 1.84 1.30 NA NA XXX88346 ......... ............ A Immunofluorescent study .............................. 0.86 1.97 1.67 NA NA 0.05 2.88 2.58 NA NA XXX88346 ......... 26 ....... A Immunofluorescent study .............................. 0.86 0.23 0.33 0.23 0.33 0.03 1.12 1.22 1.12 1.22XXX88346 ......... TC ...... A Immunofluorescent study .............................. 0.00 1.74 1.34 NA NA 0.02 1.76 1.36 NA NA XXX88347 ......... ............ A Immunofluorescent study .............................. 0.86 1.30 1.27 NA NA 0.05 2.21 2.18 NA NA XXX88347 ......... 26 ....... A Immunofluorescent study .............................. 0.86 0.18 0.31 0.18 0.31 0.03 1.07 1.20 1.07 1.20XXX88347 ......... TC ...... A Immunofluorescent study .............................. 0.00 1.12 0.96 NA NA 0.02 1.14 0.98 NA NA XXX88348 ......... ............ A Electron microscopy ...................................... 1.51 18.27 11.58 NA NA 0.13 19.91 13.22 NANA XXX88348 ......... 26 ....... A Electron microscopy ...................................... 1.51 0.42 0.59 0.42 0.59 0.06 1.99 2.16 1.992.16 XXX88348 ......... TC ...... A Electron microscopy ...................................... 0.00 17.85 11.00 NA NA 0.07 17.92 11.07 NA NAXXX88349 ......... ............ A Scanning electron microscopy ...................... 0.76 8.97 4.91 NA NA 0.09 9.82 5.76 NA NA XXX88349 ......... 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 XXX88349 ......... TC ...... A Scanning electron microscopy ...................... 0.00 8.75 4.61 NA NA 0.06 8.81 4.67 NA NA XXX88355 ......... ............ A Analysis, skeletal muscle .............................. 1.85 3.40 7.42 NA NA 0.13 5.38 9.40 NA NA XXX88355 ......... 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 XXX88355 ......... TC ...... A Analysis, skeletal muscle .............................. 0.00 2.99 6.73 NA NA 0.06 3.05 6.79 NA NA XXX88356 ......... ............ A Analysis, nerve .............................................. 3.02 6.75 4.82 NA NA 0.19 9.96 8.03 NANA XXX88356 ......... 26 ....... A Analysis, nerve .............................................. 3.02 0.79 1.14 0.79 1.14 0.12 3.93 4.28 3.93 4.28 XXX88356 ......... TC ...... A Analysis, nerve .............................................. 0.00 5.96 3.68 NA NA 0.07 6.03 3.75 NA NAXXX88358 ......... ............ A Analysis, tumor .............................................. 0.95 1.14 0.92 NA NA 0.17 2.26 2.04 NANA XXX88358 ......... 26 ....... A Analysis, tumor .............................................. 0.95 0.17 0.34 0.17 0.34 0.10 1.22 1.39 1.22 1.39 XXX88358 ......... TC ...... A Analysis, tumor .............................................. 0.00 0.97 0.57 NA NA 0.07 1.04 0.64 NA NAXXX88360 ......... ............ A Tumor immunohistochem/manual ................. 1.10 2.33 1.87 NA NA 0.08 3.51 3.05 NA NA XXX88360 ......... 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 XXX88360 ......... TC ...... A Tumor immunohistochem/manual ................. 0.00 2.04 1.46 NA NA 0.02 2.06 1.48 NA NA XXX88361 ......... ............ A Tumor immunohistochem/comput ................. 1.18 2.79 2.96 NA NA 0.17 4.14 4.31 NA NA XXX88361 ......... 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 XXX88361 ......... TC ...... A Tumor immunohistochem/comput ................. 0.00 2.53 2.53 NA NA 0.07 2.60 2.60 NA NA XXX88362 ......... ............ A Nerve teasing preparations ........................... 2.17 5.31 4.85 NA NA 0.15 7.63 7.17 NA NA XXX88362 ......... 26 ....... A Nerve teasing preparations ........................... 2.17 0.61 0.84 0.61 0.84 0.09 2.87 3.10 2.87 3.10XXX88362 ......... TC ...... A Nerve teasing preparations ........................... 0.00 4.71 4.01 NA NA 0.06 4.77 4.07 NA NA XXX88365 ......... ............ A Insitu hybridization (fish) ............................... 1.20 2.99 2.34 NA NA 0.05 4.24 3.59 NA NAXXX88365 ......... 26 ....... A Insitu hybridization (fish) ............................... 1.20 0.25 0.45 0.25 0.45 0.03 1.48 1.68 1.481.68 XXX88365 ......... 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 NAXXX88367 ......... 26 ....... A Insitu hybridization, auto ............................... 1.30 0.23 0.46 0.23 0.46 0.06 1.59 1.82 1.591.82 XXX88367 ......... TC ...... A Insitu hybridization, auto ............................... 0.00 5.06 3.88 NA NA 0.06 5.12 3.94 NA NA XXX88368 ......... ............ A Insitu hybridization, manual ........................... 1.40 4.83 3.00 NA NA 0.12 6.35 4.52 NA NA XXX88368 ......... 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 XXX88368 ......... TC ...... A Insitu hybridization, manual ........................... 0.00 4.60 2.49 NA NA 0.06 4.66 2.55 NA NA XXX88371 ......... 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 XXX88372 ......... 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 XXX88380 ......... ............ C Microdissection .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX88380 ......... 26 ....... C Microdissection .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX



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# 49213 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules88380 ......... TC ...... C Microdissection .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX88384 ......... ............ 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 XXX88384 ......... 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 XXX88384 ......... 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 XXX88385 ......... ............ A Eval molecul probes, 51–250 ........................ 1.50 14.75 9.00 NA NA 0.12 16.37 10.62 NA NA XXX88385 ......... 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 XXX88385 ......... TC ...... A Eval molecul probes, 51–250 ........................ 0.00 14.51 8.45 NA NA 0.06 14.57 8.51 NA NA XXX88386 ......... ............ A Eval molecul probes, 251–500 ...................... 1.88 14.65 8.94 NA NA 0.16 16.69 10.98 NA NA XXX88386 ......... 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 XXX88386 ......... TC ...... A Eval molecul probes, 251–500 ...................... 0.00 14.35 8.25 NA NA 0.08 14.43 8.33 NA NA XXX88399 ......... ............ C Surgical pathology procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX88399 ......... 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 XXX88399 ......... 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 XXX89049 ......... ............ A Chct for mal hyperthermia ............................. 1.40 3.62 3.57 0.20 0.25 0.06 5.08 5.03 1.661.71 XXX89060 ......... 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 XXX89100 ......... ............ A Sample intestinal contents ............................ 0.60 8.87 3.59 0.59 0.31 0.03 9.50 4.22 1.220.94 XXX89105 ......... ............ A Sample intestinal contents ............................ 0.50 7.68 3.59 0.45 0.24 0.02 8.20 4.11 0.970.76 XXX89130 ......... ............ A Sample stomach contents ............................. 0.45 6.95 3.04 0.39 0.20 0.02 7.42 3.51 0.86 0.67 XXX89132 ......... ............ A Sample stomach contents ............................. 0.19 6.51 2.79 0.29 0.12 0.01 6.71 2.99 0.49 0.32 XXX89135 ......... ............ A Sample stomach contents ............................. 0.79 8.87 3.64 0.67 0.36 0.04 9.70 4.47 1.50 1.19 XXX89136 ......... ............ A Sample stomach contents ............................. 0.21 7.13 3.08 0.32 0.15 0.01 7.35 3.30 0.54 0.37 XXX89140 ......... ............ A Sample stomach contents ............................. 0.94 6.89 3.28 0.50 0.33 0.04 7.87 4.26 1.48 1.31 XXX89141 ......... ............ A Sample stomach contents ............................. 0.85 5.54 3.48 0.40 0.35 0.03 6.42 4.36 1.28 1.23 XXX89220 ......... ............ A Sputum specimen collection ......................... 0.00 0.36 0.41 NA NA 0.02 0.38 0.43 NA NA XXX89230 ......... ............ A Collect sweat for test ..................................... 0.00 0.08 0.10 NA NA 0.02 0.10 0.12 NA NA XXX89240 ......... ............ C Pathology lab procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX90465 ......... ............ A Immune admin 1 inj, < 8 yrs ......................... 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX90466 ......... ............ 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 ZZZ90467 ......... ............ 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 0.27XXX90468 ......... ............ 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 0.21ZZZ90471 ......... ............ A Immunization admin ...................................... 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX90472 ......... ............ A Immunization admin, each add ..................... 0.15 0.12 0.13 0.04 0.11 0.01 0.28 0.29 0.20 0.27ZZZ90473 ......... ............ 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 XXX90474 ......... ............ R Immune admin oral/nasal addl ...................... 0.15 0.08 0.10 0.03 0.05 0.01 0.24 0.26 0.19 0.21ZZZ90760 ......... ............ A Hydration iv infusion, init ............................... 0.17 1.31 1.40 NA NA 0.07 1.55 1.64 NA NAXXX90761 ......... ............ 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 NAXXX90766 ......... ............ 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 ZZZ90768 ......... ............ A Ther/diag concurrent inf ................................ 0.17 0.33 0.41 NA NA 0.04 0.54 0.62 NA NA ZZZ90772 ......... ............ A Ther/proph/diag inj, sc/im .............................. 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX90773 ......... ............ A Ther/proph/diag inj, ia ................................... 0.17 0.30 0.31 NA NA 0.02 0.49 0.50 NA NAXXX90774 ......... ............ A Ther/proph/diag inj, iv push ........................... 0.18 1.34 1.31 NA NA 0.04 1.56 1.53 NA NA XXX90775 ......... ............ 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 XXX90801 ......... ............ A Psy dx interview ............................................ 2.80 1.47 1.25 0.59 0.85 0.06 4.33 4.113.45 3.71 XXX90802 ......... ............ 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 XXX90804 ......... ............ 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 XXX90805 ......... ............ 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 XXX90806 ......... ............ 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 XXX90807 ......... ............ 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 XXX90808 ......... ............ 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 XXX90809 ......... ............ 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 XXX90810 ......... ............ 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 XXX90811 ......... ............ 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 XXX90812 ......... ............ 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 XXX90813 ......... ............ 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 XXX90814 ......... ............ 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 XXX90815 ......... ............ 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 XXX90816 ......... ............ A Psytx, hosp, 20–30 min ................................. 1.25 NA NA 0.31 0.42 0.03 NA NA 1.59 1.70 XXX90817 ......... ............ 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 XXX90818 ......... ............ A Psytx, hosp, 45–50 min ................................. 1.89 NA NA 0.42 0.62 0.04 NA NA 2.35 2.55 XXX90819 ......... ............ 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 XXX90821 ......... ............ A Psytx, hosp, 75–80 min ................................. 2.83 NA NA 0.58 0.90 0.06 NA NA 3.47 3.79 XXX90822 ......... ............ 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 XXX90823 ......... ............ A Intac psytx, hosp, 20–30 min ........................ 1.36 NA NA 0.33 0.44 0.03 NA NA 1.72 1.83 XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00233 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49214 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal90824 ......... ............ 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 XXX90826 ......... ............ A Intac psytx, hosp, 45–50 min ........................ 2.01 NA NA 0.44 0.65 0.05 NA NA 2.50 2.71 XXX90827 ......... ............ 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 XXX90828 ......... ............ A Intac psytx, hosp, 75–80 min ........................ 2.94 NA NA 0.60 0.95 0.06 NA NA 3.60 3.95 XXX90829 ......... ............ 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 XXX90845 ......... ............ A Psychoanalysis .............................................. 1.79 0.38 0.53 0.31 0.49 0.04 2.21 2.362.14 2.32 XXX90846 ......... ............ 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 XXX90847 ......... ............ 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 XXX90849 ......... ............ R Multiple family group psytx ............................ 0.59 0.30 0.28 0.20 0.23 0.02 0.91 0.89 0.810.84 XXX90853 ......... ............ A Group psychotherapy .................................... 0.59 0.27 0.26 0.20 0.22 0.01 0.87 0.86 0.800.82 XXX90857 ......... ............ A Intac group psytx ........................................... 0.63 0.36 0.31 0.20 0.24 0.01 1.00 0.950.84 0.88 XXX90862 ......... ............ A Medication management ............................... 0.95 0.62 0.46 0.27 0.31 0.02 1.59 1.43 1.24 1.28 XXX90865 ......... ............ A Narcosynthesis .............................................. 2.84 1.18 1.32 0.63 0.84 0.12 4.14 4.283.59 3.80 XXX90870 ......... ............ A Electroconvulsive therapy ............................. 1.88 1.90 1.92 0.38 0.54 0.04 3.82 3.84 2.302.46 00090875 ......... ............ N Psychophysiological therapy ......................... 1.20 0.53 0.81 0.28 0.42 0.04 1.77 2.05 1.52 1.66 XXX90876 ......... ............ N Psychophysiological therapy ......................... 1.90 0.68 1.04 0.44 0.66 0.05 2.63 2.99 2.39 2.61 XXX90880 ......... ............ A Hypnotherapy ................................................ 2.19 0.56 0.92 0.37 0.61 0.05 2.80 3.162.61 2.85 XXX90885 ......... ............ B Psy evaluation of records .............................. 0.97 0.23 0.34 0.23 0.34 0.02 1.22 1.33 1.221.33 XXX90887 ......... ............ B Consultation with family ................................ 1.48 0.62 0.77 0.34 0.51 0.04 2.14 2.29 1.86 2.03 XXX90899 ......... ............ C Psychiatric service/therapy ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX90901 ......... ............ 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 00090911 ......... ............ A Biofeedback peri/uro/rectal ............................ 0.89 1.38 1.52 0.30 0.31 0.06 2.33 2.47 1.251.26 00090918 ......... ............ I ESRD related services, month ...................... 11.16 4.75 5.77 3.78 5.53 0.36 16.27 17.29 15.3017.05 XXX90919 ......... ............ 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 XXX90920 ......... ............ 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 XXX90921 ......... ............ I ESRD related services, month ...................... 4.46 1.73 2.26 1.63 2.24 0.14 6.33 6.86 6.23 6.84XXX90922 ......... ............ 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 XXX90923 ......... ............ I Esrd related services, day ............................. 0.28 0.10 0.12 0.08 0.12 0.01 0.39 0.41 0.370.41 XXX90924 ......... ............ I Esrd related services, day ............................. 0.24 0.09 0.11 0.08 0.11 0.01 0.34 0.36 0.330.36 XXX90925 ......... ............ I Esrd related services, day ............................. 0.15 0.06 0.08 0.05 0.07 0.01 0.22 0.24 0.210.23 XXX90935 ......... ............ A Hemodialysis, one evaluation ....................... 1.22 NA NA 0.54 0.64 0.04 NA NA 1.80 1.90 00090937 ......... ............ A Hemodialysis, repeated eval ......................... 2.11 NA NA 0.78 0.92 0.07 NA NA 2.96 3.10 00090945 ......... ............ A Dialysis, one evaluation ................................ 1.28 NA NA 0.56 0.66 0.04 NA NA 1.88 1.98 00090947 ......... ............ A Dialysis, repeated eval .................................. 2.16 NA NA 0.80 0.94 0.07 NA NA 3.03 3.1700090997 ......... ............ A Hemoperfusion .............................................. 1.84 NA NA 0.50 0.62 0.06 NA NA 2.40 2.52 00090999 ......... ............ C Dialysis procedure ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 XXX91000 ......... ............ A Esophageal intubation ................................... 0.73 2.22 0.80 2.22 0.80 0.04 2.99 1.57 2.99 1.57 00091000 ......... 26 ....... A Esophageal intubation ................................... 0.73 0.24 0.25 0.24 0.25 0.03 1.00 1.01 1.00 1.01 00091000 ......... TC ...... A Esophageal intubation ................................... 0.00 1.98 0.56 1.98 0.56 0.01 1.99 0.57 1.99 0.57 00091010 ......... ............ A Esophagus motility study .............................. 1.25 3.66 4.22 3.66 4.22 0.12 5.03 5.59 5.035.59 00091010 ......... 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 00091010 ......... TC ...... A Esophagus motility study .............................. 0.00 3.11 3.76 3.11 3.76 0.06 3.17 3.82 3.17 3.8200091011 ......... ............ A Esophagus motility study .............................. 1.50 5.31 5.24 5.31 5.24 0.13 6.94 6.87 6.946.87 00091011 ......... 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 00091011 ......... TC ...... A Esophagus motility study .............................. 0.00 4.61 4.68 4.61 4.68 0.06 4.67 4.74 4.67 4.7400091012 ......... ............ A Esophagus motility study .............................. 1.46 5.49 5.69 5.49 5.69 0.13 7.08 7.28 7.087.28 00091012 ......... 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 00091012 ......... TC ...... A Esophagus motility study .............................. 0.00 4.81 5.13 4.81 5.13 0.07 4.88 5.20 4.88 5.2000091020 ......... ............ A Gastric motility studies .................................. 1.44 4.79 4.59 4.79 4.59 0.13 6.36 6.16 6.36 6.16 00091020 ......... 26 ....... A Gastric motility studies .................................. 1.44 0.61 0.52 0.61 0.52 0.07 2.12 2.03 2.122.03 00091020 ......... TC ...... A Gastric motility studies .................................. 0.00 4.19 4.07 4.19 4.07 0.06 4.25 4.13 4.254.13 00091022 ......... ............ A Duodenal motility study ................................. 1.44 3.09 4.07 3.09 4.07 0.13 4.66 5.64 4.66 5.64 00091022 ......... 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 00091022 ......... 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 00091030 ......... ............ 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 00091030 ......... 26 ....... A Acid perfusion of esophagus ......................... 0.91 0.43 0.35 0.43 0.35 0.04 1.38 1.30 1.38 1.30000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00234 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49215 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules91030 ......... 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 00091034 ......... ............ A Gastroesophageal reflux test ........................ 0.97 4.12 4.95 4.12 4.95 0.12 5.21 6.04 5.21 6.04 00091034 ......... 26 ....... A Gastroesophageal reflux test ........................ 0.97 0.41 0.36 0.41 0.36 0.06 1.44 1.39 1.44 1.3900091034 ......... 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 00091035 ......... ............ A G-esoph reflx tst w/electrod .......................... 1.59 11.33 10.93 11.33 10.93 0.12 13.04 12.6413.04 12.64 00091035 ......... 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 00091035 ......... 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 00091037 ......... ............ A Esoph imped function test ............................. 0.97 3.41 3.05 3.41 3.05 0.12 4.50 4.14 4.504.14 00091037 ......... 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 00091037 ......... TC ...... A Esoph imped function test ............................. 0.00 2.99 2.69 2.99 2.69 0.06 3.05 2.75 3.05 2.7500091038 ......... ............ 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 00091038 ......... 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 1.5800091038 ......... 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 00091040 ......... ............ 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 00091040 ......... 26 ....... A Esoph balloon distension tst ......................... 0.97 0.37 0.35 0.37 0.35 0.06 1.40 1.38 1.40 1.3800091040 ......... 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 00091052 ......... ............ A Gastric analysis test ...................................... 0.79 2.99 2.59 2.99 2.59 0.05 3.83 3.433.83 3.43 00091052 ......... 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 00091052 ......... TC ...... A Gastric analysis test ...................................... 0.00 2.62 2.28 2.62 2.28 0.02 2.64 2.30 2.642.30 00091055 ......... ............ A Gastric intubation for smear .......................... 0.94 2.44 2.82 2.44 2.82 0.07 3.45 3.83 3.453.83 00091055 ......... 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 00091055 ......... TC ...... A Gastric intubation for smear .......................... 0.00 2.17 2.55 2.17 2.55 0.02 2.19 2.57 2.19 2.5700091060 ......... ............ 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 00091060 ......... 26 ....... A Gastric saline load test .................................. 0.45 0.11 0.13 0.11 0.13 0.03 0.59 0.61 0.590.61 00091060 ......... TC ...... A Gastric saline load test .................................. 0.00 1.54 1.75 1.54 1.75 0.02 1.56 1.77 1.561.77 00091065 ......... ............ A Breath hydrogen test ..................................... 0.20 1.41 1.45 1.41 1.45 0.03 1.64 1.68 1.64 1.68 00091065 ......... 26 ....... A Breath hydrogen test ..................................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.280.28 00091065 ......... 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 00091100 ......... ............ 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 00091105 ......... ............ A Gastric intubation treatment .......................... 0.37 1.76 2.02 0.07 0.09 0.03 2.16 2.42 0.470.49 00091110 ......... ............ A Gi tract capsule endoscopy ........................... 3.64 20.55 21.77 NA NA 0.16 24.35 25.57 NA NAXXX91110 ......... 26 ....... A Gi tract capsule endoscopy ........................... 3.64 1.66 1.38 1.66 1.38 0.09 5.39 5.11 5.39 5.11XXX91110 ......... TC ...... A Gi tract capsule endoscopy ........................... 0.00 18.90 20.40 NA NA 0.07 18.97 20.47 NA NA XXX91120 ......... ............ A Rectal sensation test ..................................... 0.97 9.12 10.52 9.12 10.52 0.11 10.20 11.60 10.20 11.60 XXX91120 ......... 26 ....... A Rectal sensation test ..................................... 0.97 0.30 0.33 0.30 0.33 0.07 1.34 1.37 1.341.37 XXX91120 ......... 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 XXX91122 ......... ............ A Anal pressure record ..................................... 1.77 3.76 4.77 3.76 4.77 0.21 5.74 6.75 5.74 6.75 00091122 ......... 26 ....... A Anal pressure record ..................................... 1.77 0.52 0.58 0.52 0.58 0.13 2.42 2.48 2.422.48 00091122 ......... 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 00091132 ......... ............ C Electrogastrography ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX91132 ......... 26 ....... A Electrogastrography ...................................... 0.52 0.25 0.20 0.25 0.20 0.02 0.79 0.74 0.790.74 XXX91132 ......... TC ...... C Electrogastrography ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX91133 ......... ............ C Electrogastrography w/test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX91133 ......... 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 XXX91133 ......... TC ...... C Electrogastrography w/test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX91299 ......... ............ C Gastroenterology procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX91299 ......... 26 ....... C Gastroenterology procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX91299 ......... TC ...... C Gastroenterology procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX92002 ......... ............ A Eye exam, new patient .................................. 0.88 0.97 0.97 0.27 0.32 0.02 1.87 1.87 1.171.22 XXX92004 ......... ............ A Eye exam, new patient .................................. 1.67 1.59 1.67 0.54 0.65 0.04 3.30 3.38 2.252.36 XXX92012 ......... ............ 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 XXX92014 ......... ............ A Eye exam & treatment .................................. 1.10 1.32 1.39 0.38 0.45 0.03 2.45 2.52 1.511.58 XXX92015 ......... ............ N Refraction ...................................................... 0.38 0.10 1.14 0.09 0.14 0.01 0.491.53 0.48 0.53 XXX92018 ......... ............ A New eye exam & treatment .......................... 2.50 NA NA 0.91 1.03 0.07 NA NA 3.48 3.60 XXX92019 ......... ............ 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 XXX92060 ......... ............ A Special eye evaluation .................................. 0.69 0.79 0.75 NA NA 0.03 1.51 1.47 NA NA XXX92060 ......... 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 XXX92060 ......... TC ...... A Special eye evaluation .................................. 0.00 0.56 0.47 NA NA 0.01 0.57 0.48 NA NA XXX92065 ......... ............ A Orthoptic/pleoptic training .............................. 0.37 0.89 0.62 NA NA 0.02 1.28 1.01 NA NAXXX92065 ......... 26 ....... A Orthoptic/pleoptic training .............................. 0.37 0.09 0.14 0.09 0.14 0.01 0.47 0.52 0.470.52 XXX92065 ......... TC ...... A Orthoptic/pleoptic training .............................. 0.00 0.79 0.48 NA NA 0.01 0.80 0.49 NA NA XXX92070 ......... ............ A Fitting of contact lens .................................... 0.70 0.94 1.04 0.24 0.30 0.02 1.66 1.760.96 1.02 XXX92081 ......... ............ A Visual field examination(s) ............................ 0.36 0.97 0.95 NA NA 0.02 1.35 1.33 NA NA XXX92081 ......... 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 XXX92081 ......... TC ...... A Visual field examination(s) ............................ 0.00 0.86 0.81 NA NA 0.01 0.87 0.82 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00235 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49216 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal92082 ......... ............ A Visual field examination(s) ............................ 0.44 1.36 1.26 NA NA 0.02 1.82 1.72 NA NA XXX92082 ......... 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 XXX92082 ......... TC ...... A Visual field examination(s) ............................ 0.00 1.22 1.09 NA NA 0.01 1.23 1.10 NA NA XXX92083 ......... ............ A Visual field examination(s) ............................ 0.50 1.56 1.46 NA NA 0.02 2.08 1.98 NA NA XXX92083 ......... 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 XXX92083 ......... TC ...... A Visual field examination(s) ............................ 0.00 1.39 1.26 NA NA 0.01 1.40 1.27 NA NA XXX92100 ......... ............ A Serial tonometry exam(s) .............................. 0.92 1.28 1.33 0.29 0.34 0.02 2.22 2.27 1.231.28 XXX92120 ......... ............ A Tonography & eye evaluation ....................... 0.81 1.00 1.05 0.26 0.31 0.02 1.83 1.88 1.09 1.14XXX92130 ......... ............ A Water provocation tonography ...................... 0.81 1.21 1.26 0.28 0.35 0.02 2.04 2.09 1.11 1.18XXX92135 ......... ............ A Opthalmic dx imaging .................................... 0.35 0.81 0.80 NA NA 0.02 1.18 1.17 NA NA XXX92135 ......... 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 XXX92135 ......... TC ...... A Opthalmic dx imaging .................................... 0.00 0.69 0.65 NA NA 0.01 0.70 0.66 NA NA XXX92136 ......... ............ A Ophthalmic biometry ..................................... 0.54 1.46 1.60 NA NA 0.08 2.08 2.22 NA NA XXX92136 ......... 26 ....... A Ophthalmic biometry ..................................... 0.54 0.20 0.23 0.20 0.23 0.01 0.75 0.78 0.75 0.78 XXX92136 ......... TC ...... A Ophthalmic biometry ..................................... 0.00 1.26 1.37 NA NA 0.07 1.33 1.44 NA NA XXX92140 ......... ............ A Glaucoma provocative tests .......................... 0.50 0.92 0.97 0.15 0.20 0.01 1.43 1.48 0.66 0.71 XXX92225 ......... ............ 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 XXX92226 ......... ............ A Special eye exam, subsequent ..................... 0.33 0.24 0.22 0.12 0.14 0.01 0.58 0.56 0.46 0.48XXX92230 ......... ............ A Eye exam with photos ................................... 0.60 0.73 1.33 0.21 0.20 0.02 1.35 1.95 0.830.82 XXX92235 ......... ............ A Eye exam with photos ................................... 0.81 2.33 2.54 NA NA 0.08 3.22 3.43 NA NA XXX92235 ......... 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 XXX92235 ......... TC ...... A Eye exam with photos ................................... 0.00 2.02 2.19 NA NA 0.06 2.08 2.25 NA NA XXX92240 ......... ............ A Icg angiography ............................................. 1.10 4.51 5.70 NA NA 0.09 5.70 6.89 NANA XXX92240 ......... 26 ....... A Icg angiography ............................................. 1.10 0.41 0.48 0.41 0.48 0.03 1.54 1.61 1.54 1.61 XXX92240 ......... TC ...... A Icg angiography ............................................. 0.00 4.09 5.22 NA NA 0.06 4.15 5.28 NA NA XXX92250 ......... ............ A Eye exam with photos ................................... 0.44 1.34 1.48 NA NA 0.02 1.80 1.94 NA NA XXX92250 ......... 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 XXX92250 ......... TC ...... A Eye exam with photos ................................... 0.00 1.19 1.30 NA NA 0.01 1.20 1.31 NA NA XXX92260 ......... ............ A Ophthalmoscopy/dynamometry ..................... 0.20 0.23 0.25 0.07 0.09 0.01 0.44 0.46 0.28 0.30 XXX92265 ......... ............ A Eye muscle evaluation .................................. 0.81 1.01 1.37 NA NA 0.06 1.88 2.24 NA NA XXX92265 ......... 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 XXX92265 ......... TC ...... A Eye muscle evaluation .................................. 0.00 0.76 1.10 NA NA 0.02 0.78 1.12 NA NA XXX92270 ......... ............ A Electro-oculography ....................................... 0.81 1.42 1.50 NA NA 0.05 2.28 2.36 NA NAXXX92270 ......... 26 ....... A Electro-oculography ....................................... 0.81 0.24 0.31 0.24 0.31 0.03 1.08 1.15 1.081.15 XXX92270 ......... 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 NAXXX92275 ......... 26 ....... A Electroretinography ....................................... 1.01 0.36 0.41 0.36 0.41 0.03 1.40 1.45 1.401.45 XXX92275 ......... 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 XXX92283 ......... 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 XXX92283 ......... TC ...... A Color vision examination ............................... 0.00 0.96 0.82 NA NA 0.01 0.97 0.83 NA NA XXX92284 ......... ............ A Dark adaptation eye exam ............................ 0.24 1.25 1.72 NA NA 0.02 1.51 1.98 NA NA XXX92284 ......... 26 ....... A Dark adaptation eye exam ............................ 0.24 0.09 0.08 0.09 0.08 0.01 0.34 0.33 0.34 0.33XXX92284 ......... TC ...... A Dark adaptation eye exam ............................ 0.00 1.16 1.64 NA NA 0.01 1.17 1.65 NA NA XXX92285 ......... ............ A Eye photography ........................................... 0.20 0.82 0.95 NA NA 0.02 1.04 1.17 NA NAXXX92285 ......... 26 ....... A Eye photography ........................................... 0.20 0.07 0.09 0.07 0.09 0.01 0.28 0.30 0.280.30 XXX92285 ......... 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 XXX92286 ......... TC ...... A Internal eye photography .............................. 0.00 1.92 2.55 NA NA 0.02 1.94 2.57 NA NA XXX92287 ......... ............ A Internal eye photography .............................. 0.81 1.98 2.28 0.30 0.31 0.02 2.81 3.11 1.131.14 XXX92310 ......... ............ N Contact lens fitting ......................................... 1.17 1.07 1.11 0.27 0.41 0.04 2.28 2.32 1.48 1.62 XXX92311 ......... ............ A Contact lens fitting ......................................... 1.08 1.31 1.15 0.32 0.34 0.03 2.42 2.26 1.43 1.45 XXX92312 ......... ............ A Contact lens fitting ......................................... 1.26 1.51 1.19 0.36 0.47 0.03 2.80 2.48 1.65 1.76 XXX92313 ......... ............ A Contact lens fitting ......................................... 0.92 1.49 1.17 0.33 0.30 0.02 2.43 2.11 1.27 1.24 XXX92314 ......... ............ N Prescription of contact lens ........................... 0.69 1.15 0.99 0.16 0.24 0.01 1.85 1.69 0.860.94 XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00236 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49217 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules92315 ......... ............ A Prescription of contact lens ........................... 0.45 1.35 0.98 0.13 0.15 0.01 1.81 1.44 0.590.61 XXX92316 ......... ............ A Prescription of contact lens ........................... 0.68 1.69 1.11 0.24 0.28 0.02 2.39 1.81 0.940.98 XXX92317 ......... ............ A Prescription of contact lens ........................... 0.45 1.46 1.07 0.14 0.15 0.01 1.92 1.53 0.600.61 XXX92325 ......... ............ A Modification of contact lens ........................... 0.00 0.85 0.51 NA NA 0.01 0.86 0.52 NA NA XXX92326 ......... ............ A Replacement of contact lens ......................... 0.00 0.76 1.41 NA NA 0.06 0.82 1.47 NA NA XXX92340 ......... ............ N Fitting of spectacles ...................................... 0.37 0.45 0.64 0.09 0.13 0.01 0.83 1.020.47 0.51 XXX92341 ......... ............ N Fitting of spectacles ...................................... 0.47 0.47 0.67 0.11 0.16 0.01 0.95 1.150.59 0.64 XXX92342 ......... ............ N Fitting of spectacles ...................................... 0.53 0.48 0.69 0.12 0.19 0.01 1.02 1.230.66 0.73 XXX92352 ......... ............ B Special spectacles fitting ............................... 0.37 0.57 0.65 0.09 0.13 0.01 0.95 1.03 0.47 0.51 XXX92353 ......... ............ B Special spectacles fitting ............................... 0.50 0.60 0.70 0.12 0.17 0.02 1.12 1.22 0.64 0.69 XXX92354 ......... ............ B Special spectacles fitting ............................... 0.00 0.29 6.72 NA NA 0.10 0.39 6.82 NA NAXXX92355 ......... ............ B Special spectacles fitting ............................... 0.00 0.45 3.36 NA NA 0.01 0.46 3.37 NA NAXXX92358 ......... ............ B Eye prosthesis service .................................. 0.00 0.24 0.79 NA NA 0.05 0.29 0.84 NA NA XXX92370 ......... ............ N Repair & adjust spectacles ........................... 0.32 0.39 0.51 0.07 0.12 0.02 0.73 0.85 0.41 0.46 XXX92371 ......... ............ B Repair & adjust spectacles ........................... 0.00 0.24 0.53 NA NA 0.02 0.26 0.55 NA NA XXX92499 ......... ............ C Eye service or procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX92499 ......... 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 XXX92499 ......... TC ...... C Eye service or procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX92502 ......... ............ A Ear and throat examination ........................... 1.51 NA NA 0.77 1.03 0.05 NA NA 2.33 2.59 00092504 ......... ............ A Ear microscopy examination ......................... 0.18 0.55 0.51 0.05 0.08 0.01 0.74 0.70 0.24 0.27 XXX92506 ......... ............ A Speech/hearing evaluation ............................ 0.86 3.28 2.76 0.24 0.36 0.03 4.17 3.65 1.13 1.25 XXX92507 ......... ............ A Speech/hearing therapy ................................ 0.52 1.19 1.13 0.14 0.21 0.02 1.73 1.67 0.680.75 XXX92508 ......... ............ A Speech/hearing therapy ................................ 0.26 0.52 0.51 0.08 0.11 0.01 0.79 0.78 0.350.38 XXX92511 ......... ............ A Nasopharyngoscopy ...................................... 0.84 2.92 3.21 0.61 0.74 0.03 3.79 4.08 1.481.61 00092512 ......... ............ A Nasal function studies ................................... 0.55 0.93 1.09 0.15 0.17 0.02 1.50 1.66 0.72 0.74 XXX92516 ......... ............ 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 XXX92520 ......... ............ A Laryngeal function studies ............................ 0.75 0.91 0.61 0.23 0.35 0.03 1.69 1.39 1.011.13 XXX92526 ......... ............ A Oral function therapy ..................................... 0.55 1.68 1.65 0.16 0.19 0.02 2.25 2.22 0.73 0.76 XXX92541 ......... ............ A Spontaneous nystagmus test ........................ 0.40 1.16 1.06 NA NA 0.04 1.60 1.50 NA NA XXX92541 ......... 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 XXX92541 ......... TC ...... A Spontaneous nystagmus test ........................ 0.00 1.04 0.89 NA NA 0.02 1.06 0.91 NA NA XXX92542 ......... ............ 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 XXX92542 ......... TC ...... A Positional nystagmus test ............................. 0.00 1.20 1.04 NA NA 0.02 1.22 1.06 NA NA XXX92543 ......... ............ A Caloric vestibular test .................................... 0.10 0.66 0.59 NA NA 0.02 0.78 0.71 NA NA XXX92543 ......... 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 XXX92543 ......... TC ...... A Caloric vestibular test .................................... 0.00 0.63 0.55 NA NA 0.01 0.64 0.56 NA NA XXX92544 ......... ............ A Optokinetic nystagmus test ........................... 0.26 1.06 0.94 NA NA 0.03 1.35 1.23 NA NA XXX92544 ......... 26 ....... A Optokinetic nystagmus test ........................... 0.26 0.08 0.11 0.08 0.11 0.01 0.35 0.38 0.35 0.38XXX92544 ......... TC ...... A Optokinetic nystagmus test ........................... 0.00 0.98 0.83 NA NA 0.02 1.00 0.85 NA NA XXX92545 ......... ............ A Oscillating tracking test ................................. 0.23 1.03 0.86 NA NA 0.03 1.29 1.12 NA NAXXX92545 ......... 26 ....... A Oscillating tracking test ................................. 0.23 0.07 0.10 0.07 0.10 0.01 0.31 0.34 0.310.34 XXX92545 ......... 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 NAXXX92546 ......... 26 ....... A Sinusoidal rotational test ............................... 0.29 0.09 0.12 0.09 0.12 0.01 0.39 0.42 0.390.42 XXX92546 ......... TC ...... A Sinusoidal rotational test ............................... 0.00 1.81 1.84 NA NA 0.02 1.83 1.86 NA NA XXX92547 ......... ............ A Supplemental electrical test .......................... 0.00 0.11 0.09 0.11 0.09 0.06 0.17 0.15 0.170.15 ZZZ92548 ......... ............ A Posturography ............................................... 0.50 1.72 2.12 NA NA 0.15 2.37 2.77 NANA XXX92548 ......... 26 ....... A Posturography ............................................... 0.50 0.15 0.23 0.15 0.23 0.02 0.67 0.75 0.67 0.75 XXX92548 ......... TC ...... A Posturography ............................................... 0.00 1.57 1.89 NA NA 0.13 1.70 2.02 NA NA XXX92552 ......... ............ A Pure tone audiometry, air .............................. 0.00 0.56 0.47 NA NA 0.04 0.60 0.51 NA NA XXX92553 ......... ............ A Audiometry, air & bone ................................. 0.00 0.71 0.67 NA NA 0.06 0.77 0.73 NA NA XXX92555 ......... ............ A Speech threshold audiometry ....................... 0.00 0.38 0.38 NA NA 0.04 0.42 0.42 NA NA XXX92556 ......... ............ A Speech audiometry, complete ....................... 0.00 0.52 0.56 NA NA 0.06 0.58 0.62 NA NA XXX92557 ......... ............ A Comprehensive hearing test ......................... 0.00 1.27 1.21 NA NA 0.12 1.39 1.33 NA NA XXX92561 ......... ............ A Bekesy audiometry, diagnosis ...................... 0.00 0.79 0.74 NA NA 0.06 0.85 0.80 NA NA XXX92562 ......... ............ A Loudness balance test .................................. 0.00 0.67 0.48 NA NA 0.04 0.71 0.52 NA NA XXX92563 ......... ............ 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 XXX92565 ......... ............ A Stenger test, pure tone ................................. 0.00 0.27 0.37 NA NA 0.04 0.31 0.41 NA NA XXX92567 ......... ............ A Tympanometry ............................................... 0.00 0.50 0.52 NA NA 0.06 0.56 0.58 NA NA XXX92568 ......... ............ A Acoustic refl threshold tst .............................. 0.00 0.15 0.32 NA NA 0.04 0.19 0.36 NA NAXXX92569 ......... ............ A Acoustic reflex decay test ............................. 0.00 0.16 0.35 NA NA 0.04 0.20 0.39 NA NA XXX92571 ......... ............ 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 XXX92573 ......... ............ A Lombard test ................................................. 0.00 0.49 0.39 NA NA 0.04 0.53 0.43 NANA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00237 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49218 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal92575 ......... ............ A Sensorineural acuity test ............................... 0.00 1.10 0.50 NA NA 0.02 1.12 0.52 NA NA XXX92576 ......... ............ A Synthetic sentence test ................................. 0.00 0.54 0.47 NA NA 0.05 0.59 0.52 NA NA XXX92577 ......... ............ A Stenger test, speech ..................................... 0.00 0.28 0.61 NA NA 0.07 0.35 0.68 NA NAXXX92579 ......... ............ A Visual audiometry (vra) ................................. 0.00 0.84 0.76 NA NA 0.06 0.90 0.82 NA NA XXX92582 ......... ............ A Conditioning play audiometry ........................ 0.00 1.08 0.82 NA NA 0.06 1.14 0.88 NA NA XXX92583 ......... ............ A Select picture audiometry .............................. 0.00 0.70 0.84 NA NA 0.08 0.78 0.92 NA NA XXX92584 ......... ............ A Electrocochleography .................................... 0.00 1.28 2.17 NA NA 0.21 1.49 2.38 NA NA XXX92585 ......... ............ A Auditor evoke potent, compre ....................... 0.50 2.01 2.05 NA NA 0.17 2.68 2.72 NA NA XXX92585 ......... 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 XXX92585 ......... TC ...... A Auditor evoke potent, compre ....................... 0.00 1.86 1.85 NA NA 0.14 2.00 1.99 NA NA XXX92586 ......... ............ A Auditor evoke potent, limit ............................. 0.00 1.41 1.74 NA NA 0.14 1.55 1.88 NA NA XXX92587 ......... ............ A Evoked auditory test ...................................... 0.13 0.61 1.18 NA NA 0.12 0.86 1.43 NA NAXXX92587 ......... 26 ....... A Evoked auditory test ...................................... 0.13 0.04 0.06 0.04 0.06 0.01 0.18 0.20 0.180.20 XXX92587 ......... 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 NAXXX92588 ......... 26 ....... A Evoked auditory test ...................................... 0.36 0.11 0.15 0.11 0.15 0.01 0.48 0.52 0.480.52 XXX92588 ......... 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 XXX92597 ......... ............ A Oral speech device eval ................................ 0.86 1.69 1.69 0.24 0.40 0.03 2.58 2.58 1.131.29 XXX92601 ......... ............ A Cochlear implt f/up exam < 7 ........................ 0.00 4.87 3.84 NA NA 0.07 4.94 3.91 NA NA XXX92602 ......... ............ A Reprogram cochlear implt < 7 ...................... 0.00 3.34 2.62 NA NA 0.07 3.41 2.69 NA NA XXX92603 ......... ............ A Cochlear implt f/up exam 7 > ........................ 0.00 3.17 2.40 NA NA 0.07 3.24 2.47 NA NA XXX92604 ......... ............ A Reprogram cochlear implt 7 > ...................... 0.00 2.09 1.54 NA NA 0.07 2.16 1.61 NA NA XXX92607 ......... ............ A Ex for speech device rx, 1hr ......................... 0.00 4.28 3.38 NA NA 0.05 4.33 3.43 NA NA XXX92608 ......... ............ A Ex for speech device rx addl ........................ 0.00 0.87 0.63 NA NA 0.05 0.92 0.68 NA NA XXX92609 ......... ............ A Use of speech device service ....................... 0.00 2.30 1.77 NA NA 0.04 2.34 1.81 NA NA XXX92610 ......... ............ A Evaluate swallowing function ........................ 0.00 1.62 2.98 NA NA 0.08 1.70 3.06 NA NA XXX92611 ......... ............ A Motion fluoroscopy/swallow ........................... 0.00 1.90 3.05 NA NA 0.08 1.98 3.13 NA NA XXX92612 ......... ............ 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 XXX92613 ......... ............ 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 XXX92614 ......... ............ A Laryngoscopic sensory test ........................... 1.27 2.23 2.43 0.36 0.59 0.04 3.54 3.74 1.67 1.90 XXX92615 ......... ............ 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 XXX92616 ......... ............ 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 XXX92617 ......... ............ 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 XXX92620 ......... ............ A Auditory function, 60 min .............................. 0.00 1.87 1.32 NA NA 0.06 1.93 1.38 NA NA XXX92621 ......... ............ 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 XXX92626 ......... ............ A Eval aud rehab status ................................... 0.00 1.85 2.11 NA NA 0.06 1.91 2.17 NA NA XXX92627 ......... ............ 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 ZZZ92700 ......... ............ C Ent procedure/service ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX92950 ......... ............ A Heart/lung resuscitation cpr .......................... 3.79 3.24 3.96 0.77 0.92 0.28 7.31 8.03 4.844.99 00092953 ......... ............ A Temporary external pacing ........................... 0.23 NA NA 0.07 0.07 0.02 NA NA 0.32 0.32 00092960 ......... ............ A Cardioversion electric, ext ............................. 2.25 4.42 5.84 1.47 1.25 0.07 6.74 8.16 3.79 3.57 00092961 ......... ............ A Cardioversion, electric, int ............................. 4.59 NA NA 2.49 2.18 0.29 NA NA 7.37 7.0600092970 ......... ............ A Cardioassist, internal ..................................... 3.51 NA NA 1.61 1.20 0.16 NA NA 5.28 4.87 00092971 ......... ............ A Cardioassist, external .................................... 1.77 NA NA 1.08 0.91 0.06 NA NA 2.91 2.7400092973 ......... ............ A Percut coronary thrombectomy ..................... 3.28 NA NA 1.79 1.42 0.23 NA NA 5.30 4.93 ZZZ92974 ......... ............ A Cath place, cardio brachytx .......................... 3.00 NA NA 1.67 1.30 0.21 NA NA 4.88 4.51 ZZZ92975 ......... ............ A Dissolve clot, heart vessel ............................ 7.24 NA NA 3.88 3.08 0.50 NA NA 11.62 10.8200092977 ......... ............ A Dissolve clot, heart vessel ............................ 0.00 1.73 6.47 NA NA 0.46 2.19 6.93 NA NA XXX92978 ......... ............ A Intravasc us, heart add-on ............................ 1.80 NA NA NA NA 0.30 NA NA NA NA ZZZ92978 ......... 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 ZZZ92978 ......... TC ...... A Intravasc us, heart add-on ............................ 0.00 NA NA NA NA 0.24 NA NA NA NA ZZZ92979 ......... ............ A Intravasc us, heart add-on ............................ 1.44 NA NA NA NA 0.19 NA NA NA NA ZZZ92979 ......... 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 ZZZ92979 ......... TC ...... A Intravasc us, heart add-on ............................ 0.00 NA NA NA NA 0.13 NA NA NA NA ZZZ



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00238 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49219 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules92980 ......... ............ A Insert intracoronary stent .............................. 14.82 NA NA 8.29 6.61 1.03 NA NA 24.14 22.46 00092981 ......... ............ A Insert intracoronary stent .............................. 4.16 NA NA 2.27 1.79 0.29 NA NA 6.72 6.24 ZZZ92982 ......... ............ A Coronary artery dilation ................................. 10.96 NA NA 6.20 4.95 0.76 NA NA 17.92 16.67 00092984 ......... ............ A Coronary artery dilation ................................. 2.97 NA NA 1.61 1.27 0.21 NA NA 4.79 4.45ZZZ92986 ......... ............ A Revision of aortic valve ................................. 22.64 NA NA 15.66 12.79 1.51 NA NA 39.81 36.94 09092987 ......... ............ A Revision of mitral valve ................................. 23.42 NA NA 16.09 13.18 1.59 NA NA 41.10 38.19 09092990 ......... ............ A Revision of pulmonary valve ......................... 18.06 NA NA 11.18 10.14 1.20 NA NA 30.44 29.4009092992 ......... ............ 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 09092993 ......... ............ 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 09092995 ......... ............ A Coronary atherectomy ................................... 12.07 NA NA 6.81 5.42 0.84 NA NA 19.72 18.3300092996 ......... ............ A Coronary atherectomy add-on ...................... 3.26 NA NA 1.78 1.40 0.10 NA NA 5.14 4.76 ZZZ92997 ......... ............ A Pul art balloon repr, percut ........................... 11.98 NA NA 5.18 4.91 0.40 NA NA 17.56 17.2900092998 ......... ............ A Pul art balloon repr, percut ........................... 5.99 NA NA 2.74 2.34 0.28 NA NA 9.01 8.61 ZZZ93000 ......... ............ A Electrocardiogram, complete ......................... 0.17 0.35 0.47 0.35 0.47 0.03 0.55 0.67 0.55 0.67 XXX93005 ......... ............ 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 0.250.24 XXX93012 ......... ............ A Transmission of ecg ...................................... 0.00 1.65 4.92 NA NA 0.18 1.83 5.10 NA NAXXX93014 ......... ............ A Report on transmitted ecg ............................. 0.52 0.21 0.20 0.21 0.20 0.02 0.75 0.74 0.750.74 XXX93015 ......... ............ A Cardiovascular stress test ............................. 0.75 1.93 1.95 1.93 1.95 0.14 2.82 2.84 2.822.84 XXX93016 ......... ............ A Cardiovascular stress test ............................. 0.45 0.23 0.19 0.23 0.19 0.02 0.70 0.66 0.700.66 XXX93017 ......... ............ A Cardiovascular stress test ............................. 0.00 1.55 1.65 NA NA 0.11 1.66 1.76 NA NA XXX93018 ......... ............ A Cardiovascular stress test ............................. 0.30 0.15 0.12 0.15 0.12 0.01 0.46 0.43 0.460.43 XXX93024 ......... ............ A Cardiac drug stress test ................................ 1.17 2.42 1.78 NA NA 0.12 3.71 3.07 NA NA XXX93024 ......... 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 XXX93024 ......... TC ...... A Cardiac drug stress test ................................ 0.00 1.84 1.30 NA NA 0.08 1.92 1.38 NA NA XXX93025 ......... ............ A Microvolt t-wave assess ................................ 0.75 3.94 6.68 NA NA 0.14 4.83 7.57 NA NA XXX93025 ......... 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 XXX93025 ......... TC ...... A Microvolt t-wave assess ................................ 0.00 3.56 6.37 NA NA 0.11 3.67 6.48 NA NA XXX93040 ......... ............ 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 XXX93041 ......... ............ A Rhythm ECG, tracing .................................... 0.00 0.14 0.15 NA NA 0.01 0.15 0.16 NA NA XXX93042 ......... ............ A Rhythm ECG, report ...................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX93224 ......... ............ 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 XXX93225 ......... ............ A ECG monitor/record, 24 hrs .......................... 0.00 1.08 1.20 NA NA 0.08 1.16 1.28 NA NA XXX93226 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.00 0.62 1.79 NA NA 0.14 0.76 1.93 NA NA XXX93227 ......... ............ 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 XXX93230 ......... ............ 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 XXX93231 ......... ............ 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 XXX93233 ......... ............ 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 XXX93235 ......... ............ 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 XXX93236 ......... ............ C ECG monitor/report, 24 hrs ........................... 0.00 0.00 0.00 NA NA 0.00 0.00 0.00 NA NA XXX93237 ......... ............ 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 XXX93268 ......... ............ A ECG record/review ........................................ 0.52 0.83 5.79 0.83 5.79 0.28 1.63 6.59 1.63 6.59 XXX93270 ......... ............ A ECG recording ............................................... 0.00 0.31 1.01 NA NA 0.08 0.39 1.09 NANA XXX93271 ......... ............ A Ecg/monitoring and analysis ......................... 0.00 1.99 5.01 NA NA 0.18 2.17 5.19 NA NA XXX93272 ......... ............ 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 XXX93278 ......... ............ A ECG/signal-averaged .................................... 0.25 0.59 1.09 NA NA 0.12 0.96 1.46 NA NA XXX93278 ......... 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 XXX93278 ......... TC ...... A ECG/signal-averaged .................................... 0.00 0.49 0.99 NA NA 0.11 0.60 1.10 NA NA XXX93303 ......... ............ A Echo transthoracic ......................................... 1.30 4.65 4.42 NA NA 0.27 6.22 5.99 NA NA XXX93303 ......... 26 ....... A Echo transthoracic ......................................... 1.30 0.57 0.50 0.57 0.50 0.04 1.91 1.84 1.91 1.84 XXX93303 ......... TC ...... A Echo transthoracic ......................................... 0.00 4.07 3.91 NA NA 0.23 4.30 4.14 NA NA XXX93304 ......... ............ A Echo transthoracic ......................................... 0.75 3.18 2.46 NA NA 0.15 4.08 3.36 NA NA XXX93304 ......... 26 ....... A Echo transthoracic ......................................... 0.75 0.31 0.29 0.31 0.29 0.02 1.08 1.06 1.08 1.06 XXX93304 ......... TC ...... A Echo transthoracic ......................................... 0.00 2.87 2.17 NA NA 0.13 3.00 2.30 NA NA XXX93307 ......... ............ A Echo exam of heart ....................................... 0.92 3.78 4.10 NA NA 0.26 4.96 5.28 NA NAXXX93307 ......... 26 ....... A Echo exam of heart ....................................... 0.92 0.46 0.38 0.46 0.38 0.03 1.41 1.33 1.411.33 XXX93307 ......... TC ...... A Echo exam of heart ....................................... 0.00 3.32 3.73 NA NA 0.23 3.55 3.96 NA NA XXX93308 ......... ............ A Echo exam of heart ....................................... 0.53 2.65 2.27 NA NA 0.15 3.33 2.95 NA NAXXX93308 ......... 26 ....... A Echo exam of heart ....................................... 0.53 0.27 0.22 0.27 0.22 0.02 0.82 0.77 0.820.77 XXX93308 ......... TC ...... A Echo exam of heart ....................................... 0.00 2.38 2.05 NA NA 0.13 2.51 2.18 NA NA XXX93312 ......... ............ A Echo transesophageal ................................... 2.20 7.55 5.32 NA NA 0.37 10.12 7.89 NA NA XXX93312 ......... 26 ....... A Echo transesophageal .................................. 2.20 1.01 0.85 1.01 0.85 0.08 3.29 3.13 3.29 3.13 XXX93312 ......... TC ...... A Echo transesophageal ................................... 0.00 6.54 4.47 NA NA 0.29 6.83 4.76 NA NA XXX93313 ......... ............ A Echo transesophageal ................................... 0.95 NA NA 0.14 0.19 0.06 NA NA 1.15 1.20 XXX93314 ......... ............ A Echo transesophageal ................................... 1.25 7.28 5.01 NA NA 0.33 8.86 6.59 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00239 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49220 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal93314 ......... 26 ....... A Echo transesophageal .................................. 1.25 0.57 0.50 0.57 0.50 0.04 1.86 1.79 1.86 1.79 XXX93314 ......... TC ...... A Echo transesophageal ................................... 0.00 6.71 4.51 NA NA 0.29 7.00 4.80 NA NA XXX93315 ......... ............ C Echo transesophageal .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX93315 ......... 26 ....... A Echo transesophageal .................................. 2.78 1.32 1.09 1.32 1.09 0.09 4.19 3.96 4.19 3.96 XXX93315 ......... TC ...... C Echo transesophageal ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX93316 ......... ............ A Echo transesophageal ................................... 0.95 NA NA 0.26 0.25 0.05 NA NA 1.26 1.25 XXX93317 ......... ............ C Echo transesophageal .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX93317 ......... 26 ....... A Echo transesophageal .................................. 1.83 0.74 0.69 0.74 0.69 0.08 2.65 2.60 2.65 2.60 XXX93317 ......... TC ...... C Echo transesophageal ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX93318 ......... ............ C Echo transesophageal intraop ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX93318 ......... 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 XXX93318 ......... 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 ZZZ93320 ......... 26 ....... A Doppler echo exam, heart ............................. 0.38 0.19 0.16 0.19 0.16 0.01 0.58 0.55 0.58 0.55ZZZ93320 ......... TC ...... A Doppler echo exam, heart ............................. 0.00 1.51 1.66 1.51 1.66 0.12 1.63 1.78 1.63 1.78ZZZ93321 ......... ............ 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 ZZZ93321 ......... 26 ....... A Doppler echo exam, heart ............................. 0.15 0.08 0.07 0.08 0.07 0.01 0.24 0.23 0.24 0.23ZZZ93321 ......... TC ...... A Doppler echo exam, heart ............................. 0.00 0.55 0.97 0.55 0.97 0.08 0.63 1.05 0.63 1.05ZZZ93325 ......... ............ A Doppler color flow add-on ............................. 0.07 0.67 2.37 0.67 2.37 0.22 0.96 2.66 0.962.66 ZZZ93325 ......... 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 ZZZ93325 ......... 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 2.55ZZZ93350 ......... ............ A Echo transthoracic ......................................... 1.48 5.16 3.04 NA NA 0.18 6.82 4.70 NA NA XXX93350 ......... 26 ....... A Echo transthoracic ......................................... 1.48 0.78 0.62 0.78 0.62 0.05 2.31 2.15 2.31 2.15 XXX93350 ......... TC ...... A Echo transthoracic ......................................... 0.00 4.38 2.42 NA NA 0.13 4.51 2.55 NA NA XXX93501 ......... ............ A Right heart catheterization ............................ 3.02 23.11 19.32 23.11 19.32 1.26 27.39 23.60 27.39 23.60 00093501 ......... 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 00093501 ......... 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 00093503 ......... ............ A Insert/place heart catheter ............................ 2.91 NA NA 0.49 0.63 0.20 NA NA 3.60 3.74 00093505 ......... ............ 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 00093505 ......... 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 00093505 ......... 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 00093508 ......... ............ A Cath placement, angiography ....................... 4.09 18.46 15.63 18.46 15.63 0.93 23.48 20.65 23.48 20.65 00093508 ......... 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 00093508 ......... 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 00093510 ......... ............ C Left heart catheterization ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00093510 ......... 26 ....... A Left heart catheterization ............................... 4.32 2.35 2.22 2.35 2.22 0.30 6.97 6.84 6.976.84 00093510 ......... 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 00093511 ......... ............ C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.0000093511 ......... 26 ....... A Left heart catheterization ............................... 5.02 2.66 2.50 2.66 2.50 0.35 8.03 7.87 8.037.87 00093511 ......... TC ...... C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093514 ......... ............ C Left heart catheterization ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00093514 ......... 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 00093514 ......... 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 00093524 ......... ............ C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.0000093524 ......... 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 00093524 ......... TC ...... C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093526 ......... ............ 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 00093526 ......... 26 ....... A Rt & Lt heart catheters .................................. 5.98 3.25 2.92 3.25 2.92 0.42 9.65 9.32 9.659.32 00093526 ......... 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 00093527 ......... ............ C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.0000093527 ......... 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 00093527 ......... TC ...... C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093528 ......... ............ C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.0000093528 ......... 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 00093528 ......... TC ...... C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093529 ......... ............ C Rt, lt heart catheterization ............................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00000



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00240 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49221 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules93529 ......... 26 ....... A Rt, lt heart catheterization ............................. 4.79 2.62 2.36 2.62 2.36 0.33 7.74 7.48 7.747.48 00093529 ......... TC ...... C Rt, lt heart catheterization ............................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093530 ......... ............ C Rt heart cath, congenital ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093530 ......... 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 00093530 ......... TC ...... C Rt heart cath, congenital ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093531 ......... ............ 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 12.6412.54 00093531 ......... TC ...... C R & l heart cath, congenital .......................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093532 ......... ............ C R & l heart cath, congenital .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 00093532 ......... 26 ....... A R & l heart cath, congenital .......................... 9.99 4.60 4.34 4.60 4.34 0.69 15.28 15.02 15.2815.02 00093532 ......... 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 0.0000093533 ......... ............ C R & l heart cath, congenital .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 00093533 ......... 26 ....... A R & l heart cath, congenital .......................... 6.69 3.03 2.85 3.03 2.85 0.47 10.19 10.01 10.1910.01 00093533 ......... 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 0.0000093539 ......... ............ A Injection, cardiac cath ................................... 0.40 NA NA 0.22 0.18 0.01 NA NA 0.63 0.5900093540 ......... ............ A Injection, cardiac cath ................................... 0.43 NA NA 0.24 0.19 0.01 NA NA 0.68 0.6300093541 ......... ............ 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 0.4200093543 ......... ............ A Injection for heart x-rays ............................... 0.29 NA NA 0.16 0.12 0.01 NA NA 0.46 0.4200093544 ......... ............ A Injection for aortography ............................... 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 00093545 ......... ............ A Inject for coronary x-rays .............................. 0.40 NA NA 0.22 0.18 0.01 NA NA 0.63 0.59 00093555 ......... ............ A Imaging, cardiac cath .................................... 0.81 0.65 5.11 NA NA 0.37 1.83 6.29 NA NAXXX93555 ......... 26 ....... A Imaging, cardiac cath .................................... 0.81 0.44 0.35 0.44 0.35 0.03 1.28 1.19 1.281.19 XXX93555 ......... TC ...... A Imaging, cardiac cath .................................... 0.00 0.21 4.76 NA NA 0.34 0.55 5.10 NA NA XXX93556 ......... ............ A Imaging, cardiac cath .................................... 0.83 0.93 7.89 NA NA 0.54 2.30 9.26 NA NAXXX93556 ......... 26 ....... A Imaging, cardiac cath .................................... 0.83 0.45 0.35 0.45 0.35 0.03 1.31 1.21 1.311.21 XXX93556 ......... TC ...... A Imaging, cardiac cath .................................... 0.00 0.48 7.54 NA NA 0.51 0.99 8.05 NA NA XXX93561 ......... ............ A Cardiac output measurement ........................ 0.50 NA NA NA NA 0.08 NA NA NA NA 00093561 ......... 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 00093561 ......... TC ...... A Cardiac output measurement ........................ 0.00 NA NA NA NA 0.06 NA NA NA NA 00093562 ......... ............ A Cardiac output measurement ........................ 0.16 NA NA NA NA 0.05 NA NA NA NA 00093562 ......... 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 00093562 ......... TC ...... A Cardiac output measurement ........................ 0.00 NA NA NA NA 0.04 NA NA NA NA 00093571 ......... ............ A Heart flow reserve measure .......................... 1.80 NA NA NA NA 0.30 NA NA NA NA ZZZ93571 ......... 26 ....... A Heart flow reserve measure .......................... 1.80 0.98 0.76 0.98 0.76 0.06 2.84 2.62 2.84 2.62ZZZ93571 ......... TC ...... A Heart flow reserve measure .......................... 0.00 NA NA NA NA 0.24 NA NA NA NA ZZZ93572 ......... ............ 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 ZZZ93572 ......... 26 ....... A Heart flow reserve measure .......................... 1.44 0.74 0.56 0.74 0.56 0.04 2.22 2.04 2.22 2.04ZZZ93572 ......... 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 ZZZ93580 ......... ............ A Transcath closure of asd ............................... 17.97 NA NA 9.50 7.91 1.25 NA NA 28.72 27.1300093581 ......... ............ A Transcath closure of vsd ............................... 24.39 NA NA 13.17 10.34 1.71 NA NA 39.27 36.44 00093600 ......... ............ A Bundle of His recording ................................. 2.12 NA NA NA NA 0.29 NA NA NA NA 00093600 ......... 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 00093600 ......... TC ...... A Bundle of His recording ................................. 0.00 NA NA NA NA 0.13 NA NA NA NA 00093602 ......... ............ A Intra-atrial recording ...................................... 2.12 NA NA NA NA 0.24 NA NA NA NA 00093602 ......... 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 00093602 ......... TC ...... A Intra-atrial recording ...................................... 0.00 NA NA NA NA 0.07 NA NA NA NA 00093603 ......... ............ A Right ventricular recording ............................ 2.12 NA NA NA NA 0.29 NA NA NA NA 00093603 ......... 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 00093603 ......... TC ...... A Right ventricular recording ............................ 0.00 NA NA NA NA 0.11 NA NA NA NA 00093609 ......... ............ A Map tachycardia, add-on ............................... 4.99 NA NA NA NA 0.52 NA NA NA NA ZZZ93609 ......... 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 ZZZ93609 ......... TC ...... A Map tachycardia, add-on ............................... 0.00 NA NA NA NA 0.17 NA NA NA NA ZZZ93610 ......... ............ 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 4.514.76 4.51 00093610 ......... TC ...... A Intra-atrial pacing ........................................... 0.00 NA NA NA NA 0.10 NA NA NA NA 00093612 ......... ............ A Intraventricular pacing ................................... 3.02 NA NA NA NA 0.36 NA NA NA NA 00093612 ......... 26 ....... A Intraventricular pacing ................................... 3.02 1.45 1.23 1.45 1.23 0.25 4.72 4.50 4.724.50 00093612 ......... TC ...... A Intraventricular pacing ................................... 0.00 NA NA NA NA 0.11 NA NA NA NA 00093613 ......... ............ A Electrophys map 3d, add-on ......................... 6.99 NA NA 3.78 3.02 0.49 NA NA 11.26 10.50 ZZZ93615 ......... ............ A Esophageal recording ................................... 0.99 NA NA NA NA 0.05 NA NA NA NA 00093615 ......... 26 ....... A Esophageal recording ................................... 0.99 0.49 0.33 0.49 0.33 0.03 1.51 1.35 1.51 1.35 00093615 ......... TC ...... A Esophageal recording ................................... 0.00 NA NA NA NA 0.02 NA NA NA NA 00093616 ......... ............ C Esophageal recording ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 00093616 ......... 26 ....... A Esophageal recording ................................... 1.49 0.37 0.42 0.37 0.42 0.09 1.95 2.00 1.95 2.00 00093616 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00241 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49222 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal93618 ......... ............ A Heart rhythm pacing ...................................... 4.25 NA NA NA NA 0.54 NA NA NA NA 00093618 ......... 26 ....... A Heart rhythm pacing ...................................... 4.25 2.32 1.83 2.32 1.83 0.30 6.87 6.38 6.876.38 00093618 ......... TC ...... A Heart rhythm pacing ...................................... 0.00 NA NA NA NA 0.24 NA NA NA NA 00093619 ......... ............ A Electrophysiology evaluation ......................... 7.31 NA NA NA NA 0.98 NA NA NA NA 00093619 ......... 26 ....... A Electrophysiology evaluation ......................... 7.31 3.87 3.35 3.87 3.35 0.51 11.69 11.17 11.69 11.17 00093619 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 NA NA NA NA 0.47 NA NA NA NA 00093620 ......... ............ C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00093620 ......... 26 ....... A Electrophysiology evaluation ......................... 11.57 6.24 5.19 6.24 5.19 0.80 18.61 17.56 18.6117.56 00093620 ......... TC ...... C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.0000093621 ......... ............ C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ93621 ......... 26 ....... A Electrophysiology evaluation ......................... 2.10 1.13 0.90 1.13 0.90 0.15 3.38 3.15 3.38 3.15ZZZ93621 ......... TC ...... C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00ZZZ93622 ......... ............ C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ93622 ......... 26 ....... A Electrophysiology evaluation ......................... 3.10 1.68 1.33 1.68 1.33 0.22 5.00 4.65 5.00 4.65ZZZ93622 ......... TC ...... C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00ZZZ93623 ......... ............ C Stimulation, pacing heart ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ93623 ......... 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 ZZZ93623 ......... 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 ZZZ93624 ......... ............ A Electrophysiologic study ................................ 4.80 NA NA . 4.18 0.46 NA NA 5.26 9.44 00093624 ......... 26 ....... A Electrophysiologic study ................................ 4.80 2.63 2.30 2.63 2.30 0.33 7.76 7.43 7.76 7.43 00093624 ......... TC ...... A Electrophysiologic study ................................ 0.00 NA NA . 1.98 0.13 NA NA 0.13 2.11 00093631 ......... ............ C Heart pacing, mapping .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 00093631 ......... 26 ....... A Heart pacing, mapping .................................. 7.59 2.74 2.76 2.74 2.76 0.97 11.30 11.32 11.3011.32 00093631 ......... 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 00093640 ......... ............ A Evaluation heart device ................................. 3.51 NA NA NA NA 0.66 NA NA NA NA 00093640 ......... 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 00093640 ......... TC ...... A Evaluation heart device ................................. 0.00 NA NA NA NA 0.42 NA NA NA NA 00093641 ......... ............ A Electrophysiology evaluation ......................... 5.92 NA NA NA NA 0.83 NA NA NA NA 00093641 ......... 26 ....... A Electrophysiology evaluation ......................... 5.92 3.18 2.53 3.18 2.53 0.41 9.51 8.86 9.51 8.8600093641 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 NA NA NA NA 0.42 NA NA NA NA 00093642 ......... ............ A Electrophysiology evaluation ......................... 4.88 7.45 8.90 7.45 8.90 0.57 12.90 14.35 12.90 14.35 00093642 ......... 26 ....... A Electrophysiology evaluation ......................... 4.88 2.63 2.32 2.63 2.32 0.15 7.66 7.35 7.66 7.3500093642 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 4.81 6.58 4.81 6.58 0.42 5.23 7.00 5.23 7.0000093650 ......... ............ 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 4.545.02 4.54 00093660 ......... 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 00093660 ......... 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 00093662 ......... ............ C Intracardiac ecg (ice) ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 0.00 ZZZ93662 ......... 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 ZZZ93662 ......... TC ...... C Intracardiac ecg (ice) ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 ZZZ93701 ......... ............ A Bioimpedance, thoracic ................................. 0.17 0.70 0.91 NA NA 0.02 0.89 1.10 NA NA XXX93701 ......... 26 ....... A Bioimpedance, thoracic ................................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX93701 ......... TC ...... A Bioimpedance, thoracic ................................. 0.00 0.64 0.84 NA NA 0.01 0.65 0.85 NA NA XXX93720 ......... ............ A Total body plethysmography ......................... 0.17 1.30 0.90 1.30 0.90 0.07 1.54 1.14 1.54 1.14 XXX93721 ......... ............ 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 0.220.23 XXX93724 ......... ............ A Analyze pacemaker system .......................... 4.88 3.49 5.28 3.49 5.28 0.39 8.76 10.55 8.76 10.55 00093724 ......... 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 00093724 ......... 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 0.851.19 0.85 XXX93731 ......... ............ A Analyze pacemaker system .......................... 0.45 0.80 0.70 NA NA 0.05 1.30 1.20 NA NA XXX93731 ......... 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 XXX93731 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.56 0.51 NA NA 0.04 0.60 0.55 NA NA XXX93732 ......... ............ A Analyze pacemaker system .......................... 0.92 1.17 0.94 NA NA 0.07 2.16 1.93 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00242 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49223 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules93732 ......... 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 XXX93732 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.68 0.55 NA NA 0.04 0.72 0.59 NA NA XXX93733 ......... ............ A Telephone analy, pacemaker ........................ 0.17 0.32 0.68 NA NA 0.07 0.56 0.92 NA NA XXX93733 ......... 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 XXX93733 ......... TC ...... A Telephone analy, pacemaker ........................ 0.00 0.23 0.61 NA NA 0.06 0.29 0.67 NA NA XXX93734 ......... ............ A Analyze pacemaker system .......................... 0.38 0.71 0.55 NA NA 0.03 1.12 0.96 NA NA XXX93734 ......... 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 XXX93734 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.51 0.39 NA NA 0.02 0.53 0.41 NA NA XXX93735 ......... ............ A Analyze pacemaker system .......................... 0.74 0.97 0.78 NA NA 0.06 1.77 1.58 NA NA XXX93735 ......... 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 XXX93735 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.58 0.48 NA NA 0.04 0.62 0.52 NA NA XXX93736 ......... ............ A Telephonic analy, pacemaker ....................... 0.15 0.28 0.59 NA NA 0.07 0.50 0.81 NA NA XXX93736 ......... 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 XXX93736 ......... TC ...... A Telephonic analy, pacemaker ....................... 0.00 0.21 0.53 NA NA 0.06 0.27 0.59 NA NA XXX93740 ......... ............ B Temperature gradient studies ....................... 0.16 0.04 0.15 NA NA 0.02 0.22 0.33 NA NA XXX93740 ......... 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 XXX93740 ......... TC ...... B Temperature gradient studies ....................... 0.00 0.00 0.11 NA NA 0.01 0.01 0.12 NA NA XXX93741 ......... ............ A Analyze ht pace device sngl ......................... 0.80 1.04 1.00 NA NA 0.07 1.91 1.87 NA NA XXX93741 ......... 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 1.17XXX93741 ......... TC ...... A Analyze ht pace device sngl ......................... 0.00 0.60 0.65 NA NA 0.04 0.64 0.69 NA NA XXX93742 ......... ............ A Analyze ht pace device sngl ......................... 0.91 1.17 1.07 NA NA 0.07 2.15 2.05 NA NA XXX93742 ......... 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 1.34XXX93742 ......... TC ...... A Analyze ht pace device sngl ......................... 0.00 0.68 0.67 NA NA 0.04 0.72 0.71 NA NA XXX93743 ......... ............ A Analyze ht pace device dual ......................... 1.03 1.21 1.15 NA NA 0.07 2.31 2.25 NA NA XXX93743 ......... 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 1.50XXX93743 ......... TC ...... A Analyze ht pace device dual ......................... 0.00 0.65 0.71 NA NA 0.04 0.69 0.75 NA NA XXX93744 ......... ............ A Analyze ht pace device dual ......................... 1.18 1.36 1.19 NA NA 0.08 2.62 2.45 NA NA XXX93744 ......... 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 1.73XXX93744 ......... TC ...... A Analyze ht pace device dual ......................... 0.00 0.73 0.69 NA NA 0.04 0.77 0.73 NA NA XXX93745 ......... ............ 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 XXX93745 ......... 26 ....... C Set-up cardiovert-defibrill .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX93745 ......... 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 XXX93770 ......... ............ B Measure venous pressure ............................. 0.16 0.04 0.07 NA NA 0.02 0.22 0.25 NA NA XXX93770 ......... 26 ....... B Measure venous pressure ............................. 0.16 0.04 0.05 0.04 0.05 0.01 0.21 0.22 0.21 0.22XXX93770 ......... TC ...... B Measure venous pressure ............................. 0.00 0.00 0.02 NA NA 0.01 0.01 0.03 NA NA XXX93784 ......... ............ A Ambulatory BP monitoring ............................ 0.38 1.36 1.50 1.36 1.50 0.03 1.77 1.91 1.77 1.91 XXX93786 ......... ............ A Ambulatory BP recording .............................. 0.00 1.09 0.96 NA NA 0.01 1.10 0.97 NA NA XXX93788 ......... ............ 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 XXX93797 ......... ............ A Cardiac rehab ................................................ 0.18 0.32 0.31 0.09 0.08 0.01 0.51 0.50 0.28 0.27 00093798 ......... ............ A Cardiac rehab/monitor ................................... 0.28 0.44 0.46 0.13 0.12 0.01 0.73 0.75 0.42 0.41 00093799 ......... ............ C Cardiovascular procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX93799 ......... 26 ....... C Cardiovascular procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX93799 ......... TC ...... C Cardiovascular procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXX93875 ......... ............ A Extracranial study .......................................... 0.22 2.65 2.41 NA NA 0.12 2.99 2.75 NANA XXX93875 ......... 26 ....... A Extracranial study .......................................... 0.22 0.08 0.08 0.08 0.08 0.01 0.31 0.31 0.31 0.31 XXX93875 ......... TC ...... A Extracranial study .......................................... 0.00 2.57 2.33 NA NA 0.11 2.68 2.44 NA NA XXX93880 ......... ............ A Extracranial study .......................................... 0.60 6.23 5.72 NA NA 0.39 7.22 6.71 NANA XXX93880 ......... 26 ....... A Extracranial study .......................................... 0.60 0.21 0.20 0.21 0.20 0.04 0.85 0.84 0.85 0.84 XXX93880 ......... TC ...... A Extracranial study .......................................... 0.00 6.03 5.52 NA NA 0.35 6.38 5.87 NA NA XXX93882 ......... ............ A Extracranial study .......................................... 0.40 4.17 3.67 NA NA 0.26 4.83 4.33 NANA XXX93882 ......... 26 ....... A Extracranial study .......................................... 0.40 0.12 0.14 0.12 0.14 0.04 0.56 0.58 0.56 0.58 XXX93882 ......... TC ...... A Extracranial study .......................................... 0.00 4.05 3.53 NA NA 0.22 4.27 3.75 NA NA XXX93886 ......... ............ A Intracranial study ........................................... 0.94 7.31 6.88 NA NA 0.45 8.70 8.27 NANA XXX93886 ......... 26 ....... A Intracranial study ........................................... 0.94 0.31 0.36 0.31 0.36 0.06 1.31 1.36 1.31 1.36 XXX93886 ......... TC ...... A Intracranial study ........................................... 0.00 7.00 6.53 NA NA 0.39 7.39 6.92 NA NAXXX93888 ......... ............ A Intracranial study ........................................... 0.62 4.91 4.41 NA NA 0.32 5.85 5.35 NANA XXX93888 ......... 26 ....... A Intracranial study ........................................... 0.62 0.20 0.22 0.20 0.22 0.05 0.87 0.89 0.87 0.89 XXX93888 ......... TC ...... A Intracranial study ........................................... 0.00 4.71 4.19 NA NA 0.27 4.98 4.46 NA NAXXX93890 ......... ............ A Tcd, vasoreactivity study ............................... 1.00 6.47 5.29 NA NA 0.45 7.92 6.74 NA NA XXX93890 ......... 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 XXX93890 ......... TC ...... A Tcd, vasoreactivity study ............................... 0.00 6.13 4.91 NA NA 0.39 6.52 5.30 NA NA XXX93892 ......... ............ A Tcd, emboli detect w/o inj ............................. 1.15 7.00 5.62 NA NA 0.45 8.60 7.22 NA NA XXX93892 ......... 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 XXX93892 ......... TC ...... A Tcd, emboli detect w/o inj ............................. 0.00 6.62 5.18 NA NA 0.39 7.01 5.57 NA NA XXX93893 ......... ............ A Tcd, emboli detect w/inj ................................ 1.15 6.67 5.44 NA NA 0.45 8.27 7.04 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00243 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49224 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal93893 ......... 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 XXX93893 ......... TC ...... A Tcd, emboli detect w/inj ................................ 0.00 6.29 5.00 NA NA 0.39 6.68 5.39 NA NA XXX93922 ......... ............ A Extremity study .............................................. 0.25 3.16 2.80 NA NA 0.15 3.56 3.20 NANA XXX93922 ......... 26 ....... A Extremity study .............................................. 0.25 0.08 0.08 0.08 0.08 0.02 0.35 0.35 0.35 0.35 XXX93922 ......... TC ...... A Extremity study .............................................. 0.00 3.08 2.72 NA NA 0.13 3.21 2.85 NA NAXXX93923 ......... ............ A Extremity study .............................................. 0.45 4.80 4.22 NA NA 0.26 5.51 4.93 NANA XXX93923 ......... 26 ....... A Extremity study .............................................. 0.45 0.14 0.15 0.14 0.15 0.04 0.63 0.64 0.63 0.64 XXX93923 ......... TC ...... A Extremity study .............................................. 0.00 4.66 4.08 NA NA 0.22 4.88 4.30 NA NAXXX93924 ......... ............ A Extremity study .............................................. 0.50 6.06 5.11 NA NA 0.30 6.86 5.91 NANA XXX93924 ......... 26 ....... A Extremity study .............................................. 0.50 0.17 0.17 0.17 0.17 0.05 0.72 0.72 0.72 0.72 XXX93924 ......... TC ...... A Extremity study .............................................. 0.00 5.89 4.94 NA NA 0.25 6.14 5.19 NA NAXXX93925 ......... ............ A Lower extremity study ................................... 0.58 8.24 7.15 NA NA 0.39 9.21 8.12 NA NA XXX93925 ......... 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 XXX93925 ......... TC ...... A Lower extremity study ................................... 0.00 8.04 6.95 NA NA 0.35 8.39 7.30 NA NA XXX93926 ......... ............ A Lower extremity study ................................... 0.39 5.25 4.35 NA NA 0.27 5.91 5.01 NA NA XXX93926 ......... 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 XXX93926 ......... TC ...... A Lower extremity study ................................... 0.00 5.13 4.22 NA NA 0.23 5.36 4.45 NA NA XXX93930 ......... ............ A Upper extremity study ................................... 0.46 6.35 5.60 NA NA 0.41 7.22 6.47 NA NA XXX93930 ......... 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 XXX93930 ......... TC ...... A Upper extremity study ................................... 0.00 6.20 5.44 NA NA 0.37 6.57 5.81 NA NA XXX93931 ......... ............ A Upper extremity study ................................... 0.31 4.32 3.69 NA NA 0.27 4.90 4.27 NA NA XXX93931 ......... 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 XXX93931 ......... TC ...... A Upper extremity study ................................... 0.00 4.22 3.59 NA NA 0.24 4.46 3.83 NA NA XXX93965 ......... ............ A Extremity study .............................................. 0.35 3.13 2.88 NA NA 0.14 3.62 3.37 NANA XXX93965 ......... 26 ....... A Extremity study .............................................. 0.35 0.12 0.12 0.12 0.12 0.02 0.49 0.49 0.49 0.49 XXX93965 ......... TC ...... A Extremity study .............................................. 0.00 3.02 2.76 NA NA 0.12 3.14 2.88 NA NAXXX93970 ......... ............ A Extremity study .............................................. 0.68 6.32 5.51 NA NA 0.46 7.46 6.65 NANA XXX93970 ......... 26 ....... A Extremity study .............................................. 0.68 0.21 0.23 0.21 0.23 0.06 0.95 0.97 0.95 0.97 XXX93970 ......... TC ...... A Extremity study .............................................. 0.00 6.11 5.29 NA NA 0.40 6.51 5.69 NA NAXXX93971 ......... ............ A Extremity study .............................................. 0.45 4.12 3.72 NA NA 0.30 4.87 4.47 NANA XXX93971 ......... 26 ....... A Extremity study .............................................. 0.45 0.14 0.15 0.14 0.15 0.03 0.62 0.63 0.62 0.63 XXX93971 ......... TC ...... A Extremity study .............................................. 0.00 3.98 3.58 NA NA 0.27 4.25 3.85 NA NAXXX93975 ......... ............ A Vascular study ............................................... 1.80 8.56 7.86 NA NA 0.56 10.92 10.22NA NA XXX93975 ......... 26 ....... A Vascular study ............................................... 1.80 0.62 0.61 0.62 0.61 0.13 2.55 2.54 2.55 2.54 XXX93975 ......... TC ...... A Vascular study ............................................... 0.00 7.95 7.26 NA NA 0.43 8.38 7.69 NA NAXXX93976 ......... ............ A Vascular study ............................................... 1.21 4.57 4.39 NA NA 0.35 6.13 5.95 NANA XXX93976 ......... 26 ....... A Vascular study ............................................... 1.21 0.39 0.40 0.39 0.40 0.05 1.65 1.66 1.65 1.66 XXX93976 ......... TC ...... A Vascular study ............................................... 0.00 4.18 3.99 NA NA 0.30 4.48 4.29 NA NAXXX93978 ......... ............ A Vascular study ............................................... 0.65 6.15 4.92 NA NA 0.43 7.23 6.00 NANA XXX93978 ......... 26 ....... A Vascular study ............................................... 0.65 0.23 0.22 0.23 0.22 0.06 0.94 0.93 0.94 0.93 XXX93978 ......... TC ...... A Vascular study ............................................... 0.00 5.93 4.70 NA NA 0.37 6.30 5.07 NA NAXXX93979 ......... ............ A Vascular study ............................................... 0.44 4.40 3.51 NA NA 0.27 5.11 4.22 NANA XXX93979 ......... 26 ....... A Vascular study ............................................... 0.44 0.16 0.15 0.16 0.15 0.03 0.63 0.62 0.63 0.62 XXX93979 ......... TC ...... A Vascular study ............................................... 0.00 4.23 3.35 NA NA 0.24 4.47 3.59 NA NAXXX93980 ......... ............ A Penile vascular study .................................... 1.25 3.49 3.01 NA NA 0.42 5.16 4.68 NA NAXXX93980 ......... 26 ....... A Penile vascular study .................................... 1.25 0.44 0.42 0.44 0.42 0.08 1.77 1.75 1.771.75 XXX93980 ......... TC ...... A Penile vascular study .................................... 0.00 3.05 2.59 NA NA 0.34 3.39 2.93 NA NA XXX93981 ......... ............ A Penile vascular study .................................... 0.44 2.88 2.87 NA NA 0.33 3.65 3.64 NA NAXXX93981 ......... 26 ....... A Penile vascular study .................................... 0.44 0.16 0.15 0.16 0.15 0.02 0.62 0.61 0.620.61 XXX93981 ......... TC ...... A Penile vascular study .................................... 0.00 2.71 2.73 NA NA 0.31 3.02 3.04 NA NA XXX93990 ......... ............ A Doppler flow testing ....................................... 0.25 5.34 4.33 NA NA 0.26 5.85 4.84 NA NA XXX93990 ......... 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 XXX93990 ......... TC ...... A Doppler flow testing ....................................... 0.00 5.27 4.24 NA NA 0.23 5.50 4.47 NA NA XXX94010 ......... ............ A Breathing capacity test .................................. 0.17 0.74 0.69 NA NA 0.03 0.94 0.89 NA NAXXX94010 ......... 26 ....... A Breathing capacity test .................................. 0.17 0.04 0.05 0.04 0.05 0.01 0.22 0.23 0.220.23 XXX94010 ......... TC ...... A Breathing capacity test .................................. 0.00 0.70 0.64 NA NA 0.02 0.72 0.66 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00244 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49225 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules94014 ......... ............ A Patient recorded spirometry .......................... 0.52 0.93 0.80 0.93 0.80 0.03 1.48 1.35 1.48 1.35 XXX94015 ......... ............ A Patient recorded spirometry .......................... 0.00 0.76 0.63 NA NA 0.01 0.77 0.64 NA NA XXX94016 ......... ............ A Review patient spirometry ............................. 0.52 0.17 0.17 0.17 0.17 0.02 0.71 0.71 0.710.71 XXX94060 ......... ............ A Evaluation of wheezing ................................. 0.31 1.32 1.13 1.32 1.13 0.07 1.70 1.51 1.701.51 XXX94060 ......... 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 XXX94060 ......... 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 XXX94070 ......... ............ A Evaluation of wheezing ................................. 0.60 1.01 0.87 NA NA 0.13 1.74 1.60 NA NA XXX94070 ......... 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 XXX94070 ......... TC ...... A Evaluation of wheezing ................................. 0.00 0.85 0.69 NA NA 0.10 0.95 0.79 NA NA XXX94150 ......... ............ B Vital capacity test .......................................... 0.07 0.48 0.47 NA NA 0.02 0.57 0.56 NANA XXX94150 ......... 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 XXX94150 ......... TC ...... B Vital capacity test .......................................... 0.00 0.47 0.45 NA NA 0.01 0.48 0.46 NA NAXXX94200 ......... ............ A Lung function test (MBC/MVV) ..................... 0.11 0.51 0.46 NA NA 0.03 0.65 0.60 NA NA XXX94200 ......... 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 XXX94240 ......... ............ A Residual lung capacity .................................. 0.26 0.84 0.71 NA NA 0.06 1.16 1.03 NA NA XXX94240 ......... 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 XXX94240 ......... TC ...... A Residual lung capacity .................................. 0.00 0.77 0.63 NA NA 0.05 0.82 0.68 NA NA XXX94250 ......... ............ A Expired gas collection ................................... 0.11 0.57 0.62 NA NA 0.02 0.70 0.75 NA NAXXX94250 ......... 26 ....... A Expired gas collection ................................... 0.11 0.04 0.03 0.04 0.03 0.01 0.16 0.15 0.160.15 XXX94250 ......... TC ...... A Expired gas collection ................................... 0.00 0.53 0.59 NA NA 0.01 0.54 0.60 NA NA XXX94260 ......... ............ A Thoracic gas volume ..................................... 0.13 0.77 0.63 NA NA 0.05 0.95 0.81 NA NA XXX94260 ......... 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 XXX94260 ......... TC ...... A Thoracic gas volume ..................................... 0.00 0.74 0.59 NA NA 0.04 0.78 0.63 NA NA XXX94350 ......... ............ A Lung nitrogen washout curve ........................ 0.26 0.67 0.74 NA NA 0.05 0.98 1.05 NA NA XXX94350 ......... 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 XXX94350 ......... TC ...... A Lung nitrogen washout curve ........................ 0.00 0.59 0.66 NA NA 0.04 0.63 0.70 NA NA XXX94360 ......... ............ A Measure airflow resistance ........................... 0.26 0.99 0.77 NA NA 0.07 1.32 1.10 NA NA XXX94360 ......... 26 ....... A Measure airflow resistance ........................... 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35XXX94360 ......... TC ...... A Measure airflow resistance ........................... 0.00 0.92 0.70 NA NA 0.06 0.98 0.76 NA NA XXX94370 ......... ............ A Breath airway closing volume ....................... 0.26 0.67 0.71 NA NA 0.03 0.96 1.00 NA NA XXX94370 ......... 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 XXX94370 ......... TC ...... A Breath airway closing volume ....................... 0.00 0.58 0.63 NA NA 0.02 0.60 0.65 NA NA XXX94375 ......... ............ A Respiratory flow volume loop ........................ 0.31 0.75 0.64 NA NA 0.03 1.09 0.98 NA NA XXX94375 ......... 26 ....... A Respiratory flow volume loop ........................ 0.31 0.08 0.09 0.08 0.09 0.01 0.40 0.41 0.40 0.41XXX94375 ......... TC ...... A Respiratory flow volume loop ........................ 0.00 0.66 0.55 NA NA 0.02 0.68 0.57 NA NA XXX94400 ......... ............ A CO2 breathing response curve ..................... 0.40 1.03 0.89 NA NA 0.09 1.52 1.38 NA NA XXX94400 ......... 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 XXX94450 ......... ............ 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 XXX94450 ......... TC ...... A Hypoxia response curve ................................ 0.00 0.95 0.79 NA NA 0.02 0.97 0.81 NA NA XXX94452 ......... ............ A Hast w/report ................................................. 0.31 1.21 1.07 NA NA 0.04 1.56 1.42 NA NA XXX94452 ......... 26 ....... A Hast w/report ................................................. 0.31 0.09 0.09 0.09 0.09 0.02 0.42 0.420.42 0.42 XXX94452 ......... TC ...... A Hast w/report ................................................. 0.00 1.12 0.98 NA NA 0.02 1.14 1.00 NA NAXXX94453 ......... ............ A Hast w/oxygen titrate ..................................... 0.40 1.69 1.56 NA NA 0.04 2.13 2.00 NA NAXXX94453 ......... 26 ....... A Hast w/oxygen titrate ..................................... 0.40 0.11 0.12 0.11 0.12 0.02 0.53 0.54 0.530.54 XXX94453 ......... 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 XXX94620 ......... 26 ....... A Pulmonary stress test/simple ........................ 0.64 0.20 0.20 0.20 0.20 0.03 0.87 0.87 0.87 0.87XXX94620 ......... TC ...... A Pulmonary stress test/simple ........................ 0.00 0.68 1.89 NA NA 0.10 0.78 1.99 NA NA XXX94621 ......... ............ 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 XXX94621 ......... TC ...... A Pulm stress test/complex .............................. 0.00 2.73 2.00 NA NA 0.10 2.83 2.10 NA NA XXX94640 ......... ............ 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 XXX94656 ......... ............ A Initial ventilator mgmt .................................... 1.22 1.12 1.15 0.24 0.30 0.06 2.40 2.431.52 1.58 XXX94657 ......... ............ A Continued ventilator mgmt ............................ 0.83 1.15 1.02 0.19 0.24 0.04 2.02 1.89 1.06 1.11 XXX94660 ......... ............ 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 XXX94662 ......... ............ A Neg press ventilation, cnp ............................. 0.76 NA NA 0.18 0.22 0.03 NA NA 0.97 1.01 XXX94664 ......... ............ A Evaluate pt use of inhaler ............................. 0.00 0.40 0.33 NA NA 0.04 0.44 0.37 NA NA XXX94667 ......... ............ A Chest wall manipulation ................................ 0.00 0.55 0.53 NA NA 0.05 0.60 0.58 NA NA XXX94668 ......... ............ A Chest wall manipulation ................................ 0.00 0.51 0.47 NA NA 0.02 0.53 0.49 NA NA XXX94680 ......... ............ 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 XXX94680 ......... 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 XXX94680 ......... 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00245 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49226 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal94681 ......... ............ A Exhaled air analysis, o2/co2 ......................... 0.20 1.10 2.17 NA NA 0.13 1.43 2.50 NA NA XXX94681 ......... 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 0.27XXX94681 ......... TC ...... A Exhaled air analysis, o2/co2 ......................... 0.00 1.04 2.11 NA NA 0.12 1.16 2.23 NA NA XXX94690 ......... ............ A Exhaled air analysis ...................................... 0.07 0.89 1.72 NA NA 0.05 1.01 1.84 NA NAXXX94690 ......... 26 ....... A Exhaled air analysis ...................................... 0.07 0.02 0.02 0.02 0.02 0.01 0.10 0.10 0.100.10 XXX94690 ......... 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 XXX94720 ......... 26 ....... A Monoxide diffusing capacity .......................... 0.26 0.06 0.08 0.06 0.08 0.01 0.33 0.35 0.33 0.35XXX94720 ......... TC ...... A Monoxide diffusing capacity .......................... 0.00 1.11 0.97 NA NA 0.06 1.17 1.03 NA NA XXX94725 ......... ............ A Membrane diffusion capacity ........................ 0.26 1.10 2.46 NA NA 0.13 1.49 2.85 NA NA XXX94725 ......... 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 XXX94725 ......... TC ...... A Membrane diffusion capacity ........................ 0.00 1.01 2.38 NA NA 0.12 1.13 2.50 NA NA XXX94750 ......... ............ A Pulmonary compliance study ........................ 0.23 1.90 1.48 NA NA 0.05 2.18 1.76 NA NA XXX94750 ......... 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 XXX94750 ......... TC ...... A Pulmonary compliance study ........................ 0.00 1.82 1.41 NA NA 0.04 1.86 1.45 NA NA XXX94760 ......... ............ T Measure blood oxygen level ......................... 0.00 0.06 0.05 NA NA 0.02 0.08 0.07 NA NA XXX94761 ......... ............ T Measure blood oxygen level ......................... 0.00 0.12 0.08 NA NA 0.06 0.18 0.14 NA NA XXX94762 ......... ............ A Measure blood oxygen level ......................... 0.00 0.96 0.59 NA NA 0.10 1.06 0.69 NA NA XXX94770 ......... ............ A Exhaled carbon dioxide test .......................... 0.15 0.85 0.78 NA NA 0.08 1.08 1.01 NA NA XXX94770 ......... 26 ....... A Exhaled carbon dioxide test .......................... 0.15 0.04 0.04 0.04 0.04 0.01 0.20 0.20 0.20 0.20XXX94770 ......... TC ...... A Exhaled carbon dioxide test .......................... 0.00 0.81 0.74 NA NA 0.07 0.88 0.81 NA NA XXX94772 ......... ............ C Breath recording, infant ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX94772 ......... 26 ....... C Breath recording, infant ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX94772 ......... 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 XXX94799 ......... ............ C Pulmonary service/procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX94799 ......... 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 XXX94799 ......... 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 XXX95004 ......... ............ A Percut allergy skin tests ................................ 0.00 0.16 0.12 NA NA 0.01 0.17 0.13 NA NAXXX95010 ......... ............ 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 XXX95015 ......... ............ 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 XXX95024 ......... ............ A Id allergy test, drug/bug ................................ 0.00 0.21 0.17 NA NA 0.01 0.22 0.18 NA NAXXX95027 ......... ............ A Id allergy titrate-airborne ............................... 0.00 0.24 0.17 NA NA 0.01 0.25 0.18 NA NAXXX95028 ......... ............ A Id allergy test-delayed type ........................... 0.00 0.29 0.25 NA NA 0.01 0.30 0.26 NA NA XXX95044 ......... ............ A Allergy patch tests ......................................... 0.00 0.15 0.19 NA NA 0.01 0.16 0.20 NANA XXX95052 ......... ............ A Photo patch test ............................................ 0.00 0.15 0.23 NA NA 0.01 0.16 0.24 NANA XXX95056 ......... ............ A Photosensitivity tests ..................................... 0.00 1.18 0.42 NA NA 0.01 1.19 0.43 NA NA XXX95060 ......... ............ A Eye allergy tests ............................................ 0.00 0.75 0.45 NA NA 0.02 0.77 0.47 NANA XXX95065 ......... ............ A Nose allergy test ........................................... 0.00 0.67 0.32 NA NA 0.01 0.68 0.33 NANA XXX95070 ......... ............ A Bronchial allergy tests ................................... 0.00 0.80 1.91 NA NA 0.02 0.82 1.93 NA NAXXX95071 ......... ............ A Bronchial allergy tests ................................... 0.00 0.89 2.41 NA NA 0.02 0.91 2.43 NA NAXXX95075 ......... ............ A Ingestion challenge test ................................ 0.95 0.67 0.78 0.25 0.35 0.03 1.65 1.76 1.23 1.33 XXX95078 ......... ............ A Provocative testing ........................................ 0.00 0.33 0.27 NA NA 0.02 0.35 0.29 NA NA XXX95115 ......... ............ A Immunotherapy, one injection ....................... 0.00 0.22 0.35 0.00 0.29 0.02 0.24 0.37 0.02 0.31 XXX95117 ......... ............ A Immunotherapy injections ............................. 0.00 0.27 0.44 0.00 0.38 0.02 0.29 0.46 0.02 0.40 XXX95144 ......... ............ A Antigen therapy services ............................... 0.06 0.26 0.21 0.02 0.02 0.01 0.33 0.28 0.090.09 XXX95145 ......... ............ A Antigen therapy services ............................... 0.06 0.35 0.33 0.02 0.02 0.01 0.42 0.40 0.090.09 XXX95146 ......... ............ A Antigen therapy services ............................... 0.06 0.66 0.50 0.02 0.03 0.01 0.73 0.57 0.090.10 XXX95147 ......... ............ A Antigen therapy services ............................... 0.06 0.64 0.48 0.02 0.02 0.01 0.71 0.55 0.090.09 XXX95148 ......... ............ A Antigen therapy services ............................... 0.06 0.94 0.67 0.02 0.03 0.01 1.01 0.74 0.090.10 XXX95149 ......... ............ A Antigen therapy services ............................... 0.06 1.25 0.91 0.02 0.03 0.01 1.32 0.98 0.090.10 XXX95165 ......... ............ A Antigen therapy services ............................... 0.06 0.25 0.21 0.02 0.02 0.01 0.32 0.28 0.090.09 XXX95170 ......... ............ A Antigen therapy services ............................... 0.06 0.20 0.15 0.02 0.03 0.01 0.27 0.22 0.090.10 XXX95180 ......... ............ A Rapid desensitization .................................... 2.01 1.57 1.92 0.71 0.88 0.04 3.62 3.97 2.76 2.93 XXX95199 ......... ............ C Allergy immunology services ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX95250 ......... ............ 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 0.700.72 XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00246 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49227 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules95805 ......... ............ A Multiple sleep latency test ............................. 1.88 7.27 14.76 NA NA 0.43 9.58 17.07 NA NAXXX95805 ......... 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 XXX95805 ......... 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 XXX95806 ......... TC ...... A Sleep study, unattended ............................... 0.00 3.52 2.97 NA NA 0.31 3.83 3.28 NA NA XXX95807 ......... ............ A Sleep study, attended ................................... 1.66 12.81 12.09 NA NA 0.50 14.97 14.25 NANA XXX95807 ......... 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 XXX95807 ......... TC ...... A Sleep study, attended ................................... 0.00 12.30 11.57 NA NA 0.42 12.72 11.99 NA NA XXX95808 ......... ............ A Polysomnography, 1–3 .................................. 2.65 15.72 13.82 NA NA 0.55 18.92 17.02 NA NA XXX95808 ......... 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 XXX95808 ......... TC ...... A Polysomnography, 1–3 .................................. 0.00 15.03 12.96 NA NA 0.42 15.45 13.38 NA NA XXX95810 ......... ............ 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 XXX95810 ......... TC ...... A Polysomnography, 4 or more ........................ 0.00 17.62 16.64 NA NA 0.42 18.04 17.06 NA NA XXX95811 ......... ............ A Polysomnography w/cpap ............................. 3.79 20.70 19.56 NA NA 0.61 25.10 23.96 NA NA XXX95811 ......... 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 XXX95811 ......... TC ...... A Polysomnography w/cpap ............................. 0.00 19.66 18.36 NA NA 0.43 20.09 18.79 NA NA XXX95812 ......... ............ A Eeg, 41–60 minutes ...................................... 1.08 5.90 4.50 NA NA 0.17 7.15 5.75 NA NA XXX95812 ......... 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 XXX95812 ......... TC ...... A Eeg, 41–60 minutes ...................................... 0.00 5.59 4.08 NA NA 0.11 5.70 4.19 NA NA XXX95813 ......... ............ A Eeg, over 1 hour ........................................... 1.73 6.64 5.43 NA NA 0.20 8.57 7.36 NA NA XXX95813 ......... 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 XXX95813 ......... TC ...... A Eeg, over 1 hour ........................................... 0.00 6.14 4.78 NA NA 0.11 6.25 4.89 NA NA XXX95816 ......... ............ A Eeg, awake and drowsy ................................ 1.08 5.30 4.11 NA NA 0.16 6.54 5.35 NA NA XXX95816 ......... 26 ....... A Eeg, awake and drowsy ................................ 1.08 0.30 0.42 0.30 0.42 0.06 1.44 1.56 1.44 1.56XXX95816 ......... TC ...... A Eeg, awake and drowsy ................................ 0.00 4.99 3.69 NA NA 0.10 5.09 3.79 NA NA XXX95819 ......... ............ 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 XXX95819 ......... TC ...... A Eeg, awake and asleep ................................. 0.00 5.84 3.35 NA NA 0.10 5.94 3.45 NA NA XXX95822 ......... ............ 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 XXX95822 ......... TC ...... A Eeg, coma or sleep only ............................... 0.00 5.23 4.41 NA NA 0.13 5.36 4.54 NA NA XXX95824 ......... ............ C Eeg, cerebral death only ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX95824 ......... 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 XXX95824 ......... 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 XXX95827 ......... ............ A Eeg, all night recording ................................. 1.08 11.57 4.92 NA NA 0.19 12.84 6.19 NA NA XXX95827 ......... 26 ....... A Eeg, all night recording ................................. 1.08 0.29 0.38 0.29 0.38 0.05 1.42 1.51 1.421.51 XXX95827 ......... TC ...... A Eeg, all night recording ................................. 0.00 11.28 4.54 NA NA 0.14 11.42 4.68 NA NA XXX95829 ......... ............ A Surgery electrocorticogram ........................... 6.20 25.44 29.61 NA NA 0.50 32.14 36.31 NA NAXXX95829 ......... 26 ....... A Surgery electrocorticogram ........................... 6.20 1.79 2.18 1.79 2.18 0.48 8.47 8.86 8.47 8.86XXX95829 ......... TC ...... A Surgery electrocorticogram ........................... 0.00 23.65 27.43 NA NA 0.02 23.67 27.45 NA NA XXX95830 ......... ............ A Insert electrodes for EEG .............................. 1.70 2.99 3.22 0.42 0.65 0.11 4.80 5.03 2.232.46 XXX95831 ......... ............ 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 XXX95832 ......... ............ 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 XXX95833 ......... ............ 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 XXX95834 ......... ............ 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 XXX95851 ......... ............ 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 XXX95852 ......... ............ 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 XXX95857 ......... ............ A Tensilon test .................................................. 0.53 0.59 0.60 0.16 0.21 0.02 1.14 1.15 0.71 0.76 XXX95860 ......... ............ A Muscle test, one limb .................................... 0.96 1.16 1.36 NA NA 0.07 2.19 2.39 NA NAXXX95860 ......... 26 ....... A Muscle test, one limb .................................... 0.96 0.32 0.40 0.32 0.40 0.05 1.33 1.41 1.331.41 XXX95860 ......... TC ...... A Muscle test, one limb .................................... 0.00 0.84 0.96 NA NA 0.02 0.86 0.98 NA NA XXX95861 ......... ............ A Muscle test, 2 limbs ...................................... 1.54 1.67 1.48 NA NA 0.13 3.34 3.15 NA NAXXX95861 ......... 26 ....... A Muscle test, 2 limbs ...................................... 1.54 0.51 0.64 0.51 0.64 0.07 2.12 2.25 2.122.25 XXX95861 ......... 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 NAXXX95863 ......... 26 ....... A Muscle test, 3 limbs ...................................... 1.87 0.58 0.75 0.58 0.75 0.09 2.54 2.71 2.542.71 XXX95863 ......... 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 NAXXX95864 ......... 26 ....... A Muscle test, 4 limbs ...................................... 1.99 0.63 0.81 0.63 0.81 0.09 2.71 2.89 2.712.89 XXX95864 ......... 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 XXX95865 ......... 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 XXX95865 ......... TC ...... A Muscle test, larynx ........................................ 0.00 0.88 0.73 NA NA 0.03 0.91 0.76 NA NA XXX95866 ......... ............ A Muscle test, hemidiaphragm ......................... 1.25 1.34 0.91 NA NA 0.10 2.69 2.26 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00247 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49228 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal95866 ......... 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 XXX95866 ......... TC ...... A Muscle test, hemidiaphragm ......................... 0.00 0.94 0.39 NA NA 0.03 0.97 0.42 NA NA XXX95867 ......... ............ 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 XXX95867 ......... TC ...... A Muscle test cran nerv unilat .......................... 0.00 0.89 0.66 NA NA 0.04 0.93 0.70 NA NA XXX95868 ......... ............ 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 XXX95868 ......... TC ...... A Muscle test cran nerve bilat .......................... 0.00 1.08 0.80 NA NA 0.05 1.13 0.85 NA NA XXX95869 ......... ............ 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 XXX95869 ......... TC ...... A Muscle test, thor paraspinal .......................... 0.00 0.91 0.39 NA NA 0.02 0.93 0.41 NA NA XXX95870 ......... ............ A Muscle test, nonparaspinal ........................... 0.37 1.00 0.53 NA NA 0.04 1.41 0.94 NA NA XXX95870 ......... 26 ....... A Muscle test, nonparaspinal ........................... 0.37 0.12 0.15 0.12 0.15 0.02 0.51 0.54 0.51 0.54XXX95870 ......... TC ...... A Muscle test, nonparaspinal ........................... 0.00 0.88 0.38 NA NA 0.02 0.90 0.40 NA NA XXX95872 ......... ............ A Muscle test, one fiber .................................... 2.00 1.42 1.28 NA NA 0.13 3.55 3.41 NA NAXXX95872 ......... 26 ....... A Muscle test, one fiber .................................... 2.00 0.65 0.64 0.65 0.64 0.08 2.73 2.72 2.732.72 XXX95872 ......... 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 1.360.92 ZZZ95873 ......... 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 ZZZ95873 ......... 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 0.38ZZZ95874 ......... ............ A Guide nerv destr, needle emg ...................... 0.37 0.96 0.52 0.96 0.52 0.04 1.37 0.93 1.37 0.93ZZZ95874 ......... 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 ZZZ95874 ......... 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 XXX95875 ......... 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 XXX95875 ......... TC ...... A Limb exercise test ......................................... 0.00 1.00 0.99 NA NA 0.06 1.06 1.05 NA NA XXX95900 ......... ............ A Motor nerve conduction test .......................... 0.42 0.94 1.18 NA NA 0.04 1.40 1.64 NA NA XXX95900 ......... 26 ....... A Motor nerve conduction test .......................... 0.42 0.14 0.17 0.14 0.17 0.02 0.58 0.61 0.58 0.61XXX95900 ......... TC ...... A Motor nerve conduction test .......................... 0.00 0.80 1.01 NA NA 0.02 0.82 1.03 NA NA XXX95903 ......... ............ A Motor nerve conduction test .......................... 0.60 1.04 1.15 NA NA 0.05 1.69 1.80 NA NA XXX95903 ......... 26 ....... A Motor nerve conduction test .......................... 0.60 0.18 0.24 0.18 0.24 0.03 0.81 0.87 0.81 0.87XXX95903 ......... TC ...... A Motor nerve conduction test .......................... 0.00 0.86 0.91 NA NA 0.02 0.88 0.93 NA NA XXX95904 ......... ............ A Sense nerve conduction test ......................... 0.34 0.88 1.04 NA NA 0.04 1.26 1.42 NA NA XXX95904 ......... 26 ....... A Sense nerve conduction test ......................... 0.34 0.11 0.14 0.11 0.14 0.02 0.47 0.50 0.47 0.50XXX95904 ......... TC ...... A Sense nerve conduction test ......................... 0.00 0.77 0.90 NA NA 0.02 0.79 0.92 NA NA XXX95920 ......... ............ A Intraop nerve test add-on .............................. 2.11 1.80 2.12 1.80 2.12 0.23 4.14 4.46 4.144.46 ZZZ95920 ......... 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 ZZZ95920 ......... 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 ZZZ95921 ......... ............ A Autonomic nerv function test ......................... 0.90 1.14 0.82 NA NA 0.06 2.10 1.78 NA NA XXX95921 ......... 26 ....... A Autonomic nerv function test ......................... 0.90 0.24 0.31 0.24 0.31 0.04 1.18 1.25 1.18 1.25XXX95921 ......... TC ...... A Autonomic nerv function test ......................... 0.00 0.89 0.51 NA NA 0.02 0.91 0.53 NA NA XXX95922 ......... ............ A Autonomic nerv function test ......................... 0.96 1.65 1.00 NA NA 0.07 2.68 2.03 NA NA XXX95922 ......... 26 ....... A Autonomic nerv function test ......................... 0.96 0.27 0.37 0.27 0.37 0.05 1.28 1.38 1.28 1.38XXX95922 ......... TC ...... A Autonomic nerv function test ......................... 0.00 1.38 0.63 NA NA 0.02 1.40 0.65 NA NA XXX95923 ......... ............ A Autonomic nerv function test ......................... 0.90 2.12 1.98 NA NA 0.07 3.09 2.95 NA NA XXX95923 ......... 26 ....... A Autonomic nerv function test ......................... 0.90 0.24 0.35 0.24 0.35 0.05 1.19 1.30 1.19 1.30XXX95923 ......... TC ...... A Autonomic nerv function test ......................... 0.00 1.88 1.64 NA NA 0.02 1.90 1.66 NA NA XXX95925 ......... ............ A Somatosensory testing .................................. 0.54 3.19 1.65 NA NA 0.10 3.83 2.29 NA NA XXX95925 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.17 0.21 0.17 0.21 0.04 0.75 0.79 0.75 0.79 XXX95925 ......... TC ...... A Somatosensory testing .................................. 0.00 3.02 1.44 NA NA 0.06 3.08 1.50 NA NA XXX95926 ......... ............ A Somatosensory testing .................................. 0.54 3.06 1.62 NA NA 0.09 3.69 2.25 NA NA XXX95926 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.16 0.21 0.16 0.21 0.03 0.73 0.78 0.73 0.78 XXX95926 ......... TC ...... A Somatosensory testing .................................. 0.00 2.90 1.41 NA NA 0.06 2.96 1.47 NA NA XXX95927 ......... ............ A Somatosensory testing .................................. 0.54 3.08 1.64 NA NA 0.10 3.72 2.28 NA NA XXX95927 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.16 0.23 0.16 0.23 0.04 0.74 0.81 0.74 0.81 XXX95927 ......... TC ...... A Somatosensory testing .................................. 0.00 2.93 1.42 NA NA 0.06 2.99 1.48 NA NA XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00248 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49229 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules95928 ......... ............ A C motor evoked, uppr limbs .......................... 1.50 3.98 3.26 NA NA 0.09 5.57 4.85 NA NA XXX95928 ......... 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 2.16XXX95928 ......... TC ...... A C motor evoked, uppr limbs .......................... 0.00 3.53 2.66 NA NA 0.03 3.56 2.69 NA NA XXX95929 ......... ............ A C motor evoked, lwr limbs ............................ 1.50 4.30 3.48 NA NA 0.09 5.89 5.07 NA NA XXX95929 ......... 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 2.16XXX95930 ......... ............ 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 XXX95930 ......... TC ...... A Visual evoked potential test .......................... 0.00 2.54 2.20 NA NA 0.01 2.55 2.21 NA NA XXX95933 ......... ............ A Blink reflex test .............................................. 0.59 1.10 1.04 NA NA 0.10 1.79 1.73NA NA XXX95933 ......... 26 ....... A Blink reflex test .............................................. 0.59 0.17 0.22 0.17 0.22 0.04 0.80 0.850.80 0.85 XXX95933 ......... TC ...... A Blink reflex test .............................................. 0.00 0.93 0.82 NA NA 0.06 0.99 0.88 NA NA XXX95934 ......... ............ A H-reflex test ................................................... 0.51 0.90 0.55 NA NA 0.04 1.45 1.10NA NA XXX95934 ......... 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 XXX95934 ......... TC ...... A H-reflex test ................................................... 0.00 0.73 0.34 NA NA 0.02 0.75 0.36 NANA XXX95936 ......... ............ A H-reflex test ................................................... 0.55 0.62 0.49 NA NA 0.05 1.22 1.09NA NA XXX95936 ......... 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 XXX95936 ......... TC ...... A H-reflex test ................................................... 0.00 0.44 0.27 NA NA 0.02 0.46 0.29 NANA XXX95937 ......... ............ A Neuromuscular junction test .......................... 0.65 0.92 0.69 NA NA 0.10 1.67 1.44 NA NA XXX95937 ......... 26 ....... A Neuromuscular junction test .......................... 0.65 0.20 0.25 0.20 0.25 0.08 0.93 0.98 0.93 0.98XXX95937 ......... TC ...... A Neuromuscular junction test .......................... 0.00 0.72 0.44 NA NA 0.02 0.74 0.46 NA NA XXX95950 ......... ............ A Ambulatory eeg monitoring ........................... 1.51 4.93 4.18 NA NA 0.51 6.95 6.20 NA NA XXX95950 ......... 26 ....... A Ambulatory eeg monitoring ........................... 1.51 0.42 0.59 0.42 0.59 0.08 2.01 2.18 2.01 2.18XXX95950 ......... TC ...... A Ambulatory eeg monitoring ........................... 0.00 4.52 3.60 NA NA 0.43 4.95 4.03 NA NA XXX95951 ......... ............ C EEG monitoring/videorecord ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX95951 ......... 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 XXX95951 ......... 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 XXX95953 ......... ............ 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 4.67XXX95953 ......... TC ...... A EEG monitoring/computer ............................. 0.00 6.31 6.33 NA NA 0.43 6.74 6.76 NA NA XXX95954 ......... ............ A EEG monitoring/giving drugs ........................ 2.45 4.90 4.39 NA NA 0.19 7.54 7.03 NA NA XXX95954 ......... 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 XXX95954 ......... TC ...... A EEG monitoring/giving drugs ........................ 0.00 4.39 3.48 NA NA 0.06 4.45 3.54 NA NA XXX95955 ......... ............ A EEG during surgery ....................................... 1.01 2.83 2.45 2.83 2.45 0.22 4.06 3.68 4.06 3.68 XXX95955 ......... 26 ....... A EEG during surgery ....................................... 1.01 0.29 0.34 0.29 0.34 0.05 1.35 1.40 1.351.40 XXX95955 ......... 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 XXX95956 ......... ............ A Eeg monitoring, cable/radio .......................... 3.08 17.21 15.86 NA NA 0.59 20.88 19.53 NA NAXXX95956 ......... 26 ....... A Eeg monitoring, cable/radio .......................... 3.08 1.03 1.23 1.03 1.23 0.16 4.27 4.47 4.27 4.47XXX95956 ......... TC ...... A Eeg monitoring, cable/radio .......................... 0.00 16.18 14.63 NA NA 0.43 16.61 15.06 NA NA XXX95957 ......... ............ A EEG digital analysis ...................................... 1.98 5.88 3.38 NA NA 0.23 8.09 5.59 NA NAXXX95957 ......... 26 ....... A EEG digital analysis ...................................... 1.98 0.55 0.78 0.55 0.78 0.11 2.64 2.87 2.642.87 XXX95957 ......... 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 XXX95958 ......... 26 ....... A EEG monitoring/function test ........................ 4.24 1.21 1.61 1.21 1.61 0.21 5.66 6.06 5.66 6.06XXX95958 ......... TC ...... A EEG monitoring/function test ........................ 0.00 5.46 2.67 NA NA 0.13 5.59 2.80 NA NA XXX95961 ......... ............ A Electrode stimulation, brain ........................... 2.97 3.12 2.75 NA NA 0.55 6.64 6.27 NA NA XXX95961 ......... 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 XXX95961 ......... TC ...... A Electrode stimulation, brain ........................... 0.00 2.22 1.54 NA NA 0.07 2.29 1.61 NA NA XXX95962 ......... ............ 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 ZZZ95962 ......... 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 4.80ZZZ95962 ......... 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 1.38ZZZ95965 ......... ............ C Meg, spontaneous ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX95965 ......... 26 ....... A Meg, spontaneous ......................................... 7.99 2.29 3.14 2.29 3.14 0.46 10.74 11.59 10.74 11.59 XXX95965 ......... TC ...... C Meg, spontaneous ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX95966 ......... ............ C Meg, evoked, single ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX95966 ......... 26 ....... A Meg, evoked, single ...................................... 3.99 1.22 1.59 1.22 1.59 0.19 5.40 5.77 5.405.77 XXX95966 ......... 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 XXX95967 ......... ............ C Meg, evoked, each addIl ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 ZZZ95967 ......... 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 ZZZ95967 ......... TC ...... C Meg, evoked, each addIl ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00ZZZ95970 ......... ............ 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 XXX95971 ......... ............ A Analyze neurostim, simple ............................ 0.78 0.62 0.67 0.20 0.22 0.07 1.47 1.52 1.05 1.07 XXX95972 ......... ............ A Analyze neurostim, complex ......................... 1.50 1.20 1.21 0.46 0.48 0.14 2.84 2.85 2.10 2.12 XXX95973 ......... ............ A Analyze neurostim, complex ......................... 0.92 0.56 0.61 0.24 0.32 0.07 1.55 1.60 1.23 1.31 ZZZ95974 ......... ............ A Cranial neurostim, complex ........................... 3.00 1.48 1.65 0.85 1.19 0.16 4.64 4.81 4.01 4.35 XXX95975 ......... ............ A Cranial neurostim, complex ........................... 1.70 0.74 0.85 0.48 0.67 0.12 2.56 2.67 2.30 2.49 ZZZ95978 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00249 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49230 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal95979 ......... ............ A Analyz neurostim brain addon ...................... 1.64 0.73 0.84 0.47 0.64 0.08 2.45 2.56 2.19 2.36ZZZ95990 ......... ............ A Spin/brain pump refil & main ......................... 0.00 1.67 1.54 NA NA 0.06 1.73 1.60 NA NA XXX95991 ......... ............ A Spin/brain pump refil & main ......................... 0.77 1.67 1.54 NA NA 0.06 2.50 2.37 NA NA XXX95999 ......... ............ C Neurological procedure ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX96000 ......... ............ A Motion analysis, video/3d .............................. 1.80 NA NA 0.58 0.54 0.11 NA NA 2.49 2.45 XXX96001 ......... ............ A Motion test w/ft press meas .......................... 2.15 NA NA 0.53 0.63 0.10 NA NA 2.78 2.88 XXX96002 ......... ............ 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 XXX96004 ......... ............ 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 XXX96101 ......... ............ 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 XXX96102 ......... ............ 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 XXX96103 ......... ............ A Psycho testing admin by comp ..................... 0.51 1.31 0.49 0.09 0.15 0.02 1.84 1.02 0.62 0.68XXX96105 ......... ............ 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 XXX96111 ......... ............ A Developmental test, extend ........................... 2.60 0.66 0.95 0.53 0.92 0.18 3.44 3.73 3.31 3.70 XXX96116 ......... ............ A Neurobehavioral status exam ....................... 1.86 0.53 0.76 0.42 0.59 0.18 2.57 2.80 2.46 2.63XXX96118 ......... ............ A Neuropsych tst by psych/phys ...................... 1.86 0.81 1.25 0.32 0.55 0.18 2.85 3.29 2.36 2.59XXX96119 ......... ............ 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 XXX96120 ......... ............ A Neuropsych tst admin w/comp ...................... 0.51 1.91 1.03 0.09 0.15 0.02 2.44 1.56 0.62 0.68XXX96150 ......... ............ 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 XXX96151 ......... ............ 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 XXX96152 ......... ............ A Intervene hlth/behave, indiv .......................... 0.46 0.09 0.15 0.08 0.14 0.01 0.56 0.62 0.550.61 XXX96153 ......... ............ 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 XXX96154 ......... ............ A Interv hlth/behav, fam w/pt ............................ 0.45 0.09 0.15 0.08 0.14 0.01 0.55 0.61 0.540.60 XXX96155 ......... ............ N Interv hlth/behav fam no pt ........................... 0.44 0.10 0.16 0.10 0.15 0.02 0.56 0.62 0.560.61 XXX96401 ......... ............ 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 XXX96405 ......... ............ 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 00096406 ......... ............ 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 00096409 ......... ............ A Chemo, iv push, sngl drug ............................ 0.24 2.78 2.89 NA NA 0.06 3.08 3.19 NA NA XXX96411 ......... ............ A Chemo, iv push, addl drug ............................ 0.20 1.50 1.58 NA NA 0.06 1.76 1.84 NA NA ZZZ96413 ......... ............ A Chemo, iv infusion, 1 hr ................................ 0.28 3.63 4.05 NA NA 0.08 3.99 4.41 NA NA XXX96415 ......... ............ 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 XXX96417 ......... ............ A Chemo iv infus each addl seq ...................... 0.21 1.72 1.89 NA NA 0.07 2.00 2.17 NA NA ZZZ96420 ......... ............ A Chemo, ia, push tecnique ............................. 0.17 2.70 2.67 NA NA 0.08 2.95 2.92 NA NA XXX96422 ......... ............ A Chemo ia infusion up to 1 hr ........................ 0.17 3.70 4.55 NA NA 0.08 3.95 4.80 NA NA XXX96423 ......... ............ A Chemo ia infuse each addl hr ....................... 0.17 1.93 1.89 NA NA 0.02 2.12 2.08 NA NA ZZZ96425 ......... ............ A Chemotherapy,infusion method .................... 0.17 4.54 4.49 NA NA 0.08 4.79 4.74 NA NA XXX96440 ......... ............ A Chemotherapy, intracavitary ......................... 2.37 5.56 7.49 1.00 1.17 0.17 8.10 10.03 3.54 3.71 00096445 ......... ............ A Chemotherapy, intracavitary ......................... 2.20 5.45 7.39 0.94 1.12 0.14 7.79 9.73 3.28 3.46 00096450 ......... ............ A Chemotherapy, into CNS .............................. 1.53 5.02 6.47 0.83 1.18 0.09 6.64 8.09 2.45 2.80 00096521 ......... ............ 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 NAXXX96542 ......... ............ A Chemotherapy injection ................................. 0.75 3.55 4.08 0.32 0.58 0.07 4.37 4.90 1.141.40 XXX96549 ......... ............ C Chemotherapy, unspecified ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX96567 ......... ............ A Photodynamic tx, skin ................................... 0.00 3.65 2.38 NA NA 0.04 3.69 2.42 NA NA XXX96570 ......... ............ A Photodynamic tx, 30 min ............................... 1.10 0.41 0.38 0.41 0.38 0.11 1.62 1.59 1.621.59 ZZZ96571 ......... ............ 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 ZZZ96900 ......... ............ A Ultraviolet light therapy .................................. 0.00 0.55 0.47 NA NA 0.02 0.57 0.49 NA NA XXX96902 ......... ............ B Trichogram .................................................... 0.41 0.11 0.16 0.10 0.15 0.01 0.53 0.58 0.52 0.57 XXX96910 ......... ............ A Photochemotherapy with UV–B .................... 0.00 1.95 1.23 NA NA 0.04 1.99 1.27 NA NA XXX96912 ......... ............ A Photochemotherapy with UV–A .................... 0.00 2.51 1.57 NA NA 0.05 2.56 1.62 NA NA XXX96913 ......... ............ A Photochemotherapy, UV–A or B ................... 0.00 3.55 2.15 NA NA 0.10 3.65 2.25 NA NA XXX96920 ......... ............ 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



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00250 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49231 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules96921 ......... ............ 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 00096922 ......... ............ 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 00096999 ......... ............ C Dermatological procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX97001 ......... ............ A Pt evaluation .................................................. 1.20 0.68 0.73 NA NA 0.05 1.93 1.98NA NA XXX97002 ......... ............ A Pt re-evaluation ............................................. 0.60 0.43 0.44 NA NA 0.02 1.05 1.06 NANA XXX97003 ......... ............ A Ot evaluation ................................................. 1.20 0.77 0.85 NA NA 0.06 2.03 2.11 NA NA XXX97004 ......... ............ A Ot re-evaluation ............................................. 0.60 0.54 0.64 NA NA 0.02 1.16 1.26 NANA XXX97010 ......... ............ 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 XXX97014 ......... ............ I Electric stimulation therapy ........................... 0.18 0.19 0.19 NA NA 0.01 0.38 0.38 NA NA XXX97016 ......... ............ A Vasopneumatic device therapy ..................... 0.18 0.25 0.20 NA NA 0.01 0.44 0.39 NA NA XXX97018 ......... ............ A Paraffin bath therapy ..................................... 0.06 0.17 0.12 NA NA 0.01 0.24 0.19 NA NAXXX97022 ......... ............ A Whirlpool therapy .......................................... 0.17 0.34 0.24 NA NA 0.01 0.52 0.42 NA NA XXX97024 ......... ............ A Diathermy eg, microwave .............................. 0.06 0.08 0.07 NA NA 0.01 0.15 0.14 NA NA XXX97026 ......... ............ A Infrared therapy ............................................. 0.06 0.07 0.06 NA NA 0.01 0.14 0.13 NANA XXX97028 ......... ............ A Ultraviolet therapy ......................................... 0.08 0.09 0.08 NA NA 0.01 0.18 0.17 NANA XXX97032 ......... ............ A Electrical stimulation ...................................... 0.25 0.20 0.17 NA NA 0.01 0.46 0.43 NANA XXX97033 ......... ............ A Electric current therapy ................................. 0.26 0.46 0.32 NA NA 0.01 0.73 0.59 NA NAXXX97034 ......... ............ A Contrast bath therapy .................................... 0.21 0.21 0.17 NA NA 0.01 0.43 0.39 NA NAXXX97035 ......... ............ A Ultrasound therapy ........................................ 0.21 0.10 0.10 NA NA 0.01 0.32 0.32 NA NAXXX97036 ......... ............ A Hydrotherapy ................................................. 0.28 0.45 0.35 NA NA 0.01 0.74 0.64 NANA XXX97039 ......... ............ C Physical therapy treatment ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX97110 ......... ............ A Therapeutic exercises ................................... 0.45 0.33 0.29 NA NA 0.02 0.80 0.76 NA NA XXX97112 ......... ............ A Neuromuscular reeducation .......................... 0.45 0.36 0.32 NA NA 0.01 0.82 0.78 NA NA XXX97113 ......... ............ 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 XXX97124 ......... ............ A Massage therapy ........................................... 0.35 0.28 0.24 NA NA 0.01 0.64 0.60 NA NAXXX97139 ......... ............ C Physical medicine procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX97140 ......... ............ A Manual therapy .............................................. 0.43 0.30 0.26 NA NA 0.01 0.74 0.70 NANA XXX97150 ......... ............ A Group therapeutic procedures ...................... 0.27 0.22 0.19 NA NA 0.01 0.50 0.47 NA NA XXX97530 ......... ............ A Therapeutic activities ..................................... 0.44 0.39 0.34 NA NA 0.01 0.84 0.79 NA NA XXX97532 ......... ............ A Cognitive skills development ......................... 0.44 0.23 0.21 NA NA 0.01 0.68 0.66 NA NA XXX97533 ......... ............ A Sensory integration ....................................... 0.44 0.28 0.25 NA NA 0.01 0.73 0.70 NA NAXXX97535 ......... ............ A Self care mngment training ........................... 0.45 0.39 0.35 NA NA 0.01 0.85 0.81 NA NA XXX97537 ......... ............ A Community/work reintegration ....................... 0.45 0.29 0.27 NA NA 0.01 0.75 0.73 NA NA XXX97542 ......... ............ A Wheelchair mngment training ....................... 0.45 0.30 0.29 NA NA 0.01 0.76 0.75 NA NA XXX97597 ......... ............ 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 1.16XXX97598 ......... ............ 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 XXX97605 ......... ............ 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 0.77XXX97606 ......... ............ 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 0.84XXX97750 ......... ............ 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 XXX97760 ......... ............ 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 NANA XXX97762 ......... ............ A C/o for orthotic/prosth use ............................. 0.25 0.75 0.50 NA NA 0.02 1.02 0.77 NA NA XXX97799 ......... ............ C Physical medicine procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX97802 ......... ............ 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 XXX97803 ......... ............ A Med nutrition, indiv, subseq .......................... 0.37 0.10 0.38 0.09 0.38 0.01 0.48 0.76 0.470.76 XXX97804 ......... ............ A Medical nutrition, group ................................. 0.25 0.06 0.15 0.06 0.15 0.01 0.32 0.41 0.32 0.41 XXX97810 ......... ............ 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 XXX97811 ......... ............ 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 0.70ZZZ97813 ......... ............ 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 XXX97814 ......... ............ 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 ZZZ98925 ......... ............ A Osteopathic manipulation .............................. 0.45 0.28 0.31 0.12 0.14 0.02 0.75 0.78 0.590.61 00098926 ......... ............ A Osteopathic manipulation .............................. 0.65 0.36 0.40 0.16 0.23 0.03 1.04 1.08 0.840.91 00098927 ......... ............ A Osteopathic manipulation .............................. 0.87 0.45 0.49 0.22 0.27 0.03 1.35 1.39 1.121.17 00098928 ......... ............ A Osteopathic manipulation .............................. 1.03 0.50 0.57 0.26 0.32 0.04 1.57 1.64 1.331.39 00098929 ......... ............ A Osteopathic manipulation .............................. 1.19 0.57 0.65 0.29 0.35 0.05 1.81 1.89 1.531.59 00098940 ......... ............ A Chiropractic manipulation .............................. 0.45 0.21 0.23 0.12 0.12 0.01 0.67 0.69 0.580.58 00098941 ......... ............ A Chiropractic manipulation .............................. 0.65 0.27 0.29 0.17 0.17 0.01 0.93 0.95 0.830.83 00098942 ......... ............ A Chiropractic manipulation .............................. 0.87 0.33 0.35 0.23 0.23 0.02 1.22 1.24 1.121.12 00098943 ......... ............ N Chiropractic manipulation .............................. 0.40 0.18 0.23 0.09 0.14 0.01 0.59 0.64 0.500.55 XXX99082 ......... ............ C Unusual physician travel ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX99143 ......... ............ 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 0.00XXX99144 ......... ............ 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 0.00XXX99145 ......... ............ 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 0.00ZZZ



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00251 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49232 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal99148 ......... ............ C Mod cs diff phys < 5 yrs ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX99149 ......... ............ C Mod cs diff phys 5 yrs + ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX99150 ......... ............ C Mod cs diff phys add-on ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 ZZZ99170 ......... ............ A Anogenital exam, child .................................. 1.75 1.51 1.70 0.50 0.54 0.08 3.34 3.53 2.33 2.37 00099175 ......... ............ A Induction of vomiting ..................................... 0.00 0.34 1.13 NA NA 0.10 0.44 1.23 NA NAXXX99183 ......... ............ A Hyperbaric oxygen therapy ........................... 2.34 2.61 3.08 0.58 0.69 0.16 5.11 5.58 3.08 3.19 XXX99185 ......... ............ A Regional hypothermia ................................... 0.00 1.66 0.90 NA NA 0.04 1.70 0.94 NA NA XXX99186 ......... ............ A Total body hypothermia ................................. 0.00 1.41 1.69 NA NA 0.45 1.86 2.14 NA NA XXX99195 ......... ............ A Phlebotomy ................................................... 0.00 2.60 0.98 NA NA 0.02 2.62 1.00 NANA XXX99199 ......... ............ C Special service/proc/report ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXX99201 ......... ............ 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 XXX99202 ......... ............ 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 XXX99203 ......... ............ 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 XXX99204 ......... ............ 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 XXX99205 ......... ............ 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 XXX99211 ......... ............ 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 XXX99212 ......... ............ 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 XXX99213 ......... ............ 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 XXX99214 ......... ............ 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 XXX99215 ......... ............ 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 XXX99217 ......... ............ A Observation care discharge .......................... 1.28 NA NA 0.50 0.52 0.06 NA NA 1.84 1.86 XXX99218 ......... ............ A Observation care ........................................... 1.28 NA NA 0.38 0.43 0.06 NA NA 1.72 1.77 XXX99219 ......... ............ A Observation care ........................................... 2.14 NA NA 0.60 0.69 0.10 NA NA 2.84 2.93 XXX99220 ......... ............ A Observation care ........................................... 2.99 NA NA 0.86 0.99 0.14 NA NA 3.99 4.12 XXX99221 ......... ............ A Initial hospital care ........................................ 1.88 NA NA 0.55 0.48 0.07 NA NA 2.50 2.43 XXX99222 ......... ............ A Initial hospital care ........................................ 2.56 NA NA 0.71 0.73 0.10 NA NA 3.37 3.39 XXX99223 ......... ............ A Initial hospital care ........................................ 3.78 NA NA 1.08 1.04 0.13 NA NA 4.99 4.95 XXX99231 ......... ............ 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 XXX99235 ......... ............ A Observ/hosp same date ................................ 3.41 NA NA NA NA 0.16 NA NA NA NA XXX99236 ......... ............ A Observ/hosp same date ................................ 4.26 NA NA 1.25 1.39 0.19 NA NA 5.70 5.84 XXX99238 ......... ............ A Hospital discharge day .................................. 1.28 NA NA 0.50 0.53 0.05 NA NA 1.83 1.86 XXX99239 ......... ............ A Hospital discharge day .................................. 1.90 NA NA 0.68 0.72 0.07 NA NA 2.65 2.69 XXX99241 ......... ............ A Office consultation ......................................... 0.64 0.66 0.65 0.22 0.22 0.05 1.35 1.340.91 0.91 XXX99242 ......... ............ A Office consultation ......................................... 1.34 1.08 1.05 0.47 0.46 0.10 2.52 2.491.91 1.90 XXX99243 ......... ............ A Office consultation ......................................... 1.88 1.45 1.41 0.67 0.64 0.13 3.46 3.422.68 2.65 XXX99244 ......... ............ A Office consultation ......................................... 3.02 1.95 1.85 1.09 0.96 0.16 5.13 5.034.27 4.14 XXX99245 ......... ............ A Office consultation ......................................... 3.77 2.27 2.27 1.31 1.26 0.21 6.25 6.255.29 5.24 XXX99251 ......... ............ A Initial inpatient consult ................................... 1.00 NA NA 0.31 0.26 0.05 NA NA 1.36 1.31 XXX99252 ......... ............ A Initial inpatient consult ................................... 1.50 NA NA 0.50 0.50 0.09 NA NA 2.09 2.09 XXX99253 ......... ............ A Initial inpatient consult ................................... 2.27 NA NA 0.81 0.71 0.11 NA NA 3.19 3.09 XXX99254 ......... ............ A Initial inpatient consult ................................... 3.29 NA NA 1.19 1.03 0.13 NA NA 4.61 4.45 XXX99255 ......... ............ A Initial inpatient consult ................................... 4.00 NA NA 1.40 1.36 0.18 NA NA 5.58 5.54 XXX99281 ......... ............ A Emergency dept visit ..................................... 0.45 NA NA 0.09 0.09 0.02 NA NA 0.56 0.56XXX99282 ......... ............ A Emergency dept visit ..................................... 0.88 NA NA 0.17 0.15 0.04 NA NA 1.09 1.07XXX99283 ......... ............ A Emergency dept visit ..................................... 1.34 NA NA 0.25 0.30 0.09 NA NA 1.68 1.73XXX99284 ......... ............ A Emergency dept visit ..................................... 2.56 NA NA 0.46 0.47 0.14 NA NA 3.16 3.17XXX99285 ......... ............ A Emergency dept visit ..................................... 3.80 NA NA 0.67 0.71 0.23 NA NA 4.70 4.74XXX99289 ......... ............ A Ped crit care transport ................................... 4.79 NA NA 1.11 1.37 0.24 NA NA 6.14 6.40XXX99290 ......... ............ A Ped crit care transport addl ........................... 2.40 NA NA 0.60 0.76 0.12 NA NA 3.12 3.28 ZZZ99291 ......... ............ A Critical care, first hour ................................... 4.50 2.28 2.50 1.12 1.24 0.21 6.99 7.215.83 5.95 XXX99292 ......... ............ 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 ZZZ99293 ......... ............ A Ped critical care, initial .................................. 15.98 NA NA 3.59 4.46 1.12 NA NA 20.6921.56 XXX99294 ......... ............ A Ped critical care, subseq ............................... 7.99 NA NA 1.72 2.23 0.45 NA NA 10.16 10.67XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00252 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49233 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules99295 ......... ............ A Neonate crit care, initial ................................ 18.46 NA NA 4.34 5.11 1.16 NA NA 23.96 24.73 XXX99296 ......... ............ A Neonate critical care subseq ......................... 7.99 NA NA 1.76 2.35 0.32 NA NA 10.07 10.66 XXX99298 ......... ............ 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 XXX99300 ......... ............ A Ic, infant pbw 2501–5000 gm ........................ 2.40 NA NA 0.72 0.81 0.15 NA NA 3.27 3.36 XXX99304 ......... ............ A Nursing facility care, init ................................ 1.20 0.45 0.48 0.45 0.48 0.05 1.70 1.731.70 1.73 XXX99305 ......... ............ A Nursing facility care, init ................................ 1.61 0.56 0.61 0.56 0.61 0.07 2.24 2.292.24 2.29 XXX99306 ......... ............ A Nursing facility care, init ................................ 2.01 0.65 0.73 0.65 0.73 0.09 2.75 2.832.75 2.83 XXX99307 ......... ............ A Nursing fac care, subseq .............................. 0.60 0.27 0.27 0.27 0.27 0.03 0.90 0.90 0.900.90 XXX99308 ......... ............ A Nursing fac care, subseq .............................. 1.00 0.43 0.45 0.43 0.45 0.04 1.47 1.49 1.471.49 XXX99309 ......... ............ A Nursing fac care, subseq .............................. 1.42 0.58 0.61 0.58 0.61 0.06 2.06 2.09 2.062.09 XXX99310 ......... ............ A Nursing fac care, subseq .............................. 1.77 0.73 0.77 0.73 0.77 0.08 2.58 2.62 2.582.62 XXX99315 ......... ............ 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 XXX99316 ......... ............ 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 XXX99318 ......... ............ A Annual nursing fac assessmnt ...................... 1.20 0.45 0.48 0.45 0.48 0.05 1.70 1.73 1.70 1.73XXX99324 ......... ............ A Domicil/r-home visit new pat ......................... 1.01 0.43 0.48 NA NA 0.05 1.49 1.54 NA NA XXX99325 ......... ............ A Domicil/r-home visit new pat ......................... 1.52 0.56 0.65 NA NA 0.07 2.15 2.24 NA NA XXX99326 ......... ............ A Domicil/r-home visit new pat ......................... 2.27 0.73 0.87 NA NA 0.10 3.10 3.24 NA NA XXX99327 ......... ............ A Domicil/r-home visit new pat ......................... 3.03 0.92 1.11 NA NA 0.13 4.08 4.27 NA NA XXX99328 ......... ............ A Domicil/r-home visit new pat ......................... 3.78 1.10 1.34 NA NA 0.16 5.04 5.28 NA NA XXX99334 ......... ............ A Domicil/r-home visit est pat ........................... 0.76 0.36 0.39 NA NA 0.04 1.16 1.19 NA NA XXX99335 ......... ............ A Domicil/r-home visit est pat ........................... 1.26 0.48 0.56 NA NA 0.06 1.80 1.88 NA NA XXX99336 ......... ............ A Domicil/r-home visit est pat ........................... 2.02 0.66 0.78 NA NA 0.09 2.77 2.89 NA NA XXX99337 ......... ............ A Domicil/r-home visit est pat ........................... 3.03 0.90 1.09 NA NA 0.13 4.06 4.25 NA NA XXX99341 ......... ............ A Home visit, new patient ................................. 1.01 0.37 0.45 NA NA 0.05 1.43 1.51 NA NA XXX99342 ......... ............ A Home visit, new patient ................................. 1.52 0.50 0.64 NA NA 0.07 2.09 2.23 NA NA XXX99343 ......... ............ A Home visit, new patient ................................. 2.27 0.69 0.88 NA NA 0.10 3.06 3.25 NA NA XXX99344 ......... ............ A Home visit, new patient ................................. 3.03 0.91 1.11 NA NA 0.13 4.07 4.27 NA NA XXX99345 ......... ............ A Home visit, new patient ................................. 3.78 1.08 1.34 NA NA 0.16 5.02 5.28 NA NA XXX99347 ......... ............ A Home visit, est patient ................................... 0.76 0.36 0.39 NA NA 0.04 1.16 1.19 NA NAXXX99348 ......... ............ A Home visit, est patient ................................... 1.26 0.49 0.56 NA NA 0.06 1.81 1.88 NA NAXXX99349 ......... ............ A Home visit, est patient ................................... 2.02 0.66 0.79 NA NA 0.09 2.77 2.90 NA NAXXX99350 ......... ............ A Home visit, est patient ................................... 3.03 0.91 1.11 NA NA 0.13 4.07 4.27 NA NAXXX99354 ......... ............ A Prolonged service, office ............................... 1.77 0.65 0.74 0.50 0.62 0.08 2.50 2.59 2.35 2.47 ZZZ99355 ......... ............ A Prolonged service, office ............................... 1.77 0.67 0.73 0.52 0.60 0.07 2.51 2.57 2.36 2.44 ZZZ99356 ......... ............ 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 1.53XXX99375 ......... ............ I Home health care supervision ...................... 1.73 0.76 1.35 0.40 1.26 0.07 2.56 3.15 2.20 3.06XXX99377 ......... ............ B Hospice care supervision .............................. 1.10 0.55 0.66 0.26 0.38 0.05 1.70 1.81 1.411.53 XXX99378 ......... ............ I Hospice care supervision .............................. 1.73 0.76 1.65 0.40 1.56 0.07 2.56 3.45 2.203.36 XXX99379 ......... ............ 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 XXX99380 ......... ............ 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 XXX99381 ......... ............ N Prev visit, new, infant .................................... 1.19 1.01 1.38 0.28 0.41 0.05 2.25 2.621.52 1.65 XXX99382 ......... ............ 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 XXX99383 ......... ............ 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 XXX99384 ......... ............ 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 XXX99385 ......... ............ 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 XXX99386 ......... ............ 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 XXX99387 ......... ............ N Prev visit, new, 65 & over ............................. 2.06 1.29 1.73 0.48 0.71 0.07 3.42 3.86 2.612.84 XXX99391 ......... ............ 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 XXX99392 ......... ............ 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 XXX99393 ......... ............ 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 XXX99394 ......... ............ 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 XXX99395 ......... ............ 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 XXX99396 ......... ............ 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 XXX99397 ......... ............ 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 XXX99401 ......... ............ N Preventive counseling, indiv .......................... 0.48 0.36 0.56 0.11 0.17 0.01 0.85 1.05 0.600.66 XXX99402 ......... ............ N Preventive counseling, indiv .......................... 0.98 0.48 0.77 0.23 0.34 0.02 1.48 1.77 1.231.34 XXX99403 ......... ............ N Preventive counseling, indiv .......................... 1.46 0.59 0.97 0.34 0.51 0.04 2.09 2.47 1.842.01 XXX99404 ......... ............ N Preventive counseling, indiv .......................... 1.95 0.71 1.17 0.45 0.68 0.05 2.71 3.17 2.452.68 XXX99411 ......... ............ N Preventive counseling, group ........................ 0.15 0.22 0.19 0.03 0.05 0.01 0.38 0.35 0.19 0.21 XXX99412 ......... ............ N Preventive counseling, group ........................ 0.25 0.25 0.25 0.06 0.09 0.01 0.51 0.51 0.32 0.35 XXX99431 ......... ............ 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 XXX99433 ......... ............ A Normal newborn care/hospital ...................... 0.62 NA NA 0.14 0.19 0.02 NA NA 0.78 0.83 XXX



# VerDate Aug<31>2005 17:57 Aug 21, 2006 Jkt 208001 PO 00000 Frm 00253 Fmt 4701 Sfmt 4702 E:\FR\FM\22AUP2.SGM 22AUP2mstockstill on PROD1PC63 with PROPOSAL_2

# 49234 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesADDENDUMB.—RELATIVEVALUEUNITS(RVUS)ANDRELATEDINFORMATIONUSEDINDETERMININGMEDICAREPAYMENTSFOR2007—ContinuedCPT1/HCPCS2Mod Status DescriptionPhysicianWorkRVUsFully Implemented NonFacilityPE RVUsYear2007TransitionalNon-Facility PERVUsFully Implemented Facility PERVUsYear2007Transitional Facility PERVUsMal-Practice RVUsFully Implemented NonFacilityTotalYear2007TransitionalNon-Facility TotalFully Implemented Facility TotalYear2007Transi-tional Fa-cility TotalGlobal99435 ......... ............ A Newborn discharge day hosp ....................... 1.50 NA NA 0.47 0.56 0.06 NA NA 2.03 2.12 XXX99436 ......... ............ A Attendance, birth ........................................... 1.50 NA NA 0.35 0.44 0.06 NA NA 1.91 2.00 XXX99440 ......... ............ A Newborn resuscitation ................................... 2.93 NA NA 0.68 0.87 0.12 NA NA 3.73 3.92 XXX99499 ......... ............ 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 XXXG0101 ......... ............ A CA screen;pelvic/breast exam ...................... 0.45 0.49 0.51 NA NA 0.02 0.96 0.98 NA NA XXXG0102 ......... ............ A Prostate ca screening; dre ............................ 0.17 0.33 0.38 0.06 0.06 0.01 0.51 0.56 0.240.24 XXXG0104 ......... ............ 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 000G0105 ......... ............ A Colorectal scrn; hi risk ind ............................. 3.69 6.36 6.20 1.81 1.56 0.30 10.35 10.195.80 5.55 000G0105 ......... 53 ....... A Colorectal scrn; hi risk ind ............................. 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.651.57 000G0106 ......... ............ A Colon CA screen;barium enema ................... 0.99 4.94 3.15 NA NA 0.17 6.10 4.31 NA NA XXXG0106 ......... 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 XXXG0106 ......... TC ...... A Colon CA screen;barium enema ................... 0.00 4.63 2.83 NA NA 0.13 4.76 2.96 NA NA XXXG0108 ......... ............ 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 XXXG0117 ......... ............ T Glaucoma scrn hgh risk direc ....................... 0.45 0.80 0.74 NA NA 0.01 1.26 1.20 NA NA XXXG0118 ......... ............ T Glaucoma scrn hgh risk direc ....................... 0.17 0.79 0.60 NA NA 0.01 0.97 0.78 NA NA XXXG0120 ......... ............ A Colon ca scrn; barium enema ....................... 0.99 4.94 3.15 NA NA 0.17 6.10 4.31 NA NA XXXG0120 ......... 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 XXXG0120 ......... TC ...... A Colon ca scrn; barium enema ....................... 0.00 4.63 2.83 NA NA 0.13 4.76 2.96 NA NA XXXG0121 ......... ............ 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 000G0121 ......... 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 000G0122 ......... ............ N Colon ca scrn; barium enema ....................... 0.99 5.69 3.35 NA NA 0.18 6.86 4.52 NA NA XXXG0122 ......... 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 XXXG0122 ......... TC ...... N Colon ca scrn; barium enema ....................... 0.00 5.46 3.01 NA NA 0.13 5.59 3.14 NA NA XXXG0124 ......... ............ 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 XXXG0127 ......... ............ R Trim nail(s) .................................................... 0.17 0.39 0.29 0.04 0.06 0.01 0.570.47 0.22 0.24 000G0128 ......... ............ 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 XXXG0130 ......... ............ 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 XXXG0130 ......... TC ...... A Single energy x-ray study ............................. 0.00 0.49 0.72 NA NA 0.05 0.54 0.77 NA NA XXXG0141 ......... ............ 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 XXXG0166 ......... ............ A Extrnl counterpulse, per tx ............................ 0.07 4.56 3.82 NA NA 0.01 4.64 3.90 NA NA XXXG0168 ......... ............ 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 000G0179 ......... ............ A MD recertification HHA PT ............................ 0.45 0.48 0.89 NA NA 0.02 0.95 1.36 NA NA XXXG0180 ......... ............ A MD certification HHA patient ......................... 0.67 0.56 1.09 NA NA 0.03 1.26 1.79 NA NA XXXG0181 ......... ............ A Home health care supervision ...................... 1.73 0.81 1.31 NA NA 0.07 2.61 3.11 NA NA XXXG0182 ......... ............ 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 0.000.00 YYYG0202 ......... ............ A Screeningmammographydigital ..................... 0.70 2.82 2.78 NA NA 0.10 3.62 3.58 NA NA XXXG0202 ......... 26 ....... A Screeningmammographydigital ..................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXXG0202 ......... TC ...... A Screeningmammographydigital ..................... 0.00 2.58 2.55 NA NA 0.07 2.65 2.62 NA NA XXXG0204 ......... ............ A Diagnosticmammographydigital .................... 0.87 3.42 2.94 NA NA 0.11 4.40 3.92 NA NA XXXG0204 ......... 26 ....... A Diagnosticmammographydigital .................... 0.87 0.30 0.29 0.30 0.29 0.04 1.21 1.20 1.21 1.20 XXXG0204 ......... TC ...... A Diagnosticmammographydigital .................... 0.00 3.12 2.66 NA NA 0.07 3.19 2.73 NA NA XXXG0206 ......... ............ A Diagnosticmammographydigital .................... 0.70 2.68 2.36 NA NA 0.09 3.47 3.15 NA NA XXXG0206 ......... 26 ....... A Diagnosticmammographydigital .................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXXG0206 ......... TC ...... A Diagnosticmammographydigital .................... 0.00 2.44 2.13 NA NA 0.06 2.50 2.19 NA NA XXXG0237 ......... ............ A Therapeutic procd strg endur ........................ 0.00 0.22 0.41 NA NA 0.02 0.24 0.43 NA NA XXXG0238 ......... ............ A Oth resp proc, indiv ....................................... 0.00 0.23 0.43 NA NA 0.02 0.25 0.45 NA NA XXXG0239 ......... ............ A Oth resp proc, group ..................................... 0.00 0.32 0.33 NA NA 0.02 0.34 0.35 NA NAXXXG0245 ......... ............ 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 XXXG0246 ......... ............ R Followup eval of foot pt lop ........................... 0.45 0.55 0.54 0.15 0.16 0.02 1.02 1.01 0.620.63 XXXG0247 ......... ............ R Routine footcare pt w lops ............................ 0.50 0.68 0.56 0.16 0.20 0.02 1.20 1.08 0.680.72 ZZZG0248 ......... ............ R Demonstrate use home inr mon ................... 0.00 3.30 5.78 NA NA 0.01 3.31 5.79 NA NA XXXG0249 ......... ............ R Provide test material,equipm ......................... 0.00 2.38 3.57 NA NA 0.01 2.39 3.58 NA NA XXXG0250 ......... ............ R MD review interpret of test ............................ 0.18 0.08 0.07 NA NA 0.01 0.27 0.26 NA NA XXX



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# 49235 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed RulesG0252 ......... 26 ....... N PET imaging initial dx ................................... 1.50 0.35 0.54 0.35 0.54 0.04 1.89 2.08 1.892.08 XXXG0268 ......... ............ A Removal of impacted wax md ....................... 0.61 0.60 0.62 0.17 0.22 0.02 1.23 1.25 0.80 0.85000G0270 ......... ............ 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 XXXG0271 ......... ............ 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 XXXG0275 ......... ............ 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 ZZZG0281 ......... ............ A Elec stim unattend for press ......................... 0.18 0.15 0.12 NA NA 0.01 0.34 0.31 NA NA XXXG0283 ......... ............ A Elec stim other than wound .......................... 0.18 0.15 0.12 NA NA 0.01 0.34 0.31 NA NA XXXG0288 ......... ............ A Recon, CTA for surg plan ............................. 0.00 0.99 8.21 NA NA 0.18 1.17 8.39 NA NA XXXG0289 ......... ............ A Arthro, loose body + chondro ....................... 1.48 NA NA 0.59 0.75 0.26 NA NA 2.33 2.49 ZZZG0308 ......... ............ 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 XXXG0309 ......... ............ 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 XXXG0310 ......... ............ A ESRD related svc 1 vst <2yrs ....................... 8.49 2.87 4.98 2.87 4.98 0.28 11.64 13.75 11.6413.75 XXXG0311 ......... ............ 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 XXXG0312 ......... ............ 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 XXXG0313 ......... ............ 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 XXXG0314 ......... ............ 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 XXXG0315 ......... ............ 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 XXXG0316 ......... ............ 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 XXXG0317 ......... ............ 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 XXXG0318 ......... ............ 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 XXXG0319 ......... ............ 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 XXXG0320 ......... ............ A ESD related svs home undr 2 ....................... 10.61 2.68 6.00 2.68 6.00 0.36 13.65 16.97 13.6516.97 XXXG0321 ......... ............ 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 XXXG0322 ......... ............ 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 XXXG0323 ......... ............ 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 XXXG0325 ......... ............ 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 XXXG0326 ......... ............ 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 XXXG0327 ......... ............ 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 0.23XXXG0329 ......... ............ A Electromagntic tx for ulcers ........................... 0.06 0.16 0.15 NA NA 0.01 0.23 0.22 NA NA XXXG0332 ......... ............ D Preadmin IV immunoglobulin ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXXG0337 ......... ............ X Hospice evaluation preelecti ......................... 1.34 0.31 0.46 0.31 0.46 0.09 1.74 1.89 1.74 1.89 XXXG0339 ......... ............ C Robot lin-radsurg com, first ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.000.00 XXXG0340 ......... ............ 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 XXXG0341 ......... ............ 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 18.63090G0343 ......... ............ A Laparotomy islet cell transp .......................... 19.85 NA NA 8.69 8.74 2.06 NA NA 30.60 30.65090G0344 ......... ............ A Initial preventive exam .................................. 1.34 1.10 1.12 0.42 0.47 0.10 2.54 2.56 1.86 1.91 XXXG0364 ......... ............ A Bone marrow aspirate &biopsy ..................... 0.16 0.16 0.15 0.07 0.06 0.04 0.36 0.35 0.27 0.26ZZZG0365 ......... ............ A Vessel mapping hemo access ...................... 0.25 5.34 4.33 NA NA 0.25 5.84 4.83 NA NA XXXG0365 ......... 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 XXXG0365 ......... TC ...... A Vessel mapping hemo access ...................... 0.00 5.27 4.24 NA NA 0.23 5.50 4.47 NA NA XXXG0366 ......... ............ 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 XXXG0367 ......... ............ A EKG tracing for initial prev ............................ 0.00 0.28 0.41 NA NA 0.02 0.30 0.43 NA NA XXXG0368 ......... ............ 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 XXXG0372 ......... ............ A MD service required for PMD ....................... 0.17 0.04 0.30 0.04 0.06 0.01 0.22 0.48 0.22 0.24XXXG0375 ......... ............ 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 XXXG0376 ......... ............ 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 XXXGxxx1 ......... ............ A Ultrasound exam AAA screen ....................... 0.58 2.42 1.81 NA NA 0.11 3.11 2.50 NA NA XXXGxxx1 ......... 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 XXXM0064 ........ ............ 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 XXXP3001 ......... ............ A Screening pap smear by phys ...................... 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65XXXQ0035 ......... ............ A Cardiokymography ........................................ 0.17 0.30 0.41 NA NA 0.03 0.50 0.61 NA NA XXXQ0035 ......... 26 ....... A Cardiokymography ........................................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXXQ0035 ......... TC ...... A Cardiokymography ........................................ 0.00 0.25 0.36 NA NA 0.02 0.27 0.38 NA NA XXXQ0091 ......... ............ 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 XXXQ0092 ......... ............ 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 XXXQ3001 ......... ............ C Brachytherapy Radioelements ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00XXXR0070 ......... ............ C Transport portable x-ray ................................ 0.00 0.00 0.00 0.00 0.00 0 0.00 0.00 0.00 0.00 XXXR0075 ......... ............ 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 XXX1CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply.2Copyright 2005 American Dental Association. All rights reserved.



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# 49236 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS

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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49237 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49238 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49239 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49240 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49241 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49242 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49243 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49244 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49245 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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


# 49246 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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) 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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 

# A DDENDUM 

# C.

— C ODES FOR 

# W HICH



# W E 

# R ECEIVED 

# PERC R EC



# OMMENDATIONS ON 

# PE D IRECT



# C OST 

# I NPUTS



# — 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



# A DDENDUM 

# D.

— P ROPOSED 

# 2007 G EOGRAPHIC 

# P RACTICE 

# C OST 

# I NDICES BY 

# M EDICARE 

# C ARRIER AND 

# L OCALITY

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 ......................................................................................... 1.05 4 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 ........................................................................................ 1.01 8 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


# 49247 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# D.

— P ROPOSED 

# 2007 G EOGRAPHIC 

# P RACTICE 

# C OST 

# I NDICES BY 

# M EDICARE 

# C ARRIER AND 

# L OCALITY



# — 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 0.9 77 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 ........................................................................................... 1.0 43 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 ......................................................................................... 0.9 92 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 ........................................................................................... 0.9 87 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



# A DDENDUM 

# E.

— 2007 P ROPOSED 

# GAF S

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


# 49248 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# E.

— 2007 P ROPOSED 

# GAF S



# — 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


# 49249 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# E.

— 2007 P ROPOSED 

# GAF S



# — 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



# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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


# 49250 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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


# 49251 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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


# 49252 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules

A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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 

# A DDENDUM 

# F.

— P ROPOSED 

# CPT/

HCPCS I MAGING 

# C ODES 

# D EFINED

BY 

# S ECTION 

# 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** 



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