65376 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 410 and 414

[HCFA–1120–FC]

RIN 0938–AK11

Medicare Program; Revisions to

Payment Policies Under the Physician

Fee Schedule for Calendar Year 2001

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Final rule with comment period.

SUMMARY: This final rule with comment

period makes several changes affecting

Medicare Part B payment. The changes

include: refinement of resource-based

practice expense relative value units

(RVUs); the geographic practice cost

indices; resource-based malpractice

RVUs; critical care RVUs; care plan

oversight and physician certification

and recertification for home health

services; observation care codes; ocular

photodynamic therapy and other

ophthalmological treatments; electrical

bioimpedance; antigen supply; and the

implantation of ventricular assist

devices. This rule also addresses the

comments received on the May 3, 2000

interim final rule on the supplemental

survey criteria and makes modifications

to the criteria for data submitted in

2001. Based on public comments we are

withdrawing our proposals related to

the global period for insertion, removal,

and replacement of pacemakers and

cardioverter defibrillators and low

intensity ultrasound. This final rule also

discusses or clarifies the payment policy

for incomplete medical direction, pulse

oximetry services, outpatient therapy

supervision, outpatient therapy caps,

HCPCS ‘‘G’’ Codes, and the second 5-

year refinement of work RVUs for

services furnished beginning January 1,

2002. In addition, we are finalizing the

calendar year (CY) 2000 interim

physician work RVUs and are issuing

interim RVUs for new and revised codes

for CY 2001. We are making these

changes to ensure that our payment

systems are updated to reflect changes

in medical practice and the relative

value of services. This final rule also

announces the CY 2001 Medicare

physician fee schedule conversion

factor under the Medicare

Supplementary Medical Insurance (Part

B) program as required by section

1848(d) of the Social Security Act. The

2001 Medicare physician fee schedule

conversion factor is $38.2581.

DATES: Effective date: This rule is

effective January 1, 2001.

Comment date: Comments on interim

RVUs for selected procedure codes

identified in Addendum C and on

interim practice expense RVUs and

malpractice RVUs for all codes as

shown in Addendum B will be

considered if we receive them at the

appropriate address, as provided below,

no later than 5 p.m. on January 2, 2001.

ADDRESSES: Mail written comments (1

original and 3 copies) to the following

address only: Health Care Financing

Administration, Department of Health

and Human Services, Attention: HCFA–

1120–FC, P.O. Box 8013, Baltimore, MD

21244–8013.

Please allow sufficient time for mailed

comments to be timely received in the

event of delivery delays. If you prefer,

you may deliver your written comments

by courier (1 original and 3 copies) to

one of the following addresses:

Room 443–G, Hubert H. Humphrey

Building, 200 Independence Avenue,

SW., Washington, DC 20201 or Room

C5–14–03, 7500 Security Boulevard,

Baltimore, MD 21244.

Comments mailed to the two above

addresses may be delayed and received

too late to be considered. Because of

staff and resource limitations, we cannot

accept comments by facsimile (FAX)

transmission. In commenting, please

refer to file code HCFA–1120–FC.

Comments received timely will be

available for public inspection as they

are received, generally beginning

approximately 3 weeks after publication

of a document, in Room 443–G of the

Department’s office at 200

Independence Avenue, SW.,

Washington, DC, on Monday through

Friday of each week from 8:30 to 5 p.m.

(phone: (202) 690–7890).

FOR FURTHER INFORMATION CONTACT:

Carolyn Mullen, (410) 786–4589 or Marc

Hartstein, (410) 786–4539, (for issues

related to resource-based practice

expense relative value units).

Kenneth Marsalek, (410) 786–4502

(for issues related to supplemental

practice expense survey data).

Bob Ulikowski, (410) 786–5721 (for

issues related to resource-based

malpractice relative value units and

geographic practice cost index changes).

Rick Ensor, (410) 786–5617 (for issues

related to care plan oversight and

physician certification/recertification).

Cathleen Scally, (410) 786–5714 (for

issues related to observation care codes).

Jim Menas, (410) 786–4507 (for issues

related to incomplete medical direction

and the 5-year review).

Roberta Epps, (410) 786–4503 (for

issues related to outpatient/therapy).

Marc Hartstein, (410) 786–4539 (for

issues related to the physician fee

schedule update, the sustainable growth

rate, the conversion factor, and the

regulatory impact analysis).

Diane Milstead, (410) 786–3355 (for

all other issues).

SUPPLEMENTARY INFORMATION:

Copies: To order copies of the Federal

Register containing this document, send

your request to: New Orders,

Superintendent of Documents, P.O. Box

371954, Pittsburgh, PA 15250–7954.

Specify the date of the issue requested

and enclose a check or money order

payable to the Superintendent of

Documents, or enclose your Visa,

Discover, or Master Card number and

expiration date. Credit card orders can

also be placed by calling the order desk

at (202) 512–1800 or by faxing to (202)

512–2250. The cost for each copy is $8.

As an alternative, you can view and

photocopy the Federal Register

document at most libraries designated

as Federal Depository Libraries and at

many other public and academic

libraries throughout the country that

receive the Federal Register.

To order the disks containing this

document, send your request to:

Superintendent of Documents,

Attention: Electronic Products, P.O. Box

37082, Washington, DC 20013–7082.

Please specify, ‘‘Medicare Program;

Revisions to Payment Policies Under the

Physician Fee Schedule for Calendar

Year 2001,’’ and enclose a check or

money order payable to the

Superintendent of Documents, or

enclose your VISA, Discover, or

MasterCard number and expiration date.

Credit card orders can be placed by

calling the order clerk at (202) 512–1530

(or toll free at 1–888–293–6498) or by

faxing to (202) 512–1262. The cost of the

four disks is $25.

This Federal Register document is

also available from the Federal Register

online database through GPO Access, a

service of the U.S. Government Printing

Office. The Website address is: http://

www.access.gpo.gov/nara/index.html.

Information on the physician fee

schedule can be found on our

homepage. You can access this data by

using the following directions:

1. Go to the HCFA homepage (http:/

/www.hcfa.gov).

2. Click on ‘‘Medicare.’’

3. Click on ‘‘Professional/Technical

Information.’’

4. Select Medicare Payment Systems.

5. Select Physician Fee Schedule.

Or, you can go directly to the Physician

Fee Schedule page by typing the

following: http://www.hcfa.gov/

medicare/pfsmain.htm.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65377

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

regulations impact appears throughout

the preamble and is not exclusively in

section X.

Table of Contents

I. Background

A. Legislative History

B. Published Changes to the Fee Schedule

C. Components of the Fee Schedule

Payment Amounts

D. Development of the Relative Value Units

II. Specific Proposals for Calendar Year 2001

A. Resource-Based Practice Expense

Relative Value Units

B. Geographic Practice Cost Index Changes

C. Resource-Based Malpractice Relative

Value Units

D. Critical Care Relative Value Units

E. Care Plan Oversight and Physician

Certification/Recertification

F. Observation Care Codes

G. Ocular Photodynamic Therapy and

Other Ophthalmological Treatments

H. Electrical Bioimpedance

I. Global Period for Insertion, Removal, and

Replacement of Pacemakers and

Cardioverter Defibrillators

J. Antigen Supply

K. Low Intensity Ultrasound

L. Implantation of Ventricular Assist

Devices

III. Other Issues

A. Incomplete Medical Direction

B. Payment for Pulse Oximetry Services

C. Outpatient Therapy Supervision

D. Outpatient Therapy Caps

E. HCPCS G Codes

F. Work RVUs in the Proposed Rule

G. Five-Year Refinement of Relative Value

Units

IV. Refinement of Relative Value Units for

Calendar Year 2001 and Response to

Public Comments on Interim Relative

Value Units for 2000 (Including the

Interim Relative Value Units Contained

in the July 2000 Proposed Rule)

A. Summary of Issues Discussed Related to

the Adjustment of Relative Value Units

B. Process for Establishing Work Relative

Value Units for the 2001 Physician Fee

Schedule and Clarification of CPT

Definitions

C. Other Changes to the 2001 Physician Fee

Schedule and Clarification of CPT

Definitions

V. Physician Fee Schedule Update and

Conversion Factor for Calendar Year

2001

VI. Allowed Expenditures for Physicians’

Services and the Sustainable Growth

Rate

A. Medicare Sustainable Growth Rate

B. Physicians’ Services

C. Provisions Related to the SGR

D. Preliminary Estimate of the SGR for

2001

E. Sustainable Growth Rate for CY 2000

F. Sustainable Growth Rate for FY 2000

G. Calculation of the FY 2000, CY 2000,

and CY 2001 Sustainable Growth Rates

VII. Provisions of the Final Rule

VIII. Collection of Information Requirements

IX. Response to Comments

X. Regulatory Impact Analysis

A. Resource-Based Practice Expense

Relative Value Units

B. Geographic Practice Cost Index Changes

C. Resource-Based Malpractice Relative

Value Units

D. Critical Care Relative Value Units

E. Care Plan Oversight and Physician

Certification/Recertification

F. Observation Care Codes

G. Ocular Photodynamic Therapy and

Other Ophthalmological Treatments

H. Electrical Bioimpedance

I. Global Period for Insertion, Removal, and

Replacement of Pacemakers and

Cardioverter Defibrillators

J. Antigen Supply

K. Increased Space Allotment in Physical

Therapy Salary Equivalency Guidelines

XI. Federalism

Addendum A—Explanation and Use of

Addendum B

Addendum B—2001 Relative Value Units

and Related Information Used in

Determining Medicare Payments for

2001

Addendum C—Codes with Interim RVUs

Addendum D—2002 Geographic Practice

Cost Indices by Medicare Carrier and

Locality

Addendum E—2001 Geographic Practice

Cost Indices by Medicare Carrier and

Locality

Addendum F—Proposed 2002 Versus 1999

Geographic Adjustment Factors (GAF)

Addendum G—Malpractice

In addition, because of the many

organizations and terms to which we

refer by acronym in this final rule, we

are listing these acronyms and their

corresponding terms in alphabetical

order below:

AMA American Medical Association

BBA Balanced Budget Act of 1997

BBRA Balanced Budget Refinement Act of

1999

CF Conversion factor

CFR Code of Federal Regulations

CPT [Physicians’] Current Procedural

Terminology

[4th Edition, 1997, copyrighted by the

American Medical Association]

CPEP Clinical Practice Expert Panel

CRNA Certified Registered Nurse

Anesthetist

E/M Evaluation and management

EB Electrical bioimpedance

FMR Fair market rental

GAF Geographic adjustment factor

GPCI Geographic practice cost index

HCFA Health Care Financing

Administration

HCPCS HCFA Common Procedure Coding

System

HHA Home health agency

HHS [Department of] Health and Human

Services

IDTFs Independent Diagnostic Testing

Facilities

MCM Medicare Carrier Manual

MedPAC Medicare Payment Advisory

Commission

MEI Medicare Economic Index

MGMA Medical Group Management

Association

MSA Metropolitan Statistical Area

NAMCS National Ambulatory Medical Care

Survey

OBRA Omnibus Budget Reconciliation Act

PC Professional component

PEAC Practice Expense Advisory

Committee

PPAC Practicing Physicians Advisory

Council

PPS Prospective payment system

RUC [AMA’s Specialty Society] Relative

[Value] Update Committee

RVU Relative value unit

SGR Sustainable growth rate

SMS [AMA’s] Socioeconomic Monitoring

System

TC Technical component

I. Background

A. Legislative History

Since January 1, 1992, Medicare has

paid for physicians’ services under

section 1848 of the Social Security Act

(the Act), ‘‘Payment for Physicians’

Services.’’ This section contains three

major elements—(1) a fee schedule for

the payment of physicians’ services; (2)

a sustainable growth rate for the rates of

increase in Medicare expenditures for

physicians’ services; and (3) limits on

the amounts that nonparticipating

physicians can charge beneficiaries. The

Act requires that payments under the

fee schedule 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, and malpractice expense.

Section 1848(c)(2)(B)(ii)(II) of the Act

provides that adjustments in RVUs may

not cause total physician fee schedule

payments to differ by more than $20

million from what they would have

been had the adjustments not been

made. If adjustments to RVUs cause

expenditures to change by more than

$20 million, we must make adjustments

to the conversion factors (CFs) to

preserve budget neutrality.

B. Published Changes to the Fee

Schedule

In the July 2000 proposed rule (65 FR

44177), we listed all of the final rules

published through November 1999,

relating to the updates to the RVUs and

revisions to payment policies under the

physician fee schedule. In the July 2000

proposed rule (65 FR 44176), we

discussed several issues affecting

Medicare payment for physicians’

services, including:

65378 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Refinement of resource-based practice

expense RVUs;

• Changes to the geographic practice

cost indices;

• Resource-based malpractice RVUs;

• Critical care RVUs;

• Care plan oversight and physician

certification/recertification;

• Observation care codes;

• Ocular photodynamic therapy and

other ophthalmological treatments;

• Electrical bioimpedance;

• The global period for insertion,

removal, and replacement of

pacemakers and cardioverter

defibrillators;

• Antigen supply;

• Low intensity ultrasound; and

• The implantation of ventricular

assist devices.

This proposed rule also discussed or

clarified the payment policy for

incomplete medical direction, pulse

oximetry services, outpatient therapy

supervision, outpatient therapy caps,

and the second 5-year refinement of

work RVUs for services furnished

beginning January 1, 2002.

This final rule affects the regulations

set forth at part 410, Supplementary

medical insurance (SMI) benefits and

part 414, Payment for Part B medical

and other services.

The information in this final rule

updates information in the July 2000

proposed rule and the May 3, 2000

interim final rule with comment period

(65 FR 25664) discussed later.

C. Components of the Fee Schedule

Payment Amounts

Under the formula set forth in section

1848(b)(1) of the Act, the payment

amount for each service paid under the

physician fee schedule is the product of

three factors—(1) a nationally uniform

relative value for the service; (2) a

geographic adjustment factor (GAF) for

each physician fee schedule area; and

(3) a nationally uniform CF for the

service. The CF converts the relative

values into payment amounts.

For each physician fee schedule

service, there are three relative values—

(1) an RVU for physician work; (2) an

RVU for practice expense; and (3) an

RVU for malpractice expense. For each

of these components of the fee schedule

there is a geographic practice cost index

(GPCI) for each fee schedule area. The

GPCIs reflect the relative costs of

practice expenses, malpractice

insurance, and physician work in an

area compared to the national average

for each component.

The general formula for calculating

the Medicare fee schedule amount for a

given service in a given fee schedule

area can be expressed as:

Payment = [(RVU work × GPCI work) +

(RVU practice expense × GPCI

practice expense) + (RVU malpractice

× GPCI malpractice)] × CF

The CF for CY 2001 appears in section

V. The RVUs for CY 2001 are in

Addendum B. The GPCIs for CY 2001

can be found in Addendum E.

Section 1848(e) of the Act requires us

to develop GAFs for all physician fee

schedule areas. The total GAF for a fee

schedule area is equal to a weighted

average of the individual GPCIs for each

of the three components of the service.

Thus, the GPCIs reflect the relative

practice expenses, malpractice

insurance, and physician work in an

area compared to the national average.

In accordance with the statute, however,

the GAF for the physician’s work

reflects one-quarter of the relative cost

of physician’s work compared to the

national average.

D. Development of the Relative Value

Units

1. Work Relative Value Units

Approximately 7,500 codes represent

services included in the physician fee

schedule. The 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 work

RVUs for most codes in a cooperative

agreement with us. In constructing the

vignettes for the original RVUs, Harvard

worked with panels of expert physicians

and obtained input from physicians

from numerous specialties.

The RVUs for radiology services were

based on the American College of

Radiology (ACR) relative value scale,

which we integrated into the overall

physician fee schedule. The RVUs for

anesthesia services were based on RVUs

from a uniform relative value guide. We

established a separate CF for anesthesia

services while we continue to recognize

time as a factor in determining payment

for these services. As a result, there is

a separate payment system for

anesthesia services.

2. Practice Expense and Malpractice

Expense Relative Value Units

Section 121 of the Social Security Act

Amendments of 1994 (Pub. L. No. 103–

432), enacted on October 31, 1994,

required us to develop a methodology

for a resource-based system for

determining practice expense RVUs for

each physician service. As amended by

the Balanced Budget Act of 1997 (BBA)

(Pub. L. No. 105–33), section 1848(c)

required the new payment methodology

to be phased in over 4 years, effective

for services furnished in 1999, with

resource-based practice expense RVUs

becoming fully effective in 2002. The

BBA also requires us to implement

resource-based malpractice RVUs for

services furnished beginning in 2000.

II. Specific Proposals for Calendar Year

2001

In response to the publication of the

July 2000 proposed rule, we received

approximately 600 comments. We

received comments from individual

physicians, health care workers, and

professional associations and societies.

The majority of comments addressed the

proposals related to practice expense,

observation care, antigen supplies, care

plan oversight, and certification and

recertification of home health services.

The proposed rule discussed policies

that affected the number of RVUs on

which payment for certain services

would be based. Certain changes

implemented through this final rule are

subject to the $20 million limitation on

annual adjustments contained in section

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

After reviewing the comments and

determining the policies we would

implement, we have estimated the costs

and savings of these policies, and added

those costs and savings to the estimated

costs associated with any other changes

in RVUs for 2001. We discuss in detail

the effects of these changes in the

Regulatory Impact Analysis (section X).

For the convenience of the reader, the

headings for the policy issues

correspond to the headings used in the

July 2000 proposed rule. More detailed

background information for each issue

can be found in the May 2000 interim

final rule with comment period and the

July 2000 proposed rule.

A. Resource-Based Practice Expense

Relative Value Units

1. Resource-Based Practice Expense

Legislation

Section 121 of the Social Security Act

Amendments of 1994 (Pub. L. No. 103–

432), enacted on October 31, 1994,

required us to develop a methodology

for a resource-based system for

determining practice expense RVUs for

each physician’s services beginning in

1998. In developing the methodology,

we were to consider the staff,

equipment, and supplies used in

furnishing medical and surgical services

in various settings. The legislation

specifically required that, in

implementing the new system of

practice expense RVUs, we must apply

the same budget-neutrality provisions

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65379

that we apply to other adjustments

under the physician fee schedule.

Section 4505(a) of the BBA delayed

the effective date of the resource-based

practice expense RVU system until

January 1, 1999. In addition, section

4505(b) of the BBA provided for a 4-year

transition period from charge-based

practice expense RVUs to resourcebased RVUs. The practice expense RVUs

for CY 1999 were the product of 75

percent of charge-based RVUs and 25

percent of the resource-based RVUs. For

CY 2000, the RVUs were 50 percent

charge-based and 50 percent resourcebased. For CY 2001, the RVUs are 25

percent charge-based and 75 percent

resource-based. After CY 2001, the

RVUs will be totally resource-based.

Section 4505(e) of the BBA provided

that, in 1998, the practice expense RVUs

would be adjusted for certain services in

anticipation of the implementation of

resource-based practice expenses

beginning in 1999. As a result, we

increased practice expense RVUs for

office visits. For other services in which

practice expense RVUs exceeded 110

percent of the work RVUs and were

furnished less than 75 percent of the

time in an office setting, we reduced the

1998 practice expense RVUs to a

number equal to 110 percent of the work

RVUs. This limitation did not apply to

services that had proposed resourcebased practice expense RVUs that

increased from their 1997 practice

expense RVUs as reflected in the June

18, 1997 proposed rule (62 FR 33196).

The services affected, and the final

RVUs for 1998, were published in the

October 1997 final rule (62 FR 59103).

The most recent legislation affecting

resource-based practice expense was

included in the Balanced Budget

Refinement Act of 1999 (BBRA) (Pub. L.

No. 106–113). Section 212 of the BBRA

stated that we must 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. These data would

supplement the data we normally

collect in determining the practice

expense component of the physician fee

schedule for payments in CY 2001 and

CY 2002.

2. Current Methodology for Computing

Practice Expense Relative Value Unit

System

Effective with services on or after

January 1, 1999, we established a new

methodology for computing resourcebased practice expense RVUs that used

the two significant sources of actual

practice expense data we have available:

the Clinical Practice Expert Panel

(CPEP) data and the AMA’s

Socioeconomic Monitoring System

(SMS) data. The methodology is based

on an assumption that current aggregate

specialty practice costs are a reasonable

way to establish initial estimates of

relative resource costs of physicians’

services across specialties. It then

allocates these aggregate specialty

practice costs to specific procedures

and, thus, can be considered as a ‘‘topdown’’ approach. The methodology can

be summarized as follows:

a. Practice Expense Cost Pools. We

used actual practice expense data by

specialty, derived from the 1995

through 1997 SMS survey data, to create

six cost pools—administrative labor,

clinical labor, medical supplies, medical

equipment, office supplies, and all other

expenses. There were three steps in the

creation of the cost pools.

• Step (1) We used the AMA’s SMS

survey of actual cost data to determine

practice expenses per hour by cost

category. The practice expenses per

hour for each physician respondent’s

practice was calculated as the practice

expenses for the practice divided by the

total number of hours spent in patient

care activities. The practice expenses

per hour for the specialty were an

average of the practice expenses per

hour for the respondent physicians in

that specialty. In addition, for the CY

2000 physician fee schedule, we used

data from a survey submitted by the

Society of Thoracic Surgeons (STS) in

calculating thoracic and cardiac

surgery’s practice expense per hour.

(See the November 1999 final rule (64

FR 59391) for additional information

concerning acceptance of this data.)

• Step (2) We determined the total

number of physician hours (by

specialty) spent treating Medicare

patients. This was calculated from

physician time data for each procedure

code and from Medicare claims data.

• Step (3) We calculated the practice

expense pools by specialty and by cost

category by multiplying the specialty

practice expenses per hour for each

category by the total physician hours.

For services with work RVUs equal to

zero (including the technical component

(TC) of services with a TC and

professional component (PC)), we

created a separate practice expense

pool, using the average clinical staff

time from the CPEP data (since these

codes by definition do not have

physician time), and the ‘‘all

physicians’’ practice expense per hour.

b. Cost Allocation Methodology. For

each specialty, we separated the six

practice expense pools into two groups

and used a different allocation basis for

each group.

(i) Direct Costs

For direct costs (including clinical

labor, medical supplies, and medical

equipment), we used the CPEP data as

the allocation basis. The CPEP data for

clinical labor, medical supplies, and

medical equipment were used to

allocate the clinical labor, medical

supplies, and medical equipment cost

pools, respectively.

For the separate practice expense pool

for services with work RVUs equal to

zero, we used 1998 practice expense

RVUs to allocate the direct cost pools

(clinical labor, medical supplies, and

medical equipment cost pools) as an

interim measure. Also, for all radiology

services that are assigned work RVUs,

we used the 1998 practice expense

relative values for radiology services as

an interim measure to allocate the direct

practice expense cost pool for radiology.

For all other specialties that perform

radiology services, we used the CPEP

data for radiology services in the

allocation of that specialty’s direct

practice expense cost pools.

(ii) Indirect Costs

To allocate the cost pools for indirect

costs, including administrative labor,

office expenses, and all other expenses,

we used the total direct costs, as

described above, in combination with

the physician fee schedule work RVUs.

We converted the work RVUs to dollars

using the Medicare CF (expressed in

1995 dollars for consistency with the

SMS survey years).

The SMS pool was divided by the

CPEP pool for each specialty to produce

a scaling factor that was applied to the

CPEP direct cost inputs. This was

intended to match costs counted as

practice expenses in the SMS survey

with items counted as practice expenses

in the CPEP process. When the

specialty-specific scaling factor exceeds

the average scaling factor by more than

three standard deviations, we used the

average scaling factor. (See the

November 1999 final rule (64 FR 59390)

for further discussion of this issue).

For procedures performed by more

than one specialty, the final procedure

code allocation was a weighted average

of allocations for the specialties that

perform the procedure, with the weights

being the frequency with which each

specialty performs the procedure on

Medicare patients.

c. Other Methodological Issues. 

(i) Global Practice Expense Relative

Value Units

For services with the PC and TC paid

under the physician fee schedule, the

global practice expense RVUs were set

equal to the sum of the PC and TC.

65380 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

(ii) Practice Expenses per Hour

Adjustments and Specialty Crosswalks

Since many specialties identified in

our claims data did not correspond

exactly to the specialties included in the

practice expense tables from the SMS

survey data, it was necessary to

crosswalk these specialties to the most

appropriate SMS specialty category. We

also made the following adjustments to

the practice expense per hour data. (For

the rationale for these adjustments to

the practice expense per hour see the

November 1998 final rule (63 FR

58841).)

• We set the medical materials and

supplies practice expenses per hour for

the specialty of ‘‘oncology’’ equal to the

‘‘all physician’’ medical materials and

supplies practice expenses per hour.

• We based the administrative

payroll, office, and other practice

expenses per hour for the specialties of

‘‘physical therapy’’ and ‘‘occupational

therapy’’ on data used to develop the

salary equivalency guidelines for these

specialties. We set the remaining

practice expense per hour categories

equal to the ‘‘all physician’’ practice

expenses per hour from the SMS survey

data.

• Due to uncertainty concerning the

appropriate crosswalk and time data for

the nonphysician specialty

‘‘audiologist,’’ we derived the resourcebased practice expense RVUs for codes

performed by audiologists from the

practice expenses per hour of the other

specialties that perform these codes.

• For the specialty of ‘‘emergency

medicine,’’ we used the ‘‘all physician’’

practice expense per hour to create

practice expense cost pools for the

categories ‘‘clerical payroll’’ and ‘‘other

expenses.’’

• For the specialty of ‘‘podiatry,’’ we

used the ‘‘all physician’’ practice

expense per hour to create the practice

expense pool.

• For the specialty of ‘‘pathology,’’ we

removed the supervision and autopsy

hours reimbursed through Part A of the

Medicare program from the practice

expense per hour calculation.

• For the specialty ‘‘maxillofacial

prosthetics,’’ we used the ‘‘all

physician’’ practice expense per hour to

create practice expense cost pools and,

as an interim measure, allocated these

pools using the 1998 practice expense

RVUs.

• We split the practice expenses per

hour for the specialty ‘‘radiology’’ into

‘‘radiation oncology’’ and ‘‘radiology

other than radiation oncology’’ and used

this split practice expense per hour to

create practice expense cost pools for

these specialties.

(iii) Time Associated with the Work

RVUs

The time data resulting from the

refinement of the work RVUs have been,

on average, 25 percent greater than the

time data obtained by the Harvard study

for the same services. We increased the

Harvard research team’s time data to

ensure consistency between these data

sources.

For services with no assigned

physician time (such as, dialysis,

physical therapy, psychology, and many

radiology and other diagnostic services),

we calculated estimated total physician

time based on work RVUs, maximum

clinical staff time for each service as

shown in the CPEP data, or the

judgment of our clinical staff.

We calculated the time for CPT codes

00100 through 01996, using the base

and time units from the anesthesia fee

schedule and the Medicare allowed

claims data.

3. Refinement

a. Background

Section 4505(d)(1)(C) of the BBA

required us to develop a refinement

process to be used during each of the 4

years of the transition period. We did

not propose a specific long-term

refinement process in the June 1998

proposed rule (63 FR 30835). Rather, we

set out the parameters for an acceptable

refinement process for practice expense

RVUs and solicited comments on our

proposal. We received a large variety of

comments about broad methodology

issues, practice expense per hour data,

and detailed code level data. We made

some adjustments to our proposal when

we were convinced an adjustment was

appropriate. We also indicated that we

would consider other comments for

possible refinement and that the values

of all codes would be considered

interim for 1999 and for future years

during the transition period.

We outlined in the November 1998

final rule (63 FR 58832) the steps we

were undertaking as part of the initial

refinement process. These steps

included—

• Establishment of a mechanism to

receive independent advice for dealing

with broad practice expense RVU

technical and methodological issues;

• Evaluation of any additional

recommendations from the General

Accounting Office, the Medicare

Payment Advisory Commission

(MedPAC), and the Practicing

Physicians Advisory Council (PPAC);

and

• Consultation with physician groups

and other groups concerning these

issues.

We also discussed a proposal

submitted by the AMA’s Specialty

Society Relative Value Update

Committee (RUC) for development of a

new advisory committee, the Practice

Expense Advisory Committee (PEAC), to

review comments and recommendations

on the code-specific CPEP data during

the refinement period. In addition, we

solicited comments and suggestions

about our practice expense methodology

from organizations that have a broad

range of interests and expertise in

practice expense and survey issues.

In the July 22, 1999 proposed rule, the

November 1999 final rule, and the July

2000 proposed rule, we provided further

information on refinement activities

underway, including the

recommendations from the PEAC and

the support contract that we awarded to

focus on methodologic issues. The

following is an update on activities with

respect to these initiatives, as well as

the status of refinement with respect to

other areas of concern such as the SMS

data and CPEP inputs.

b. SMS Data

We have received many comments on

both our 1998 and 1999 proposed and

final rules from a number of medical

specialty societies expressing concerns

regarding the accuracy of the SMS data.

Some commenters stated their belief

that the sample size for their specialty

was not large enough to yield reliable

data. Other specialties not represented

in the SMS survey objected that the

crosswalk used for their practice

expense per hour was not appropriate

and requested that their own data be

used instead. Commenters also raised

questions about whether the direct

patient care hours for their specialty

were overstated by the SMS to the

specialty’s disadvantage.

We consider dealing with these issues

to be one of the major priorities of the

refinement effort. Therefore, we have

undertaken the following activities:

(i) Interim Final Rule on Supplemental

Practice Expense Survey Data

On May 3, 2000, we published an

interim final rule (65 FR 25664) that set

forth the criteria for physician and nonphysician specialty groups to submit

supplemental practice expense survey

data for use in determining payments

under the physician fee schedule.

Section 212 of the BBRA amended

section 1848(c) of the Act to require us

to establish a process under which we

will accept and use, to the maximum

extent practicable and consistent with

sound data practices, data collected or

developed by entities and organizations.

These data will supplement the data we

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65381

normally collect in determining the

practice expense component of the

physician fee schedule for payments in

CY 2001 and CY 2002.

To obtain data that could be used in

computing practice expense RVUs

beginning January 1, 2001, we

published the criteria in the May 2000

interim final rule (65 FR 25666) that we

will apply to supplemental survey data

submitted to us by August 1, 2000. We

also provided a 60-day period for

submission of comments on the criteria

that we will consider for survey data

submitted between August 2, 2000 and

August 1, 2001 for use in computing the

practice expense RVUs for the CY 2002

physician fee schedule. (See the May

2000 interim final rule for further

information on the criteria and process).

We are responding to comments

received on the interim final rule in this

rule, and are publishing the criteria to

be used for 2001 submission.

The following are specific criteria and

discussion in the May 2000 interim final

rule.

• Physician groups must draw their

sample from the AMA Physician

Masterfile to ensure a nationally

representative sample that includes both

members and non-members of a

physician specialty group.

• Physician groups must arrange for

the AMA to send the sample directly to

their survey contractor to ensure

confidentiality of the sample; that is, to

ensure comparability in the methods

and data collected, specialties must not

know the names of the specific

individuals in the sample.

• Non-physician specialties not

included in the AMA’s SMS must

develop a method to draw a nationally

representative sample of members and

non-members. At a minimum, these

groups must include former members in

their survey sample. The sample must

be drawn by the non-physician group’s

survey contractor, or another

independent party, in a way that

ensures the confidentiality of the

sample; that is, to ensure comparability

in the methods and data collected,

specialties must not know the names of

the specific individuals in the sample.

• A group (or its contractors) must

conduct the survey based on the SMS

survey instruments and protocols,

including administration and follow-up

efforts, and definitions of practice

expense and hours in patient care. In

addition, any cover letters or other

information furnished to survey sample

participants must be comparable to such

information previously supplied by the

SMS contractor to its sample

participants.

• A group must use a contractor that

has experience with the SMS or a

survey firm with experience

successfully conducting national multispecialty surveys of physicians using

nationally representative random

samples.

• A group must submit raw survey

data to us, including all complete and

incomplete survey responses as well as

any cover letters and instructions that

accompanied the survey, by August 1,

2000 for data analysis and editing to

ensure consistency. All personal

identifiers in the raw data must be

eliminated. (Send data to Health Care

Financing Administration, Department

of Health and Human Services, Attn:

Kenneth Marsalek, C4–03–06, 7500

Security Boulevard, Baltimore, MD

21244–8013.)

• Raw survey data submitted to us

between August 2, 2000 and August 1,

2001 will be considered for use in

computing practice expense RVUs for

CY 2002.

• The physician practice expense

data from surveys that we use in our

code-level practice expense calculations

are the practice expenses per physician

hour in the six practice expense

categories—clinical labor, medical

supplies, medical equipment,

administrative labor, office overhead,

and other. Supplemental survey data

must include data for these categories.

Ideally, we would like to calculate

practice expense values with precision;

however, we recognize that we must

achieve a balance. Conducting surveys

is expensive, and there is a tension

between achieving large sample sizes,

which increases precision, and smaller

ones, which conserves costs.

In addition, in the May 2000 interim

final rule (65 FR 25666) we indicated

that we believed an achievable level of

precision is a coefficient of variation,

that is, the ratio of the standard error of

the mean to the mean expressed as a

percent, not greater than 10 percent, for

overall practice expenses or practice

expenses per hour. For existing surveys

the standard deviation is frequently the

same magnitude as the mean. If the

standard deviation equals the mean,

then a usable sample size of 100 will

yield a coefficient of variation of 10

percent. For small, homogeneous

subspecialties, the variations in practice

expenses may be lower because a

smaller sample size achieves this level

of precision. Other ways of expressing

precision (for example, 95 percent

confidence intervals) are also acceptable

if they are approximately equivalent to

a coefficient of variation of 10 percent

or better. We indicated that will

consider surveys for which the

precision of the practice expenses are

equal to or better than this level of

precision and that meet the other survey

criteria. Also, we indicated that we will

require documentation regarding how

the practice expenses were calculated

and we will verify the calculations. We

have the statutory authority, however, to

determine the final practice expense

RVUs.

We also indicated that, since the

physician fee schedule is a national fee

schedule, we would require that the

survey be representative of the target

population of physicians nationwide.

We can presume national

representativeness if a random sample is

drawn from a complete nationwide

listing of the physician specialty or

subspecialty and the response rate, the

percent of usable responses received

from the sample, is high, for example,

80 to 90 percent. If any of these

conditions (random sample, complete

nationwide listing, and high response

rate) are not achieved, then the potential

impacts of the deviations upon national

representativeness must be explored

and documented. For example, if the

response rate is low, then justification

must be furnished to demonstrate that

the responders are not significantly

different from non-responders with

regard to factors affecting practice

expense. Differential weighting of

subsamples may improve the

representativeness. Minor deviations

from national representativeness may be

acceptable.

Comments on Criteria for Submitting

Supplemental Practice Expense Data

We received comments from 17

specialty groups concerning the criteria

for the acceptance of supplemental data.

While many of these comments

contained positive feedback on aspects

of our interim final rule, they all

contained statements of opposition to

specific requirements and/or

suggestions for improving the process.

Outlined below are the comments from

specialty groups and our responses

concerning the requirements for

supplemental survey data.

Required Sampling From the AMA’s

Physician Masterfile

Comment: Four groups stated that the

requirement for survey respondents to

be drawn solely from the AMA

Physician Masterfile is inappropriate for

the specialties of radiology and

radiation oncology. They believe that

hospital-based radiologists and

radiation oncologists do not encounter

the same practice expenses for staff and

supplies as those radiologists and

radiation oncologists working in

65382 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

freestanding centers. According to the

groups, radiologists and radiation

oncologists working in a freestanding

center encounter capital intensive TC

services not incurred by hospital-based

physicians and, often, these TC

component costs are borne by nonphysician entities not included in the

Physician Masterfile. The groups also

believe that the small number of

radiologists and radiation oncologists

who own and operate a freestanding

center will not be represented in a

sample from the Physician Masterfile.

The groups suggest that we work with

the professional community to develop

a list of freestanding radiation centers

from which we could extract a

geographically diverse sample.

Alternatively, the groups suggest that,

because of potential low response rates,

we include all radiation practices in the

survey sample and use the data for those

physicians not working at freestanding

centers only in the calculation of PC

services.

One group expressed concern that by

sampling from the AMA Physician

Masterfile, a substantial number of

emergency medicine practices are

overlooked. The small number of

physician practice owners leads to a

strong possibility that these owners will

not be selected in the random sample.

They suggest that we permit an

additional sample of large emergency

medicine practice groups to supplement

the current survey.

Response: The Physician Masterfile is

the most extensive list of physicians in

the United States, and, therefore, we

believe it is the most appropriate list

from which to develop a random sample

of physicians within a specialty.

Currently, we are not aware of a

complete list of radiation and radiation

oncology practices or emergency

medicine practice groups that exists that

is more comprehensive than the

Physician Masterfile with the

information necessary to extract a

representative random sample. If such a

list were to exist or be developed in the

future, we would consider the

appropriateness and potential uses for

sampling. We would welcome

information from physician and other

organizations on specific data sources

from which representative samples of

physicians could be selected, if there is

concern that the AMA Masterfile is not

a comprehensive list for the specialty.

Comment: One group commented that

the AMA Physician Masterfile may

contain ‘‘self-designated’’

dermatologists who do not meet the

criteria for ‘‘qualified’’ dermatologists.

They defined ‘‘qualified’’ dermatologists

as board certified dermatologists,

associates and affiliate members such as

osteopathic dermatologists, physicians

conducting research in dermatology,

and practicing dermatologists certified

by a foreign board but now practicing in

the United States. According to the

group, other, ‘‘self-designated’’

dermatologists should not be included

in the sample for dermatology because

their practice expense data could be

unrepresentative and potentially

damaging to the practice expense RVUs

for dermatology.

Response: Self-designation of

specialty is not unique to

dermatologists. In the Physician

Masterfile, all specialties are based on

self-designation. The SMS survey deals

with the issue of self-designation by

asking respondents if their specialty

designation is representative of the

specialty practice from which they gain

the majority of their medical income. It

is important to note that if any

physician who is self-designated as a

dermatologist furnishes dermatological

services to Medicare patients, it is

appropriate for this physician to be

included in the sample because this

physician receives income for

dermatological services.

Comment: Three groups suggested

that the requirement to sample from the

Physician Masterfile may not be

reasonable, as it serves only to limit

specialties’ ability to present alternative

data to us. They noted that the

requirement to sample from the

Physician Masterfile is based on the

assumption that physicians outside of

the specialty group have different costs

than members of the group. One

commenter maintained that the

substantial variance in practice

expenses within members’ practices

makes it unlikely that non-members’

practices would extend this variance. In

addition, one group suggested that

societies representing a smaller

proportion of specialty practitioners

should be allowed to explore options for

addressing potential bias beyond

sampling from the Physician Masterfile.

According to the group, nonmembers of

a specialty society are unlikely to

respond to what they consider a timeconsuming and intrusive survey about

sensitive financial issues.

Response: We believe that the

commenter is arguing that is should be

sufficient to draw a sample from the

members of a specialty society because

there is unlikely to be a difference in

practice expense per hour between

members and nonmembers of a

specialty society. Our goal in collecting

practice expense data is to create

practice expense values that reflect the

costs of both members and nonmembers of a specialty society. We

cannot assume that the average practice

expenses of members and non-members

of a specialty group are comparable

without data to support this finding.

The AMA Physician Masterfile is the

most comprehensive list of physicians

practicing in the United States. A

specialty society’s members are likely to

include only a portion of the physicians

practicing in that specialty. Thus, we

believe that it is likely that a random

sample selected from the AMA

Physician Masterfile is going to be more

representative of a specialty than a

sample drawn from a specialty society’s

membership list. For this reason, we are

maintaining the requirement that the

sample of physicians must be drawn

from the AMA Physician Masterfile.

Required Use of SMS Survey

Instruments and Protocol

Comment: One group expressed

concern that the SMS survey does not

account for care hours induced by the

Emergency Treatment and Labor Act

(EMTALA) in the patient care hours

question, thereby overstating the hours

and understating the practice expense

costs. They recommend that a question

be added to the SMS that asks

respondents about the patient care

hours they spend in an average week

providing EMTALA-induced care. Each

specialty’s average amount of EMTALAinduced care should then be deducted

from the total hours spent in patient

care. The commenter recognized that

this is a long-term recommendation and

wished to work on an interim solution

with us.

Response: We understand the group’s

concerns and have contracted with The

Lewin Group to provide

recommendations on both the

modification of future surveys to

account for EMTALA-induced patient

care hours and the use of these data to

adjust practice expense values. We have

also made specific comments to the

AMA requesting that this issue be

addressed in any future work they may

do with regard to collecting survey data.

In the interim, we have made an

adjustment to the practice expense per

hour for emergency medicine to address

this issue. We have no reason to believe

emergency medicine is being

disadvantaged in the interim as a result

of this adjustment. We will consider

The Lewin Group’s recommendations.

Comment: Six groups questioned the

adequacy of the SMS survey for the

purpose of accurately assessing a

particular specialty’s practice expenses.

For example, one group believes that

additional questions are needed to

account for cardiology TC questions.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65383

They recommend that we revise the

criteria for supplemental surveys to

allow for the collection of additional

data through specialty-specific

questions.

Response: We consider the SMS

survey to be adequate for the purpose of

accurately assessing practice expenses.

However, we agree that additional

clarification and examples tailored to

specific specialties may improve the

accuracy of the data collected. Although

we do not want specialties to change the

basic structure of the SMS practice

expense module, we have not precluded

any groups from collecting additional

data specific to the specialty in their

supplemental surveys.

Comment: One group suggested that

we adopt the AMA’s practice level

Practice Expense survey in place of the

SMS and revise the criteria for

supplemental survey data accordingly.

They also suggested that our references

to the SMS survey may be

misunderstood by specialty groups

referencing the AMA’s practice level

survey instrument, and that we must

clarify this distinction. Two groups

recommended that the specialty groups

should collect practice level data, rather

than individual physician estimates.

One group also suggested that a practice

level survey should be developed to

more appropriately capture the practice

expenses.

Response: The AMA has fielded the

practice expense level survey with

minimal success. At this time, we

understand that the AMA does not plan

to continue with the practice expense

level survey. We are currently using the

physician level SMS as the basis for

supplemental surveys, and will

continue to use this survey to maintain

consistency with our existing data. We

cannot use the AMA’s practice level

survey, or any other survey, until it has

been evaluated to determine if the

survey data can be incorporated into our

practice expense methodology. In

addition, we would have to determine if

it is possible to reconcile the outcomes

of the physician level and practice level

surveys. We have asked The Lewin

Group to review the AMA’s practice

level survey to determine how the data

collected could be used to calculate

practice expenses per hour values.

Comment: Four groups requested that

specialty groups be allowed to conduct

the supplemental surveys by mail with

follow-up phone interviews. The groups

believe this will reduce the cost of

administering a survey.

Response: As explained previously, to

help obtain comparable data, we believe

supplemental surveys should follow the

SMS methodology.

Comment: Two groups expressed

concern that requiring cover letters and

other information furnished to survey

participants to be comparable to those

supplied by the SMS contractor will

hamper response rates. They believe

specialty groups should be able to

provide correspondence that explains

the importance of the data for the

benefit of the specialty without our

‘‘censorship.’’

Response: Although specialty-specific

correspondence may increase response

rates, it could potentially introduce bias

into the practice expense data. We

believe that it is essential to obtain

unbiased data.

Comment: One group suggested we

use the tax form 1120 as a foundation

for validating practice expense data.

They suggested that independent

accountants could be used to compare

the practice expense data submitted to

the actual expenses on the tax form.

Response: The Lewin Group has

considered this recommendation and,

after discussions with the AMA and

numerous physician specialty groups,

has determined that practitioners may

not respond to the survey if they believe

their data may be audited. However,

The Lewin Group does believe that a

closer link between the survey

worksheet and a practice’s tax forms

may improve the accuracy of the data.

We may consider this as a longer-term

refinement issue.

Comment: One group recommended

that we develop a workable alternative

to the SMS survey. They noted the

indefinite suspension of the SMS

survey, and the lack of evidence that the

SMS is the best source of obtaining

practice expense data at the specialty

level as reasons for their suggestion.

They suggested we develop a set of core

questions and standard definitions to be

incorporated in each specialty’s survey.

If we create an alternative to the SMS,

They requested that we take into

account the extensive amount of time

involved in designing and conducting

an effective practice expense survey.

Response: The Lewin Group has

already worked with specialty groups to

modify the SMS survey for

administration as a supplemental

survey. The Lewin Group will continue

to help specialty groups field

supplemental surveys.

Comment: One group requested that

we keep the specialty groups updated

on the status of the SMS survey and any

potential solutions or alternate plans we

develop to account for the absence of

new SMS data. They stated that keeping

the specialties current would allow

them to anticipate extra spending on

survey projects.

Response: The best source of current

information on the status of the SMS

survey would, of course, be from the

AMA. Any plans on our part would be

included in information provided as

part of future revisions to practice

expenses.

Comments on the Response Rate

Comment: Seven groups objected to

the response rate of 80 to 90 percent

mentioned as a criterion for the

presumed national representativeness of

a sample. The groups stated that the

SMS has never achieved a response rate

this high, and that specialty groups

should not be expected to achieve a

response rate higher than that achieved

by the SMS. Two groups suggested an

acceptable response rate of 30 to 40

percent, and the American Academy of

Ophthalmology (AAO) suggested an

acceptable response rate of 30 percent.

The ACR requested an acceptable

response rate of no higher than 65

percent. Three groups objected to our

response rate but did not suggest an

alternative rate.

Response: The 80 to 90 percent

response rate was presented as a rate at

which we can presume that the sample

is nationally representative, but not as

an absolute requirement for the

acceptance of data. As we stated in the

May 3, 2000 interim final rule (65 FR

25666), we are attempting to be as

reasonable as possible. However,

surveys with a response rate lower than

80 percent cannot be assumed to be

nationally representative, and, for us to

accept these data, a specialty group

must demonstrate that the survey

respondents are not significantly

different from non-respondents. In

addition, based on our review of the

supplemental surveys submitted, we are

modifying our criteria concerning an

acceptable level of precision for surveys.

We now believe a reasonable level of

precision for surveys to be used for

supplementing current data is a 90-

percent confidence interval with a range

of plus or minus 10 percent of the mean

(that is, 1.645 times the standard error

of the mean, divided by the mean,

should be equal to or less than 10

percent of the mean).

Comment: One group commented that

it is highly unlikely that small

specialties will be able to achieve the

coefficient of variation of less than 10

percent for overall practice expenses or

practice expenses per hour that we

require for the acceptance of

supplemental data. They note that the

original SMS survey did not achieve

this threshold for many small specialties

and, therefore, question the application

65384 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

of the requirement to supplemental

surveys.

Response: In developing the resourcebased practice expense RVUs, we

consulted widely with physician

groups, researchers, and others to

identify possible data sources. Nearly all

commenters agreed that the SMS data,

while not specifically designed for the

purpose of establishing practice expense

RVUs, was the best available data for

this purpose. We believe our criteria, as

discussed above, help assure that any

data used to supplement the SMS data

are statistically valid and representative.

Further, we believe these criteria are

reasonable and achievable. For example,

a specialty society for thoracic surgeons

submitted supplemental data that we

incorporated last year. These data from

the STS achieve our statistical criteria

for supplemental surveys. We also note

that the 90-percent confidence interval

requirement seems very reasonable in

that, in general, a 95-percent confidence

interval is a more typical statistical

standard value.

Comment: One group requested that

we provide the specialty groups ‘‘with

a comprehensive definition of

‘complete’ and ‘incomplete’ data in

addition to an explanation of the extent

to which incomplete data will be

excluded or utilized in practice expense

calculations.’’ At a minimum, the group

requested indicators for required and

non-required data fields on the survey

instrument.

Response: The required data fields for

the survey instrument are available from

our contractor, The Lewin Group, and

from the protocols and guidelines we

have created for the supplemental

surveys. The original SMS survey data

obtained from the AMA was accepted

only for surveys with complete practice

expense and patient care per-hour

information. We will continue to use

these criteria for the acceptance of data.

(A copy of the guidelines and

procedures may be obtained by

contracting Lane Koeing at The Lewin

Group at (703) 269–5659.)

Data Adjustment

Comment: Three groups commented

on our use of the 1995 through 1997

specialty practice expense per-hour data

from the SMS and our deflation of

supplemental survey data to 1995

practice costs. The groups stated that we

should use the most current data

available for all specialties rather than

earlier data of questionable relevance.

Response: We indicated in the July

2000 proposed rule (65 FR 44181) that,

based on a recommendation by The

Lewin Group, we have incorporated the

1998 SMS data into our practice

expense per-hour calculations and that

we are now basing our practice expense

per-hour calculations on a 4-year

average. Regarding the deflation of the

practice costs to 1995, as long as the

same deflator is used across specialties,

the particular year to which the

specialties are deflated is insignificant.

The base year of 1995 was chosen to be

consistent with the data we have

already.

Comment: One group commented on

our decision to weight average the

supplemental data with the existing

SMS data already being used. According

to the group, this decision is flawed

because it erroneously assumes that the

SMS data currently in use is correct. In

addition, they believe that the SMS

sample size for emergency physicians

has been too small to provide valid data

for the calculation of practice expenses.

The group suggested that it is

inappropriate for us to weight average

data from this unrepresentative sample

with supplemental survey data for

emergency physicians.

Response: The SMS data is the best

data currently available for the

calculation of practice expenses. As

refinements of the practice expense

methodology are identified and

included, we will extrapolate and apply

them to past SMS data to the extent

possible. Weight averaging the

supplemental survey data with the

existing SMS data would be used to

increase the sample size. We also

established the criteria for supplemental

surveys in the May 3, 2000 interim final

rule (65 FR 25666) as a guideline for

those specialties seeking to increase

their sample size.

Short Time Frame for Data Submission

Comment: Three groups expressed

concern with the short time frame we

have provided for specialty groups to

develop the survey methodologies, find

a contractor, and provide the data for

computation of RVUs.

Response: Section 212 of the BBRA

required that we establish, through

regulation, a process for any

organization to collect and submit

supplemental survey data for use in

establishing payments for the calendar

years 2001 and 2002 physician fee

schedules. Thus, the amount of work

required to be accomplished in a short

time was largely due to the

requirements of the statute itself.

Cost Burden of the Supplemental

Surveys

Comment: Two groups commented

that we should share the cost burden for

the supplemental surveys. According to

the groups, the supplemental surveys

will be filling in the data gap left by the

SMS and, therefore, we should

subsidize the cost of completing the

surveys. In addition, one group

commented that the efforts needed to

meet the supplemental survey

requirements may be prohibitively

costly for many specialties without

subsidization from us. One group also

commented that we should take into

account the AMA’s problems with the

expense of administering the SMS

before fully adopting the survey

protocol. Specifically, they suggested

that we look for less costly, and more

cost-effective, ways of validating the

data than telephone interviews.

Response: We have no funding for

supplemental surveys, and we are not

currently considering such approaches.

As we have previously explained, we

believe the SMS data are currently the

best available source of practice cost

information. We believe there are

significant, methodological advantages

to obtaining practice cost information

through multi-specialty surveys such as

SMS, rather than through surveys of

more limited groups of specialties. The

supplemental survey process allows

specialties the option to provide

additional information.

Comment: Two groups suggested that

we should eliminate some of the criteria

for the acceptance of outside survey

data if a specialty can demonstrate that

the collected data are valid practice

expense data for the specialty.

According to one commenter, some

specialty groups may have valid data

that does not exactly meet the criteria

we outlined, but nevertheless could be

a valuable data source.

Response: In the May 3, 2000 interim

final rule (65 FR 25666), we presented

the criteria for specialty societies

seeking to collect new practice expense

data through supplemental surveys. The

process established by these criteria, as

amended by this final rule, should be

followed by specialty societies to collect

future supplemental practice expense

data.

Survey Contractor Requirements

Comment: One group expressed

concern about contracting for survey

research. According to the group, many

specialties have staff capable of

analyzing the survey data. Requiring

specialties to contract for the surveys

could eliminate certain subspecialties

from administering a supplemental

survey due to cost burden.

Response: We recognize the cost

burden of contracting for the

supplemental survey administration;

however, to ensure the integrity of the

practice expense data, we are requiring

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65385

that a disinterested third party

administer supplemental surveys.

Comment: One group questioned our

requirement for specialties to use a

survey contractor with experience in

conducting national multi-specialty

surveys of physicians using random

samples. They believe that a contractor

with experience surveying health care

professionals and using random sample

techniques should be sufficient.

Response: We believe our initial

requirements represent a preferred way

to collect valid and reliable data. We

will, however, consider survey

contractors with experience surveying

health care professionals, collecting

financial information, and using random

samples.

Comment: Two groups are concerned

with our requirement for raw survey

data to be submitted to us. One group

believes that we should outsource the

analysis of the survey responses. The

other group opposes the submission of

raw data to us because they believe

physicians will be unlikely to respond

to sensitive financial questions if they

are informed that their individual

responses will be sent directly to the

government.

Response: The raw survey data have

been submitted to The Lewin Group,

and they have provided us with only

aggregate practice expense values.

HCFA’s Use of the Supplemental Survey

Data

Comment: One group expressed

concern about our use of the

supplemental survey data. Before

administering an expensive survey, they

want assurance from us that the

supplemental data will be used.

Alternatively, the group believes we

should conduct a survey across all

specialties. They commented that we

must adopt one of these options to

remove flawed data that does not

account for the unique practice

expenses related to emergency

medicine.

Response: The criteria for the

consideration of supplemental survey

data are described in this final rule. We

anticipate incorporating data that meet

these criteria in the practice expense

methodology.

Comment: One group requested that

we provide specialty groups with the

criteria for determining if data supplied

between August 2, 2000 and August 1,

2001 is usable. We state in the interim

final rule that submitted data will be

considered, but we do not state whether

the criteria for acceptance will be the

same as the criteria for data supplied by

August 1, 2000.

Response: The criteria for accepting

supplemental survey data were

presented in the May 3, 2000 interim

final rule. These criteria were subject to

public comment, and any modification

we have made to these criteria, as a

result of the comments, are part of this

final rule.

Result of Evaluation of Comments

The criteria published May 3, 2000

will be used for surveys submitted in

2001 with the following modifications.

• We had proposed that specialty

groups use a contractor that has

experience with the SMS or a survey

firm with experience successfully

conducting national multi-specialty

surveys of physicians using nationally

representative random samples. We

have modified the criteria to provide for

using a contractor that has experience

surveying health care professionals,

collecting financial information and

using random samples.

• In addition, based on our review of

the supplemental surveys submitted, we

are modifying our criteria concerning an

acceptable level of precision for surveys.

We now believe a reasonable level of

precision for surveys to be used for

supplementing current data is a 90

percent confidence interval with a range

of plus or minus 10 percent of the mean;

(that is, 1.645 times the standard error

of the mean, divided by the mean,

should be equal to or less than 10

percent of the mean).

With respect to response rates, we are

concerned about the low response rates

received from supplemental surveys

submitted to us in 2000. While we

acknowledge that the timing of the

surveys (that is, short-field time and

time of year) contributed to the low

response rates, we believe that groups

will have more time to conduct surveys

and, thus, are likely to obtain better

response rates in future surveys. While

we continue to believe that it is

impossible and impractical to set rigid

cutoffs, we are expecting higher

response rates than were achieved in the

supplemental surveys submitted to us in

2000. We would like to see detailed

analyses that indicate the sample is

representative of the population. While

The Lewin Group was able to perform

some limited analyses of response bias

for the supplemental surveys received

in 2000, we expect that these

supplemental surveys received in 2001

will provide detailed analyses with

respect to possible response bias on

factors that could affect practice

expenses. Such analyses should

consider variables such as specialty

society membership, years in practice,

board certification, gender, geographic

distribution of respondents, and

practice arrangements (for example, solo

practitioners or large group practices).

We will not consider supplemental data

in the practice expense methodology

unless we receive detailed analyses that

give us confidence that survey

respondents are representative of the

profession on items that affect practice

expense. In addition, the data must

appear reasonable and consistent with

other data used to determine practice

expense RVUs.

Submission of Supplemental Surveys

In response to the May 3, 2000

interim final rule, three organizations

submitted supplemental survey data for

consideration. One survey was

submitted by the American Physical

Therapy Association (APTA), and a

joint survey was submitted by the

American Association of Vascular

Surgery (AAVS) and the Society for

Vascular Surgery (SVS). Our contractor,

The Lewin Group, has evaluated the

data submitted by each organization and

recommended that we use these data.

The full recommendation and

discussion will be made available on the

HCFA website. We have decided to use

the data submitted by the AAVS and

SVS to supplement the information we

are currently using. However, we have

decided not to use the data submitted by

the APTA. The revised practice expense

per hour figures that we are using for

vascular surgery are:

Clinical staff Admin staff Office

expense Supplies Equipment Other Total

20.2 .................................................................................. 18.1 17.7 3.2 4.5 11.4 75.1

These figures are from the

supplemental survey information

provided to us from the Lewin Group

adjusted by the MEI so the figures

reflect 1995 data. That is, we divided

the 1999 practice expense per hour data

by the cumulative MEI for 1996–1999

(1.0877).

65386 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Both supplemental surveys have

extremely low response rates (about 14

percent for vascular surgeons and 11

percent for physical therapists). We

specified the criteria we would apply

for supplemental surveys in the May

2000 interim final rule (65 FR 25666).

While we did not establish a precise

minimum response rate, we did indicate

that surveys with response rates less

than 80 percent to 90 percent require an

analysis to determine to what extent the

sample is representative of the

population. The extremely low response

rates achieved by these two

supplemental surveys and the relatively

small number of responses make it

extremely difficult, and very subjective,

to determine whether the data are

representative of each specialty. Our

contractor was able to make very limited

assessments of this issue based on the

data provided.

However, in our May 2000 interim

final rule, we indicated that, based on

our review of existing physician

practice expense surveys, we believe

that an achievable level of precision is

a coefficient of variation, that is, the

ratio of the standard error of the mean

to the mean expressed as a percent, not

greater than 10 percent, for overall

practice expenses or practice expenses

per hour. For existing surveys, the

standard deviation is frequently the

same magnitude as the mean. We

indicated in the May 2000 interim final

rule that we would consider practice

expenses for which the precision of the

practice expenses is equal to or better

than this level of precision and that

meet the other survey criteria.

The data submitted by the AAVS and

the SVS met the level of precision. The

data submitted by the APTA did not rise

to this level of precision; they did not

meet this objective criterion set out in

the May 2000 interim final rule. Thus,

we do not have, in the survey data

submitted by the APTA, data that

convince us of both the

representativeness or the precision of

the surveys. For that reason, we are

unable to incorporate the supplemental

survey data submitted by the APTA in

the practice expense system.

We note, however, that we have made

an adjustment to the practice expense

data for physical and occupational

therapy services based on other

comments received. These comments

and adjustments are described

elsewhere in this regulation.

In addition, one specialty society also

submitted data concerning clinical staff

in the hospital setting. The data

submitted were not in the context of

supplemental survey data. We discuss

the issues addressed by these data

elsewhere in this preamble.

(ii) Proposals for SMS Refinement

In the July 2000 proposed rule (65 FR

44180), we discussed the tasks that our

contractor, The Lewin Group, was

undertaking to assist us with broad

practice expense technical and

methodological issues. We also

highlighted the recommendations that

were contained in the first draft report

that the contractor submitted, ‘‘Practice

Expense Methodology,’’ dated

September 24, 1999. This report is on

our homepage under the title ‘‘Practice

Expense Methodology Report.’’ (Access

to our homepage is discussed under the

‘‘Supplementary Information’’ section

above.)

The report contained various

recommendations aimed at increasing

the validity and reliability of the AMA’s

SMS survey. Although the Lewin

Group’s recommendations were made

specifically to address improving the

SMS survey for calculating practice

expense RVUs, we believe the

recommendations will be useful in

making refinements to any other survey

instrument that may be used in

calculating practice expense RVUs. The

recommendations fell into the three

following areas:

• The use of data supplementary to

the SMS survey.

• Suggested changes to the survey

instrument.

• Recommendations for using the

data in calculating the specialty-specific

practice expense per hour.

In response to the report’s

recommendations on the use of the SMS

data, we proposed to incorporate data

from the 1998 SMS survey, which is the

latest data available, into our practice

expense per-hour calculations. In

addition, we proposed basing the

practice expense per hour calculations

on a 4-year average, rather than the 3-

year average recommended in the

contractor’s report. We published a table

that contained the practice expense perhour calculations for CY 2001 that

resulted from the above proposals. We

also proposed standardizing the practice

expense data to reflect a 1995 cost year

consistent with the pricing information

we are using for the estimates of

practice expense inputs for individual

procedures. To standardize costs, we

proposed inflating 1995 cost data by the

MEI and deflating 1996 and 1997 costs

data. This proposal has virtually no

impact on the practice expense per-hour

calculations.

After discussions with the AMA’s

SMS staff, we did not propose, as

recommended by our contractor, to

revise edits and trims to the SMS survey

data to exclude data that fall outside set

acceptable ranges.

In the July 2000 proposed rule (65 FR

44184), we also discussed the

suggestions we made to the AMA for

including additional questions in the

SMS survey that would make it more

useful for calculating specialty-specific

practice expenses more precisely. It now

appears that the AMA may no longer

undertake a multi-specialty survey to

collect practice expense information.

While we will continue our discussion

with the AMA regarding any future

plans for practice expense data

collection, as stated above, we believe

these recommendations will be useful in

the design of any other survey used in

developing practice expense RVUs.

As we indicated earlier, we proposed

to use data from the 1998 SMS to

develop the 2001 practice expense

RVUs. Furthermore, data from the 1999

SMS will become available later this

year for use in developing the 2002

practice expense RVUs. In addition,

section 1848(c)(2)(B) of the Act requires

that not less often than every 5 years, we

review and make adjustments to RVUs.

Thus, we are required by the statute to

review and make adjustments to the

practice expense RVUs 5 years after the

end of the transition period, that is, no

later than 2007. Regardless of whether

the AMA continues to collect data on

practice expenses, we will be

developing plans for making

refinements to practice expense RVUs

beyond 2002.

Comment: One specialty society

indicated that SMS data from 1998 and

1999 is available and we have not used

this data in the past because of fears that

the data may be tainted now that some

physicians know that the responses

could affect Medicare fees. The

commenter recommended that we use

data from 1996 through 1999, rather

than the 1995 through 1998 data we

have proposed using.

Response: In the November 2, 1998

final rule (63 FR 58821), we expressed

concern about the potential biases that

may exist in surveys collected by

individual specialties and in any survey

data collected in the SMS survey

process subsequent to our June 5, 1998

proposed rule. There is no relationship

between this concern and any decisions

that we have made with respect to

incorporating available data from the

SMS survey process into the practice

expense methodology. Since SMS

survey data from 1998 was collected

more than 1 year before the June 1998

proposed rule announcing the ‘‘top

down’’ methodology, any implication

that we did not previously propose use

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65387

of the data because of a concern about

bias in the data is inaccurate. Rather, we

have not previously proposed using the

data because it was unavailable to us

before this year’s proposed rule. In

addition, we did not propose using SMS

data from 1999 because it was

unavailable to us at the time of the

proposed rule. We will consider using

1999 data from the SMS for setting 2002

physician fee schedule rates. As we

stated in our July 2000 proposed rule

(65 FR 44184), we welcome comments

on long term strategies for collecting

practice expense data in the future.

Comment: We received two comments

that indicated that the SMS sample for

gastroenterology is small and

inadequate, that the response rate in the

SMS is the lowest among any specialty,

and that the practice expense

calculations are probably inaccurate.

One of these commenters also urged us

to work with the AMA and the medical

community to improve the aggregate

specialty-specific data. A specialty

society representing pediatrics

reiterated the concern that the pediatric

specialties are not adequately

represented in the SMS, and a society

representing geriatrics also believed that

the sample size of geriatricians is not

large enough to yield reliable data.

Another commenter was concerned

about the inadequate sample size of

radiation oncologists in the SMS and

believed that the use of the Physician

Masterfile under-samples non-hospital

based radiation oncologists and oversamples hospital-based radiation

oncologists, who do not incur the same

practice expenses for equipment and

staff. Several imaging specialties stated

that the SMS does not capture the

practice expenses for TC services,

probably because the SMS sample is

skewed toward professional-component

only providers. These commenters

argued that, even if the sample of TC

providers were adequate, the higher TC

costs would be diluted by the lower PC

costs, and thus it is necessary to perform

a survey of only TC providers to use in

the practice expense calculations.

Response: Since concerns regarding

the representation of various specialty

societies in the SMS data were raised

previously, we are reiterating our

general response that can be found in

more detail in the November 2, 1998

final rule (63 FR 58821). As we

indicated in that rule, many of the

criticisms of the SMS data could well be

made about any other practice expense

survey. At the time, we proposed use of

the SMS data for developing the

practice expense RVUs, we indicated

that it was the best available data source

on aggregate practice expenses. Since

we are continuing to rely on the SMS

data in the process for determining

practice expense RVUs, we believe that

the specialty-specific representation in

the data is now improved by

incorporating an additional year of data.

The practice expense per hour will be

based on a larger number of survey

responses that will likely result in

improved representativeness of the data.

Comment: One commenter contended

that the data in the practice expense

per-hour table in the July 2000 proposed

rule do not appear logical, objective, or

consistent. There is an unexplained

range of clerical payroll per hour among

similar specialties, and the ranking of

the practice expenses among specialties

appears to be untenable; for example,

the total practice expense per hour for

dermatology is almost two times greater

than for gastroenterology.

Response: We believe that different

specialties are likely to have differences

in practice expense per-hour for indirect

types of costs depending upon the

nature of the practice. With respect to

the examples identified, dermatologists

are generally in office-based practices,

while gastroenterologists provide most

services in hospitals. The nature of

these types of practices may result in

very different expenses for

administrative personnel. Without

disaggregating the costs and describing

the different administrative activities

that are performed by employees of the

different types of specialties, it is

difficult to explain deviations in the

practice expense per hour among

specialties. Nevertheless, we reviewed

data on administrative practice

expenses per hour across specialties for

each individual SMS data year and

found, with some exceptions, that there

is stability among the relative practice

expense per hour for this item across

years. For instance, for 3 of the 4 years

that there is survey data, the

administrative practice expense per

hour for gastroenterology is between 61

and 63 percent of dermatology (in the

remaining year, it is 53 percent). We

believe that the apparent stability of the

relative practice expense per hour

across specialties provide assurance of

the data’s reliability.

Comment: We received a number of

comments expressing concern about our

decision to incorporate 1998 SMS data

into the practice expense methodology.

Several commenters noted that there

were a small number of usable

responses for some specialties to

calculate the practice expense per hour

using the 1998 SMS data, citing that

cardiac and thoracic surgeons and

radiation oncologists had only three

responses. Another commenter stated

that, in the past, we have been

unwilling to use SMS data if the number

of survey respondents is low. Other

commenters expressed concern that for

some specialties, the small sample of

physicians would mean that the practice

expense per hour could not be

calculated accurately and such unstable

data would produce some substantial

changes. These commenters suggested

that we not incorporate additional data,

including the 1998 SMS data, until a

representative practice expense sample

can be performed with an adequate

number of respondents for all

specialties.

One specialty commented that

inclusion of the 1998 SMS data is

premature because of questions

regarding its validity, since AMA is

redeveloping the SMS with the

possibility of seeking specialty-society

input, and there are questions regarding

the validity of the 1998 SMS data. While

some commenters agreed with the

general principle of using the most

current data, they argued that the

quality of the 1998 SMS data does not

merit inclusion into our practice

expense per-hour calculations. One

commenter stated that the SMS survey

does not recognize the unique nature of

emergency medicine.

Alternatively, there were many

comments that supported our use of the

1998 SMS data. These commenters

generally indicated that we should use

the most current data because practice

expenses may change over time. In

addition, these commenters indicated

that there is no evidence that the 1998

SMS data is tainted or otherwise

objectionable. Other commenters

indicated that including more survey

responses from later SMS years will

result in practice expense values that

are more representative of physicians’

costs. Some commenters indicated that

practice expense data based on a 4-year

sample provides greater assurance of its

quality. Many of the commenters that

suggested incorporating the 1998 SMS

data also indicated that we should use

the 1999 data from the SMS when it

becomes available. Other commenters

supported our proposal to base the

practice expense per-hour calculation

on a 4-year average of SMS data as

opposed to a 3-year average, because it

will help to compensate for the low

number of survey responses from some

specialties in the prior years’ SMS

surveys.

One commenter believed that we

should follow our contractor’s

recommendation and use a rolling 3-

year average, because using 4 years

results in older data completed by

persons less familiar with the SMS.

65388 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Other commenters supported using only

the latest 3 years of data to eliminate the

oldest practice expense data from the

methodology.

Response: While the lower response

rates in the 1998 SMS data are a

concern, we continue to believe it is

appropriate to incorporate these

additional data into the practice

expense methodology. In general, even

though there are fewer responses in the

1998 SMS data, it is unclear to us why

this alone indicates that we should

reject incorporating the data. Generally,

the inclusion of more survey data will

improve the data’s representativeness

and lead to more stability in the practice

expense methodology. Furthermore, to

the extent that there are fewer responses

to the 1998 SMS survey, there will be

less impact on a given specialty because

the practice expense per-hour

calculation is weighted by the number

of respondents from each respective

year. With respect to the stability of the

data, the AMA indicated that a

statistical test of the data ‘‘revealed only

marginal evidence of a statistically

significant change in PE–HR across

specialties when all specialty-level

changes were considered jointly. In

other words, the combined set of

changes in relative PE–HR were with

the range of what could be expected by

sampling error.’’ Thus, although there

may have been some large changes in

practice expense per hour across years

for some specialties, there appears to be

overall stability across years among all

physicians.

In general, use of the 1998 SMS

improves the stability of the practice

expense per hour and results in little

specialty level impact. For the 35

specialties listed in our impact table in

the July 2000 proposed rule (65 FR

44203), 21 specialties will experience an

impact that is near zero. There are nine

specialties that will experience an

impact of approximately 1 percent as a

result of inclusion of the data. For two

(cardiac and thoracic surgery) of the

four specialties that show a payment

impact of approximately 2 percent, the

data were affected by more than just the

inclusion of the 1998 SMS data. In the

November 1999 final rule (64 FR 59391),

we indicated that supplemental data

would be incorporated in the practice

expense per hour and we would not

include data from the 1995 SMS. We are

now adding the 1995 SMS data as well

as the 1998 SMS data to the calculation

of practice expense per hour and

increased the likelihood that there

would be a larger impact on the practice

expense per hour. For one specialty

(physical and occupational therapy,

included in the nonphysician

practitioner category), we made an error

in the practice expense per hour

calculation in the July 2000 proposed

rule. After correcting this error, there is

only approximately a 1-percent increase

in the nonphysician practitioner

category from incorporating the

additional SMS data. We believe that

these results support the argument that

the practice expense per hour is

generally stable and that it is

appropriate to include 1998 SMS data in

the practice expense methodology.

With respect to the comment that it is

premature to incorporate 1998 SMS data

into the practice expense methodology

because of AMA efforts to redesign the

survey and include specialty society

input, we are unsure of the AMA’s

efforts in this regard. Nevertheless,

while we would welcome

multispecialty involvement in an effort

to collect practice expense data

specifically for the purpose of

determining relative value units, we

believe that such efforts should not have

any bearing on our decision to

incorporate later SMS data into the

practice expense methodology at this

time. If new data were to be collected

under a redesigned survey process, it

could be at least 2 years before such

data is available to us. In the interim, we

believe it is appropriate to include the

latest SMS data into our methodology.

We disagree with the commenter who

suggested that the older SMS data

should be eliminated from the practice

expense per hour calculations because

the surveys were completed by

respondents less familiar with the SMS.

The SMS is a longstanding survey that

was originally developed by the AMA in

1981. There is no evidence that data

from earlier SMS surveys is less reliable

than later survey information.

Comment: A commenter representing

urologists stated that, if we are not going

to accept our contractor’s

recommendation to revise the edits and

trims to the SMS survey data, the use of

median values, rather than means,

would produce the most fair relative

ranking of the practice expense per hour

among medical specialties.

Response: We believe it is appropriate

and consistent with the statute to use

the mean practice expense per hour

rather than the median. Under the

practice expense methodology, the

practice expense per hour for each

specialty is multiplied by the physician

time per procedure and number of

Medicare allowed services and summed

at the specialty level to produce

aggregate specialty cost pools. In theory,

the aggregate practice expense pools

would reflect actual physicians’ costs if

the utilization data for all payers, not

just Medicare payers, were used. (In

reality, however, the data is potentially

biased by the inclusion of mid-level

practitioners. See the June 5, 1998

proposed rule (63 FR 30832) for a more

detailed discussion of this issue). If the

median practice expense per hour were

used, however, the aggregate cost pools

would not be reflective of physicians’

actual expenses, because very high-cost

or low-cost practice data would be

excluded. Since the statute indicates

that we should ‘‘recognize all staff,

equipment, supplies and expenses,’’ we

believe use of the mean rather than the

median practice expense per hour will

result in the practice expense RVUs

being more reflective of all physician

practice costs.

Comment: We received several

comments that were concerned about

the AMA’s decision to no longer collect

practice expense data from the SMS.

One commenter noted that the Lewin

Group recommendations described in

the proposed rule were aimed at

improving the SMS surveys and/or

practice level surveys that the AMA no

longer intends to perform. Other

commenters expressed concern about

plans for gathering practice expense

data for years after 1999, particularly if

the AMA will not continue the SMS

survey. Two commenters recommended

that we initiate a dialogue with

specialty societies to develop a

workable alternative and another that

we consider creating and funding a

survey to collect practice expense data

in the future. One organization

commented that the AMA’s decision to

no longer collect practice expense data

means that issues related to

uncompensated care in the practice

expense methodology will not be

addressed. This commenter stated that

we should continue to work with

emergency physicians to ensure that

what the society feels are flawed

practice expense data are no longer used

to determine payment amounts for

emergency physicians.

Response: We share these

commenters’ concerns about the AMA’s

decision to no longer collect practice

expense data. However, we continue to

believe that the recommendations of the

Lewin Group and our suggestions to the

AMA regarding improvements that

could be made to the SMS and practice

level survey will be helpful in future

practice expense data collection efforts.

As the AMA indicated in a letter to us

(see 63 FR 30829 for the AMA’s more

detailed comments), the SMS data were

never collected for the purpose of

developing relative values. The Lewin

Group recommendations and our

suggestions to the AMA were intended

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65389

to tailor the SMS or a practice level

survey to be more suitable for this

purpose. While our comments were

addressed specifically to improving the

ability of the SMS or a practice level

survey to be used for developing

practice expense RVUs, there is no

reason that these suggestions would not

be equally valid for any alternative

practice expense survey instrument that

may be developed. Thus, we continue to

believe that there is merit in the work

of the Lewin Group and in our

suggestions on improvements to the

AMA survey.

With respect to the concerns

expressed about gathering practice

expense data beyond 1999, we have

published criteria that specialties must

follow to submit supplementary practice

expense survey data that can be

included in the practice expense

calculations. Thus, there is a process for

specialties to collect representative data

on practice expenses for a specialty that

can be used to influence the calculation

of practice expense RVUs. Furthermore,

we are currently planning to use 1999

SMS data to determine the practice

expense per hour for calculating

practice expense RVUs for 2002. Thus,

the fully implemented resource-based

practice expense RVUs will be based on

a weighted 5-year average of the latest

SMS survey data.

Regardless of whether the AMA were

to continue the SMS survey, it is

unclear whether it would be necessary

or even desirable to incorporate more

recent practice expense per hour data

into the methodology on an annual

basis. While the practice expense may

increase or decrease over time, the

important variable for the practice

expense methodology is whether there

is a relative change among specialties in

practice expense per hour. Again, with

exceptions for some specialties, there

generally appears to be stability in the

relative practice expense per hour

among specialties in the SMS data we

are using. Indeed, there generally was

little redistribution in payment resulting

from use of the latest SMS data. For 21

of the 35 specialties listed in Table 1 of

the July 2000 proposed rule (65 FR

44203), the percent change in practice

expense from using the latest SMS data

was near zero. For nine of the remaining

14 specialties, the impact on payments

was only 1 percent. For only five of 35

specialties listed was the impact on

payments 2 percent or greater. Thus, if

there is year to year stability in the

relative practice expense per hour

among specialties, it will likely make

little difference whether we incorporate

additional practice expense data into

the methodology.

However, it is possible that there will

be more significant changes in relative

practice expense per hour over time

among specialties. The statute requires

that we make refinements in the

practice expense RVUs at least every 5

years. While we expect to continue

making refinements to the inputs for

individual codes on an annual basis, it

could be several years before we might

require practice expense data from a

multi-specialty survey after the initial

refinement period ends in 2002. While

we consider how to approach this issue,

we welcome the comments that

suggested that we seek input from the

medical community in developing a

mutually satisfactory and equitable

approach to obtaining the needed

information on practice expenses for

future refinement efforts.

Comment: A society representing

vascular surgeons commented that

separately billable income should be

deducted from practice expenses as part

of the practice expense per hour

calculations, because the inclusion of

this income may account for the

inexplicably wide range in the practice

expense calculations among specialties.

Response: We agree that it is desirable

to identify separately billable services.

As explained elsewhere, this is an issue

for future SMS revisions.

Comment: One commenter suggested

that we move the SMS clinical labor

expenses to the indirect expense

category, as was done with the

administrative labor cost. The

commenter stated that with the

inclusion of high administrative costs,

the indirect costs will vary considerably

among specialties and expressed their

concern that the determination of the

scaling factor is not an equitable means

to distribute these indirect costs. The

commenter encouraged us, along with

our contractor, to examine this issue in

detail.

Response: We are reviewing issues

related to indirect expenses with our

contractor.

Comment: A commenter stated that

separately billable income of mid-level

practitioners should be deducted from

practice expenses as part of the practice

expense per hour calculations. The

commenter suggested that the total

practice expense pools should be

adjusted by the Medicare income

received by physicians for the work of

physician assistants and other mid-level

practitioners. The commenter indicated

that the pools can be adjusted easily for

cardiac and thoracic surgery because the

data on billing for these mid-level

practitioners are easily available from

our data files.

Response: We believe that the

numerator of the practice expense per

hour calculation should exclude any

costs associated with mid-level

practitioners and the denominator

should include their patient care hours.

Unfortunately, the data from the SMS

do not permit the calculations to be

performed in this way. We believe that

this issue should be addressed in any

multispecialty survey instrument that

will be used in the future to collect

practice expense data and determine

practice expense RVUs. We disagree

with the commenter that there is a

feasible way of making an adjustment to

the aggregate practice expense pools

themselves to address this issue. While

it is unclear from the comment about

how such an adjustment would be

made, it is possible that the commenter

believed that we can use Medicare

utilization data to determine the

proportion of total allowed services for

cardiac thoracic surgery procedures,

where the specialty data indicates that

the service is performed by a mid-level

practitioner assisting at surgery; perhaps

the commenter assumes that we would

use this proportion to reduce the size of

the aggregate cost pool. We believe that

it is not possible to make an equitable

adjustment in this way. First, the

aggregate cost pools are constructed

using a total practice per hour figure,

and the proportional adjustment would

reflect only Medicare data. Second, it is

not clear to us how such a calculation

would be made. An assumption would

have to be made that where a mid-level

practitioner is performing a given type

of service, the work is being furnished

for a given type of physician specialist.

For instance, if a physician assistant is

assisting at surgery for a heart

procedure, we would have to assume

that practitioner is working for a cardiac

or thoracic surgeon. Even this simplified

example presents a dilemma, because it

would be unclear whether to adjust the

pool of the cardiac or thoracic surgeon

in this instance. We believe that, even

if these assumptions could be made for

some services, it would be difficult to

make similar assumptions, for example,

for evaluation and management services

when the mid-level practitioner could

be working for one of many different

specialists. For these reasons, we are not

making an adjustment to the practice

expense pools at this time.

(iii) Direct Patient Care Hours

In our July 2000 proposed rule (65 FR

44184), we discussed the many

concerns that have been raised from

various specialty societies concerning

our calculation of direct patient care

hours. Several previous commenters

65390 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

representing surgical specialty societies

have raised concern that the hours

computed for their specialties have been

overstated, because non-billable hours,

such as stand-by time, have been

included. In addition, commenters

representing emergency room

physicians raised the issue that the

hours spent on uncompensated care

were probably also included in the

survey responses to the detriment of this

specialty.

We then discussed the steps we were

taking to improve the future accuracy of

these data. We recommended more

precise wording for future survey

questions so that only the appropriate

practitioner hours are included.

We also discussed the second draft

report issued by our contractor, entitled

‘‘Validating Patient Care Hours Used in

HCFA’s Practice Expense

Methodology.’’ This report, which is on

our homepage under the title

‘‘Validating Patient Care Hours,’’

explores alternative methods that we

might use to validate the time data

collected by the SMS survey. We have

extended The Lewin Group’s contract so

that, among other refinement tasks, the

above validations can be performed. We

also solicited comments and suggestions

as to other steps we could take to verify

and improve the accuracy of the

specialty-specific patient care hours.

Comment: We received several

comments, primarily from surgical

specialty societies, reiterating the

concerns about patient care hours

discussed in the July 2000 proposed

rule. In particular, commenters urged

that we find a way to identify nonbillable hours, such as down-time

between surgeries, stand-by time, phone

calls, ‘‘curbstone’’ consultations, and

uncompensated care, so that these nonbillable hours can be subtracted from

the specialties’ direct patient care hours.

In addition, several commenters raised

the concern that the SMS survey data on

patient care hours varies considerably

by specialty.

The comments also contained a

number of recommendations. One

commenter suggested that we could use

a blend of the all-physician and the

specialty-specific hours. A specialty

society, citing concerns about the

variability between the SMS and the

Harvard/RUC time data, recommended

that we collect information on the

Medicare share of practice hours in the

SMS to produce a check of the

meaningfulness of the pool allocations.

Another specialty society, claiming that

the SMS data on patient care hours are

sure to be imprecise, urged us to use a

standardized number of hours in the

practice expense calculation or to

statistically limit the impact of this

variable. While one commenter

recommended that we use the average

number of hours per week that

physicians’ offices are open to calculate

the practice expense per hour, another

commenter argued that the assumption

of a 40-hour work week for all

specialties would result in a significant

distortion of practice expenses per hour.

Response: We do agree that the

patient care hours data would be more

precise if we could ensure that there is

a standard definition understood across

specialties, so that non-billable hours

would not be included in the data. As

discussed in the July 2000 proposed

rule (65 FR 44185), we suggested adding

a clarifying definition of hours to be

included to any future multi-specialty

practice expense surveys. In addition,

we referred to the work our contractor

is doing to validate the patient care

hours; one of the tasks will be a

comparison between the SMS hours

data and the Harvard/RUC physician

time data. Once this analysis is

completed, it could form a basis for

deciding whether any adjustment to the

SMS data is either advisable or

workable. As for the recommendations

that we use either a standard time for all

specialties or the actual time the

physicians’ offices are open, we believe

these recommendations stem from the

mistaken impression that a specialty

that actually works longer billable hours

is somehow disadvantaged by our

methodology. First, we believe that

some specialties do put in more billable

hours per week than other specialties,

and using a standard number of hours

for all specialties would thus be

inaccurate and inequitable. Second,

while it can be argued, as some

commenters claimed, that most practice

expense costs are generally incurred

during the hours the physician’s office

is open, we do not have a two-tiered

system of payment in which we pay less

for surgeries performed at 6:00 a.m. than

we do for those performed during office

hours on the grounds that the earlier

procedure somehow incurs less practice

expense. Rather, we average the

payments across each service, regardless

of the time it is performed. Likewise, the

practice expense per hour calculation is

an average of the costs per hour, in

which some hours would have higher

costs and some lower. In addition, the

direct patient care that takes place

outside of office hours should be

reflected in increases in the utilization

data for that specialty that, in turn,

increases the practice expense cost

pools for the same specialty.

Comment: One commenter urged that

any uncompensated care adjustment be

allowed only for emergency department

services that are furnished by practices

in areas that have a disproportionate

share of uncompensated care.

Response: If we were to propose any

further adjustments for uncompensated

care, we would publish them in a

proposed rule, subject to comment by

all interested parties.

Comment: A specialty society

expressed concern that, because

podiatrists are not surveyed by SMS,

any validation of patient care hours

performed by our contractor would not

apply to podiatry. This commenter also

stated that the specialty society has

shared with us two of the society’s own

surveys containing patient care hour

data, and requested that we either

validate and use this data or take

responsibility for collecting this data.

Response: We understand the points

that are made by this commenter and

will consider this further if we make

adjustments to the patient care hours. In

addition, now that a process and criteria

have been spelled out for the

submission of supplementary practice

expense data, the specialty society can

also submit additional survey data that

should include information on

podiatrists’ patient care hours.

(c) CPEP Data

(i) Relative Value Update Committee’s

Practice Expense Advisory Committee

(PEAC)

1999 RUC Recommendations on CPEP

Inputs

The PEAC, a subcommittee of the

RUC, held its initial meetings last year

to begin to refine the clinical staff,

supply and equipment inputs for

physician fee schedule services. In the

November 1999 final rule (64 FR 59394),

we responded to the RUC

recommendations for the refinement of

the direct inputs for 65 codes originally

reviewed by the PEAC and subsequently

approved by the RUC and noted that our

actions on all of the recommended

inputs were subject to comment. We

received the following comments on our

revisions to the RUC recommendations:

Comment: One specialty society

questioned the removal of lysol, tissues,

and biohazard bags from the supply list

for all codes, since these items represent

costs that physicians must pay.

Additionally, one organization objected

to our removal of self-administered

drugs from all codes, and another

society, as well as the RUC, objected to

the removal of betadine from the

supplies recommended for the postprocedure period.

Response: We believe that the

removal of such items as tissues, lysol,

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65391

and biohazard bags will help simplify

the refinement of the CPEP supply data

without having a noticeable impact on

the payment for any service. We

removed the costs of these minor

supplies from the overall CPEP supply

list either because of the difficulty in

measuring their use or because the

supplies were not fully used up during

a single procedure. Throughout the

supply data, the quantities for biohazard

bags and tissues were reported

incorrectly; for example, codes were

assigned 5 boxes of tissues or 250

tissues when the intention was to assign

5 single tissues at a cost of 5 cents. The

PEAC/RUC has since extended this

simplification by eliminating paper

towels and room disinfectant from their

recent recommendations. We proposed

to eliminate the very few selfadministered drugs on our supply list

from the CPEP data because we believe

that it is reasonable to exclude noncovered items in the allocation of the

specialty-specific cost pools. With

respect to betadine, we note that it is

included in the recommendations for

the post-surgical supply package that we

have accepted in this rule, which can be

used by any surgical specialty for its

codes. Therefore, we will not be adding

back any of these individual supplies at

this time.

CPT Code 17003, Destruction by Any

Method, Second Through 14 Lesions

CPT Code 17004, Destruction by Any

Method, 15 or More Lesions

Comment: One organization

commented that we should have

corrected the obvious and egregious

anomaly in these codes whereby the

payment for destruction of 14 lesions is

considerably higher than the payment

for 15 lesions.

Response: We agree that the values for

these two codes appear anomalous.

However, we do not assign practice

expense RVUs to services. Rather, these

RVUs are allocated based on the inputs

that are associated with each service.

Both of the above codes, along with CPT

Code 17001, Destruction by any method,

first lesion, were presented by the

dermatology specialty societies to the

PEAC, but we received

recommendations only on the supplies

for these services. We accepted these

recommendations in general, but

deleted many specific supplies from

CPT Code 17003 because it is an addon code. We have re-examined the

current CPEP inputs for CPT Code

17001, 17003, and 17004, and believe

that the inputs for labor and equipment

appear to be appropriate. The source of

the anomaly seems to be in the supply

inputs for these services. To ensure that

the appropriate revisions are made to

the supply lists, we need specific

recommendations from the RUC or the

relevant specialty societies.

CPT Code 17304 Through 17310, Chemo

Surgery (Mohs’ Micrographic

Technique) [First and Subsequent

Stages]

Comment: A commenter representing

Mohs surgeons, while acknowledging

the revisions made in the final rule to

the lists of supplies, indicated that we

erroneously omitted some supplies from

the updated list. The commenter

provided information on the supplies

omitted, as well as the rationale for why

these supplies need to be included.

Response: We appreciate the detailed

explanation regarding the use of these

supplies. After review, we note that,

with few exceptions, all the supplies the

commenter claimed were omitted are in

fact already included in our CPEP

database as originally recommended.

We explained in the November 1999

final rule that we were deleting Valium,

which is separately billable, and

Tylenol, which is self-administrable

from all codes; therefore, these drugs

will not be included for any of these

services. In addition, we are not

convinced that it is typical to suture the

wound after each stage of surgery, and

the commenter stated that the wound is

not closed until it is determined that no

further procedures are necessary.

Therefore, we believe that only one set

of sutures and suture kit are typically

needed, which we are including in the

supplies only for CPT code 17304. We

also note that the tincture benzoin swab

requested by the commenter was not

included in the original RUC

recommendation, though we are adding

it at this time.

CPT Code 56340, Laparoscopy, Surgical;

Cholecystectomy (Any Method)

Comment: A specialty society

representing surgeons and the RUC

objected to the decreases we made to the

PEAC/RUC recommendations for the

pre- and post-service times for this CPT

code. They indicated that there were

extensive discussions about this code at

the PEAC/RUC meeting, and that

adequate information was provided to

support this change for pre-service time.

The commenters also objected to our

elimination of the time for the second

registered nurse in the post-service

period and requested that we provide

the basis for determining that this is not

typical practice.

Response: There was insufficient

rationale for the PEAC

recommendations transmitted to us.

Moreover, the PEAC is currently

working on establishing a standardized

methodology for refining the pre- and

post-procedure clinical staff times. This

code, like all other surgical codes

involving pre- and post-procedure staff

time will undergo further refinement.

We are not changing the clinical staff

times now, but will review them upon

receipt of the PEAC recommendations

for pre- and post-procedure time for

surgical procedures in general.

CPT Ophthalmology Codes 65855,

66170, 66172, 66821, 66984, 67036,

67038, 67039, and 67040

Comment: Three specialty societies

representing ophthalmologists and the

RUC expressed concern that we did not

accept the RUC recommendation to

increase the pre-service period to 42

minutes for the above CPT codes, but

rather deleted all pre-service clinical

staff time. The commenters also noted

that the statement in the November 1998

final rule that we were retaining the

original CPEP value of zero minutes was

in error for CPT codes 66170, 66172,

66984, 67036, 67038, 67039, and 67040

because the CPEP panel had assigned 24

minutes of clinical staff pre-service

times to these codes. Commenters

requested that we accept RUC

recommendations for 42 minutes of

clinical staff time in the pre-service

period for all these codes because

facility-based surgical procedures

require significant pre-service clinical

staff work.

Response: We thank the commenters

for pointing out our inadvertent error

regarding the pre-service time in the

original CPEP data for seven of the

above ophthalmology codes. Although

we are not convinced that each of the

codes would have as much as 42

minutes of pre-service clinical staff

time, we will use this as an interim

value for pre-service time. We

understand that the PEAC and RUC are

planning to develop standardized

approaches to assign the pre- and postsurgical clinical staff times, as well as

coordination of care times, across wide

ranges of codes for the different global

periods. These pre-service times can

then be revisited in light of future

recommendations.

Comment: Several ophthalmic

societies opposed our decision to

decrease the post-service clinical staff

time approved by the PEAC/RUC for

ophthalmic surgical procedures. The

commenter representing three

ophthalmic sub-specialties also stated

that we did not consider the consensus

agreement to replace the Ophthalmic

Medical Personnel (OMP) staff type

with the Certified Ophthalmic

65392 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Technician (COMT) staff type for

ophthalmic procedures. Another

specialty society believed we should

have collapsed the two staff types into

the OMP staff type, because this was

agreed upon at the 1997 validation

panels.

Response: At the time that the

November 1999 final rule was

developed, we had received a comment

from the specialty society that had

presented these codes to the PEAC. This

comment described the building-block

approach that was used to arrive at the

post-service clinical times.

Unfortunately, there was a

miscommunication regarding the

specific building blocks that were used

to arrive at the total times, and our total

times were different from those of the

RUC. We have since received a

clarification from the specialty society,

and we are restoring the clinical postservice times to their recommended

values.

There appears not be a consensus

among the ophthalmic specialty

societies regarding which staff type to

use for ophthalmology codes. In

addition, we have not used any of the

decisions from the 1997 validation

panels in refining the practice expense

inputs, but have accepted the RUC

recommendations for the use of the

OMP staff types for the codes that have

been refined to date. We have not

received from the RUC any

recommendation regarding a global

change in the staff type for

ophthalmology services, but would

certainly consider any future

recommendation from the RUC on this

issue.

CPT Code 85060 Blood Smear,

Peripheral, Interpretation by Physician

With Written Report and CPT Code

85097 Bone Marrow; Smear

Interpretation Only, With or Without

Differential Cell Count

In the November 1999 rule (64 FR

59397), we stated that these were

professional services and, if any practice

expenses were incurred, they could be

reported using other applicable codes.

Therefore, we removed all practice

expense inputs for these two codes.

Comment: Two specialty societies and

the RUC requested that we use the

recommendations of the RUC to

establish a TC for CPT Code 85060, even

though we would not use the RVUs for

payment purposes, because other payers

are increasingly using our RVUs to

establish fees. The commenters also

stated that the interpretation of blood

smears can require additional slides and

services. Commenters did not agree that

the activity associated with the

technical portion of CPT Code 85097 is

included in payment for other services

when this service is performed outside

a hospital, as is increasingly occurring.

They indicated that creation of a TC

component for CPT Code 85097, using

the RUC recommendations, would allow

the laboratory that receives the

specimen to bill for the technical costs

in preparing the slide for examination

by the physician, and recommended

this TC component be paid under the

physician fee schedule.

Response: We do not want, at this

time, to create a TC for a code that we

do not cover, such as CPT Code 85060.

However, as mentioned elsewhere in

this final rule, we are further

considering the issue of valuing noncovered services. We will publish

practice expense RVUs for CPT Code

85097, so that it can be paid when

furnished in a nonfacility setting. We

will use the RUC recommended inputs

to calculate the practice expense RVUs.

CPT 88104 Cytopathology, Fluids,

Washings or Brushings, Except Cervical

or Vaginal; Smears With Interpretation

Comment: Several commenters

pointed out that, while we accepted the

RUC recommendation that included

filter paper in the list of supplies for this

code, this was not reflected in the CPEP

database.

Response: This item was omitted

inadvertently from the CPEP database

and will now be included.

In the November 1999 final rule, we

deferred action on the RUC

recommendations for a few groups of

CPT codes on which we had significant

questions. In the July 2000 proposed

rule (65 FR 44185), we proposed to

accept two groups of CPT codes of the

RUC recommendations with the

revisions noted below, while the RUC

recommendation discussed below for

the antigen service has not been

previously addressed.

Prostate Procedures

CPT 52647 Non-Contact Laser

Coagulation of Prostate, Including

Control of Postoperative Bleeding,

Complete (Vasectomy, Meatotomy,

Cystourethroscopy, Urethral Calibration

and/or Dilation, and Internal

Urethrotomy Are Included)

CPT 53850 Transurethral Destruction

of Prostate Tissue; by Microwave

Thermotherapy

CPT 53852 Transurethral Destruction

of Prostate Tissue; by Radiofrequency

Thermotherapy

We discussed the inputs for these

codes at length with the relevant

specialty society, and arrived at a

consensus on the staff, supplies, and

equipment that were needed for these

services.

Comment: The American Urological

Association (AUA) applauded us for our

proposal to accept the RUC

recommendations for the three heat

therapy prostate procedures and agreed

that all inputs are now included in the

CPEP data for these services. One

manufacturer recommended that we

adopt our proposal for CPT code 53850

in this final rule. Three individual

urologists and a manufacturer

commented that we should add

equipment, such as an autoclave, rigid

cystoscope, video system or ultrasound

equipment to the equipment inputs for

CPT Code 53852. The manufacturer also

stated the prices in the CPEP database

for the generator system and the hand

piece are now outdated, and included

the suggested current prices. Two of

these commenters also included a list of

supplies, most of which are already in

the CPEP inputs for this code.

Response: Because our proposal is

based on a recommendation from the

RUC, and the AUA has stated that it

believes the current inputs for this code

are correct, we will not add the

suggested equipment or supplies at this

time, nor change the prices for any of

the equipment. However, we have

awarded a contract to have all of our

direct cost inputs re-priced and any

information that is sent to us on current

pricing will be forwarded to our

contractor.

Chemotherapy Procedures

CPT 96408 Chemotherapy

Administration, Intravenous; Push

Technique

CPT 96410 Chemotherapy

Administration, Intravenous; Infusion

Technique, Up to One Hour

The RUC had recommended 102

minutes of clinical staff time for CPT

code 96408 and 121 minutes for CPT

code 96410. After the publication of the

November 1999 final rule we met with

representatives of the American Society

of Clinical Oncology (ASCO) and

discussed the society’s breakdown by

specific tasks of the above staff times.

Included in this breakdown were 20

minutes for pre- and post-procedure

education and 15 minutes for three

phone calls after each visit.

Because we believed that the times for

patient education and phone calls

should be averaged over the whole

course of chemotherapy treatment, and

because there appeared to be some

duplication in the pre- and postprocedure education tasks, we reduced

both the patient education and phone

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65393

call times by 5 minutes. Therefore, we

proposed 92 minutes of clinical staff

time for CPT code 96408 and 111

minutes for CPT code 96410.

Comment: ASCO objected to the 10-

minute reduction of the clinical staff

time for CPT 96408 and 96410. The

commenter argued that the original RUC

recommendation was reasonable and

appropriate for both services and should

be adopted. The comment also objected

to our revision of a RUC

recommendation unless we have a

concrete reason to do so.

Response: Upon reviewing the times

the RUC has since recommended for

patient education and post-visit phone

calls for comparable services, we are

adding the 5 minutes we had removed

from both patient education and phone

calls in the proposed rule. We will now

use the RUC-recommended total times

of 102 minutes of clinical staff time for

CPT code 96408 and 121 minutes for

CPT code 96410. We believe that the

total time is consistent with subsequent

recommendations that we are accepting,

though as the PEAC and RUC continue

to develop standardized times for

clinical staff functions, all previously

valued codes are subject to possible

review.

CPT 95165 Allergen Immunotherapy

The RUC did not forward any

recommendations on the specific inputs

required to perform the above service.

However, we did receive a

recommendation about the

interpretation of the meaning of a dose

for purposes of calculating the practice

expense RVUs for this service. Because

we did not believe the recommendation

resolved the ambiguity and confusion in

the medical community surrounding

this issue, we did not accept this

recommendation in the July proposed

rule. Since that time, we have received

clarifying comments from relevant

specialties on both the definition of

dose and the practice expense inputs to

use for this code.

The practice expense inputs have

been analyzed and adjusted so that they

now correspond to the practice expense

of preparing a one cc dose from a ten cc

(ten dose) vial. The practice expense

inputs for CPT code 95165 are based on

an assumption that ten doses are

typically included in each vial. Payment

will be based on a maximum of ten

doses per multidose vial. The practice

expense RVUs for preparing a ten dose

vial will remain the same, even if

twenty doses are obtained from the vial

(for example, if the physician

administers 0.5cc doses, instead of one

cc doses). Therefore, Medicare should

be billed for a maximum of ten doses

per vial, even if more than ten doses are

obtained from the vial. Furthermore,

when a physician dilutes a multidose

vial (for example, by taking a one cc

aliquot from a multidose vial and

mixing it with nine cc’s of diluent in a

new multidose vial), Medicare should

not be billed an additional amount for

these diluted doses for CPT 95165. The

additional clinical staff and supply costs

for preparing such a diluted vial are

minimal, because allergens represent

over 80% of the direct costs of preparing

a multidose vial. In a diluted vial there

are no associated allergen costs, since

they have already been billed in

preparation of the initial vial. Therefore,

we expect a maximum of ten doses to

be billed for each multidose vial. If

fewer doses are prepared from this vial,

a dose number less than ten per vial

should be billed.

The practice expense inputs per one

cc dose are as follows:

Clinical Staff: 2.2 minutes

Supplies: Allergen $6.05

0.5 needles and syringes

0.1 vial and cap

one alcohol pad

1 pair of nonsterile gloves

If multiplied by ten, the inputs

correspond to the total practice expense

of a ten cc vial from which ten doses of

one cc each are administered.

Commenters recommended that a

typical ten cc multidose vial contains

five antigens and no diluent and that the

total number of needles and syringes for

the ten cc vial is five. The cost data for

allergens was obtained from catalogue

information and is based on the typical

practice of using standardized extracts

when available.

In view of the clarification we have

made regarding practice expense inputs,

we will revise Section 15050(B)(7) of the

Medicare Carriers Manual. In May 1998,

we changed the language of that section,

in part, to clarify our payment policy for

antigen preparation. At that time we

stated, ‘‘A dose of code 95165 is the

total amount of antigen to be

administered to a patient during one

treatment session, whether mixed or in

separate visits.’’ Two examples of

antigen preparation and administration

follow immediately after this language.

We will revise this section of the

carrier manual to define a dose as a one

cc aliqout from a single multidose vial.

With this clarification physicians will

be able to bill Medicare for each dose

prepared in each multidose vial. We

plan to issue new instructions to the

carriers and update the carrier manual

to ensure that appropriate payment is

made as of January 1, 2001.

2000 RUC Recommendations on CPEP

Inputs

We believe that the recommendations

received this year from the PEAC/RUC

for the refinement of the CPEP inputs

for existing codes mark a positive step

in the CPEP refinement process. We

received recommendations for clinical

staff, supply and equipment inputs for

49 CPT codes, and for the supply and

equipment inputs for four additional

services. But the significance of the

recommendations goes beyond the

number of codes that were refined. First,

included in these recommendations

were the refinements for the 15 major

evaluation and management (E/M)

codes. These 15 codes represent over

25% of the payments made under the

physician fee schedule. This was a

breakthrough not only because the

clinical staff times for these codes had

previously been a point of major

contention, but also because agreement

on the inputs for E/M services may

make it easier in the future to refine the

post-surgical visits for thousands of

services. Second, the PEAC/RUC

approved supply packages for three

specialties: obstetrics-gynecology,

ophthalmology and neurosurgery; as a

result, the supply inputs for hundreds of

codes are now refined. We also

understand that the PEAC will be

developing further supply packages and

is also setting up workgroups to

determine approaches to standardizing

pre- and post-procedure clinical staff

times.

We have reviewed the submitted RUC

recommendations and have accepted all

of them with only two minor revisions.

In order to be consistent with a revision

made previously in the November 1999

final rule, we have deleted the skin

marking pen when it appears in a

recommended supply list because it is

not practical to allocate its use to

individual procedures. In addition, for

the ophthalmology codes that were

refined before the supply packages were

adopted, we have substituted the

ophthalmology visit supply package as

appropriate. If future decisions are made

on standard clinical staff times, all of

these refined codes can be revisited to

determine whether any further

refinements would be appropriate.

Following is a list of the CPT codes

that were included in the PEAC/RUC

recommendations: (The complete

PEAC/RUC recommendations and the

revised CPEP database can be found on

our website. See the Supplementary

Information section of this rule for

directions on accessing our web site.)

CPT 57452 Examination of vagina

65394 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

CPT 57454 Vagina examination and

biopsy

CPT 57500 Biopsy of cervix.

CPT 59000 Amniocentesis

CPT 62270 Spinal fluid tap, diagnostic

CPT 65730 Corneal transplant

CPT 67311 Revise eye muscle

CPT 67800 Remove eyelid lesion

CPT 67961 Revision of eyelid

CPT 90471 Immunization admin*

CPT 90472 Immunization admin, each

add*

CPT 90782 Injection, sc/im

CPT 92270 Electro-oculography

CPT 92275 Electroretinography

CPT 92582 Conditioning play

audiometry

CPT 94621 Pulm stress test/complex

CPT 95812 Electroencephalogram

(EEG)

CPT 95822 Sleep

electroencephalogram

CPT 95829 Surgery electrocorticogram

CPT 95830 Insert electrodes for EEG

CPT 95861 Muscle test, two limbs

CPT 95863 Muscle test, 3 limbs

CPT 95864 Muscle test, 4 limbs

CPT 95867 Muscle test, head or neck

CPT 95868 Muscle test, head or neck

CPT 95870 Muscle test nonparaspinal

CPT 95903 Motor nerve conduction

test

CPT 95925 Somatosensory testing

CPT 95926 Somatosensory testing

CPT 95930 Visual evoked potential

test

CPT 99141 Sedation, iv/im or inhalant

CPT 99142 Sedation, oral/rectal/nasal

CPT 99201 Office/outpatient visit, new

CPT 99202 Office/outpatient visit, new

CPT 99203 Office/outpatient visit, new

CPT 99204 Office/outpatient visit, new

CPT 99205 Office/outpatient visit, new

CPT 99211 Office/outpatient visit, est

CPT 99212 Office/outpatient visit, est

CPT 99213 Office/outpatient visit, est

CPT 99214 Office/outpatient visit, est

CPT 99215 Office/outpatient visit, est

CPT 99241 Office consultation

CPT 99242 Office consultation

CPT 99243 Office consultation

CPT 99244 Office consultation

CPT 99245 Office consultation

CPT 95813 Electroencephalogram

(EEG)

CPT 95816 Electroencephalogram

(EEG)

CPT 94060 Evaluation of wheezing

CPT 95921 Autonomic nerv function

test

CPT 95922 Autonomic nerv function

test

CPT 95923 Autonomic nerv function

test

*Note: These are noncovered under the

Medicare physician fee schedule.

Other Comments on Refinement of

CPEP Inputs

Comment: One commenter asked that

we clarify whether we plan to

implement the RUC CPEP

recommendations on a rolling basis, or

whether all changes will be made at

once.

Response: Unless we announce a

change in approach, we plan to deal

with the RUC’s recommendations on a

rolling basis as we receive them.

Comment: A commenter representing

three ophthalmology sub-specialty

societies expressed disappointment in

our belief that it is preferable to have a

multi-specialty agreement on changing

the CPEP data, rather than accepting the

recommendations of a single group. The

commenter argued that there is little or

no added value from such multispecialty review when the impact of the

changes is limited to a single specialty

and when members of other specialties

have no additional clinical knowledge.

Response: We strongly disagree with

this comment. We have found that the

input and recommendations of the RUC

play a crucial role in the practice

expense refinement. Also, because there

are many codes that are shared across a

number of specialties, changes in

payment for even a specialty-specific

service can affect the payment of the

shared services that the specialty

performs. Therefore, we believe that it is

fair and equitable to have a multispecialty consensus on these changes. In

addition, we have found, in our role as

observers at RUC meetings, that RUC

members, of whatever specialty, ask

pertinent questions and make clinically

relevant observations.

Comment: A specialty society

representing many medical specialties

recommended that we should use

panels, corresponding to the refinement

panels we use for work, to make

recommendations on code-level

refinements that are submitted to us.

Response: We certainly do not rule

out the use of such refinement panels

for code-level practice expense

recommendations when and if such

panels would be necessary and useful.

We have used these panels for work

RVU refinement in those cases when we

have not accepted the RUC

recommendations on a number of codes

and subsequently have received

comments disagreeing with our actions.

Because we have made so few revisions

in this current final rule to the PEAC/

RUC recommendations for practice

expense inputs, there may be no need

for practice expense panels next year,

although we will consider this issue.

(ii) Clinical Staff Time

In the November 1999 final rule (64

FR 59399), we removed estimates of all

clinical staff time allotted to the use of

clinical staff in the facility setting from

the CPEP data. Commenters have since

noted that the clinical staff times

reported by some CPEP panels for preand post-service times for 0-day global

services performed in the office were

recorded in the intra-service field in the

CPEP database. These times were,

therefore, deleted along with the times

for the use of clinical staff in the facility

setting.

In the July 2000 proposed rule (65 FR

44186), we stated that these data are not

comparable to the data we excluded for

clinical staff used in the facility setting.

We reviewed the ‘‘CPEP Recorders’

Notes Files’’ compiled for each CPEP

panel by Abt Associates, Inc., the

contractor managing the CPEP panels.

When the notes indicated that clinical

staff estimates were for activities

performed in physicians’ offices, we

proposed to reinstate the time data for

0-day global services.

Comment: Many medical societies

representing specialists such as

gastroenterologists, internists,

rheumatologists, cardiologists,

osteopaths and podiatrists, as well as

the AMA, expressed strong support for

this proposal to reinstate the pre- and

post-procedure clinical staff time in the

office for 0-day global services. One

reason given in the comments for this

support is that this time for staff in the

office is not comparable to the data

excluded for clinical staff used in the

facility setting.

Response: We are pleased that all

commenters supported this proposal,

and we are implementing this

refinement in this rule.

Comment: An organization

representing cardiologists stated, in a

comment on the November 1999 final

rule, that we should enlist the assistance

of medical specialties to identify codes

for which clinical staff are used in the

physician’s office during the intraservice period for facility services. In a

comment on the current proposed rule,

this society agreed with our proposal to

add some pre- and post-service clinical

staff time to 0-day global services and

listed several 0-day cardiology services

for which it recommended the addition

of clinical staff time.

Response: In this proposal, we added

only clinical staff time in the facility

setting for those 0-day services when the

CPEP recorder notes specified that the

time was for pre- and post-service time

for staff in the office. We believe that

this is appropriate because these CPEP

data are as valid as all other non-refined

CPEP data. We also believe that changes

to the CPEP data for this pre- and postservice clinical staff time should go

through the same refinement process as

other desired changes and that any

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65395

group recommending the addition of

such time should present this issue to

the PEAC/RUC for refinement. We also

understand that the issue of

‘‘coordination of care’’ clinical staff time

is one that the PEAC may address across

the board at some future meeting. In

addition, from the description of the

staff duties for the codes listed by the

commenter, it is not clear that this staff

is in the office, rather than in the facility

performing facility nursing functions.

Therefore, we will not be making these

changes at this time.

Comment: An emergency physician

organization recommended that we not

limit this proposal to 0-day global

period services and submitted the CPEP

recorders’ notes for emergency room

visits, CPT codes 99281 through 99285.

The notes indicate that the CPEP panel

added 3 minutes of pre-service time and

4 minutes of post-service time for office

staff involved in admissions to the

emergency room. The commenter

recommended that this time be

reinstated for these emergency room

visit codes.

Response: These emergency room

visits have an XXX global period. By the

current definition, XXX services do not

include pre- and post-service times.

Before implementing this specific

recommendation, we hope to receive

input from the RUC/PEAC on the

general issue of appropriate pre- and

post-staff times for the different global

periods, in order to ensure consistency

in our approach to this issue.

In the November 1999 final rule (64

FR 59399) we finalized our decision to

remove from the CPEP data all clinical

staff times associated with physician’s

staff used in the facility setting. We

implemented this policy for the

following reasons—(1) We should not

pay twice for the same service; (2) It is

not typical practice for most specialty

societies to use their own staff in the

facility setting; and (3) Inclusion of

these costs is arguably inconsistent with

both the statute and Medicare

regulations. In response to the

November 1999 final rule, we received

many comments on this final decision,

which, for the most part, reiterated

comments that had been made on the

original proposal.

Comment: Although several primary

care groups expressed support for this

decision, most of the commenters

objected to the exclusion of this clinical

staff CPEP data. Many of these

organizations urged us to postpone the

implementation of this policy and to

collect additional information before

making a decision on how to treat these

costs. However, taking the opposite

approach, a primary care organization

stated that the clinical staff time should

be removed for services furnished in the

facility until the PEAC/RUC can

determine that the time for these

services is typical and not duplicative of

physician work. Several commenters

again raised the argument that the BBA

prohibits us from excluding these

clinical staff costs because the BBA

requires us to recognize all costs, not

just those that can be tied to specific

procedures. Many organizations

reiterated the claim that the practice of

taking staff to the hospital is either

typical or prevalent in their specialties.

However, only the specialty society

representing thoracic surgeons

submitted any additional information to

support this claim. The STS surveyed

their members in July 2000,and reported

that 74 percent of the respondents said

they employ clinical staff who assist in

the hospital, though more than half

report that they receive Medicare

payment for some of these personnel.

Commenters made the following

recommendations:

Several organizations contended that

hospitals no longer supply the staff to

furnish adequate care. In relation to this

point, two commenters recommended

that the issue of cost shifts between

hospitals and other providers is one that

we should not ignore, and, if there is

any double payment, Part A payment to

the affected hospitals should be

adjusted.

Another specialty society

recommended that we establish a

modifier to allow for documentation of

and payment for non-physician clinical

staff who furnish services in a facility

setting. This modifier would indicate

whether there is a physician practice

expense or a hospital practice expense

that has been transferred to the

physician practice, to ascertain whether

payment should come from Medicare

Part A or Part B.

One organization recommended that

the SMS data be adjusted by the income

received for the work of physician

assistants.

Response: We have considered all the

comments that we have received on this

issue, both on the July 22, 1999

proposed rule and the November 1999

final rule. Though many of the

commenters raised interesting points,

there were neither new arguments nor

evidence presented that would cause us

to delay or abandon this policy. While

we particularly appreciate the effort

undertaken by the thoracic surgeons to

develop data on the prevalence of their

use of clinical staff in the hospital, the

survey addresses only the question of

typicality. As stated above, there are two

other reasons why we eliminated this

clinical staff time. First, we believe that

we already pay the facility for the

clinical staff needed for patient care.

Much of what is claimed as physician’s

clinical staff time in the facility is either

separately billable (as illustrated by the

survey submitted by the commenter) or

is accounted for in the work RVUs.

Furthermore, by law, the hospital itself

must furnish all services and items to a

hospital patient, either directly or under

arrangement. (For a more detailed

description of our rationale for this

policy, see the November 1999 final rule

(64 FR 59402).)

As to the recommendations made by

the commenters, we agree that it would

be desirable to remove costs associated

with these mid-level practitioners from

the SMS data as well. This would

answer the concern raised by another

commenter that removing the clinical

staff from the CPEP data introduces

further inconsistency with the SMS

data. It is for that reason that we had

recommended to the AMA that several

specific questions be added to the SMS

survey to capture the needed

information on this clinical staff issue,

and we anticipate that we will, in the

future, be able to obtain such data.

Although we would be interested in

receiving data on the cost shifts between

hospitals and other providers, we

believe that the suggested use of a

modifier for this purpose would be

extremely difficult to implement and

also burdensome for the practitioner.

First, however, we must clarify that,

even if the practice of bringing

physician staff to the hospital pre-dates

the advent of the hospital prospective

payment system, any costs associated

with such a practice were explicitly

included in the hospital Diagnosis

Related Group (DRG) payments in the

September 1, 1983 interim final rule

with comment and in the January 4,

1984 final rule. These rules reference

section 1862(a)(14) of the Act, and the

discussion makes clear that, with

certain limited exceptions, all

nonphysician services furnished to

hospital inpatients are to be paid under

Part A. The exception provided that, for

any cost reporting period beginning

before October 1, 1986, a hospital that

has followed a practice, since before

October 1, 1982, of allowing direct

billing under Part B to an extent that

immediate compliance with the

bundling requirements would threaten

the stability of patient care, could

continue to bill under Part B. There is

no indication that the waiver was

extended. In response to a comment, we

stated the following: ‘‘In order for a

payment system that is based on a

national average rate for a particular

65396 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

diagnosis to succeed, it is vital that the

services and supplies included in the

payment be essentially the same in

every hospital. If the statute had not

included the rebundling provision, it

would have been possible for hospitals

to collect the full prospective payment

rate for inpatient services and, at the

same time, reduce their costs by having

outside providers and suppliers furnish

many of the necessary services and bill

Part B.’’ Furthermore, these rules state

that, to calculate the PPS standardized

amounts, base year costs were adjusted

‘‘to include the costs of services that

were billed under Part B of the program

by another provider or supplier during

the base period but will be billed under

Part A as inpatient hospital services

effective October 1, 1983.’’

We do agree that it would be helpful

to determine whether hospitals are still

providing the staffing that is assumed in

their DRG payments. To this end, we

have requested that the Office of

Inspector General conduct an

independent assessment of staffing

arrangements between hospitals and

thoracic surgeons.

(iii) Supplies

In the November 1999 final rule, we

deleted certain casting supplies from the

CPEP data for the casting and strapping

CPT codes 29000 through 29750. In the

July 2000 proposed rule, we identified

additional CPT codes for the treatment

of fractures/dislocations and additional

casting and splinting supplies that are

separately billable under section

1861(s)(5) of the Act. Therefore, we

proposed the removal of inputs for

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

archbars, and elastics from the following

CPT codes: 23500 through 23680; 24500

through 24685; 25500 through 25695;

26600 through 26785; 27500 through

27566; 27750 through 27848; 28400

through 28675, and 29000 through

29750.

Comment: Several specialty societies,

representing orthopedic surgeons,

podiatrists, and occupational therapists

supported our proposal to delete casting

supplies from the CPEP inputs for all

applicable fracture management and

cast/strapping application procedure

codes for which these supplies are

separately billable. The orthopedic

surgery specialty society comment also

included a list of non-fracture/

dislocation codes for which it

recommended deleting casting supplies

and another list of non-fracture codes

from which the supplies should be

deleted if they are separately billable for

these services and left in the CPEP data

if they are not. This commenter also

stated that the soft goods, such as

stockinette, that we propose to delete do

not currently have a HCPCS code, and

requested that these supplies remain on

the CPEP list until a separate code is

established.

Response: We appreciate the support

expressed for our proposal. Consistent

with the statute that limits separate

payment for casting supplies only to the

treatment of fractures and dislocations,

we are not deleting these supplies from

either of the two lists of additional

codes supplied in the above comment.

Also, we will delete soft goods, such as

stockinette, from the CPEP data for the

appropriate codes, because these are

casting supplies that may be separately

billed. We will, however, also request

that HCPCS codes be developed for

these items. Therefore, we will

implement the policy as proposed.

Comment: A commenter representing

dermatologists sought clarification on

whether the unna boot would be

separately billable. The commenter

stated that the unna boot is not in the

list of supplies to be deleted from the

CPEP data, but CPT code 29580,

Application of paste boot, falls within

the range of codes listed under this

proposal.

Response: We are not deleting the

unna boot from CPT code 29580,

because this code can be appropriately

used for cases other than fractures, and

in those cases the supply is not

separately billable.

Comment: One supplier of casting

supplies agreed with our proposal to

delete these casting supplies from the

CPEP data, but suggested that we

include their product, Procel cast liner,

on this list as well, to clarify that it is

separately billable.

Response: The purpose of the

proposal was not to list all the casting

supplies that could be separately

billable, but rather to delete from our

CPEP input database any casting

supplies that are currently listed.

Because the Procel cast liner is not

currently in our database, it does not

need to be deleted.

(iv) Equipment

We currently use the original CPEP

definitions for equipment that

distinguish between ‘‘procedure

specific’’ equipment and ‘‘overhead’’

equipment. Under the ‘‘top-down’’

methodology, the CPEP inputs are used

only as allocators of the specialtyspecific practice expense pools, and we

believe the distinction between types of

equipment has served to hinder the

process of refining the CPEP inputs

while not leading to a substantive

distinction in how we value services.

Therefore, we proposed to combine both

categories of equipment into a single

‘‘equipment’’ category, assuming an

average 50 percent utilization for all

equipment.

We also proposed to delete from the

CPEP data equipment that is not used

typically with any service, but is on

‘‘standby’’ for many services, or that is

used for multiple services at the same

time. The following is the list of

equipment that we proposed to delete

from the CPEP inputs of all services:

autoclave, wheelchair, refrigerator, film

file cabinet, hazard material spill kit,

embryo freezer, water system,

flammable reagent cabinet, utility

freezer, ultra low temperature freezer,

acid cabinet, bulk storage refrigerator,

abortion clinic security system, abortion

clinic security guard, gomco suction

machine, doppler, laser printer, lead

shielding, defibrillator with cardiac

monitor, blood pressure/pulse oximetry

monitor, blood pressure monitor,

printer, crash cart—no defibrillator, and

smoke evacuator.

The following is a list of equipment

that we proposed to delete as ‘‘standby’’

equipment for most codes, but that we

believed typically may be used with a

designated subset of procedures:

X-ray view box—four panels (retain

when currently in the CPEP data for

codes in the range CPT codes 70010

through 79999).

ECG machine—3 channel (retain

when currently in the CPEP data for

CPT codes 93000 through 93221).

Pulse oximeter (retain when currently

in the CPEP data for CPT codes 94620,

94621, 94680, 94681 and 94690; 94760

through 94770, 95807 through 95811

and 95819).

ECG/blood pressure monitor—3

channel (retain when currently in the

CPEP data for CPT codes 43200 through

43202 and 43234 through 43239).

Cardiac monitor (retain when

currently in the CPEP data for CPT

codes 31615 through 31628).

ECG-Burdick (except for HCPCS code

G0166).

Comment: All the specialty societies

that commented on these proposals

were supportive of what one commenter

characterized as ‘‘HCFA’s efforts to

streamline the treatment of medical

equipment’’ and agreed that the changes

will facilitate the refinement process.

One of these commenters stated that a

standardized utilization rate overstates

the use of some equipment and

understates it for others and

recommended that we continue to seek

reliable data on this issue. Another

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65397

commenter recommended that we need

to provide clear and specific criteria for

including medical equipment in the

direct practice expense inputs, and gave

three possible options—(1) equipment

used primarily for a specific procedure

or group of procedures; (2) all

equipment used for a specific

procedure; or (3) all equipment that

typically must be available when a

specific procedure is performed.

Response: We agree that clear criteria

are needed for including equipment in

the inputs for a given procedure. The

major criterion used for clinical staff

time and supplies is that the suggested

input must be typically used in the

performance of a service to be included

as a direct practice expense. We believe

that the same criterion should be

applied to equipment. This criterion can

be applied more clearly than the other

options mentioned by the commenters,

and, thus, should result in more

consistent assignment of equipment

across all services. Regarding utilization

rates, we did solicit information on

specific equipment utilization rates in

the 1997 Notice of Intent to Regulate,

but very little hard data were submitted.

For most specialties, equipment costs

are a very small portion of total practice

expense, averaging less than 5 percent

of the total practice expense per hour for

the ‘‘all physicians’’ category. In

addition, for most equipment, a change

in the utilization rate would produce a

negligible difference in the practice

expense RVUs for any service.

Therefore, with perhaps a few specific

exceptions, and because of the apparent

difficulty in obtaining reliable objective

data, we expect that this issue will not

be a high priority issue during the

refinement process.

Comment: One specialty society

agreed that it is appropriate to capture

as indirect expense the costs of the

equipment that we have proposed to

delete. The specialty society expressed

concern that the SMS survey would not

include most of this equipment as

indirect expense, disadvantaging certain

specialties who have relatively higher

costs for indirect or stand-by equipment.

Other commenters questioned how the

costs of stand-by and multiple-use

equipment can be reflected if the

equipment is not included in the

calculation of practice expense. One

society stressed that, because of the high

costs of radiology equipment, it is

critical that overhead costs are

accounted for.

Response: The commenter raised a

valid point about the relationship

between the deleted ‘‘indirect’’

equipment and the SMS cost pools. The

costs for this deleted equipment are

included in the SMS cost pools for each

specialty. However, we believe this

proposal simplifies the refinement of

equipment without introducing new

problems. First, it is not clear whether

much of this equipment, such as laser

printers, lead shielding, refrigerators

and freezers, cabinets, water systems,

security systems, smoke evacuators and

hazard material spill kits, would have

been included as medical equipment or

as indirect costs in the SMS survey.

Second, stand-by equipment, such as

crash carts, wheelchairs and ECG

machines, would often be available for

more than one procedure at a time.

Allocating costs of these items for every

service for which they are available,

rather than for services for which they

are typically used, can mean that we are

allocating more than their actual costs

and thus overstating their value. Third,

the inclusion of the costs of equipment

that is not typically used in a service

means that we have different criteria for

equipment than we do for other direct

inputs. Fourth, most of this equipment

is relatively low cost, which is one

reason the impacts of this proposal are

not significant. We also want to clarify

that combining all equipment into one

category does not eliminate from the

practice expense calculations any of the

overhead equipment, such as the most

expensive radiology equipment, that is

typically used for a given service.

Comment: Societies representing

various imaging specialties requested

clarification on the doppler that was

included in the list of potentially

deleted items, because, if this is an

image-directed spectral doppler, it

should not be deleted. One of these

commenters supported the elimination

of x-ray boxes because they are no

longer typically used in current

radiology practice.

Response: The doppler we are

deleting from all but the relevant

procedures is a hand-held doppler, with

a cost of $1350, that can be used on

obstetric patients, not the ultrasonic

doppler at $155,000.

Comment: A society representing

obstetricians and gynecologists

recommended that the following

equipment that we proposed deleting

from all services be retained for specific

codes:

The doppler should be retained for

the prenatal codes CPT 59400, 59425,

59426, 59510, 59610 and 59618.

The blood pressure and pulse

oximetry monitors should be retained

for procedures requiring anesthesia or

sedation, CPT 58555, 58558, 58120,

58800, 59140, 59160, 59812, 59820,

59840 and 59841.

The suction machine should be

maintained for procedures that include

evacuation of the uterus, CPT 58120,

59140, 59160, 59812, 59820, 59821,

59840, 59841.

Response: We will retain the doppler,

monitor and suction machine for the

recommended services. Because these

were the only code-specific changes

recommended in comments on our

equipment proposals, we will be

implementing our proposals with only

the above changes.

Comment: The American Academy of

Dermatology (AAD) wanted clarification

on whether we are proposing that

dermatology-related standby equipment

be assigned to the overhead category,

because the specialty gains one percent

on the overhead proposal and loses one

percent on the standby equipment

proposal.

Response: We are proposing to delete

from the inputs the identified ‘‘standby’’

equipment from those codes for which

the equipment is not typically used. It

is a coincidence that the impact came

out as it did.

Comment: One primary care specialty

society recommended that we propose a

methodology in the 2001 proposed rule

for the use of an alpha-numeric code for

billing unusual equipment costs

associated with a procedure that are not

properly captured in the practice

expense data.

Response: We will certainly consider

this idea, although we foresee many

policy and operational difficulties in

implementing this recommendation.

(v) CPEP Anomalies

In the November 1999 final rule, we

made corrections to the CPEP data for a

number of codes when we learned that

the data contained errors and anomalies

that we could easily correct. In the July

2000 proposed rule, we listed other

egregious errors and anomalies that we

are proposing to correct. As we have

previously stated, though certain

revisions may be made now, all practice

expense inputs for these codes are still

subject to further comment, refinement,

and potential PEAC and RUC review

and recommendations. We received the

following comments on our proposed

corrections.

Comment: A major primary care

organization agreed with our decision to

correct major errors in the CPEP practice

expense data that had been identified by

specialty societies. Another association

stated appreciation for our correction of

the supply list for CPT code 68761 to

reflect the cost of a punctal plug.

Response: We are pleased that there

was no disagreement on any of the

proposed revisions we made in the

November 1999 final rule and the July

65398 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

2000 proposed rule to correct egregious

errors and anomalies in CPEP data, with

the exception of those discussed below.

Therefore, we will be implementing all

other changes at this time.

Comment: Two specialty societies,

representing obstetrics and family

practice, pointed out that we proposed

to crosswalk the CPEP inputs for CPT

59618, which includes antepartum care,

delivery and postpartum care, from CPT

59410, which only includes delivery

and postpartum care. They

recommended that we change the

crosswalk to CPT 59510, Routine

obstetric care including antepartum

care, cesarean delivery, and postpartum

care.

Response: The above proposed

crosswalk was a typographical error. We

thank the commenters for pointing this

out, and we are now crosswalking the

CPEP inputs for CPT 59618 from the

inputs for CPT 59510 as requested.

Comment: A specialty society

representing interventional radiologists

agreed that we had appropriately

removed the clinical supplies listed in

the facility setting for CPT codes 47510,

Insert catheter, bile duct and 47511,

Insert bile duct drain. They

recommended that these supplies be

listed in the office setting, because these

are 90-day global services with two

post-procedure visits.

Response: We have added postprocedure supplies to these two codes

by crosswalking from the supplies

assigned to CPT code 45525, Change

bile duct catheter, adjusted for two postvisits.

Comment: A radiology specialty

society objected to our proposal to

crosswalk the inputs of CPT code 78206,

Liver image (3D) with flow from the

inputs of CPT code 78205, Liver

imaging (3D). The specialty society

suggested that it will work with the

PEAC and RUC to determine the

appropriate additional expenses.

Response: We view crosswalks of

CPEP inputs as a temporary solution,

and we would welcome a

recommendation from the RUC.

Comment: One specialty society

commented that they had previously

identified inaccurate inputs, which lead

to anomalous RVUs that we have not yet

addressed. The commenter requested

the status of these suggested changes for

13 procedures. For 11 of these

procedures there is a request to increase

the number of post-operative office

visits. For CPT code 52276,

Cystourethroscopy with direct vision

internal urethrotomy, the commenter

questioned why the facility practice

expense RVUs are much lower than

those for CPT 52340, Cystourethroscopy

with incision, fulguration, or resection

of congenial posterior urethral valves, or

congenital obstructive hypertrophic

mucosal folds, even though the practice

expenses are similar. The commenter

also noted that the supply cost for a

double stent (CPEP supply code 93119)

should be decreased from $359 to $150.

Response: We do not view a request

to increase the number of post-operative

visits as a correction of an egregious

error, because it is not clear without

supporting evidence that the current

number of post-operative visits in our

database is inappropriate. It would be

most beneficial to discuss this issue

with the RUC, which could then make

recommendations to us. In regard to the

second issue, CPT 52340, a code that

will be deleted in 2001, is a 90-day

global service, while CPT 52276 is a 0-

day global service and therefore has

lower practice expense RVUs. The

double stent is currently priced at

$179.50. We appreciate the information

that this may be overpriced. However,

we have awarded a contract to have the

prices of all the CPEP clinical staff,

supply and equipment inputs updated

in time for next year’s proposed rule

and will revise the costs at that time. If

the society has documentation on the

correct price for this item, we will send

this information to our contractor.

Comment: An association

representing psychiatrists reiterated

their concern regarding the physician

times assigned to the psychotherapy

codes that include evaluation and

management services (E/M). The society

recommended that the times assigned to

each psychotherapy E/M code be

increased so that the total time would be

7 minutes more than the time assigned

to the corresponding psychotherapy

code without E/M. The commenter

argued that this added time would be

equal to the time assigned to CPT 99211,

the lowest level office visit with an

established patient, and that this

corresponds to the adjustment made to

the work RVUs for the psychotherapy

codes with E/M services. In addition,

the comment requested that we make

the physician time for CPT 90847,

Family psychotherapy (with patient

present), equal to CPT 90846, Family

psychotherapy (without the patient

present) and the time for CPT 90857,

Interactive group psychotherapy, equal

to CPT 90853, Group psychotherapy.

Response: We agree that an increase

of seven minutes in the physician times

for the psychotherapy codes with E/M is

reasonable, and we will make the

appropriate changes in our physician

time database. In addition, we also agree

that the times for CPT 90847 and 90846

should be equal, as should the times for

CPT 90857 and 90853, and we will

make those increases in physician time

as well.

Comment: The association

representing psychiatrists also

commented that the clinical staff times

for psychotherapy with E/M services are

underestimated and questioned why we

did not correct this as an egregious

error.

Response: We included as egregious

errors and anomalies only those

instances where there was a clear error

or anomaly in the CPEP data and also

where the correct input would be

obvious, without the benefit of a multispecialty recommendation. We did not

consider the clinical staff times for

psychotherapy codes to fall into that

category; in fact, we have concerns that

the clinical staff time for most of the

psychotherapy codes is, in fact,

overstated. Therefore, we believe that

this issue might better be dealt with

initially by the RUC.

Comment: A manufacturer of

diathermy equipment commented that

the practice expense RVUs for CPT code

97024, Application of a modality to one

or more areas; diathermy, are

undervalued. The commenter stated that

this payment rate will threaten the

ability of providers to make this service

available to the Medicare population.

Response: In checking our direct cost

inputs for this service, neither the

clinical staff time nor the supplies seem

inappropriate. The issue appears to arise

from a discrepancy in the cost of the

diathermy machine itself. The machine

in our database is priced at $2850. The

price range quoted by the manufacturer

is for $18,000 to $30,000. There is

obviously a wide range of machines

available, and we will need to

determine the most typical cost to a

practice. As mentioned earlier, we have

granted a contract to re-price all of our

direct cost inputs, including equipment.

We would welcome information on this

and other equipment used by

practitioners and would find recent

invoices particularly helpful.

(d) Calculation of Practice Expense

Pools—Other Issues

(i) Technical Refinement to Practice

Expense Pools

The Act requires payment of some

practitioner services (services of

certified registered nurse anesthetists,

nurse practitioners, clinical nurse

specialists, physician assistants, and

certified nurse mid-wives) based on a

percentage of the physician fee schedule

payment amount. Since the payment

under the physician fee schedule for a

service performed by a mid-level

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65399

practitioner is required to be based on

a percentage of the amount paid to a

physician for a service, we proposed

using only physician practice expense

data in determining the practice

expense RVUs for each practitioner

service. Removal of the services

performed by mid-level practitioners

from the practice expense calculations

would assist in simplifying the

methodology and would also be

consistent with the statutory

requirement that we pay for their

services based on a percentage of the fee

schedule amount.

Comment: A primary care

organization expressed concern that

removing the services performed by

mid-level practitioners from the practice

expense calculations might have

implications that were not discussed in

the proposed rule. The comment

encouraged us to withdraw the proposal

until there is more information and a

thorough discussion of the issue. The

AMA stated in its comment that it

would be difficult for us to include such

mid-level practitioner data since we do

not have reliable information

concerning the extent to which these

practitioners are self-employed or are

employed by physicians. The comment

further noted that we have

recommended that the AMA request in

any practice expense survey the amount

of revenue and patient care hours

generated by mid-level practitioners.

Another primary care organization

agreed that this proposal will make the

methodology more consistent with the

statutory requirement.

Response: The statute specifies the

payment amounts for practitioners such

as nurse practitioners, physician

assistants, and certified nurse

specialists. Because payment for these

practitioners is not based on the

calculation of their own practice

expense cost pools, we are removing

these services from the practice expense

computations and will consider further

adjustments as additional information

becomes available.

(ii) Medicare Utilization Data

We have received, in response to

previous rules, comments from several

surgical specialties urging us to evaluate

the Medicare claims data to eliminate

potential errors in the specialties

associated with each service. In the June

2000 proposed rule, we described the

analyses we ran to determine whether

potential errors in the claims data have

an adverse impact on any specialty or

merely represent ‘‘noise’’ that creates no

significant effect. We tested, for

neurosurgery, ophthalmology and

otolaryngology, the impact of

reassigning to the dominant specialty

the small proportion of allowed services

associated with specialties not expected

to perform these services. The impacts

did not even approach a 1-percent

increase or decrease in any scenario.

We stated our belief that these

simulations demonstrated that the small

percentage of potential errors in our

very large database have no adverse

effect on specialty-specific practice

expense RVUs. Therefore, we did not

propose any further action at this time.

Comment: One surgical specialty

society expressed concern that we had

dismissed the impact of less than 1

percent as inconsequential and

encouraged us to develop a software

program to reassign obvious errors in

the specialty-specific assignment of

procedures to the appropriate specialty.

Response: We believe that developing

software would not be an easy solution

to what we still see as an issue of little

significance for the calculation of

practice expense RVUs. On what basis

do we decide what an obvious error

would be? At this time, we do not have

policies that limit payment for given

services to only certain physician

specialties, and we are not convinced

that the medical community would

actually support our doing this. In

addition, because many services are

performed appropriately by more than

one specialty, on what basis would we

decide to which specialty the services

should be reassigned? Therefore, though

we would certainly want the possible

error rate to be zero, at this time we do

not plan to propose any changes in our

method of handling the utilization data

for the purposes of calculating practice

expense.

(iii) Allocation of Practice Expense

Pools to Codes

In the July 2000 proposed rule, we

discussed the work The Lewin Group

had recently begun on the third phase

of the project, which concentrates

specifically on evaluating the indirect

cost allocation methodology and

considers alternatives to allocating

indirect costs by the current method.

We expect their report on this analysis,

which will be placed on our website, to

be available soon.

Comment: Two specialty societies

commented that we should develop and

implement ways to reduce or eliminate

the pool leakage that can occur in the

weight-averaging step of our

methodology when procedures are

performed by multiple specialties. One

commenter argued that the problem is

in the allocation formula that sets up the

leakage, not the averaging.

Response: These comments refer to

methodological issues surrounding the

development of the practice expense

relative value units under the ‘‘top

down’’ methodology. We use a

combination of data on practice expense

per hour from the SMS survey, the time

estimated to perform individual

procedures and Medicare utilization

data to create aggregate cost pools.

These cost pools are allocated to

individual codes. Once the costs are

allocated, estimates of practice expenses

for individual procedures are then

weight-averaged by the specialties

performing each procedure to produce

practice expense RVUs for a procedure.

The above commenters are concerned

that this process does not result in

practice expense payments to each

specialty that equal the aggregate cost

pools. To the extent that there is ‘‘pool

leakage,’’ it implies that an individual

specialty’s practice expense payments

are less than its aggregate practice

expense pool. The implication of the

comments we have received on this

issue is that specialties that receive

aggregate cost payments that are less

than the aggregate cost pools are

underpaid. We disagree. As we

indicated in the November 1999 final

rule (64 FR 59390), we believe it is more

likely that the aggregate practice

expense pools are overstated, rather

than that aggregate practice expense

payments to a specialty are too low.

As we indicated both in that rule and

in the June 5, 1998 proposed rule (63 FR

30832), there are two potential sources

of bias in the practice expense per hour

data that may result in an overstatement

of the aggregate practice expense pool.

First, mid-level practitioners may have

been included in the numerator of the

practice expense per hour calculation

even though there is generally separate

payment for their services. Thus, a midlevel practitioner would be analogous to

an employee physician who also

generates revenue and whose costs are

not included in the practice expense

calculation, rather than to a registered

nurse or other practitioner who cannot

furnish a separately billable service.

Second, the mid-level practitioner’s

hours spent are not included in the

denominator of the practice expense per

hour calculation even though, like a

physician, the mid-level practitioner is

generating patient care revenues during

the hours spent in patient care. To the

extent that a specialty depends on the

use of mid-level practitioners, then the

aggregate specialty practice expense

pools are likely to be overstated. Based

on information in our utilization data

and comments made to us by one of the

65400 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

commenters, we believe this is the case

with thoracic surgery. Rather than

developing a process that ensures that

aggregate practice expense payments are

equal to overstated aggregate practice

expense pools, we believe the better

option is to address the issue of midlevel practitioners in the practice

expense methodology. In this final rule,

we have already addressed one aspect of

this issue. Specifically, we have

eliminated any utilization data that

reflects that the service was performed

by a mid-level practitioner. The other

aspect of this proposal that we would

like to address is the practice expense

per hour calculation itself. As we have

indicated elsewhere, we are interested

in addressing this and other issues

related to the practice expense

methodology as we develop long-term

plans for refining the practice expense

RVUs beyond 2002.

(iv) Zero Work Pool

There were no proposals in the July

2000 proposed rule on this issue.

However, in the November 1999 final

rule, we implemented the proposal to

remove requested services from the zero

work pool and return them to the

specialty-specific cost pools.

Comment: Many specialty societies

and the AMA expressed approval of our

decision to remove a list of CPT codes

from the ‘‘zero work pool’’ in response

to specific requests to do so. Other

organizations, representing specialties

with technical services, supported our

decisions—(1) not to modify the

practice expense RVUs for diagnostic

imaging ‘‘zero work’’ services in any

substantial way at this time; and (2) to

keep the zero work pool intact, at least

until we can develop a methodology

that accurately captures TC costs.

Several commenters did express a

concern that we erroneously removed

from the pool an amount equal to the

increased payment the removed services

would receive in their own pools, rather

than the payment rate the services were

assigned in the zero-work pool. Another

specialty society representing TC

providers argued that the RVUs of the

codes remaining in the pool should

have been maintained at their previous

level.

Response: We are pleased that there is

general support of our adjustments to

the zero work pool. With respect to the

concern expressed, we did deal with the

removal of services from the zero work

pool in a manner that seems consistent

with the views of the commenters. We

only subtracted from the pool the

dollars for the utilization associated

with the removed services, which

would represent the rate the services

were assigned in the zero-work pool, not

the increased rate in the specialtyspecific pool. With regard to the

recommendation that the RVUs of the

remaining services in the zero-work

pool should be maintained in spite of

any adjustment we make, we believe

that such an approach would be unfair

to the other services in the fee schedule

whose practice expense RVUs are not

similarly protected from the effects of

changes we make in the practice

expense calculations.

(e) Site of Service

Clarifying the Definition of Facility/

Nonfacility

In the July 2000 proposed rule, we

clarified the definition of facility and

nonfacility sites of service for the

purposes of practice expense

calculations. This distinction takes into

account the higher expenses of the

practitioner in the nonfacility setting.

The major purpose of this distinction is

to ensure that Medicare does not

duplicate payment, to the physician and

to the facility, for any of the practice

expenses incurred in performing a

service for a Medicare patient. For

purposes of the site-of-service, we have

defined hospitals, skilled nursing

facilities (SNFs), and ambulatory

surgical centers as facilities, because

they will receive a facility payment for

their provision of services. In the July

2000 proposed rule, we proposed to

revise § 414.22(b)(5)(i) (Practice expense

RVUs) to define community mental

health centers (CMHCs) as facility

settings since CMHCs also receive a

separate facility payment for their

services.

In addition, we clarified that the

nonfacility practice expense RVUs

should be applied to all outpatient

therapy services (physical therapy,

occupational therapy, and speech

language pathology), even when they

are provided in a facility. Only the

facility can bill for therapy services

furnished to hospital and SNF patients.

Because there will be only one bill for

this service and because the payment

must reflect the practice expenses

incurred in furnishing the service, the

higher nonfacility RVUs are used to pay

for therapy services even in the facility

setting.

Comment: Three specialty societies

representing gastroenterologists

reiterated their disagreement with our

site-of-service policy because they

believe—

• The policy offers a financial

incentive for physicians to perform

certain gastroenterological procedures

in their offices, rather than in an ASC

or hospital outpatient department;

• The policy allows the procedures to

be furnished in a physician’s office that

does not have to meet accreditation

standards;

• The wide divergence between the

payments in the two settings may be

encouraging the performance of

gastrointestinal procedures by nongastroenterologists; and,

• This reduction of payments for

endoscopy services in the facility setting

is contrary to the intent of the statute.

The commenters had varying

recommendations on this issue: one

comment urged us to provide the same

practice expense RVUs in the facility

and nonfacility settings for 18

endoscopic gastroenterological

procedures. Another commenter

suggested that because we now pay

therapy services at the nonfacility rate

regardless of setting, we should do the

same for the colorectal screening codes.

A major specialty society stated that it

is in the process of working with

gastroenterology societies to develop a

proposal to create a single site-of-service

payment rate for those services that are

furnished less than 10 percent of the

time in the office.

Response: We believe that some of the

commenters continue to misunderstand

the reasons for the distinction between

the facility and nonfacility sites of

service and the actual implications of

this distinction. We have perhaps added

to this confusion by continuing, on

occasion, to use the term ‘‘site-of-service

differential’’ to describe this policy.

Under the charge-based practice

expense methodology, there was an

actual differential; certain services were

automatically reduced by a predetermined amount when furnished in

the facility setting. However, in our

current resource-based ‘‘top-down’’

approach, we employ no such

reduction. Rather, we carry out the

statutory requirement to develop

practice expense RVUs that reflect the

relative resources involved with

furnishing each service. We doubt that

any specialty society would argue that

the direct costs of performing a service

in the office setting are not higher than

in the facility setting. In the office

setting, the physician must bear the

costs for all of the clinical staff, supplies

and equipment needed to perform a

given service; in the facility setting,

these costs are the responsibility of the

facility. Our RVUs reflect the relative

resources used in furnishing the service

in each of the facility and nonfacility

settings. Therefore, to the extent that we

have correctly identified the relative

direct costs, there should be no

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65401

incentive to perform a service in either

setting. It is true that we pay more to the

physician if the service is furnished in

the office, but that is because greater

resources are involved with furnishing

the service in that setting. The fact that

there is a significant difference between

the facility and nonfacility payment for

any given service seems to us both

expected and appropriate. We believe

that properly reflecting the relative

resources involved with furnishing

services in the facility and nonfacility

settings creates no incentive to perform

a service in one setting or another. In

contrast, a policy that paid the same

amount for a service furnished in a

facility and nonfacility setting would

create an incentive to furnish the service

in the facility setting and, thus, would

not be incentive-neutral.

We have serious reservations about

adopting a policy to develop a single

site-of-service payment for services that

are furnished less than 10 percent of the

time in the office. First, if there are real

concerns regarding patient safety when

certain procedures are furnished in the

office, sufficient evidence should be

presented to the relevant parties so that

an appropriate coverage decision can be

made. We emphasize that such a

decision would be a coverage decision,

and would not be a payment policy

issue. Second, a 10-percent threshold

could eliminate payment in the office

setting for some high-volume

procedures done thousands of times

there. Third, we have some concern that

this issue may be a matter of contention

between those specialties that generally

perform procedures in physician-owned

ASCs and other specialties that would

utilize the office setting. We would

suggest that this issue, either as a

general proposal or on a code-specific

level, be discussed in the PEAC/RUC,

where a multi-specialty

recommendation could then be

submitted to us.

The site-of-service policy for therapy

services mentioned by a commenter as

a precedent is not applicable to other

services in the physician fee schedule.

As described above, the facility itself

must bill for both the technical and

professional portion of the therapy

service; in these circumstances, the

therapist does not bill Medicare at all.

Therefore, the nonfacility RVUs are

used to ensure that the facility is paid

for the direct costs incurred in the

service.

Comment: A specialty society

representing pediatricians believed that

the site-of-service differentials will

likely have an adverse impact on

pediatric specialty care that is primarily

hospital-based. Most pediatric subspecialists, most of whom are not

hospital-employed, incur practice

expense (in the form of a lease or rent)

when they provide ambulatory services

in a hospital-owned facility. This

expense most typically includes

administrative and clinical staff.

Response: We would need more

information on the scenario described

before we can formulate a definitive

response on this issue. For example, it

is not clear whether these pediatric

services as described would always be

considered ‘‘facility’’ services. A visit to

a physician’s office that is leased from

a hospital could, in many

circumstances, be considered a ‘‘nonfacility’’ service by Medicare, if there is

not a Part A bill for the same service. In

addition, indirect expenses, such as rent

or administrative staff salaries, are

treated the same in all sites under our

methodology. We would welcome

further discussion on this issue.

Comment: A comment from an

association representing providers of

services in long-term care facilities

contended that there should be a site-ofservice differential for settings such as

SNFs, where patient acuity is higher

and where services must be transported

to the patients. Use of data from the

SMS survey for services performed

outside of the physician’s office is not

appropriate. An occupational therapy

association stated that, though they

concur with our clarification that

therapy services would always be paid

at the nonfacility rate, the resources

necessary to provide therapy services in

facilities are not adequately reflected in

our practice expense calculations. A

commenter representing geriatricians

commented that pre-and post-care

involved in nursing home visits are not

reflected in the nursing home visits.

Response: The practice expense RVUs

for the office and facility settings differ

primarily as a result of the differences

in the direct costs in these sites. Because

the SNF would bear the costs of the

clinical staff, supplies and equipment,

the cost to the practitioner is less than

it would be in the office setting. It is not

clear to us how the acuity of the patients

in a SNF would affect the direct practice

expense costs of the practitioner, or

what resources are not reflected in our

calculations, since the practitioner is

not responsible for the direct costs in

that setting. If there is clinical staff time

for staff back in the office associated

with nursing home visits, this issue

should be brought to the attention of the

PEAC/RUC, because they are

considering an approach to

standardizing ‘‘coordination of care’’

clinical staff times for various services

to make recommendations to us on this

issue.

Comment: A long-term care

association recommended that we

clarify our policy on mixed facilities,

which are SNFs that also have nursing

home beds, to state that the

presumption should be made that the

therapist is treating a nonfacility

patient. A society representing

podiatrists requested confirmation of

this policy.

Response: We do not agree that the

above recommendation would be a

clarification of our policy on ‘‘mixed’’

facilities. We explicitly stated in our

July 1999 proposed rule that a service in

a mixed facility should be designated as

a facility service (that is, the place of

service would be a SNF), unless the

practitioners can verify that no Part A

claim will be made for the service. In

the latter case, the place of service

would be a nursing home, and the

service would be paid at the nonfacility

rate. We did not change this policy in

our November 1999 final rule, and we

believe that this is an appropriate

policy.

Comment: Commenters were

supportive of the expansion of the

definition of facilities to include

community mental health centers

(CMHCs). However, one commenter,

representing a state health department,

requested that we clarify the distinction

between CMHCs and other types of

community mental health entities to

which this would not apply.

Response: A CMHC is a distinct type

of facility certified for Medicare

participation for the purpose of

providing ‘‘partial hospitalization

services’’. As we had explained in the

proposed rule, Medicare payment to a

facility typically includes the cost of

services furnished. If an entity is not

participating in the Medicare program,

the nonfacility practice expense RVUs

would apply to the services. We believe

this may not have been clear in the

proposed rule. We are revising

§ 414.22(b)(5)(i)(A) to specifically

provide that, for calculation of practice

expense RVUs, a CMHC is considered to

be a facility and revising

§ 414.22(b)(5)(i)(B) to parallel the

language of § 414.22(b)(5)(i)(A). We also

specify that the nonfacility practice

expense RVUs are applicable to

outpatient therapy services regardless of

the actual setting.

Comment: One organization

commented that the proposed rule did

not address coverage or payment for

‘‘inpatient’’ only services performed in

the outpatient setting, and referenced

the outpatient PPS rule published April

7, 2000.

65402 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Response: This issue is addressed in

the outpatient prospective payment

system rules.

(f) Other Practice Expense Issue

Comment: One specialty society

recommended that we keep the practice

expense RVUs that will be fully

resource-based in 2002 as interim RVUs

for a minimum of another three years,

during which we would consider

comments for further code-level

refinement.

Response: As long as there is a good

faith effort on the part of all parties to

continue the quality work that the

PEAC/RUC has already undertaken, we

do not plan to close the door on further

code-level refinements in 2002. We

understand the magnitude of this task

and have an interest in ensuring that

there is sufficient time to deal with the

CPEP inputs of all services in a

thoughtful and equitable manner.

Comment: A specialty society

representing neurological surgeons

made a number of comments critical of

the methodology used to allocate

practice expenses. These criticisms

pertained to virtually every aspect of the

methodology. For instance, there was

criticism of the CPEP data, the SMS

data, and the idea that indirect practice

expenses are a function of the amount

of time spent in patient care activities.

The commenter further indicated that

the ‘‘cursory efforts to ‘validate’ CPEP

data by having it reviewed by RUC’s

Practice Expense Advisory Committee

(PEAC) seems more pro forma rather

than have it based on some independent

appraisal of the real costs that may be

involved.’’ In addition to the criticism

cited above with respect to the

methodology for allocating indirect

costs, the commenter suggested that we

should have summed the three indirect

cost categories (administrative labor,

office expense, and other expense), and

allocated the result to individual codes

based on the work RVUs. The

commenter suggested that this was a

better method than the ‘‘unnecessarily

tortuous’’ approach we adopted that

‘‘used the total SMS pool and divided

it by the pool of direct expenses * * *

to generate a scaling factor that

represented the fraction of the total that

the CPEP data calculation claimed as

direct.’’ In addition, the commenter

objected to a ‘‘single adjustment’’ of 25

percent made to the Harvard physician

time data that are being used to generate

the practice cost pools. They indicated

that this adjustment distorts time values

for many codes. The commenter

suggested that RUC time data would be

more reliable than Harvard time data

and that we should consider

establishing a rank order reliability in

the time data based on dependability of

the process that generated the time

values. For instance, the commenter

suggested that operative logs would

provide a measure of skin-to-skin time

for intraoperative portion of surgical

procedures that should rank above a

group of estimates of the same time

made by surgeons.

Response: With respect to the

criticism of the CPEP data, we

acknowledge that there are limitations

and anomalies in the data that may

distort values for some services. As

required by the BBA, we have

established a refinement process that

will address the inputs for many codes.

In this final rule, we are reflecting

refinements to the practice expense

inputs for office visits and office

consultations. As a result, services that

account for approximately 22 percent of

Medicare allowed charges for

physicians’ services will have been

reviewed and the inputs been refined.

As we describe elsewhere in this rule,

we are making other refinements with

respect to how equipment costs are

being allocated, and we are continuing

to consult with the PEAC on developing

supply cost packages that will facilitate

refinement of this aspect of the practice

expense inputs. Although the

commenter believed that surveys of

physician practices for resource inputs

would be an improvement over the

scrutiny being applied by the PEAC, we

disagree. A survey process to collect

direct cost inputs for the over 7,000

procedures on the Medicare physician

fee schedule would be enormously

expensive and time consuming and may

be unlikely to yield better results than

are being recommended by the RUC/

PEAC. We believe the RUC/PEAC

process allows for a multispecialty

review of inputs for particular

procedures. These RUC/PEAC

recommendations have been helpful to

us in simplifying the number of data

inputs going into individual codes and

in improving the overall quality of the

data that are being used to determine

practice expense RVUs.

With respect to the indirect

methodology, the commenter is

essentially suggesting that we abandon

the direct inputs and use the work RVUs

as the basis for allocating all indirect

costs. While this approach may be

simpler, we disagree that such a

methodology will improve overall

equity in Medicare payment for

physicians’ services. It would, of course,

likely increase payments to specialties

with relatively high work values and

low direct costs. Furthermore, we do not

believe this approach would be

consistent with the statutory

requirement to recognize ‘‘all staff,

equipment and supplies and expenses’’

in determining the practice expense

RVUs.

We do agree with the commenter that

it may be helpful to validate physician

time data using independent

information sources such as operative

logs. In fact, as we described in the July

2000 proposed rule (65 FR 44202), we

have several efforts underway to obtain

information on times spent performing

individual procedures, including using

inpatient and outpatient records and

operative reports on skin-to-skin

surgical times for selected procedures.

Comment: One surgical specialty

society reiterated its contention that we

have not been providing the impact

analysis required by the BBA and

requested that we do so. The

osteopathic surgeons requested that we

publish the impacts rounded to a tenth

of a percent and that we display the

impact for the entire period of the

transition rather than for the individual

year. A society representing radiation

oncology also requested that we expand

the percentage of impact by several

decimal places; although the impact

table for radiation oncology displays

zero percentage impact for each

category, there is a total increase of one

percent. An ophthalmology society

requested that we publish more detailed

impacts, and enumerated five additional

impact analyses or tables we should

include in the final rule. Three other

specialty societies urged us to conduct

the sensitivity analyses recommended

by the GAO, because, without knowing

the effect of a change in methodology or

data, it is difficult to know whether the

proposed change is acceptable.

Response: We have addressed these

comments in previous rules. We provide

a discussion of impacts in each

proposed and final rule. We also

provide detailed information on the

HCFA web page, which allows any

group to select services of interest and

determine the impacts resulting from

payment rates.

Comment: A commenter suggested

that we should identify a way to

incorporate the cost of compliance with

regulations into the practice expense

payments or into the annual updates to

the physician fee schedule.

Response: To the extent that these

costs are due to increased clinical or

administrative staff time, the SMS or

supplementary surveys should reflect

these expenses, so they are already

reflected in the practice expense

calculations.

Comment: A specialty society

representing podiatrists requested

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65403

clarification concerning the reduction in

practice expense RVUs for CPT code

11750, Removal of nail bed, as

compared to the previous charge-based

RVUs.

Response: Because the charge-based

practice expense RVUs were not based

on the resources used to perform a

service, the payment for many services

either increased or decreased, some

significantly, when we implemented

resource-based practice expense. In

themselves, such changes are not

indicative of an error in our

calculations. A comparison to the values

assigned to codes in the same or similar

families would be more important. It

appears that the fully implemented

practice expense RVUs for CPT 11750

are in the same range as the values for

related services. If the specialty society

believes this is not the case, we would

need more information as to which

codes’ values appear anomalous.

Comment: An occupational therapy

association noted that the fullyimplemented practice expense RVUs for

CPT 97110, Therapeutic exercises are

greater than those for CPT 97530,

Therapeutic activities, even though the

CPEP inputs that we accepted should be

the same for both services. The

commenter also questioned why, in the

November 1999 final rule, the practice

expense RVUs for the occupational

therapy evaluation and re-evaluation

services, CPT 97003 and 97004, were

lower than those for the physical

therapy evaluation and re-evaluation

services, CPT 97001 and 97002.

Response: We checked the CPEP

inputs for CPT codes 97110 and 97530.

The time associated with the use of

procedure-specific equipment for CPT

97110 was inadvertently overstated,

causing a slight increase in the

equipment cost for that service. We have

corrected this error. In addition, as we

explained in the November 1999 final

rule, we deleted the tables in the

equipment lists from CPT 97530

because we believed the service would

typically be performed while the patient

was standing. However, even when two

services have identical inputs, the final

practice expense RVUs can differ, if a

different mix of specialties perform the

two services. One reason for the

difference between the occupational and

physical therapy evaluation and reevaluation services is that the

occupational therapy codes were only

valued by one CPEP panel. The physical

therapy codes were valued by two CPEP

panels, one of which estimated higher

staff times than the other, giving these

codes a higher average time. The

refinement of these codes should

remove this issue, although, for the

reason explained above, the practice

expense RVUs may still not be identical.

Comment: Two organizations

representing audiologists submitted a

joint comment which reiterated their

concern regarding our use of data from

the other specialties that perform

audiology services to calculate the

practice expense RVUs for these

services. The specialty society intended

to perform a survey of audiologists’

practice expenses in order to gather

more accurate data.

Response: We have published the

criteria and process for the submission

of specialty-specific supplementary

survey data. We would welcome this

additional information.

Comment: A specialty society

representing geriatricians contended

that this specialty requires more office

space than other providers and wanted

us to increase the space requirements

beyond what is allowed for internists.

They believe we have set a precedent for

this by altering the space allotment for

physician and occupational therapists.

Response: Under our current practice

expense methodology, we do not have

space requirements for any physician

specialty. The amount of office space

needed would presumably be reflected

in the SMS indirect costs for each

surveyed specialty, but we have no way

of knowing what this is, or of making an

adjustment to these costs for a given

specialty or sub-specialty. The

adjustment for the physical therapists

was a different issue. Because we

believed that the crosswalk to the ‘‘all

physician’’ rate that we used for

physical therapy would overstate the

indirect costs, we substituted a lower

rate based on a study of physical and

occupational therapists that computed

costs for therapy services partially on

the space used for therapy agencies and

later made an adjustment to that rate.

This adjustment would have no

relevance to any other specialty.

Comment: A commenter objected to

the use of salary equivalency guidelines

to determine the indirect cost pools for

physical therapists. The commenter

indicated that the original estimate of

250 square feet was insufficient to

reflect expenses for therapists in private

practice. While we agreed that these

space requirements were insufficient

and increased the space to 500 square

feet, the commenter continues to believe

that the salary equivalency data is not

an accurate measure of the expenses

associated with operating a physical

therapy office since these apply to

therapy services furnished by an outside

contractor to an outpatient hospital,

skilled nursing facility, home health

agency, clinic, rehabilitation agency or

public health agency.

Response: In general, we believe it is

better to use data that reflect a specific

physician specialty or nonphysician

practitioners’ costs if they are available.

For the direct expense items (clinical

staff, equipment and medical supplies),

there was no data available for physical

therapy so we used a crosswalk to the

all physician rate. For the indirect cost

items, we used the information that is

directly applicable to physical therapy

for use in the practice expense

methodology. While the use of salary

equivalency guidelines data may have

been developed for contract physical

therapists providing services in

facilities, we believe that a potential

shortcoming for its use is related to the

number of square feet of space that are

allotted for each therapist. In response

to previous comments we increased the

space allocation to 500 square feet in the

November 1999 final rule (64 FR 59404).

While we are currently using 500 square

feet for the space allotment and believe

that that amount may recognize some

components of indirect costs, the figure

still may understate the space

requirements for private practice

physical therapists because it does not

recognize other components of indirect

costs that are not incurred by contract

physical therapists working in a facility

setting. In an earlier comment, the

American Physical Therapy Association

indicated that 250 square feet is

inadequate for physical therapists in

private practice. The comment indicates

that approximately 700 to 850 square

feet per therapist are necessary. We are

increasing the space requirements from

the salary equivalency guidelines for

physical therapy to 750 square feet. This

revision will result in use of the

following practice expense per hour for

physical therapy for calculation of the

2001 practice expense RVUs:

Clinical staff Admin staff Office expense Supplies Equipment Other Total

12.3 5.8 7.5 7.3 3.1 4.4 40.4

65404 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Comment: Many individuals and

several specialty groups expressed

concern about the relatively low rates

contained in the July 2000 proposed

rule with respect to pain management

services. They suggested that this may

be due to the practice expense

component for these services being

undervalued. They also pointed out that

a few of the services seemed to have

significant reductions.

Response: A few of the pain

management codes were affected by a

programming error related to work

RVUs. We apologize for the error and

ensured that this was corrected in this

final rule. To the extent that the rates

are low due to the practice expense

component being undervalued, we

would recommend that specialty groups

forward the codes in question to the

RUC/PEAC for refinement.

B. Geographic Practice Cost Index

Changes

The Act requires that payments vary

among fee schedule areas to the extent

that resource costs vary as measured by

the GPCIs. Section 1848(e)(1)(C) of the

Act requires us to review and, if

necessary, adjust the GPCIs at least

every 3 years. This section of the Act

also requires us to phase in the

adjustment over 2 years and implement

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. (A detailed discussion of the

development of the GPCIs and

references to obtaining studies on the

development of the GPCIs can be found

in the July 17, 2000 proposed rule (65

FR 44189).) The first review and

revision was implemented in 1995, and

the second review was implemented in

1998.

The 2001 through 2003 GPCIs

represent the third GPCI update. The

2002 GPCIs (Addendum D) are the fullyrevised GPCIs. The 2001 GPCIs

(Addendum E) represent the one-half

transition GPCIs. Addendum F shows

the estimated effects on area payments

of the fully-revised 2002 GPCIs. The

payment effects in 2001 will be about

one-half of these amounts.

The same data sources and

methodology used for the 1998 through

2000 GPCIs were used for the 2001

through 2003 GPCIs. The only

differences between the 1998 through

2000 GPCIs and the proposed GPCIs are

in the cost shares and RVU weighting.

1. Work Geographic Practice Cost

Indices

The work GPCIs are based on the

decennial census. The 1992 through

1994 work GPCIs were based on 1980

census data because 1990 census data

were not yet available. The work GPCIs

were revised in 1995 with new data

from the 1990 census. New census data

will not be available again until after the

2000 census. We searched for other data

that would enable us to update the work

GPCIs between the decennial censuses,

but no acceptable data sources were

found.

We therefore made no significant

changes to the 2001 through 2003 work

GPCIs from the 1998 through 2000 work

GPCIs, other than the generally

negligible changes resulting from using

1998, rather than 1994, RVUs for this

GPCI update, because we were unable to

find acceptable data for use between the

decennial censuses. We believe that

making no changes is preferable to

making inaccurate changes based on

unacceptable data. We believe that this

is a reasonable position given the

generally small magnitude of the

changes in payments resulting from the

changes in the work GPCIs from the

1980 to the 1990 census data.

2. Practice Expense Geographic Practice

Cost Indices

a. Employee Wage Indices

As with the work GPCIs, the

employee wage indices are based on

decennial census data. For the same

reasons discussed above pertaining to

the work GPCIs, we are not changing the

employee wage indices during this GPCI

update.

b. Rent Indices

The office rental indices are again

based on HUD residential rent data. No

changes have been made in the

methodology. The rental indices are

based on 2000 rather than 1994 HUD

data.

c. Medical Equipment, Supplies, and

Miscellaneous Expenses

As with all previous GPCIs, this

component will be given a national

value of 1.000, indicating no measurable

differences among areas in costs.

3. Malpractice Geographic Practice Cost

Indices

As with the previous GPCIs,

malpractice premium data were

collected for a mature ‘‘claims made’’

policy with $1 million to $3 million

limits of coverage, with adjustments

made for mandatory patient

compensation funds. The only

difference is that we proposed to use

more recent data. The proposed

malpractice indices are based on 1996

through 1998 data, compared to the

1992 through 1994 data used in the

previous GPCI update.

We received the following comments

and responses on our proposed GPCI

changes.

Comment: One commenter stated that

Medicare physician reimbursement

should not vary by geographic area.

Response: The law requires that

payments vary among payment

localities as locality cost differences

vary as measured by the GPCIs.

However, the work GPCI by law reflects

only 1⁄4 of the difference in the relative

value of physicians’ work in the area

and the national average.

Comment: One commenter stated that

we should not use census data on the

earnings of other highly educated

professionals as a proxy for physician

earnings. The commenter suggested that

we instead use IRS income tax data on

actual physician income, which also has

the advantage of being available on an

annual basis rather than every 10 years

like the decennial census.

Response: As stated in this year’s

proposed rule and in all previous

reports on the GPCIs, the actual reported

earnings of physicians were not used to

adjust geographical differences in fees

because the fees are in large part a

determinant of the earnings. We believe

that the earnings of physicians will vary

among areas to the same extent that the

earnings of other professionals vary. The

GPCI compares average hourly wages of

professionals among geographic areas.

IRS data on the earnings of physicians

and other professionals were previously

examined as a possible work GPCI data

source. The IRS data were rejected for

numerous reasons, chiefly because—(1)

they did not control for hours worked,

and thus, average hourly earnings could

not be determined; (2) the business tax

returns of physicians and other

professionals include entrepreneurial

return, as well as the opportunity cost

of time (what a physician on salary

could earn per hour); and, (3) the

business returns contain no information

on the number and mix of employees

(physicians are included with other

nonphysician employees). The Medicare

physician fee schedule is based on the

principle that fees should reflect costs,

such as opportunity wages, but not

other factors, such as entrepreneurial

profit.

Comment: Two commenters stated

that the rent GPCI for Puerto Rico is

severely understated. They believe the

HUD rental data to be inordinately low

relative to the national average because

of the high level of poverty in Puerto

Rico. They believe that physician rents

are relatively higher compared to the

national average than reflected by the

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65405

HUD data. The commenters suggested

that we fund a special study to examine

the rental costs in Puerto Rico to see if

the HUD rent proxy is inadequate to

reflect physician rental costs, and, if so,

to expand the study to other areas with

inordinately high poverty rates.

Response: For the next GPCI update,

we will again look for alternative

sources to the HUD data.

Comment: One commenter whose

malpractice GPCI would have decreased

under the proposed rule stated that this

would reflect decreasing malpractice

premiums, while in reality their

malpractice premiums have increased

since 1997, and, therefore, their

malpractice GPCI must be wrong.

Response: A decreasing malpractice

GPCI does not necessarily reflect

decreasing malpractice premiums. An

area’s malpractice GPCI reflects its

relative position compared to the

national average. An area could have

increasing malpractice premiums and

still experience a decrease in its

malpractice GPCI if its premiums

increased less than the national average

rate of increase.

Comment: A commenter from Kansas

commented that Kansas prohibits

territorial rating of malpractice

premiums within the State; yet we show

two different malpractice GPCIs for

Kansas. They state that one of these

must be an error.

Response: We agree. Kansas is a single

statewide locality under the physician

fee schedule. We show two sets of

GPCIs because Kansas is served by two

carriers. However, the GPCIs should be

the same. The malpractice GPCI shown

in the proposed rule for carrier 00740

was erroneous. Both carriers should

have the same malpractice GPCI of

0.823.

Result of Evaluation of Comments

The 2002 fully-effective revised GPCIs

and the transitional 2001 revised GPCIs

can be found at Addendum D and

Addendum E, respectively. No changes

were made in the 2002 and 2001 GPCIs

from those proposed in the July 17, 2000

proposed rule, except to correct the

erroneous Kansas malpractice GPCI

discussed above. Since the revised

GPCIs could result in total payments

either greater or less than payments that

would have been made if the GPCIs

were not revised, it was necessary to

adjust the GPCIs for budget neutrality as

required by law. Therefore, we adjusted

the 2001 through 2002 GPCIs as follows:

work by 0.99699; practice expense by

0.99235; and malpractice by 1.00215.

C. Resource-Based Malpractice Relative

Value Units

Resource-based malpractice RVUs

replaced the prior charge-based

malpractice RVUs on January 1, 2000. A

detailed description of the methodology

used in establishing the 2000

malpractice RVUs can be found in the

July 1999 proposed rule (64 FR 39610)

and the November 1999 final rule (64

FR 59383). The 2000 malpractice RVUs

are based on 1993 through 1995

malpractice insurance premium data,

the latest data available when we began

collecting data to establish the resourcebased malpractice RVUs. We stated in

last year’s proposed and final rules that

we were collecting more recent

premium data, and would update the

malpractice RVUs as soon as we had

finished collecting and analyzing the

more recent data.

In the July 2000 proposed rule we

stated that we had obtained, and were

currently examining, malpractice

premium data for 1996 through 1998.

We provided a table that compared the

1993 through 1995 average premiums

(used to calculate the 2000 malpractice

RVUs) with the 1996 through 1998

average premiums (used to calculate the

2001 malpractice RVUs). The table

showed that there was very little change

in the national average premiums from

1993 through 1995 to 1996 through

1998. We, therefore, anticipated

minimal changes in malpractice RVUs

from use of the more recent data.

In addition, in response to comments

received on last year’s rule, we

proposed to accept a comment regarding

crosswalking specialties. We proposed

to crosswalk surgical oncology to

general surgery rather than to all

physicians. We also indicated that the

malpractice values to be included in the

final rule reflecting the updated data

would remain interim.

Comment: Numerous commenters

commended the use of more recent 1996

through 1998 malpractice premium data

to replace the 1993 through 1995 data in

calculating the malpractice RVUs.

Response: We plan to use the most

recent available data in updating

malpractice RVUs.

Comment: Commenters stated that

since the proposed 2001 malpractice

RVUs were not available for comment in

the July proposed rule, and are being

seen for the first time in this final rule,

they be considered interim and subject

to comment and revision.

Response: We agree. The proposed

2001 malpractice RVUs will be

considered interim, subject to revision

in 2002 based on comments received on

this final rule.

Comment: Some commenters stated

that they were unable to duplicate the

malpractice RVU calculations using the

premium data and risk factors shown in

our previous proposed and final rules.

They requested that we provide them

with all necessary information to

reproduce the malpractice RVUs.

Response: To address this concern,

we had our contractor, KPMG

Consulting, prepare a technical

addendum. This addendum presents a

detailed explanation of all of the

information used—a table of specialty

premiums, risk factors for each specialty

either from the premium data or insurer

rating manuals, code crosswalks for new

and revised CPT codes, and the budgetneutrality factor used by KPMG—with

examples of the methodology used in

calculating the malpractice RVUs. It also

discusses special circumstances, such as

the use of different risk factors for OB/

GYN for surgical, nonsurgical, and

delivery services, and the use of the

surgical risk factor for cardiology for

certain cardiac catheterization services

even though the services are not in the

surgery section of CPT. When combined

with our 1999 specialty utilization data,

it should be possible to reproduce

KPMG’s malpractice RVU calculations.

This technical document can be found

at Addendum G.

Comment: One commenter stated that

we should explore the collection of nonM.D. and non-D.O. premium data (such

as for podiatrists, chiropractors, and

nurse practitioners) for future

malpractice RVU updates.

Response: We will consider searching

for such data for specialties such as

podiatrists and chiropractors. We would

not expect to collect such information

for groups such as nurse practitioners

since the law establishes their payments

at 85 percent of the physician rate.

Comment: One commenter suggested

that certain invasive electrophysiology

codes, have the same relative risks as

cardiac catheterization codes, and

should be assigned a surgical risk factor

similar to the risk factor assigned to

cardiac catheterization codes.

Response: We agree, and have

assigned a surgical risk factor to CPT

codes 93600 through 93612, 93618

through 93641, and 93650 through

93652.

Comment: One commenter stated that

since most OB/GYNs perform both

obstetrics and gynecology, the higher

obstetrics premium should be used for

all services performed by OB/GYNs.

Response: We disagree. This comment

was also addressed in the November

1999 final rule. To reiterate our

response, it is true that a physician

furnishing a wide range of services—

65406 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

from low-risk visits to high-risk

surgeries or deliveries—will probably

pay a malpractice premium driven by

the higher-risk procedures.

The purpose of the resource-based

malpractice RVUs is not to guarantee

each physician an absolute return of

malpractice costs. It is rather to

construct malpractice RVUs based on

the relative malpractice costs among

services. We believe that it is reasonable

to use the lower risk factors for the

values of the lower risk services and to

allocate the higher relative values to the

higher risk services that cause them. In

the case of OB/GYN services, the higher

obstetrical premiums were used for

services that were clearly obstetrical and

were causing the higher obstetrical

premiums; the gynecological surgical

risk factor was used for the surgical

services, and the lower nonsurgical

GYN risk factor was used for all other

services. We would further note that

even if we were to adopt the approach

suggested by this comment, it would

have very little, if any, impact on

payment rates since OB/GYN specialties

perform such a small proportion of the

low risk visits provided to patients in

the U.S.

Result of Evaluation of Comments

New malpractice RVUs based on the

more recent 1996 through 1998

premium data will become effective on

January 1, 2001. These malpractice

RVUs will be considered interim for

2001 and subject to comment and

possible revision in 2002. These

malpractice RVUs can be found in

Addendum B.

D. Critical Care Relative Value Units

Based on revisions to the definition of

critical care services (CPT codes 99291

and 99292) in the CPT manual for CY

2001, we proposed to value the

physician work at 4.0 RVUs for CPT

code 99291 and 2.0 RVUs for CPT code

99292.

In addition, consistent with our

discussion in the July 2000 proposed

rule for electrical bioimpedance (EB),

(see section H), we proposed not to

allow separate Medicare payment for EB

when it is furnished in conjunction with

critical care services (CPT codes 99291

and 99292).

Comment: Commenters supported the

revision to the physician work for these

two codes. However, in the regulatory

impact section of the July 2000

proposed rule (65 FR 44208), we stated

that ‘‘* * * any impact of this proposal

would be incorporated in the physician

fee budget neutrality calculations.’’

Commenters believed it would be

inappropriate to make a budget

neutrality adjustment, since we made no

adjustment last year. They argue that

such an adjustment would skew

payments.

Response: As indicated in the

previous response, we are restoring the

work RVUs for critical care to 4.0 for

CPT code 99291 and 2.0 for CPT code

99292. The earlier reductions to the

work RVUs were made assuming there

would be a substitution of critical care

for other services that would increase

net payments if there were no

reductions to the work RVUs. We

believe this substitution will not occur

because of additional revisions to the

definition of critical care for 2001. Thus

net payments would decrease if we do

not restore critical care RVUs to their

former levels.

Comment: One commenter urged that

we reconsider including payment for EB

services within the critical care codes,

because they believed it would have a

negative impact on its use in hospitals.

Response: The physician work

required to perform this service involves

reading and interpreting a series of

numerical measurements. This is

generally performed in conjunction with

an evaluation and management service

because the measurements produced by

this procedure are difficult to interpret

without a clinical evaluation of the

patient. We continue to believe that it is

appropriate to include payment for this

service within the critical care service

since the critical care service includes

the review of EB tests. Other services

such as the interpretation of cardiac

output measurements (CPT 93561 and

93562) are currently included in the

payment for critical care services, and

we do not believe this has had an

adverse impact on their performance in

the hospital.

Result of Evaluation of Comments

We will finalize our proposal and

value the physician work at 4.0 RVUs

for CPT code 99291 and 2.0 RVUs for

CPT code 99292. In addition, we will

not allow separate Medicare payment

for EB when provided in conjunction

with critical care services (CPT codes

99291 and 99292).

E. Care Plan Oversight and Physician

Certification and Recertification

In anticipation of CPT revisions to the

definition of care plan oversight, we

proposed establishing two new HCPCS

codes for care plan oversight to be

consistent with our payment policies.

For the 2001 physician fee schedule, we

proposed adding a new HCPCS code

G0181 (care plan oversight, home

health), using the CPT 2000 definition

associated with CPT code 99375 and a

new HCPCS code G0182 (care plan

oversight, hospice) using the CPT 2000

definition associated with CPT code

99378. The definitions proposed for

these new codes are:

G0181 Physician supervision of a

patient under care of Medicare-covered

home health agency (patient not

present) requiring complex and

multidisciplinary care modalities

involving regular physician

development and/or revision of care

plans, review of laboratory and other

studies, communication (including

telephone calls) with other health care

professionals involved with the

patient’s care, integration of new

information into the treatment plan and/

or adjustment of medical therapy,

within a calendar month; 30 minutes or

more.

G0182 Physician supervision of a

patient under care of Medicare-covered

hospice (patient not present) requiring

complex and multidisciplinary care

modalities involving regular physician

development and/or revision of care

plans, review of laboratory and other

studies, communication (including

telephone calls) with other health care

professionals involved with the

patient’s care, integration of new

information into the treatment plan and/

or adjustment of medical therapy,

within a calendar month; 30 minutes or

more.

We also stated that current policy

guidance that applied to CPT codes

99375 and 99378 will continue to apply

to these G codes, and current payments

for CPT codes 99375 and 99378 will be

maintained in G0181 and G0182.

In addition, we proposed establishing

two new HCPCS codes (G0180 and

G0179) to describe the physician’s

services involved in physician

certification (and recertification) of

Medicare-covered home health services.

These services include creation and

review of a plan of care for a patient and

verification that the home health agency

initially complies with the physician’s

plan of care. The physician’s work in

reviewing data collected in the home

health agency’s patient assessment,

including the Outcome and Assessment

Information Set (OASIS) data, would be

included in these services.

The proposed text for the new codes

was as follows:

• G0180 (referred to as Gxxx3 in the

proposal but renumbered in this final

rule) Physician services for the initial

certification of Medicare-covered home

health services, for a patient’s home

health certification period, and

• G0179 (referred to as Gxxx4 in the

proposal but renumbered in this final

rule) Physician services for the

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65407

recertification of Medicare-covered

home health services, for a patient’s

home health certification period.

Under the proposed rule, the use of

these codes would have been restricted

to physicians who are permitted to

certify that home health services are

required by a patient according to

section 1814(a)(2)(C) and section

1835(a)(2)(A) of the Act.

Under the proposed rule, the

physician certification for home health

code (G0180), could be reported only

once every 60 days, except in the rare

situation when the patient starts a new

episode before 60 days elapses and

requires a new plan of care to start a

new episode. For services within the

episode (generally beyond the first week

or two of care plan implementation) that

are consistent with the definition of care

plan oversight, the care plan oversight

code (G0181) would be used.

Because we believed that the

physician work associated with HCPCS

code G0180 is equivalent to that of a

level 3 established patient office visit

(CPT code 99213), we proposed a value

of 0.67 for the work RVUs. For G0179,

we proposed a value of 0.45 work RVUs

because we believe the work equates to

a level 2 established patient office visit

(CPT code 99212). For practice expense

RVUs, we proposed to crosswalk both

G0180 and G0179 to the practice

expense inputs currently used for care

plan oversight (CPT code 99375), since

both the certification and recertification

and care plan oversight codes do not

require a face-to-face encounter between

the beneficiary and the physician.

Care Plan Oversight

Comment: Several commenters

objected to our proposal for G codes for

care plan oversight services because the

rationale presented in the July 2000

proposed rule (65 FR 44196) for the

change was not clear. They stated that

the public was not aware of specific

definition changes proposed by the CPT

panel, so they could not determine

whether the new CPT definitions

conflicted with Medicare policy. Thus,

the commenters challenged the need for

such a complicated change.

Response: We understand the

concerns of the commenters but we

were at that time unable to provide the

full text of the revised CPT codes in the

proposed rule. The CPT Committee had

not yet released the definitions. The

2001 revised CPT code definitions for

CPT codes 99375 and 99378 make a

significant change. Specifically, the new

definitions include the time the

physician spends communicating with

non-professional caretakers involved in

delivering the home health or hospice

services.

While we recognize that non-health

professionals contribute to the care of

both home health and hospice patients,

our long-standing policy has been that

payment for these services is included

in the payment for evaluation and

management services. As we indicated

in the December 8, 1994 final rule (59

FR 63421) that originally established

Medicare policies for care plan

oversight services, we recognize for

separate payment only the physician’s

communications to the health care

professionals involved in the patient’s

care. The goal in care plan management

is to be certain that the home health or

hospice professional staff communicate

with the patient’s physician to allow the

beneficiary to receive appropriate care.

This continues to be the justification for

an additional payment.

Comment: One organization requested

clarification on whether nurse

practitioners are able to bill for care

plan oversight and physician

certification and recertification services.

They stated that the preamble

discussion suggested only physicians

may bill for these services. The

commenter believed that under the

provisions of the BBA, nurse

practitioners practicing within the scope

of State law are also permitted to

perform these services.

Response: Under the provisions of the

BBA, nurse practitioners, physician

assistants and clinical nurse specialists,

practicing within the scope of State law,

can bill for care plan oversight services.

These non-physician practitioners must

have been providing ongoing care for

the patient through evaluation and

management (E/M) services (but not if

they are involved only in the delivery of

the Medicare-covered home health or

hospice service). Sections 1814(a)(2)(C)

and 1835(a)(2)(A) of the Act require that

physicians certify and recertify the

necessity of home health care in order

for a particular beneficiary to receive

covered services. Thus, without regard

to payment issues, in order to be

effective, a certification must be made

by a physician. We agree with

commenters that, according to section

1861(s)(2)(K) of the Act, nurse

practitioners and others can perform

and, where appropriate, bill for a service

that is a physician service and within

the scope of their practice. In adopting

codes for certification and

recertification of home health services

and denominating them as billable

physician services, we might be

perceived as enabling these

practitioners to bill those codes.

However, nurse practitioners and others

not specified under section 1861(r) of

the Act cannot meet the requirements

for certifying and recertifying home

health services under sections 1814 and

1835 of the Act that independently

require physician certification and

recertification to establish the necessity

of treatment.

Comment: Many commenters

indicated they knew about the CPT

panel’s plans to change the code

definition for 2001. They indicated that

the CPT definition revision adding the

reference to non-health professionals

was merely to clarify that

communication with these individuals

is sometimes just as integral in

providing good care. Some commenters

also suggested that this was allowable

when the codes were originally

developed.

Response: We disagree with the

commenters. When we originally

established a separate payment for this

service, we established a G code to

describe the service. The CPT

subsequently adopted the code. It was

always our intent, as discussed above, to

count the time spent with other health

care professionals toward the 30-minute

threshold. Although we agree that

interactions with non-health care

professionals are important to the

overall care of patients, as explained in

the previous response, such

communication is included in the previsit and post-visit work of evaluation

and management codes.

Comment: Many commenters

expressed concern that adopting these G

codes would complicate billing for care

plan oversight services and exacerbate

confusion surrounding these services,

particularly since two sets of codes will

exist for care plan oversight (CPT and

HCPCS).

Response: Although we understand

the commenter’s concern, we feel the

revised definitions for CPT codes 99375

and 99378 necessitate the establishment

of temporary HCPCS codes G0181 and

G0182. To assure consistency with

current Medicare policy, we find it

necessary to retain the current

definitions of care plan oversight by the

use of temporary HCPCS codes G0181

and G0182.

Certification and Recertification

Comment: Commenters generally

supported the proposed new codes for

certification and recertification, and

some commenters emphasized that the

codes will have a positive impact on

patient care and also enhance the role

of the physician in home care. However,

some commenters were concerned that

the CPT/RUC process was not used for

the introduction of these codes, and

65408 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

recommended that these codes be

submitted to the CPT panel for

establishment of codes.

Response: We wanted the home

health certification and recertification

codes to become active as soon as

possible after the implementation of

Medicare’s new home health

prospective payment system that was

effective October 1, 2000. Requesting

the CPT panel to adopt these codes was

likely to delay their introduction.

However, we will now ask the CPT

panel to consider adopting these codes.

Comment: A few commenters

expressed concern that the proposed

values for the codes were provided with

no explanation; thus, it was difficult to

evaluate the proposal.

Response: To value these codes, we

estimated the value of the work

involved. We expect to re-evaluate these

services once physicians become more

familiar with the new home health

payment system and use of this

procedure code. In addition, if the CPT

panel adopts the codes, we expect that

the RUC would also review them.

Comment: A few commenters asked

whether surgeons may bill for this

service or whether the service is

included in the surgeon’s global fee.

These commenters recommended that

surgeons be allowed to bill outside the

global surgery rules.

Response: Surgeons who refer

patients for Medicare-covered home

health care and who are certifying (or

recertifying) the plan of care will be able

to report codes G0179 and G0180.

Comment: We received comments

that objected to our proposal to adjust

the conversion factor to assure that

physicians expenditures would not

increase as a result of separate payment

for this service. Some commenters

stated that a budget-neutrality

adjustment should not be performed

because they believed these were new

services that should appropriately

increase physician expenditures.

Response: We address this comment

in the impact section of this rule.

Comment: One commenter suggested

we revise the definition of certification

and delete reference to a ‘‘patient who

has not received Medicare-covered

home health services for at least 60

days.’’ There are scenarios when a

patient may require a new initial

certification but 60 days have not

lapsed.

Response: Based on the opinions of

our medical experts, we believe that

creating a new plan of care is

significantly more work than making

even major modifications to a home

health care plan. We plan to reconsider

this issue once we have more

experience with these codes.

Comment: Another commenter

expressed concern about the ambiguity

of codes for care plan oversight,

certification, and recertification. The

commenter also believed we needed to

take a more comprehensive approach to

informing physicians about the home

health prospective payment system and

new codes.

Response: We expect the discussion

of these codes in this preamble to clarify

their use. If additional questions remain,

they can be addressed to our contractors

who process Medicare bills. Our

contractors will notify physicians about

fee schedule changes for 2001.

Result of Evaluation of Comments

For care plan oversight, we are

establishing the following two new

codes as proposed:

• G0181 Physician supervision of a

patient receiving Medicare-covered

services from a participating home

health agency (patient not present)

requiring complex and

multidisciplinary care modalities

involving regular physician

development and/or revision of care

plans, review of subsequent reports of

patient status, review of laboratory and

other studies, communication

(including telephone calls) with other

health care professionals involved in

patient’s care, integration of new

information into the medical treatment

plan and/or adjustment of medical

therapy, within a calendar month; 30

minutes or more, and

• G0182 Physician supervision of a

patient receiving Medicare-covered

services from a Medicare-participating

hospice (patient not present) requiring

complex and multidisciplinary care

modalities involving regular physician

development and/or revision of care

plans, review of subsequent reports of

patient status, review of laboratory and

other studies, communication

(including phone calls) with other

health professionals involved in

patient’s care, integration of new

information into the medical treatment

plan and/or adjustment of medical

therapy, within a calendar month; 30

minutes or more.

As stated in the proposed rule,

current policy guidance that applied to

CPT codes 99375 and 99378 will

continue to apply to these G codes, and

current payments for CPT codes 99375

and 99378 will be maintained in G0181

and G0182, respectively.

For the services involved in physician

certification (and recertification) and the

development of a plan of care for a

patient for whom the physician has

prescribed Medicare-covered home

health services, we are establishing two

new codes as proposed:

• G0180 Physician services for

initial certification of Medicare-covered

home health services, billable once for

a patient’s home health certification

period. This code will be used when the

patient has not received Medicarecovered home health services for at least

60 days.

• G0179 Physician services for

recertification of Medicare-covered

home health services, billable once for

a patient’s home health certification

period. This code would be used after

a patient has received services for at

least 60 days (or one certification

period) when the physician signs the

certification after the initial certification

period.

The G0179 code will be reported only

once every 60 days, except in the rare

situation when the patient starts a new

episode before 60 days elapses and

requires a new plan of care to start a

new episode. For services within the

episode that are consistent with the

definition of care plan oversight, the

care plan oversight code (G0181) would

be used.

Consistent with section 1835(a)(2) of

the Act, a physician who has a

significant ownership interest in, or a

significant financial or contractual

relationship with a home health agency

(HHA), generally cannot bill this code

for patients served by that HHA.

We have retained the proposed

relative values, for the reasons stated

earlier. The physician work associated

with HCPCS code G0180 will be valued

at 0.67 and for G0179 the physician

work will be valued at 0.45. We will use

the practice expense inputs used for

care plan oversight (G0181) for both

codes.

F. Observation Care Codes

In the July 17, 2000 proposed rule (65

FR 44196) we indicated that allowing

payment under the fee schedule for CPT

codes 99234 through 99236,

Observation or inpatient hospital care

services (including the admission and

discharge services) for a patient on the

same date, conflicts with two policies

currently in the Medicare Carrier

Manual (MCM). Section 15505.1(c) in

the MCM states that we only pay for a

hospital admission when a patient is

admitted as an inpatient and is

discharged on the same day. Section

15504.b of the MCM states that CPT

codes 99218 through 99220 (Initial

Observation Care) should be used if the

patient is discharged on the same day as

the admission for observation only.

Observation care discharge (CPT code

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65409

99217) may be used only on the second

or subsequent days for observation care.

These policies also result in different

payments for patients whose inpatient

stay is less than 24 hours based solely

on whether they were in the hospital at

midnight. For example, a physician who

admits a patient to observation or to

inpatient care at 8 a.m. and then

discharges the patient at 8 p.m. the same

day is paid for only the admission

service. On the other hand, a physician

who admits a patient to observation or

to inpatient care at 8 p.m. and then

discharges the patient at 8 a.m. the next

day, is allowed payment for both the

admission and discharge services.

In response to these concerns, and to

clarify our payment policy, we proposed

the following:

Inpatient Stay of 24 Hours or More

We would pay for both inpatient

hospital admission services (CPT codes

99221 through 99223) and hospital

discharge services (CPT codes 99238

and 99239) when a patient is a hospital

inpatient for a period of 24 hours or

more. The medical record would have to

document that the patient was an

inpatient for at least 24 hours for both

of these services to be paid.

Inpatient or Observation Stay of Less

Than 8 Hours

If a patient is admitted as a hospital

inpatient or an observation care patient

for less than 8 hours, we will pay for

only the admission service (CPT codes

99221 to 99223 or 99218 to 99220) on

that day. The discharge service is not a

separately billable service.

Inpatient or Observation Stay of 8 or

More Hours, But Less Than 24 Hours

If a patient is admitted as a hospital

inpatient or an observation care patient

for a period of 8 or more hours, but less

than 24 hours, we will pay for both the

admission and discharge services under

CPT codes 99234 through 99236 with

the following proposed physician work

RVUs and documentation requirements:

Physician Work RVUs

To properly value both the admission

and discharge work of these services, we

proposed to continue valuing the

admission portion of the physician work

as equivalent to CPT codes 99218

through 99220 (or CPT codes 99221

through 99223) and to reduce the

discharge work RVUs from 1.28 to 0.67.

Thus, the work RVUs would be as

follows: CPT code 99234—1.95 RVUs;

CPT code 99235—2.81 RVUs; CPT code

99236—3.66 RVUs. Our policy would

allow payment for CPT codes 99234

through 99236 only for stays of equal to

or greater than 8 hours, but less than 24

hours.

In addition to the documentation

guidelines for history, physical

examination, and medical decision

making described in CPT 2000 for CPT

codes 99234 through 99236, we

proposed requiring the following to be

documented in the medical record:

• A stay involving 8 hours, but less

than 24 hours.

• The billing physician was present

and personally performed the services.

• The admission and discharge notes

were written by the billing physician.

Comment: A number of commenters

disagreed with our proposal. They

stated that we recently accepted the

work values for CPT codes 99234

through 99236 and should not make

changes now. They also stated that,

instead of finalizing our proposal, we

should change our payment policy in

the MCM regarding payment for

hospital admissions and discharges on

the same day. Other commenters said

that the proposed documentation

requirements were onerous. These

commenters said that the work value for

discharging a patient on the same day as

admission to the hospital or observation

was the same as the work value for

discharging a patient in the hospital for

one or more days.

Response: We agree with the

commenters that the work value for

discharging a patient on the same day as

admission is similar to the work value

for discharging a patient on subsequent

days.

We disagree with the commenters on

the subject of documentation. We do not

believe it is onerous to require a

physician to document the length of

time the patient remains in observation

status. Minimal documentation, such as

noting the hours in observation status,

is required in the medical record to do

this. There are other reasons to

document the time a patient was seen

and orders were written. For example,

such documentation allows physicians

and facilities to improve the quality of

care they deliver. We also continue to

believe that a recorded time requirement

is necessary to assure that patients are

truly being observed and treated for

conditions that require ongoing care.

Regarding payment for admission and

discharge on the same day, we have

long established policy that we will pay

for only one E/M service per physician

per patient per day for the same

diagnosis, and we do not wish to revisit

that policy.

Admission and discharge of a patient

from observation or the hospital on the

same calendar date should be billed as

CPT code 99234 or 99235 or 99236. The

hospital and observation admission/

discharge codes should be used when a

patient is admitted and discharged on

different calendar dates.

In view of the foregoing explanation,

our policy is as follows:

• The relative work values of CPT

codes 99234 through 99236 will remain

unchanged.

• For a physician to appropriately

report CPT codes 99234 through 99236

for Medicare payment, the patient must

be an inpatient or an observation care

patient for a minimum of 8 hours on the

same calendar date.

• When the patient is admitted to

observation status for less than 8 hours

on the same date, then CPT codes 99218

through 99220 should be used by the

physician and no discharge code should

be reported.

• When patients are admitted for

observation care and then discharged on

a different calendar date, the physician

should use CPT codes 99218 through

99220 and CPT observation discharge

code 99217.

• When patients are admitted to

inpatient hospital care and then

discharged on a different calendar date,

the physician should use CPT codes

99221 through 99223 and CPT hospital

discharge day management codes 99238

or 99239.

• For an inpatient admission and

discharge less than 8 hours later on the

same calendar date, CPT codes 99221

through 99223 should be used for the

admission service, and the hospital

discharge day management service

should not be billed.

• The physician must satisfy the

documentation requirements for both

admission to and discharge from

inpatient or observation care to bill CPT

codes 99234, 99235, or 99236. The

length of time for observation care or

treatment status must also be

documented.

We believe that this policy meets the

concerns of the commenters and allows

us to resolve the discrepancies in

payment policy regarding same day

hospital and observation care admission

and discharge.

Result of Evaluation of Comments

The work RVUs for CPT codes 99234

through 99236 used for reporting

admission for observation care, or

inpatient hospital care and discharge on

the same calendar date will not be

changed. The policies outlined above

must be followed when reporting these

codes.

65410 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

G. Ocular Photodynamic Therapy and

Other Ophthalmological Treatments

Ocular photodynamic therapy (OPT)

is a treatment recently approved by the

Food and Drug Administration for agerelated macular degeneration, the most

common cause of blindness in the

elderly. For CPT 2000, ocular

photodynamic therapy was added to

CPT code 67220, which was formerly

limited to photocoagulation by laser.

Because we believe that OPT is

significantly different from laser

photocoagulation, we proposed to

establish new HCPCS codes that

specifically identify these procedures as

follows:

Gxxx5—‘‘Destruction of localized

lesion of choroid (e.g., choroidal

neovascularization); photocoagulation

(e.g., by laser), one or more sessions.’’

We proposed using this code in place of

CPT code 67220 and maintaining the

work and malpractice RVUs and the

CPEP inputs presently used for CPT

code 67220 for payment of this new ‘‘G’’

code.

Gxxx6—‘‘Destruction of localized

lesion of choroid (e.g., choroidal

neovascularization); ocular

photodynamic therapy (includes

intravenous infusion).’’ We proposed a

value of 0.55 work RVUs and 0.52 RVUs

for the malpractice component with a

global period of ‘‘XXX.’’

We also proposed the following

practice expense inputs for non-facility

settings:

• Clinical Staff Time. Registered

nurse/ophthalmology technician—40

minutes;

• Supplies. Ophthaine, mydriacil,

myolfrin, gonisol, post myd spectacles,

verteporfin and also infusion supplies

including sterile and non-sterile gloves,

butterfly needle, syringe, band aid,

alcohol swab, staff gown, iv infusion set,

and infusion pump cassette;

• Equipment. Laser, infusion pump,

and exam lane. We noted that, while we

proposed establishment of procedure

codes for ocular photodynamic therapy,

coverage of the procedure is at the

discretion of the local carrier.

In instances where both eyes are

treated the same day, we proposed the

use of the following HCPCS add-on

code: Gxxx7—‘‘Destruction of localized

lesion of choroid (e.g., choroidal

neovascularization); ocular

photodynamic therapy (includes

intravenous infusion) other eye.’’ (List

separately in addition to Gxxx6.) For

this add-on code we proposed a ‘‘ZZZ’’

global period, with .28 work RVUs (half

of that proposed for Gxxx6) and .52

malpractice RVUs (identical to that

proposed for Gxxx6). The proposed

practice expense inputs for services in

the non-facility setting were as follows:

• Clinical Staff Time. Registered

nurse/ophthalmology technician—5

minutes;

• Supplies. Ophthaine, mydriacil,

myolfrin, and gonisol.

In addition, we identified several

other specific ophthalmological

treatments that are not distinctly

identified in CPT 2000. We proposed to

establish specific HCPCS codes for these

procedures:

‘‘Destruction of localized lesion of

choroid (e.g., choroidal

neovascularization); transpupillary

thermotherapy, one or more sessions’’;

‘‘Destruction of localized lesion of

choroid (e.g., choroidal

neovascularization); photocoagulation,

feeder vessel technique, one or more

sessions’’; and

‘‘Destruction of macular drusen,

photocoagulation, one or more

sessions’’.

We did not propose RVUs for HCPCS

codes Gxxx8 through Gxx10 and

indicated that the procedures

represented experimental procedures

and that the codes would be used for

tracking purposes.

Since publication of the proposed

rule, the AMA CPT editorial panel has

approved a CPT code for Ocular

Photodynamic Therapy, CPT code

67221, effective for CPT 2001, and

removed the procedure as an example of

a service included in CPT code 67220.

In addition, verteporfin has been

approved for inclusion in the United

States Pharmacopeia and can now be

billed separately as a drug under the

Medicare program.

Comment: Several commenters

requested that we withdraw our

proposal to establish a G code for OPT

in view of the establishment of a CPT

code for this service. These commenters

also recommended that we continue to

recognize CPT code 67220 with its

current RVUs.

Response: We agree with the

commenters and are withdrawing our

proposed G code for OPT. We will

establish RVUs for CPT 67221 as

described below. We will also continue

to recognize CPT code 67220 and will

maintain its current RVUs. We are

removing verteporfin from the supplies

included in practice expenses because

the drug is now separately billable

under Medicare.

Comment: We received comments in

agreement with our proposal to

establish an add-on G code for OPT

performed on a second eye at the same

sitting.

Response: We agree with the

commenters and are finalizing this

proposal. We will establish RVUs for

this G code as described in a response

found later in this section.

Comment: We received comments

from physician groups agreeing with our

proposal to establish three G codes for

transpupillary thermotherapy (TTT),

feeder vessel technique, and destruction

of macular drusen. It was also pointed

out that these services are not

necessarily experimental, as we had

stated in the proposed rule. All of these

commenters said that coding these

procedures as CPT 67220 was

inappropriate because the work

involved in performing these three

procedures was substantially less than

the work required for 67220. These

commenters also agreed with our goal of

tracking the utilization of these services

and offered to assist us in developing

national payment policy when

appropriate. One commenter,

representing a laser manufacturer,

recommended continuing to allow TTT

to be coded as 67220. Although this

commenter stated that the work of TTT

was similar to the work of 67220, no

rationale was submitted for this

comparison.

Response: We agree with the

commenters who supported our

proposal and are finalizing it. However,

coverage and payment for these G codes

will be at the discretion of each carrier.

We want to thank the commenters

offering to assist us in developing

national payment policy at the

appropriate time. We will review the

frequency with which these procedures

are performed on Medicare

beneficiaries, and, when there is

sufficient Medicare experience with this

procedure, we will consider

development of national payment

policies for these services.

Comment: Several national

ophthalmologic organizations submitted

detailed information and

recommendations regarding work RVUs,

practice expense inputs, and

malpractice RVUs for OPT.

Comment: Regarding work RVUs, the

physician organizations submitted a

joint recommendation of 5.08 work

RVUs for this service based on a RUC

survey and comparison of OPT to

similar retinal procedures such as CPT

codes 67141 and 67210 and the similar

photodynamic procedure 43228 and

96570.

Response: Based on comments

received from specialty societies and a

comparison of the work values for this

procedure with the work values for CPT

code 67210 (Destruction of localized

lesion of retina), we have assigned 4.01

work RVUs to this service. The

intraservice times and work intensities

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65411

for CPT codes 67210 and 67221 are

comparable. Therefore, adjusting for the

work value of the postoperative visits

(because CPT code 67210 has a 90-day

global period) and the 20 percent

retreatment rate included in CPT code

67210 and then applying the

intraservice work intensity of CPT codes

67210 and 67221 yields an appropriate

work value for CPT 67221. In addition,

we are assigning a 0-day global period

to this code, since this most accurately

reflects the pre-, intra-, and post-service

work and practice expense RVUs for

this procedure.

Comment: Commenters agreed that

the work value for performing OPT on

a second eye at the same session as the

first eye was 10 percent of the work

value for the first eye. This was felt to

be uniform for pre-, intra-, and postservice work.

Response: We agree with the

commenters and are establishing a work

RVU of 0.47 for G0184, the add-on code

for the second eye. The global period for

this code will be ZZZ as proposed.

Comment: Commenters agreed with

our crosswalk of malpractice RVUs from

CPT code 67220.

Response: We are finalizing our

malpractice RVUs as proposed.

Comment: Commenters submitted a

list of practice expense inputs for ocular

photodynamic therapy.

Response: We agree with the practice

expense inputs submitted by the

commenters; however, we are adjusting

the registered nurse time to eliminate a

duplication in the counting of tasks

reflected in their comments (reduction

of two minutes) and have omitted the

lens, which is reusable. A list of the

direct inputs for practice expense is

provided below under ‘‘Result of

Evaluation of Comments’’.

Result of Evaluation of Comments

We will continue to recognize CPT

code 67220 ‘‘Destruction of localized

lesion of choroids (e.g., choroidal

neovascularization); photocoagulation,

one or more sessions, (e.g., by laser)’’

with its current RVUs. We are

recognizing new CPT 67221

‘‘Destruction of localized lesion of

choroids (e.g., choroidal

neovascularization); photodynamic

therapy (includes intravenous

infusion)’’ for ocular photodynamic

therapy and establishing a work RVU of

4.01, a malpractice RVU of 0.52 and

using the following direct inputs for

determining practice expense:

• Clinical Staff Time. Registered

nurse—65 minutes; Certified

ophthalmology technician—14 minutes;

• Equipment. Laser, infusion pump,

exam chair and slit lamp; and,

• Supplies. Opthaine, mydriacyl,

myolfrin, gonisol, infusion kit (includes

all infusion supplies), gloves, drape,

gown, band aid.

For G0184 ‘‘Destruction of localized

lesion of choroid (e.g., choroidal

neovascularization); ocular

photodynamic therapy (includes

intravenous infusion) other eye’’ which

is the add-on code for ocular

photodynamic therapy of the second

eye, we are establishing a work RVU

0.47 and a malpractice RVU of 0.52. The

following direct inputs will be used for

calculating practice expense:

• Supplies. Opthaine, mydriacyl,

myolfrin, and gonisol.

In addition, we are establishing the

following HCPCS codes for other

ophthalmologic procedures:

G0185 for ‘‘Destruction of localized

lesion of choroid (e.g., choroidal

neovascularization); transpupillary

thermotherapy, one or more sessions’’;

G0186 for ‘‘Destruction of localized

lesion of choroid (e.g., choroidal

neovascularization); photocoagulation,

feeder vessel technique, one or more

sessions’’; and G0187 for ‘‘Destruction

of macular drusen, photocoagulation,

one or more sessions’’. Coverage and

payment for these G codes will be at the

discretion of each carrier.

H. Electrical Bioimpedance

Electrical bioimpedance (EB), a

noninvasive method of measuring

cardiac input, is a covered procedure

under Medicare, if medically necessary.

Performance of this procedure is

reported by the Level 2 HCPCS code

M0302, and the procedure is currently

carrier-priced. In the July 17, 2000 rule,

we proposed the following RVUs for

this procedure:

1. Practice Expense

We proposed the following direct

inputs for determining practice expense

RVUs.

• Clinical staff time. Registered

nurse—15 minutes.

• Supplies. Four disposable sensors,

patient gown, exam table paper, and

pillowcase.

• Equipment. Cardiac output monitor

and exam table.

2. Malpractice

We proposed 0.02 RVUs for this

procedure.

3. Physician Work

We stated that with respect to RVUs

for physician work, we had insufficient

information to propose a work value

and invited comments on this subject.

We also proposed that the payment

for this procedure be included in

reporting critical care. Therefore,

separate payment would not be made

for this procedure when provided in

conjunction with critical care services

(CPT codes 99291 and 99292).

Comment: There was general

agreement with the proposed direct

practice expense inputs. Commenters

agreed that, although the amount of time

for the procedure can vary, the typical

time is 15 minutes. They noted that the

price for the sensors per treatment was

higher than the type of sensors used in

an EKG. Commenters also indicated that

the average cost of the bioimpedance

monitor was $27,000 (we had priced the

equipment at $22,790). A specialty

group provided direct practice data

obtained from a survey they had

conducted. The data reflected similar

supplies as proposed, with the addition

of alcohol swabs and also stated the

price of the equipment was $26,225.

These data also reflected a clinical staff

(registered nurse) time of 29 minutes.

Response: For the practice expense

inputs, we are adjusting the cost used

for the bioimpedance monitor

(increasing the proposed amount

$22,790 to $25,700). In addition, the

alcohol swabs will be added to the

supplies. The specific price allocated to

the disposable sensors was $9.95 which

was comparable to the $9 to $10 range

reflected in the comments received;

therefore, no change is being made to

the price of the sensors. We are making

no adjustment to the clinical staff time

because, based on further discussions

and observation of the service being

performed, we believe 15 minutes of

registered nurse time is reasonable.

Comment: While some commenters

agreed with the proposed value of .02

for malpractice, a few commenters

indicated that the proposed value of .02

for malpractice was slightly low. They

recommended a value of .06 that is the

malpractice RVU for CPT code 93720

(plethysmography).

Response: We will finalize our

proposal of .02 RVUs for the malpractice

component of this service because we

continue to believe it is most similar to

the malpractice component for an EKG.

Comment: Commenters recommended

work values ranging from 0 work RVUs

to work RVUs similar to EKG

Interpretation (CPT code 93010), Total

Body Plethysmography (CPT code

93720), Exercise Tolerance Test (CPT

code 93018), Cardiac Output

Measurement by thermodilution (CPT

code 93561) and Echocardiography

(CPT code 93320).

Response: The physician work

required for performance of this service

involves reading and interpreting a

series of numerical measurements. This

65412 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

is generally done in conjunction with an

evaluation and management service

because the measurements produced by

this procedure are difficult to interpret

without a clinical evaluation of the

patient. To determine what, if any, work

RVUs to establish for this procedure, we

identified physician work that would be

attributed to this procedure and would

not be billed as part of an evaluation

and management service.

The fact that the information gained

from a test is used in making treatment

decisions is irrelevant to the issue of

determining physician work (for

example, results of urinalyses, complete

blood counts (CBCs) are used to make

clinical decisions, but these tests do not

contain a physician work component).

For example, it is possible to make an

electrocardigraphic diagnosis (for

example, left ventricular hypertrophy,

acute Myocardial Infarction, Heart

Block) through analysis of the

waveforms on an EKG without a clinical

evaluation of the patient. This

separately identifiable work is what

justifies establishment of work RVUs for

interpretation of EKGs. It is not as easy

to identify separately identifiable work

in the case of cardiac bioimpedance.

The measurements produced by cardiac

bioimpedance include blood pressure,

pulse, cardiac output, vascular

resistance and thoracic fluid content.

Generally, abnormalities in any of these

do not allow a diagnosis to be made (for

example, hypertension or heart failure).

These measurements are used to

provide additional information to a

physician who is clinically evaluating a

patient, in much the same way that

results of a CBC and urinalysis are used.

However, after reviewing the comments,

we currently believe there is a small

amount of physician work in

interpreting the measurements

produced by cardiac bioimpedance that

is not billable as part of an E/M service.

For example, if a physician reviews,

interprets, and issues a report, then

separate work can be identified.

We believe that this physician work is

most similar to the work of interpreting

an EKG and have assigned a work RVU

of .17 for the professional component of

cardiac bioimpedance. We wish to

emphasize that in order for the PC to be

billed, all the requirements for billing a

diagnostic test must be satisfied. We

will also bundle the PC into critical care

when critical care services are

furnished, since the critical care service

includes the review of such tests.

Furthermore, we will allow this service

to be billed once per physician, per

patient, per day.

Result of Evaluation of Comments

For HCPCS code M0302, we are

establishing a work RVU of .17, a

malpractice value of .02 and are using

the following inputs for PE

• Clinical Staff Time. Registered

nurse—15 minutes.

• Supplies. Four disposable sensors,

patient gown, exam table paper,

pillowcase, and four alcohol swabs.

• Equipment. Cardiac output monitor

and exam table (using a price of $25,700

for the monitor).

We note that there is a TC and a PC

for this service. The direct practice

expense inputs listed above will be part

of the TC.

I. Global Period for Insertion, Removal,

and Replacement of Pacemakers and

Cardioverter Defibrillators

We proposed to change the global

period for the insertion, removal, and

replacement of pacemakers and

cardioverter defibrillators (CPT codes

33206, 33207, 33208, 33212, 33213,

33214, 33216, 33217, 33218, 33220,

33233, 33234, 33235, 33240, 33241,

33244, 33249, 33282, and 33284) to 0

days. This would permit separate

payment for any care furnished during

the post-operative period by the

physician who performed the

pacemaker or cardioverter defibrillator

procedure. We also proposed an

adjustment to the physician work RVUs

and practice expense inputs to reflect

the change in global period for these

codes.

Comment: Several physician

organizations recommended withdrawal

of this proposal. They commented that

the proposed reduction in work and

payment for these codes was too drastic

and was inappropriate since most of the

work in these procedures was

intraservice work. They also stated that

physicians who insert pacemakers and

cardioverter defibrillators generally do

not see their patients postoperatively

and do not render any postoperative

care for related conditions.

Response: We are deferring this

proposal because of the concerns raised

about the adjustment to the work RVU

under our proposed policy.

Nonetheless, we believe that some

commenters have raised points that, if

accurate, suggest that a 0-day global

period and adjustment to the work RVU

is appropriate. We proposed this policy

because of our concern that

cardiologists are providing postoperative services during the 90-day

global period, as well as evaluation and

management services to treat underlying

heart conditions that are unrelated to

the insertion, removal and replacement

of a pacemaker or cardioverter

defibrillator.

Our proposed policy was intended to

facilitate separate payment for the

evaluation and management services

unrelated to the surgical service. Our

concern was that the 90-day global

period was precluding separate payment

for the evaluation and management

services. However, we received

comments that indicated that

cardiologists do not typically provide

the post-operative services related to

surgical service. If this is the case, we

believe that a 0-day global period is

appropriate for these procedures.

Moreover, if the comment is accurate,

the current (not the proposed) work and

practice expense RVUs are likely

overstated because these values are

based on one physician providing both

the surgical and post-operative services.

In general, we believe that the

refinement process is useful for

revaluing services when the nature of

the service has changed from its

previous valuation. If the commenters

are correct, the issue of the global period

and appropriate relative value units for

these services will need further review.

We look forward to working with the

physician community to better

understand the typical practice with

regard to the provision of services

related to insertion, removal and

replacement of pacemakers and

cardioverter defibrillators. We welcome

any review of this issue that may be

undertaken by the RUC as part of their

recommendation related to the 5-year

review of work and the PEAC on issues

related to practice expense.

Nevertheless, we are not finalizing

our proposal with respect to this issue

because we believe that physicians have

raised valid concerns that the

adjustment to the work RVU in the

proposal may result in an

underpayment for the service. Until

there is further review of this issue, we

are continuing with current pricing for

these services and the use of a 90-day

global period.

Result of Evaluation of Comments

No change will be made to the global

period for CPT codes 33206, 33207,

33208, 33212, 33213, 33214, 33216,

33217, 33218, 33220, 33233, 33234,

33235, 33240, 33241, 33244, 33249,

33282, and 33284 in this rule.

J. Antigen Supply

In the July 2000 rule we proposed

amending § 410.68(b), Antigens: Scope

and conditions, to change the limitation

of antigen supply from 12-weeks to 12-

months to be more reflective of current

industry standards and guidelines.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65413

Comments: The majority of

commenters, including national and

State specialty associations, supported

this change and indicated that it was not

only reflective of current industry

standards but would improve patient

care and benefit patients and

practitioners alike. However, a few

commenters did not agree with this

revision, and felt that stability of the

extracts over time is still questionable.

They recommended that the 12-weeks

limitation be maintained, or that it be

changed to no more than 6 months.

Response: We continue to believe that

revising the regulation is appropriate, so

that it is reflective of current industry

standards. To the extent that the 12-

month time period is inappropriate for

specific antigens, it is a physician’s

responsibility to assure that the clinical

potency of the antigen is preserved by

furnishing a supply of antigens for a

shorter time frame. The revision to the

regulation simply allows a physician to

furnish a 12-month supply of antigens

when the physician believes it is

appropriate, based on the specific

antigens involved.

Result of Evaluation of Comments

We are revising the regulation at

§ 410.68(b) as proposed.

K. Low Intensity Ultrasound

We proposed to remove the RVUs that

were assigned to CPT code 20979, low

intensity ultrasound stimulation to aid

bone healing. We made this proposal

because of concerns raised by

commenters, and because the service

was a noncovered service under

Medicare.

Comment: One specialty organization

pointed out that on July 31, 2000,

subsequent to publication of the

proposed rule, a HCFA National

Coverage Decision Memorandum was

issued stating that ultrasound

stimulation for the treatment of

established nonunions is now covered

under Medicare.

Response: As pointed out by the

commenter, since publication of our

proposed rule on July 17, 2000, a

National Coverage Decision has been

made that states that low intensity

ultrasound will be covered by Medicare

as a treatment modality for nonunion of

extremity fractures. This restricted

coverage takes effect on April 1, 2001.

Therefore, this service will be

noncovered until that time. Although

low intensity ultrasound was approved

under the durable medical equipment

benefit, a single training session for the

patient in the use of the device is

required. This session is generally

provided by a physician, or under the

direction of a physician, and is

appropriately reported as CPT code

20979, ‘‘Low intensity ultrasound

stimulation to aid bone healing,

noninvasive (nonoperative)’’. This

service is comparable to the service

provided under CPT code 20974

‘‘Electrical bone stimulation to aid bone

healing; noninvasive (nonoperative)’’.

Both are training sessions provided to a

patient once per course of treatment by

a physician or under a physician’s

direction. Based on this, and in light of

concerns raised on the interim RVUs

contained in last year’s final rule, we

will crosswalk the work RVUs and the

malpractice RVUs for CPT code 20974

to CPT code 20979. We will use the

following direct inputs for determining

practice expense:

• Clinical Staff Time. Technician—45

minutes.

• Equipment. Exam table.

• Supplies. Minimum visit package.

In addition, we are assigning a global

period of ‘‘XXX’’. However, we expect

that CPT code 20979 will be billed only

once per treatment period, and we will

require the use of the -25 modifier with

any E/M service billed by a physician

for the same patient on the same day as

CPT code 20979. Therefore, any E/M

service billed in addition to CPT code

20979 must be distinct and separately

identifiable.

Comment: One commenter agreed

with our proposed elimination of RVUs

for this code, and requested that we

eliminate all RVUs for status N codes

(that is, codes that are non-covered by

Medicare). The commenter felt that the

RVUs associated with status N codes

may contain overvalued

misrepresentations and that since nongovernmental insurers use the Medicare

Fee Schedule as a basis for payment, use

of RVUs for status N codes grossly

misrepresents equitable payment for

these types of services.

Response: As noted in the response

above, based on the National Coverage

Decision Memorandum, we are

retaining the RVUs for CPT code 20979

in the Medicare fee schedule. We will

further review issues related to

publishing RVUs for non-covered

services and may address it in future

rulemaking.

Result of Evaluation of Comments

We are assigning .62 work RVUs and

.04 malpractice RVUs to CPT code

20979 (which are the values also used

for CPT code 20974) and the direct

inputs of: technician time of 45 min., an

exam table, and minimum supply

package will be used to determine

practice expense. We note that the

inputs for practice expense are subject

to refinement.

L. Implantation of Ventricular Assist

Devices

In the July 2000 rule, we proposed to

revise the practice expense RVUs

associated with the CPT codes 33975

and 33976 (implantation of ventricular

assist devices) to reflect an ‘‘XXX’’

global period. The purpose of this

revision was to ensure that the practice

expense RVUs reflect the global period

change published in the April 11, 2000

correction notice (65 FR 19332) to the

November 1999 final rule. No comments

were received on this proposal and we

are finalizing it as proposed.

III. Other Issues

A. Incomplete Medical Direction

We currently do not have a national

policy that instructs carriers on the

method of payment for a service when

the anesthesiologist does not fulfill all

the medical direction requirements. One

option carriers may use is instructing

the anesthesiologist to report this

service as a reduced or unusual service

to determine appropriate payment. We

did not make a specific proposal, but

indicated that we would like to clarify

this policy. We outlined possible

options in the July 2000 proposed rule

that could be alternatives for future

rulemaking consideration. We requested

comments, particularly from physicians

and practitioners most affected by this

policy.

We received comments from both of

the major anesthesia groups, the

American Society of Anesthesiologists

and the American Association of Nurse

Anesthetists, as well as a few state

anesthesiology groups and practicing

anesthesiologists. We will review these

suggestions as we determine whether to

make a future proposal.

B. Payment for Pulse Oximetry Services

In the July 2000 proposed rule, we

clarified that we will continue to pay

separately for certain diagnostic codes,

including pulse oximetry (CPT codes

94760 and 94761), when they are

medically necessary and there are no

other services payable under the

physician fee schedule billed on the

same date by the same supplier.

Comment: Commenters were

appreciative of the policy clarification;

however, they continue to believe that

we should allow separate payment for

this service when provided in

conjunction with other services,

particularly after years of paying

separately for this service. Under

current policy, physicians are unable to

65414 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

receive payment for the practice

expense associated with the service if it

is provided on the same day as another

service (for example, E/M). Commenters

continue to believe that there is

additional identifiable work involved

that should be paid by Medicare. One

commenter stated that this activity is

not included in an E/M vignette, and

thus, it should not be bundled into an

E/M service.

Response: As explained in last year’s

final rule, we believe pulse oximetry is

no more resource intensive, and

arguably less so, than recording the

patient’s temperature, another example

of a diagnostic service for which we do

not make separate payment. Because

this technology has progressed and been

simplified and reduced in cost, pulse

oximetry is a routine, minor part of a

procedure or visit. We will continue to

bundle payment for CPT codes 94760

and 94761 when they are provided the

same day as other services. The

interpretation of pulse oximetry is part

of the medical decision making

included in the E/M service. The

medical decision making process

involves the physician’s assessment and

treatment plan unique to the individual

patient. CPT vignettes are examples and

do not necessarily include every

potential activity which may occur in

the medical decision making process.

Comment: One commenter pointed

out that we require an arterial blood gas

(ABG) or pulse oximetry for patients

requiring oxygen, and that an ABG is a

more expensive service than pulse

oximetry, and also can be more

burdensome to the patient. Therefore,

we should continue to reimburse for

this service.

Response: As previously explained,

we will make separate payment for

pulse oximetry services (CPT codes

94760 and 94761) when it is medically

necessary and there are no other

services payable under the physician fee

schedule billed on the same day by the

same supplier.

Result of Evaluation of Comments

We will continue with the policy of

bundling payment for pulse oximetry

(CPT codes 94760 and 94761) when it

is provided on the same day as another

service. Separate payment for these

codes may be made only when the

services are medically necessary and

there are no other services payable

under the physician fee schedule billed

on the same date by the same supplier.

C. Outpatient Therapy Supervision

In the July 2000 proposed rule, we

clarified that therapy assistants must be

personally supervised by the therapist

in private practice and employed

directly by the therapist, by the

partnership or group to which the

therapist belongs. We did not make a

proposal, and the discussion was

provided for informational purposes

only. We felt that this explanation was

necessary, since revisions in the

November 1998 final rule (63 FR 58814)

had prompted confusion in the therapy

industry. They believed that we had

misinterpreted the supervision

requirement or had established a new

requirement for therapy assistants in the

private practice setting. We wanted to

clarify that the requirements for therapy

assistants in a private practice setting

had not changed from the longstanding

requirements established in Medicare

Carriers Manual (MCM) instructions

(see section 2215F, HCFA Pub. 6)

revised in 1981.

Comment: Two therapy associations

asserted that we have established a new

supervision requirement for therapy

assistants in the private setting. They

base their assertion upon an analysis of

the legislative and regulatory history

pertaining to supervision of therapy

assistants in a private practice setting.

According to the associations, we

should state in this rule that direct

supervision, rather than personal

supervision, is required for therapy

assistants in the private practice setting.

In addition, they requested this

statement because Medicare carriers are

now examining claims prior to 1999,

and seeking money from therapists for

services furnished without the therapist

being ‘‘in the room’’ with the therapy

assistant.

Response: In light of the comments

received, we are carefully examining

this issue. We did not propose any

change in the supervision requirement

for therapy assistants in the private

setting in the final rule published

November 2, 1998 (63 FR 58860). Any

change in the level of supervision

would need to be addressed in a future

proposed rule.

Comment: Two medical associations

requested clarification as to whether a

physical therapist could bill for services

without ever providing or supervising

the performance of that service. In

addition, clarifications were requested

about the application of the physical

therapy supervision policy and the

‘‘incident to’’ rules applicable to the

physician services benefit.

Response: First, we note that the

physical therapy supervision policy

only relates to the therapist in the

private practice setting. A therapist

cannot bill for services that he or she

has not either personally performed or

supervised the performance of the

service. Moreover, there is no ‘‘incident

to’’ provision in the physical therapy

benefit, unlike the physician services

benefit. However, a physician may

employ a therapist, and the services of

the therapist may be billed as ‘‘incident

to’’ the physician’s services if all the

requirements of section 2050 through

2050.1 of the MCM are met.

Comment: A revision in section

2050.2 of the MCM is urged by a

psychiatric association to allow

physicians who own a practice to be off

the premises when other legally

authorized practitioners, for example,

psychologists and clinical social

workers are present. An analogy to

physical therapists in private practice

was provided.

Response: The regulatory change that

allowed physical therapists in private

practice to be off the premises when

other qualified therapists are present

resulted from Congressional statements

in both the House and Senate committee

reports associated with our fiscal year

1997 appropriations process. To address

the concerns expressed in these reports,

we revised the regulations at

§§ 410.59(c)(2) and 410.60(c)(2). With

respect to the commenters reference to

section 2050 of the MCM, this section

discusses services and supplies

furnished ‘‘incident to’’ a physician’s

professional services. As stated in

section 2050.2 of the MCM, in order for

the services of a nonphysician

practitioner to be covered as incident to

the services of the physician, the

services must meet all the requirements

for coverage specified in sections 2050

through 2050.1. There is no analogy

between physicians and therapists in

this circumstance, because there is no

similar benefit covering services and

supplies provided incident to a

therapist’s professional services. We

have, therefore, no plans to revise

section 2050.2 of the MCM. We would

also note that some practitioners, such

as clinical psychologists and clinical

social workers, have a statutory benefit

under Medicare, and may provide and

bill for services without supervision of

a psychiatrist.

D. Outpatient Therapy Caps

Section 221 of the BBRA placed a 2-

year moratorium on Medicare Part B

outpatient therapy caps (the $1500 cap

on outpatient physical therapy services

including speech language-pathology

services and the $1500 cap on

outpatient occupational therapy services

in all nonhospital settings). The two

$1500 caps were implemented in 1999

as required by the BBA.

The BBRA also requires us to submit

to the Congress a report by January 1,

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65415

2001 that includes recommendations

on—(1) the establishment of a

mechanism for assuring appropriate

utilization of outpatient therapy

services; (2) the establishment of an

alternative payment policy for

outpatient therapy services based on

classifications of individuals by

diagnostic category, functional status,

prior use of services (in both inpatient

and outpatient settings), and other

criteria, in place of uniform dollar

limitations, and (3) how to do this in a

budget-neutral manner.

In the July 17, 2000 rule, we provided

examples of informal recommendations

we have received on this issue, and

asked for comments from the public on

other alternatives that we might

consider in developing a payment

policy for outpatient therapy services.

We indicated that this information

would be considered in preparing our

report to Congress on outpatient therapy

services.

Result of Evaluation of Comments

Several organizations commented on

the issue of outpatient therapy caps.

Some groups responded to the examples

provided in the proposed rule, while

others offered other alternatives. We

appreciate the information provided and

will consider it as we develop the report

to Congress.

E. HCPCS G Codes

Several commenters recommended

that, instead of creating G codes, we

work more closely with the AMA CPT

Editorial Panel to establish or revise

CPT codes to meet our requirements.

We have a long-established working

relationship with the AMA CPT

Editorial Panel. We prefer the use of

CPT codes to the use of G codes for

reporting physicians’ services. In fact,

this year, we initiated the establishment

of a new CPT code that describes ocular

photodynamic therapy (67221) for CPT

2001, and the revision of an old CPT

code (67220) to remove ocular

photodynamic therapy. We did this

proactively to avoid the need to

establish a G code. We, along with the

ophthalmology societies, brought these

recommendations to the CPT Editorial

Panel. Thus we were able to withdraw

our proposal for a G code for ocular

photodynamic therapy. We also worked

with the panel to establish CPT codes

for artificial skin placement and wound

care management that will enable to us

to retire our G codes for these services.

We believe that sometimes HCPCS

level 2 codes are useful to the CPT

Editorial Panel process. For example,

use of a new service can be tracked with

the G codes to determine if a future CPT

code is appropriate.

Frequently, we create G codes to

reflect our own coverage and payment

requirements. These requirements are

usually very specific, and may make it

inappropriate to create a CPT code for

general use.

Moreover, in response to requests

from physicians and others, we make

coverage decisions on a rolling basis.

Because the CPT process requires at

least 1 year between approval and

implementation of a CPT code, we must

create a G code during the interim. We

occasionally have specific coverage and

payment requirements according to

which Medicare payment is not made

for a specific CPT code. This was the

case with the revision of the care plan

oversight codes. We specifically

informed the CPT Editorial Panel before

the codes were revised that the

proposed revisions would be

inconsistent with our established

payment policy, and, therefore, we

would need to create G codes for care

plan oversight and not use the revised

CPT codes. Similarly, we are finalizing

our proposal to create G codes for

several ophthalmologic procedures to

track the use of these services and

permit coverage and payment on a

carrier-by-carrier basis. We had

comments from the appropriate medical

specialty societies, and determined that

it was not appropriate to create CPT

codes for these services at present. The

specialty societies supported our

creation of the G codes; this mechanism

permits payment for these services

while establishing a way to track their

use. In the case of physician

certification and recertification of a plan

of care for home health services, we

created two new G codes because of our

interest in providing explicit payment

for these services as a result of

development of the home health

prospective payment system (PPS). As

we indicated in the home health PPS

rule (65 FR 41163), we have decided to

‘‘focus our attention on physician

certification efforts and education in

order to better involve the physician in

the delivery of home health services.’’

While we are imposing no new

regulatory requirements on physicians

related to these services, we felt that it

was important to establish these two

new codes quickly to allow separate

payment for these services as soon as

possible after implementation of the

home health PPS on October 1, 2000.

Use of G codes is also consistent with

section 1848(c)(5) of the Act, which

specifically provides us with the

authority to establish a uniform

procedure coding system for the coding

of all physicians’ services.

In summary, we support the use of

CPT codes. We establish G codes only

when absolutely necessary. We would

like to assure the medical community

that we will continue work with the

AMA CPT Editorial Panel to minimize

the need for G codes. However, we have

the responsibility for developing and

implementing payment policy for the

Medicare program. On occasion, we

need to establish G codes to

appropriately administer the Medicare

program.

F. Work RVUs in Proposed Rule

Comment: A few commenters stated

that work RVUs for some services were

incorrect due to the incorrect placement

of the decimal in Addendum B of the

July 2000 proposed rule (65 FR 44210).

They requested that we correct them in

the final rule.

Response: Due to a programming

error, some services were assigned

incorrect work RVUs in Addendum B of

the proposed rule. We have taken steps

to ensure that this programming error is

corrected.

G. Five-Year Refinement of Relative

Value Units

In the July 17, 2000 proposed rule (65

FR 44201), we included a discussion on

the activities underway with respect to

the second five-year refinement of work

RVUs. We indicated that we had

received comments on potentially

misvalued services from approximately

30 specialty groups, organizations and

individuals, involving over 900 codes.

We shared these comments with the

RUC, which makes recommendations to

us on the assignment of RVUs to new

and revised CPT codes. We also

discussed current initiatives involving

the validation of physician time data.

Comment: Commenters expressed

concern about the discussion on fiveyear review activities. They were unsure

as to how the contractor activities

outlined in the proposed rule would be

coordinated with the RUC

recommendations on work RVUs that

will be forwarded to us for

consideration. Commenters also

expressed concern that contractor

activities are primarily focused on

physician time. They cautioned that

other factors need to be considered in

conjunction with time (for example,

stress, physician effort, and technical

effort) when valuing physician work.

Response: We discussed the data

obtained by our contractors with the

RUC. We also discussed with the RUC

and the physician community the best

65416 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

use of the data obtained by our

contractors.

Comment: One organization stated

that, during the initial five-year review,

budget neutrality was achieved by

applying an 8.3 percent reduction to all

physician work RVUs. They strongly

encouraged us to distribute any impact

across all specialties and all CPT codes

for the current 5-year review.

Response: Based on our prior

experience, we acknowledge that there

has been significant interest in how we

make adjustments to achieve budget

neutrality as a result of work

refinement. We will discuss potential

options and propose an adjustment to

ensure budget neutrality resulting from

the work RVU refinement in next year’s

proposed rule.

Comment: One commenter asked

when the Health Economics Research

(HER) study data discussed in the

proposed rule would be available.

Response: We anticipate that the

study data will be available by

December 1, 2000. We will be posting

this information on our homepage.

(Access to the homepage is discussed in

the introductory section of this rule

under SUPPLEMENTARY INFORMATION.)

IV. Refinement of Relative Value Units

for Calendar Year 2001 and Responses

to Public Comments on Interim Relative

Value Units for 2000 (Including the

Interim Relative Value Units Contained

in the July 17, 2000 Proposed Rule)

A. Summary of Issues Discussed Related

to the Adjustment of Relative Value

Units

Section IV.B. of this final rule

describes the methodology used to

review the comments received on the

RVUs for physician work and the

process used to establish RVUs for new

and revised CPT codes. Changes to

codes on the physician fee schedule

reflected in Addendum B are effective

for services furnished beginning January

1, 2001.

B. Process for Establishing Work

Relative Value Units for the 2001 Fee

Schedule and Clarification of CPT

Definitions

Our November 2, 1999 final rule on

the 2000 physician fee schedule (64 FR

59380) announced the final work RVUs

for Medicare payment for existing

procedure codes under the physician fee

schedule and interim RVUs for new and

revised codes. The RVUs contained in

the rule apply to physician services

furnished beginning January 1, 2000.

We announced that we considered the

RVUs for the interim codes to be subject

to public comment under the annual

refinement process. In this section, we

summarize the refinements to the

interim work RVUs that have occurred

since publication of the November 1999

final rule and our establishment of the

work RVUs for new and revised codes

for the 2001 fee schedule.

Work Relative Value Unit Refinements

of Interim and Related Relative Value

Units

1. Methodology (Includes Table titled

Work Relative Value Unit Refinements

of the 2000 Interim and Related Relative

Value Units)

Although the RVUs in the November

1999 final rule were used to calculate

2000 payment amounts, we considered

the RVUs for the new or revised codes

to be interim. We accepted comments

for a period of 60 days. We received

substantive comments from

approximately 11 specialty societies on

approximately 29 CPT codes with

interim work RVUs. Only comments on

codes listed in Addendum C of the

November 1999 final rule were

considered.

We used a process similar to the

process used in 1997. (See the October

31, 1997 final rule on the physician fee

schedule (62 FR 59084) for the

discussion of refinement of CPT codes

with interim work RVUs.) We convened

a multispecialty panel of physicians to

assist us in the review of the comments.

The comments that we did not submit

to panel review are discussed at the end

of this section, as well as those that

were reviewed by the panel. We invited

one representative from each of those

specialty societies from which

substantive comments were received to

attend a panel for discussion of the

codes on which they had commented.

The panel was moderated by our

medical staff, and consisted of the

following representatives.

Voting Members

• One or two clinicians representing

the commenting specialty(s), based

upon our determination of those

specialties which are most identified

with the service(s) in question.

Although commenting specialties were

welcomed to observe the entire

refinement process, they were only

involved in the discussion of those

services for which they were invited to

participate.

• Two Primary care clinicians

nominated by the American Academy of

Family Physicians and the American

Society of Internal Medicine.

• Five Carrier medical directors.

• Four clinicians with practices in

related specialties, who were expected

to have knowledge of the services under

review.

The panel discussed the work

involved in each procedure under

review in comparison to the work

associated with other services on the fee

schedule. We had assembled a set of

reference services, and asked the panel

members to compare the clinical aspects

of the work of services they believed

were incorrectly valued to one or more

of the reference services. In compiling

the set, we attempted to include—(1)

services that are commonly performed

whose work RVUs are not controversial;

(2) services that span the entire

spectrum from the easiest to the most

difficult; and (3) at least three services

performed by each of the major

specialties so that each specialty would

be represented. The set listed

approximately 300 services. Group

members were encouraged to make

comparisons to reference services. The

intent of the panel process was to

capture each participant’s independent

judgement based on the discussion and

his or her clinical experience. Following

each discussion, each participant rated

the work for the procedure. Ratings

were individual and confidential, and

there was no attempt to achieve

consensus among the panel members.

We then analyzed the ratings based on

a presumption that the interim RVUs

were correct. To overcome this

presumption, the inaccuracy of the

interim RVUs had to be apparent to the

broad range of physicians participating

in each panel.

Ratings of work were analyzed for

consistency among the groups

represented on each panel. In general

terms, we used statistical tests to

determine whether there was enough

agreement among the groups of the

panel, and whether the agreed-upon

RVUs were significantly different from

the interim RVUs published in

Addendum C of the November 1999

final rule. We did not modify the RVUs

unless there was a clear indication for

a change. If there was agreement across

groups for change, but the groups did

not agree on what the new RVUs should

be, we eliminated the outlier group, and

looked for agreement among the

remaining groups as the basis for new

RVUs. We used the same methodology

in analyzing the ratings that we first

used in the refinement process for the

1993 fee schedule. The statistical tests

were described in detail in the

November 25, 1992 final rule (57 FR

55938).

Our decision to convene

multispecialty panels of physicians and

to apply the statistical tests described

above was based on our need to balance

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65417

the interests of those who commented

on the work RVUs against the

redistributive effects that would occur

in other specialties. Of the 11 codes

reviewed by the multispecialty panel,

all were the subject of requests for

increased values. Of the 11 interim work

RVUs that were reviewed, 9 were

increased and 2 were unchanged.

We also received comments on RVUs

that were interim for 2000, but which

we did not submit to the panel for

review for a variety of reasons. These

comments and our decisions on those

comments are discussed in further

detail below.

The table below lists the interim and

related codes reviewed during the

refinement process described in this

section. This table includes the

following information:

• CPT Code. This is the CPT code for

a service.

• Description. This is an abbreviated

version of the narrative description of

the code.

• 2000 Work RVU. The work RVUs

that appeared in the November 1999

rule are shown for each reviewed code.

• Requested Work RVU. This column

identifies the work RVUs requested by

commenters.

• 2001 Work RVU. This column

contains the final RVUs for physician

work.

REFINEMENT OF 2000 INTERIM WORK RELATIVE VALUE UNITS

CPT code Description 2000 work

RVU

Requested

work RVU

2001 work

RVU

27096 ....... Inject sacroiliac joint .............................................................................................. 1.10 1.40 1.40

61862 ....... Implant neurostimul, subcort ................................................................................. 19.34 27.34 19.34

61885 ....... Implant neurostim one array ................................................................................. 5.85 8.00 5.85

62263 ....... Lysis epidural adhesions ...................................................................................... 6.02 7.20 6.14

72275 ....... Epidurography ....................................................................................................... 0.54 0.83 0.76

73542 ....... X-ray exam, sacroiliac joint ................................................................................... 0.54 0.64 0.59

76873 ....... Echograp trans r, pros study ................................................................................ 0.99 1.92 1.55

93741 ....... Analyze ht pace device sngl ................................................................................. 0.64 0.90 0.80

93742 ....... Analyze ht pace device sngl ................................................................................. 0.73 1.03 0.91

93743 ....... Analyze ht pace device dual ................................................................................. 0.83 1.17 1.03

93744 ....... Analyze ht pace device dual ................................................................................. 0.95 1.33 1.18

*All CPT codes and descriptions copyright 2000 American Medical Association.

2. Interim 2000 Codes.

CPT code 11980 Subcutaneous

hormone pellet implantation.

We did not receive a work RVU

recommendation from the RUC for this

code, and therefore crosswalked it to

CPT 11980 for the 2000 fee schedule.

One commenter indicated that a

recommendation for work RVUs would

be included in the RUC

recommendations for 2001, and urged

that we accept this RVU

recommendation.

Final decision: The 2001 RUC

recommendation for CPT Code 11980

has been reviewed and accepted.

CPT Code 27096 Injection Procedure

for Sacroiliac Joint Arthrography and/or

Aesthetic Steroid

We reduced the work RVU for 27096

from the RUC proposed value of 1.40 to

1.10 based on a weighted average with

CPT code 20610 (Large joint injectionwork RVU of 0.79) Commenters pointed

out that while this was one of the codes

used prior to approval of CPT code

27096, it (20610) was cited as being

inadequate, because the sacroiliac joint

injection requires more precision and

skill than does a large joint (for

example, hip) injection. They also

indicated that the reduction made by

HCFA to account for the fact that this

procedure may be performed without

contrast was not justified. In light of

these comments we referred the code to

a refinement panel for review.

Final decision: As a result of the

statistical analysis of the refinement

panel ratings, the final work RVUs are

established as 1.40 for CPT code 27096.

CPT code 61862 Subcortical

neurostimulator array implantation.

The RUC evaluated this code using a

building block approach that included

the work of sterotactic localization, the

device implantation and 140 minutes of

intra-operative testing.

A few commenters expressed concern

about our rejection of the RUC

recommendation of 27.34 work RVUs

and our proposed 19.34 work RVUs. We

subtracted 8.00 RVUs attributed to 140

minutes of intra-operative testing, since

this time was variable and it could be

reported under other CPT codes. The

commenters explained that the

assignment of surgeon work during this

140 minutes of electrode maneuvering

was done by comparing the work,

including intensity, to CPT code 99291

at an equivalent rate of 4.00 RVUs for

each of the approximately 2 hours in

this average. Information was provided

during the discussion at the RUC that

the time of 140 minutes was truly an

average, with some testing requiring as

long as 3 to 4 hours to achieve

satisfactory electrode placement. The

commenters recommended that we

restore the missing 8.00 RVUs and

accept the RUC recommendation of

27.34 for this code. Due to the questions

concerning our reduction of 8.00 RVUs,

we referred this code to a refinement

panel for review.

Final decision: As a result of the

statistical analysis of the refinement

panel ratings we are retaining the work

RVU of 19.34 for CPT code 61862.

CPT Code 61885 Incision and

Subcutaneous Placement of Cranial

Neurostimulator Pulse Generator or

Receiver, Direct or Inductive Coupling;

With Connection to a Single Electrode

Array

CPT Code 61885 was revised to add

a delimiter to the code that specified

connection of the neurostimulator to a

single electrode array, and a new code

(CPT code 61886) was introduced for

situations involving two or more

electrode arrays. We had received

recommendations for work RVUs for the

revised CPT code 61885, as well as the

new CPT code 61886. Commenters

disagreed with our statement that there

was no evidence to justify an increase

in the work RVU for CPT code 61885.

We also noted that the work RVU for

this code had been increased in the last

5-year review. Commenters felt that the

RUC analyses presented supported an

increase in the work RVU. In light of

these comments, we referred this code

to the refinement panel for review.

Final decision: As a result of the

statistical analysis of the refinement

panel ratings, the final work RVUs are

5.85 for CPT code 61885.

65418 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

CPT Code 62263 Percutaneous Lysis of

Epidural Adhesions Using Solution

Injection (for Example, Hypertonic

Saline, Enzyme) or Mechanical Means

(for Example, Spring-wound Catheter)

Including Radiologic Localization

(Includes Contrast When Administered)

This was a new CPT code for which

the RUC had recommended work RVUs

of 7.20. We reduced the value to 6.02

based on two determinations—(1) that

the RUC had erroneously counted the

insertion of a catheter twice in

compiling the component services; and

(2) the appropriate building block for

the fluoroscopic guidance was code

76003, not 76005. Commenters

requested that we reconsider these

decisions. They indicated that they had

intentionally doubled the value for

catheter insertion, as insertion of a

catheter into a tight scarred epidural

space involved more work than the

typical epidural injection. They also felt

that the fluoroscopic code the RUC had

used was appropriate, and more

accurately reflected the work involved.

In response to these comments, we

referred this code to the refinement

panel for review.

Final decision: As a result of our

statistical analysis of the refinement

panel ratings the final work RVU for

CPT 62263 will be 6.14.

CPT Codes 62310, 62311, 62318, 62319

Epidural or Subarachnoid Spine

Injection Procedures

We had agreed with the relativity of

these new codes established by the

RUC, but in order to retain budget

neutrality within this family of codes,

we had to uniformly reduce the RUC

recommended values. Commenters

indicated that our calculations of the

amount of reduction in the work RVUs

needed slight adjustments. The

specialties involved in developing the

work RVUs submitted the following rescaled work RVUs that they felt were a

better reflection of the budget neutrality

adjustment while preserving the intrafamily relativity of the new codes

(62310–1.95; 62311–1.57; 62318–2.26;

and 62319–1.88).

Final decision: We reviewed the work

RVUs submitted by the specialty, and

found the proposed work RVUs not to

be budget neutral. We apply a standard

technique, using the most recent

available data, to arrive at budget

neutral values. The work RVUs, as

published in the November 1999 final

rule will be retained.

CPT Code 72275 Epidurography

We reduced the work RVUs for this

new code by approximately one third,

from the 0.83 recommended by RUC to

0.54. Commenters disagreed with this

reduction, noting that the comparison

codes selected by HCFA medical staff to

support this reduction did not

accurately reflect the work involved.

They indicated that the RUC survey

reflected that there was a greater amount

of time involved. This code was referred

to the refinement panel for review.

Final decision: As a result of our

statistical analysis of the refinement

panel ratings, we are assigning a work

RVU of 0.76 to CPT code 72275.

CPT Code 73542 Sacroiliac Joint

Arthrography

The RUC recommended value of 0.64

work RVUs was reduced to 0.54 work

RVUs based on our belief that there was

no difference in work from the primary

survey reference code (CPT code 73525

which has a work RVU of 0.54).

Commenters disagreed with this

reduction. Although the time estimates

between CPT code 73542 and the

reference code are similar, the mean

intensity/complexity measures are

consistently higher for CPT code 73542,

and therefore warranted the RUC

recommended work RVU of .64. The

RUC valued this code not only

according to the time required, but also

according to the intensity of the service.

Commenters recommended adoption of

the RUC work RVUs of 0.64 for CPT

code 73542. This code was referred to

the refinement panel for review.

Final decision: As a result of our

statistical analysis of the refinement

panel ratings, we are assigning a work

RVU of 0.59 to CPT code 73542.

CPT Code 76005 Fluoroscopic

Guidance and Localization of Needle or

Catheter Tip for Spine or Paraspinous

Diagnostic or Therapeutic Injection

Procedures (Epidural, Transforaminal

Epidural, Subarachnoid, Paravertebral

Facet Joint, Paravertebral Facet Joint

Nerve or Sacroiliac Joint) Including

Neurolytic Agent Destruction

The RUC recommended value of 0.60

work RVUs for this new code was

reduced to 0.54, because we did not

believe there was enough difference in

work from the primary survey reference

code 76003 (0.54 work RVUs).

Commenters disagreed with this

determination, and indicated that the

survey data results were evidence that

comparison between CPT codes 76005

and 76003 was not appropriate, since

the survey showed more time for CPT

code 76005, as well as a consistently

higher estimation of intensity and

complexity. Commenters also pointed

out that another established code in the

same family (CPT code 76001 with a

work RVU of .67) was also previously

used to report this service.

Final decision: The RUC

recommended .60 work RVUs for CPT

code 76005. We reduced this

recommendation to .54 work RVUs

based upon reference procedure CPT

code 76003. We inadvertently failed to

also examine the other reference

procedures identified on the RUC

survey. Based upon the other reference

procedures which were listed, CPT code

76001 (work RVU = .67), we are

changing the work RVU to the RUC

recommended value of .60.

CPT Code 76873 Prostate Volume

Study

We reduced the RUC recommendation

of 1.92 work RVUs to .99, since we did

not believe that general anesthesia is

used in this procedure. Commenters

disagreed with this point and indicated

that, because the patient must remain

motionless during the procedure,

significant sedation, either general or

spinal anesthesia, is used. Thus, this is

usually performed in a hospital

operating room (outpatient) or

ambulatory surgical center. Commenters

also objected to the comparison we

made between this code (76873) and

CPT code 76805 Echography, pregnant

uterus, B-scan and/or real time with

image documentation; complete. An

obstetric ultrasound does not require

anesthesia and is done in a physician’s

office. Commenters also questioned our

statement that we would not allow

payment for a prostate volume study

when performed on the same day as

seed implantation or other services that

are part of seed implantation. During the

RUC deliberations, it was specifically

discussed that the prostate volume

study was not included in the work for

seed implantation (CPT code 55859).

This code was referred to the refinement

panel for review.

Final decision: As a result of our

statistical analysis of the refinement

panel ratings, we are assigning a work

RVU of 1.55 to CPT code 76873.

CPT Codes 90471 and 90472

Immunization Administration

In the final rule published November

2, 1999, we included a discussion of

practice expense inputs and omitted a

discussion of the RUC recommended

work RVUs for these codes. Commenters

encouraged us to publish the values for

these codes, noting that while these are

not reimbursed under the Medicare

program, fee schedule values provide

guidance to other payers who use the

fee schedule.

Final decision: While we realize that

other payers may use the RVUs under

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65419

the physician fee schedule, since these

are noncovered services under

Medicare, we are not including values

for these services in the fee schedule.

The discussion on practice expense was

erroneously included. As we indicated

in an earlier discussion, we will be

examining the issue of including values

for noncovered services in the fee

schedule.

CPT Codes 93741, 93742, 93743, 93744

Electronic Analysis of Pacing

Cardioverter-Defibrillator

We reduced the RUC

recommendations for work RVUs for

these codes (93741–0.64; 93742–0.73;

93743–0.83, and 93744–0.95) because

we felt there were inconsistencies

between the recommendations and the

survey data. Commenters stated that the

differences in time reflected between

the earlier surveys and three 1998 and

1999 surveys were a result of the large

increase in the complexity of the

technologies associated with these

procedures over the last few years. With

older devices, there was less

information to analyze. The new

technology provides more information,

thus, the work involved is significantly

greater than it was when the reference

procedure was initially evaluated. These

codes were referred to the refinement

panel for review.

Final decision: As a result of our

statistical analysis of the refinement

panel ratings, we are assigning the

following work RVUs: 93741–0.80,

93742–0.91, 93743–1.03, 93744–1.18.

Practice Expense Refinements of 2000

Interim and Related Relative Value

Units

We received the following comments

on the interim practice expense RVUs

assigned to the new and revised CPT

codes for 2000:

CPT Code 33410 Replacement, Aortic

Valve, With Cardiopulmonary Bypass;

With Stentless Tissue Valve

A specialty group commented that the

practice expense RVUs for this code

should be slightly higher than for CPT

code 33406, Replacement, aortic valve,

with cardiopulmonary bypass; with

homograft valve (freehand), due to the

difference in the grafts. However, the

practice expense RVUs for CPT code

33410 are 0.09 less than the practice

expense RVUs for CPT code 33406. The

commenter adds that, due to this error,

physicians have received unfairly low

reimbursement for this procedure in CY

2000, and should receive fair

compensation after this error is

corrected.

Response: The RUC made no

recommendation on the practice

expense inputs for this code, but the

Society of Thoracic Surgeons

recommended that we crosswalk the

direct inputs from those assigned to CPT

code 33406, which we did. The

identified payment anomaly did not

exist in the practice expense RVUs

published in our November 1999 final

rule. There was a calculation error

reflected in the published RVU values

in the July 2000 proposed rule (65 FR

44210) that has been corrected in this

final rule. We hope that the code will be

refined soon, so that it will no longer be

necessary to use a crosswalk for the

practice expense inputs.

CPT Code 33249 Insertion or

Repositioning of Electrode Lead(s) for

Single or Dual Chamber Pacing

Cardioverter Defibrillator and Insertion

of Pulse Generator

We received comments from two

organizations representing cardiology

and pacing electrophysiology on the

interim PE RVUs for this procedure.

Both commenters indicated that the

practice expense RVUs should be

increased to account for the fact that

under the revised definition, this

procedure now includes the

implantation of dual chamber ICDs.

Response: We did not receive a

practice expense recommendation on

this revised code from either the RUC or

the specialty societies, and we kept the

practice expense inputs at their original

level. Because this is a procedure that

would only be performed in the facility

setting, an increase in the physician

work involved to perform the service

would not lead to an increase in the

practice expense, unless there would be

more post-surgical visits associated with

the revised service. No claim has been

made that this is the case. Therefore, we

believe that there is no justification for

increasing the practice expense RVUs.

CPT code 92961, Cardioversion,

elective, electrical conversion of

arrhythmia; internal (separate

procedure)

One organization indicated that, for

the PE inputs, we crosswalked this code

to CPT code 93610, intra-atrial pacing,

which does not include costs associated

with a cardioversion, which is part of

the procedure. They recommended that

we use a building block approach, using

inputs from CPT code 93610–26 (a

similar intra-atrial pacing code) and

CPT code 92960 (a similar cardioversion

code) for establishing the PE RVUs.

Response: We did not originally

receive a practice expense

recommendation on this code from

either the RUC or the specialty society.

Because this is a 0-day procedure that

would only be performed in the facility

setting, there would be few or no direct

inputs associated with the service.

Thus, an increase in the physician work

involved to perform the service would

not lead to an increase in the practice

expense. CPT code 92960 also has no

inputs in the facility setting, so

including that code as an added

crosswalk, as recommended in the

comment, would have no effect on the

practice expense RVUs for CPT code

92961. Therefore, we are making no

change in our recommended crosswalk.

CPT Code 93727 Electronic Analysis of

Implantable Loop Recorder (ILR) System

(Includes Retrieval of Recorded and

Stored ECG Data, Physician Review and

Interpretation of Retrieved ECG Data

and Reprogramming)

Two organizations objected to our

crosswalk of the practice expense inputs

for this code from CPT code 93272,

Patient demand single or multiple event

recording with presymptom memory

loop, per 30 day period of time;

physician review and interpretation

only. The commenters stated that this

crosswalk does not accurately reflect all

the practice expense inputs associated

with the service, and recommended we

crosswalk the inputs from CPT code

93271, Patient demand single or

multiple event recording with

presymptom memory loop, per 30 day

period of time; monitoring, receipt of

transmissions, and analysis.

Response: We did not originally

receive a practice expense

recommendation on this revised code

from either the RUC or the specialty

societies. We have reviewed this

comment, and have changed the

crosswalk as recommended by the

commenters.

CPT 90471/72 Immunization

Administration and CPT 99173 Visual

Screening Test

Two organizations requested that we

publish the RUC recommended values

for these immunization codes, as well as

the visual screening test and other

services with RUC recommendations

not reimbursed under Medicare,

because other payors use the RVUs

under the physician fee schedule.

Response: While we realize that other

payers may use the RBRVS fee schedule,

since these are non-covered services

under Medicare, as indicated above, we

are not including values for these

services in the fee schedule.

We received the following comments

on HCPCS codes established in the

November 2, 1999 Final Rule:

65420 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

G0166 External Counterpulsation

One commenter indicated this service

was undervalued and recommended

inputs for this code. We continue to

believe that the values assigned in last

year’s rule are appropriate, and we are

retaining these values.

G0167 Hyperbaric Oxygen Treatment

We received comments expressing

concerns about the new code, G0167,

Hyperbaric Oxygen Treatment Not

Requiring Physician Attendance, per

Treatment. The commenter requested

that we clarify the intended use of this

code. Our contractors have discretion to

cover hyperbaric oxygen with or

without physician supervision. Our

coverage staff is currently reviewing

hyperbaric oxygen therapy services

policies generally, including the

appropriate levels of physician

supervision. The progress of this review

can be tracked on our web site,

http:\\www.hcfa.gov, by selecting

Coverage Policies.

G0168 Wound Closure Utilizing Tissue

Adhesives Only

One specialty was concerned that the

services described by this code were not

coded as a simple repair as

recommended by the CPT panel. The

commenter suggested that the cost of the

supply, Dermabond, could be

reimbursed separately. Another

commenter was concerned about the 10-

day global period assigned to this code.

The work and practice expense values

for this code were based upon an

evaluation and management visit, CPT

code 99212, except that the price of

Dermabond was added as a practice

expense. We assigned these values

because many of these wounds could

have been closed with Steri-strips, a

service that is also coded with

evaluation and management, rather than

a simple repair. We will be analyzing

the use of HCPCS code G0168 to learn

more about the use of this product, and

will consider revaluing it after that

analysis is completed.

Although we believe that the typical

service involving the use of Dermabond

as the only closure will typically not

involve a visit for suture removal, we

concede that, if another visit were

needed for a complication, we should

allow another evaluation and

management visit. For this reason, we

will change the global period to 0 days.

G0169 Removal of Devitalized Tissue,

Without Use of Anesthesia

For 2000, we created G0169 to

describe a service that involved removal

of devitalized tissue. For 2001, CPT

adopted a code 97601 that is sufficiently

similar to the services described by

G0169 that we will ask providers to

utilize that code for selective removal of

devitalized tissue, and we will eliminate

G0169. We crosswalked the values for

G0169 to CPT Code 97601. This code

will continue to have no global period.

Establishment of Interim Work Relative

Value Units for New and Revised

Physician’s Current Procedural

Terminology Codes and New HCFA

Common Procedure Coding System

Codes for 2001 (Includes Table titled

American Medical Association

Specialty Relative Value Update

Committee and Health Care

Professionals Advisory Committee

Recommendations and HCFA’s

Decisions for New and Revised 2001

CPT Codes)

One aspect of establishing RVUs for

2001 was related to the assignment of

interim work RVUs for all new and

revised CPT codes. As described in our

November 25, 1992 notice in the 1993

fee schedule (57 FR 55983) and in

section III.B. of our November 22, 1996

final rule (61 FR 59505 through 59506)

we established a process, based on

recommendations received from the

AMA’s RUC, for establishing interim

work RVUs for new and revised codes.

This year we received work RVU

recommendations for approximately 131

new and revised CPT codes from the

RUC. Our staff and medical officers

reviewed the RUC recommendations by

comparing them to our reference set or

to other comparable services for which

work RVUs had been previously

established, or to both of these criteria.

We also considered the relationships

among the new and revised codes for

which we received RUC

recommendations. We agreed with the

majority of these relationships reflected

in the RUC values. In some instances,

when we agreed with the relationships,

we revised the work RVUs to achieve

work neutrality within families of

codes, that is, the work RVUs have been

adjusted so that the sum of the new or

revised work RVUs (weighted by

projected frequency of use) for a family

will be the same as the sum of the

current work RVUs (weighted by

projected frequency of use). For

approximately 91 percent of the RUC

recommendations, proposed work RVUs

were accepted, and for approximately 9

percent, we disagreed with the RUC

recommendation. In a majority of

instances, we agreed with the relativity

proposed by the RUC, but needed to

decrease work RVUs to retain budget

neutrality.

There were also 38 CPT codes for

which we did not receive a RUC

recommendation. After a review of these

CPT codes by our staff and medical

officers, we established interim work

RVUs for the majority of these services.

For those services for which we could

not arrive at interim work RVUs, we

have assigned a carrier priced status

until such time as the RUC provides

work RVU recommendations.

We received 5 recommendations from

the Health Care Professionals Advisory

Committee (HCPAC). Two of the

HCPAC recommendations were reduced

while 3 of the recommendations were

for services that we do not cover.

Additionally, there were 2 services for

which we did not receive

recommendations from the HCPAC.

The table titled AMA RUC and

HCPAC Recommendations and HCFA

Decisions for New and Revised 2001

CPT Codes lists the new or revised CPT

codes, and their associated work RVUs,

that will be interim in 2001. This table

includes the following information:

• A ‘‘#’’ identifies a new code for

2001.

• CPT code. This is the CPT code for

a service.

• Modifier. A ‘‘26’’ in this column

indicates that the work RVUs are for the

professional component of the code.

• Description. This is an abbreviated

version of the narrative description of

the code.

• RUC recommendations. This

column identifies the work RVUs

recommended by the RUC.

• HCPAC recommendations. This

column identifies the work RVUs

recommended by the HCPAC.

• HCFA decision. This column

indicates whether we agreed with the

RUC recommendation (‘‘agree’’) or we

disagreed with the RUC

recommendation (‘‘disagree’’). Codes for

which we did not accept the RUC

recommendation are discussed in

greater detail following this table. An

‘‘(a)’’ indicates that no RUC

recommendation was provided. A

discussion follows the table.

• HCFA Work RVUs. This column

contains the RVUs for physician work

based on our reviews of the RUC

recommendations.

• 2001 Work RVUs. This column

establishes the 2001 work RVUs for

physician work.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65421

AMA RUC AND HCPAC RECOMMENDATIONS AND HCFA DECISIONS FOR NEW AND REVISED 2001 CPT CODES

CPT*

code MOD Description

RUC recommendationHCPAC recommendation

HCFA

decision

HCFA work

RVU

2000 work

RVU

11980# ..... ........... IMPLANT HORMONE PELLET(S) .................... 1.48 .................... Agree ........... 1.48 1.48

15342# ..... ........... CULTURED SKIN GRAFT, 25 CM ................... 1.50 .................... Disagree ...... 1.00 1.00

15343# ..... ........... CULTURE SKN GRAFT ADDL 25 CM ............. 0.38 .................... Disagree ...... 0.25 0.25

16035 ....... ........... INCISION OF BURN SCAB, INITI .................... 3.75 .................... Agree ........... 3.75 3.75

16036# ..... ........... INCISE BURN SCAB, ADDL INCIS .................. 1.50 .................... Agree ........... 1.50 1.50

19100 ....... ........... BX BREAST PERCUT W/O IMAGE ................. 1.27 .................... Agree .......... 1.27 1.27

19101 ....... ........... BIOPSY OF BREAST, OPEN ........................... 3.18 .................... Agree ........... 3.18 3.18

19102# ..... ........... BX BREAST PERCUT W/IMAGE ..................... 2.00 .................... Agree .......... 2.00 2.00

19103# ..... ........... BX BREAST PERCUT W/DEVICE ................... 2.37 .................... Agree .......... 2.37 2.37

19120 ....... ........... REMOVAL OF BREAST LESION ..................... 5.56 .................... Agree ........... 5.56 5.56

19125 ....... ........... EXCISION, BREAST LESION .......................... 6.06 .................... Agree ........... 6.06 6.06

19126 ....... ........... EXCISION, ADDL BREAST LESION ................ 2.93 .................... Agree ........... 2.93 2.93

19295# ..... ........... PLACE BREAST CLIP, PERCUT ..................... 0.00 .................... Agree ........... 0.00 0.00

21199# ..... ........... RECONSTR LWR JAW W/ADVANCE ............. 16.00 .................... Agree .......... 16.00 16.00

22520# ..... ........... PERCUT VERTEBROPLASTY THOR .............. 8.91 .................... Agree ........... 8.91 8.91

22521# ..... ........... PERCUT VERTEBROPLASTY LUMB .............. 8.34 .................... Agree ........... 8.34 8.34

22522# ..... ........... PERCUT VERTEBROPLASTY ADDL .............. 4.31 .................... Disagree ...... 3.00 3.00

30465# ..... ........... REPAIR NASAL STENOSIS ............................. 11.64 .................... Agree ........... 11.64 11.64

33140 ....... ........... HEART REVASCULARIZE (TMR) .................... 20.00 .................... Agree ........... 20.00 20.00

33141# ..... ........... HEART TMR W/OTHER PROCEDURE ........... 4.84 .................... Agree .......... 4.84 4.84

33533 ....... ........... CABG, ARTERIAL, SINGLE ............................. 25.83 .................... Agree ........... 25.83 25.83

33534 ....... ........... CABG, ARTERIAL, TWO .................................. 28.82 .................... Agree ........... 28.82 28.82

33535 ....... ........... CABG, ARTERIAL, THREE .............................. 31.81 .................... Agree .......... 31.81 31.81

33536 ....... ........... CABG, ARTERIAL, FOUR OR MORE .............. 34.79 .................... Agree .......... 34.79 34.79

34800# ..... ........... ENDOVASC ABDO REPAIR W/TUBE ............. 20.75 .................... Agree ........... 20.75 20.75

34802# ..... ........... ENDOVASC ABDO REPR W/DEVICE ............. 23.00 .................... Agree ........... 23.00 23.00

34804# ..... ........... ENDOVASC ABDO REPR W/DEVICE ............. 23.00 .................... Agree ........... 23.00 23.00

34808# ..... ........... ENDOVASC ABDO OCCLUD DEVICE ............ 4.13 .................... Agree .......... 4.13 4.13

34812# ..... ........... XPOSE FOR ENDOPROSTH, AORTIC ........... 6.75 .................... Agree ........... 6.75 6.75

34813# ..... ........... XPOSE FOR ENDOPROSTH, FEMORL .......... 4.80 .................... Agree ........... 4.80 4.80

34820# ..... ........... XPOSE FOR ENDOPROSTH, ILIAC ................ 9.75 .................... Agree ........... 9.75 9.75

34825# ..... ........... ENDOVASC EXTEND PROSTH, INIT ............. 12.00 .................... Agree ........... 12.00 12.00

34826# ..... ........... ENDOVASC EXTEN PROSTH, ADDL ............. 4.13 .................... Agree ........... 4.13 4.13

34830# ..... ........... OPEN AORTIC TUBE PROSTH REPR ........... 32.59 .................... Agree ........... 32.59 32.59

34831# ..... ........... OPEN AORTOILIAC PROSTH REPR .............. 35.34 .................... Agree ........... 35.34 35.34

34832# ..... ........... OPEN AORTOFEMOR PROSTH REPR .......... 35.34 .................... Agree ........... 35.34 35.34

35600# ..... ........... HARVEST ARTERY FOR CABG ...................... 4.95 .................... Agree ........... 4.95 4.95

36540# ..... ........... COLLECT BLOOD VENOUS DEVICE ............. 0.00 .................... Agree ........... 0.00 0.00

36831 ....... ........... AV FISTULA EXCISION, OPEN ....................... 8.00 .................... Agree .......... 8.00 8.00

36832 ....... ........... AV FISTULA REVISION, OPEN ....................... 10.50 .................... Agree ........... 10.50 10.50

36870# ..... ........... AV FISTULA REVISION, OPEN ....................... 5.16 .................... Agree ........... 5.16 5.16

38500 ....... ........... BIOPSY/REMOVAL, LYMPH NODES .............. 2.88 .................... Agree ........... 2.88 2.88

38530 ....... ........... BIOPSY/REMOVAL, LYMPH NODES .............. 6.13 .................... Agree ........... 6.13 6.13

43231# ..... ........... ESOPH ENDOSCOPY W/US EXAM ................ 4.09 .................... Agree .......... 4.09 4.09

43232# ..... ........... ESOPH ENDOSCOPY W/US FN BX ............... 4.71 .................... Agree ........... 4.71 4.71

43240# ..... ........... ESOPH ENDOSCOPE W/DRAIN CYST .......... 7.39 .................... Agree .......... 7.39 7.39

43241 ....... ........... UPPER GI ENDOSCOPY WITH TUBE ............ 2.59 .................... Agree ........... 2.59 2.59

43242# ..... ........... UPPR GI ENDOSCOPY W/US FN BX ............. 5.51 .................... Agree ........... 5.51 5.51

43256# ..... ........... UPPR GI ENDOSCOPY W STENT .................. (a) .................... (a) ................ 4.35 4.35

43752# ..... ........... NASAL/OROGASTRIC W/STENT .................... (a) .................... (a) ................ 0.00 0.00

44132# ..... ........... ENTERECTOMY, CADAVER DONOR ............. carrier .................... Disagree ...... 0.00 0.00

44133# ..... ........... ENTERECTOMY, LIVE DONOR ...................... carrier .................... Disagree ...... 0.00 0.00

44135# ..... ........... INTESTINE TRANSPLNT, CADAVER .............. carrier .................... Disagree ...... 0.00 0.00

44136# ..... ........... INTESTINE TRANSPLANT, LIVE ..................... carrier .................... Disagree ...... 0.00 0.00

44370# ..... ........... SMALL BOWEL ENDOSCOPY/STENT ............ (a) .................... (a) ................ 4.33 4.33

44379# ..... ........... S BOWEL ENDOSCOPE W/STENT ................ (a) .................... (a) ................ 7.07 7.07

44383# ..... ........... ILEOSCOPY W/STENT .................................... (a) .................... (a) ................ 2.41 2.41

44397# ..... ........... COLONOSCOPY W STENT ............................. 4.78 .................... Disagree ...... 4.23 4.23

44500 ....... ........... INTRO, GASTROINTESTINAL TUBE .............. 0.49 .................... Agree ........... 0.49 0.49

45327# ..... ........... PROCTOSIGMOIDOSCOPY W/STENT ........... 2.66 .................... Disagree ...... 1.46 1.46

45341# ..... ........... SIGMOIDOSCOPY W/ULTRASOUND ............. 3.46 .................... Agree ........... 3.46 3.46

45342# ..... ........... SIGMOIDOSCOPY W/US GUIDE BX .............. 4.08 .................... Agree ........... 4.08 4.08

45345# ..... ........... SIGMODOSCOPY W/STENT ........................... 2.92 .................... Disagree ...... 2.66 2.66

45387# ..... ........... COLONOSCOPY W/STENT ............................. 5.66 .................... Disagree ...... 5.62 5.62

47379# ..... ........... LAPAROSCOPE PROCEDURE, LIVER ........... carrier .................... Agree ........... carrier carrier

50545# ..... ........... LAPARO RADICAL NEPHRECTOMY .............. 24.00 .................... Agree ........... 24.00 24.00

50546 ....... ........... LAPAROSCOPIC NEPHRECTOMY ................. 20.48 .................... Agree ........... 20.48 20.48

50548 ....... ........... LAPARO REMOVE K/URETER ........................ 24.40 .................... Agree ........... 24.40 24.40

50947# ..... ........... LAPARO NEW URETER/BLADDER ................ 24.50 .................... Agree ........... 24.50 24.50

50948# ..... ........... LAPARO NEW URETER/BLADDER ................ 22.50 .................... Agree ........... 22.50 22.50

65422 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

AMA RUC AND HCPAC RECOMMENDATIONS AND HCFA DECISIONS FOR NEW AND REVISED 2001 CPT CODES—

Continued

CPT*

code MOD Description

RUC recommendationHCPAC recommendation

HCFA

decision

HCFA work

RVU

2000 work

RVU

50949# ..... ........... LAPAROSCOPE PROC, URETER ................... carrier .................... Agree ........... carrier carrier

52341# ..... ........... CYSTO W/URETER STRICTURE TX .............. 6.00 .................... Agree ........... 6.00 6.00

52342# ..... ........... CYSTO W/UP STRICTURE TX ........................ 6.50 .................... Agree .......... 6.50 6.50

52343# ..... ........... CYSTO W/RENAL STRICTURE TX ................. 7.20 .................... Agree .......... 7.20 7.20

52344# ..... ........... CYSTO/URETERO, STONE REMOVE ............ 7.70 .................... Agree .......... 7.70 7.70

52345# ..... ........... CYSTO/URETERO W/UP STRICTURE ........... 8.20 .................... Agree ........... 8.20 8.20

52346# ..... ........... CYSTOURETERO W/RENAL STRICT ............. 9.23 .................... Agree ........... 9.23 9.23

52351# ..... ........... CYSTOURETRO & OR PYELOSCOPE ........... 5.86 .................... Agree ........... 5.86 5.86

52352# ..... ........... CYSTOURETRO W/STONE REMOVE ............ 6.88 .................... Agree ........... 6.88 6.88

52353# ..... ........... CYSTOURETERO W/LITHOTRIPSY ............... 7.97 .................... Agree ........... 7.97 7.97

52354# ..... ........... CYSTOURETERO W/BIOPSY .......................... 7.34 .................... Agree ........... 7.34 7.34

52355# ..... ........... CYSTOURETERO W/EXCISE TUMOR ........... 8.82 .................... Agree ........... 8.82 8.82

52400# ..... ........... CYSTOURETERO W/CONGEN REPR ............ 9.68 .................... Agree ........... 9.68 9.68

54512# ..... ........... EXCISE LESION TESTIS ................................. 8.58 .................... Agree ........... 8.58 8.58

54522# ..... ........... ORCHIECTOMY, PARTIAL .............................. 9.50 .................... Agree ........... 9.50 9.50

55873# ..... ........... CRYOABLATE PROSTATE .............................. 17.80 .................... Agree ........... 17.80 17.80

57022# ..... ........... I &D VAGINAL HEMATOMA, OB ..................... 2.56 .................... Agree .......... 2.56 2.56

57023# ..... ........... I &D VAG HEMATOMA, TRAUMA ................... (a) .................... (a) ................ 2.56 2.56

57287# ..... ........... REVISE/REMOVE SLING REPAIR .................. 10.71 .................... Agree ........... 10.71 10.71

58353# ..... ........... ENDOMETR ABLATE, THERMAL .................... 3.56 .................... Agree ........... 3.56 3.56

61697# ..... ........... BRAIN ANEURYSM REPR, COMPLX ............. 50.52 .................... Agree ........... 50.52 50.52

61698# ..... ........... BRAIN ANEURYSM REPR, COMPLX ............. 48.41 .................... Agree ........... 48.41 48.41

61700 ....... ........... BRAIN ANEURYSM REPR , SIMPLE .............. 50.52 .................... Agree ........... 50.52 50.52

61702 ....... ........... INNER SKULL VESSEL SURGERY ................. 48.41 .................... Agree ........... 48.41 48.41

62252# ..... 26 CSF SHUNT REPROGRAM ............................. 0.74 .................... Agree ........... 0.74 0.74

63040 ....... ........... LAMINOTOMY, SINGLE CERVICAL ................ (a) .................... (a) ................ 18.81 18.81

63042 ....... ........... LAMINOTOMY, SINGLE LUMBAR ................... (a) .................... (a) ................ 17.47 17.47

63043# ..... ........... LAMINOTOMY, ADDL CERVICAL ................... (a) .................... (a) ................ 0.00 0.00

63044# ..... ........... LAMINOTOMY, ADDL LUMBAR ...................... (a) .................... (a) ................ 0.00 0.00

64612 ....... ........... DESTROY NERVE, FACE MUSCLE ................ 1.96 .................... Agree ........... 1.96 1.96

64613 ....... ........... DESTROY NERVE, SPINE MUSCLE .............. 1.96 .................... Agree ........... 1.96 1.96

64614# ..... ........... DESTROY NERVE, EXTREM MUSC ............... 2.20 .................... Agree ........... 2.20 2.20

66982# ..... ........... CATARACT SURGERY, COMPLEX ................ 13.50 .................... Agree ........... 13.50 13.50

66984 ....... ........... CATARACT SURG W/IOL, I STAGE ................ 10.23 .................... Agree .......... 10.23 10.23

67221# ..... ........... OCULAR PHOTODYNAMIC THER .................. (a) .................... (a) ................ 4.01 4.01

69714# ..... ........... IMPLANT TEMPLE BONE W/STIMUL ............. 14.00 .................... Agree ........... 14.00 14.00

69715# ..... ........... TEMPLE BNE IMPLNT W/STIMULAT .............. 18.25 .................... Agree ........... 18.25 18.25

69717# ..... ........... TEMPLE BONE IMPLANT REVISION .............. 14.98 .................... Agree ........... 14.98 14.98

69718# ..... ........... REVISE TEMPLE BONE IMPLANT .................. 18.50 .................... Agree ........... 18.50 18.50

70496# ..... ........... CT ANGIOGRAPHY, HEAD .............................. 1.75 .................... Agree ........... 1.75 1.75

70498# ..... ........... CT ANGIOGRAPHY, NECK .............................. 1.75 .................... Agree ........... 1.75 1.75

70540 ....... 26 MRI ORBIT/FACE/NECK W/O DYE ................. 1.48 .................... Disagree ...... 0.98 0.98

70542# ..... 26 MRI ORBIT/FACE/NECK W/DYE ..................... 1.78 .................... Disagree ...... 1.17 1.17

70543# ..... 26 MRI ORBT/FAC/NCK W/O&W DYE ................. 2.36 .................... Disagree ...... 1.56 1.56

70544# ..... 26 MR ANGIOGRAPHY HEAD W/O DYE ............. 1.20 .................... Agree ........... 1.20 1.20

70545# ..... 26 MR ANGIOGRAPHY HEAD W/DYE ................. 1.20 .................... Agree ........... 1.20 1.20

70546# ..... 26 MR ANGIOGRAPH HEAD W/O&W DYE ......... 1.80 .................... Agree ........... 1.80 1.80

70547# ..... 26 MR ANGIOGRAPHY NECK W/O DYE ............. 1.20 .................... Agree ........... 1.20 1.20

70548# ..... 26 MR ANGIOGRAPHY NECK W/DYE ................. 1.20 .................... Agree ........... 1.20 1.20

70549# ..... 26 MR ANGIOGRAPH NECK W/O&W DYE ......... 1.80 .................... Agree ........... 1.80 1.80

71275# ..... 26 CT ANGIOGRAPHY, CHEST ........................... (a) .................... (a) ................ 1.20 1.20

71550 ....... 26 MRI CHEST W/O DYE ...................................... (a) .................... (a) ................ 1.10 1.10

71551# ..... 26 MRI CHEST W/DYE .......................................... (a) .................... (a) ................ 1.30 1.30

71552# ..... 26 MRI CHEST W/O&W DYE ................................ (a) .................... (a) ................ 1.70 1.70

72191# ..... 26 CT ANGIOGRAPH PELV W/O&W DYE ........... (a) .................... (a) ................ 1.20 1.20

72195# ..... 26 MRI PELVIS W/O DYE ..................................... (a) .................... (a) ................ 1.10 1.10

72196 ....... 26 MRI PELVIS W/DYE ......................................... (a) .................... (a) ................ 1.30 1.30

72197# ..... 26 MRI PELVIS W/O & W DYE ............................. (a) .................... (a) ................ 1.70 1.70

73206# ..... 26 CT ANGIO UPR EXTRM W/O&W DYE ............ (a) .................... (a) ................ 1.20 1.20

73218# ..... 26 MRI UPPER EXTREMITY W/O DYE ................ (a) .................... (a) ................ 0.98 0.98

73219# ..... 26 MRI UPPER EXTREMITY W/DYE .................... (a) .................... (a) ................ 1.17 1.17

73220 ....... 26 MRI UPPR EXTREMITY W/O&W DYE ............ (a) .................... (a) ................ 1.56 1.56

73221 ....... 26 MRI JOINT UPR EXTREM W/O DYE .............. (a) .................... (a) ................ 0.98 0.98

73222# ..... 26 MRI JOINT UPR EXTREM W/ DYE ................. (a) .................... (a) ................ 1.17 1.17

73223# ..... 26 MRI JOINT UPR EXTR W/O&W DYE .............. (a) .................... (a) ................ 1.56 1.56

73706# ..... 26 CT ANGIO LWR EXTR W/O&W DYE .............. (a) .................... (a) ................ 1.20 1.20

73718# ..... 26 MRI LOWER EXTREMITY W/O DYE ............... (a) .................... (a) ................ 0.98 0.98

73719# ..... 26 MRI LOWER EXTREMITY W/DYE ................... (a) .................... (a) ................ 1.17 1.17

73720 ....... 26 MRI LWR EXTREMITY W/O&W DYE .............. (a) .................... (a) ................ 1.56 1.56

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65423

AMA RUC AND HCPAC RECOMMENDATIONS AND HCFA DECISIONS FOR NEW AND REVISED 2001 CPT CODES—

Continued

CPT*

code MOD Description

RUC recommendationHCPAC recommendation

HCFA

decision

HCFA work

RVU

2000 work

RVU

73721 ....... 26 MRI JOINT OF LWR EXTRE W/O D ................ (a) .................... (a) ................ 0.98 0.98

73722# ..... 26 MRI JOINT OF LWR EXTR W/DYE ................. (a) .................... (a) ................ 1.17 1.17

73723# ..... 26 MRI JOINT LWR EXTR W/O&W DYE .............. (a) .................... (a) ................ 1.56 1.56

74175# ..... 26 CT ANGIO ABDOM W/O&W DYE .................... (a) .................... (a) ................ 1.20 1.20

74181 ....... 26 MRI ABDOMEN W/O DYE ................................ (a) .................... (a) ................ 1.10 1.10

74182# ..... 26 MRI ABDOMEN W/DYE .................................... (a) .................... (a) ................ 1.30 1.30

74183# ..... 26 MRI ABDOMEN W/O&W DYE .......................... (a) .................... (a) ................ 1.70 1.70

75635# ..... 26 CT ANGIO ABDOMINAL ARTERIES ............... (a) .................... (a) ................ 1.89 1.89

75952# ..... ........... ABDOM ANEURYSM ENDOVAS RPR ............ 4.00 .................... Agree ........... 4.00 4.00

75953# ..... ........... ABDOM ANEURYSM ENDOVAS RPR ............ 1.36 .................... Agree ........... 1.36 1.36

76012# ..... ........... PERCUT VERTEBROPLASTY FLUOR ............ 1.31 .................... Agree ........... 1.31 1.31

76013# ..... ........... PERCUT VERTEBROPLASTY, CT .................. 1.38 .................... Agree ........... 1.38 1.38

76393# ..... 26 MR GUIDANCE FOR NEEDLE PLACE ........... 1.50 .................... Agree ........... 1.50 1.50

76818 ....... 26 FETL BIOPHYS PROFIL W/STRESS .............. 1.05 .................... Disagree ...... 0.86 0.86

76819# ..... 26 FETL BIOPHYS PROFIL W/O STRS ............... 0.77 .................... Disagree ...... 0.63 0.63

76975 ....... 26 GI ENDOSCOPIC ULTRASOUND ................... 0.81 .................... Agree .......... 0.81 0.81

77520 ....... 26 PROTON TRMT, SIMPLE W/O COMP ............ carrier .................... Agree ........... carrier carrier

77522# ..... 26 PROTON TRMT, SIMPLE W/COMP ................ carrier .................... Agree ........... carrier carrier

77523 ....... 26 PROTON TRMT, INTERMEDIATE ................... carrier .................... Agree ........... carrier carrier

77525# ..... 26 PROTON TREATMENT, COMPLEX ................ carrier .................... Agree ........... carrier carrier

90940# ..... ........... HEMODIALYSIS ACCESS STUDY .................. 0.00 .................... Agree ........... 0.00 0.00

91132# ..... ........... ELECTROGASTROGRAPHY ........................... carrier .................... Agree ........... carrier carrier

91133# ..... ........... ELECTROGASTROGRAPHY W/TEST ............ carrier .................... Agree ........... carrier carrier

92585 ....... ........... AUDITOR EVOKE POTENT, COMPRE ........... 0.50 .................... Agree ........... 0.50 0.50

92586# ..... ........... AUDITOR EVOKE POTENT, LIMIT .................. 0.00 .................... Agree .......... 0.00 0.00

93662# ..... ........... INTRACARDIAC ECG (ICE) ............................. 2.80 .................... Agree ........... 2.80 2.80

93668# ..... ........... PERIPHERAL VASCULAR REHAB .................. 0.00 .................... Agree ........... 0.00 0.00

96570# ..... ........... PHOTODYNAMIC TX, 30 MIN ......................... 1.10 .................... Agree ........... 1.10 1.10

96571# ..... ........... PHOTODYNAMIC TX, ADDL 15 MIN ............... 0.55 .................... Agree ........... 0.55 0.55

97532# ..... ........... COGNITIVE SKILLS DEVELOPMENT ............. .................... 0.51 Disagree ...... 0.44 0.44

97533# ..... ........... SENSORY INTEGRATION ............................... .................... 0.48 Disagree ...... 0.44 0.44

97601# ..... ........... WOUND CARE SELECTIVE ............................ .................... (a) (a) ................ 0.50 0.50

97602# ..... ........... WOUND CARE NON-SELECTIVE ................... .................... (a) (a) ................ 0.00 0.00

97802# ..... ........... MEDICAL NUTRITION, INDIV, IN .................... .................... 0.45 Disagree ...... 0.00 0.00

97803# ..... ........... MED NUTRITION, INDIV, SUBSEQ ................. .................... 0.37 Disagree ...... 0.00 0.00

97804# ..... ........... MEDICAL NUTRITION, GROUP ...................... .................... 0.25 Diagree ....... 0.00 0.00

99172# ..... ........... OCULAR FUNCTION SCREEN ........................ 0.00 .................... Agree ........... 0.00 0.00

a No RUC recommendation provided.

# New Codes.

* All numeric HCPCS CPT Copyright 2000 American Medical Association.

Discussion of Codes for Which There

Were No RUC Recommendations or for

Which the RUC Recommendations Were

Not Accepted

The following is a summary of our

rationale for not accepting particular

RUC work RVU recommendations. It is

arranged by type of service in CPT

order. Additionally, we also discuss

those CPT codes for which we received

no RUC recommendations for physician

work RVUs. This summary refers only

to work RVUs.

Bioengineered Tissue Grafts (CPT Codes

15342 and 15343)

Temporary HCPCS Codes G0170 and

G0171, established in the November

1999 final rule, will be deleted. The two

aforementioned deleted codes have been

replaced by CPT codes 15342 and

15343. The RUC recommended that the

work RVUs for CPT codes 15342 and

15343 be crosswalked from deleted

HCPCS codes G0170 and G0171, which

are currently being used to report

bioengineered tissue grafts. The work

RVUs for CPT codes 15342 and 15343

are crosswalked from G0170 and G0171,

with the following modification.

Currently, HCPCS code G0170 includes

the work of CPT codes 15000 and

15350. The CPT instructions for CPT

code 15342 state that it can be billed

with CPT code 15000. For this reason

the crosswalk for CPT code 15342

would be to 25 percent of the work RVU

of CPT code 15350, or 1.00 work RVUs.

This percentage was chosen because

CPT code 15342 is for graft sizes of up

to 25 square centimeters, and CPT code

15350 is for graft sizes up to 100 square

centimeters. Similarly, the RUC

recommended work RVUs for CPT code

15343 are adjusted to 25 percent of

15351, or 0.25 work RVUs.

Additionally, we note that some

commenters requested the global period

for HCPCS code G0170 be lowered from

ten to seven days. This was not done,

because we use only three global period

lengths zero, ten, and ninety days.

Clearly the ten-day global period is the

most appropriate and consistent with

the recommendation of the commenters.

This decision will be applied to CPT

code 15342. CPT code 15343 is an addon service that does not have a global

period.

Percutaneous Vertebroplasty (CPT Code

22522)

The RUC recommended a work RVU

of 4.31 for CPT code 22522. The RUC

arrived at this value based upon the fact

that the work involved with CPT code

22522 was 50 percent of the total work

of CPT codes 22520 and 22521. The

RUC failed to remove the pre-service

65424 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

99213 and the post-service 99238

associated with CPT codes 22520 and

22521 before performing their

calculations. CPT code 22522 is an addon procedure, and there should be no

pre-and post-service work associated

with this service. We have removed the

work RVUs of 99213 (pre-service) and

99238 (post-service) from the weighted

average of CPT codes 22520 and 22521.

For this reason, we have assigned a

work RVU of 3.00 to CPT code 22522.

Naso- or Oro-gastric Tube Placement

(CPT Code 43752)

The RUC did not supply us with a

recommendation for CPT code 43752.

We believe that this service is bundled

into evaluation and management

services. For this reason, there is no

work RVU associated with this service.

Small Bowel Implantation (CPT Codes

44132, 44133, 44135, and 44136)

The RUC recommended carrier

pricing for these services. These services

are not covered transplant services

under Medicare. For this reason, there

are no work RVUs associated with these

services.

Endoscopic Enteral Stenting (CPT Codes

43256, 44370, 44379, 44383, 44397,

45327, 45345, 45387)

The RUC determined a work

increment, from the applicable

endoscopic base code, for

transendoscopic stent placement

including predilation of 1.96 RVUs. We

agree with this increment. For the

endoscopic stent placement CPT codes

for which we did not receive a work

recommendation from the RUC, we

applied this increment to the applicable

endoscopic basecode. Because

endoscopic stent placement is being

currently billed under existing

endoscopic CPT codes, we needed to

make a work neutrality adjustment to

each family of codes in which a stent

placement code had been created.

Incision and Drainage of Vaginal

Hematoma (CPT Code 57023)

The RUC did not supply a work RVU

recommendation for CPT code 57023.

We did receive a work RVU

recommendation for similar CPT code

57022. Until such time as we receive

more information allowing us to

appropriately value CPT code 57023, we

will adopt the RUC recommended work

RVU for CPT code 57022. For these

reasons, we have assigned a work RVU

of 2.56 to CPT code 57023.

Laminotomy Re-Exploration (CPT Codes

63040, 63042, 63043, and 63044)

The RUC did not supply work RVU

recommendations for CPT codes 63040

through 63044. CPT codes 63040 and

63042 were revised to account for single

interspace cervical and lumbar

laminotomy, respectively. CPT codes

63043 and 63044 were added to account

for each additional cervical and lumbar

interspace laminotomy(s). We will

bundle CPT code 63043 into CPT code

63040 and CPT code 63044 into CPT

code 63042, and retain the existing work

RVUs for CPT codes 63040 and 63042.

We will re-evaluate these services when

the RUC supplies work RVU

recommendations.

Ocular Photodynamic Therapy (CPT

Code 67221)

The RUC did not supply work RVU

recommendations for CPT code 67221.

Subsequent to the publication of the

July 2000 proposed rule in which we

proposed establishing a new HCPCS

code for this service, the CPT editorial

panel approved CPT code 67221 for

ocular photodynamic therapy. We have

deleted our proposed temporary code

and established values for CPT code

67221. Based on comments received

from specialty societies and a

comparison of the work values for this

procedure with CPT code 67210,

Destruction of localized lesion of retina,

we have assigned 4.01 work RVUs to

this service. The intraservice times and

work intensities for CPT codes 67210

and 67221 are comparable. Therefore,

adjusting for the work value of the

postoperative visits (because 67210 has

a 90-day global period) and the 20

percent retreatment rate included in

CPT code 67210, and then applying the

intraservice work intensity of 67210 to

67221, yields an appropriate work value

for 67221. For a further discussion of

this issue, see section II.G.

Computed Tomographic Angiography

(CPT Codes 71275, 72191, 73206, 73706,

74175, and 75635)

CPT created a series of new codes for

2001 describing computed tomographic

(CT) angiography for different parts of

the body. The RUC submitted work

recommendations of 1.75 RVUs for CPT

codes 70496 and 70498, with which we

agree. The RUC did not submit work

recommendations for the other CT

angiography codes. The RUC compared

the head and neck CPT angiography

codes to MRI angiography and CT scans

without contrast followed by contrast of

the same region in determining the

values for these services. However,

upon our review, we determined that

the work RVUs recommended by the

RUC were more comparable to the work

RVUs associated with CPT code 75671,

Angiography, carotid, cerebral, bilateral,

radiological interpretation and

supervision, and CPT code 75680,

Angiography, carotid, cervical, bilateral,

radiological interpretation and

supervision. Both CPT code 75671 and

CPT code 75680 have work RVUs of

1.66. The proportional work RVU

increase from the angiography

supervision and interpretation code to

the CT angiography code was 1.05.

Therefore, in determining the work

RVUs of the other CT angiography

codes, we—(1) compared each code to

its most comparable angiographic

radiological supervision and

interpretation code, and (2) applied a

proportionate work increase of 1.05 to

the CT angiography code. The CPT

codes to which we compared the CT

angiography codes were 75605, 75736,

75710, 75625, and 75630. Note that CT

angiography of the extremities has been

valued as a unilateral service. However,

CPT code 75635 is valued for bilateral

lower extremity run.

Magnetic Resonance Imaging

Procedures (CPT Codes 70540, 70542,

70543, 71550, 71551, 71552, 72195,

72196, 72197, 73218, 73219, 73220,

73221, 73222, 73223, 73718, 73719,

73720, 73721, 73722, 73723, 74181,

74182, and 74183)

CPT 2000 has a single code to

describe MRI of each region of the body

except for MRI of the brain, where three

separate codes exist that describe MRI of

the brain without contrast, with

contrast, and without contrast followed

by contrast. For CPT 2001 the single

MRI code for each area of the body will

be broken out into three separate CPT

codes describing MRI for that body area

without contrast, with contrast, and

without contrast followed by contrast.

The only codes for which we received

work RVU recommendations from the

RUC were CPT 70540 (MRI orbit/face/

neck, w/o contrast), 70542 (MRI orbit/

face/neck, w/contrast), and 70543 (MRI

orbit/face/neck, w/out then w/contrast).

The recommended work RVUs were

1.48, 1.78, and 2.36 respectively. The

services that will be described under

these three CPT codes are currently

being coded under a single CPT code,

70540 (current descriptor is Magnetic

Resonance (e.g. proton) imaging, orbit,

face, and neck with a current work RVU

of 1.48). For this reason we must make

the new CPT codes work neutral to the

current CPT code; that is, the total work

RVUs associated with the three new

codes must result in the same total work

RVUs of the current CPT code. The RUC

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65425

recommendations were not work

neutral. Since neither the RUC nor the

specialty society supplied us with

relative utilization rates for these CPT

codes, we applied the current relative

utilization pattern for MRI of the brain.

MRI of the brain currently has three

separate CPT codes for MRI without

contrast, with contrast, and without

contrast followed by contrast. This

resulted in work RVUs of 0.98, 1.17, and

1.56 for MRI of the orbit, face, and neck

without contrast, with contrast, and

without contrast followed by contrast,

respectively.

We did not receive work

recommendations or utilization data for

any of the other new MRI codes. In each

case, a single MRI code describing MRI

of a body area was broken out into three

codes describing MRI of that body area

without contrast, with contrast, and

without contrast followed by contrast.

In order to assign appropriate work

values for these codes, we followed the

following procedure for MRI of each

body area—(1) we assigned a work RVU

to MRI without contrast, MRI with

contrast, and MRI without contrast

followed by contrast that maintained the

same relationship as the work RVUs the

RUC assigned to the three codes for MRI

of the orbit, face, and neck, (2) we

determined the total work RVUs for the

body area by utilization of the current

MRI code for that body area, (3) we

applied the relative utilization of the

brain MRI codes to the new MRI codes

for each body area, and (4) we adjusted

the work RVUs assigned in step 1 for

MRI of each body area to make them

work neutral to the work RVUs

determined from step 2.

Fetal Biophysical Profile (CPT Code

76818 and CPT Code 76819)

The RUC recommended a work RVU

of 1.05 for CPT code 76818 and 0.77 for

CPT code 76819. Although we agree

with the relativity established by the

RUC, the codes needed to be adjusted

for budget neutrality. For this reason,

we have assigned 0.86 work RVUs to

CPT code 76818 and 0.63 work RVUs to

CPT code 76819.

Sensory Integrative Techniques (CPT

Code 97532 and CPT Code 97533)

The RUC recommended a work RVU

of 0.51 for CPT code 97532 and 0.48 for

CPT code 97533. These two new

services were created to replace the

deleted CPT code 97770. We believe the

work associated with these two new

services is analogous to deleted CPT

code 97770. For this reason, we have

assigned the same work RVU (0.44) that

was assigned to deleted CPT code 97770

to both CPT code 97532 and CPT code

97533.

Active Wound Care Management (CPT

Code 97601 and CPT Code 97602)

The HCPAC did not supply a work

RVU recommendation for either CPT

code 97601 or CPT code 97602. We had

established temporary HCPCS code

G0169 for the work described in new

CPT code 97601. For this reason, we

have assigned the same work RVU (0.50)

to CPT code 97601 that was assigned to

now-deleted HCPCS code G0169. We

consider CPT code 97602 to be bundled

into CPT code 97601 and therefore will

not establish work RVUs for this service.

Medical Nutrition Therapy (CPT Codes

97802 Through 97804)

The HCPAC supplied work RVU

recommendations of: 0.45 for CPT code

97802, 0.37 for CPT code 97803, and

0.25 for CPT code 97804. These services

do not fall under any enumerated

category of Medicare services, and thus

these services are not covered by

Medicare. Additionally, these services

are not physician services and,

therefore, would not be assigned

physician work RVUs. Finally, the

American Diabetic Association is

unhappy with the descriptors CPT has

assigned to CPT codes 97802 through

97804, and is in the process of

submitting a request to CPT for a

revision to the descriptors for these

services. For these reasons, we have

decided not to assign work RVUs to

these services.

Establishment of Interim Practice

Expense Relative Value Units for New

and Revised Physician’s Current

Procedural Terminology (CPT) Codes

and New HCFA Common Procedure

Coding System Codes for 2001.

We have developed a process for

establishing interim practice expense

RVUs (PERVUs) for new and revised

codes that is similar to that used for

work RVUs. Under this process, the

RUC recommends the practice expense

direct inputs, that is, the staff time,

supplies and equipment associated with

each new code. We then review the

recommendations in a manner similar to

our evaluation of the recommended

work RVUs.

The RUC recommendations on the

practice expense inputs for the new and

revised 2001 codes were submitted to us

as interim recommendations. We,

therefore, consider that these

recommendations are still subject to

further refinement by the PEAC, or by

us, if it is determined that such future

review is needed. We do have concerns

regarding some of the recommended

inputs, particularly clinical staff times,

for certain services, and we may revisit

these inputs in light of future decisions

of the PEAC regarding supply and

equipment packages and standardized

approaches to pre- and post-service

clinical staff times.

We have accepted, at least in the

interim, almost all of the practice

expense recommendations submitted by

the RUC for the codes listed in the

following table titled ‘‘AMA RUC and

HCPAC Recommendations and HCFA

Decisions for New and Revised 2001

CPT Codes.’’ We made the following

minor changes to the inputs where

relevant:

• We rounded all clinical staff time to

the nearest minute.

• For consistency with the CPEP

revisions contained in the November

1999 final rule, we deleted separately

billable fluid and contrast material, and

the skin marking pen, disinfectant and

biohazard bag, because these items

cannot easily be allocated to individual

services.

• The RUC assigned the E/M visit

supply package, which includes a

tongue depressor, drape sheet, and

disposable otoscope speculum, as well

as the E/M equipment package, which

includes an otoscope-ophthalmoscope,

to several vascular, spine and other

post-surgical visits. We deleted the

otoscope-ophthalmoscope, because it is

not typically used for such post-surgical

visits and, instead of the E/M visit

supply package, substituted the multispecialty minimum visit supply package

that includes: exam table paper, patient

gown, pillow case, nonsterile gloves,

and thermometer probe cover. We also

added a patient education book.

• For those codes refined before the

multi-specialty minimum visit supply

package was adopted, we substituted

this package for the list of individual

items when they matched exactly. In the

same manner, we substituted the

ophthalmology visit supply package as

appropriate.

• For CPT 11980, Subcutaneous

hormone pellet implantation, we

deleted the disinfectant solution

because it is already included in the

OB–GYN visit supply package assigned

to this code.

• The RUC only priced CPT 36870,

Thrombectomy, percutaneous,

arteriovenous fistula, in the office

setting. We added inputs for the facility

setting, using the clinical staff time for

coordinating pre-surgery services and

providing pre-service education, as well

as the clinical staff time for the one

post-surgical visit. We also added the

supply and equipment inputs for the

post-surgical visit. For the non-facility

setting, we added a multi-specialty

65426 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

minimum visit supply package for the

post-surgical visit. However, we deleted

the oxygen tank from the equipment

inputs, because it appeared that it is

only used on a stand-by basis, and

would thus be considered an indirect

cost.

• The RUC Health Care Professional

Advisory Committee submitted a

recommendation on the inputs for CPT

97533, Sensory integrative techniques.

The inputs included a long list of

specific equipment that we have

combined into one package called

‘‘sensory integration equipment.’’

• The RUC deferred making a

recommendation on the practice

expense inputs for CPT 43752, Naso- or

oro-gastric tube placement. We have

assumed that this service is performed

only in the facility setting, and, as a 0-

day global, has no direct inputs.

For the following CPT codes we did

not receive practice expense

recommendations. Therefore, we are

providing practice expense inputs

through crosswalking to an existing

code as indicated below:

New CPT code Existing CPT code

43256 Upper GI Endoscopy .................................................................. 43241 Upper GI endoscopy with tube.

44370 Small bowel endoscopy/stent ..................................................... 44363 Endocholaniopancreatograph.

44379 S bowel endoscope w/stent ........................................................ 44377 Small bowel endoscopy/biopsy.

44383 Ileoscopy w/stent ........................................................................ 44382 Small bowel endoscopy.

57023 I&D vag hematoma, trauma ........................................................ 57022 I&D vag hematoma,ob.

71275 CT angiography, chest ................................................................ 71270–TC Contrast CAT scans of chest.

71551 CT angiography, chest ................................................................ 70552–TC Magnetic image, brain (MRI).

71552 MRI chest w/o&w dye ................................................................. 70553–TC Magnetic image, brain (MRI).

72191 CT angiograph pelv w/o&w dye .................................................. 72194–TC Contrast CAT scans of pelvis.

72195 MRI pelvis w/o dye ..................................................................... 70551–TC Magnetic image , brain (MRI).

72197 MRI pelvis w/o&w dye ................................................................ 70553–TC Magnetic image, brain (MRI).

73206 CT angio upr extrm w&w/o dye .................................................. 73202–TC Contrast CAT scans of arm.

73218 MRI uppr extremity w/o dye ........................................................ 70551–TC Magnetic image , brain (MRI).

73219 MRI uppr extremity w/ dye .......................................................... 70552–TC Magnetic image, brain (MRI).

73222 MRI joint upr extrem w/dye ......................................................... 70552–TC Magnetic image, brain (MRI).

73223 MRI joint upr extr w/o&w dye ..................................................... 70553–TC Magnetic image, brain (MRI).

73706 CT angio lwr extr w/o&w dye ...................................................... 73702–TC Contrast CAT scans of leg.

73718 MRI lower extremity w/o dye ...................................................... 70551–TC Magnetic image , brain (MRI).

73719 MRI lower extremity w/ dye ........................................................ 70552–TC Magnetic image, brain (MRI).

73722 MRI joint of lwr extr w/dye .......................................................... 70552–TC Magnetic image, brain (MRI).

73723 MRI joint lwr extr w/o&w dye ...................................................... 70553–TC Magnetic image, brain (MRI).

74175 CT angio abdom w/o&w dye ...................................................... 74170–TC Contrast CAT scans, abdomen.

74182 MRI abdomen w/dye ................................................................... 70552–TC Magnetic image, brain (MRI).

74183 MRI abdomen w/o& w dye ......................................................... 70553–TC Magnetic image, brain (MRI).

75635 CT angio abdominal arteries ...................................................... 74170–TC Contrast CAT scans, abdomen.

C. Other Changes to the 2001 Physician

Fee Schedule and Clarification of CPT

Definitions

For the 2001 physician fee schedule,

we are establishing or revising several

alpha-numeric HCPCS codes for

reporting certain services that are not

clearly described by existing CPT codes.

This is in addition to the HCPCS codes

for ocular photodynamic therapy,

certification/recertification for home

health services and care plan oversight

previously discussed. We view these

codes as temporary since we will be

referring them to the CPT Editorial

Panel for possible inclusion in future

editions of CPT. Additionally, included

in this section are some clarifications of

proper use of some new or revised

codes.

Evaluation of Swallowing Function

We are proposing the following new

codes to describe the evaluation of

swallowing function. These codes will

replace the more general CPT 92525,

Evaluation of swallowing and oral

function for feeding, which represents a

combination of these separate

examinations. Our contractors requested

the more precise coding to improve

claims review for evaluation of

dysphagia. The new codes are described

as follows:

G0193 Endoscopy study of

swallowing function, often referred to as

fiberoptic endoscopic evaluation of

swallowing (FEES).

G0194 Sensory testing during

endoscoping study of swallowing. This

service, often referred to as fiberoptic

endoscopic evaluation of swallowing

with testing, will be coded as an add-on

code to G0193.

The creation of these two codes does

not imply coverage. Coverage of G0193

and G0194 remains at the discretion of

the contractor processing the Medicare

claim. These codes will be priced by

contractors.

Two additional codes are also used to

describe swallowing evaluations:

G0195 Clinical evaluation of

swallowing function. This service

describes the clinical examination and

evaluation of the patient, typically by a

speech and language pathologist.

G0196 Evaluation of swallowing

involving swallowing of radio-opaque

materials. This code involves the

participation and interpretation of

results from the dynamic observation of

the patient swallowing materials of

various consistencies. It is observed

fluoroscopically and typically recorded

on video. This evaluation involves using

the information to assess the patient’s

swallowing function and developing a

treatment plan for the patient.

Both codes G0195 and G0196 will be

assigned the same work and malpractice

RVUs as CPT 92525. For practice

expense, we have crosswalked the

inputs from 92525 for these codes. CPT

92525 will no longer be an active code

for Medicare.

Note that CPT 31575 (laryngoscopy,

flexible fiberoptic, diagnostic) and CPT

31579 (laryngoscopy, flexible or rigid

fiberoptic, with stroboscopy) should not

be used for evaluations of swallowing.

Speech-Generating Devices

Because of the change in coverage

policy on speech-generating devices,

effective January 1, 2001, we needed

codes that more specifically describe the

services needed to evaluate and train

patients to use these devices. As a

result, we will be replacing CPT 92597,

Evaluation for use and/or fitting of voice

prosthetic or augmentative/alternative

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65427

communication device to supplement

oral speech) and 92598, Modification of

voice prosthetic or augmentative/

alternative communication device or

supplemental oral speech, with the

following new codes:

G0197 Evaluation of patient for

prescription of speech-generating

devices. This code describes the

services to evaluate a patient to specify

the speech-generating device

recommended to meet the patient’s

needs and capacity for use. This code

involves face-to-face involvement of the

practitioner (typically a speech and

language pathologist experienced in the

use of these devices) with the patient.

The work and malpractice RVUs for this

new code will be cross-walked to the

ones used for CPT code 92597, the code

it replaces. For practice expense, we

have crosswalked the inputs to CPT

code 92527 for these codes.

G0198 Patient adaptation and

training for use of speech-generating

devices. This code describes the

services delivered to the patient to adapt

the device to the patient, and train him

or her in its use. This code involves

face-to-face involvement of the

practitioner (typically a speech and

language pathologist experienced in the

use of these devices) with the patient.

The work and malpractice RVUs, as

well as the practice expense inputs for

this new code, will be crosswalked to

the ones used for CPT code 92598, the

code it replaces.

G0199 Re-evaluation of patient

using speech-generating devices. This

code describes the services to reevaluate a patient who has previously

been evaluated for a speech-generating

device, and either is currently using a

device or did not have a device

recommended. This code involves faceto-face involvement of the practitioner

(typically a speech and language

pathologist experienced in the use of

these devices) with the patient. The

work RVUs for this new code will be 75

percent of the value for CPT code 92597,

reflecting that it is likely to be less

intensive than the initial evaluation.

The malpractice and practice expense

inputs are also crosswalked to CPT code

92957.

G0200 Evaluation of patient for

prescription of voice prosthetic. This

code describes the services to evaluate

a patient for the use of a voice prosthetic

device. This code involves face-to-face

involvement of the practitioner

(typically a speech and language

pathologist experienced in the use of

these devices) with the patient. The

work and malpractice RVUs for this new

code will be crosswalked to the ones

used for CPT code 92597, the code it

replaces. We will also crosswalk

practice expense inputs to CPT code

92957.

G0201 Modification or training in

use of voice prosthetic. This code

involves the modification or training of

a patient in the use of a voice prosthetic.

This code involves face-to-face

involvement of the practitioner

(typically a speech and language

pathologist experienced in the use of

these devices) with the patient. The

work and malpractice RVUs, as well as

the practice expense inputs for this new

code, will be crosswalked to the ones

used for CPT code 92598, the code it

replaces. The RUC recommendations, as

well as the revised CPEP data for all

codes, can be found on our homepage.

See the SUPPLEMENTARY INFORMATION

section of this rule for instructions on

accessing our website.

V. Physician Fee Schedule Update and

Conversion Factor for Calendar Year

2001

The 2001 physician fee schedule

conversion factor is $38.2581. The

separate 2001 national average

anesthesia conversion factor is $17.26.

The 2001 physician fee schedule

update is 5.1 percent. However,

miscellaneous adjustments will result in

an increase in the conversion factor

from 2000 to 2001 of 4.5 percent. The

specific calculations to determine the

physician fee schedule update and

conversion factor for physicians’

services for calendar year 2001 are

explained below.

Detail on Calculation of the Calendar

Year 2001 Physician Fee Schedule

Update and the 2001 Conversion Factor

Physician Fee Schedule Update and

Conversion Factor

The conversion factor is affected by

section 1848(c)(2)(B)(ii)(II) of the Act,

which requires that changes to the

relative value units of the Medicare

physician fee schedule not cause

expenditures to increase or decrease by

more than $20 million from the amount

of expenditures that would have been

made if such adjustments had not been

made. We implement this requirement

through a uniform budget-neutrality

adjustment to the conversion factor.

There are two changes that will require

us to make an adjustment to the

conversion factor to meet the budget

neutrality requirements in section

1848(c)(2)(B)(ii)(II). We are making a 0.3

percent reduction (0.997) in the

conversion factor to account for separate

payment for certification and

recertification of a plan of care for home

health services. We are also making a

0.14 percent (0.9986) reduction in the

conversion factor to account for an

anticipated increase in the volume and

intensity of services.

After considering this factor, as well

as the percent change in the MEI, the

update adjustment factor, and statutory

adjustment described below, the 2001

conversion factor is calculated as

follows:

2000 Conversion Factor—$36.6137

2001 Update—1.05163

2001 Legislative Adjustment—0.998

Volume and Intensity Adjustment—

0.9986

Other Factors—0.997

2001 Conversion Factor—$38.2581

Under section 1848(d)(3) of the Act,

the update is equal to the product of the

MEI and the update adjustment factor.

For 2001, the MEI is equal to 2.1 percent

(1.021). A more detailed description of

the MEI and its calculation follows. The

update adjustment factor is equal to 3.0

percent (1.030). Thus, the product of the

MEI (1.021) and the update adjustment

factor (1.030) equal the 2001 update

(1.05163). Section 1848(d)(4)(F) of the

Act provides for an additional

adjustment to the update for 2001 of

¥0.2 percent (0.998). Thus, taking into

account the 2001 update, the 2001

legislative adjustment, the 2001 volume

and intensity adjustment, and the

adjustment for certification and

recertification of a plan of care for home

health services, the conversion factor for

2001 is determined as follows: $36.6137

× 1.05163 × 0.998 × 0.9986 × 0.997 =

$38.2581.

The MEI and the update adjustment

factor are described below.

The Percentage Change in the Medicare

Economic Index

The MEI measures the weightedaverage annual price change for various

inputs needed to produce physicians’

services. The MEI is a fixed-weight

input price index, with an adjustment

for the change in economy-wide labor

productivity. This index, which has

1996 base weights, is comprised of two

broad categories: Physician’s own time

and physician’s practice expense.

The physician’s own time component

represents the net income portion of

business receipts and primarily reflects

the input of the physician’s own time

into the production of physicians’

services in physicians’ offices. This

category consists of two

subcomponents—wages and salaries,

and fringe benefits. These components

are adjusted by the 10-year moving

average annual percent change in output

per man-hour for the nonfarm business

sector to account for productivity

growth in the general economy.

65428 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

The physician’s practice expense

category represents the rate of price

growth in nonphysician inputs to the

production of services in physicians’

offices. This category consists of wages

and salaries and fringe benefits for

nonphysician staff and other nonlabor

inputs. Like physician’s own time, the

nonphysician staff categories are

adjusted for productivity using the 10-

year moving average annual percent

change in output per man-hour for the

nonfarm business sector. The

physician’s practice expense component

also includes the following categories of

nonlabor inputs—office expense,

medical materials and supplies,

professional liability insurance, medical

equipment, professional car, and other

expense. The table below presents a

listing of the MEI cost categories with

associated weights and percent changes

for price proxies for the 2001 update.

The calendar year 2001 MEI is 2.1

percent.

INCREASE IN THE MEDICARE ECONOMIC INDEX UPDATE FOR CALENDAR YEAR 2001 1

Cost categories and price measures 1996

weights 2

CY 2001

percent

changes

Medicare Economic Index Total ...................................................................................................................................... 100.0 2.1

1. Physician’s Own Time 3 4 ............................................................................................................................................. 54.5 1.7

a. Wages and Salaries: Average hourly earnings private nonfarm, net of productivity .......................................... 44.2 1.6

b. Fringe Benefits: Employment Cost Index, Benefits, private nonfarm, net of productivity ................................... 10.3 2.4

2. Physician’s Practice Expense 3 ................................................................................................................................... 45.5 2.5

a. Nonphysician Employee Compensation .............................................................................................................. 16.8 1.8

1. Wages and Salaries: Employment Cost Index, wages and salaries, weighted by occupation, net of productivity .......................................................................................................................................................... 12.4 1.7

2. Fringe Benefits: Employment Cost Index, fringe benefits, white collar, net of productivity ......................... 4.4 2.6

b. Office Expense: Consumer Price Index for Urban Consumers (CPI–U), housing .............................................. 11.6 2.5

c. Medical Materials and Supplies: Producer Price Index (PPI), ethical drugs/PPI, surgical appliances and supplies/CPI–U, medical equipment and supplies (equally weighted) ...................................................................... 4.5 2.0

d. Professional Liability Insurance: HCFA professional liability insurance survey 5 ................................................ 3.2 7.2

e. Medical Equipment: PPI, medical instruments and equipment. .......................................................................... 1.9 ¥1.1

f. Other Professional Expense ................................................................................................................................. 7.6 2.8

1. Professional Car: CPI–U, private transportation ........................................................................................... 1.3 5.5

2. Other: CPI–U, all items less food and energy .............................................................................................. 6.3 2.1

Addendum:

Productivity: 10-year moving average of output per man-hour, nonfarm business sector ...................................... n/a 1.9

Physician’s Own Time, not productivity adjusted ..................................................................................................... 54.5 3.7

Wages and salaries, not productivity adjusted ................................................................................................. 44.2 3.6

Fringe benefits, not productivity adjusted ......................................................................................................... 10.3 4.4

Nonphysician Employee Compensation, not productivity adjusted ......................................................................... 16.8 4.0

Wages and salaries, not productivity adjusted ................................................................................................. 12.4 3.9

Fringe benefits, not productivity adjusted ......................................................................................................... 4.4 4.6

1The rates of historical change are for the 12-month period ending June 30, 2000, which is the period used for computing the calendar year

2001 update. The price proxy values are based upon the latest available Bureau of Labor Statistics data as of September 15, 2000. 2The weights shown for the MEI components are the 1996 base-year weights, which may not sum to subtotals or totals because of rounding.

The MEI is a fixed-weight, Laspeyres-type input price index whose category weights indicate the distribution of expenditures among the inputs to

physicians’ services for calendar year 1996. To determine the MEI level for a given year, the price proxy level for each component is multiplied

by its 1996 weight. The sum of these products (weights multiplied by the price index levels) over all cost categories yields the composite MEI

level for a given year. The annual percent change in the MEI levels is an estimate of price change over time for a fixed market basket of inputs

to physicians’ services. 3The Physician’s Own Time and Nonphysician Employee Compensation category price measures include an adjustment for productivity. The

price measure for each category is divided by the 10-year moving average of output per man-hour in the nonfarm business sector. For example,

the fringe benefits component of the Nonphysician Compensation category is calculated by dividing the rate of growth in the employment cost

index-benefits for private, white collar workers by the 10-year moving average rate of growth of output per man-hour for the nonfarm business

sector. Dividing one plus the decimal form of the percent change in the employment cost index-benefits (1+.046=1.046) by one plus the decimal

form of the percent change in the 10-year moving average of labor productivity (1+.019=1.019) equals one plus the change in the employment

cost index-benefits for white collar workers net of the change in output per manhour (1.046/1.019=1.026). All Physician’s Own Time and Nonphysician Employee Compensation categories are adjusted in this way. Due to a higher level of precision the computer calculated quotient may

differ from the quotient calculated from rounded individual percent changes. 4The average hourly earnings proxy, the Employment Cost Index proxies, as well as the CPI–U, housing and CPI–U, private transportation are

published in the Current Labor Statistics Section of the Bureau of Labor Statistics’ Monthly Labor Review. The remaining CPIs and PPIs in the

revised index can be obtained from the Bureau of Labor Statistics’ CPI Detailed Report or Producer Price Indexes. 5 Derived from a HCFA survey of several major insurers (the latest available historical percent change data are for the period ending second

quarter of 2000).

N/A Productivity is factored into the MEI compensation categories as an adjustment to the price variables; therefore, no explicit weight exists

for productivity in the MEI.

The Update Adjustment Factor

Under sections 1848(d)(3) and (d)(4)

of the Act, the physician fee schedule

update is equal to the product of the

Medicare Economic Index and an

‘‘update adjustment factor.’’ The update

adjustment factor represents an amount

that is applied to the inflation update to

reflect success or failure in meeting the

expenditure target that the law refers to

as ‘‘allowed expenditures.’’ Allowed

expenditures are equal to actual

expenditures in a base period updated

each year by the sustainable growth rate.

The sustainable growth rate is a

percentage increase that is determined

by a formula specified in section 1848(f)

of the Act. The next section describes

the SGR and its calculation in detail.

The update adjustment factor is

determined based on a comparison of

actual and allowed expenditures. For

years beginning with 1999, the BBA

required that the update adjustment

factor be determined under section

1848(d)(3) of the Act to equal—

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65429

(i) the difference between—(I) the sum

of the allowed expenditures for

physicians’ services (as determined

under subparagraph (C)) for the period

beginning April 1, 1997, and ending on

March 31 of the year involved, and (II)

the amount of actual expenditures for

physicians’ services furnished during

the period beginning April 1, 1997, and

ending on March 31 of the preceding

year; divided by—

(ii) the actual expenditures for

physicians’ services for the 12-month

period ending on March 31 of the

preceding year, increased by the

sustainable growth rate under

subsection (f) for the fiscal year which

begins during such 12-month period.

Pub. L. No. 106–113, the Medicare,

Medicaid and State Children’s Health

Insurance Program Balanced Budget

Refinement Act of 1999 (BBRA) made

changes to the methodology for

determining the physician fee schedule

update beginning in 2001. In particular,

it established that the methodology in

section 1848(d)(3) of the Act would only

be used for determining the physician

fee schedule update for 1999 and 2000.

The BBRA established that the

physician fee schedule update for 2001

and subsequent years would be

determined under section 1848(d)(4) of

the Act. While the general principle of

adjusting the inflation update (the MEI)

by the update adjustment factor

continues, the BBRA made fundamental

changes to the calculation of the update

adjustment factor. In general, these

changes do two things. First, the

measurement of actual expenditures

will occur on the basis of a calendar

year rather than an April 1 to March 31

year. This essentially conforms the

measurement of actual expenditures

with other aspects of the SGR system

that are also occurring on the basis of a

calendar year as a result of BBRA

amendments. As we explained in our

April 10, 2000 SGR final notice (65 FR

19000), the BBRA essentially changed

the SGR system from one that spanned

3 different time periods, ((1)

measurement of actual expenditures on

the basis of an April 1 to March 31

period; (2) calculation of the SGR rate of

increase on a federal fiscal year basis;

and (3) application of the update on a

calendar year basis) to one that spans

only one time period. (All three are on

the basis of a calendar year). Second, it

ensures that any deviation between

cumulative actual expenditures and

cumulative allowed expenditures will

be corrected over several years rather

than in a single year. This will result in

less year-to-year volatility in the

physician fee schedule update than

would occur if adjustments to the

update are made to bring expenditures

in line with the target in one year.

Under section 1848(d)(4)(A) of the

Act, the physician fee schedule update

for a year is equal to the product of—

(1) 1 plus the Secretary’s estimate of the

percentage increase in the MEI for the

year, and (2) 1 plus the Secretary’s

estimate of the update adjustment factor

for the year. Under section 1848(d)(4)(B)

of the Act, the update adjustment factor

for a year beginning with 2001 is equal

to the sum of the following:

(i) Prior Year Adjustment Component.

An amount determined by:

(I) Computing the difference (which

may be positive or negative) between

the amount of the allowed expenditures

for physicians’ services for the prior

year (the year prior to the year for which

the update is being determined) and the

amount of the actual expenditures for

such services for that year;

(II) Dividing that difference by the

amount of the actual expenditures for

such services for that year; and

(III) Multiplying that quotient by 0.75.

(ii) Cumulative Adjustment

Component. An amount determined by:

(I) Computing the difference (which

may be positive or negative) between

the amount of the allowed expenditures

for physicians’ services from April 1,

1996 through the end of the prior year

and the amount of the actual

expenditures for such services during

that period;

(II) Dividing that difference by actual

expenditures for such services for the

prior year as increased by the

sustainable growth rate for the year for

which the update adjustment factor is to

be determined; and

(III) Multiplying that quotient by 0.33.

Thus, the CY 2001 update adjustment

factor will be determined as the sum of

the following:

(i) Prior Year Adjustment Component.

This equals the difference between

allowed expenditures in 2000 and our

current estimate of actual expenditures

for 2000. This difference is divided by

our current estimate of actual

expenditures for 2000 and the quotient

is multiplied by 0.75. Our current

estimate of allowed expenditures for CY

2000 is $56.6 billion. Our current

estimate of actual expenditures for all of

2000 based on claims received through

June 30 is $55.1 billion. Thus, the prior

year adjustment component is equal to:

(($56.6¥$55.1)/$55.1)) × 0.75 = .020

(ii) Cumulative Adjustment

Component. This amount equals the

difference between allowed

expenditures for the period April 1,

1996 through December 31, 2000

($244.4 billion) and actual expenditures

for the same period ($240.6 billion)

divided by the product of actual

expenditures for the year 2000 ($55.1)

increased by the SGR for 2001 (5.6

percent). This quotient is multiplied by

0.33. Thus, the cumulative adjustment

component is equal to:

(($244.4¥$240.6)/($55.1×1.056)) × 0.33

= 0.022.

The prior year adjustment component

and the cumulative adjustment

component are added. Adding these

figures together would make the update

adjustment factor equal 0.042. However,

section 1848(d)(4)(D) of the Act

indicates that the update adjustment

factor determined under section

1848(d)(4)(B) of the Act for a year may

not be less than ¥0.07 or greater than

0.03. Since 0.042 exceeds 0.03, we are

limiting the update adjustment factor

consistent with section 1848(d)(4)(D) of

the Act to 0.03. Section 1848(d)(4)(A)(ii)

of the Act indicates that 1 should be

added to the update adjustment factor

determined under section 1848(d)(4)(B)

of the Act. Thus, adding 1 to 0.03 makes

the update adjustment factor equal

1.030.

(As indicated in the SGR discussion

below, allowed expenditures through

the end of CY 2000 will be revised one

more time, no later than November 1,

2001. We will also be revising the

measurement of actual expenditures for

CY 2000 based on claims received

through June 30, 2001. These revised

figures will be determined no later than

November 1, 2001. The SGR for 2001

will also be revised two more times.

Any differences that result in the update

adjustment factor for 2001 from revision

of estimates will be reflected in update

adjustment factor determined for 2002.)

VI. Allowed Expenditures for

Physicians’ Services and the

Sustainable Growth Rate

A. Medicare Sustainable Growth Rate

Section 1848(f) of the Social Security

Act (the Act), as amended by section

4503 of the Balanced Budget Act of 1997

(BBA) (Pub. L. 105–33), enacted on

August 5, 1997, replaced the Medicare

Volume Performance Standard (MVPS)

with a Sustainable Growth Rate (SGR).

Section 1848(f)(2) of the Act specifies

the formula for establishing yearly SGR

targets for physicians’ services under

Medicare. The use of SGR targets is

intended to control the actual growth in

aggregate Medicare expenditures for

physicians’ services.

The SGR targets are not limits on

expenditures. Payments for services are

not withheld if the SGR target is

exceeded by actual expenditures.

Rather, the appropriate fee schedule

65430 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

update, as specified in section

1848(d)(3) of the Act, is adjusted to

reflect the success or failure in meeting

the SGR target. If expenditures exceed

the target, the update is reduced. If

expenditures are less than the target, the

update is increased.

As with the MVPS, the statute

specifies a formula to calculate the SGR

based on our estimate of the change in

each of four factors. The four factors for

calculating the SGR are as follows:

(1) The estimated change in fees for

physicians’ services.

(2) The estimated change in the

average number of Medicare fee-forservice beneficiaries.

(3) The estimated projected growth in

real gross domestic product (GDP) per

capita.

(4) The estimated change in

expenditures due to changes in law or

regulations.

Section 211 of the BBRA amended

sections 1848(d) and 1848(f) of the Act

with respect to the physician fee

schedule update and the SGR. Section

211(b) of the BBRA maintains the

formula for calculating the SGR, but

amends section 1848(f)(2) of the Act to

apply the SGR on a calendar year (CY)

basis beginning with 2000 while

maintaining the SGR on a fiscal year

(FY) basis for FY 1998 through FY 2000.

Specifically, section 1848(f)(2) of the

Act, as amended by section 211(b) of the

BBRA, states that—‘‘* * * [t]he

sustainable growth rate for all

physicians’ services for a fiscal year

(beginning with fiscal 1998 and ending

with fiscal year 2000) and a year

beginning with 2000 shall be equal to

the product of:

(1) 1 plus the Secretary’s estimate of

the weighted average percentage

increase (divided by 100) in the fees for

all physicians’ services in the applicable

period involved,

(2) 1 plus the Secretary’s estimate of

the percentage change (divided by 100)

in the average number of individuals

enrolled under this part (other than

Medicare+Choice plan enrollees) from

the previous applicable period to the

applicable period involved,

(3) 1 plus the Secretary’s estimate of

the projected percentage growth in real

gross domestic product per capita

(divided by 100) from the previous

applicable period to the applicable

period involved; and

(4) 1 plus the Secretary’s estimate of

the percentage change (divided by 100)

in expenditures for all physicians’

services in the applicable period

(compared with the previous applicable

period) which will result from changes

in law and regulations, determined

without taking into account estimated

changes in expenditures resulting from

the update adjustment factor

determined under section 1834 (d)(3)(B)

or (d)(4)(B) of the Act, as the case may

be, minus 1 and multiplied by 100.’’

Under section 1848(f)(4)(C) of the Act,

as added by section 211(b)(3) of the

BBRA, the term ‘‘applicable period’’

means—(1) a FY, in the case of FY 1998,

FY 1999 and FY 2000, and (2) a CY with

respect to a year beginning with 2000.

To make the transition from a FY SGR

to a CY SGR in 1999 using the FY 2000

SGR, sections 211(b)(2) and (b)(3) of the

BBRA require us to calculate SGRs for

both FY and CY 2000. Section

1848(d)(4)(C) of the Act, as modified by

section 211(a)(1)(B) of the BBRA,

required us to determine the allowed

expenditures for both the 9-month

period beginning April 1, 1999 and for

CY 1999. The SGR for CY 2000 is then

applied to allowed expenditures for CY

1999.

As stated in the April 10 final notice

(65 FR 19002), the BBRA requires the

estimate of the FY 2000 and CY 2000

SGR to be revised based on more recent

data, but, as explained below, the BBRA

does not provide for revision of either

the FY 1998 or the FY 1999 SGR. This

means that, for the transition to a

calendar year SGR system, allowed

expenditures for the period April 1,

1999 through December 31, 1999

(determined by applying the FY 2000

SGR to allowed expenditures for the 12-

month period ending March 31, 1999)

are subject to change based on revision

of the FY 2000 SGR; allowed

expenditures for the period January 1,

1999 through March 31, 1999

(determined using the FY 1999 SGR) are

not subject to revision.

In general, the BBRA requires us to

publish SGRs for three different time

periods, no later than November 1 of

each year, using the best data available

as of September 1 of each year. Under

section 1848(f)(3)(C)(i) of the Act, as

added by section 211(b)(5) of the BBRA,

the SGR is estimated and subsequently

revised twice (beginning with the FY

and CY 2000 SGRs) based on later data.

Under section 1848(f)(3)(C)(ii) of the

Act, there are no further revisions to the

SGR once it has been estimated and

subsequently revised in each of the 2

years following the initial estimate.

The requirement of revisions to the

SGR based on later data means that we

will estimate and publish an SGR for the

upcoming year, the contemporaneous

year, and the preceding year by not later

than November 1 of each year. For

example, by not later than November 1,

2002, we will publish an estimate of the

SGR for CY 2003, a revision of the CY

2002 SGR estimated in the previous

year, and a revision of the CY 2001 SGR

first estimated two years earlier and first

revised in the previous year. Under

section 1848(f)(3)(C)(ii) of the Act, this

would be the final revision to the CY

2001 SGR.

Sections 1848(f)(3)(A) and (f)(3)(B) of

the Act, as added by section 211(b)(5) of

the BBRA, specify special rules with

respect to the SGR and the CY 2001 and

CY 2002 updates. Section 1848(f)(3)(A)

of the Act requires us, not later than

November 1, 2000, to revise the SGRs

for FY 2000 and CY 2000 and to

establish the SGR for CY 2001, based on

the best data available, as of September

1, 2000. Section 1848(f)(3)(B) of the Act

requires us, by not later than November

1, 2001, to revise the SGRs for FY 2000

and CYs 2000 and 2001 and to establish

the SGR for CY 2002, based on the best

data available as of September 1, 2001.

In accordance with section

1848(f)(3)(C)(ii) of the Act, there will be

no further revisions to the FY 2000 and

CY 2000 SGRs after their revision in the

2001 notice.

Physicians’ Services

Section 1848(f)(4)(A) of the Act

defines the scope of physicians’ services

covered by the SGR. The BBRA made no

changes to this definition that was also

used for the MVPS. For this reason, we

are continuing to use the same

definition of physicians’ services for the

SGR in this notice as we did in prior

SGR notices and for the MVPS

published in the Federal Register (61

FR 59717) on November 22, 1996.

C. Provisions Related to the SGR

We are implementing section

211(b)(1)(A) of the BBRA that requires

us to publish in the Federal Register,

not later than November 1, 2000, a

notice containing—(1) a preliminary

estimate of the SGR for 2001; and (2) a

revised estimate of the CY 2000 SGR. In

addition, consistent with section

1848(f)(3)(A) of the Act, we are revising

the SGR for FY 2000 for purposes of

determining the physician fee schedule

update for 2001 under section

1848(d)(4)(B) of the Act.

In general, the update for a year is

based on the Medicare Economic Index

(MEI) as adjusted, within bounds, by the

amount of actual expenditures for

physicians’ services compared to

allowed (that is, growth target)

expenditures. A key difference between

the MVPS and the SGR is that the

comparison of actual and allowed

expenditures is made on a cumulative

basis under the SGR, while it was made

on an annual basis under the MVPS.

The ‘‘update adjustment factor’’ in

section 1848(d)(4)(B) of the Act is an

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65431

adjustment to the MEI that reflects the

difference between actual expenditures

and target expenditures.

Section 1848(d)(3)(C) of the Act, as

modified by the BBA, defines allowed

expenditures for the 12-month period

ending March 31, 1997 as equal to

actual expenditures for physicians’

services during that period (that is,

April 1, 1996 through March 31, 1997),

as we have estimated. Section

1848(d)(3)(C) of the Act defines allowed

expenditures for subsequent 12-month

periods to be equal to allowed

expenditures for physicians’ services for

the previous year increased by the SGR

for the FY which begins during the 12-

month period. For example, allowed

expenditures for the 12-month period

April 1, 1997 through March 31, 1998

are equal to allowed expenditures for

the 12-months ending March 31, 1997,

increased by the SGR for FY 1998. As

explained above, BBRA subsequently

provided for a transition to a calendar

year SGR system in 1999 with allowed

expenditures in 2000 equal to 1999

allowed expenditures increased by the

2000 SGR. Allowed expenditures for

each subsequent year will equal

expenditures from the prior year

updated by the SGR.

The following table shows annual and

cumulative allowed expenditures for

physicians’ services from April 1, 1996

through December 31, 2001.

Period Annual allowed expenditures Cumulative allowed expenditures FY or CY SGR

4/1/96–3/31/97 ............................... $48.9 billion .................................. $48.9 billion .................................. N/A.

4/1/97–3/31/98 ............................... $49.6 billion .................................. $98.5 billion .................................. FY 1998=1.5%.

4/1/98–3/31/99 ............................... $49.4 billion .................................. $147.9 billion ................................ FY 1999=-0.3%.

1/1/99–3/31/99 ............................... $12.5 billion..

4/1/99–12/31/00 ............................. $39.5 billion .................................. $187.9 billion ................................ FY 2000=7.9%.

1/1/99–12/31/99 ............................. $52.4 billion .................................. Included in $187.9 billion above ... See Note.

1/1/00–12/31/00 ............................. $56.6 billion .................................. $244.4 billion ................................ CY 2000=8.1%.

1/1/01–12/31/01 ............................. $59.8 billion .................................. $304.2 billion ................................ CY 2001=5.6%.

Note: Allowed expenditures for the first

quarter of 1999 are based on the FY 1999

SGR and allowed expenditures for the last

three quarters of 1999 are based on the FY

2000 SGR.

In the above table, for the period April

1996 through March 1997, annual

allowed expenditures are equal to actual

expenditures for the period. Annual

allowed expenditures for each

subsequent year are equal to the figure

from the prior April 1 through March 31

12-month period (shown in the annual

allowed expenditure column)

multiplied by the SGR figure one row

down in the right hand column. For

example, allowed expenditures from

April 1997 through March 1998 are

equal to $48.9 multiplied by 1.015.

Cumulative allowed expenditures in a

year are equal to the sum of the annual

allowed expenditures figure in the same

row and annual allowed expenditures

for all prior years. The transition to the

calendar SGR occurs in 1999. Our

current estimates of the FY 2000 SGR of

7.9 percent (2.1 percent for factor 1, 0.8

percent for factor 2, 4.5 percent for

factor 3 and 0.3 percent for factor 4), the

CY 2000 SGR of 8.1 percent (2.1 percent

for factor 1, 1.0 percent for factor 2, 4.3

percent for factor 3, and 0.5 percent for

factor 4) and the CY 2001 SGR (1.9

percent for factor 1, 0.9 percent for

factor 2, 2.7 percent for factor 3 and 0.0

percent for factor 4) are described in

more detail below. All estimates are

based on the best data available to the

Secretary as of September 1.

Allowed expenditures for the April 1,

1999 through the December 31, 1999

period are based on the FY 2000 SGR.

As previously discussed, section

1848(f)(3) of the Act requires two

revisions to the FY 2000 SGR. The first

revision must be made not later than

November 1, 2000 based on the best

data available as of September 1, 2000;

the second revision must be made not

later than November 1, 2001, based on

the best data available as of September

1, 2001. The allowed expenditures

figure in the above table for the April 1,

1999 through the December 31, 1999

period reflects the revisions of the FY

2000 SGR contained in this notice.

Similarly, the allowed expenditure

figure for 2000 reflects our current

estimate of the SGR for 2000. Both

figures will be revised for the final time

not later than November 1, 2001.

As we explained in our April 10, 2000

SGR notice (65 FR 19002), section

1848(d)(4)(C)(ii)(II) of the Act, as added

by section 211(a)(1)(B) of the BBRA,

specifies that allowed expenditures for

the year of 1999 must be our estimate

of the amount of the allowed

expenditures that would be permitted

under section 1848(d)(3)(C) of the Act

for that year. We are, therefore,

calculating allowed expenditures for CY

1999 as the sum of allowed

expenditures for—(1) The January 1,

1999 through March 31, 1999 period;

and (2) allowed expenditures for the

April 1, 1999 through December 31,

1999 period.

Annual allowed expenditures for the

period April 1, 1998 through March 31,

1999 are $49.4 billion. Our actuarial

estimate of allowed expenditures for the

3-month period January 1, 1999 through

March 31, 1999 is $12.5 billion that was

determined by updating quarterly

allowed expenditures included in the

January 1, 1997 through March 31, 1997

period by the SGRs for FY 1998, FY

1999 and FY 2000. Adding this figure to

the $39.9 billion figure for April 1, 1999

through December 31, 1999 equals

allowed expenditures for 1999 of $52.4

billion. (Due to rounding, the figures

may not add precisely to the total for

2000.)

Allowed expenditures for the period

April 1, 1998 through March 30, 1999

are equal to allowed expenditures for

the previous 12-month period increased

by the FY 1999 SGR. As discussed in

the April 10, 2000 SGR final notice (65

FR 19001), because there is no provision

in the Act for revising the FY 1999 SGR

or, consequently, the allowed

expenditures for the April 1, 1998

through March 31, 1999 period, we are

not revising the January 1, 1999 through

March 31, 1999 portion of allowed

expenditures included in the 1999

allowed expenditures. Thus, allowed

expenditures for the January 1, 1999 to

March 31, 1999 period are the same as

those included in our April 10, 2000

final notice (65 FR 19002). However, as

indicated above, revisions to the FY

2000 SGR contained in this notice result

in an increase in our earlier estimates of

allowed expenditures for April 1, 1999

through December 31, 1999 and, hence,

allowed expenditures for 1999.

D. Preliminary Estimate of the SGR for

CY 2001

According to sections 1848(f)(2)(A)

through (f)(2)(D) of the Act, as amended

by section 211(b) of the BBRA, we have

determined the preliminary estimate of

the CY 2001 SGR to be 5.6 percent. Our

determination is based on estimates of

the following four statutory factors as

indicated in the table below:

65432 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Statutory factors April 10

estimate

Current

estimate

Fees ...................... 1.5 1.9

Enrollment ............. ¥0.6 0.9

Real Per Capita

GDP .................. 1.9 2.7

Law and Regulation .................... 0.0 ¥0.0

Total .................. 2.8 5.6

(Note: Consistent with section 1848(f)(2)

of the Act, the statutory factors are

multiplied, not added, to produce the

total (that is, 1.019 × 0.991 × 1.027 ×

1.000 = 1.056.) A more detailed

explanation of each figure is provided

below.

E. Sustainable Growth Rate for CY 2000

According to sections 1848(f)(2)(A)

through (f)(2)(D) of the Act, as amended

by section 211(b) of the BBRA, our

current estimate of the CY 2000 SGR is

8.1 percent. This compares to an

estimate of 5.8 percent included in our

April 10, 2000 notice (65 FR 19003).

The table below shows our April 10 and

current estimates of the four statutory

factors that determine the CY 2000 SGR:

Statutory factors April 10

estimate

Current

estimate

Fees ...................... 2.1 2.1

Enrollment ............. ¥0.6 1.0

Real Per Capita

GDP .................. 2.5 4.3

Law and Regulation .................... 1.7 0.5

Total .................. 5.8 8.1

A more detailed explanation of each

figure is provided below.

F. Sustainable Growth Rate for FY 2000

According to sections 1848(f)(2)(A)

through (f)(2)(D) of the Act, as amended

by section 211(b) of the BBRA, our

current estimate of the FY 2000 SGR is

7.9 percent. This is in comparison to an

estimate of 2.1 percent included in our

October 1, 1999 notice (64 FR 53394). At

the time of the April 10, 2000 final

(SGR) notice, we estimated the SGR for

FY 2000 would be 5.7 percent. The table

below shows our October 1, 1999 and

current estimates of the four statutory

factors that determine the FY 2000 SGR:

Statutory factors April 10

estimate

Current

estimate

Fees ...................... 2.1 2.1

Enrollment ............. ¥0.4 0.8

Real Per Capita

GDP .................. 2.7 4.5

Law and Regulation .................... 1.2 0.3

Statutory factors April 10

estimate

Current

estimate

Total .................. 5.7 7.9

A more detailed explanation of each

figure is provided below.

G. Calculation of the FY 2000 CY 2000

and CY 2001 Sustainable Growth Rate

1. Detail on the CY 2001 SGR

A more detailed discussion of our

preliminary estimates of the four

elements of the 2001 SGR follows.

Factor 1—Changes in Fees for

Physicians’ Services (Before Applying

Legislative Adjustments) for CY 2001

This factor was calculated as a

weighted average of the CY 2001 fee

increases that apply for the different

types of services included in the

definition of physicians’ services for the

SGR.

Physicians’ services represent

approximately 89 percent of allowed

charges for physicians’ services under

the SGR and are updated by the

Medicare Economic Index (MEI). Our

current estimate of the MEI for 2001 is

2.1 percent. Diagnostic laboratory tests

represent approximately 11 percent of

the Medicare allowed charges for

physicians’ services under the SGR. The

BBA provided for a 0.0 percent update

for CY 2001 for laboratory services. The

table below shows both the physicians’

and laboratory service updates that were

used to determine the percentage

increase in physicians’ fees for CY 2001.

Weight Update

Physician ................ .89 2.1

Laboratory ............... .11 0.0

Weighted Average .. 1.0 1.9

After taking into account the elements

described in the table, we estimate that

the weighted-average increase in fees for

CY 2001 for physicians’ services under

the SGR (before applying any legislative

adjustments) will be 1.9 percent.

Factor 2—The Percentage Change in the

Average Number of Part B Enrollees

from CY 2000 to CY 2001

This factor is our estimate of the

percent change in the average number of

fee-for-service enrollees for CY 2001 as

compared to CY 2000. Medicare+Choice

(M+C) plan enrollees, whose Medicarecovered medical care is outside the

scope of the SGR, are excluded from this

estimate. Our actuaries estimate that the

average number of Medicare Part B feefor-service enrollees (excluding

beneficiaries enrolled in M+C plans)

will increase by 0.9 percent in calendar

year 2001. This estimate was derived by

subtracting estimated M+C enrollment

from estimated overall Medicare

enrollment as illustrated in the table

below.

2000 2001

Overall ..................... 37.476

million.

37.824

million.

Medicare+Choice .... 6.303 ......

million .....

6.382

million.

Net ........................... 31.174

million.

31.442

million.

Percent Increase ..... ................ 0.9 percent.

In our April 10 final notice (65 FR

19005), we indicated that the

enrollment factor is one of two elements

of the SGR upon which there has been

the largest difference between our

actuaries’ estimates and the actual

percentage change in the factor. At this

time, our actuary has no information on

actual enrollment in M+C organizations

for 2001. While we do receive

information on whether a M+C Plan will

continue to participate or withdraw

from the program in 2001, it remains

difficult to estimate the number of

beneficiaries that will select a M+C plan

or fee-for-service before the start of the

calendar year. While some managed

care organizations will no longer offer a

M+C plan, other plans are available as

an option to most beneficiaries in areas

where there have been plan

withdrawals. We have considered this

issue in developing our 2001 M+C

enrollment estimate. While there have

been plan withdrawals the past three

years, we have continued to observe

increased enrollments. For 2001, we

considered the issue of plan

withdrawals and are forecasting a

smaller increase than in prior years.

Since beneficiaries have the option of

moving between the fee-for-service and

M+C sectors on a monthly basis, there

may be movement during the year

between the fee-for-service and M+C

programs. This is another factor that

contributes to the difficulty of

estimating the size of the M+C enrollee

population prior to the start of a

calendar year. Since the fee-for-service

enrollment figure is determined net of

the change in M+C enrollment, it makes

early estimates of this factor difficult.

We would further point out that our

estimate of this factor will have little

bearing on the estimate of the update

adjustment factor for 2001; it has no

impact since the update adjustment is

already at its limit. Since the law

requires revisions of the estimates used

in setting the SGR, we will have

information on actual enrollment in

M+C plans for the first eight months of

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65433

2001, and will be better able to predict

the change in fee-for-service enrollment

for the year by the time we determine

the 2002 physician fee schedule. Thus,

our estimate of the increase in fee-forservice enrollment contained in this

final rule has no affect on the 2001

physician fee schedule update and will

reflect later estimates based largely on

actual information for the period by the

time we set the 2002 physician fee

schedule update.

Factor 3—Estimated Real Gross

Domestic Product Per Capita Growth in

CY 2001

Section 1848(f)(2)(C) of the Act, as

amended by section 211 of the BBRA,

requires us to estimate growth in real

GDP per capita. This factor is applied on

a CY basis beginning with the CY 2000

SGR. We estimate that the growth in real

GDP will be 2.7 percent in CY 2001. Our

past experience indicates that there

have also been large changes in

estimates of real per capita GDP growth

and the actual change in this factor.

Again, we note that we will use revised

estimates of real per capita GDP growth

in setting future year updates.

Factor 4—Percentage Change in

Expenditures for Physicians’ Services

Resulting From Changes in Law or

Regulations in CY 2001 Compared With

CY 2000

There are no statutory or regulatory

provisions that will affect expenditures

in CY 2001 relative to CY 2000. The

percentage change in expenditures for

physicians’ services resulting from

changes in law or regulations is

estimated to be 0.0 percent for 2001.

2. Detail on Calculation of the FY 2000

and CY 2000 SGRs

A more detailed discussion of our

revised estimates of the four elements of

the FY 2000 and CY 2000 SGR follows.

Factor 1—Changes in Fees for

Physicians’ Services (Before Applying

Legislative Adjustments) for FY 2000

SGR and CY 2000 SGR.

We are continuing to use 2.1 percent

for this element of the SGR for the FY

2000 SGR and the CY 2000 SGR. This

factor is unchanged from earlier

estimates previously described

respectively for FY 2000 and CY 2000

in the October 1, 1999 Federal Register

(65 FR 53395) and the April 10, 2000

Federal Register (65 FR 19003).

Factor 2—The Percentage Change in the

Average Number of Part B Enrollees for

the FY 2000 SGR and CY 2000 SGR.

This factor is our estimate of the

percent change in the average number of

fee-for-service enrollees for FY 2000 as

compared to FY 1999 and CY 2000 as

compared to CY 1999. As we indicated

above, this factor is difficult to estimate

prior to the beginning of the period for

which the estimates are being made

because of the interaction of the fee-forservice and M+C program and the lack

of availability of actual data on

beneficiary selection of M+C

enrollment. We currently have such

information on actual enrollment in the

M+C program for FY 2000 and CY 2000

that permits estimates of the change in

fee-for-service enrollment for these

years that will be more reflective of the

final actual change. The estimates for

FY 2000 and CY 2000 were derived by

subtracting estimated M+C enrollment

from estimated overall Medicare

enrollment as illustrated in the tables

below.

1999 2000

Overall ..................... 37.055

million.

37.746

million.

Medicare+Choice .... 6.191 ......

million .....

6.303

million.

Net ........................... 30.864

million.

31.174

million.

Percent Increase ..... ................ 1.0 percent.

Our actuaries’ estimate of the percent

change in the average number of fee-forservice enrollees, net of M+C enrollment

for 2000 compared to 1999 (0.8 percent

for fiscal year 2000, and 1.0 percent for

calendar year 2000) is greater than

earlier estimates of this factor (¥4.3

percent for FY 2000 and ¥0.6 percent

for CY 2000). This is because the

historical base from which our actuarial

estimate is made has changed (that is,

we have more information on actual

enrollment in M+C plans from CY 1999

and CY 2000 that affects our estimates

for these and future years).

Factor 3—Estimated Real Gross

Domestic Product Per Capita Growth in

FY 2000 and CY 2000

In the FY 2000 SGR notice published

on October 1, 1999 (64 FR 53396), we

estimated that real GDP growth per

capita for FY 2000 would be 1.8 percent.

In our April 10, 2000 SGR notice, we

estimated that real per capita GDP

growth for CY 2000 would be 2.5

percent. We are now estimating real

GDP growth per capita to be 4.5 percent

for FY 2000 and 4.3 percent for CY

2000. As we explained in our April 10,

2000 SGR notice (65 FR 19004), the

higher estimate of the FY 2000 SGR is

due in part to Bureau of Economic

Analysis (BEA) revisions to the

historical National Income and Product

Accounts (NIPA) and in part due to a

change in the outlook for growth in

2000. The historical revisions, released

by BEA on October 29, 1999, raised

historical real GDP per capita growth by

0.2 percentage points on average

between 1959 and 1998, with larger

differences in recent years. (For detailed

description of changes to NIPA, see

Brent R. Moulton, Robert P. Parker, and

Eugene P. Seskin, ‘‘A Preview of the

1999 Comprehensive Revision of the

National Income and Product

Accounts,’’ Survey of Current Business

(August, 1999): 7–20.) Subsequently, the

projections of growth in real GDP per

capita for FY 2000 have been revised

upwards to reflect these revisions. Also,

projections of real GDP per capita in

2000 (both FY and CY) have been

revised upward to reflect stronger than

expected stock market performance and

less than expected buildup of

inventories in preparation for Y2K in

1999.

Factor 4—Percentage Change in

Expenditures for Physicians’ Services

Resulting From Changes in Law or

Regulations in FY 2000 Compared With

FY 1999 and CY 2000 Compared With

CY 1999

As we explained in our October 1,

1999 and April 10, 2000 SGR notices,

legislative changes contained in the

BBA and the BBRA will have an impact

on expenditures for physicians’ services

under the SGR in FY 2000 and CY 2000.

Section 4103 of the BBA mandates a

new prostate screening benefit effective

January 1, 2000. We originally did not

include any costs associated with the

prostate screening benefit in our FY

2000 SGR notice published on August 1,

1999 (64 FR 53394). In the CY 2000 SGR

notice published on April 10, 2000 (65

FR 19004), we indicated that inclusion

of the prostate screening benefit would

increase the FY 2000 SGR by 1.4

percentage points. We inadvertently

included both the estimated physician

and hospital expenditures associated

with the prostate screening benefit in

this figure while only Part B physician

expenditures should be included in the

SGR. In the April 10, 2000 SGR notice,

we estimated that factor 4 would be 1.2

percentage points for the FY 2000 SGR

and 1.7 percentage points for the CY

2000 SGR. The corresponding figures

are now 0.3 percent for FY 2000 and 0.5

percent for CY 2000. The correction of

the prostate screening benefit largely

explains the reduction in this factor

from our April 10, 2000 notice. We also

incorporated a higher price for the

prostate screening test itself that has the

effect of slightly increasing this

component of the FY and CY 2000 SGR.

Other factors that affect the FY 2000 and

65434 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

CY 2000 SGR are the elimination of the

requirement that subluxation of the

spine be demonstrated by an x-ray

before a beneficiary can receive

Medicare coverage for chiropractic

services. This provision is resulting in a

small increase in expenditures in FY

2000 and CY 2000. The impact of BBA

Medicare Secondary Payer provisions

will have marginal impact on reducing

expenditures in FY 2000 and CY 2000.

Certain BBRA provisions also have a

small impact on expenditures in FY

2000 and CY 2000. Section 224 of the

BBRA increases payments for pap

smears and is slightly increasing

expenditures. Section 221 of the BBRA

postponed the implementation of

payment caps on physical and

occupational therapy and speechlanguage pathology services. The effect

of this provision on physicians and

independent practitioners is resulting in

a small increase in expenditures for

these years. There is no effect on the

SGR of provisions related to the

technical component of a physician

pathology service or the use of modifier

25. We are not implementing the

proposed policy related to modifier 25,

and the savings associated with the

technical component of a physician

pathology service are not large enough

to affect calculation of the FY 2001 SGR.

After taking into account these

provisions, the percentage change in

expenditures for physicians’ services

resulting from changes in law or

regulations is estimated to be 0.3

percent for FY 2000 and 0.5 percent for

CY 2000.

VII. Provisions of the Final Rule

The provisions of this final rule

restate the provisions of the July 2000

proposed rule, except as noted

elsewhere in the preamble. Following is

a highlight of the changes made from

the proposed rule:

For changes related to the Geographic

Practice Cost Index (GPCI), we made no

changes in the 2002 and 2001 GPCIs

from those proposed in the July 2000

proposed rule except to correct the

Kansas malpractice GPCI. Since the

revised GPCIs could not result in total

payments either greater or lesser than

payments that would have been made if

GPCIs were not revised, it was necessary

to adjust the GPCIs for budget neutrality

as required by law. Therefore, we

adjusted the 2001 through 2002 GPCIs

as follows—work by 0.99699; practice

expense by 0.99235; and malpractice by

1.00215.

For malpractice RVUs, new

malpractice RVUs, based on the more

recent 1996 through 1998 premium

data, will become effective January 1,

2001. These malpractice RVUs will be

considered interim for 2001 and subject

to comment and possible revision in

2002.

We are not finalizing our proposal

relating to global period for insertion,

removal, and replacement of

pacemakers and cardioverter

defibrillators, because we believe that

physicians have raised valid concerns

that the adjustment to the work RVUs in

the proposed rule may result in an

underpayment for the service. Until we

review this issue further, we are

continuing with current pricing for

these services and the use of the 90-day

global period.

For our proposal relating to low

intensity ultrasound, we are assigning

.62 work RVUs and .04 malpractice

RVUs to CPT code 20979 (which are the

values also used for CPT code 20974).

To determine the practice expense

RVUs, we are applying direct inputs of

technician time of 45 minutes and an

exam table and minimum supply

package. Since the publication of the

July 2000 proposed rule, a national

coverage decision has been made stating

that low intensity ultrasound will be

covered by Medicare as a treatment

modality for nonunion of extremity

fractures beginning April 1, 2001.

For our proposal concerning

observation care codes CPT 99234

through 99236, we are not adjusting the

work RVUs as proposed. We are

maintaining the current work RVUs and

clarifying the policies to be followed for

the use of these codes.

VIII. Collection of Information

Requirements

This document does not impose

information collection and

recordkeeping requirements.

Consequently, it need not be reviewed

by the Office of Management and

Budget under the authority of the

Paperwork Reduction Act of 1995.

IX. Response to Comments

Because of the large number of items

of correspondence we normally receive

on Federal Register documents

published for comment, 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, if we proceed

with a subsequent document, we will

respond to the comments in the

preamble to that document.

X. Regulatory Impact Analysis

We have examined the impacts of this

final rule as required by Executive

Order 12866, the Unfunded Mandates

Reform Act of 1995 (UMRA) (Pub. L.

104–4), the Regulatory Flexibility Act of

1980 (RFA) (Pub. L. 96–354), and

Executive Order 13132 of August 4,

1999 (Federalism).

EO 12866 directs agencies to assess

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

(RIA) must be prepared for major rules

with economically significant effects

($100 million or more annually). In the

proposed rule impact analysis, we

indicated that the rule would not be a

major rule because it would not increase

or decrease expenditures to a physician

specialty or geographic area by more

than $100 million. While the changes in

the Medicare physician fee schedule are

for the most part, budget neutral, they

do involve redistribution of Medicare

spending among procedures and

physician specialties and geographic

areas. The redistributive effect of this

rule on any particular specialty or

geographic area is, in our estimate,

likely to exceed $100 million for at least

one physician specialty. For this reason,

we are considering this to be a major

rule. The GPCI changes are expected to

increase payments by less than $10

million in one locality and decrease

payments by about $20 million in

another locality. The effect on all other

payment localities is likely to be less

than these amounts.

The UMRA also requires (in section

202) that agencies prepare an

assessment of anticipated costs and

benefits before developing any rule that

may result in expenditure in any one

year by State, local, or tribal

governments, in the aggregate, or by the

private sector, of $100 million or more.

We have determined that this rule has

no consequential effect on State, local,

or tribal governments. We believe the

private sector cost of this rule falls

below the above-stated threshold as

well.

The RFA requires that we analyze

regulatory options for small businesses

and other small 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 and lessen

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65435

significant adverse economic impact on

the small entities.

In addition, section 1102(b) of the Act

requires us to prepare a regulatory

impact analysis if a rule may have a

significant impact on the operations of

a substantial number of small rural

hospitals. This analysis must conform to

the provisions of section 604 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 of

a Metropolitan Statistical Area and has

fewer than 50 beds.

For purposes of the RFA, all

physicians are considered to be small

entities. There are about 700,000

physicians and other practitioners who

receive Medicare payment under the

physician fee schedule.

For the purpose of EO 12866 and the

RFA we have prepared the following

analysis, which, together with the rest of

this preamble, meets all four assessment

requirements. It explains the rationale

for and purpose of the rule, details the

costs and benefits of the rule, analyzes

alternatives, and presents the measures

we considered to minimize the burden

on small entities.

A. Resource-Based Practice Expense

Relative Value Units

Revisions in resource-based practice

expense RVUs for physicians’ services

are calculated to be budget neutral, that

is, the total practice expense RVUs for

calendar year 2001 are calculated to be

the same as the total practice expense

RVUs that we estimate would have

occurred without the changes in this

regulation. This also means that

increases in practice expense RVUs for

some services will necessarily be offset

by corresponding decreases in values for

other services.

The following table shows the impact

on total allowed charges by specialty of

this rule’s practice expense changes. In

addition to the provisions of the rule,

this table incorporates any impacts that

result from using 1999 utilization data

and other changes that we have made to

practice expense inputs. The column

labeled ‘‘Year 2001–2002 Impact’’

shows the impact on the fully

implemented practice expense RVUs of

changes resulting from this final rule.

The column labeled ‘‘Year 2001’’ impact

reflects only the 2001 portion of the

changes from ‘‘Year 2001–2002 Impact’’

column. The difference between the two

columns reflects the effect of the

transition to fully implemented practice

expense RVUs. That is, the impact in

the 2001 column will reflect 75 percent

of the impact on the fully implemented

RVUs. These impacts are in addition to

the impacts announced in previous

rules related to the adoption of resourcebased practice relative value units.

IMPACT OF PRACTICE EXPENSE CHANGES, TRANSITION, AND 2001–2002 IMPACT

Specialty

Allowed

charges

(billions $)

Year 2001

impact

%

2001–2002

impact

%

Anesthesiology ......................................................................................................................................... 1.5 ¥1 ¥1

Cardiac Surgery ....................................................................................................................................... 0.3 ¥1 ¥2

Cardiology ................................................................................................................................................ 4.1 ¥1 ¥1

Chiropractor ............................................................................................................................................. 0.4 1 1

Clinics ...................................................................................................................................................... 1.5 0 0

Dermatology ............................................................................................................................................. 1.4 ¥1 ¥2

Emergency Medicine ............................................................................................................................... 1.0 0 0

Family Practice ........................................................................................................................................ 3.3 ¥2 ¥2

Gastroenterology ..................................................................................................................................... 1.2 1 2

General Practice ...................................................................................................................................... 1.0 ¥1 ¥2

General Surgery ...................................................................................................................................... 1.9 0 0

Hematology Oncology ............................................................................................................................. 0.6 ¥2 ¥2

Internal Medicine ..................................................................................................................................... 6.8 ¥1 ¥1

Nephrology ............................................................................................................................................... 0.9 2 3

Neurology ................................................................................................................................................. 0.8 0 0

Neurosurgery ........................................................................................................................................... 0.3 ¥1 ¥1

Nonphysician Practitioner ........................................................................................................................ 1.1 1 2

Obstetrics/Gynecology ............................................................................................................................. 0.4 0 ¥1

Ophthalmology ......................................................................................................................................... 3.7 0 0

Optometrist .............................................................................................................................................. 0.5 ¥1 ¥2

Orthopedic Surgery .................................................................................................................................. 2.2 ¥1 ¥1

Other Physician ....................................................................................................................................... 1.5 0 0

Otolaryngology ......................................................................................................................................... 0.6 ¥2 ¥2

Pathology ................................................................................................................................................. 0.6 ¥2 ¥3

Plastic Surgery ......................................................................................................................................... 0.2 0 1

Podiatry .................................................................................................................................................... 1.1 0 0

Psychiatry ................................................................................................................................................ 1.0 1 1

Pulmonary ................................................................................................................................................ 1.0 0 1

Radiation Oncology ................................................................................................................................. 0.7 0 0

Radiology ................................................................................................................................................. 3.0 4 5

Rheumatology .......................................................................................................................................... 0.3 ¥1 ¥1

Suppliers .................................................................................................................................................. 0.5 ¥5 ¥6

Thoracic Surgery ..................................................................................................................................... 0.5 ¥1 ¥1

Urology ..................................................................................................................................................... 1.3 0 0

Vascular Surgery ..................................................................................................................................... 0.3 ¥1 ¥1

The following table shows the impact

of this final rule compared to the

proposed rule that was published on

July 17. There are 3 major changes that

occurred between the proposed and

final rule that may have an impact on

specialty level payments. First, we

corrected an error in the practice

expense methodology that affected

physical and occupational therapy. We

inadvertently used the incorrect practice

expense per hour for physical and

65436 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

occupational therapy in the proposed

rule. This caused the nonphysician

practitioner category to reflect a 4

percent increase in payments. The

correct figure should have been 1

percent. Second, we are using 1999

utilization data. Use of the 1999

utilization data generally appears to

have little impact on any particular

specialty. It does result in a small

reduction in payments for pathology

and a somewhat larger reduction in

payments for the supplier category.

Third, we adopted the

recommendations of the RUC and PEAC

to make refinements to the practice

expense inputs for office visits and

office consultation services. This change

will have the effect of reducing

payments for specialties whose incomes

are derived in large part from these

services. We note that the table shows

the impact of this rule only and does not

incorporate practice expense changes

from two final rules, November 2, 1998

(63 FR 58895) and November 2, 1999

(64 FR 59433), that resulted in large

increases in payments for visit and

consultation services provided in

physicians’ offices. Since the statute

requires a transition to payments based

on resource-based practice expense

RVUs, the increase in payments for

these services is occurring over a 4-year

period. Payment for these services is

continuing to increase under the

transition to resource-based practice

expense RVUs. However, it is increasing

by a lesser amount than earlier

anticipated.

IMPACT OF PRACTICE EXPENSE CHANGES OF THE FINAL RULE COMPARED TO THE PROPOSED RULE

Specialty

Allowed

charges

(billions $)

Proposed

rule

impact %

Final

2001–2002

impact %

Anesthesiology ......................................................................................................................................... 1.5 ¥1 ¥1

Cardiac Surgery ....................................................................................................................................... 0.3 ¥3 ¥2

Cardiology ................................................................................................................................................ 3.9 0 ¥1

Chiropractor ............................................................................................................................................. 0.4 1 1

Clinics ...................................................................................................................................................... 1.5 0 0

Dermatology ............................................................................................................................................. 1.3 0 ¥2

Emergency Medicine ............................................................................................................................... 0.9 0 0

Family Practice ........................................................................................................................................ 3.2 0 ¥2

Gastroenterology ..................................................................................................................................... 1.1 2 2

General Practice ...................................................................................................................................... 1.0 0 ¥2

General Surgery ...................................................................................................................................... 1.9 ¥1 0

Hematology Oncology ............................................................................................................................. 0.6 ¥1 ¥2

Internal Medicine ..................................................................................................................................... 6.7 0 ¥1

Nephrology ............................................................................................................................................... 0.9 2 3

Neurology ................................................................................................................................................. 0.8 0 0

Neurosurgery ........................................................................................................................................... 0.3 ¥1 ¥1

Nonphysician Practitioner ........................................................................................................................ 0.9 4 2

Obstetrics/Gynecology ............................................................................................................................. 0.4 ¥1 ¥1

Ophthalmology ......................................................................................................................................... 3.7 ¥1 0

Optometrist .............................................................................................................................................. 0.5 ¥2 ¥2

Orthopedic Surgery .................................................................................................................................. 2.2 ¥1 ¥1

Other Physician ....................................................................................................................................... 1.3 1 0

Otolaryngology ......................................................................................................................................... 0.6 ¥1 ¥2

Pathology ................................................................................................................................................. 0.6 ¥1 ¥3

Plastic Surgery ......................................................................................................................................... 0.2 0 1

Podiatry .................................................................................................................................................... 1.1 0 0

Psychiatry ................................................................................................................................................ 1.1 ¥1 1

Pulmonary ................................................................................................................................................ 1.0 0 1

Radiation Oncology ................................................................................................................................. 0.6 1 0

Radiology ................................................................................................................................................. 2.9 3 5

Rheumatology .......................................................................................................................................... 0.3 0 ¥1

Suppliers .................................................................................................................................................. 0.5 ¥1 ¥6

Thoracic Surgery ..................................................................................................................................... 0.5 ¥2 ¥1

Urology ..................................................................................................................................................... 1.3 0 0

Vascular Surgery ..................................................................................................................................... 0.3 ¥1 ¥1

The following table titled Impact of

this Final Rule on Payments for Selected

Codes shows the percentage change in

total payment (in 2001 physician fee

schedule dollars) for selected highvolume procedures that result from

practice expense and malpractice

changes announced in this final rule.

These tables reflect the impact of this

final rule only on the fully implemented

fee schedule amount. The payments in

these columns are determined using a

conversion factor $38.2581. The RVUs

used for calculating payment in the

‘‘old’’ columns are from the November

2, 1999 final rule. The RVUs used in

calculating payments in the ‘‘new’’

columns are from this final rule. By

using the conversion factor of $38.2581

and the 2001 malpractice RVUs to

calculate payments in both the ‘‘old’’

and ‘‘new’’ columns, the impact of

changes in practice expense are

illustrated. These tables do not show the

actual impact on payment from 2000 to

2001 because they do not incorporate

the effect of the transition or physician

fee schedule update (that is, ‘‘old’’ and

‘‘new’’ payments both reflect use of the

2001 conversion factor).

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65437

IMPACT OF THIS FINAL RULE ONLY ON PAYMENT FOR SELECTED CODES

Procedure

code Description Oldfacility

New

facility

Percent

change

Old

nonfacility

New

nonfacility

Percent

change

11721 ............. ............ Debride nail, 6 or more ........................................ $30.22 $30.61 1 $41.32 $42.47 3

17000 ............. ............ Destroy benign/premal lesion .............................. 34.43 34.43 0 63.13 63.89 1

27130 ............. ............ Total hip replacement .......................................... 1,487.09 1,502.78 1 NA NA NA

27236 ............. ............ Treat thigh fracture .............................................. 1,135.88 1,153.10 2 NA NA NA

27244 ............. ............ Treat thigh fracture .............................................. 1,157.31 1,177.58 2 NA NA NA

27447 ............. ............ Total knee replacement ....................................... 1,556.72 1,570.88 1 NA NA NA

33533 ............. ............ CABG, arterial, single .......................................... 1,904.49 1,859.73 ¥2 NA NA NA

35301 ............. ............ Rechanneling of artery ......................................... 1,180.64 1,172.99 ¥1 NA NA NA

43239 ............. ............ Upper GI endoscopy, biopsy ............................... 143.85 157.24 9 283.11 298.03 5

45385 ............. ............ Lesion removal colonoscopy ............................... 283.49 299.94 6 478.99 502.33 5

66821 ............. ............ After cataract laser surgery ................................. 184.79 215.01 16 212.72 229.93 8

66984 ............. ............ Cataract surg w/iol, i stage .................................. 680.99 698.21 3 NA NA NA

67210 ............. ............ Treatment of retinal lesion ................................... 575.40 575.78 0 629.73 628.20 0

71010 ............. 26 Chest x-ray ........................................................... 9.18 9.56 4 9.18 9.56 4

71020 ............. 26 Chest x-ray ........................................................... 11.09 11.86 7 11.09 11.86 7

88305 ............. 26 Tissue exam by pathologist ................................. 42.47 42.08 ¥1 42.47 42.08 ¥1

90801 ............. ............ Psy dx interview ................................................... 144.62 145.00 0 152.27 153.80 1

90806 ............. ............ Psytx, off, 45-50 min ............................................ 97.56 96.41 ¥1 101.77 102.15 0

90807 ............. ............ Psytx, off, 45-50 min w/e&m ................................ 103.68 104.44 1 108.27 109.80 1

90862 ............. ............ Medication management ...................................... 48.59 48.97 1 53.18 53.94 1

90921 ............. ............ ESRD related services, month ............................ 272.02 278.90 3 272.02 278.90 3

90935 ............. ............ Hemodialysis, one evaluation .............................. 63.13 77.66 23 NA NA NA

92004 ............. ............ Eye exam, new patient ........................................ 91.44 92.58 1 130.46 131.23 1

92012 ............. ............ Eye exam established pat ................................... 37.88 37.88 0 66.19 66.19 0

92014 ............. ............ Eye exam & treatment ......................................... 61.60 62.36 1 94.50 94.88 0

92980 ............. ............ Insert intracoronary stent ..................................... 840.15 845.89 1 NA NA NA

92982 ............. ............ Coronary artery dilation ....................................... 621.69 626.67 1 NA NA NA

93000 ............. ............ Electrocardiogram, complete ............................... NA NA NA 27.55 27.55 0

93010 ............. ............ Electrocardiogram report ..................................... 9.18 9.56 4 9.18 9.56 4

93015 ............. ............ Cardiovascular stress test ................................... NA NA NA 109.04 108.65 0

93307 ............. 26 Echo exam of heart ............................................. 50.88 51.27 1 50.88 51.27 1

93510 ............. 26 Left heart catheterization ..................................... 244.47 246.38 1 244.47 246.38 1

98941 ............. ............ Chiropractic manipulation .................................... 32.14 32.52 1 36.73 37.49 2

99202 ............. ............ Office/outpatient visit, new ................................... 47.82 48.21 1 76.13 63.89 ¥16

99203 ............. ............ Office/outpatient visit, new ................................... 73.07 73.46 1 107.51 95.65 ¥11

99204 ............. ............ Office/outpatient visit, new ................................... 107.89 108.65 1 152.27 137.73 ¥10

99205 ............. ............ Office/outpatient visit, new ................................... 142.32 143.85 1 187.85 174.46 ¥7

99211 ............. ............ Office/outpatient visit, est ..................................... 9.18 9.18 0 26.40 21.04 ¥20

99212 ............. ............ Office/outpatient visit, est ..................................... 24.10 24.49 2 40.55 37.49 ¥8

99213 ............. ............ Office/outpatient visit, est ..................................... 35.58 35.96 1 54.33 52.41 ¥4

99214 ............. ............ Office/outpatient visit, est ..................................... 58.53 58.92 1 84.55 82.64 ¥2

99215 ............. ............ Office/outpatient visit, est ..................................... 94.50 95.26 1 120.90 120.90 0

99221 ............. ............ Initial hospital care ............................................... 68.10 68.86 1 NA NA NA

99222 ............. ............ Initial hospital care ............................................... 113.24 114.01 1 NA NA NA

99223 ............. ............ Initial hospital care ............................................... 157.62 159.15 1 NA NA NA

99231 ............. ............ Subsequent hospital care .................................... 34.05 34.43 1 NA NA NA

99232 ............. ............ Subsequent hospital care .................................... 55.86 56.24 1 NA NA NA

99233 ............. ............ Subsequent hospital care .................................... 79.58 80.34 1 NA NA NA

99236 ............. ............ Observ/hosp same date ....................................... 202.39 194.34 4 NA NA NA

99238 ............. ............ Hospital discharge day ........................................ 67.33 67.72 1 NA NA NA

99239 ............. ............ Hospital discharge day ........................................ 91.82 92.58 1 NA NA NA

99241 ............. ............ Office consultation ............................................... 34.43 34.81 1 63.89 48.97 ¥23

99242 ............. ............ Office consultation ............................................... 70.78 71.54 1 106.74 91.05 ¥15

99243 ............. ............ Office consultation ............................................... 94.11 95.26 1 134.67 120.90 ¥10

99244 ............. ............ Office consultation ............................................... 138.88 140.79 1 185.17 171.78 ¥7

99245 ............. ............ Office consultation ............................................... 184.40 186.70 1 232.99 223.04 ¥4

99251 ............. ............ Initial inpatient consult ......................................... 37.88 38.26 1 NA NA NA

99252 ............. ............ Initial inpatient consult ......................................... 74.99 75.37 1 NA NA NA

99253 ............. ............ Initial inpatient consult ......................................... 101.77 102.15 0 NA NA NA

99254 ............. ............ Initial inpatient consult ......................................... 145.00 146.15 1 NA NA NA

99255 ............. ............ Initial inpatient consult ......................................... 198.94 200.47 1 NA NA NA

99261 ............. ............ Follow-up inpatient consult .................................. 24.49 24.87 2 NA NA NA

99262 ............. ............ Follow-up inpatient consult .................................. 47.44 47.82 1 NA NA NA

99263 ............. ............ Follow-up inpatient consult .................................. 69.63 70.01 1 NA NA NA

99282 ............. ............ Emergency dept visit ........................................... 27.93 27.93 0 NA NA NA

99283 ............. ............ Emergency dept visit ........................................... 62.74 62.74 0 NA NA NA

99284 ............. ............ Emergency dept visit ........................................... 97.56 97.94 0 NA NA NA

99285 ............. ............ Emergency dept visit ........................................... 152.65 153.03 0 NA NA NA

99291 ............. ............ Critical care, first hour .......................................... 202.39 208.89 3 211.18 218.45 3

99292 ............. ............ Critical care, addl 30 min ..................................... 101.00 104.06 3 108.27 111.71 3

99301 ............. ............ Nursing facility care ............................................. 63.13 63.51 1 NA NA NA

99302 ............. ............ Nursing facility care ............................................. 84.17 84.93 1 NA NA NA

99303 ............. ............ Nursing facility care ............................................. 104.44 105.59 1 NA NA NA

99311 ............. ............ Nursing fac care, subseq ..................................... 31.37 31.75 1 NA NA NA

99312 ............. ............ Nursing fac care, subseq ..................................... 52.03 52.41 1 NA NA NA

99313 ............. ............ Nursing fac care, subseq ..................................... 73.84 74.60 1 NA NA NA

99348 ............. ............ Home visit, est patient ......................................... 69.63 70.01 1 75.75 77.28 2

99350 ............. ............ Home visit, est patient ......................................... 161.83 164.13 1 171.78 176.37 3

65438 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

B. Geographic Practice Cost Index

Changes

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

requires that payments under the

Medicare physician fee schedule vary

among payment areas only to the extent

that area costs vary as reflected by the

area GPCIs. The GPCIs measure area

cost differences in the three components

of the physician fee schedule: Physician

work, practice expenses (employee

wages, rent, medical supplies, and

equipment), and malpractice insurance.

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

that the GPCIs be reviewed and, if

necessary, revised at least every 3 years.

The first GPCI revision was

implemented in 1995. The second

revision was implemented in 1998, and

the next revision will be implemented

in 2001. Section 1848(e)(1)(C) of the Act

also requires that the GPCI revisions be

phased in equally over a 2-year period

if more than one year has elapsed since

the last adjustment.

An estimate of the overall effects of

proposed GPCI changes on fee schedule

area payments can be demonstrated by

a comparison of area geographic

adjustment factors (GAFs). The GAFs

are a weighted composite of each area’s

work, practice expense, and malpractice

expense GPCIs using the national GPCI

cost share weights. While we do not

actually use the GAFs in computing the

fee schedule payment for a specific

service, they are useful in comparing

overall area costs and payments. The

actual effect on payment for any actual

service will deviate from the GAF to the

extent that the service’s proportions of

work, practice expense, and malpractice

expense RVUs differ from those of the

GAF. Addendum H shows the estimated

effects of the revised GPCIs on area

GAFs in descending order.

Only 14 of the 89 fee schedule areas

will change by at least 2 percent. Only

16 areas will change by from 1 to 1.9

percent. The remaining 59 areas are

estimated to experience payment

changes of less than 1 percent under the

revised GPCIs. These are very minor

changes that would be expected in that

we are revising only the rent indices,

comprising 11.6 percent of the total

GPCI, and the malpractice expense

indices, comprising 3.2 percent of the

GPCI. Thus, only about 15 percent of the

GPCIs will be subject to change. The

effects in the transition year 2001 will

only be one-half of these amounts as the

revised GPCIs will be phased in over a

2-year period as required by law.

C. Resource-Based Malpractice Relative

Value Units

The malpractice RVUs in this final

rule reflect the newer data and

refinements made as a result of

comments made on last year’s rule. As

we anticipated in the proposed rule, use

of the updated data results in little

impact on the specialty level payments.

Tables showing the impacts can be

found in the technical addendum at

Addendum G. Of the 62 specialties

shown, the overall median effect on

specialty payments is 0.0 percent. The

median impact on specialties whose

payments are estimated to increase is

+0.2 percent. The median impact on

specialties whose payments are

expected to decrease is -0.1 percent.

D. Critical Care Relative Value Units

As we explained in the preamble in

the November 1999 final rule, we

established interim work RVUs for 2000

for CPT codes 99291 and 99292 (critical

care services). These RVUs were

decreased in 2000 due to concerns about

changes in the CPT definition for these

services. In the proposed rule we

indicated our intent to increase the

work RVUs for critical care services and

value the physician work at 4.0 RVUs

for CPT code 99291 and 2.0 RVUs for

CPT code 99292 because of changes that

were made to the definition of critical

care for 2001. The earlier reductions to

the work RVUs were made assuming

there would be a substitution of use of

the critical care codes for other codes

that would increase net payments if

there were no reductions to the work

RVUs. We do not believe this

substitution will occur because of

additional revisions to the definition of

critical care for 2001. Thus net

payments would decrease if we do not

restore critical care RVUs to their former

levels. For this reason we are finalizing

our proposal and increasing the work

RVUs to 4.0 RVUs for CPT code 99292.

E. Care Plan Oversight and Physician

Certification/Recertification

We are establishing two new HCPCS

codes for care plan oversight that are

consistent with our coverage criteria.

We are establishing two new HCPCS

codes to describe the services involved

in physician certification or

recertification and development of a

plan of care for a patient for whom the

physician has prescribed Medicarecovered home health services. We are

assuming there would be no additional

cost or savings as a result of the two new

HCPCS codes for care plan oversight.

We are merely instituting these codes

for consistency with our coverage

criteria, and they would be used in

place of the CPT codes when these

services are provided.

In our proposed rule we indicated

that new HCPCS codes are being

established for physician certification or

recertification and development of a

plan of care. We stated that payment for

these services is currently included in

the payment for a variety of services

such as E/M services that are provided

independently to patients as part of a

global surgical service. Under this

proposal, we would instead pay

separately for the certification and

recertification of the plan of care for

home health services. Since we are

proposing to pay separately for a service

that is currently included in our

payment for other services, this

proposal would increase Medicare

expenditures for physicians’ services

without an adjustment to the physician

fee schedule CF. For this reason, we

proposed to adjust the physician fee

schedule CF to ensure that Medicare

payments for physicians’ services do not

increase as a result of this proposal.

Comment: We received several

comments that objected to any budget

neutrality adjustment related to the

establishment of new codes related to

certification and recertification of a plan

of care for home health services.

According to the AMA, the home health

PPS rule published on July 3, 2000

indicates that we want more physician

effort devoted to home health services,

and not just a continuation of current

efforts. The AMA stated that our home

health PPS rule indicates an intent to

focus on physician certification efforts

and education ‘‘in order to better

involve the physician in the delivery of

home health services.’’ (65 FR 41127).

Response: Although we are

establishing new codes to describe

certification and recertification of a plan

of care for home health services, we

disagree that the establishment of these

codes constitutes a new requirement to

furnish a physicians’ service as a

condition of payment for home health

services. We note that the proposed

regulations applicable to home health

services, published on October 10, 1999,

would have modified 42 CFR section

424.22 to add a new paragraph (a)(1)(v)

to specify that as a condition for

payment of home health services under

Medicare Part A or Medicare Part B, a

physician must certify that the

individual is correctly assigned to one

of the home health resource groups.

However, in response to comments we

eliminated this requirement and did not

make a modification to the regulation.

We also proposed to make a conforming

change at paragraph (b)(1) of § 424.22

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65439

regarding the timing of the

recertification. Specifically, we

proposed to amend § 424.22(b) by

replacing the phrase ‘‘at least every 2

months’’ with ‘‘at least every 60 days.’’

We believe this is a minor conforming

change to the regulation that will have

little or no impact on expenditures.

While we believe it is beneficial to

establish separate codes for the

certification and recertification services,

the home health regulations do not

impose any new requirements on

physicians that will increase

expenditures. As indicated in our April

2000, Program Memorandum (Provider

Education Article: Role of Physicians in

the Home Health Prospective Payment

System, transmittal B–00–16), the

prospective payment system does not

introduce change to the plan of care. It

remains the beneficiary’s physician’s

responsibility to develop a plan of care

based on his or her intimate knowledge

of the medical condition of the home

health patient.

The sustainable growth rate

determined under section 1848(f) of the

Act allows for an adjustment for

changes in expenditures that ‘‘will

result from changes in law and

regulations.’’ Since there are no new

requirements being imposed upon

physicians and there are no regulatory

changes that would mandate an

adjustment to the SGR, we are making

a budget neutrality adjustment to the

conversion factor to ensure that

expenditures do not increase as a result

of this provision. We estimate that

paying separately for certification and

recertification of a plan of care for home

health services will increase Medicare

payments without the 0.3 percent

offsetting adjustment to the conversion

factor that we have applied.

F. Observation Care Codes

We believe that there are not any

significant costs for this policy

clarification. We believe physicians

have not typically been billing for the

discharge component of a hospital or

observation stay of less than 8 hours.

However, physicians who have been

billing 99234 through 99236 for stays

less than 8 hours in length would see a

small reduction in payment. This policy

clarification will give clear guidance to

physicians and Medicare contractors in

reviewing medical records and would

assure consistent payment across

contractors.

G. Ocular Photodynamic Therapy and

Other Ophthalmological Treatments

As previously stated, we are

establishing national HCPCS codes and

payment amounts for ocular

photodynamic therapy. If we did not

establish national codes and pricing for

this procedure, carriers that determined

that this procedure is covered would

use unlisted codes and determine

pricing locally. There will be no budget

effects associated with establishing

national codes and payment amounts

for this service since national pricing

would substitute for use of unlisted

codes and carrier pricing.

H. Electrical Bioimpedance

As stated earlier, we are establishing

a national payment amount for electrical

bioimpedance. This rule establishes

national pricing amounts for a service

currently priced by carriers. This change

will have little impact on the Medicare

program costs.

I. Global Period for Insertion, Removal,

and Replacement of Pacemakers and

Cardioverter Defibrillators

We proposed to change the global

period for certain CPT codes involving

the insertion, removal, and replacement

of pacemakers and cardioverter

defibrillators from 90 days to 0 days.

The proposed changes were not

anticipated to result in cost or savings

because we proposed to reduce the work

and practice expense RVUs to account

for any claims that we would receive for

post-operative visits that were

previously bundled into payment for the

90-day global surgical service. As a

result of comments received on the

proposed rule, we are not adopting the

proposed policy. The global period will

remain at 90 days, and we will not

implement the proposed reductions to

the work and practice expense RVUs.

Thus, since there is no change in policy,

there are no budget implications of our

decision on this issue in the final rule.

J. Antigen Supply

Our change from permitting a

physician to bill for a 12-month, as

opposed to a 12-week supply of antigen

could benefit beneficiaries, since they

will be able to obtain a year’s supply of

medication in a single visit. We believe

that this change has no impact on

program costs. Also, there is no impact

on the beneficiary, since this change

only aggregates four prescriptions into

one, and the cost to the beneficiary

remains the same.

K. Increased Space Allotment in

Physical Therapy Salary Equivalency

Guidelines

We are making an adjustment to our

application of the salary equivalency

guidelines that are used to determine

the indirect components of the practice

expense per hour for physical and

occupational therapy. Payments for all

outpatient physical and occupational

therapy services will increase by 3 and

4 percent, respectively. This change will

be budget neutral among all physician

fee schedule services.

Other issues mentioned in the

preamble are merely discussions or

clarifications and, therefore, have no

budgetary impact.

Budget-Neutrality

Each year since the fee schedule has

been implemented, our actuaries have

determined any adjustments needed to

meet the budget-neutrality requirement

of the statute. A component of the

actuarial determination of budgetneutrality involves estimating the

impact of changes in the volume-andintensity of physicians’ services

provided to Medicare beneficiaries as a

result of the proposed changes.

Consistent with the provision in the

November 1998 final rule, the actuaries

would use a model that assumes a 30

percent volume-and-intensity response

to price reductions. This year there will

be a 5.0 percent increase in the

conversion factor resulting from the

physician fee schedule update. Since

this update will offset any negative

payment impacts resulting from this

final rule, no volume and intensity

adjustment is being incorporated into

the physician fee schedule conversion

factor in 2001.

Impact on Beneficiaries

Although changes in physicians’

payments when the physician fee

schedule was implemented in 1992

were large, we detected no problems

with beneficiary access to care.

Furthermore, since beginning our

transition to a resource-based practice

expense system in 1999, we have not

found that there are problems with

beneficiary access to care.

XI. Federalism

We have reviewed this final rule

under the threshold criteria of EO

13132, Federalism, and we have

determined that the final rule does not

significantly affect the rights, roles, and

responsibilities of States.

List of Subjects

42 CFR Part 410

Health facilities, Health professions,

Kidney diseases, Laboratories,

Medicare, Rural areas, X-rays.

42 CFR Part 414

Administrative practice and

procedure, Health facilities, Health

professions, Kidney diseases, Medicare,

65440 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Reporting and recordkeeping

requirements, Rural areas, X-rays.

For the reasons set forth in the

preamble, HCFA amends 42 CFR

chapter IV as follows:

PART 410—SUPPLEMENTARY

MEDICAL INSURANCE (SMI)

BENEFITS

1. The authority citation for part 410

continues to read as follows:

Authority: Secs. 1102 and 1871 of the

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

1395hh).

2. In § 410.68, republish the

introductory text and revise the

introductory text for paragraph (b) to

read as follows:

§ 410.68 Antigens: Scope and conditions.

Medicare Part B pays for—

* * * * *

(b) A supply of antigen sufficient for

not more than 12 months that is—

* * * * *

PART 414—PAYMENT FOR PART B

MEDICAL AND OTHER HEALTH

SERVICES

3. 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,

1395(hh), and 1395rr(b)(1).

4. Revise § 414.22(b)(5)(i) to read as

follows:

§ 414.22 Relative value units (RVUs).

* * * * *

(b) * * *

(5) * * *

(i) Usually there are two levels of

practice expense RVUs that correspond

to each code.

(A) Facility practice expense RVUs.

The lower facility practice expense

RVUs apply to services furnished to

patients in the hospital, skilled nursing

facility, community mental health

center, or in an ambulatory surgical

center when the physician performs

procedures on the ASC approved

procedures list. (The facility practice

expense RVUs for a particular code may

not be greater than the non-facility

RVUs for the code.)

(B) Non-facility practice expense

RVUs. The higher non-facility practice

expense RVUs apply to services

performed in a physician’s office, a

patient’s home, an ASC if the physician

is performing a procedure not on the

ASC approved procedures list, a nursing

facility, or a facility or institution other

than a hospital or skilled nursing

facility, community mental health

center, or ASC performing an ASC

approved procedure.

(C) Outpatient therapy services.

Outpatient therapy services billed under

the physician fee schedule are paid

using the non-facility practice expense

RVU component.

* * * * *

(Catalog of Federal Domestic Assistance

Program No. 93.778, Medical Assistance

Program)

(Catalog of Federal Domestic Assistance

Program No. 93.773, Medicare—Hospital

Insurance; and Program No. 93.774,

Medicare—Supplementary Medical

Insurance Program)

Dated: October 20, 2000.

Michael M. Hash,

Acting Administrator, Health Care Financing

Administration.

Dated: October 23, 2000.

Donna E. Shalala,

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 2001. Addendum

B contains the RVUs for work, nonfacility practice expense, facility

practice expense, and malpractice

expense, and other information for all

services included in the physician fee

schedule.

Addendum B—2001 Relative Value

Units and Related Information Used in

Determining Medicare Payments for

2001

This addendum contains the

following information for each CPT

code and alphanumeric HCPCS code,

except for alphanumeric codes

beginning with B (enteral and parenteral

therapy), E (durable medical

equipment), K (temporary codes for

nonphysicians’ services or items), or L

(orthotics), and codes for

anesthesiology.

1. CPT/HCPCS code. This is the CPT

or alphanumeric HCPCS number for the

service. Alphanumeric HCPCS codes are

included at the end of this addendum.

2. Modifier. A modifier is shown if

there is a technical component (modifier

TC) and a professional component (PC)

(modifier ¥26) for the service. If there

is a PC and a TC for the service,

Addendum B contains three entries for

the code: One for the global values (both

professional and technical); one for

modifier ¥26 (PC); and one for modifier

TC. The global service is not designated

by a modifier, and physicians must bill

using the code without a modifier if the

physician furnishes both the PC and the

TC of the service.

Modifier ¥53 is shown for a

discontinued procedure. There will be

RVUs for the code (CPT code 45378)

with this modifier.

3. Status indicator. This indicator

shows whether the CPT/HCPCS code is

in the physician fee schedule and

whether it is separately payable if the

service is covered.

A = Active code. These codes are

separately payable under the fee

schedule if covered. There will be RVUs

for codes with this status. The presence

of an ‘‘A’’ indicator does not mean that

Medicare has made a national decision

regarding the coverage of the service.

Carriers remain responsible for coverage

decisions in the absence of a national

Medicare policy.

B = Bundled code. Payment for

covered services is always bundled into

payment for other services not specified.

If RVUs are shown, they are not used for

Medicare payment. If these services are

covered, payment for them is subsumed

by the payment for the services to which

they are incident. (An example is a

telephone call from a hospital nurse

regarding care of a patient.)

C = Carrier-priced code. Carriers will

establish RVUs and payment amounts

for these services, generally on a caseby-case basis following review of

documentation, such as an operative

report.

D = Deleted code. These codes are

deleted effective with the beginning of

the calendar year.

E = Excluded from physician fee

schedule by regulation. These codes are

for items or services that we chose to

exclude from the physician fee schedule

payment by regulation. No RVUs are

shown, and no payment may be made

under the physician fee schedule for

these codes. Payment for them, if they

are covered, continues under reasonable

charge or other payment procedures.

G = Code not valid for Medicare

purposes. Medicare does not recognize

codes assigned this status. Medicare

uses another code for reporting of, and

payment for, these services.

N = Noncovered service. These codes

are noncovered services. Medicare

payment may not be made for these

codes. If RVUs are shown, they are not

used for Medicare payment.

P = Bundled or excluded code. There

are no RVUs for these services. No

separate payment should be made for

them under the physician fee schedule.

— If the item or service is covered as

incident to a physician’s service and

is furnished on the same day as a

65441

physician’s service, payment for it is

bundled into the payment for the

physician’s service to which it is

incident (an example is an elastic

bandage furnished by a physician

incident to a physician’s service).

— If the item or service is covered as

other than incident to a physician’s

service, it is excluded from the

physician fee schedule (for example,

colostomy supplies) and is paid under

the other payment provisions of the

Act.

R = Restricted coverage. Special

coverage instructions apply. If the

service is covered and no RVUs are

shown, it is carrier-priced.

T = Injections. There are RVUs for

these services, but they are only paid if

there are no other services payable

under the physician fee schedule billed

on the same date by the same provider.

If any other services payable under the

physician fee schedule are billed on the

same date by the same provider, these

services are bundled into the service(s)

for which payment is made.

X = Exclusion by law. These codes

represent an item or service that is not

within the definition of ‘‘physicians

services’’ for physician fee schedule

payment purposes. No RVUs are shown

for these codes, and no payment may be

made under the physician fee schedule.

(Examples are ambulance services and

clinical diagnostic laboratory services.)

4. Description of code. This is an

abbreviated version of the narrative

description of the code.

5. Physician work RVUs. These are the

RVUs for the physician work for this

service in 2000. Codes that are not used

for Medicare payment are identified

with a ‘‘+.’’

6. Fully implemented non-facility

practice expense RVUs. These are the

fully implemented resource-based

practice expense RVUs for non-facility

settings.

7. Year 2000 Transition non-facility

practice expense RVUs. Blended nonfacility practice expense RVUs for use in

2000.

8. Fully implemented facility practice

expense RVUs. These are the fully

implemented resource-based practice

expense RVUs for facility settings.

9. Year 2000 transition facility

practice expense RVUs. Blended facility

practice expense RVUs for use in 2000.

10. Malpractice expense RVUs. These

are the RVUs for the malpractice

expense for the service for 2000.

11. Fully implemented non-facility

total. This is the sum of the work, fully

implemented non-facility practice

expense, and malpractice expense

RVUs.

12. Year 2000 transition non-facility

total. This is the sum of the work,

transition non-facility practice expense,

and malpractice expense RVUs for use

in 2000.

13. Fully implemented facility total.

This is the sum of the work, fully

implemented facility practice expense,

and malpractice expense RVUs.

14. Year 2000 transition facility total.

This is the sum of the work, transition

facility practice expense, and

malpractice expense RVUs for use in

2000.

15. Global period. This indicator

shows the number of days in the global

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

An explanation of the alpha codes

follows:

MMM = The code describes a service

furnished in uncomplicated maternity

cases including antepartum care,

delivery, and postpartum care. The

usual global surgical concept does not

apply. See the 1999 Physicians’ Current

Procedural Terminology for specific

definitions.

XXX = The global concept does not

apply.

YYY = The global period is to be set

by the carrier (for example, unlisted

surgery codes).

ZZZ = The code is part of another

service and falls within the global

period for the other service.

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

10040 ............ A Acne surgery of skin abscess .............. 1.18 1.58 1.27 0.52 0.44 0.05 2.81 2.50 1.75 1.67 010

10060 ............ A Drainage of skin abscess ..................... 1.17 1.29 1.09 0.65 0.55 0.08 2.54 2.34 1.90 1.80 010

10061 ............ A Drainage of skin abscess ..................... 2.40 1.99 1.67 1.15 0.95 0.17 4.56 4.24 3.72 3.52 010

10080 ............ A Drainage of pilonidal cyst ..................... 1.17 2.01 1.64 0.69 0.59 0.09 3.27 2.90 1.95 1.85 010

10081 ............ A Drainage of pilonidal cyst ..................... 2.45 2.77 2.38 1.60 1.35 0.19 5.41 5.02 4.24 3.99 010

10120 ............ A Remove foreign body ........................... 1.22 1.75 1.44 0.71 0.60 0.10 3.07 2.76 2.03 1.92 010

10121 ............ A Remove foreign body ........................... 2.69 2.71 2.31 1.80 1.49 0.25 5.65 5.25 4.74 4.43 010

10140 ............ A Drainage of hematoma/fluid ................. 1.53 1.37 1.16 0.86 0.71 0.15 3.05 2.84 2.54 2.39 010

10160 ............ A Puncture drainage of lesion ................. 1.20 1.48 1.21 0.76 0.62 0.11 2.79 2.52 2.07 1.93 010

10180 ............ A Complex drainage, wound ................... 2.25 1.46 1.38 1.26 1.23 0.25 3.96 3.88 3.76 3.73 010

11000 ............ A Debride infected skin ............................ 0.60 0.55 0.52 0.24 0.24 0.05 1.20 1.17 0.89 0.89 000

11001 ............ A Debride infected skin add-on ............... 0.30 0.31 0.30 0.11 0.12 0.02 0.63 0.62 0.43 0.44 ZZZ

11010 ............ A Debride skin, fx .................................... 4.20 2.45 2.91 2.01 2.58 0.45 7.10 7.56 6.66 7.23 010

11011 ............ A Debride skin/muscle, fx ........................ 4.95 3.89 4.20 2.66 3.28 0.53 9.37 9.68 8.14 8.76 000

11012 ............ A Debride skin/muscle/bone, fx ............... 6.88 5.69 6.05 4.22 4.95 0.89 13.46 13.82 11.99 12.72 000

11040 ............ A Debride skin, partial ............................. 0.50 0.47 0.46 0.21 0.21 0.05 1.02 1.01 0.76 0.76 000

11041 ............ A Debride skin, full ................................... 0.82 0.64 0.63 0.34 0.33 0.08 1.54 1.53 1.24 1.23 000

11042 ............ A Debride skin/tissue ............................... 1.12 0.90 0.85 0.47 0.44 0.11 2.13 2.08 1.70 1.67 000

11043 ............ A Debride tissue/muscle .......................... 2.38 2.60 2.44 1.41 1.55 0.24 5.22 5.06 4.03 4.17 010

11044 ............ A Debride tissue/muscle/bone ................. 3.06 3.11 3.10 1.83 2.14 0.34 6.51 6.50 5.23 5.54 010

11055 ............ R Trim skin lesion .................................... 0.27 0.35 0.33 0.12 0.13 0.02 0.64 0.62 0.41 0.42 000

11056 ............ R Trim skin lesions, 2 to 4 ....................... 0.39 0.39 0.39 0.17 0.18 0.03 0.81 0.81 0.59 0.60 000

11057 ............ R Trim skin lesions, over 4 ...................... 0.50 0.44 0.41 0.21 0.20 0.04 0.98 0.95 0.75 0.74 000

11100 ............ A Biopsy of skin lesion ............................ 0.81 1.53 1.29 0.38 0.36 0.04 2.38 2.14 1.23 1.21 000

11101 ............ A Biopsy, skin add-on .............................. 0.41 0.74 0.63 0.20 0.19 0.02 1.17 1.06 0.63 0.62 ZZZ

11200 ............ A Removal of skin tags ............................ 0.77 1.10 0.94 0.31 0.29 0.04 1.91 1.75 1.12 1.10 010

11201 ............ A Remove skin tags add-on .................... 0.29 0.47 0.40 0.12 0.11 0.02 0.78 0.71 0.43 0.42 ZZZ

11300 ............ A Shave skin lesion ................................. 0.51 1.04 0.93 0.23 0.25 0.03 1.58 1.47 0.77 0.79 000

11301 ............ A Shave skin lesion ................................. 0.85 1.13 1.03 0.39 0.39 0.04 2.02 1.92 1.28 1.28 000

11302 ............ A Shave skin lesion ................................. 1.05 1.23 1.17 0.49 0.49 0.05 2.33 2.27 1.59 1.59 000

11303 ............ A Shave skin lesion ................................. 1.24 1.36 1.39 0.55 0.60 0.06 2.66 2.69 1.85 1.90 000

65442

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

11305 ............ A Shave skin lesion ................................. 0.67 0.81 0.75 0.30 0.30 0.04 1.52 1.46 1.01 1.01 000

11306 ............ A Shave skin lesion ................................. 0.99 1.08 1.00 0.44 0.43 0.05 2.12 2.04 1.48 1.47 000

11307 ............ A Shave skin lesion ................................. 1.14 1.20 1.16 0.51 0.51 0.05 2.39 2.35 1.70 1.70 000

11308 ............ A Shave skin lesion ................................. 1.41 1.28 1.34 0.64 0.67 0.07 2.76 2.82 2.12 2.15 000

11310 ............ A Shave skin lesion ................................. 0.73 1.14 1.04 0.34 0.35 0.04 1.91 1.81 1.11 1.12 000

11311 ............ A Shave skin lesion ................................. 1.05 1.25 1.17 0.51 0.50 0.05 2.35 2.27 1.61 1.60 000

11312 ............ A Shave skin lesion ................................. 1.20 1.33 1.30 0.58 0.59 0.06 2.59 2.56 1.84 1.85 000

11313 ............ A Shave skin lesion ................................. 1.62 1.60 1.61 0.76 0.77 0.09 3.31 3.32 2.47 2.48 000

11400 ............ A Removal of skin lesion ......................... 0.91 2.41 1.95 0.73 0.62 0.06 3.38 2.92 1.70 1.59 010

11401 ............ A Removal of skin lesion ......................... 1.32 2.43 2.01 0.89 0.76 0.09 3.84 3.42 2.30 2.17 010

11402 ............ A Removal of skin lesion ......................... 1.61 2.51 2.13 0.97 0.85 0.12 4.24 3.86 2.70 2.58 010

11403 ............ A Removal of skin lesion ......................... 1.92 2.76 2.39 1.10 0.99 0.16 4.84 4.47 3.18 3.07 010

11404 ............ A Removal of skin lesion ......................... 2.20 2.91 2.56 1.20 1.09 0.18 5.29 4.94 3.58 3.47 010

11406 ............ A Removal of skin lesion ......................... 2.76 3.19 2.90 1.42 1.58 0.25 6.20 5.91 4.43 4.59 010

11420 ............ A Removal of skin lesion ......................... 1.06 2.02 1.66 0.77 0.65 0.08 3.16 2.80 1.91 1.79 010

11421 ............ A Removal of skin lesion ......................... 1.53 2.35 1.96 1.00 0.85 0.11 3.99 3.60 2.64 2.49 010

11422 ............ A Removal of skin lesion ......................... 1.76 2.50 2.13 1.07 0.93 0.14 4.40 4.03 2.97 2.83 010

11423 ............ A Removal of skin lesion ......................... 2.17 2.93 2.55 1.24 1.11 0.17 5.27 4.89 3.58 3.45 010

11424 ............ A Removal of skin lesion ......................... 2.62 3.09 2.70 1.44 1.27 0.21 5.92 5.53 4.27 4.10 010

11426 ............ A Removal of skin lesion ......................... 3.78 3.73 3.30 1.90 1.92 0.34 7.85 7.42 6.02 6.04 010

11440 ............ A Removal of skin lesion ......................... 1.15 2.57 2.12 0.93 0.79 0.08 3.80 3.35 2.16 2.02 010

11441 ............ A Removal of skin lesion ......................... 1.61 2.72 2.27 1.17 0.99 0.11 4.44 3.99 2.89 2.71 010

11442 ............ A Removal of skin lesion ......................... 1.87 2.79 2.40 1.27 1.11 0.14 4.80 4.41 3.28 3.12 010

11443 ............ A Removal of skin lesion ......................... 2.49 3.34 2.90 1.61 1.41 0.18 6.01 5.57 4.28 4.08 010

11444 ............ A Removal of skin lesion ......................... 3.42 3.77 3.23 2.03 1.72 0.25 7.44 6.90 5.70 5.39 010

11446 ............ A Removal of skin lesion ......................... 4.49 4.23 3.66 2.53 2.14 0.30 9.02 8.45 7.32 6.93 010

11450 ............ A Removal, sweat gland lesion ............... 2.73 3.99 3.72 1.10 1.55 0.26 6.98 6.71 4.09 4.54 090

11451 ............ A Removal, sweat gland lesion ............... 3.95 4.90 4.46 1.66 2.03 0.39 9.24 8.80 6.00 6.37 090

11462 ............ A Removal, sweat gland lesion ............... 2.51 4.08 3.72 1.02 1.42 0.23 6.82 6.46 3.76 4.16 090

11463 ............ A Removal, sweat gland lesion ............... 3.95 5.57 4.72 1.69 1.81 0.40 9.92 9.07 6.04 6.16 090

11470 ............ A Removal, sweat gland lesion ............... 3.25 4.40 4.06 1.33 1.75 0.30 7.95 7.61 4.88 5.30 090

11471 ............ A Removal, sweat gland lesion ............... 4.41 5.41 4.73 1.84 2.05 0.40 10.22 9.54 6.65 6.86 090

11600 ............ A Removal of skin lesion ......................... 1.41 2.58 2.24 0.95 0.87 0.09 4.08 3.74 2.45 2.37 010

11601 ............ A Removal of skin lesion ......................... 1.93 2.66 2.37 1.10 1.02 0.12 4.71 4.42 3.15 3.07 010

11602 ............ A Removal of skin lesion ......................... 2.09 2.72 2.54 1.34 1.25 0.13 4.94 4.76 3.56 3.47 010

11603 ............ A Removal of skin lesion ......................... 2.35 2.90 2.79 1.41 1.36 0.16 5.41 5.30 3.92 3.87 010

11604 ............ A Removal of skin lesion ......................... 2.58 3.09 3.02 1.49 1.47 0.18 5.85 5.78 4.25 4.23 010

11606 ............ A Removal of skin lesion ......................... 3.43 3.65 3.58 1.80 2.20 0.28 7.36 7.29 5.51 5.91 010

11620 ............ A Removal of skin lesion ......................... 1.34 2.53 2.26 0.89 0.85 0.09 3.96 3.69 2.32 2.28 010

11621 ............ A Removal of skin lesion ......................... 1.97 2.70 2.50 1.36 1.26 0.12 4.79 4.59 3.45 3.35 010

11622 ............ A Removal of skin lesion ......................... 2.34 2.87 2.75 1.52 1.44 0.15 5.36 5.24 4.01 3.93 010

11623 ............ A Removal of skin lesion ......................... 2.93 2.82 2.82 1.74 1.66 0.20 5.95 5.95 4.87 4.79 010

11624 ............ A Removal of skin lesion ......................... 3.43 3.19 3.26 1.95 1.90 0.25 6.87 6.94 5.63 5.58 010

11626 ............ A Removal of skin lesion ......................... 4.30 4.20 4.08 2.38 2.71 0.35 8.85 8.73 7.03 7.36 010

11640 ............ A Removal of skin lesion ......................... 1.53 2.64 2.43 1.11 1.06 0.10 4.27 4.06 2.74 2.69 010

11641 ............ A Removal of skin lesion ......................... 2.44 3.00 2.82 1.67 1.54 0.15 5.59 5.41 4.26 4.13 010

11642 ............ A Removal of skin lesion ......................... 2.93 2.92 2.89 1.90 1.78 0.18 6.03 6.00 5.01 4.89 010

11643 ............ A Removal of skin lesion ......................... 3.50 3.29 3.29 2.19 2.05 0.24 7.03 7.03 5.93 5.79 010

11644 ............ A Removal of skin lesion ......................... 4.55 3.94 3.91 2.72 2.52 0.33 8.82 8.79 7.60 7.40 010

11646 ............ A Removal of skin lesion ......................... 5.95 5.22 5.09 3.43 3.75 0.46 11.63 11.50 9.84 10.16 010

11719 ............ R Trim nail(s) ........................................... 0.11 0.49 0.43 0.04 0.06 0.01 0.61 0.55 0.16 0.18 000

11720 ............ A Debride nail, 1-5 ................................... 0.32 0.42 0.40 0.13 0.14 0.02 0.76 0.74 0.47 0.48 000

11721 ............ A Debride nail, 6 or more ........................ 0.54 0.53 0.55 0.22 0.24 0.04 1.11 1.13 0.80 0.82 000

11730 ............ A Removal of nail plate ........................... 1.13 0.74 0.68 0.46 0.41 0.09 1.96 1.90 1.68 1.63 000

11732 ............ A Remove nail plate, add-on ................... 0.57 0.29 0.29 0.23 0.21 0.05 0.91 0.91 0.85 0.83 ZZZ

11740 ............ A Drain blood from under nail ................. 0.37 0.64 0.59 0.14 0.16 0.03 1.04 0.99 0.54 0.56 000

11750 ............ A Removal of nail bed ............................. 1.86 1.53 1.72 0.79 0.88 0.16 3.55 3.74 2.81 2.90 010

11752 ............ A Remove nail bed/finger tip ................... 2.67 1.97 2.24 1.73 1.68 0.33 4.97 5.24 4.73 4.68 010

11755 ............ A Biopsy, nail unit .................................... 1.31 1.04 1.05 0.59 0.71 0.06 2.41 2.42 1.96 2.08 000

11760 ............ A Repair of nail bed ................................. 1.58 1.68 1.51 1.17 1.01 0.17 3.43 3.26 2.92 2.76 010

11762 ............ A Reconstruction of nail bed ................... 2.89 2.13 2.30 1.84 1.73 0.32 5.34 5.51 5.05 4.94 010

11765 ............ A Excision of nail fold, toe ....................... 0.69 0.95 0.85 0.44 0.40 0.05 1.69 1.59 1.18 1.14 010

11770 ............ A Removal of pilonidal lesion .................. 2.61 2.95 2.94 1.30 1.70 0.24 5.80 5.79 4.15 4.55 010

11771 ............ A Removal of pilonidal lesion .................. 5.74 5.30 5.20 3.99 4.22 0.56 11.60 11.50 10.29 10.52 090

11772 ............ A Removal of pilonidal lesion .................. 6.98 6.06 5.85 4.43 4.63 0.68 13.72 13.51 12.09 12.29 090

11900 ............ A Injection into skin lesions ..................... 0.52 0.73 0.62 0.23 0.21 0.02 1.27 1.16 0.77 0.75 000

11901 ............ A Added skin lesions injection ................. 0.80 0.85 0.75 0.37 0.33 0.03 1.68 1.58 1.20 1.16 000

11920 ............ R Correct skin color defects .................... 1.61 2.16 1.94 0.85 0.96 0.17 3.94 3.72 2.63 2.74 000

11921 ............ R Correct skin color defects .................... 1.93 2.53 2.28 1.05 1.17 0.21 4.67 4.42 3.19 3.31 000

11922 ............ R Correct skin color defects .................... 0.49 0.38 0.38 0.26 0.29 0.05 0.92 0.92 0.80 0.83 ZZZ

11950 ............ R Therapy for contour defects ................. 0.84 1.27 1.28 0.47 0.68 0.06 2.17 2.18 1.37 1.58 000

11951 ............ R Therapy for contour defects ................. 1.19 1.69 1.59 0.51 0.71 0.10 2.98 2.88 1.80 2.00 000

11952 ............ R Therapy for contour defects ................. 1.69 2.09 1.89 0.90 1.00 0.17 3.95 3.75 2.76 2.86 000

11954 ............ R Therapy for contour defects ................. 1.85 2.76 2.39 0.96 1.04 0.19 4.80 4.43 3.00 3.08 000

11960 ............ A Insert tissue expander(s) ...................... 9.08 NA NA 10.49 9.97 0.88 NA NA 20.45 19.93 090

11970 ............ A Replace tissue expander ...................... 7.06 NA NA 5.06 5.90 0.77 NA NA 12.89 13.73 090

11971 ............ A Remove tissue expander(s) ................. 2.13 6.02 5.14 3.81 3.48 0.21 8.36 7.48 6.15 5.82 090

11975 ............ N Insert contraceptive cap ....................... +1.48 1.56 1.46 0.59 0.73 0.14 3.18 3.08 2.21 2.35 XXX

11976 ............ R Removal of contraceptive cap .............. 1.78 1.55 1.51 0.72 0.89 0.17 3.50 3.46 2.67 2.84 XXX

11977 ............ N Removal/reinsert contra cap ................ +3.30 2.28 2.35 1.32 1.63 0.31 5.89 5.96 4.93 5.24 XXX

11980 ............ A Implant hormone pellet(s) .................... 1.48 1.14 1.14 0.63 0.63 0.10 2.72 2.72 2.21 2.21 000

12001 ............ A Repair superficial wound(s) .................. 1.70 2.31 1.89 0.84 0.79 0.13 4.14 3.72 2.67 2.62 010

12002 ............ A Repair superficial wound(s) .................. 1.86 2.41 2.02 0.87 0.87 0.15 4.42 4.03 2.88 2.88 010

65443

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

12004 ............ A Repair superficial wound(s) .................. 2.24 2.60 2.26 0.99 1.05 0.17 5.01 4.67 3.40 3.46 010

12005 ............ A Repair superficial wound(s) .................. 2.86 3.07 2.70 1.25 1.34 0.23 6.16 5.79 4.34 4.43 010

12006 ............ A Repair superficial wound(s) .................. 3.67 4.17 3.61 1.95 1.95 0.31 8.15 7.59 5.93 5.93 010

12007 ............ A Repair superficial wound(s) .................. 4.12 4.62 3.95 2.28 2.20 0.37 9.11 8.44 6.77 6.69 010

12011 ............ A Repair superficial wound(s) .................. 1.76 2.39 1.99 0.85 0.84 0.14 4.29 3.89 2.75 2.74 010

12013 ............ A Repair superficial wound(s) .................. 1.99 2.55 2.19 0.90 0.96 0.16 4.70 4.34 3.05 3.11 010

12014 ............ A Repair superficial wound(s) .................. 2.46 2.86 2.47 1.08 1.13 0.18 5.50 5.11 3.72 3.77 010

12015 ............ A Repair superficial wound(s) .................. 3.19 3.31 2.92 1.28 1.40 0.24 6.74 6.35 4.71 4.83 010

12016 ............ A Repair superficial wound(s) .................. 3.93 3.83 3.49 1.51 1.75 0.32 8.08 7.74 5.76 6.00 010

12017 ............ A Repair superficial wound(s) .................. 4.71 5.35 4.93 2.46 2.76 0.39 10.45 10.03 7.56 7.86 010

12018 ............ A Repair superficial wound(s) .................. 5.53 6.32 6.14 2.75 3.46 0.46 12.31 12.13 8.74 9.45 010

12020 ............ A Closure of split wound .......................... 2.62 2.62 2.29 1.49 1.44 0.24 5.48 5.15 4.35 4.30 010

12021 ............ A Closure of split wound .......................... 1.84 2.10 1.74 1.15 0.95 0.19 4.13 3.77 3.18 2.98 010

12031 ............ A Layer closure of wound(s) .................... 2.15 2.76 2.27 1.20 1.00 0.15 5.06 4.57 3.50 3.30 010

12032 ............ A Layer closure of wound(s) .................... 2.47 2.84 2.42 1.29 1.11 0.15 5.46 5.04 3.91 3.73 010

12034 ............ A Layer closure of wound(s) .................... 2.92 3.12 2.74 1.46 1.50 0.21 6.25 5.87 4.59 4.63 010

12035 ............ A Layer closure of wound(s) .................... 3.43 3.05 2.81 1.68 1.78 0.30 6.78 6.54 5.41 5.51 010

12036 ............ A Layer closure of wound(s) .................... 4.05 5.22 4.55 2.52 2.52 0.41 9.68 9.01 6.98 6.98 010

12037 ............ A Layer closure of wound(s) .................... 4.67 5.56 5.01 2.88 3.00 0.49 10.72 10.17 8.04 8.16 010

12041 ............ A Layer closure of wound(s) .................... 2.37 3.06 2.52 1.27 1.07 0.17 5.60 5.06 3.81 3.61 010

12042 ............ A Layer closure of wound(s) .................... 2.74 3.05 2.61 1.42 1.23 0.17 5.96 5.52 4.33 4.14 010

12044 ............ A Layer closure of wound(s) .................... 3.14 3.20 2.84 1.62 1.66 0.24 6.58 6.22 5.00 5.04 010

12045 ............ A Layer closure of wound(s) .................... 3.64 3.58 3.26 1.86 1.97 0.34 7.56 7.24 5.84 5.95 010

12046 ............ A Layer closure of wound(s) .................... 4.25 5.24 4.70 2.59 2.71 0.40 9.89 9.35 7.24 7.36 010

12047 ............ A Layer closure of wound(s) .................... 4.65 5.96 5.56 2.92 3.28 0.41 11.02 10.62 7.98 8.34 010

12051 ............ A Layer closure of wound(s) .................... 2.47 3.03 2.55 1.42 1.20 0.16 5.66 5.18 4.05 3.83 010

12052 ............ A Layer closure of wound(s) .................... 2.77 3.01 2.66 1.38 1.24 0.17 5.95 5.60 4.32 4.18 010

12053 ............ A Layer closure of wound(s) .................... 3.12 3.16 2.85 1.52 1.62 0.20 6.48 6.17 4.84 4.94 010

12054 ............ A Layer closure of wound(s) .................... 3.46 3.48 3.32 1.65 1.94 0.25 7.19 7.03 5.36 5.65 010

12055 ............ A Layer closure of wound(s) .................... 4.43 4.67 4.38 2.16 2.50 0.35 9.45 9.16 6.94 7.28 010

12056 ............ A Layer closure of wound(s) .................... 5.24 6.70 6.31 2.89 3.45 0.43 12.37 11.98 8.56 9.12 010

12057 ............ A Layer closure of wound(s) .................... 5.96 6.55 6.42 3.87 4.41 0.50 13.01 12.88 10.33 10.87 010

13100 ............ A Repair of wound or lesion .................... 3.12 3.41 2.87 1.88 1.57 0.21 6.74 6.20 5.21 4.90 010

13101 ............ A Repair of wound or lesion .................... 3.92 3.66 3.31 2.35 2.05 0.22 7.80 7.45 6.49 6.19 010

13102 ............ A Repair wound/lesion add-on ................ 1.24 0.74 0.74 0.59 0.59 0.10 2.08 2.08 1.93 1.93 ZZZ

13120 ............ A Repair of wound or lesion .................... 3.30 3.52 3.01 1.94 1.64 0.23 7.05 6.54 5.47 5.17 010

13121 ............ A Repair of wound or lesion .................... 4.33 3.88 3.63 2.42 2.18 0.25 8.46 8.21 7.00 6.76 010

13122 ............ A Repair wound/lesion add-on ................ 1.44 0.87 0.87 0.69 0.69 0.12 2.43 2.43 2.25 2.25 ZZZ

13131 ............ A Repair of wound or lesion .................... 3.79 3.76 3.36 2.24 1.95 0.25 7.80 7.40 6.28 5.99 010

13132 ............ A Repair of wound or lesion .................... 5.95 4.61 4.70 3.31 3.10 0.32 10.88 10.97 9.58 9.37 010

13133 ............ A Repair wound/lesion add-on ................ 2.19 1.22 1.22 1.04 1.04 0.17 3.58 3.58 3.40 3.40 ZZZ

13150 ............ A Repair of wound or lesion .................... 3.81 5.24 4.41 2.68 2.49 0.29 9.34 8.51 6.78 6.59 010

13151 ............ A Repair of wound or lesion .................... 4.45 5.19 4.56 3.13 2.68 0.28 9.92 9.29 7.86 7.41 010

13152 ............ A Repair of wound or lesion .................... 6.33 5.91 5.83 4.04 3.73 0.38 12.62 12.54 10.75 10.44 010

13153 ............ A Repair wound/lesion add-on ................ 2.38 1.35 1.35 1.13 1.13 0.18 3.91 3.91 3.69 3.69 ZZZ

13160 ............ A Late closure of wound .......................... 10.48 NA NA 6.41 5.71 1.19 NA NA 18.08 17.38 090

14000 ............ A Skin tissue rearrangement ................... 5.89 7.49 6.54 4.63 3.94 0.46 13.84 12.89 10.98 10.29 090

14001 ............ A Skin tissue rearrangement ................... 8.47 8.96 8.01 6.01 5.80 0.65 18.08 17.13 15.13 14.92 090

14020 ............ A Skin tissue rearrangement ................... 6.59 8.11 7.41 5.32 5.32 0.50 15.20 14.50 12.41 12.41 090

14021 ............ A Skin tissue rearrangement ................... 10.06 9.44 8.77 7.16 7.06 0.69 20.19 19.52 17.91 17.81 090

14040 ............ A Skin tissue rearrangement ................... 7.87 8.37 8.12 6.08 5.48 0.53 16.77 16.52 14.48 13.88 090

14041 ............ A Skin tissue rearrangement ................... 11.49 10.20 9.79 7.97 7.05 0.68 22.37 21.96 20.14 19.22 090

14060 ............ A Skin tissue rearrangement ................... 8.50 8.86 8.75 6.95 7.32 0.59 17.95 17.84 16.04 16.41 090

14061 ............ A Skin tissue rearrangement ................... 12.29 11.08 11.16 8.92 8.11 0.75 24.12 24.20 21.96 21.15 090

14300 ............ A Skin tissue rearrangement ................... 11.76 10.43 10.89 8.48 9.43 0.88 23.07 23.53 21.12 22.07 090

14350 ............ A Skin tissue rearrangement ................... 9.61 NA NA 6.38 6.43 1.09 NA NA 17.08 17.13 090

15000 ............ A Skin graft .............................................. 4.00 2.51 2.47 1.97 2.06 0.37 6.88 6.84 6.34 6.43 000

15001 ............ A Skin graft add-on .................................. 1.00 0.57 0.57 0.44 0.44 0.11 1.68 1.68 1.55 1.55 ZZZ

15050 ............ A Skin pinch graft .................................... 4.30 4.88 4.15 3.95 3.45 0.46 9.64 8.91 8.71 8.21 090

15100 ............ A Skin split graft ....................................... 9.05 6.28 5.94 6.19 5.88 0.94 16.27 15.93 16.18 15.87 090

15101 ............ A Skin split graft add-on .......................... 1.72 1.20 1.33 0.78 1.02 0.18 3.10 3.23 2.68 2.92 ZZZ

15120 ............ A Skin split graft ....................................... 9.83 8.99 8.39 6.68 6.65 0.87 19.69 19.09 17.38 17.35 090

15121 ............ A Skin split graft add-on .......................... 2.67 1.58 1.98 1.28 1.75 0.27 4.52 4.92 4.22 4.69 ZZZ

15200 ............ A Skin full graft ........................................ 8.03 9.61 8.33 5.66 5.37 0.73 18.37 17.09 14.42 14.13 090

15201 ............ A Skin full graft add-on ............................ 1.32 1.00 1.21 0.67 0.90 0.14 2.46 2.67 2.13 2.36 ZZZ

15220 ............ A Skin full graft ........................................ 7.87 9.69 8.58 6.21 5.97 0.68 18.24 17.13 14.76 14.52 090

15221 ............ A Skin full graft add-on ............................ 1.19 0.98 1.17 0.59 0.80 0.12 2.29 2.48 1.90 2.11 ZZZ

15240 ............ A Skin full graft ........................................ 9.04 9.30 8.63 7.08 6.97 0.77 19.11 18.44 16.89 16.78 090

15241 ............ A Skin full graft add-on ............................ 1.86 1.52 1.79 0.97 1.28 0.17 3.55 3.82 3.00 3.31 ZZZ

15260 ............ A Skin full graft ........................................ 10.06 9.24 8.96 7.59 7.72 0.63 19.93 19.65 18.28 18.41 090

15261 ............ A Skin full graft add-on ............................ 2.23 1.63 2.00 1.18 1.55 0.17 4.03 4.40 3.58 3.95 ZZZ

15342 ............ A Cultured skin graft, 25 cm .................... 1.00 2.20 2.20 0.78 0.78 0.39 3.59 3.59 2.17 2.17 010

15343 ............ A Culture skn graft addl 25 cm ................ 0.25 0.28 0.28 0.10 0.10 0.09 0.62 0.62 0.44 0.44 ZZZ

15350 ............ A Skin homograft ..................................... 4.00 7.22 6.00 4.35 3.85 0.42 11.64 10.42 8.77 8.27 090

15351 ............ A Skin homograft add-on ......................... 1.00 0.94 0.94 0.43 0.43 0.11 2.05 2.05 1.54 1.54 ZZZ

15400 ............ A Skin heterograft .................................... 4.00 5.14 4.14 5.14 4.14 0.40 9.54 8.54 9.54 8.54 090

15401 ............ A Skin heterograft add-on ........................ 1.00 1.15 1.15 0.48 0.48 0.11 2.26 2.26 1.59 1.59 ZZZ

15570 ............ A Form skin pedicle flap .......................... 9.21 8.44 7.82 6.41 6.30 0.96 18.61 17.99 16.58 16.47 090

15572 ............ A Form skin pedicle flap .......................... 9.27 7.54 7.12 6.21 6.12 0.93 17.74 17.32 16.41 16.32 090

15574 ............ A Form skin pedicle flap .......................... 9.88 8.53 7.86 6.93 6.66 0.92 19.33 18.66 17.73 17.46 090

15576 ............ A Form skin pedicle flap .......................... 8.69 8.97 7.58 6.38 5.63 0.72 18.38 16.99 15.79 15.04 090

15600 ............ A Skin graft .............................................. 1.91 6.42 5.50 2.31 2.30 0.19 8.52 7.60 4.41 4.40 090

15610 ............ A Skin graft .............................................. 2.42 4.49 4.13 2.63 2.70 0.25 7.16 6.80 5.30 5.37 090

65444

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

15620 ............ A Skin graft .............................................. 2.94 6.76 6.00 3.24 3.31 0.28 9.98 9.22 6.46 6.53 090

15630 ............ A Skin graft .............................................. 3.27 6.12 5.57 3.67 3.73 0.28 9.67 9.12 7.22 7.28 090

15650 ............ A Transfer skin pedicle flap ..................... 3.97 6.18 5.82 3.81 4.04 0.36 10.51 10.15 8.14 8.37 090

15732 ............ A Muscle-skin graft, head/neck ............... 17.84 NA NA 11.53 12.85 1.50 NA NA 30.87 32.19 090

15734 ............ A Muscle-skin graft, trunk ........................ 17.79 NA NA 11.45 13.75 1.91 NA NA 31.15 33.45 090

15736 ............ A Muscle-skin graft, arm .......................... 16.27 NA NA 10.80 12.50 1.78 NA NA 28.85 30.55 090

15738 ............ A Muscle-skin graft, leg ........................... 17.92 NA NA 11.35 12.01 1.95 NA NA 31.22 31.88 090

15740 ............ A Island pedicle flap graft ........................ 10.25 8.98 9.56 7.14 8.18 0.62 19.85 20.43 18.01 19.05 090

15750 ............ A Neurovascular pedicle graft ................. 11.41 NA NA 8.14 9.35 1.12 NA NA 20.67 21.88 090

15756 ............ A Free muscle flap, microvasc ................ 35.23 NA NA 18.83 22.29 3.11 NA NA 57.17 60.63 090

15757 ............ A Free skin flap, microvasc ..................... 35.23 NA NA 22.18 24.80 3.37 NA NA 60.78 63.40 090

15758 ............ A Free fascial flap, microvasc ................. 35.10 NA NA 22.50 25.04 3.52 NA NA 61.12 63.66 090

15760 ............ A Composite skin graft ............................ 8.74 9.29 8.95 6.80 7.08 0.72 18.75 18.41 16.26 16.54 090

15770 ............ A Derma-fat-fascia graft ........................... 7.52 NA NA 6.08 6.59 0.78 NA NA 14.38 14.89 090

15775 ............ R Hair transplant punch grafts ................. 3.96 3.08 3.09 1.60 1.98 0.43 7.47 7.48 5.99 6.37 000

15776 ............ R Hair transplant punch grafts ................. 5.54 3.93 4.04 2.99 3.34 0.60 10.07 10.18 9.13 9.48 000

15780 ............ A Abrasion treatment of skin ................... 7.29 6.36 5.19 6.36 4.98 0.41 14.06 12.89 14.06 12.68 090

15781 ............ A Abrasion treatment of skin ................... 4.85 4.83 4.65 4.83 4.14 0.27 9.95 9.77 9.95 9.26 090

15782 ............ A Abrasion treatment of skin ................... 4.32 4.14 3.43 4.14 3.27 0.21 8.67 7.96 8.67 7.80 090

15783 ............ A Abrasion treatment of skin ................... 4.29 4.49 3.87 3.48 2.86 0.26 9.04 8.42 8.03 7.41 090

15786 ............ A Abrasion, lesion, single ........................ 2.03 1.71 1.45 1.29 1.05 0.11 3.85 3.59 3.43 3.19 010

15787 ............ A Abrasion, lesions, add-on ..................... 0.33 0.38 0.35 0.17 0.16 0.02 0.73 0.70 0.52 0.51 ZZZ

15788 ............ R Chemical peel, face, epiderm .............. 2.09 3.08 2.71 1.05 1.19 0.11 5.28 4.91 3.25 3.39 090

15789 ............ R Chemical peel, face, dermal ................ 4.92 5.68 4.66 3.69 3.17 0.27 10.87 9.85 8.88 8.36 090

15792 ............ R Chemical peel, nonfacial ...................... 1.86 2.84 2.27 1.83 1.51 0.10 4.80 4.23 3.79 3.47 090

15793 ............ A Chemical peel, nonfacial ...................... 3.74 NA NA 3.38 2.67 0.17 NA NA 7.29 6.58 090

15810 ............ A Salabrasion ........................................... 4.74 3.80 3.88 3.80 3.88 0.42 8.96 9.04 8.96 9.04 090

15811 ............ A Salabrasion ........................................... 5.39 4.07 4.07 4.07 4.07 0.52 9.98 9.98 9.98 9.98 090

15819 ............ A Plastic surgery, neck ............................ 9.38 NA NA 6.87 7.33 0.77 NA NA 17.02 17.48 090

15820 ............ A Revision of lower eyelid ....................... 5.15 10.70 9.56 6.60 6.49 0.30 16.15 15.01 12.05 11.94 090

15821 ............ A Revision of lower eyelid ....................... 5.72 11.31 10.19 6.77 6.79 0.31 17.34 16.22 12.80 12.82 090

15822 ............ A Revision of upper eyelid ....................... 4.45 8.92 8.02 5.99 5.82 0.22 13.59 12.69 10.66 10.49 090

15823 ............ A Revision of upper eyelid ....................... 7.05 10.19 9.74 7.17 7.47 0.32 17.56 17.11 14.54 14.84 090

15824 ............ R Removal of forehead wrinkles .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15825 ............ R Removal of neck wrinkles .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15826 ............ R Removal of brow wrinkles .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15828 ............ R Removal of face wrinkles ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15829 ............ R Removal of skin wrinkles ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15831 ............ A Excise excessive skin tissue ................ 12.40 NA NA 8.18 8.81 1.30 NA NA 21.88 22.51 090

15832 ............ A Excise excessive skin tissue ................ 11.59 NA NA 7.82 8.12 1.21 NA NA 20.62 20.92 090

15833 ............ A Excise excessive skin tissue ................ 10.64 NA NA 7.50 7.31 1.17 NA NA 19.31 19.12 090

15834 ............ A Excise excessive skin tissue ................ 10.85 NA NA 6.14 6.55 1.18 NA NA 18.17 18.58 090

15835 ............ A Excise excessive skin tissue ................ 11.67 NA NA 5.73 6.20 1.13 NA NA 18.53 19.00 090

15836 ............ A Excise excessive skin tissue ................ 9.34 NA NA 6.18 6.21 0.95 NA NA 16.47 16.50 090

15837 ............ A Excise excessive skin tissue ................ 8.43 7.85 7.51 6.11 6.20 0.78 17.06 16.72 15.32 15.41 090

15838 ............ A Excise excessive skin tissue ................ 7.13 NA NA 5.70 5.87 0.58 NA NA 13.41 13.58 090

15839 ............ A Excise excessive skin tissue ................ 9.38 7.60 6.36 6.06 5.21 0.88 17.86 16.62 16.32 15.47 090

15840 ............ A Graft for face nerve palsy .................... 13.26 NA NA 9.85 11.35 1.15 NA NA 24.26 25.76 090

15841 ............ A Graft for face nerve palsy .................... 23.26 NA NA 15.30 16.05 2.65 NA NA 41.21 41.96 090

15842 ............ A Flap for face nerve palsy ..................... 37.96 NA NA 21.94 24.32 3.99 NA NA 63.89 66.27 090

15845 ............ A Skin and muscle repair, face ............... 12.57 NA NA 8.97 10.48 0.80 NA NA 22.34 23.85 090

15850 ............ B Removal of sutures .............................. +0.78 1.38 1.13 0.31 0.33 0.04 2.20 1.95 1.13 1.15 XXX

15851 ............ A Removal of sutures .............................. 0.86 1.56 1.25 0.35 0.31 0.05 2.47 2.16 1.26 1.22 000

15852 ............ A Dressing change,not for burn ............... 0.86 1.75 1.43 0.37 0.34 0.07 2.68 2.36 1.30 1.27 000

15860 ............ A Test for blood flow in graft ................... 1.95 1.36 1.39 0.83 0.99 0.13 3.44 3.47 2.91 3.07 000

15876 ............ R Suction assisted lipectomy ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15877 ............ R Suction assisted lipectomy ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15878 ............ R Suction assisted lipectomy ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15879 ............ R Suction assisted lipectomy ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

15920 ............ A Removal of tail bone ulcer ................... 7.95 NA NA 5.53 4.95 0.83 NA NA 14.31 13.73 090

15922 ............ A Removal of tail bone ulcer ................... 9.90 NA NA 7.27 7.08 1.06 NA NA 18.23 18.04 090

15931 ............ A Remove sacrum pressure sore ............ 9.24 NA NA 5.71 5.08 0.95 NA NA 15.90 15.27 090

15933 ............ A Remove sacrum pressure sore ............ 10.85 NA NA 7.78 7.71 1.14 NA NA 19.77 19.70 090

15934 ............ A Remove sacrum pressure sore ............ 12.69 NA NA 8.45 8.36 1.35 NA NA 22.49 22.40 090

15935 ............ A Remove sacrum pressure sore ............ 14.57 NA NA 10.35 10.81 1.56 NA NA 26.48 26.94 090

15936 ............ A Remove sacrum pressure sore ............ 12.38 NA NA 9.01 9.55 1.32 NA NA 22.71 23.25 090

15937 ............ A Remove sacrum pressure sore ............ 14.21 NA NA 10.43 11.48 1.51 NA NA 26.15 27.20 090

15940 ............ A Remove hip pressure sore ................... 9.34 NA NA 6.02 5.48 0.98 NA NA 16.34 15.80 090

15941 ............ A Remove hip pressure sore ................... 11.43 NA NA 9.75 9.23 1.23 NA NA 22.41 21.89 090

15944 ............ A Remove hip pressure sore ................... 11.46 NA NA 8.66 9.01 1.21 NA NA 21.33 21.68 090

15945 ............ A Remove hip pressure sore ................... 12.69 NA NA 9.77 10.35 1.38 NA NA 23.84 24.42 090

15946 ............ A Remove hip pressure sore ................... 21.57 NA NA 14.60 15.46 2.32 NA NA 38.49 39.35 090

15950 ............ A Remove thigh pressure sore ................ 7.54 NA NA 5.24 4.75 0.80 NA NA 13.58 13.09 090

15951 ............ A Remove thigh pressure sore ................ 10.72 NA NA 7.72 7.87 1.14 NA NA 19.58 19.73 090

15952 ............ A Remove thigh pressure sore ................ 11.39 NA NA 7.44 7.52 1.19 NA NA 20.02 20.10 090

15953 ............ A Remove thigh pressure sore ................ 12.63 NA NA 8.94 9.17 1.38 NA NA 22.95 23.18 090

15956 ............ A Remove thigh pressure sore ................ 15.52 NA NA 10.66 12.63 1.64 NA NA 27.82 29.79 090

15958 ............ A Remove thigh pressure sore ................ 15.48 NA NA 10.97 12.85 1.66 NA NA 28.11 29.99 090

15999 ............ C Removal of pressure sore .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

16000 ............ A Initial treatment of burn(s) .................... 0.89 0.99 0.84 0.27 0.25 0.06 1.94 1.79 1.22 1.20 000

16010 ............ A Treatment of burn(s) ............................ 0.87 1.08 0.90 0.38 0.33 0.07 2.02 1.84 1.32 1.27 000

16015 ............ A Treatment of burn(s) ............................ 2.35 1.79 1.90 1.00 1.30 0.22 4.36 4.47 3.57 3.87 000

16020 ............ A Treatment of burn(s) ............................ 0.80 1.09 0.91 0.26 0.24 0.06 1.95 1.77 1.12 1.10 000

65445

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

16025 ............ A Treatment of burn(s) ............................ 1.85 1.74 1.43 0.69 0.58 0.16 3.75 3.44 2.70 2.59 000

16030 ............ A Treatment of burn(s) ............................ 2.08 2.98 2.38 0.95 0.85 0.18 5.24 4.64 3.21 3.11 000

16035 ............ A Incision of burn scab, initi .................... 3.75 NA NA 1.59 1.70 0.36 NA NA 5.70 5.81 090

16036 ............ A Incise burn scab, addl incis .................. 1.50 NA NA 0.64 0.64 0.18 NA NA 2.32 2.32 ZZZ

17000 ............ A Destroy benign/premal lesion ............... 0.60 1.04 0.90 0.27 0.26 0.03 1.67 1.53 0.90 0.89 010

17003 ............ A Destroy lesions, 2-14 ........................... 0.15 0.23 0.21 0.07 0.07 0.01 0.39 0.37 0.23 0.23 ZZZ

17004 ............ A Destroy lesions, 15 or more ................. 2.79 2.46 2.46 1.29 1.27 0.12 5.37 5.37 4.20 4.18 010

17106 ............ A Destruction of skin lesions ................... 4.59 4.45 3.86 2.64 2.24 0.28 9.32 8.73 7.51 7.11 090

17107 ............ A Destruction of skin lesions ................... 9.16 6.54 5.91 4.73 4.05 0.53 16.23 15.60 14.42 13.74 090

17108 ............ A Destruction of skin lesions ................... 13.20 8.64 9.01 7.26 7.97 0.89 22.73 23.10 21.35 22.06 090

17110 ............ A Destruct lesion, 1-14 ............................ 0.65 1.00 0.86 0.26 0.25 0.04 1.69 1.55 0.95 0.94 010

17111 ............ A Destruct lesion, 15 or more .................. 0.92 1.15 1.03 0.40 0.38 0.04 2.11 1.99 1.36 1.34 010

17250 ............ A Chemical cautery, tissue ...................... 0.50 0.66 0.59 0.21 0.21 0.04 1.20 1.13 0.75 0.75 000

17260 ............ A Destruction of skin lesions ................... 0.91 1.29 1.28 0.42 0.47 0.04 2.24 2.23 1.37 1.42 010

17261 ............ A Destruction of skin lesions ................... 1.17 1.41 1.44 0.55 0.60 0.05 2.63 2.66 1.77 1.82 010

17262 ............ A Destruction of skin lesions ................... 1.58 1.61 1.70 0.75 0.81 0.07 3.26 3.35 2.40 2.46 010

17263 ............ A Destruction of skin lesions ................... 1.79 1.72 1.90 0.83 0.93 0.08 3.59 3.77 2.70 2.80 010

17264 ............ A Destruction of skin lesions ................... 1.94 1.80 2.05 0.85 0.99 0.08 3.82 4.07 2.87 3.01 010

17266 ............ A Destruction of skin lesions ................... 2.34 2.00 2.35 0.97 1.15 0.11 4.45 4.80 3.42 3.60 010

17270 ............ A Destruction of skin lesions ................... 1.32 1.49 1.48 0.62 0.65 0.06 2.87 2.86 2.00 2.03 010

17271 ............ A Destruction of skin lesions ................... 1.49 1.57 1.65 0.72 0.78 0.06 3.12 3.20 2.27 2.33 010

17272 ............ A Destruction of skin lesions ................... 1.77 1.71 1.88 0.85 0.94 0.07 3.55 3.72 2.69 2.78 010

17273 ............ A Destruction of skin lesions ................... 2.05 1.86 2.10 0.98 1.09 0.09 4.00 4.24 3.12 3.23 010

17274 ............ A Destruction of skin lesions ................... 2.59 2.12 2.46 1.19 1.33 0.11 4.82 5.16 3.89 4.03 010

17276 ............ A Destruction of skin lesions ................... 3.20 2.42 2.74 1.70 1.74 0.15 5.77 6.09 5.05 5.09 010

17280 ............ A Destruction of skin lesions ................... 1.17 1.33 1.45 0.54 0.63 0.05 2.55 2.67 1.76 1.85 010

17281 ............ A Destruction of skin lesions ................... 1.72 1.69 1.84 0.83 0.91 0.07 3.48 3.63 2.62 2.70 010

17282 ............ A Destruction of skin lesions ................... 2.04 1.85 2.09 0.99 1.09 0.09 3.98 4.22 3.12 3.22 010

17283 ............ A Destruction of skin lesions ................... 2.64 2.15 2.43 1.25 1.35 0.11 4.90 5.18 4.00 4.10 010

17284 ............ A Destruction of skin lesions ................... 3.21 2.44 2.78 1.51 1.61 0.14 5.79 6.13 4.86 4.96 010

17286 ............ A Destruction of skin lesions ................... 4.44 3.06 3.47 2.46 2.43 0.22 7.72 8.13 7.12 7.09 010

17304 ............ A Chemosurgery of skin lesion ................ 7.60 7.71 6.87 3.67 3.30 0.31 15.62 14.78 11.58 11.21 000

17305 ............ A 2nd stage chemosurgery ...................... 2.85 3.58 3.30 1.38 1.34 0.12 6.55 6.27 4.35 4.31 000

17306 ............ A 3rd stage chemosurgery ...................... 2.85 3.62 3.10 1.39 1.23 0.12 6.59 6.07 4.36 4.20 000

17307 ............ A Followup skin lesion therapy ................ 2.85 3.17 2.78 1.40 1.25 0.12 6.14 5.75 4.37 4.22 000

17310 ............ A Extensive skin chemosurgery .............. 0.95 1.49 1.15 0.48 0.38 0.05 2.49 2.15 1.48 1.38 000

17340 ............ A Cryotherapy of skin .............................. 0.76 1.35 1.09 0.27 0.24 0.04 2.15 1.89 1.07 1.04 010

17360 ............ A Skin peel therapy ................................. 1.43 1.51 1.21 0.69 0.56 0.06 3.00 2.70 2.18 2.05 010

17380 ............ R Hair removal by electrolysis ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

17999 ............ C Skin tissue procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

19000 ............ A Drainage of breast lesion ..................... 0.84 1.18 0.99 0.30 0.28 0.07 2.09 1.90 1.21 1.19 000

19001 ............ A Drain breast lesion add-on ................... 0.42 0.79 0.66 0.15 0.15 0.03 1.24 1.11 0.60 0.60 ZZZ

19020 ............ A Incision of breast lesion ....................... 3.57 6.66 5.38 3.38 2.92 0.35 10.58 9.30 7.30 6.84 090

19030 ............ A Injection for breast x-ray ...................... 1.53 10.60 8.08 0.54 0.54 0.07 12.20 9.68 2.14 2.14 000

19100 ............ A Bx breast percut w/o image ................. 1.27 3.33 2.67 0.46 0.43 0.10 4.70 4.04 1.83 1.80 000

19101 ............ A Biopsy of breast, open ......................... 3.18 9.82 8.00 2.97 2.86 0.20 13.20 11.38 6.35 6.24 010

19102 ............ A Bx breast percut w/image .................... 2.00 4.58 4.58 0.73 0.73 0.08 6.66 6.66 2.81 2.81 000

19103 ............ A Bx breast percut w/device .................... 2.37 10.83 10.83 0.86 0.86 0.08 13.28 13.28 3.31 3.31 000

19110 ............ A Nipple exploration ................................. 4.30 8.03 6.69 4.42 3.98 0.44 12.77 11.43 9.16 8.72 090

19112 ............ A Excise breast duct fistula ..................... 3.67 6.84 5.77 3.08 2.95 0.38 10.89 9.82 7.13 7.00 090

19120 ............ A Removal of breast lesion ..................... 5.56 4.41 4.10 3.62 3.50 0.56 10.53 10.22 9.74 9.62 090

19125 ............ A Excision, breast lesion ......................... 6.06 5.04 4.57 3.78 3.62 0.61 11.71 11.24 10.45 10.29 090

19126 ............ A Excision, addl breast lesion ................. 2.93 NA NA 1.11 1.23 0.30 NA NA 4.34 4.46 ZZZ

19140 ............ A Removal of breast tissue ..................... 5.14 8.71 7.70 3.76 3.99 0.52 14.37 13.36 9.42 9.65 090

19160 ............ A Removal of breast tissue ..................... 5.99 NA NA 4.56 4.54 0.61 NA NA 11.16 11.14 090

19162 ............ A Remove breast tissue, nodes .............. 13.53 NA NA 8.08 8.61 1.38 NA NA 22.99 23.52 090

19180 ............ A Removal of breast ................................ 8.80 NA NA 6.01 6.03 0.88 NA NA 15.69 15.71 090

19182 ............ A Removal of breast ................................ 7.73 NA NA 5.06 5.44 0.79 NA NA 13.58 13.96 090

19200 ............ A Removal of breast ................................ 15.49 NA NA 9.47 9.88 1.51 NA NA 26.47 26.88 090

19220 ............ A Removal of breast ................................ 15.72 NA NA 9.40 9.96 1.56 NA NA 26.68 27.24 090

19240 ............ A Removal of breast ................................ 16.00 NA NA 9.00 9.31 1.62 NA NA 26.62 26.93 090

19260 ............ A Removal of chest wall lesion ............... 15.44 NA NA 10.55 9.28 1.64 NA NA 27.63 26.36 090

19271 ............ A Revision of chest wall .......................... 18.90 NA NA 13.98 14.27 2.27 NA NA 35.15 35.44 090

19272 ............ A Extensive chest wall surgery ................ 21.55 NA NA 15.55 15.08 2.54 NA NA 39.64 39.17 090

19290 ............ A Place needle wire, breast ..................... 1.27 4.85 3.76 0.45 0.46 0.06 6.18 5.09 1.78 1.79 000

19291 ............ A Place needle wire, breast ..................... 0.63 1.65 1.31 0.22 0.23 0.03 2.31 1.97 0.88 0.89 ZZZ

19295 ............ A Place breast clip, percut ....................... 0.00 2.61 2.61 0.94 0.94 0.01 2.62 2.62 0.95 0.95 ZZZ

19316 ............ A Suspension of breast ........................... 10.69 NA NA 7.63 8.91 1.15 NA NA 19.47 20.75 090

19318 ............ A Reduction of large breast ..................... 15.62 NA NA 10.48 11.71 1.69 NA NA 27.79 29.02 090

19324 ............ A Enlarge breast ...................................... 5.85 NA NA 4.62 4.36 0.63 NA NA 11.10 10.84 090

19325 ............ A Enlarge breast with implant .................. 8.45 NA NA 6.75 6.66 0.90 NA NA 16.10 16.01 090

19328 ............ A Removal of breast implant ................... 5.68 NA NA 4.60 4.47 0.61 NA NA 10.89 10.76 090

19330 ............ A Removal of implant material ................ 7.59 NA NA 5.33 5.05 0.81 NA NA 13.73 13.45 090

19340 ............ A Immediate breast prosthesis ................ 6.33 NA NA 3.32 4.38 0.68 NA NA 10.33 11.39 ZZZ

19342 ............ A Delayed breast prosthesis .................... 11.20 NA NA 7.96 8.90 1.21 NA NA 20.37 21.31 090

19350 ............ A Breast reconstruction ........................... 8.92 13.94 12.38 6.87 7.07 0.95 23.81 22.25 16.74 16.94 090

19355 ............ A Correct inverted nipple(s) ..................... 7.57 11.53 9.99 5.94 5.79 0.80 19.90 18.36 14.31 14.16 090

19357 ............ A Breast reconstruction ........................... 18.16 NA NA 13.92 13.74 1.96 NA NA 34.04 33.86 090

19361 ............ A Breast reconstruction ........................... 19.26 NA NA 12.29 14.68 2.08 NA NA 33.63 36.02 090

19364 ............ A Breast reconstruction ........................... 41.00 NA NA 22.88 21.69 3.91 NA NA 67.79 66.60 090

19366 ............ A Breast reconstruction ........................... 21.28 NA NA 12.38 13.74 2.27 NA NA 35.93 37.29 090

19367 ............ A Breast reconstruction ........................... 25.73 NA NA 15.65 17.20 2.78 NA NA 44.16 45.71 090

19368 ............ A Breast reconstruction ........................... 32.42 NA NA 19.45 20.05 3.51 NA NA 55.38 55.98 090

65446

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

19369 ............ A Breast reconstruction ........................... 29.82 NA NA 18.59 19.41 3.24 NA NA 51.65 52.47 090

19370 ............ A Surgery of breast capsule .................... 8.05 NA NA 6.16 6.30 0.86 NA NA 15.07 15.21 090

19371 ............ A Removal of breast capsule .................. 9.35 NA NA 7.26 7.59 1.01 NA NA 17.62 17.95 090

19380 ............ A Revise breast reconstruction ................ 9.14 NA NA 7.15 7.56 0.98 NA NA 17.27 17.68 090

19396 ............ A Design custom breast implant .............. 2.17 4.99 4.17 0.80 1.03 0.23 7.39 6.57 3.20 3.43 000

19499 ............ C Breast surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

20000 ............ A Incision of abscess ............................... 2.12 1.94 1.69 1.18 1.00 0.17 4.23 3.98 3.47 3.29 010

20005 ............ A Incision of deep abscess ...................... 3.42 2.81 2.61 2.22 2.16 0.34 6.57 6.37 5.98 5.92 010

20100 ............ A Explore wound, neck ............................ 10.08 6.00 5.85 4.65 4.84 0.99 17.07 16.92 15.72 15.91 010

20101 ............ A Explore wound, chest ........................... 3.22 3.04 2.71 1.36 1.45 0.24 6.50 6.17 4.82 4.91 010

20102 ............ A Explore wound, abdomen .................... 3.94 3.36 3.04 1.71 1.80 0.35 7.65 7.33 6.00 6.09 010

20103 ............ A Explore wound, extremity ..................... 5.30 4.12 3.79 3.02 2.97 0.57 9.99 9.66 8.89 8.84 010

20150 ............ A Excise epiphyseal bar .......................... 13.69 NA NA 7.66 9.11 0.96 NA NA 22.31 23.76 090

20200 ............ A Muscle biopsy ....................................... 1.46 1.70 1.58 0.64 0.79 0.17 3.33 3.21 2.27 2.42 000

20205 ............ A Deep muscle biopsy ............................. 2.35 3.53 3.16 1.00 1.26 0.23 6.11 5.74 3.58 3.84 000

20206 ............ A Needle biopsy, muscle ......................... 0.99 3.02 2.53 0.36 0.53 0.06 4.07 3.58 1.41 1.58 000

20220 ............ A Bone biopsy, trocar/needle .................. 1.27 4.78 3.94 2.87 2.51 0.06 6.11 5.27 4.20 3.84 000

20225 ............ A Bone biopsy, trocar/needle .................. 1.87 4.28 3.86 2.85 2.70 0.11 6.26 5.84 4.83 4.68 000

20240 ............ A Bone biopsy, excisional ........................ 3.23 NA NA 4.11 3.59 0.33 NA NA 7.67 7.15 010

20245 ............ A Bone biopsy, excisional ........................ 3.95 NA NA 4.69 4.49 0.44 NA NA 9.08 8.88 010

20250 ............ A Open bone biopsy ................................ 5.03 NA NA 4.29 4.59 0.50 NA NA 9.82 10.12 010

20251 ............ A Open bone biopsy ................................ 5.56 NA NA 4.72 5.13 0.79 NA NA 11.07 11.48 010

20500 ............ A Injection of sinus tract .......................... 1.23 5.19 3.99 3.76 2.87 0.10 6.52 5.32 5.09 4.20 010

20501 ............ A Inject sinus tract for x-ray ..................... 0.76 12.72 9.62 0.27 0.29 0.03 13.51 10.41 1.06 1.08 000

20520 ............ A Removal of foreign body ...................... 1.85 5.22 4.11 3.33 2.60 0.17 7.24 6.13 5.35 4.62 010

20525 ............ A Removal of foreign body ...................... 3.50 6.39 5.40 4.14 3.71 0.40 10.29 9.30 8.04 7.61 010

20550 ............ A Inject tendon/ligament/cyst ................... 0.86 1.96 1.57 0.22 0.22 0.06 2.88 2.49 1.14 1.14 000

20600 ............ A Drain/inject, joint/bursa ......................... 0.66 1.35 1.14 0.27 0.27 0.06 2.07 1.86 0.99 0.99 000

20605 ............ A Drain/inject, joint/bursa ......................... 0.68 1.68 1.38 0.27 0.27 0.06 2.42 2.12 1.01 1.01 000

20610 ............ A Drain/inject, joint/bursa ......................... 0.79 2.08 1.68 0.55 0.48 0.08 2.95 2.55 1.42 1.35 000

20615 ............ A Treatment of bone cyst ........................ 2.28 4.45 3.47 2.46 1.91 0.19 6.92 5.94 4.93 4.38 010

20650 ............ A Insert and remove bone pin ................. 2.23 4.30 3.52 2.88 2.45 0.28 6.81 6.03 5.39 4.96 010

20660 ............ A Apply,remove fixation device ............... 2.51 NA NA 1.47 1.53 0.48 NA NA 4.46 4.52 000

20661 ............ A Application of head brace .................... 4.89 NA NA 6.52 5.93 0.92 NA NA 12.33 11.74 090

20662 ............ A Application of pelvis brace ................... 6.07 NA NA 5.11 5.61 0.81 NA NA 11.99 12.49 090

20663 ............ A Application of thigh brace ..................... 5.43 NA NA 4.75 4.82 0.77 NA NA 10.95 11.02 090

20664 ............ A Halo brace application .......................... 8.06 NA NA 8.25 7.23 1.49 NA NA 17.80 16.78 090

20665 ............ A Removal of fixation device ................... 1.31 2.20 1.79 1.23 1.06 0.17 3.68 3.27 2.71 2.54 010

20670 ............ A Removal of support implant ................. 1.74 5.50 4.33 3.43 2.67 0.23 7.47 6.30 5.40 4.64 010

20680 ............ A Removal of support implant ................. 3.35 5.02 4.67 5.02 4.67 0.46 8.83 8.48 8.83 8.48 090

20690 ............ A Apply bone fixation device ................... 3.52 NA NA 1.88 2.40 0.47 NA NA 5.87 6.39 090

20692 ............ A Apply bone fixation device ................... 6.41 NA NA 2.49 3.36 0.60 NA NA 9.50 10.37 090

20693 ............ A Adjust bone fixation device .................. 5.86 NA NA 11.60 9.38 0.85 NA NA 18.31 16.09 090

20694 ............ A Remove bone fixation device ............... 4.16 8.17 6.83 5.77 5.03 0.57 12.90 11.56 10.50 9.76 090

20802 ............ A Replantation, arm, complete ................ 41.15 NA NA 27.94 31.19 5.81 NA NA 74.90 78.15 090

20805 ............ A Replant, forearm, complete .................. 50.00 NA NA 50.26 50.22 3.95 NA NA 104.21 104.17 090

20808 ............ A Replantation hand, complete ............... 61.65 NA NA 43.46 48.17 6.49 NA NA 111.60 116.31 090

20816 ............ A Replantation digit, complete ................. 30.94 NA NA 42.68 39.69 3.01 NA NA 76.63 73.64 090

20822 ............ A Replantation digit, complete ................. 25.59 NA NA 39.15 35.71 3.07 NA NA 67.81 64.37 090

20824 ............ A Replantation thumb, complete ............. 30.94 NA NA 36.49 35.05 3.48 NA NA 70.91 69.47 090

20827 ............ A Replantation thumb, complete ............. 26.41 NA NA 45.63 40.75 3.21 NA NA 75.25 70.37 090

20838 ............ A Replantation foot, complete ................. 41.41 NA NA 28.37 31.51 5.85 NA NA 75.63 78.77 090

20900 ............ A Removal of bone for graft .................... 5.58 6.70 5.79 5.81 5.12 0.77 13.05 12.14 12.16 11.47 090

20902 ............ A Removal of bone for graft .................... 7.55 NA NA 8.28 7.55 1.06 NA NA 16.89 16.16 090

20910 ............ A Remove cartilage for graft .................... 5.34 8.05 6.25 6.51 5.10 0.50 13.89 12.09 12.35 10.94 090

20912 ............ A Remove cartilage for graft .................... 6.35 NA NA 7.26 6.70 0.55 NA NA 14.16 13.60 090

20920 ............ A Removal of fascia for graft ................... 5.31 NA NA 5.42 5.13 0.54 NA NA 11.27 10.98 090

20922 ............ A Removal of fascia for graft ................... 6.61 8.54 7.60 6.14 5.80 0.88 16.03 15.09 13.63 13.29 090

20924 ............ A Removal of tendon for graft ................. 6.48 NA NA 6.62 6.44 0.82 NA NA 13.92 13.74 090

20926 ............ A Removal of tissue for graft ................... 5.53 NA NA 6.15 5.32 0.73 NA NA 12.41 11.58 090

20930 ............ B Spinal bone allograft ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

20931 ............ A Spinal bone allograft ............................ 1.81 NA NA 0.96 1.19 0.34 NA NA 3.11 3.34 ZZZ

20936 ............ B Spinal bone autograft ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

20937 ............ A Spinal bone autograft ........................... 2.79 NA NA 1.52 1.86 0.43 NA NA 4.74 5.08 ZZZ

20938 ............ A Spinal bone autograft ........................... 3.02 NA NA 1.62 2.00 0.52 NA NA 5.16 5.54 ZZZ

20950 ............ A Fluid pressure, muscle ......................... 1.26 NA NA 2.08 1.86 0.16 NA NA 3.50 3.28 000

20955 ............ A Fibula bone graft, microvasc ................ 39.21 NA NA 29.43 31.80 4.35 NA NA 72.99 75.36 090

20956 ............ A Iliac bone graft, microvasc ................... 39.27 NA NA 28.36 28.57 5.77 NA NA 73.40 73.61 090

20957 ............ A Mt bone graft, microvasc ...................... 40.65 NA NA 24.17 25.69 5.74 NA NA 70.56 72.08 090

20962 ............ A Other bone graft, microvasc ................. 39.27 NA NA 28.68 28.81 5.19 NA NA 73.14 73.27 090

20969 ............ A Bone/skin graft, microvasc ................... 43.92 NA NA 32.20 35.04 4.34 NA NA 80.46 83.30 090

20970 ............ A Bone/skin graft, iliac crest .................... 43.06 NA NA 29.96 33.14 4.64 NA NA 77.66 80.84 090

20972 ............ A Bone/skin graft, metatarsal .................. 42.99 NA NA 18.72 24.79 6.07 NA NA 67.78 73.85 090

20973 ............ A Bone/skin graft, great toe ..................... 45.76 NA NA 22.14 28.07 4.65 NA NA 72.55 78.48 090

20974 ............ A Electrical bone stimulation ................... 0.62 0.38 1.21 0.34 0.72 0.09 1.09 1.92 1.05 1.43 000

20975 ............ A Electrical bone stimulation ................... 2.60 NA NA 1.41 1.83 0.42 NA NA 4.43 4.85 000

20979 ............ A Us bone stimulation .............................. 0.62 0.57 0.57 0.25 0.25 0.04 1.23 1.23 0.91 0.91 000

20999 ............ C Musculoskeletal surgery ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

21010 ............ A Incision of jaw joint ............................... 10.14 NA NA 6.96 8.00 0.54 NA NA 17.64 18.68 090

21015 ............ A Resection of facial tumor ..................... 5.29 NA NA 6.95 6.79 0.52 NA NA 12.76 12.60 090

21025 ............ A Excision of bone, lower jaw ................. 10.06 7.37 6.65 6.86 5.71 0.79 18.22 17.50 17.71 16.56 090

21026 ............ A Excision of facial bone(s) ..................... 4.85 5.45 4.94 4.79 4.02 0.40 10.70 10.19 10.04 9.27 090

21029 ............ A Contour of face bone lesion ................. 7.71 6.81 7.41 6.04 5.68 0.74 15.26 15.86 14.49 14.13 090

65447

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

21030 ............ A Removal of face bone lesion ............... 6.46 5.37 4.94 4.87 4.11 0.60 12.43 12.00 11.93 11.17 090

21031 ............ A Remove exostosis, mandible ............... 3.24 3.33 3.50 2.11 2.08 0.28 6.85 7.02 5.63 5.60 090

21032 ............ A Remove exostosis, maxilla ................... 3.24 3.29 3.52 2.16 2.15 0.27 6.80 7.03 5.67 5.66 090

21034 ............ A Removal of face bone lesion ............... 16.17 11.88 10.81 10.61 9.85 1.37 29.42 28.35 28.15 27.39 090

21040 ............ A Removal of jaw bone lesion ................. 2.11 2.97 2.98 1.86 1.77 0.19 5.27 5.28 4.16 4.07 090

21041 ............ A Removal of jaw bone lesion ................. 6.71 5.59 5.76 4.35 4.05 0.56 12.86 13.03 11.62 11.32 090

21044 ............ A Removal of jaw bone lesion ................. 11.86 NA NA 7.90 8.52 0.87 NA NA 20.63 21.25 090

21045 ............ A Extensive jaw surgery .......................... 16.17 NA NA 10.26 11.45 1.20 NA NA 27.63 28.82 090

21050 ............ A Removal of jaw joint ............................. 10.77 NA NA 11.22 11.63 0.84 NA NA 22.83 23.24 090

21060 ............ A Remove jaw joint cartilage ................... 10.23 NA NA 10.06 10.60 1.16 NA NA 21.45 21.99 090

21070 ............ A Remove coronoid process ................... 8.20 NA NA 6.07 6.40 0.67 NA NA 14.94 15.27 090

21076 ............ A Prepare face/oral prosthesis ................ 13.42 9.75 11.32 7.34 7.51 1.36 24.53 26.10 22.12 22.29 010

21077 ............ A Prepare face/oral prosthesis ................ 33.75 24.53 28.47 18.46 18.88 3.43 61.71 65.65 55.64 56.06 090

21079 ............ A Prepare face/oral prosthesis ................ 22.34 17.32 20.57 12.77 13.37 1.59 41.25 44.50 36.70 37.30 090

21080 ............ A Prepare face/oral prosthesis ................ 25.10 19.47 23.12 14.35 15.02 2.55 47.12 50.77 42.00 42.67 090

21081 ............ A Prepare face/oral prosthesis ................ 22.88 17.74 21.06 13.08 13.69 1.87 42.49 45.81 37.83 38.44 090

21082 ............ A Prepare face/oral prosthesis ................ 20.87 15.17 17.61 11.42 11.68 1.46 37.50 39.94 33.75 34.01 090

21083 ............ A Prepare face/oral prosthesis ................ 19.30 14.97 17.78 11.03 11.55 1.96 36.23 39.04 32.29 32.81 090

21084 ............ A Prepare face/oral prosthesis ................ 22.51 17.45 20.72 12.87 13.47 1.57 41.53 44.80 36.95 37.55 090

21085 ............ A Prepare face/oral prosthesis ................ 9.00 6.53 7.58 4.93 5.04 0.65 16.18 17.23 14.58 14.69 010

21086 ............ A Prepare face/oral prosthesis ................ 24.92 19.33 22.95 14.25 14.92 1.86 46.11 49.73 41.03 41.70 090

21087 ............ A Prepare face/oral prosthesis ................ 24.92 18.10 21.01 13.64 13.95 2.22 45.24 48.15 40.78 41.09 090

21088 ............ C Prepare face/oral prosthesis ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

21089 ............ C Prepare face/oral prosthesis ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

21100 ............ A Maxillofacial fixation ............................. 4.22 5.87 4.69 4.00 3.29 0.18 10.27 9.09 8.40 7.69 090

21110 ............ A Interdental fixation ................................ 5.21 5.21 5.41 4.54 4.16 0.28 10.70 10.90 10.03 9.65 090

21116 ............ A Injection, jaw joint x-ray ........................ 0.81 7.87 6.10 0.31 0.43 0.05 8.73 6.96 1.17 1.29 000

21120 ............ A Reconstruction of chin .......................... 4.93 10.28 8.69 6.23 5.65 0.29 15.50 13.91 11.45 10.87 090

21121 ............ A Reconstruction of chin .......................... 7.64 8.07 7.59 5.81 5.89 0.56 16.27 15.79 14.01 14.09 090

21122 ............ A Reconstruction of chin .......................... 8.52 NA NA 7.37 7.22 0.59 NA NA 16.48 16.33 090

21123 ............ A Reconstruction of chin .......................... 11.16 NA NA 8.46 8.55 1.16 NA NA 20.78 20.87 090

21125 ............ A Augmentation, lower jaw bone ............. 10.62 9.06 8.08 8.64 7.76 0.72 20.40 19.42 19.98 19.10 090

21127 ............ A Augmentation, lower jaw bone ............. 11.12 9.54 9.30 6.73 7.19 0.76 21.42 21.18 18.61 19.07 090

21137 ............ A Reduction of forehead .......................... 9.82 NA NA 7.11 7.26 0.53 NA NA 17.46 17.61 090

21138 ............ A Reduction of forehead .......................... 12.19 NA NA 9.81 9.76 1.47 NA NA 23.47 23.42 090

21139 ............ A Reduction of forehead .......................... 14.61 NA NA 9.37 9.92 1.02 NA NA 25.00 25.55 090

21141 ............ A Reconstruct midface, lefort .................. 18.10 NA NA 11.10 12.22 1.63 NA NA 30.83 31.95 090

21142 ............ A Reconstruct midface, lefort .................. 18.81 NA NA 11.26 12.47 1.16 NA NA 31.23 32.44 090

21143 ............ A Reconstruct midface, lefort .................. 19.58 NA NA 11.26 12.62 0.90 NA NA 31.74 33.10 090

21145 ............ A Reconstruct midface, lefort .................. 19.94 NA NA 11.47 12.49 2.09 NA NA 33.50 34.52 090

21146 ............ A Reconstruct midface, lefort .................. 20.71 NA NA 12.11 13.11 2.13 NA NA 34.95 35.95 090

21147 ............ A Reconstruct midface, lefort .................. 21.77 NA NA 13.29 14.15 1.52 NA NA 36.58 37.44 090

21150 ............ A Reconstruct midface, lefort .................. 25.24 NA NA 14.79 16.10 1.09 NA NA 41.12 42.43 090

21151 ............ A Reconstruct midface, lefort .................. 28.30 NA NA 18.36 19.38 1.98 NA NA 48.64 49.66 090

21154 ............ A Reconstruct midface, lefort .................. 30.52 NA NA 18.36 19.78 4.86 NA NA 53.74 55.16 090

21155 ............ A Reconstruct midface, lefort .................. 34.45 NA NA 18.36 20.58 5.48 NA NA 58.29 60.51 090

21159 ............ A Reconstruct midface, lefort .................. 42.38 NA NA 21.53 24.56 6.74 NA NA 70.65 73.68 090

21160 ............ A Reconstruct midface, lefort .................. 46.44 NA NA 24.59 27.66 4.39 NA NA 75.42 78.49 090

21172 ............ A Reconstruct orbit/forehead ................... 27.80 NA NA 18.52 19.40 1.91 NA NA 48.23 49.11 090

21175 ............ A Reconstruct orbit/forehead ................... 33.17 NA NA 18.89 20.78 5.16 NA NA 57.22 59.11 090

21179 ............ A Reconstruct entire forehead ................. 22.25 NA NA 18.57 18.33 2.48 NA NA 43.30 43.06 090

21180 ............ A Reconstruct entire forehead ................. 25.19 NA NA 18.88 19.17 2.15 NA NA 46.22 46.51 090

21181 ............ A Contour cranial bone lesion ................. 9.90 NA NA 8.73 8.48 0.97 NA NA 19.60 19.35 090

21182 ............ A Reconstruct cranial bone ..................... 32.19 NA NA 22.46 23.26 2.53 NA NA 57.18 57.98 090

21183 ............ A Reconstruct cranial bone ..................... 35.31 NA NA 23.72 24.80 2.75 NA NA 61.78 62.86 090

21184 ............ A Reconstruct cranial bone ..................... 38.24 NA NA 21.55 23.78 4.12 NA NA 63.91 66.14 090

21188 ............ A Reconstruction of midface .................... 22.46 NA NA 15.60 16.11 1.85 NA NA 39.91 40.42 090

21193 ............ A Reconst lwr jaw w/o graft ..................... 17.15 NA NA 10.99 11.58 1.53 NA NA 29.67 30.26 090

21194 ............ A Reconst lwr jaw w/graft ........................ 19.84 NA NA 12.06 12.92 1.39 NA NA 33.29 34.15 090

21195 ............ A Reconst lwr jaw w/o fixation ................. 17.24 NA NA 12.93 13.05 1.20 NA NA 31.37 31.49 090

21196 ............ A Reconst lwr jaw w/fixation .................... 18.91 NA NA 12.84 13.32 1.62 NA NA 33.37 33.85 090

21198 ............ A Reconstr lwr jaw segment .................... 14.16 NA NA 11.81 12.88 1.05 NA NA 27.02 28.09 090

21199 ............ A Reconstr lwr jaw w/advance ................ 16.00 NA NA 10.53 10.53 1.00 NA NA 27.53 27.53 090

21206 ............ A Reconstruct upper jaw bone ................ 14.10 NA NA 10.08 10.31 1.01 NA NA 25.19 25.42 090

21208 ............ A Augmentation of facial bones ............... 10.23 9.92 10.49 8.37 9.33 0.92 21.07 21.64 19.52 20.48 090

21209 ............ A Reduction of facial bones ..................... 6.72 8.72 7.79 5.68 5.51 0.60 16.04 15.11 13.00 12.83 090

21210 ............ A Face bone graft .................................... 10.23 8.85 9.69 7.95 7.49 0.88 19.96 20.80 19.06 18.60 090

21215 ............ A Lower jaw bone graft ............................ 10.77 8.66 9.71 6.88 6.77 1.04 20.47 21.52 18.69 18.58 090

21230 ............ A Rib cartilage graft ................................. 10.77 NA NA 10.09 10.38 0.96 NA NA 21.82 22.11 090

21235 ............ A Ear cartilage graft ................................. 6.72 11.59 10.70 7.92 7.95 0.52 18.83 17.94 15.16 15.19 090

21240 ............ A Reconstruction of jaw joint ................... 14.05 NA NA 11.45 12.78 1.15 NA NA 26.65 27.98 090

21242 ............ A Reconstruction of jaw joint ................... 12.95 NA NA 11.47 12.47 1.40 NA NA 25.82 26.82 090

21243 ............ A Reconstruction of jaw joint ................... 20.79 NA NA 14.68 14.92 1.85 NA NA 37.32 37.56 090

21244 ............ A Reconstruction of lower jaw ................. 11.86 NA NA 9.00 10.29 0.95 NA NA 21.81 23.10 090

21245 ............ A Reconstruction of jaw ........................... 11.86 16.50 15.49 10.10 10.69 0.88 29.24 28.23 22.84 23.43 090

21246 ............ A Reconstruction of jaw ........................... 12.47 12.41 11.70 10.75 10.46 1.21 26.09 25.38 24.43 24.14 090

21247 ............ A Reconstruct lower jaw bone ................. 22.63 NA NA 18.73 20.80 2.21 NA NA 43.57 45.64 090

21248 ............ A Reconstruction of jaw ........................... 11.48 8.79 10.02 7.96 7.69 1.01 21.28 22.51 20.45 20.18 090

21249 ............ A Reconstruction of jaw ........................... 17.52 11.31 13.71 10.15 10.23 1.39 30.22 32.62 29.06 29.14 090

21255 ............ A Reconstruct lower jaw bone ................. 16.72 NA NA 10.92 13.18 1.13 NA NA 28.77 31.03 090

21256 ............ A Reconstruction of orbit ......................... 16.19 NA NA 13.34 14.84 1.04 NA NA 30.57 32.07 090

21260 ............ A Revise eye sockets .............................. 16.52 NA NA 11.45 13.52 1.25 NA NA 29.22 31.29 090

21261 ............ A Revise eye sockets .............................. 31.49 NA NA 19.08 19.14 2.20 NA NA 52.77 52.83 090

65448

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

21263 ............ A Revise eye sockets .............................. 28.42 NA NA 14.95 19.70 2.16 NA NA 45.53 50.28 090

21267 ............ A Revise eye sockets .............................. 18.90 NA NA 14.53 14.86 1.35 NA NA 34.78 35.11 090

21268 ............ A Revise eye sockets .............................. 24.48 NA NA 12.60 13.62 0.79 NA NA 37.87 38.89 090

21270 ............ A Augmentation, cheek bone .................. 10.23 10.37 10.38 9.16 9.48 0.73 21.33 21.34 20.12 20.44 090

21275 ............ A Revision, orbitofacial bones ................. 11.24 NA NA 11.10 10.75 1.03 NA NA 23.37 23.02 090

21280 ............ A Revision of eyelid ................................. 6.03 NA NA 6.22 6.47 0.27 NA NA 12.52 12.77 090

21282 ............ A Revision of eyelid ................................. 3.49 NA NA 5.20 4.94 0.21 NA NA 8.90 8.64 090

21295 ............ A Revision of jaw muscle/bone ............... 1.53 NA NA 3.62 2.98 0.13 NA NA 5.28 4.64 090

21296 ............ A Revision of jaw muscle/bone ............... 4.25 NA NA 5.20 4.88 0.30 NA NA 9.75 9.43 090

21299 ............ C Cranio/maxillofacial surgery ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

21300 ............ A Treatment of skull fracture ................... 0.72 2.34 2.01 0.27 0.42 0.09 3.15 2.82 1.08 1.23 000

21310 ............ A Treatment of nose fracture ................... 0.58 2.54 2.11 0.15 0.29 0.05 3.17 2.74 0.78 0.92 000

21315 ............ A Treatment of nose fracture ................... 1.51 3.29 2.96 1.24 1.38 0.12 4.92 4.59 2.87 3.01 010

21320 ............ A Treatment of nose fracture ................... 1.85 4.82 4.25 1.98 2.04 0.15 6.82 6.25 3.98 4.04 010

21325 ............ A Treatment of nose fracture ................... 3.77 NA NA 3.66 3.86 0.31 NA NA 7.74 7.94 090

21330 ............ A Treatment of nose fracture ................... 5.38 NA NA 5.41 5.66 0.48 NA NA 11.27 11.52 090

21335 ............ A Treatment of nose fracture ................... 8.61 NA NA 7.04 7.85 0.64 NA NA 16.29 17.10 090

21336 ............ A Treat nasal septal fracture ................... 5.72 NA NA 5.44 5.19 0.45 NA NA 11.61 11.36 090

21337 ............ A Treat nasal septal fracture ................... 2.70 4.98 4.50 3.12 3.11 0.22 7.90 7.42 6.04 6.03 090

21338 ............ A Treat nasoethmoid fracture .................. 6.46 NA NA 5.88 5.77 0.53 NA NA 12.87 12.76 090

21339 ............ A Treat nasoethmoid fracture .................. 8.09 NA NA 6.85 7.06 0.76 NA NA 15.70 15.91 090

21340 ............ A Treatment of nose fracture ................... 10.77 NA NA 9.26 9.36 0.85 NA NA 20.88 20.98 090

21343 ............ A Treatment of sinus fracture .................. 12.95 NA NA 9.93 9.94 1.06 NA NA 23.94 23.95 090

21344 ............ A Treatment of sinus fracture .................. 19.72 NA NA 13.34 12.49 1.72 NA NA 34.78 33.93 090

21345 ............ A Treat nose/jaw fracture ........................ 8.16 8.74 8.70 7.41 7.70 0.60 17.50 17.46 16.17 16.46 090

21346 ............ A Treat nose/jaw fracture ........................ 10.61 NA NA 10.26 10.25 0.85 NA NA 21.72 21.71 090

21347 ............ A Treat nose/jaw fracture ........................ 12.69 NA NA 9.31 9.79 1.14 NA NA 23.14 23.62 090

21348 ............ A Treat nose/jaw fracture ........................ 16.69 NA NA 10.25 10.77 1.50 NA NA 28.44 28.96 090

21355 ............ A Treat cheek bone fracture .................... 3.77 4.79 4.02 2.40 2.22 0.29 8.85 8.08 6.46 6.28 010

21356 ............ A Treat cheek bone fracture .................... 4.15 NA NA 3.22 3.66 0.36 NA NA 7.73 8.17 010

21360 ............ A Treat cheek bone fracture .................... 6.46 NA NA 5.72 6.22 0.52 NA NA 12.70 13.20 090

21365 ............ A Treat cheek bone fracture .................... 14.95 NA NA 11.28 11.81 1.30 NA NA 27.53 28.06 090

21366 ............ A Treat cheek bone fracture .................... 17.77 NA NA 12.09 12.35 1.41 NA NA 31.27 31.53 090

21385 ............ A Treat eye socket fracture ..................... 9.16 NA NA 7.68 8.36 0.64 NA NA 17.48 18.16 090

21386 ............ A Treat eye socket fracture ..................... 9.16 NA NA 7.98 8.45 0.76 NA NA 17.90 18.37 090

21387 ............ A Treat eye socket fracture ..................... 9.70 NA NA 8.14 8.13 0.78 NA NA 18.62 18.61 090

21390 ............ A Treat eye socket fracture ..................... 10.13 NA NA 8.49 9.39 0.70 NA NA 19.32 20.22 090

21395 ............ A Treat eye socket fracture ..................... 12.68 NA NA 9.99 10.11 1.09 NA NA 23.76 23.88 090

21400 ............ A Treat eye socket fracture ..................... 1.40 2.92 2.64 1.08 1.23 0.12 4.44 4.16 2.60 2.75 090

21401 ............ A Treat eye socket fracture ..................... 3.26 5.56 4.87 3.19 3.09 0.34 9.16 8.47 6.79 6.69 090

21406 ............ A Treat eye socket fracture ..................... 7.01 NA NA 6.51 6.30 0.59 NA NA 14.11 13.90 090

21407 ............ A Treat eye socket fracture ..................... 8.61 NA NA 7.74 7.73 0.67 NA NA 17.02 17.01 090

21408 ............ A Treat eye socket fracture ..................... 12.38 NA NA 9.63 9.53 1.24 NA NA 23.25 23.15 090

21421 ............ A Treat mouth roof fracture ..................... 5.14 7.37 7.19 6.29 6.25 0.42 12.93 12.75 11.85 11.81 090

21422 ............ A Treat mouth roof fracture ..................... 8.32 NA NA 7.13 7.83 0.69 NA NA 16.14 16.84 090

21423 ............ A Treat mouth roof fracture ..................... 10.40 NA NA 8.10 8.74 0.95 NA NA 19.45 20.09 090

21431 ............ A Treat craniofacial fracture .................... 7.05 NA NA 5.28 5.59 0.58 NA NA 12.91 13.22 090

21432 ............ A Treat craniofacial fracture .................... 8.61 NA NA 7.28 7.30 0.55 NA NA 16.44 16.46 090

21433 ............ A Treat craniofacial fracture .................... 25.35 NA NA 17.70 18.15 2.46 NA NA 45.51 45.96 090

21435 ............ A Treat craniofacial fracture .................... 17.25 NA NA 11.67 12.35 1.66 NA NA 30.58 31.26 090

21436 ............ A Treat craniofacial fracture .................... 28.04 NA NA 18.85 18.11 2.32 NA NA 49.21 48.47 090

21440 ............ A Treat dental ridge fracture .................... 2.70 5.34 4.84 3.37 3.33 0.22 8.26 7.76 6.29 6.25 090

21445 ............ A Treat dental ridge fracture .................... 5.38 6.92 6.85 5.27 5.56 0.55 12.85 12.78 11.20 11.49 090

21450 ............ A Treat lower jaw fracture ....................... 2.97 6.53 5.67 2.67 2.77 0.23 9.73 8.87 5.87 5.97 090

21451 ............ A Treat lower jaw fracture ....................... 4.87 6.51 6.47 5.49 5.57 0.39 11.77 11.73 10.75 10.83 090

21452 ............ A Treat lower jaw fracture ....................... 1.98 8.85 7.02 3.80 3.23 0.14 10.97 9.14 5.92 5.35 090

21453 ............ A Treat lower jaw fracture ....................... 5.54 7.43 7.38 6.20 6.30 0.49 13.46 13.41 12.23 12.33 090

21454 ............ A Treat lower jaw fracture ....................... 6.46 NA NA 5.93 6.38 0.55 NA NA 12.94 13.39 090

21461 ............ A Treat lower jaw fracture ....................... 8.09 9.57 9.59 7.73 8.21 0.73 18.39 18.41 16.55 17.03 090

21462 ............ A Treat lower jaw fracture ....................... 9.79 10.92 11.11 7.87 8.83 0.80 21.51 21.70 18.46 19.42 090

21465 ............ A Treat lower jaw fracture ....................... 11.91 NA NA 7.39 7.83 0.84 NA NA 20.14 20.58 090

21470 ............ A Treat lower jaw fracture ....................... 15.34 NA NA 9.78 11.91 1.36 NA NA 26.48 28.61 090

21480 ............ A Reset dislocated jaw ............................ 0.61 1.58 1.40 0.18 0.32 0.05 2.24 2.06 0.84 0.98 000

21485 ............ A Reset dislocated jaw ............................ 3.99 3.80 3.45 3.49 2.92 0.31 8.10 7.75 7.79 7.22 090

21490 ............ A Repair dislocated jaw ........................... 11.86 NA NA 7.45 7.30 1.31 NA NA 20.62 20.47 090

21493 ............ A Treat hyoid bone fracture ..................... 1.27 NA NA 3.05 2.67 0.10 NA NA 4.42 4.04 090

21494 ............ A Treat hyoid bone fracture ..................... 6.28 NA NA 5.24 5.97 0.44 NA NA 11.96 12.69 090

21495 ............ A Treat hyoid bone fracture ..................... 5.69 NA NA 4.80 4.91 0.41 NA NA 10.90 11.01 090

21497 ............ A Interdental wiring .................................. 3.86 4.72 4.62 3.78 3.91 0.31 8.89 8.79 7.95 8.08 090

21499 ............ C Head surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

21501 ............ A Drain neck/chest lesion ........................ 3.81 4.15 3.61 3.64 3.23 0.36 8.32 7.78 7.81 7.40 090

21502 ............ A Drain chest lesion ................................. 7.12 NA NA 8.58 7.58 0.79 NA NA 16.49 15.49 090

21510 ............ A Drainage of bone lesion ....................... 5.74 NA NA 8.10 7.11 0.67 NA NA 14.51 13.52 090

21550 ............ A Biopsy of neck/chest ............................ 2.06 2.27 1.93 1.24 1.05 0.13 4.46 4.12 3.43 3.24 010

21555 ............ A Remove lesion, neck/chest .................. 4.35 4.17 3.56 2.54 2.34 0.41 8.93 8.32 7.30 7.10 090

21556 ............ A Remove lesion, neck/chest .................. 5.57 NA NA 3.31 3.51 0.51 NA NA 9.39 9.59 090

21557 ............ A Remove tumor, neck/chest .................. 8.88 NA NA 8.03 8.33 0.85 NA NA 17.76 18.06 090

21600 ............ A Partial removal of rib ............................ 6.89 NA NA 8.77 7.80 0.81 NA NA 16.47 15.50 090

21610 ............ A Partial removal of rib ............................ 14.61 NA NA 10.79 9.50 1.85 NA NA 27.25 25.96 090

21615 ............ A Removal of rib ...................................... 9.87 NA NA 9.65 9.99 1.20 NA NA 20.72 21.06 090

21616 ............ A Removal of rib and nerves ................... 12.04 NA NA 9.02 8.74 1.31 NA NA 22.37 22.09 090

21620 ............ A Partial removal of sternum ................... 6.79 NA NA 8.89 8.53 0.77 NA NA 16.45 16.09 090

21627 ............ A Sternal debridement ............................. 6.81 NA NA 15.57 13.04 0.82 NA NA 23.20 20.67 090

65449

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

21630 ............ A Extensive sternum surgery ................... 17.38 NA NA 14.42 14.31 1.95 NA NA 33.75 33.64 090

21632 ............ A Extensive sternum surgery ................... 18.14 NA NA 15.62 14.85 2.16 NA NA 35.92 35.15 090

21700 ............ A Revision of neck muscle ...................... 6.19 8.78 7.71 7.38 6.66 0.31 15.28 14.21 13.88 13.16 090

21705 ............ A Revision of neck muscle/rib ................. 9.60 NA NA 7.70 7.09 0.92 NA NA 18.22 17.61 090

21720 ............ A Revision of neck muscle ...................... 5.68 7.31 6.53 7.27 6.50 0.80 13.79 13.01 13.75 12.98 090

21725 ............ A Revision of neck muscle ...................... 6.99 NA NA 6.85 6.45 0.90 NA NA 14.74 14.34 090

21740 ............ A Reconstruction of sternum ................... 16.80 NA NA 15.71 14.22 2.03 NA NA 34.54 33.05 090

21750 ............ A Repair of sternum separation ............... 10.77 NA NA 13.10 11.81 1.35 NA NA 25.22 23.93 090

21800 ............ A Treatment of rib fracture ...................... 0.96 2.17 1.84 1.00 0.96 0.09 3.22 2.89 2.05 2.01 090

21805 ............ A Treatment of rib fracture ...................... 2.75 NA NA 4.14 3.47 0.29 NA NA 7.18 6.51 090

21810 ............ A Treatment of rib fracture(s) .................. 6.86 NA NA 7.05 7.28 0.60 NA NA 14.51 14.74 090

21820 ............ A Treat sternum fracture .......................... 1.28 2.59 2.31 1.47 1.47 0.15 4.02 3.74 2.90 2.90 090

21825 ............ A Treat sternum fracture .......................... 7.41 NA NA 11.82 10.74 0.84 NA NA 20.07 18.99 090

21899 ............ C Neck/chest surgery procedure ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

21920 ............ A Biopsy soft tissue of back .................... 2.06 2.35 1.98 0.79 0.70 0.12 4.53 4.16 2.97 2.88 010

21925 ............ A Biopsy soft tissue of back .................... 4.49 10.52 8.42 4.40 3.83 0.44 15.45 13.35 9.33 8.76 090

21930 ............ A Remove lesion, back or flank ............... 5.00 4.59 4.18 2.72 2.78 0.49 10.08 9.67 8.21 8.27 090

21935 ............ A Remove tumor, back ............................ 17.96 NA NA 13.07 11.59 1.87 NA NA 32.90 31.42 090

22100 ............ A Remove part of neck vertebra ............. 9.73 NA NA 8.60 8.52 1.55 NA NA 19.88 19.80 090

22101 ............ A Remove part, thorax vertebra .............. 9.81 NA NA 8.47 8.53 1.51 NA NA 19.79 19.85 090

22102 ............ A Remove part, lumbar vertebra ............. 9.81 NA NA 8.68 7.73 1.46 NA NA 19.95 19.00 090

22103 ............ A Remove extra spine segment .............. 2.34 NA NA 1.29 1.57 0.37 NA NA 4.00 4.28 ZZZ

22110 ............ A Remove part of neck vertebra ............. 12.74 NA NA 10.49 10.51 2.20 NA NA 25.43 25.45 090

22112 ............ A Remove part, thorax vertebra .............. 12.81 NA NA 10.91 10.87 1.96 NA NA 25.68 25.64 090

22114 ............ A Remove part, lumbar vertebra ............. 12.81 NA NA 10.36 9.74 1.98 NA NA 25.15 24.53 090

22116 ............ A Remove extra spine segment .............. 2.32 NA NA 1.18 1.49 0.40 NA NA 3.90 4.21 ZZZ

22210 ............ A Revision of neck spine ......................... 23.82 NA NA 16.86 16.40 4.23 NA NA 44.91 44.45 090

22212 ............ A Revision of thorax spine ....................... 19.42 NA NA 14.33 15.44 2.78 NA NA 36.53 37.64 090

22214 ............ A Revision of lumbar spine ...................... 19.45 NA NA 14.87 15.25 2.78 NA NA 37.10 37.48 090

22216 ............ A Revise, extra spine segment ................ 6.04 NA NA 3.27 3.83 0.98 NA NA 10.29 10.85 ZZZ

22220 ............ A Revision of neck spine ......................... 21.37 NA NA 15.47 16.12 3.65 NA NA 40.49 41.14 090

22222 ............ A Revision of thorax spine ....................... 21.52 NA NA 13.59 13.89 3.08 NA NA 38.19 38.49 090

22224 ............ A Revision of lumbar spine ...................... 21.52 NA NA 15.81 15.84 3.20 NA NA 40.53 40.56 090

22226 ............ A Revise, extra spine segment ................ 6.04 NA NA 3.27 3.83 1.01 NA NA 10.32 10.88 ZZZ

22305 ............ A Treat spine process fracture ................ 2.05 3.02 2.88 1.86 2.01 0.29 5.36 5.22 4.20 4.35 090

22310 ............ A Treat spine fracture .............................. 2.61 4.38 3.97 3.27 3.14 0.37 7.36 6.95 6.25 6.12 090

22315 ............ A Treat spine fracture .............................. 8.84 NA NA 8.89 8.16 1.37 NA NA 19.10 18.37 090

22318 ............ A Treat odontoid fx w/o graft ................... 21.50 NA NA 14.53 14.53 4.26 NA NA 40.29 40.29 090

22319 ............ A Treat odontoid fx w/graft ...................... 24.00 NA NA 16.80 16.80 4.76 NA NA 45.56 45.56 090

22325 ............ A Treat spine fracture .............................. 18.30 NA NA 14.19 12.90 2.61 NA NA 35.10 33.81 090

22326 ............ A Treat neck spine fracture ..................... 19.59 NA NA 15.24 15.75 3.54 NA NA 38.37 38.88 090

22327 ............ A Treat thorax spine fracture ................... 19.20 NA NA 14.50 15.20 2.75 NA NA 36.45 37.15 090

22328 ............ A Treat each add spine fx ....................... 4.61 NA NA 2.29 2.91 0.66 NA NA 7.56 8.18 ZZZ

22505 ............ A Manipulation of spine ........................... 1.87 4.60 3.81 2.97 2.58 0.27 6.74 5.95 5.11 4.72 010

22520 ............ A Percut vertebroplasty thor .................... 8.91 NA NA 3.95 3.95 0.89 NA NA 13.75 13.75 010

22521 ............ A Percut vertebroplasty lumb .................. 8.34 NA NA 3.72 3.72 0.84 NA NA 12.90 12.90 010

22522 ............ A Percut vertebroplasty addl ................... 3.00 NA NA 1.20 1.20 0.30 NA NA 4.50 4.50 ZZZ

22548 ............ A Neck spine fusion ................................. 25.82 NA NA 17.66 19.42 4.98 NA NA 48.46 50.22 090

22554 ............ A Neck spine fusion ................................. 18.62 NA NA 13.60 15.58 3.51 NA NA 35.73 37.71 090

22556 ............ A Thorax spine fusion .............................. 23.46 NA NA 16.73 18.43 3.78 NA NA 43.97 45.67 090

22558 ............ A Lumbar spine fusion ............................. 22.28 NA NA 14.49 16.34 3.18 NA NA 39.95 41.80 090

22585 ............ A Additional spinal fusion ........................ 5.53 NA NA 2.90 3.64 0.98 NA NA 9.41 10.15 ZZZ

22590 ............ A Spine & skull spinal fusion ................... 20.51 NA NA 15.27 17.31 3.81 NA NA 39.59 41.63 090

22595 ............ A Neck spinal fusion ................................ 19.39 NA NA 14.26 16.48 3.62 NA NA 37.27 39.49 090

22600 ............ A Neck spine fusion ................................. 16.14 NA NA 12.55 14.23 2.89 NA NA 31.58 33.26 090

22610 ............ A Thorax spine fusion .............................. 16.02 NA NA 12.52 14.17 2.66 NA NA 31.20 32.85 090

22612 ............ A Lumbar spine fusion ............................. 21.00 NA NA 15.30 17.07 3.28 NA NA 39.58 41.35 090

22614 ............ A Spine fusion, extra segment ................ 6.44 NA NA 3.49 4.15 1.04 NA NA 10.97 11.63 ZZZ

22630 ............ A Lumbar spine fusion ............................. 20.84 NA NA 15.53 16.65 3.79 NA NA 40.16 41.28 090

22632 ............ A Spine fusion, extra segment ................ 5.23 NA NA 2.80 3.46 0.90 NA NA 8.93 9.59 ZZZ

22800 ............ A Fusion of spine ..................................... 18.25 NA NA 13.59 15.64 2.71 NA NA 34.55 36.60 090

22802 ............ A Fusion of spine ..................................... 30.88 NA NA 21.22 23.60 4.42 NA NA 56.52 58.90 090

22804 ............ A Fusion of spine ..................................... 36.27 NA NA 23.90 25.61 5.23 NA NA 65.40 67.11 090

22808 ............ A Fusion of spine ..................................... 26.27 NA NA 18.27 18.70 4.36 NA NA 48.90 49.33 090

22810 ............ A Fusion of spine ..................................... 30.27 NA NA 19.89 19.91 4.49 NA NA 54.65 54.67 090

22812 ............ A Fusion of spine ..................................... 32.70 NA NA 21.94 23.49 4.67 NA NA 59.31 60.86 090

22818 ............ A Kyphectomy, 1-2 segments .................. 31.83 NA NA 20.99 23.41 5.01 NA NA 57.83 60.25 090

22819 ............ A Kyphectomy, 3 or more ........................ 36.44 NA NA 20.73 23.21 5.20 NA NA 62.37 64.85 090

22830 ............ A Exploration of spinal fusion .................. 10.85 NA NA 9.58 10.43 1.73 NA NA 22.16 23.01 090

22840 ............ A Insert spine fixation device ................... 12.54 NA NA 8.31 7.86 2.03 NA NA 22.88 22.43 ZZZ

22841 ............ B Insert spine fixation device ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

22842 ............ A Insert spine fixation device ................... 12.58 NA NA 6.79 6.95 2.04 NA NA 21.41 21.57 ZZZ

22843 ............ A Insert spine fixation device ................... 13.46 NA NA 8.80 8.92 2.10 NA NA 24.36 24.48 ZZZ

22844 ............ A Insert spine fixation device ................... 16.44 NA NA 10.46 10.68 2.42 NA NA 29.32 29.54 ZZZ

22845 ............ A Insert spine fixation device ................... 11.96 NA NA 7.90 7.47 2.22 NA NA 22.08 21.65 ZZZ

22846 ............ A Insert spine fixation device ................... 12.42 NA NA 8.17 8.27 2.26 NA NA 22.85 22.95 ZZZ

22847 ............ A Insert spine fixation device ................... 13.80 NA NA 8.90 9.06 2.36 NA NA 25.06 25.22 ZZZ

22848 ............ A Insert pelv fixation device ..................... 6.00 NA NA 4.74 5.11 0.88 NA NA 11.62 11.99 ZZZ

22849 ............ A Reinsert spinal fixation ......................... 18.51 NA NA 13.69 13.46 2.87 NA NA 35.07 34.84 090

22850 ............ A Remove spine fixation device .............. 9.52 NA NA 8.41 8.80 1.51 NA NA 19.44 19.83 090

22851 ............ A Apply spine prosth device .................... 6.71 NA NA 5.07 5.54 1.11 NA NA 12.89 13.36 ZZZ

22852 ............ A Remove spine fixation device .............. 9.01 NA NA 8.18 8.80 1.40 NA NA 18.59 19.21 090

22855 ............ A Remove spine fixation device .............. 15.13 NA NA 11.26 10.47 2.74 NA NA 29.13 28.34 090

65450

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

22899 ............ C Spine surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

22900 ............ A Remove abdominal wall lesion ............ 5.80 NA NA 4.37 4.10 0.58 NA NA 10.75 10.48 090

22999 ............ C Abdomen surgery procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

23000 ............ A Removal of calcium deposits ............... 4.36 8.91 7.56 6.62 5.85 0.50 13.77 12.42 11.48 10.71 090

23020 ............ A Release shoulder joint .......................... 8.93 NA NA 9.98 9.46 1.23 NA NA 20.14 19.62 090

23030 ............ A Drain shoulder lesion ........................... 3.43 5.78 4.92 4.20 3.74 0.42 9.63 8.77 8.05 7.59 010

23031 ............ A Drain shoulder bursa ............................ 2.74 5.66 4.38 3.82 2.93 0.33 8.73 7.45 6.89 6.00 010

23035 ............ A Drain shoulder bone lesion .................. 8.61 NA NA 14.63 12.66 1.19 NA NA 24.43 22.46 090

23040 ............ A Exploratory shoulder surgery ............... 9.20 NA NA 10.88 10.68 1.28 NA NA 21.36 21.16 090

23044 ............ A Exploratory shoulder surgery ............... 7.12 NA NA 9.95 9.34 0.97 NA NA 18.04 17.43 090

23065 ............ A Biopsy shoulder tissues ....................... 2.27 2.57 2.11 1.30 1.16 0.14 4.98 4.52 3.71 3.57 010

23066 ............ A Biopsy shoulder tissues ....................... 4.16 7.35 5.83 6.09 4.89 0.50 12.01 10.49 10.75 9.55 090

23075 ............ A Removal of shoulder lesion .................. 2.39 5.10 4.28 3.04 2.74 0.25 7.74 6.92 5.68 5.38 010

23076 ............ A Removal of shoulder lesion .................. 7.63 NA NA 7.98 6.95 0.87 NA NA 16.48 15.45 090

23077 ............ A Remove tumor of shoulder ................... 16.09 NA NA 14.00 12.50 1.81 NA NA 31.90 30.40 090

23100 ............ A Biopsy of shoulder joint ........................ 6.03 NA NA 8.00 7.80 0.81 NA NA 14.84 14.64 090

23101 ............ A Shoulder joint surgery .......................... 5.58 NA NA 8.13 7.76 0.77 NA NA 14.48 14.11 090

23105 ............ A Remove shoulder joint lining ................ 8.23 NA NA 9.59 9.65 1.13 NA NA 18.95 19.01 090

23106 ............ A Incision of collarbone joint .................... 5.96 NA NA 8.53 7.69 0.82 NA NA 15.31 14.47 090

23107 ............ A Explore treat shoulder joint .................. 8.62 NA NA 9.60 9.77 1.19 NA NA 19.41 19.58 090

23120 ............ A Partial removal, collar bone ................. 7.11 NA NA 8.87 7.90 0.99 NA NA 16.97 16.00 090

23125 ............ A Removal of collar bone ........................ 9.39 NA NA 10.29 10.02 1.27 NA NA 20.95 20.68 090

23130 ............ A Remove shoulder bone, part ................ 7.55 NA NA 9.12 8.75 1.06 NA NA 17.73 17.36 090

23140 ............ A Removal of bone lesion ....................... 6.89 NA NA 8.32 7.37 0.82 NA NA 16.03 15.08 090

23145 ............ A Removal of bone lesion ....................... 9.09 NA NA 11.32 10.70 1.24 NA NA 21.65 21.03 090

23146 ............ A Removal of bone lesion ....................... 7.83 NA NA 9.97 8.90 1.11 NA NA 18.91 17.84 090

23150 ............ A Removal of humerus lesion ................. 8.48 NA NA 9.44 8.88 1.14 NA NA 19.06 18.50 090

23155 ............ A Removal of humerus lesion ................. 10.35 NA NA 10.79 10.48 1.20 NA NA 22.34 22.03 090

23156 ............ A Removal of humerus lesion ................. 8.68 NA NA 9.69 9.34 1.18 NA NA 19.55 19.20 090

23170 ............ A Remove collar bone lesion ................... 6.86 NA NA 10.75 9.37 0.84 NA NA 18.45 17.07 090

23172 ............ A Remove shoulder blade lesion ............. 6.90 NA NA 10.98 9.64 0.95 NA NA 18.83 17.49 090

23174 ............ A Remove humerus lesion ...................... 9.51 NA NA 10.91 10.50 1.30 NA NA 21.72 21.31 090

23180 ............ A Remove collar bone lesion ................... 8.53 NA NA 14.81 12.28 1.18 NA NA 24.52 21.99 090

23182 ............ A Remove shoulder blade lesion ............. 8.15 NA NA 15.51 13.42 1.08 NA NA 24.74 22.65 090

23184 ............ A Remove humerus lesion ...................... 9.38 NA NA 14.87 13.55 1.24 NA NA 25.49 24.17 090

23190 ............ A Partial removal of scapula .................... 7.24 NA NA 8.00 7.65 0.97 NA NA 16.21 15.86 090

23195 ............ A Removal of head of humerus ............... 9.81 NA NA 10.43 10.24 1.38 NA NA 21.62 21.43 090

23200 ............ A Removal of collar bone ........................ 12.08 NA NA 13.60 12.69 1.48 NA NA 27.16 26.25 090

23210 ............ A Removal of shoulder blade .................. 12.49 NA NA 13.62 12.66 1.61 NA NA 27.72 26.76 090

23220 ............ A Partial removal of humerus .................. 14.56 NA NA 14.40 14.07 2.03 NA NA 30.99 30.66 090

23221 ............ A Partial removal of humerus .................. 17.74 NA NA 16.08 16.98 2.51 NA NA 36.33 37.23 090

23222 ............ A Partial removal of humerus .................. 23.92 NA NA 19.73 18.87 3.37 NA NA 47.02 46.16 090

23330 ............ A Remove shoulder foreign body ............ 1.85 5.35 4.16 4.63 3.55 0.18 7.38 6.19 6.66 5.58 010

23331 ............ A Remove shoulder foreign body ............ 7.38 NA NA 8.97 7.34 1.02 NA NA 17.37 15.74 090

23332 ............ A Remove shoulder foreign body ............ 11.62 NA NA 11.33 11.14 1.62 NA NA 24.57 24.38 090

23350 ............ A Injection for shoulder x-ray ................... 1.00 9.36 7.16 0.36 0.41 0.05 10.41 8.21 1.41 1.46 000

23395 ............ A Muscle transfer,shoulder/arm ............... 16.85 NA NA 13.44 13.10 2.29 NA NA 32.58 32.24 090

23397 ............ A Muscle transfers ................................... 16.13 NA NA 13.98 14.28 2.24 NA NA 32.35 32.65 090

23400 ............ A Fixation of shoulder blade .................... 13.54 NA NA 12.95 12.38 1.91 NA NA 28.40 27.83 090

23405 ............ A Incision of tendon & muscle ................. 8.37 NA NA 8.93 8.73 1.12 NA NA 18.42 18.22 090

23406 ............ A Incise tendon(s) & muscle(s) ............... 10.79 NA NA 10.82 10.67 1.48 NA NA 23.09 22.94 090

23410 ............ A Repair of tendon(s) .............................. 12.45 NA NA 11.69 11.74 1.72 NA NA 25.86 25.91 090

23412 ............ A Repair of tendon(s) .............................. 13.31 NA NA 12.27 12.83 1.86 NA NA 27.44 28.00 090

23415 ............ A Release of shoulder ligament .............. 9.97 NA NA 9.61 8.61 1.39 NA NA 20.97 19.97 090

23420 ............ A Repair of shoulder ................................ 13.30 NA NA 13.09 13.79 1.86 NA NA 28.25 28.95 090

23430 ............ A Repair biceps tendon ........................... 9.98 NA NA 10.44 9.82 1.40 NA NA 21.82 21.20 090

23440 ............ A Remove/transplant tendon ................... 10.48 NA NA 10.67 9.95 1.47 NA NA 22.62 21.90 090

23450 ............ A Repair shoulder capsule ...................... 13.40 NA NA 12.42 12.78 1.86 NA NA 27.68 28.04 090

23455 ............ A Repair shoulder capsule ...................... 14.37 NA NA 12.88 13.88 2.01 NA NA 29.26 30.26 090

23460 ............ A Repair shoulder capsule ...................... 15.37 NA NA 13.54 13.97 2.17 NA NA 31.08 31.51 090

23462 ............ A Repair shoulder capsule ...................... 15.30 NA NA 13.37 14.13 2.16 NA NA 30.83 31.59 090

23465 ............ A Repair shoulder capsule ...................... 15.85 NA NA 12.30 13.07 1.61 NA NA 29.76 30.53 090

23466 ............ A Repair shoulder capsule ...................... 14.22 NA NA 12.80 13.84 2.00 NA NA 29.02 30.06 090

23470 ............ A Reconstruct shoulder joint .................... 17.15 NA NA 14.38 15.33 2.40 NA NA 33.93 34.88 090

23472 ............ A Reconstruct shoulder joint .................... 16.92 NA NA 14.29 15.77 2.37 NA NA 33.58 35.06 090

23480 ............ A Revision of collar bone ......................... 11.18 NA NA 11.14 10.14 1.56 NA NA 23.88 22.88 090

23485 ............ A Revision of collar bone ......................... 13.43 NA NA 12.41 12.39 1.84 NA NA 27.68 27.66 090

23490 ............ A Reinforce clavicle ................................. 11.86 NA NA 10.53 10.61 1.11 NA NA 23.50 23.58 090

23491 ............ A Reinforce shoulder bones .................... 14.21 NA NA 12.58 12.88 2.00 NA NA 28.79 29.09 090

23500 ............ A Treat clavicle fracture ........................... 2.08 3.55 3.11 2.37 2.23 0.26 5.89 5.45 4.71 4.57 090

23505 ............ A Treat clavicle fracture ........................... 3.69 5.46 4.79 3.77 3.53 0.50 9.65 8.98 7.96 7.72 090

23515 ............ A Treat clavicle fracture ........................... 7.41 NA NA 7.68 7.64 1.03 NA NA 16.12 16.08 090

23520 ............ A Treat clavicle dislocation ...................... 2.16 3.47 2.98 2.40 2.18 0.26 5.89 5.40 4.82 4.60 090

23525 ............ A Treat clavicle dislocation ...................... 3.60 5.33 4.54 3.63 3.26 0.44 9.37 8.58 7.67 7.30 090

23530 ............ A Treat clavicle dislocation ...................... 7.31 NA NA 8.76 8.36 0.85 NA NA 16.92 16.52 090

23532 ............ A Treat clavicle dislocation ...................... 8.01 NA NA 8.08 8.02 1.13 NA NA 17.22 17.16 090

23540 ............ A Treat clavicle dislocation ...................... 2.23 4.11 3.50 2.38 2.21 0.24 6.58 5.97 4.85 4.68 090

23545 ............ A Treat clavicle dislocation ...................... 3.25 4.72 4.08 3.44 3.12 0.39 8.36 7.72 7.08 6.76 090

23550 ............ A Treat clavicle dislocation ...................... 7.24 NA NA 7.68 7.92 0.94 NA NA 15.86 16.10 090

23552 ............ A Treat clavicle dislocation ...................... 8.45 NA NA 8.29 8.20 1.18 NA NA 17.92 17.83 090

23570 ............ A Treat shoulder blade fx ........................ 2.23 3.54 3.12 2.49 2.33 0.29 6.06 5.64 5.01 4.85 090

23575 ............ A Treat shoulder blade fx ........................ 4.06 5.59 4.94 3.98 3.73 0.53 10.18 9.53 8.57 8.32 090

23585 ............ A Treat scapula fracture .......................... 8.96 NA NA 8.82 8.71 1.25 NA NA 19.03 18.92 090

65451

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

23600 ............ A Treat humerus fracture ......................... 2.93 5.41 4.85 3.52 3.43 0.39 8.73 8.17 6.84 6.75 090

23605 ............ A Treat humerus fracture ......................... 4.87 8.14 7.40 6.40 6.09 0.67 13.68 12.94 11.94 11.63 090

23615 ............ A Treat humerus fracture ......................... 9.35 NA NA 9.52 9.93 1.31 NA NA 20.18 20.59 090

23616 ............ A Treat humerus fracture ......................... 21.27 NA NA 15.55 17.72 2.98 NA NA 39.80 41.97 090

23620 ............ A Treat humerus fracture ......................... 2.40 5.12 4.62 3.26 2.81 0.32 7.84 7.34 5.98 5.53 090

23625 ............ A Treat humerus fracture ......................... 3.93 7.07 6.34 5.32 5.03 0.53 11.53 10.80 9.78 9.49 090

23630 ............ A Treat humerus fracture ......................... 7.35 NA NA 7.67 7.95 1.03 NA NA 16.05 16.33 090

23650 ............ A Treat shoulder dislocation .................... 3.39 5.17 4.45 3.33 3.07 0.31 8.87 8.15 7.03 6.77 090

23655 ............ A Treat shoulder dislocation .................... 4.57 NA NA 4.03 3.82 0.52 NA NA 9.12 8.91 090

23660 ............ A Treat shoulder dislocation .................... 7.49 NA NA 7.64 7.97 1.01 NA NA 16.14 16.47 090

23665 ............ A Treat dislocation/fracture ...................... 4.47 7.39 6.45 5.59 5.10 0.60 12.46 11.52 10.66 10.17 090

23670 ............ A Treat dislocation/fracture ...................... 7.90 NA NA 8.11 8.44 1.10 NA NA 17.11 17.44 090

23675 ............ A Treat dislocation/fracture ...................... 6.05 8.17 7.20 6.49 5.94 0.83 15.05 14.08 13.37 12.82 090

23680 ............ A Treat dislocation/fracture ...................... 10.06 NA NA 9.31 9.99 1.39 NA NA 20.76 21.44 090

23700 ............ A Fixation of shoulder .............................. 2.52 NA NA 3.22 2.98 0.35 NA NA 6.09 5.85 010

23800 ............ A Fusion of shoulder joint ........................ 14.16 NA NA 13.53 14.38 1.97 NA NA 29.66 30.51 090

23802 ............ A Fusion of shoulder joint ........................ 16.60 NA NA 15.01 15.08 2.34 NA NA 33.95 34.02 090

23900 ............ A Amputation of arm & girdle .................. 19.72 NA NA 14.73 14.46 2.47 NA NA 36.92 36.65 090

23920 ............ A Amputation at shoulder joint ................ 14.61 NA NA 13.74 14.06 1.92 NA NA 30.27 30.59 090

23921 ............ A Amputation follow-up surgery ............... 5.49 NA NA 6.55 6.07 0.78 NA NA 12.82 12.34 090

23929 ............ C Shoulder surgery procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

23930 ............ A Drainage of arm lesion ......................... 2.94 5.81 4.80 3.91 3.37 0.32 9.07 8.06 7.17 6.63 010

23931 ............ A Drainage of arm bursa ......................... 1.79 5.38 4.24 3.37 2.63 0.21 7.38 6.24 5.37 4.63 010

23935 ............ A Drain arm/elbow bone lesion ............... 6.09 NA NA 12.01 10.28 0.84 NA NA 18.94 17.21 090

24000 ............ A Exploratory elbow surgery .................... 5.82 NA NA 5.68 6.00 0.77 NA NA 12.27 12.59 090

24006 ............ A Release elbow joint .............................. 9.31 NA NA 8.12 8.03 1.27 NA NA 18.70 18.61 090

24065 ............ A Biopsy arm/elbow soft tissue ............... 2.08 5.40 4.27 3.20 2.51 0.14 7.62 6.49 5.42 4.73 010

24066 ............ A Biopsy arm/elbow soft tissue ............... 5.21 8.49 7.10 6.36 5.51 0.61 14.31 12.92 12.18 11.33 090

24075 ............ A Remove arm/elbow lesion .................... 3.92 7.81 6.40 5.71 4.82 0.43 12.16 10.75 10.06 9.17 090

24076 ............ A Remove arm/elbow lesion .................... 6.30 NA NA 6.80 6.10 0.70 NA NA 13.80 13.10 090

24077 ............ A Remove tumor of arm/elbow ................ 11.76 NA NA 13.16 12.53 1.32 NA NA 26.24 25.61 090

24100 ............ A Biopsy elbow joint lining ....................... 4.93 NA NA 5.48 5.26 0.62 NA NA 11.03 10.81 090

24101 ............ A Explore/treat elbow joint ....................... 6.13 NA NA 6.32 6.57 0.84 NA NA 13.29 13.54 090

24102 ............ A Remove elbow joint lining .................... 8.03 NA NA 7.40 7.95 1.09 NA NA 16.52 17.07 090

24105 ............ A Removal of elbow bursa ...................... 3.61 NA NA 4.83 4.65 0.49 NA NA 8.93 8.75 090

24110 ............ A Remove humerus lesion ...................... 7.39 NA NA 9.06 8.88 0.99 NA NA 17.44 17.26 090

24115 ............ A Remove/graft bone lesion .................... 9.63 NA NA 9.34 9.09 1.15 NA NA 20.12 19.87 090

24116 ............ A Remove/graft bone lesion .................... 11.81 NA NA 11.19 11.03 1.66 NA NA 24.66 24.50 090

24120 ............ A Remove elbow lesion ........................... 6.65 NA NA 6.29 6.35 0.87 NA NA 13.81 13.87 090

24125 ............ A Remove/graft bone lesion .................... 7.89 NA NA 6.54 6.48 0.88 NA NA 15.31 15.25 090

24126 ............ A Remove/graft bone lesion .................... 8.31 NA NA 7.07 7.31 0.90 NA NA 16.28 16.52 090

24130 ............ A Removal of head of radius ................... 6.25 NA NA 6.41 6.63 0.87 NA NA 13.53 13.75 090

24134 ............ A Removal of arm bone lesion ................ 9.73 NA NA 15.37 13.89 1.31 NA NA 26.41 24.93 090

24136 ............ A Remove radius bone lesion ................. 7.99 NA NA 6.52 7.27 0.85 NA NA 15.36 16.11 090

24138 ............ A Remove elbow bone lesion .................. 8.05 NA NA 7.33 7.23 1.12 NA NA 16.50 16.40 090

24140 ............ A Partial removal of arm bone ................. 9.18 NA NA 15.69 14.15 1.23 NA NA 26.10 24.56 090

24145 ............ A Partial removal of radius ...................... 7.58 NA NA 10.25 9.42 1.01 NA NA 18.84 18.01 090

24147 ............ A Partial removal of elbow ....................... 7.54 NA NA 10.30 9.52 1.04 NA NA 18.88 18.10 090

24149 ............ A Radical resection of elbow ................... 14.20 NA NA 10.77 11.51 1.90 NA NA 26.87 27.61 090

24150 ............ A Extensive humerus surgery .................. 13.27 NA NA 13.78 14.16 1.81 NA NA 28.86 29.24 090

24151 ............ A Extensive humerus surgery .................. 15.58 NA NA 15.34 15.26 2.19 NA NA 33.11 33.03 090

24152 ............ A Extensive radius surgery ...................... 10.06 NA NA 8.92 8.54 1.19 NA NA 20.17 19.79 090

24153 ............ A Extensive radius surgery ...................... 11.54 NA NA 7.24 8.26 0.64 NA NA 19.42 20.44 090

24155 ............ A Removal of elbow joint ......................... 11.73 NA NA 8.75 9.48 1.42 NA NA 21.90 22.63 090

24160 ............ A Remove elbow joint implant ................. 7.83 NA NA 7.29 6.78 1.07 NA NA 16.19 15.68 090

24164 ............ A Remove radius head implant ............... 6.23 NA NA 6.33 6.25 0.84 NA NA 13.40 13.32 090

24200 ............ A Removal of arm foreign body ............... 1.76 5.66 4.40 3.13 2.43 0.15 7.57 6.31 5.04 4.34 010

24201 ............ A Removal of arm foreign body ............... 4.56 8.52 7.22 7.15 6.19 0.56 13.64 12.34 12.27 11.31 090

24220 ............ A Injection for elbow x-ray ....................... 1.31 10.24 7.82 0.48 0.50 0.07 11.62 9.20 1.86 1.88 000

24301 ............ A Muscle/tendon transfer ......................... 10.20 NA NA 8.82 8.76 1.30 NA NA 20.32 20.26 090

24305 ............ A Arm tendon lengthening ....................... 7.45 NA NA 7.11 6.17 0.98 NA NA 15.54 14.60 090

24310 ............ A Revision of arm tendon ........................ 5.98 NA NA 7.62 6.52 0.74 NA NA 14.34 13.24 090

24320 ............ A Repair of arm tendon ........................... 10.56 NA NA 9.86 9.89 1.00 NA NA 21.42 21.45 090

24330 ............ A Revision of arm muscles ...................... 9.60 NA NA 8.31 8.61 1.21 NA NA 19.12 19.42 090

24331 ............ A Revision of arm muscles ...................... 10.65 NA NA 8.75 9.17 1.41 NA NA 20.81 21.23 090

24340 ............ A Repair of biceps tendon ....................... 7.89 NA NA 7.19 7.29 1.08 NA NA 16.16 16.26 090

24341 ............ A Repair arm tendon/muscle ................... 7.90 NA NA 7.25 7.34 1.08 NA NA 16.23 16.32 090

24342 ............ A Repair of ruptured tendon .................... 10.62 NA NA 8.86 9.46 1.48 NA NA 20.96 21.56 090

24350 ............ A Repair of tennis elbow ......................... 5.25 NA NA 5.88 5.56 0.72 NA NA 11.85 11.53 090

24351 ............ A Repair of tennis elbow ......................... 5.91 NA NA 6.31 5.97 0.82 NA NA 13.04 12.70 090

24352 ............ A Repair of tennis elbow ......................... 6.43 NA NA 6.58 6.48 0.90 NA NA 13.91 13.81 090

24354 ............ A Repair of tennis elbow ......................... 6.48 NA NA 6.53 6.42 0.88 NA NA 13.89 13.78 090

24356 ............ A Revision of tennis elbow ...................... 6.68 NA NA 6.70 7.00 0.90 NA NA 14.28 14.58 090

24360 ............ A Reconstruct elbow joint ........................ 12.34 NA NA 9.59 10.88 1.69 NA NA 23.62 24.91 090

24361 ............ A Reconstruct elbow joint ........................ 14.08 NA NA 10.32 11.30 1.95 NA NA 26.35 27.33 090

24362 ............ A Reconstruct elbow joint ........................ 14.99 NA NA 10.85 9.92 1.92 NA NA 27.76 26.83 090

24363 ............ A Replace elbow joint .............................. 18.49 NA NA 13.18 15.40 2.52 NA NA 34.19 36.41 090

24365 ............ A Reconstruct head of radius .................. 8.39 NA NA 7.59 7.73 1.11 NA NA 17.09 17.23 090

24366 ............ A Reconstruct head of radius .................. 9.13 NA NA 8.00 8.73 1.28 NA NA 18.41 19.14 090

24400 ............ A Revision of humerus ............................ 11.06 NA NA 11.87 11.19 1.53 NA NA 24.46 23.78 090

24410 ............ A Revision of humerus ............................ 14.82 NA NA 13.81 14.17 1.89 NA NA 30.52 30.88 090

24420 ............ A Revision of humerus ............................ 13.44 NA NA 15.37 14.87 1.82 NA NA 30.63 30.13 090

24430 ............ A Repair of humerus ................................ 12.81 NA NA 12.12 12.91 1.80 NA NA 26.73 27.52 090

65452

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

24435 ............ A Repair humerus with graft .................... 13.17 NA NA 13.09 13.75 1.84 NA NA 28.10 28.76 090

24470 ............ A Revision of elbow joint ......................... 8.74 NA NA 7.13 7.50 1.23 NA NA 17.10 17.47 090

24495 ............ A Decompression of forearm ................... 8.12 NA NA 9.57 8.74 0.92 NA NA 18.61 17.78 090

24498 ............ A Reinforce humerus ............................... 11.92 NA NA 11.57 11.49 1.67 NA NA 25.16 25.08 090

24500 ............ A Treat humerus fracture ......................... 3.21 4.99 4.43 3.25 3.13 0.41 8.61 8.05 6.87 6.75 090

24505 ............ A Treat humerus fracture ......................... 5.17 8.65 7.71 6.67 6.22 0.72 14.54 13.60 12.56 12.11 090

24515 ............ A Treat humerus fracture ......................... 11.65 NA NA 10.75 10.68 1.63 NA NA 24.03 23.96 090

24516 ............ A Treat humerus fracture ......................... 11.65 NA NA 11.14 10.97 1.63 NA NA 24.42 24.25 090

24530 ............ A Treat humerus fracture ......................... 3.50 6.03 5.26 4.71 4.27 0.47 10.00 9.23 8.68 8.24 090

24535 ............ A Treat humerus fracture ......................... 6.87 8.56 7.74 6.60 6.27 0.96 16.39 15.57 14.43 14.10 090

24538 ............ A Treat humerus fracture ......................... 9.43 NA NA 9.73 9.46 1.25 NA NA 20.41 20.14 090

24545 ............ A Treat humerus fracture ......................... 10.46 NA NA 9.57 9.88 1.47 NA NA 21.50 21.81 090

24546 ............ A Treat humerus fracture ......................... 15.69 NA NA 12.98 12.44 2.18 NA NA 30.85 30.31 090

24560 ............ A Treat humerus fracture ......................... 2.80 4.81 4.19 3.04 2.87 0.35 7.96 7.34 6.19 6.02 090

24565 ............ A Treat humerus fracture ......................... 5.56 7.82 6.80 5.85 5.32 0.74 14.12 13.10 12.15 11.62 090

24566 ............ A Treat humerus fracture ......................... 7.79 NA NA 9.23 8.57 1.10 NA NA 18.12 17.46 090

24575 ............ A Treat humerus fracture ......................... 10.66 NA NA 7.98 8.10 1.44 NA NA 20.08 20.20 090

24576 ............ A Treat humerus fracture ......................... 2.86 4.53 3.98 3.15 2.95 0.38 7.77 7.22 6.39 6.19 090

24577 ............ A Treat humerus fracture ......................... 5.79 7.93 7.03 5.99 5.58 0.81 14.53 13.63 12.59 12.18 090

24579 ............ A Treat humerus fracture ......................... 11.60 NA NA 10.67 10.27 1.62 NA NA 23.89 23.49 090

24582 ............ A Treat humerus fracture ......................... 8.55 NA NA 9.71 9.08 1.20 NA NA 19.46 18.83 090

24586 ............ A Treat elbow fracture ............................. 15.21 NA NA 10.70 12.02 2.12 NA NA 28.03 29.35 090

24587 ............ A Treat elbow fracture ............................. 15.16 NA NA 10.48 11.58 2.14 NA NA 27.78 28.88 090

24600 ............ A Treat elbow dislocation ........................ 4.23 6.77 5.61 4.98 4.27 0.49 11.49 10.33 9.70 8.99 090

24605 ............ A Treat elbow dislocation ........................ 5.42 NA NA 4.73 4.17 0.72 NA NA 10.87 10.31 090

24615 ............ A Treat elbow dislocation ........................ 9.42 NA NA 7.53 8.17 1.31 NA NA 18.26 18.90 090

24620 ............ A Treat elbow fracture ............................. 6.98 NA NA 6.42 5.84 0.90 NA NA 14.30 13.72 090

24635 ............ A Treat elbow fracture ............................. 13.19 NA NA 15.05 14.29 1.84 NA NA 30.08 29.32 090

24640 ............ A Treat elbow dislocation ........................ 1.20 3.46 2.87 1.77 1.60 0.11 4.77 4.18 3.08 2.91 010

24650 ............ A Treat radius fracture ............................. 2.16 4.45 3.95 2.80 2.41 0.28 6.89 6.39 5.24 4.85 090

24655 ............ A Treat radius fracture ............................. 4.40 7.12 6.16 5.15 4.68 0.58 12.10 11.14 10.13 9.66 090

24665 ............ A Treat radius fracture ............................. 8.14 NA NA 8.78 8.52 1.13 NA NA 18.05 17.79 090

24666 ............ A Treat radius fracture ............................. 9.49 NA NA 9.51 9.92 1.32 NA NA 20.32 20.73 090

24670 ............ A Treat ulnar fracture ............................... 2.54 4.38 3.82 3.00 2.78 0.33 7.25 6.69 5.87 5.65 090

24675 ............ A Treat ulnar fracture ............................... 4.72 7.27 6.41 5.36 4.97 0.65 12.64 11.78 10.73 10.34 090

24685 ............ A Treat ulnar fracture ............................... 8.80 NA NA 9.13 9.13 1.23 NA NA 19.16 19.16 090

24800 ............ A Fusion of elbow joint ............................ 11.20 NA NA 9.41 9.93 1.41 NA NA 22.02 22.54 090

24802 ............ A Fusion/graft of elbow joint .................... 13.69 NA NA 11.10 11.63 1.89 NA NA 26.68 27.21 090

24900 ............ A Amputation of upper arm ..................... 9.60 NA NA 10.61 10.04 1.18 NA NA 21.39 20.82 090

24920 ............ A Amputation of upper arm ..................... 9.54 NA NA 11.85 10.73 1.22 NA NA 22.61 21.49 090

24925 ............ A Amputation follow-up surgery ............... 7.07 NA NA 8.88 8.36 0.95 NA NA 16.90 16.38 090

24930 ............ A Amputation follow-up surgery ............... 10.25 NA NA 11.00 10.47 1.23 NA NA 22.48 21.95 090

24931 ............ A Amputate upper arm & implant ............ 12.72 NA NA 11.26 11.48 1.56 NA NA 25.54 25.76 090

24935 ............ A Revision of amputation ......................... 15.56 NA NA 11.88 12.63 1.58 NA NA 29.02 29.77 090

24940 ............ C Revision of upper arm .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

24999 ............ C Upper arm/elbow surgery ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

25000 ............ A Incision of tendon sheath ..................... 3.38 NA NA 6.59 5.95 0.45 NA NA 10.42 9.78 090

25020 ............ A Decompression of forearm ................... 5.92 NA NA 10.29 8.90 0.75 NA NA 16.96 15.57 090

25023 ............ A Decompression of forearm ................... 12.96 NA NA 15.90 13.40 1.50 NA NA 30.36 27.86 090

25028 ............ A Drainage of forearm lesion ................... 5.25 NA NA 9.39 7.60 0.61 NA NA 15.25 13.46 090

25031 ............ A Drainage of forearm bursa ................... 4.14 NA NA 9.02 6.95 0.50 NA NA 13.66 11.59 090

25035 ............ A Treat forearm bone lesion .................... 7.36 NA NA 15.16 13.08 0.98 NA NA 23.50 21.42 090

25040 ............ A Explore/treat wrist joint ......................... 7.18 NA NA 8.56 7.97 0.96 NA NA 16.70 16.11 090

25065 ............ A Biopsy forearm soft tissues .................. 1.99 2.45 2.04 2.45 1.94 0.12 4.56 4.15 4.56 4.05 010

25066 ............ A Biopsy forearm soft tissues .................. 4.13 NA NA 7.36 5.94 0.49 NA NA 11.98 10.56 090

25075 ............ A Removal of forearm lesion ................... 3.74 NA NA 6.81 5.70 0.40 NA NA 10.95 9.84 090

25076 ............ A Removal of forearm lesion ................... 4.92 NA NA 11.51 9.66 0.59 NA NA 17.02 15.17 090

25077 ............ A Remove tumor, forearm/wrist ............... 9.76 NA NA 15.13 13.65 1.10 NA NA 25.99 24.51 090

25085 ............ A Incision of wrist capsule ....................... 5.50 NA NA 9.88 8.66 0.71 NA NA 16.09 14.87 090

25100 ............ A Biopsy of wrist joint .............................. 3.90 NA NA 6.64 6.15 0.50 NA NA 11.04 10.55 090

25101 ............ A Explore/treat wrist joint ......................... 4.69 NA NA 7.23 6.82 0.60 NA NA 12.52 12.11 090

25105 ............ A Remove wrist joint lining ...................... 5.85 NA NA 10.05 9.29 0.77 NA NA 16.67 15.91 090

25107 ............ A Remove wrist joint cartilage ................. 6.43 NA NA 10.23 9.11 0.82 NA NA 17.48 16.36 090

25110 ............ A Remove wrist tendon lesion ................. 3.92 NA NA 7.72 6.55 0.48 NA NA 12.12 10.95 090

25111 ............ A Remove wrist tendon lesion ................. 3.39 NA NA 6.01 5.38 0.42 NA NA 9.82 9.19 090

25112 ............ A Reremove wrist tendon lesion .............. 4.53 NA NA 6.88 6.17 0.54 NA NA 11.95 11.24 090

25115 ............ A Remove wrist/forearm lesion ................ 8.82 NA NA 15.45 13.53 1.11 NA NA 25.38 23.46 090

25116 ............ A Remove wrist/forearm lesion ................ 7.11 NA NA 14.43 12.95 0.90 NA NA 22.44 20.96 090

25118 ............ A Excise wrist tendon sheath .................. 4.37 NA NA 7.17 6.68 0.55 NA NA 12.09 11.60 090

25119 ............ A Partial removal of ulna ......................... 6.04 NA NA 10.00 9.30 0.80 NA NA 16.84 16.14 090

25120 ............ A Removal of forearm lesion ................... 6.10 NA NA 13.26 11.72 0.81 NA NA 20.17 18.63 090

25125 ............ A Remove/graft forearm lesion ................ 7.48 NA NA 14.52 12.75 1.02 NA NA 23.02 21.25 090

25126 ............ A Remove/graft forearm lesion ................ 7.55 NA NA 13.95 12.31 1.00 NA NA 22.50 20.86 090

25130 ............ A Removal of wrist lesion ........................ 5.26 NA NA 7.50 6.77 0.66 NA NA 13.42 12.69 090

25135 ............ A Remove & graft wrist lesion ................. 6.89 NA NA 8.29 7.70 0.89 NA NA 16.07 15.48 090

25136 ............ A Remove & graft wrist lesion ................. 5.97 NA NA 6.38 6.07 0.58 NA NA 12.93 12.62 090

25145 ............ A Remove forearm bone lesion ............... 6.37 NA NA 14.00 12.12 0.82 NA NA 21.19 19.31 090

25150 ............ A Partial removal of ulna ......................... 7.09 NA NA 10.98 10.05 0.96 NA NA 19.03 18.10 090

25151 ............ A Partial removal of radius ...................... 7.39 NA NA 13.77 11.89 0.93 NA NA 22.09 20.21 090

25170 ............ A Extensive forearm surgery ................... 11.09 NA NA 16.06 14.70 1.52 NA NA 28.67 27.31 090

25210 ............ A Removal of wrist bone ......................... 5.95 NA NA 8.02 7.34 0.73 NA NA 14.70 14.02 090

25215 ............ A Removal of wrist bones ........................ 7.89 NA NA 11.15 10.72 1.02 NA NA 20.06 19.63 090

25230 ............ A Partial removal of radius ...................... 5.23 NA NA 7.44 7.09 0.66 NA NA 13.33 12.98 090

65453

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

25240 ............ A Partial removal of ulna ......................... 5.17 NA NA 9.61 8.65 0.69 NA NA 15.47 14.51 090

25246 ............ A Injection for wrist x-ray ......................... 1.45 9.80 7.49 0.52 0.53 0.07 11.32 9.01 2.04 2.05 000

25248 ............ A Remove forearm foreign body ............. 5.14 NA NA 9.04 7.37 0.54 NA NA 14.72 13.05 090

25250 ............ A Removal of wrist prosthesis ................. 6.60 NA NA 8.15 7.64 0.84 NA NA 15.59 15.08 090

25251 ............ A Removal of wrist prosthesis ................. 9.57 NA NA 11.55 10.90 1.15 NA NA 22.27 21.62 090

25260 ............ A Repair forearm tendon/muscle ............. 7.80 NA NA 15.60 12.95 0.97 NA NA 24.37 21.72 090

25263 ............ A Repair forearm tendon/muscle ............. 7.82 NA NA 14.95 12.78 0.94 NA NA 23.71 21.54 090

25265 ............ A Repair forearm tendon/muscle ............. 9.88 NA NA 15.75 13.97 1.19 NA NA 26.82 25.04 090

25270 ............ A Repair forearm tendon/muscle ............. 6.00 NA NA 14.52 11.80 0.76 NA NA 21.28 18.56 090

25272 ............ A Repair forearm tendon/muscle ............. 7.04 NA NA 15.17 12.31 0.89 NA NA 23.10 20.24 090

25274 ............ A Repair forearm tendon/muscle ............. 8.75 NA NA 14.96 13.02 1.11 NA NA 24.82 22.88 090

25280 ............ A Revise wrist/forearm tendon ................ 7.22 NA NA 14.31 11.88 0.91 NA NA 22.44 20.01 090

25290 ............ A Incise wrist/forearm tendon .................. 5.29 NA NA 16.18 12.81 0.66 NA NA 22.13 18.76 090

25295 ............ A Release wrist/forearm tendon .............. 6.55 NA NA 14.02 11.34 0.84 NA NA 21.41 18.73 090

25300 ............ A Fusion of tendons at wrist .................... 8.80 NA NA 9.51 9.13 1.07 NA NA 19.38 19.00 090

25301 ............ A Fusion of tendons at wrist .................... 8.40 NA NA 9.29 8.81 1.08 NA NA 18.77 18.29 090

25310 ............ A Transplant forearm tendon ................... 8.14 NA NA 14.58 12.87 1.01 NA NA 23.73 22.02 090

25312 ............ A Transplant forearm tendon ................... 9.57 NA NA 15.53 13.72 1.22 NA NA 26.32 24.51 090

25315 ............ A Revise palsy hand tendon(s) ............... 10.20 NA NA 16.30 14.41 1.26 NA NA 27.76 25.87 090

25316 ............ A Revise palsy hand tendon(s) ............... 12.33 NA NA 17.13 15.72 1.74 NA NA 31.20 29.79 090

25320 ............ A Repair/revise wrist joint ........................ 10.77 NA NA 10.68 10.34 1.32 NA NA 22.77 22.43 090

25332 ............ A Revise wrist joint .................................. 11.41 NA NA 11.17 11.09 1.46 NA NA 24.04 23.96 090

25335 ............ A Realignment of hand ............................ 12.88 NA NA 13.34 13.10 1.66 NA NA 27.88 27.64 090

25337 ............ A Reconstruct ulna/radioulnar ................. 10.17 NA NA 12.37 11.61 1.31 NA NA 23.85 23.09 090

25350 ............ A Revision of radius ................................. 8.78 NA NA 14.82 13.18 1.17 NA NA 24.77 23.13 090

25355 ............ A Revision of radius ................................. 10.17 NA NA 15.90 14.40 1.44 NA NA 27.51 26.01 090

25360 ............ A Revision of ulna .................................... 8.43 NA NA 14.97 12.97 1.17 NA NA 24.57 22.57 090

25365 ............ A Revise radius & ulna ............................ 12.40 NA NA 16.30 15.02 1.67 NA NA 30.37 29.09 090

25370 ............ A Revise radius or ulna ........................... 13.36 NA NA 17.80 16.54 1.88 NA NA 33.04 31.78 090

25375 ............ A Revise radius & ulna ............................ 13.04 NA NA 17.62 16.85 1.84 NA NA 32.50 31.73 090

25390 ............ A Shorten radius or ulna .......................... 10.40 NA NA 15.88 14.30 1.38 NA NA 27.66 26.08 090

25391 ............ A Lengthen radius or ulna ....................... 13.65 NA NA 17.19 15.95 1.73 NA NA 32.57 31.33 090

25392 ............ A Shorten radius & ulna .......................... 13.95 NA NA 16.60 15.83 1.73 NA NA 32.28 31.51 090

25393 ............ A Lengthen radius & ulna ........................ 15.87 NA NA 16.76 16.43 1.87 NA NA 34.50 34.17 090

25400 ............ A Repair radius or ulna ............................ 10.92 NA NA 16.07 14.98 1.50 NA NA 28.49 27.40 090

25405 ............ A Repair/graft radius or ulna ................... 14.38 NA NA 18.35 17.13 1.95 NA NA 34.68 33.46 090

25415 ............ A Repair radius & ulna ............................ 13.35 NA NA 17.45 16.19 1.87 NA NA 32.67 31.41 090

25420 ............ A Repair/graft radius & ulna .................... 16.33 NA NA 19.23 18.41 2.20 NA NA 37.76 36.94 090

25425 ............ A Repair/graft radius or ulna ................... 13.21 NA NA 24.28 21.47 1.61 NA NA 39.10 36.29 090

25426 ............ A Repair/graft radius & ulna .................... 15.82 NA NA 19.50 17.81 2.23 NA NA 37.55 35.86 090

25440 ............ A Repair/graft wrist bone ......................... 10.44 NA NA 10.42 10.27 1.41 NA NA 22.27 22.12 090

25441 ............ A Reconstruct wrist joint .......................... 12.90 NA NA 11.51 11.72 1.83 NA NA 26.24 26.45 090

25442 ............ A Reconstruct wrist joint .......................... 10.85 NA NA 10.57 9.84 1.24 NA NA 22.66 21.93 090

25443 ............ A Reconstruct wrist joint .......................... 10.39 NA NA 14.29 13.26 1.30 NA NA 25.98 24.95 090

25444 ............ A Reconstruct wrist joint .......................... 11.15 NA NA 12.32 11.99 1.43 NA NA 24.90 24.57 090

25445 ............ A Reconstruct wrist joint .......................... 9.69 NA NA 12.33 12.06 1.26 NA NA 23.28 23.01 090

25446 ............ A Wrist replacement ................................ 16.55 NA NA 13.85 15.33 2.20 NA NA 32.60 34.08 090

25447 ............ A Repair wrist joint(s) .............................. 10.37 NA NA 10.42 10.43 1.34 NA NA 22.13 22.14 090

25449 ............ A Remove wrist joint implant ................... 14.49 NA NA 14.60 13.08 1.77 NA NA 30.86 29.34 090

25450 ............ A Revision of wrist joint ........................... 7.87 NA NA 11.62 10.70 0.88 NA NA 20.37 19.45 090

25455 ............ A Revision of wrist joint ........................... 9.49 NA NA 11.16 10.73 1.07 NA NA 21.72 21.29 090

25490 ............ A Reinforce radius ................................... 9.54 NA NA 14.92 13.55 1.19 NA NA 25.65 24.28 090

25491 ............ A Reinforce ulna ...................................... 9.96 NA NA 15.39 14.01 1.41 NA NA 26.76 25.38 090

25492 ............ A Reinforce radius and ulna .................... 12.33 NA NA 14.11 13.62 1.62 NA NA 28.06 27.57 090

25500 ............ A Treat fracture of radius ......................... 2.45 4.18 3.77 2.86 2.46 0.28 6.91 6.50 5.59 5.19 090

25505 ............ A Treat fracture of radius ......................... 5.21 7.49 6.59 5.56 5.14 0.69 13.39 12.49 11.46 11.04 090

25515 ............ A Treat fracture of radius ......................... 9.18 NA NA 9.22 8.99 1.22 NA NA 19.62 19.39 090

25520 ............ A Treat fracture of radius ......................... 6.26 7.81 7.42 6.24 6.24 0.85 14.92 14.53 13.35 13.35 090

25525 ............ A Treat fracture of radius ......................... 12.24 NA NA 10.96 11.25 1.68 NA NA 24.88 25.17 090

25526 ............ A Treat fracture of radius ......................... 12.98 NA NA 14.15 13.83 1.80 NA NA 28.93 28.61 090

25530 ............ A Treat fracture of ulna ............................ 2.09 4.09 3.73 2.78 2.40 0.27 6.45 6.09 5.14 4.76 090

25535 ............ A Treat fracture of ulna ............................ 5.14 7.49 6.59 5.51 5.10 0.68 13.31 12.41 11.33 10.92 090

25545 ............ A Treat fracture of ulna ............................ 8.90 NA NA 9.20 8.96 1.23 NA NA 19.33 19.09 090

25560 ............ A Treat fracture radius & ulna ................. 2.44 4.19 3.76 2.85 2.75 0.27 6.90 6.47 5.56 5.46 090

25565 ............ A Treat fracture radius & ulna ................. 5.63 7.76 7.09 5.77 5.59 0.76 14.15 13.48 12.16 11.98 090

25574 ............ A Treat fracture radius & ulna ................. 7.01 NA NA 8.10 8.17 0.96 NA NA 16.07 16.14 090

25575 ............ A Treat fracture radius/ulna ..................... 10.45 NA NA 10.07 10.46 1.46 NA NA 21.98 22.37 090

25600 ............ A Treat fracture radius/ulna ..................... 2.63 4.41 4.08 2.99 2.63 0.34 7.38 7.05 5.96 5.60 090

25605 ............ A Treat fracture radius/ulna ..................... 5.81 7.93 7.02 5.96 5.54 0.81 14.55 13.64 12.58 12.16 090

25611 ............ A Treat fracture radius/ulna ..................... 7.77 NA NA 9.26 8.58 1.08 NA NA 18.11 17.43 090

25620 ............ A Treat fracture radius/ulna ..................... 8.55 NA NA 9.01 8.69 1.17 NA NA 18.73 18.41 090

25622 ............ A Treat wrist bone fracture ...................... 2.61 4.38 3.90 2.98 2.55 0.33 7.32 6.84 5.92 5.49 090

25624 ............ A Treat wrist bone fracture ...................... 4.53 7.14 6.35 5.22 4.41 0.61 12.28 11.49 10.36 9.55 090

25628 ............ A Treat wrist bone fracture ...................... 8.43 NA NA 9.06 8.73 1.14 NA NA 18.63 18.30 090

25630 ............ A Treat wrist bone fracture ...................... 2.88 4.53 3.99 3.07 2.60 0.37 7.78 7.24 6.32 5.85 090

25635 ............ A Treat wrist bone fracture ...................... 4.39 7.18 6.30 4.16 3.58 0.39 11.96 11.08 8.94 8.36 090

25645 ............ A Treat wrist bone fracture ...................... 7.25 NA NA 8.97 8.54 0.93 NA NA 17.15 16.72 090

25650 ............ A Treat wrist bone fracture ...................... 3.05 4.62 4.19 3.12 2.70 0.37 8.04 7.61 6.54 6.12 090

25660 ............ A Treat wrist dislocation .......................... 4.76 NA NA 5.36 4.52 0.59 NA NA 10.71 9.87 090

25670 ............ A Treat wrist dislocation .......................... 7.92 NA NA 8.85 8.56 1.07 NA NA 17.84 17.55 090

25675 ............ A Treat wrist dislocation .......................... 4.67 7.16 5.99 5.15 4.48 0.57 12.40 11.23 10.39 9.72 090

25676 ............ A Treat wrist dislocation .......................... 8.04 NA NA 8.91 8.67 1.10 NA NA 18.05 17.81 090

25680 ............ A Treat wrist fracture ............................... 5.99 NA NA 6.39 5.46 0.61 NA NA 12.99 12.06 090

65454

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

25685 ............ A Treat wrist fracture ............................... 9.78 NA NA 9.54 9.54 1.25 NA NA 20.57 20.57 090

25690 ............ A Treat wrist dislocation .......................... 5.50 NA NA 6.86 6.47 0.78 NA NA 13.14 12.75 090

25695 ............ A Treat wrist dislocation .......................... 8.34 NA NA 8.84 8.54 1.07 NA NA 18.25 17.95 090

25800 ............ A Fusion of wrist joint .............................. 9.76 NA NA 10.00 10.42 1.30 NA NA 21.06 21.48 090

25805 ............ A Fusion/graft of wrist joint ...................... 11.28 NA NA 10.95 11.58 1.51 NA NA 23.74 24.37 090

25810 ............ A Fusion/graft of wrist joint ...................... 10.57 NA NA 10.47 11.01 1.37 NA NA 22.41 22.95 090

25820 ............ A Fusion of hand bones .......................... 7.45 NA NA 8.81 8.83 0.96 NA NA 17.22 17.24 090

25825 ............ A Fuse hand bones with graft ................. 9.27 NA NA 9.82 10.13 1.20 NA NA 20.29 20.60 090

25830 ............ A Fusion, radioulnar jnt/ulna .................... 10.06 NA NA 14.92 13.52 1.27 NA NA 26.25 24.85 090

25900 ............ A Amputation of forearm .......................... 9.01 NA NA 13.27 11.87 1.08 NA NA 23.36 21.96 090

25905 ............ A Amputation of forearm .......................... 9.12 NA NA 15.11 13.26 1.06 NA NA 25.29 23.44 090

25907 ............ A Amputation follow-up surgery ............... 7.80 NA NA 13.20 11.46 1.01 NA NA 22.01 20.27 090

25909 ............ A Amputation follow-up surgery ............... 8.96 NA NA 15.15 12.87 1.07 NA NA 25.18 22.90 090

25915 ............ A Amputation of forearm .......................... 17.08 NA NA 20.21 19.45 2.41 NA NA 39.70 38.94 090

25920 ............ A Amputate hand at wrist ........................ 8.68 NA NA 9.28 8.86 1.06 NA NA 19.02 18.60 090

25922 ............ A Amputate hand at wrist ........................ 7.42 NA NA 9.14 8.36 0.93 NA NA 17.49 16.71 090

25924 ............ A Amputation follow-up surgery ............... 8.46 NA NA 9.22 8.95 1.07 NA NA 18.75 18.48 090

25927 ............ A Amputation of hand .............................. 8.80 NA NA 13.46 11.80 1.02 NA NA 23.28 21.62 090

25929 ............ A Amputation follow-up surgery ............... 7.59 NA NA 7.05 6.57 0.89 NA NA 15.53 15.05 090

25931 ............ A Amputation follow-up surgery ............... 7.81 NA NA 13.94 11.69 0.88 NA NA 22.63 20.38 090

25999 ............ C Forearm or wrist surgery ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

26010 ............ A Drainage of finger abscess .................. 1.54 4.86 3.78 3.48 2.68 0.14 6.54 5.46 5.16 4.36 010

26011 ............ A Drainage of finger abscess .................. 2.19 6.80 5.52 5.69 4.69 0.25 9.24 7.96 8.13 7.13 010

26020 ............ A Drain hand tendon sheath .................... 4.67 NA NA 11.55 9.67 0.59 NA NA 16.81 14.93 090

26025 ............ A Drainage of palm bursa ........................ 4.82 NA NA 11.71 10.01 0.60 NA NA 17.13 15.43 090

26030 ............ A Drainage of palm bursa(s) ................... 5.93 NA NA 12.14 10.66 0.72 NA NA 18.79 17.31 090

26034 ............ A Treat hand bone lesion ........................ 6.23 NA NA 13.35 11.16 0.79 NA NA 20.37 18.18 090

26035 ............ A Decompress fingers/hand .................... 9.51 NA NA 15.30 12.88 1.12 NA NA 25.93 23.51 090

26037 ............ A Decompress fingers/hand .................... 7.25 NA NA 11.76 10.55 0.87 NA NA 19.88 18.67 090

26040 ............ A Release palm contracture .................... 3.33 NA NA 11.19 9.17 0.45 NA NA 14.97 12.95 090

26045 ............ A Release palm contracture .................... 5.56 NA NA 12.37 10.59 0.74 NA NA 18.67 16.89 090

26055 ............ A Incise finger tendon sheath .................. 2.69 7.04 6.17 6.76 5.96 0.36 10.09 9.22 9.81 9.01 090

26060 ............ A Incision of finger tendon ....................... 2.81 NA NA 6.66 5.30 0.35 NA NA 9.82 8.46 090

26070 ............ A Explore/treat hand joint ........................ 3.69 NA NA 10.22 8.04 0.35 NA NA 14.26 12.08 090

26075 ............ A Explore/treat finger joint ....................... 3.79 NA NA 10.82 9.14 0.40 NA NA 15.01 13.33 090

26080 ............ A Explore/treat finger joint ....................... 4.24 NA NA 11.59 9.55 0.52 NA NA 16.35 14.31 090

26100 ............ A Biopsy hand joint lining ........................ 3.67 NA NA 7.39 6.35 0.45 NA NA 11.51 10.47 090

26105 ............ A Biopsy finger joint lining ....................... 3.71 NA NA 10.68 9.14 0.45 NA NA 14.84 13.30 090

26110 ............ A Biopsy finger joint lining ....................... 3.53 NA NA 10.69 8.81 0.44 NA NA 14.66 12.78 090

26115 ............ A Removal of hand lesion ....................... 3.86 7.21 5.95 7.21 5.95 0.48 11.55 10.29 11.55 10.29 090

26116 ............ A Removal of hand lesion ....................... 5.53 NA NA 12.26 10.20 0.69 NA NA 18.48 16.42 090

26117 ............ A Remove tumor, hand/finger .................. 8.55 NA NA 14.41 12.18 1.01 NA NA 23.97 21.74 090

26121 ............ A Release palm contracture .................... 7.54 NA NA 14.23 12.92 0.94 NA NA 22.71 21.40 090

26123 ............ A Release palm contracture .................... 9.29 NA NA 15.22 13.89 1.17 NA NA 25.68 24.35 090

26125 ............ A Release palm contracture .................... 4.61 NA NA 2.57 2.64 0.57 NA NA 7.75 7.82 ZZZ

26130 ............ A Remove wrist joint lining ...................... 5.42 NA NA 14.77 12.44 0.65 NA NA 20.84 18.51 090

26135 ............ A Revise finger joint, each ....................... 6.96 NA NA 15.48 12.93 0.87 NA NA 23.31 20.76 090

26140 ............ A Revise finger joint, each ....................... 6.17 NA NA 14.41 12.00 0.76 NA NA 21.34 18.93 090

26145 ............ A Tendon excision, palm/finger ............... 6.32 NA NA 14.33 12.03 0.77 NA NA 21.42 19.12 090

26160 ............ A Remove tendon sheath lesion ............. 3.15 7.20 6.03 6.96 5.85 0.39 10.74 9.57 10.50 9.39 090

26170 ............ A Removal of palm tendon, each ............ 4.77 NA NA 7.97 6.75 0.60 NA NA 13.34 12.12 090

26180 ............ A Removal of finger tendon ..................... 5.18 NA NA 7.83 6.96 0.64 NA NA 13.65 12.78 090

26185 ............ A Remove finger bone ............................. 5.25 NA NA 8.35 7.41 0.67 NA NA 14.27 13.33 090

26200 ............ A Remove hand bone lesion ................... 5.51 NA NA 12.39 10.51 0.71 NA NA 18.61 16.73 090

26205 ............ A Remove/graft bone lesion .................... 7.70 NA NA 14.03 12.26 0.95 NA NA 22.68 20.91 090

26210 ............ A Removal of finger lesion ...................... 5.15 NA NA 12.94 10.76 0.64 NA NA 18.73 16.55 090

26215 ............ A Remove/graft finger lesion ................... 7.10 NA NA 13.35 11.52 0.77 NA NA 21.22 19.39 090

26230 ............ A Partial removal of hand bone ............... 6.33 NA NA 11.81 10.01 0.84 NA NA 18.98 17.18 090

26235 ............ A Partial removal, finger bone ................. 6.19 NA NA 11.45 9.72 0.78 NA NA 18.42 16.69 090

26236 ............ A Partial removal, finger bone ................. 5.32 NA NA 11.29 9.52 0.66 NA NA 17.27 15.50 090

26250 ............ A Extensive hand surgery ........................ 7.55 NA NA 15.93 13.58 0.92 NA NA 24.40 22.05 090

26255 ............ A Extensive hand surgery ........................ 12.43 NA NA 16.86 15.07 1.05 NA NA 30.34 28.55 090

26260 ............ A Extensive finger surgery ....................... 7.03 NA NA 15.76 13.38 0.83 NA NA 23.62 21.24 090

26261 ............ A Extensive finger surgery ....................... 9.09 NA NA 16.90 14.77 0.84 NA NA 26.83 24.70 090

26262 ............ A Partial removal of finger ....................... 5.67 NA NA 12.80 10.89 0.70 NA NA 19.17 17.26 090

26320 ............ A Removal of implant from hand ............. 3.98 NA NA 11.74 9.77 0.49 NA NA 16.21 14.24 090

26350 ............ A Repair finger/hand tendon .................... 5.99 NA NA 18.01 15.07 0.73 NA NA 24.73 21.79 090

26352 ............ A Repair/graft hand tendon ..................... 7.68 NA NA 17.48 14.90 0.93 NA NA 26.09 23.51 090

26356 ............ A Repair finger/hand tendon .................... 8.07 NA NA 19.37 16.48 0.99 NA NA 28.43 25.54 090

26357 ............ A Repair finger/hand tendon .................... 8.58 NA NA 18.82 15.90 1.02 NA NA 28.42 25.50 090

26358 ............ A Repair/graft hand tendon ..................... 9.14 NA NA 18.56 15.93 1.07 NA NA 28.77 26.14 090

26370 ............ A Repair finger/hand tendon .................... 7.11 NA NA 18.65 15.81 0.90 NA NA 26.66 23.82 090

26372 ............ A Repair/graft hand tendon ..................... 8.76 NA NA 18.77 15.81 1.06 NA NA 28.59 25.63 090

26373 ............ A Repair finger/hand tendon .................... 8.16 NA NA 21.22 17.77 0.98 NA NA 30.36 26.91 090

26390 ............ A Revise hand/finger tendon ................... 9.19 NA NA 14.49 13.03 1.09 NA NA 24.77 23.31 090

26392 ............ A Repair/graft hand tendon ..................... 10.26 NA NA 19.80 17.19 1.26 NA NA 31.32 28.71 090

26410 ............ A Repair hand tendon .............................. 4.63 NA NA 14.50 11.77 0.57 NA NA 19.70 16.97 090

26412 ............ A Repair/graft hand tendon ..................... 6.31 NA NA 14.96 12.85 0.80 NA NA 22.07 19.96 090

26415 ............ A Excision, hand/finger tendon ................ 8.34 NA NA 14.51 12.72 0.77 NA NA 23.62 21.83 090

26416 ............ A Graft hand or finger tendon .................. 9.37 NA NA 15.87 14.25 1.20 NA NA 26.44 24.82 090

26418 ............ A Repair finger tendon ............................. 4.25 NA NA 14.16 11.59 0.50 NA NA 18.91 16.34 090

26420 ............ A Repair/graft finger tendon .................... 6.77 NA NA 15.68 13.30 0.83 NA NA 23.28 20.90 090

26426 ............ A Repair finger/hand tendon .................... 6.15 NA NA 15.05 13.00 0.77 NA NA 21.97 19.92 090

65455

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

26428 ............ A Repair/graft finger tendon .................... 7.21 NA NA 15.60 13.19 0.84 NA NA 23.65 21.24 090

26432 ............ A Repair finger tendon ............................. 4.02 NA NA 11.01 8.69 0.48 NA NA 15.51 13.19 090

26433 ............ A Repair finger tendon ............................. 4.56 NA NA 12.66 10.57 0.56 NA NA 17.78 15.69 090

26434 ............ A Repair/graft finger tendon .................... 6.09 NA NA 12.09 10.41 0.71 NA NA 18.89 17.21 090

26437 ............ A Realignment of tendons ....................... 5.82 NA NA 12.52 10.49 0.74 NA NA 19.08 17.05 090

26440 ............ A Release palm/finger tendon ................. 5.02 NA NA 16.09 13.04 0.62 NA NA 21.73 18.68 090

26442 ............ A Release palm & finger tendon ............. 8.16 NA NA 18.28 14.63 0.94 NA NA 27.38 23.73 090

26445 ............ A Release hand/finger tendon ................. 4.31 NA NA 15.96 12.85 0.54 NA NA 20.81 17.70 090

26449 ............ A Release forearm/hand tendon .............. 7.00 NA NA 16.72 14.05 0.84 NA NA 24.56 21.89 090

26450 ............ A Incision of palm tendon ........................ 3.67 NA NA 7.26 6.06 0.46 NA NA 11.39 10.19 090

26455 ............ A Incision of finger tendon ....................... 3.64 NA NA 7.52 6.15 0.47 NA NA 11.63 10.26 090

26460 ............ A Incise hand/finger tendon ..................... 3.46 NA NA 7.09 5.79 0.44 NA NA 10.99 9.69 090

26471 ............ A Fusion of finger tendons ...................... 5.73 NA NA 12.48 10.49 0.73 NA NA 18.94 16.95 090

26474 ............ A Fusion of finger tendons ...................... 5.32 NA NA 12.82 10.87 0.69 NA NA 18.83 16.88 090

26476 ............ A Tendon lengthening .............................. 5.18 NA NA 12.78 10.37 0.62 NA NA 18.58 16.17 090

26477 ............ A Tendon shortening ............................... 5.15 NA NA 12.24 10.26 0.60 NA NA 17.99 16.01 090

26478 ............ A Lengthening of hand tendon ................ 5.80 NA NA 12.59 10.61 0.77 NA NA 19.16 17.18 090

26479 ............ A Shortening of hand tendon ................... 5.74 NA NA 12.82 11.05 0.76 NA NA 19.32 17.55 090

26480 ............ A Transplant hand tendon ....................... 6.69 NA NA 17.21 14.68 0.84 NA NA 24.74 22.21 090

26483 ............ A Transplant/graft hand tendon ............... 8.29 NA NA 18.04 15.84 1.03 NA NA 27.36 25.16 090

26485 ............ A Transplant palm tendon ....................... 7.70 NA NA 17.12 14.60 0.94 NA NA 25.76 23.24 090

26489 ............ A Transplant/graft palm tendon ............... 9.55 NA NA 16.57 13.35 0.98 NA NA 27.10 23.88 090

26490 ............ A Revise thumb tendon ........................... 8.41 NA NA 13.78 12.45 1.05 NA NA 23.24 21.91 090

26492 ............ A Tendon transfer with graft .................... 9.62 NA NA 14.89 13.54 1.19 NA NA 25.70 24.35 090

26494 ............ A Hand tendon/muscle transfer ............... 8.47 NA NA 14.21 12.63 1.13 NA NA 23.81 22.23 090

26496 ............ A Revise thumb tendon ........................... 9.59 NA NA 14.17 13.00 1.17 NA NA 24.93 23.76 090

26497 ............ A Finger tendon transfer .......................... 9.57 NA NA 14.43 13.00 1.17 NA NA 25.17 23.74 090

26498 ............ A Finger tendon transfer .......................... 14.00 NA NA 16.72 15.74 1.74 NA NA 32.46 31.48 090

26499 ............ A Revision of finger ................................. 8.98 NA NA 15.73 13.90 0.94 NA NA 25.65 23.82 090

26500 ............ A Hand tendon reconstruction ................. 5.96 NA NA 13.22 10.86 0.66 NA NA 19.84 17.48 090

26502 ............ A Hand tendon reconstruction ................. 7.14 NA NA 14.34 12.19 0.87 NA NA 22.35 20.20 090

26504 ............ A Hand tendon reconstruction ................. 7.47 NA NA 9.92 9.26 0.84 NA NA 18.23 17.57 090

26508 ............ A Release thumb contracture .................. 6.01 NA NA 13.12 10.97 0.76 NA NA 19.89 17.74 090

26510 ............ A Thumb tendon transfer ......................... 5.43 NA NA 12.52 10.52 0.71 NA NA 18.66 16.66 090

26516 ............ A Fusion of knuckle joint ......................... 7.15 NA NA 13.26 11.07 0.90 NA NA 21.31 19.12 090

26517 ............ A Fusion of knuckle joints ........................ 8.83 NA NA 13.63 12.14 0.96 NA NA 23.42 21.93 090

26518 ............ A Fusion of knuckle joints ........................ 9.02 NA NA 13.33 11.77 1.13 NA NA 23.48 21.92 090

26520 ............ A Release knuckle contracture ................ 5.30 NA NA 16.37 13.49 0.65 NA NA 22.32 19.44 090

26525 ............ A Release finger contracture ................... 5.33 NA NA 16.76 13.56 0.66 NA NA 22.75 19.55 090

26530 ............ A Revise knuckle joint ............................. 6.69 NA NA 16.92 14.09 0.86 NA NA 24.47 21.64 090

26531 ............ A Revise knuckle with implant ................. 7.91 NA NA 17.34 14.81 1.01 NA NA 26.26 23.73 090

26535 ............ A Revise finger joint ................................. 5.24 NA NA 9.17 8.19 0.66 NA NA 15.07 14.09 090

26536 ............ A Revise/implant finger joint .................... 6.37 NA NA 16.01 13.91 0.80 NA NA 23.18 21.08 090

26540 ............ A Repair hand joint .................................. 6.43 NA NA 13.41 11.86 0.81 NA NA 20.65 19.10 090

26541 ............ A Repair hand joint with graft .................. 8.62 NA NA 14.78 13.51 1.12 NA NA 24.52 23.25 090

26542 ............ A Repair hand joint with graft .................. 6.78 NA NA 12.82 11.15 0.87 NA NA 20.47 18.80 090

26545 ............ A Reconstruct finger joint ........................ 6.92 NA NA 14.05 11.97 0.79 NA NA 21.76 19.68 090

26546 ............ A Repair nonunion hand .......................... 8.92 NA NA 14.06 12.75 1.14 NA NA 24.12 22.81 090

26548 ............ A Reconstruct finger joint ........................ 8.03 NA NA 14.23 12.24 0.98 NA NA 23.24 21.25 090

26550 ............ A Construct thumb replacement .............. 21.24 NA NA 19.62 20.09 1.80 NA NA 42.66 43.13 090

26551 ............ A Great toe-hand transfer ........................ 46.58 NA NA 28.61 32.92 6.57 NA NA 81.76 86.07 090

26553 ............ A Single transfer, toe-hand ...................... 46.27 NA NA 28.33 32.63 1.99 NA NA 76.59 80.89 090

26554 ............ A Double transfer, toe-hand .................... 54.95 NA NA 33.90 39.01 7.76 NA NA 96.61 101.72 090

26555 ............ A Positional change of finger ................... 16.63 NA NA 22.41 20.99 2.13 NA NA 41.17 39.75 090

26556 ............ A Toe joint transfer .................................. 47.26 NA NA 28.88 33.24 6.67 NA NA 82.81 87.17 090

26560 ............ A Repair of web finger ............................. 5.38 NA NA 13.01 11.02 0.60 NA NA 18.99 17.00 090

26561 ............ A Repair of web finger ............................. 10.92 NA NA 13.50 12.54 0.69 NA NA 25.11 24.15 090

26562 ............ A Repair of web finger ............................. 9.68 NA NA 9.60 10.09 0.98 NA NA 20.26 20.75 090

26565 ............ A Correct metacarpal flaw ....................... 6.74 NA NA 13.16 11.45 0.84 NA NA 20.74 19.03 090

26567 ............ A Correct finger deformity ........................ 6.82 NA NA 13.05 10.95 0.84 NA NA 20.71 18.61 090

26568 ............ A Lengthen metacarpal/finger .................. 9.08 NA NA 17.58 15.48 1.10 NA NA 27.76 25.66 090

26580 ............ A Repair hand deformity .......................... 18.18 NA NA 16.65 17.07 1.46 NA NA 36.29 36.71 090

26585 ............ A Repair finger deformity ......................... 14.05 NA NA 14.49 14.38 1.08 NA NA 29.62 29.51 090

26587 ............ C Reconstruct extra finger ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

26590 ............ A Repair finger deformity ......................... 17.96 NA NA 13.95 14.98 1.32 NA NA 33.23 34.26 090

26591 ............ A Repair muscles of hand ....................... 3.25 NA NA 12.58 10.06 0.37 NA NA 16.20 13.68 090

26593 ............ A Release muscles of hand ..................... 5.31 NA NA 11.76 9.94 0.64 NA NA 17.71 15.89 090

26596 ............ A Excision constricting tissue .................. 8.95 NA NA 9.03 9.01 0.87 NA NA 18.85 18.83 090

26597 ............ A Release of scar contracture ................. 9.82 NA NA 15.29 13.64 1.20 NA NA 26.31 24.66 090

26600 ............ A Treat metacarpal fracture ..................... 1.96 4.04 3.45 2.72 2.25 0.25 6.25 5.66 4.93 4.46 090

26605 ............ A Treat metacarpal fracture ..................... 2.85 5.80 4.97 4.19 3.46 0.38 9.03 8.20 7.42 6.69 090

26607 ............ A Treat metacarpal fracture ..................... 5.36 NA NA 7.89 6.88 0.70 NA NA 13.95 12.94 090

26608 ............ A Treat metacarpal fracture ..................... 5.36 NA NA 8.03 6.99 0.73 NA NA 14.12 13.08 090

26615 ............ A Treat metacarpal fracture ..................... 5.33 NA NA 7.66 7.07 0.70 NA NA 13.69 13.10 090

26641 ............ A Treat thumb dislocation ........................ 3.94 6.59 5.24 4.79 3.89 0.42 10.95 9.60 9.15 8.25 090

26645 ............ A Treat thumb fracture ............................. 4.41 6.99 5.84 5.11 4.43 0.54 11.94 10.79 10.06 9.38 090

26650 ............ A Treat thumb fracture ............................. 5.72 NA NA 8.20 7.24 0.77 NA NA 14.69 13.73 090

26665 ............ A Treat thumb fracture ............................. 7.60 NA NA 8.62 8.20 0.97 NA NA 17.19 16.77 090

26670 ............ A Treat hand dislocation .......................... 3.69 6.17 4.89 4.66 3.76 0.36 10.22 8.94 8.71 7.81 090

26675 ............ A Treat hand dislocation .......................... 4.64 5.73 5.48 4.42 4.49 0.56 10.93 10.68 9.62 9.69 090

26676 ............ A Pin hand dislocation ............................. 5.52 NA NA 8.10 7.39 0.76 NA NA 14.38 13.67 090

26685 ............ A Treat hand dislocation .......................... 6.98 NA NA 8.23 7.74 0.95 NA NA 16.16 15.67 090

26686 ............ A Treat hand dislocation .......................... 7.94 NA NA 9.08 8.52 1.05 NA NA 18.07 17.51 090

65456

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

26700 ............ A Treat knuckle dislocation ...................... 3.69 4.73 3.79 2.81 2.35 0.35 8.77 7.83 6.85 6.39 090

26705 ............ A Treat knuckle dislocation ...................... 4.19 5.90 4.91 4.06 3.53 0.50 10.59 9.60 8.75 8.22 090

26706 ............ A Pin knuckle dislocation ......................... 5.12 NA NA 5.47 5.37 0.64 NA NA 11.23 11.13 090

26715 ............ A Treat knuckle dislocation ...................... 5.74 NA NA 7.79 6.96 0.75 NA NA 14.28 13.45 090

26720 ............ A Treat finger fracture, each .................... 1.66 2.82 2.41 1.57 1.33 0.20 4.68 4.27 3.43 3.19 090

26725 ............ A Treat finger fracture, each .................... 3.33 4.81 4.03 3.02 2.48 0.43 8.57 7.79 6.78 6.24 090

26727 ............ A Treat finger fracture, each .................... 5.23 NA NA 8.21 6.82 0.69 NA NA 14.13 12.74 090

26735 ............ A Treat finger fracture, each .................... 5.98 NA NA 8.11 7.10 0.77 NA NA 14.86 13.85 090

26740 ............ A Treat finger fracture, each .................... 1.94 3.51 2.95 2.40 1.96 0.24 5.69 5.13 4.58 4.14 090

26742 ............ A Treat finger fracture, each .................... 3.85 7.01 5.80 5.08 4.35 0.49 11.35 10.14 9.42 8.69 090

26746 ............ A Treat finger fracture, each .................... 5.81 NA NA 8.20 7.44 0.74 NA NA 14.75 13.99 090

26750 ............ A Treat finger fracture, each .................... 1.70 3.35 2.74 2.21 1.88 0.19 5.24 4.63 4.10 3.77 090

26755 ............ A Treat finger fracture, each .................... 3.10 4.69 3.81 2.88 2.45 0.37 8.16 7.28 6.35 5.92 090

26756 ............ A Pin finger fracture, each ....................... 4.39 NA NA 8.02 6.53 0.56 NA NA 12.97 11.48 090

26765 ............ A Treat finger fracture, each .................... 4.17 NA NA 7.17 6.10 0.51 NA NA 11.85 10.78 090

26770 ............ A Treat finger dislocation ......................... 3.02 4.47 3.56 2.54 2.11 0.27 7.76 6.85 5.83 5.40 090

26775 ............ A Treat finger dislocation ......................... 3.71 5.76 4.63 3.73 3.11 0.43 9.90 8.77 7.87 7.25 090

26776 ............ A Pin finger dislocation ............................ 4.80 NA NA 8.16 6.69 0.63 NA NA 13.59 12.12 090

26785 ............ A Treat finger dislocation ......................... 4.21 NA NA 7.14 6.16 0.54 NA NA 11.89 10.91 090

26820 ............ A Thumb fusion with graft ........................ 8.26 NA NA 14.62 12.77 1.11 NA NA 23.99 22.14 090

26841 ............ A Fusion of thumb ................................... 7.13 NA NA 13.55 11.84 0.97 NA NA 21.65 19.94 090

26842 ............ A Thumb fusion with graft ........................ 8.24 NA NA 14.30 13.05 1.10 NA NA 23.64 22.39 090

26843 ............ A Fusion of hand joint .............................. 7.61 NA NA 13.47 11.83 0.99 NA NA 22.07 20.43 090

26844 ............ A Fusion/graft of hand joint ..................... 8.73 NA NA 13.92 12.44 1.12 NA NA 23.77 22.29 090

26850 ............ A Fusion of knuckle ................................. 6.97 NA NA 12.95 10.97 0.89 NA NA 20.81 18.83 090

26852 ............ A Fusion of knuckle with graft ................. 8.46 NA NA 13.85 11.94 1.05 NA NA 23.36 21.45 090

26860 ............ A Fusion of finger joint ............................. 4.69 NA NA 11.91 10.10 0.60 NA NA 17.20 15.39 090

26861 ............ A Fusion of finger jnt, add-on .................. 1.74 NA NA 0.97 1.25 0.22 NA NA 2.93 3.21 ZZZ

26862 ............ A Fusion/graft of finger joint .................... 7.37 NA NA 13.47 11.50 0.92 NA NA 21.76 19.79 090

26863 ............ A Fuse/graft added joint .......................... 3.90 NA NA 2.20 2.57 0.51 NA NA 6.61 6.98 ZZZ

26910 ............ A Amputate metacarpal bone .................. 7.60 NA NA 13.09 11.22 0.90 NA NA 21.59 19.72 090

26951 ............ A Amputation of finger/thumb .................. 4.59 NA NA 11.69 9.55 0.56 NA NA 16.84 14.70 090

26952 ............ A Amputation of finger/thumb .................. 6.31 NA NA 13.00 10.84 0.74 NA NA 20.05 17.89 090

26989 ............ C Hand/finger surgery .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

26990 ............ A Drainage of pelvis lesion ...................... 7.48 NA NA 14.64 11.82 0.92 NA NA 23.04 20.22 090

26991 ............ A Drainage of pelvis bursa ...................... 6.68 10.23 8.16 9.12 7.33 0.85 17.76 15.69 16.65 14.86 090

26992 ............ A Drainage of bone lesion ....................... 13.02 NA NA 18.42 15.55 1.75 NA NA 33.19 30.32 090

27000 ............ A Incision of hip tendon ........................... 5.62 NA NA 6.94 5.71 0.76 NA NA 13.32 12.09 090

27001 ............ A Incision of hip tendon ........................... 6.94 NA NA 7.78 6.47 0.95 NA NA 15.67 14.36 090

27003 ............ A Incision of hip tendon ........................... 7.34 NA NA 8.47 8.19 0.93 NA NA 16.74 16.46 090

27005 ............ A Incision of hip tendon ........................... 9.66 NA NA 9.89 8.33 1.36 NA NA 20.91 19.35 090

27006 ............ A Incision of hip tendons ......................... 9.68 NA NA 9.82 8.63 1.33 NA NA 20.83 19.64 090

27025 ............ A Incision of hip/thigh fascia .................... 11.16 NA NA 9.71 8.94 1.38 NA NA 22.25 21.48 090

27030 ............ A Drainage of hip joint ............................. 13.01 NA NA 11.74 11.90 1.81 NA NA 26.56 26.72 090

27033 ............ A Exploration of hip joint .......................... 13.39 NA NA 11.91 12.06 1.87 NA NA 27.17 27.32 090

27035 ............ A Denervation of hip joint ........................ 16.69 NA NA 15.58 14.90 1.70 NA NA 33.97 33.29 090

27036 ............ A Excision of hip joint/muscle .................. 12.88 NA NA 13.11 12.94 1.80 NA NA 27.79 27.62 090

27040 ............ A Biopsy of soft tissues ........................... 2.87 5.79 4.54 3.67 2.95 0.21 8.87 7.62 6.75 6.03 010

27041 ............ A Biopsy of soft tissues ........................... 9.89 NA NA 8.23 6.90 1.01 NA NA 19.13 17.80 090

27047 ............ A Remove hip/pelvis lesion ..................... 7.45 9.26 7.46 6.90 5.69 0.79 17.50 15.70 15.14 13.93 090

27048 ............ A Remove hip/pelvis lesion ..................... 6.25 NA NA 7.61 6.88 0.73 NA NA 14.59 13.86 090

27049 ............ A Remove tumor, hip/pelvis ..................... 13.66 NA NA 12.83 12.37 1.60 NA NA 28.09 27.63 090

27050 ............ A Biopsy of sacroiliac joint ....................... 4.36 NA NA 6.47 6.15 0.53 NA NA 11.36 11.04 090

27052 ............ A Biopsy of hip joint ................................. 6.23 NA NA 7.70 7.63 0.85 NA NA 14.78 14.71 090

27054 ............ A Removal of hip joint lining .................... 8.54 NA NA 10.00 10.05 1.17 NA NA 19.71 19.76 090

27060 ............ A Removal of ischial bursa ...................... 5.43 NA NA 7.51 6.70 0.60 NA NA 13.54 12.73 090

27062 ............ A Remove femur lesion/bursa ................. 5.37 NA NA 6.76 6.22 0.74 NA NA 12.87 12.33 090

27065 ............ A Removal of hip bone lesion ................. 5.90 NA NA 8.00 7.52 0.76 NA NA 14.66 14.18 090

27066 ............ A Removal of hip bone lesion ................. 10.33 NA NA 11.59 10.84 1.42 NA NA 23.34 22.59 090

27067 ............ A Remove/graft hip bone lesion .............. 13.83 NA NA 13.57 13.33 1.95 NA NA 29.35 29.11 090

27070 ............ A Partial removal of hip bone .................. 10.72 NA NA 15.98 14.00 1.36 NA NA 28.06 26.08 090

27071 ............ A Partial removal of hip bone .................. 11.46 NA NA 17.00 15.06 1.51 NA NA 29.97 28.03 090

27075 ............ A Extensive hip surgery ........................... 17.23 NA NA 16.36 15.94 2.22 NA NA 35.81 35.39 090

27076 ............ A Extensive hip surgery ........................... 22.12 NA NA 19.45 19.03 2.86 NA NA 44.43 44.01 090

27077 ............ A Extensive hip surgery ........................... 23.13 NA NA 18.67 19.15 3.18 NA NA 44.98 45.46 090

27078 ............ A Extensive hip surgery ........................... 13.44 NA NA 14.31 13.23 1.67 NA NA 29.42 28.34 090

27079 ............ A Extensive hip surgery ........................... 13.75 NA NA 14.21 13.00 1.86 NA NA 29.82 28.61 090

27080 ............ A Removal of tail bone ............................ 6.39 NA NA 7.57 6.98 0.80 NA NA 14.76 14.17 090

27086 ............ A Remove hip foreign body ..................... 1.87 5.06 3.95 3.76 2.90 0.17 7.10 5.99 5.80 4.94 010

27087 ............ A Remove hip foreign body ..................... 8.54 NA NA 8.40 7.28 1.09 NA NA 18.03 16.91 090

27090 ............ A Removal of hip prosthesis .................... 11.15 NA NA 10.64 10.45 1.55 NA NA 23.34 23.15 090

27091 ............ A Removal of hip prosthesis .................... 22.14 NA NA 16.74 17.93 3.11 NA NA 41.99 43.18 090

27093 ............ A Injection for hip x-ray ............................ 1.30 11.51 8.86 0.51 0.61 0.09 12.90 10.25 1.90 2.00 000

27095 ............ A Injection for hip x-ray ............................ 1.50 9.74 7.56 0.53 0.65 0.10 11.34 9.16 2.13 2.25 000

27096 ............ A Inject sacroiliac joint ............................. 1.40 11.08 11.08 0.54 0.54 0.08 12.56 12.56 2.02 2.02 000

27097 ............ A Revision of hip tendon ......................... 8.80 NA NA 9.29 9.06 1.22 NA NA 19.31 19.08 090

27098 ............ A Transfer tendon to pelvis ..................... 8.83 NA NA 9.46 9.19 1.24 NA NA 19.53 19.26 090

27100 ............ A Transfer of abdominal muscle .............. 11.08 NA NA 11.72 10.87 1.57 NA NA 24.37 23.52 090

27105 ............ A Transfer of spinal muscle ..................... 11.77 NA NA 11.73 10.40 1.66 NA NA 25.16 23.83 090

27110 ............ A Transfer of iliopsoas muscle ................ 13.26 NA NA 11.14 11.23 1.38 NA NA 25.78 25.87 090

27111 ............ A Transfer of iliopsoas muscle ................ 12.15 NA NA 10.68 11.17 1.48 NA NA 24.31 24.80 090

27120 ............ A Reconstruction of hip socket ................ 18.01 NA NA 13.95 15.37 2.45 NA NA 34.41 35.83 090

27122 ............ A Reconstruction of hip socket ................ 14.98 NA NA 13.50 14.60 2.08 NA NA 30.56 31.66 090

65457

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

27125 ............ A Partial hip replacement ........................ 14.69 NA NA 13.14 14.24 2.05 NA NA 29.88 30.98 090

27130 ............ A Total hip replacement ........................... 20.12 NA NA 16.26 18.20 2.82 NA NA 39.20 41.14 090

27132 ............ A Total hip replacement ........................... 23.30 NA NA 18.07 20.51 3.26 NA NA 44.63 47.07 090

27134 ............ A Revise hip joint replacement ................ 28.52 NA NA 20.79 24.10 3.97 NA NA 53.28 56.59 090

27137 ............ A Revise hip joint replacement ................ 21.17 NA NA 16.92 19.01 2.97 NA NA 41.06 43.15 090

27138 ............ A Revise hip joint replacement ................ 22.17 NA NA 17.49 19.69 3.11 NA NA 42.77 44.97 090

27140 ............ A Transplant femur ridge ......................... 12.24 NA NA 11.32 11.49 1.67 NA NA 25.23 25.40 090

27146 ............ A Incision of hip bone .............................. 17.43 NA NA 15.05 14.24 2.27 NA NA 34.75 33.94 090

27147 ............ A Revision of hip bone ............................ 20.58 NA NA 16.98 17.34 2.61 NA NA 40.17 40.53 090

27151 ............ A Incision of hip bones ............................ 22.51 NA NA 18.71 18.84 3.12 NA NA 44.34 44.47 090

27156 ............ A Revision of hip bones ........................... 24.63 NA NA 19.63 19.69 3.48 NA NA 47.74 47.80 090

27158 ............ A Revision of pelvis ................................. 19.74 NA NA 17.11 16.75 2.60 NA NA 39.45 39.09 090

27161 ............ A Incision of neck of femur ...................... 16.71 NA NA 13.71 14.17 2.32 NA NA 32.74 33.20 090

27165 ............ A Incision/fixation of femur ...................... 17.91 NA NA 14.27 15.25 2.51 NA NA 34.69 35.67 090

27170 ............ A Repair/graft femur head/neck ............... 16.07 NA NA 13.36 14.47 2.20 NA NA 31.63 32.74 090

27175 ............ A Treat slipped epiphysis ........................ 8.46 NA NA 6.93 5.52 1.19 NA NA 16.58 15.17 090

27176 ............ A Treat slipped epiphysis ........................ 12.05 NA NA 9.74 10.13 1.68 NA NA 23.47 23.86 090

27177 ............ A Treat slipped epiphysis ........................ 15.08 NA NA 11.27 11.82 2.11 NA NA 28.46 29.01 090

27178 ............ A Treat slipped epiphysis ........................ 11.99 NA NA 9.28 9.80 1.68 NA NA 22.95 23.47 090

27179 ............ A Revise head/neck of femur .................. 12.98 NA NA 9.62 10.24 1.84 NA NA 24.44 25.06 090

27181 ............ A Treat slipped epiphysis ........................ 14.68 NA NA 10.44 11.40 1.74 NA NA 26.86 27.82 090

27185 ............ A Revision of femur epiphysis ................. 9.18 NA NA 9.66 8.00 1.29 NA NA 20.13 18.47 090

27187 ............ A Reinforce hip bones ............................. 13.54 NA NA 12.74 13.60 1.89 NA NA 28.17 29.03 090

27193 ............ A Treat pelvic ring fracture ...................... 5.56 6.96 5.88 5.22 4.57 0.77 13.29 12.21 11.55 10.90 090

27194 ............ A Treat pelvic ring fracture ...................... 9.65 9.13 7.91 7.47 6.66 1.32 20.10 18.88 18.44 17.63 090

27200 ............ A Treat tail bone fracture ......................... 1.84 2.86 2.55 1.70 1.68 0.22 4.92 4.61 3.76 3.74 090

27202 ............ A Treat tail bone fracture ......................... 7.04 NA NA 18.67 15.67 0.69 NA NA 26.40 23.40 090

27215 ............ A Treat pelvic fracture(s) ......................... 10.05 NA NA 9.86 10.40 1.37 NA NA 21.28 21.82 090

27216 ............ A Treat pelvic ring fracture ...................... 15.19 NA NA 14.71 12.20 2.15 NA NA 32.05 29.54 090

27217 ............ A Treat pelvic ring fracture ...................... 14.11 NA NA 12.20 13.10 1.95 NA NA 28.26 29.16 090

27218 ............ A Treat pelvic ring fracture ...................... 20.15 NA NA 15.73 15.75 2.85 NA NA 38.73 38.75 090

27220 ............ A Treat hip socket fracture ...................... 6.18 7.30 6.63 5.56 5.33 0.85 14.33 13.66 12.59 12.36 090

27222 ............ A Treat hip socket fracture ...................... 12.70 NA NA 9.85 9.12 1.77 NA NA 24.32 23.59 090

27226 ............ A Treat hip wall fracture .......................... 14.91 NA NA 12.71 13.82 2.07 NA NA 29.69 30.80 090

27227 ............ A Treat hip fracture(s) .............................. 23.45 NA NA 16.85 17.98 3.24 NA NA 43.54 44.67 090

27228 ............ A Treat hip fracture(s) .............................. 27.16 NA NA 19.05 19.70 3.77 NA NA 49.98 50.63 090

27230 ............ A Treat thigh fracture ............................... 5.50 7.28 6.36 5.83 5.27 0.73 13.51 12.59 12.06 11.50 090

27232 ............ A Treat thigh fracture ............................... 10.68 NA NA 8.81 9.05 1.45 NA NA 20.94 21.18 090

27235 ............ A Treat thigh fracture ............................... 12.16 NA NA 10.58 11.57 1.71 NA NA 24.45 25.44 090

27236 ............ A Treat thigh fracture ............................... 15.60 NA NA 12.30 13.81 2.18 NA NA 30.08 31.59 090

27238 ............ A Treat thigh fracture ............................... 5.52 NA NA 5.91 5.77 0.76 NA NA 12.19 12.05 090

27240 ............ A Treat thigh fracture ............................... 12.50 NA NA 9.84 10.01 1.69 NA NA 24.03 24.20 090

27244 ............ A Treat thigh fracture ............................... 15.94 NA NA 12.54 13.83 2.23 NA NA 30.71 32.00 090

27245 ............ A Treat thigh fracture ............................... 20.31 NA NA 15.00 15.67 2.85 NA NA 38.16 38.83 090

27246 ............ A Treat thigh fracture ............................... 4.71 6.93 6.25 5.51 5.18 0.66 12.30 11.62 10.88 10.55 090

27248 ............ A Treat thigh fracture ............................... 10.45 NA NA 9.50 10.25 1.45 NA NA 21.40 22.15 090

27250 ............ A Treat hip dislocation ............................. 6.95 NA NA 6.02 5.38 0.68 NA NA 13.65 13.01 090

27252 ............ A Treat hip dislocation ............................. 10.39 NA NA 7.88 7.09 1.37 NA NA 19.64 18.85 090

27253 ............ A Treat hip dislocation ............................. 12.92 NA NA 10.50 11.44 1.81 NA NA 25.23 26.17 090

27254 ............ A Treat hip dislocation ............................. 18.26 NA NA 13.68 13.92 2.52 NA NA 34.46 34.70 090

27256 ............ A Treat hip dislocation ............................. 4.12 NA NA 4.14 3.62 0.49 NA NA 8.75 8.23 010

27257 ............ A Treat hip dislocation ............................. 5.22 NA NA 4.51 4.64 0.56 NA NA 10.29 10.42 010

27258 ............ A Treat hip dislocation ............................. 15.43 NA NA 12.99 13.47 2.06 NA NA 30.48 30.96 090

27259 ............ A Treat hip dislocation ............................. 21.55 NA NA 16.92 17.36 2.99 NA NA 41.46 41.90 090

27265 ............ A Treat hip dislocation ............................. 5.05 NA NA 5.62 5.15 0.65 NA NA 11.32 10.85 090

27266 ............ A Treat hip dislocation ............................. 7.49 NA NA 7.04 6.49 1.04 NA NA 15.57 15.02 090

27275 ............ A Manipulation of hip joint ....................... 2.27 NA NA 3.30 2.99 0.31 NA NA 5.88 5.57 010

27280 ............ A Fusion of sacroiliac joint ....................... 13.39 NA NA 13.47 12.83 1.98 NA NA 28.84 28.20 090

27282 ............ A Fusion of pubic bones .......................... 11.34 NA NA 12.18 11.58 1.14 NA NA 24.66 24.06 090

27284 ............ A Fusion of hip joint ................................. 16.76 NA NA 14.51 14.82 2.36 NA NA 33.63 33.94 090

27286 ............ A Fusion of hip joint ................................. 16.79 NA NA 14.53 15.02 2.37 NA NA 33.69 34.18 090

27290 ............ A Amputation of leg at hip ....................... 23.28 NA NA 16.73 19.44 2.94 NA NA 42.95 45.66 090

27295 ............ A Amputation of leg at hip ....................... 18.65 NA NA 13.87 14.89 2.35 NA NA 34.87 35.89 090

27299 ............ C Pelvis/hip joint surgery ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

27301 ............ A Drain thigh/knee lesion ......................... 6.49 15.18 12.05 13.65 10.91 0.80 22.47 19.34 20.94 18.20 090

27303 ............ A Drainage of bone lesion ....................... 8.28 NA NA 13.62 11.81 1.14 NA NA 23.04 21.23 090

27305 ............ A Incise thigh tendon & fascia ................. 5.92 NA NA 8.75 7.59 0.77 NA NA 15.44 14.28 090

27306 ............ A Incision of thigh tendon ........................ 4.62 NA NA 7.02 5.81 0.62 NA NA 12.26 11.05 090

27307 ............ A Incision of thigh tendons ...................... 5.80 NA NA 7.66 6.56 0.78 NA NA 14.24 13.14 090

27310 ............ A Exploration of knee joint ....................... 9.27 NA NA 9.47 9.71 1.29 NA NA 20.03 20.27 090

27315 ............ A Partial removal, thigh nerve ................. 6.97 NA NA 4.59 4.90 0.79 NA NA 12.35 12.66 090

27320 ............ A Partial removal, thigh nerve ................. 6.30 NA NA 4.32 4.65 0.78 NA NA 11.40 11.73 090

27323 ............ A Biopsy, thigh soft tissues ..................... 2.28 5.63 4.47 3.29 2.59 0.17 8.08 6.92 5.74 5.04 010

27324 ............ A Biopsy, thigh soft tissues ..................... 4.90 NA NA 6.48 5.57 0.59 NA NA 11.97 11.06 090

27327 ............ A Removal of thigh lesion ........................ 4.47 8.14 6.73 6.16 5.24 0.50 13.11 11.70 11.13 10.21 090

27328 ............ A Removal of thigh lesion ........................ 5.57 NA NA 6.74 6.16 0.66 NA NA 12.97 12.39 090

27329 ............ A Remove tumor, thigh/knee ................... 14.14 NA NA 13.75 13.49 1.68 NA NA 29.57 29.31 090

27330 ............ A Biopsy, knee joint lining ....................... 4.97 NA NA 5.94 5.94 0.66 NA NA 11.57 11.57 090

27331 ............ A Explore/treat knee joint ........................ 5.88 NA NA 7.00 7.01 0.81 NA NA 13.69 13.70 090

27332 ............ A Removal of knee cartilage ................... 8.27 NA NA 8.35 8.73 1.15 NA NA 17.77 18.15 090

27333 ............ A Removal of knee cartilage ................... 7.30 NA NA 7.89 8.10 1.03 NA NA 16.22 16.43 090

27334 ............ A Remove knee joint lining ...................... 8.70 NA NA 9.15 9.46 1.21 NA NA 19.06 19.37 090

27335 ............ A Remove knee joint lining ...................... 10.00 NA NA 9.91 10.42 1.41 NA NA 21.32 21.83 090

65458

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

27340 ............ A Removal of kneecap bursa .................. 4.18 NA NA 5.58 5.23 0.58 NA NA 10.34 9.99 090

27345 ............ A Removal of knee cyst ........................... 5.92 NA NA 6.91 6.71 0.81 NA NA 13.64 13.44 090

27347 ............ A Remove knee cyst ................................ 5.78 2.83 2.83 2.83 2.83 0.76 9.37 9.37 9.37 9.37 090

27350 ............ A Removal of kneecap ............................ 8.17 NA NA 8.35 8.70 1.15 NA NA 17.67 18.02 090

27355 ............ A Remove femur lesion ........................... 7.65 NA NA 9.58 9.24 1.07 NA NA 18.30 17.96 090

27356 ............ A Remove femur lesion/graft ................... 9.48 NA NA 10.57 10.15 1.29 NA NA 21.34 20.92 090

27357 ............ A Remove femur lesion/graft ................... 10.53 NA NA 11.14 10.74 1.48 NA NA 23.15 22.75 090

27358 ............ A Remove femur lesion/fixation ............... 4.74 NA NA 2.64 3.22 0.67 NA NA 8.05 8.63 ZZZ

27360 ............ A Partial removal, leg bone(s) ................. 10.50 NA NA 17.03 15.10 1.42 NA NA 28.95 27.02 090

27365 ............ A Extensive leg surgery ........................... 16.27 NA NA 13.70 14.06 2.26 NA NA 32.23 32.59 090

27370 ............ A Injection for knee x-ray ......................... 0.96 11.76 8.98 0.35 0.43 0.06 12.78 10.00 1.37 1.45 000

27372 ............ A Removal of foreign body ...................... 5.07 8.26 7.12 6.11 5.51 0.62 13.95 12.81 11.80 11.20 090

27380 ............ A Repair of kneecap tendon .................... 7.16 NA NA 7.84 8.02 1.00 NA NA 16.00 16.18 090

27381 ............ A Repair/graft kneecap tendon ................ 10.34 NA NA 9.61 10.27 1.44 NA NA 21.39 22.05 090

27385 ............ A Repair of thigh muscle ......................... 7.76 NA NA 8.19 8.46 1.09 NA NA 17.04 17.31 090

27386 ............ A Repair/graft of thigh muscle ................. 10.56 NA NA 10.30 10.88 1.49 NA NA 22.35 22.93 090

27390 ............ A Incision of thigh tendon ........................ 5.33 NA NA 7.14 6.54 0.69 NA NA 13.16 12.56 090

27391 ............ A Incision of thigh tendons ...................... 7.20 NA NA 8.32 7.71 0.99 NA NA 16.51 15.90 090

27392 ............ A Incision of thigh tendons ...................... 9.20 NA NA 10.27 9.78 1.23 NA NA 20.70 20.21 090

27393 ............ A Lengthening of thigh tendon ................ 6.39 NA NA 7.78 7.37 0.90 NA NA 15.07 14.66 090

27394 ............ A Lengthening of thigh tendons ............... 8.50 NA NA 10.01 9.06 1.17 NA NA 19.68 18.73 090

27395 ............ A Lengthening of thigh tendons ............... 11.73 NA NA 12.74 12.40 1.63 NA NA 26.10 25.76 090

27396 ............ A Transplant of thigh tendon ................... 7.86 NA NA 9.71 9.20 1.11 NA NA 18.68 18.17 090

27397 ............ A Transplants of thigh tendons ................ 11.28 NA NA 11.12 10.75 1.58 NA NA 23.98 23.61 090

27400 ............ A Revise thigh muscles/tendons ............. 9.02 NA NA 10.60 10.09 1.18 NA NA 20.80 20.29 090

27403 ............ A Repair of knee cartilage ....................... 8.33 NA NA 8.40 8.69 1.16 NA NA 17.89 18.18 090

27405 ............ A Repair of knee ligament ....................... 8.65 NA NA 9.09 9.40 1.21 NA NA 18.95 19.26 090

27407 ............ A Repair of knee ligament ....................... 10.28 NA NA 9.84 9.79 1.38 NA NA 21.50 21.45 090

27409 ............ A Repair of knee ligaments ..................... 12.90 NA NA 11.26 12.30 1.75 NA NA 25.91 26.95 090

27418 ............ A Repair degenerated kneecap ............... 10.85 NA NA 10.38 11.03 1.51 NA NA 22.74 23.39 090

27420 ............ A Revision of unstable kneecap .............. 9.83 NA NA 9.27 9.89 1.38 NA NA 20.48 21.10 090

27422 ............ A Revision of unstable kneecap .............. 9.78 NA NA 9.28 9.88 1.37 NA NA 20.43 21.03 090

27424 ............ A Revision/removal of kneecap ............... 9.81 NA NA 9.26 9.87 1.38 NA NA 20.45 21.06 090

27425 ............ A Lateral retinacular release .................... 5.22 NA NA 6.73 6.61 0.73 NA NA 12.68 12.56 090

27427 ............ A Reconstruction, knee ............................ 9.36 NA NA 8.93 9.49 1.29 NA NA 19.58 20.14 090

27428 ............ A Reconstruction, knee ............................ 14.00 NA NA 11.90 12.64 1.95 NA NA 27.85 28.59 090

27429 ............ A Reconstruction, knee ............................ 15.52 NA NA 12.90 12.73 2.18 NA NA 30.60 30.43 090

27430 ............ A Revision of thigh muscles .................... 9.67 NA NA 9.28 9.50 1.35 NA NA 20.30 20.52 090

27435 ............ A Incision of knee joint ............................ 9.49 NA NA 9.18 8.79 1.33 NA NA 20.00 19.61 090

27437 ............ A Revise kneecap .................................... 8.46 NA NA 9.35 9.54 1.18 NA NA 18.99 19.18 090

27438 ............ A Revise kneecap with implant ............... 11.23 NA NA 10.53 11.25 1.56 NA NA 23.32 24.04 090

27440 ............ A Revision of knee joint ........................... 10.43 NA NA 10.16 10.73 1.42 NA NA 22.01 22.58 090

27441 ............ A Revision of knee joint ........................... 10.82 NA NA 10.62 10.45 1.49 NA NA 22.93 22.76 090

27442 ............ A Revision of knee joint ........................... 11.89 NA NA 11.14 11.91 1.68 NA NA 24.71 25.48 090

27443 ............ A Revision of knee joint ........................... 10.93 NA NA 10.79 11.35 1.52 NA NA 23.24 23.80 090

27445 ............ A Revision of knee joint ........................... 17.68 NA NA 14.40 16.08 2.49 NA NA 34.57 36.25 090

27446 ............ A Revision of knee joint ........................... 15.84 NA NA 13.47 14.83 2.22 NA NA 31.53 32.89 090

27447 ............ A Total knee replacement ........................ 21.48 NA NA 16.49 18.78 3.00 NA NA 40.97 43.26 090

27448 ............ A Incision of thigh .................................... 11.06 NA NA 11.43 11.88 1.51 NA NA 24.00 24.45 090

27450 ............ A Incision of thigh .................................... 13.98 NA NA 13.08 13.84 1.96 NA NA 29.02 29.78 090

27454 ............ A Realignment of thigh bone ................... 17.56 NA NA 15.09 15.58 2.46 NA NA 35.11 35.60 090

27455 ............ A Realignment of knee ............................ 12.82 NA NA 11.85 12.15 1.78 NA NA 26.45 26.75 090

27457 ............ A Realignment of knee ............................ 13.45 NA NA 11.12 11.95 1.88 NA NA 26.45 27.28 090

27465 ............ A Shortening of thigh bone ...................... 13.87 NA NA 13.46 13.42 1.86 NA NA 29.19 29.15 090

27466 ............ A Lengthening of thigh bone ................... 16.33 NA NA 14.73 14.69 1.92 NA NA 32.98 32.94 090

27468 ............ A Shorten/lengthen thighs ....................... 18.97 NA NA 16.62 17.04 2.68 NA NA 38.27 38.69 090

27470 ............ A Repair of thigh ...................................... 16.07 NA NA 15.06 15.82 2.24 NA NA 33.37 34.13 090

27472 ............ A Repair/graft of thigh .............................. 17.72 NA NA 15.99 17.28 2.49 NA NA 36.20 37.49 090

27475 ............ A Surgery to stop leg growth ................... 8.64 NA NA 9.08 8.91 1.13 NA NA 18.85 18.68 090

27477 ............ A Surgery to stop leg growth ................... 9.85 NA NA 9.19 9.83 1.31 NA NA 20.35 20.99 090

27479 ............ A Surgery to stop leg growth ................... 12.80 NA NA 10.25 10.84 1.81 NA NA 24.86 25.45 090

27485 ............ A Surgery to stop leg growth ................... 8.84 NA NA 8.73 8.69 1.24 NA NA 18.81 18.77 090

27486 ............ A Revise/replace knee joint ..................... 19.27 NA NA 15.36 17.27 2.70 NA NA 37.33 39.24 090

27487 ............ A Revise/replace knee joint ..................... 25.27 NA NA 18.66 21.53 3.54 NA NA 47.47 50.34 090

27488 ............ A Removal of knee prosthesis ................. 15.74 NA NA 13.48 14.50 2.21 NA NA 31.43 32.45 090

27495 ............ A Reinforce thigh ..................................... 15.55 NA NA 14.84 15.77 2.18 NA NA 32.57 33.50 090

27496 ............ A Decompression of thigh/knee ............... 6.11 NA NA 7.19 6.62 0.77 NA NA 14.07 13.50 090

27497 ............ A Decompression of thigh/knee ............... 7.17 NA NA 7.29 6.97 0.84 NA NA 15.30 14.98 090

27498 ............ A Decompression of thigh/knee ............... 7.99 NA NA 9.17 8.59 0.97 NA NA 18.13 17.55 090

27499 ............ A Decompression of thigh/knee ............... 9.00 NA NA 9.05 8.76 1.18 NA NA 19.23 18.94 090

27500 ............ A Treatment of thigh fracture ................... 5.92 9.04 8.25 7.02 6.73 0.80 15.76 14.97 13.74 13.45 090

27501 ............ A Treatment of thigh fracture ................... 5.92 10.04 9.00 7.97 7.45 0.83 16.79 15.75 14.72 14.20 090

27502 ............ A Treatment of thigh fracture ................... 10.58 NA NA 10.58 10.02 1.49 NA NA 22.65 22.09 090

27503 ............ A Treatment of thigh fracture ................... 10.58 NA NA 10.57 10.01 1.49 NA NA 22.64 22.08 090

27506 ............ A Treatment of thigh fracture ................... 17.45 NA NA 13.47 14.45 2.33 NA NA 33.25 34.23 090

27507 ............ A Treatment of thigh fracture ................... 13.99 NA NA 11.88 13.09 1.95 NA NA 27.82 29.03 090

27508 ............ A Treatment of thigh fracture ................... 5.83 7.00 6.40 5.30 5.12 0.80 13.63 13.03 11.93 11.75 090

27509 ............ A Treatment of thigh fracture ................... 7.71 NA NA 8.59 7.59 1.08 NA NA 17.38 16.38 090

27510 ............ A Treatment of thigh fracture ................... 9.13 NA NA 7.16 7.22 1.26 NA NA 17.55 17.61 090

27511 ............ A Treatment of thigh fracture ................... 13.64 NA NA 12.39 13.36 1.91 NA NA 27.94 28.91 090

27513 ............ A Treatment of thigh fracture ................... 17.92 NA NA 14.77 15.43 2.51 NA NA 35.20 35.86 090

27514 ............ A Treatment of thigh fracture ................... 17.30 NA NA 14.24 14.96 2.41 NA NA 33.95 34.67 090

27516 ............ A Treat thigh fx growth plate ................... 5.37 7.49 6.93 5.77 5.64 0.74 13.60 13.04 11.88 11.75 090

65459

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

27517 ............ A Treat thigh fx growth plate ................... 8.78 9.64 9.35 7.70 7.90 1.22 19.64 19.35 17.70 17.90 090

27519 ............ A Treat thigh fx growth plate ................... 15.02 NA NA 12.63 12.91 2.09 NA NA 29.74 30.02 090

27520 ............ A Treat kneecap fracture ......................... 2.86 5.35 4.84 3.71 3.20 0.38 8.59 8.08 6.95 6.44 090

27524 ............ A Treat kneecap fracture ......................... 10.00 NA NA 8.44 9.14 1.40 NA NA 19.84 20.54 090

27530 ............ A Treat knee fracture ............................... 3.78 5.86 5.32 4.22 4.09 0.51 10.15 9.61 8.51 8.38 090

27532 ............ A Treat knee fracture ............................... 7.30 7.46 7.14 5.67 5.79 1.02 15.78 15.46 13.99 14.11 090

27535 ............ A Treat knee fracture ............................... 11.50 NA NA 11.25 11.61 1.61 NA NA 24.36 24.72 090

27536 ............ A Treat knee fracture ............................... 15.65 NA NA 11.55 11.84 2.19 NA NA 29.39 29.68 090

27538 ............ A Treat knee fracture(s) ........................... 4.87 7.41 6.47 5.38 4.95 0.67 12.95 12.01 10.92 10.49 090

27540 ............ A Treat knee fracture ............................... 13.10 NA NA 9.97 10.45 1.80 NA NA 24.87 25.35 090

27550 ............ A Treat knee dislocation .......................... 5.76 7.36 6.22 5.63 4.92 0.68 13.80 12.66 12.07 11.36 090

27552 ............ A Treat knee dislocation .......................... 7.90 NA NA 7.54 6.59 1.10 NA NA 16.54 15.59 090

27556 ............ A Treat knee dislocation .......................... 14.41 NA NA 13.65 13.62 2.01 NA NA 30.07 30.04 090

27557 ............ A Treat knee dislocation .......................... 16.77 NA NA 14.85 15.10 2.37 NA NA 33.99 34.24 090

27558 ............ A Treat knee dislocation .......................... 17.72 NA NA 15.08 15.27 2.51 NA NA 35.31 35.50 090

27560 ............ A Treat kneecap dislocation .................... 3.82 5.86 4.78 3.93 3.34 0.40 10.08 9.00 8.15 7.56 090

27562 ............ A Treat kneecap dislocation .................... 5.79 NA NA 5.36 5.43 0.69 NA NA 11.84 11.91 090

27566 ............ A Treat kneecap dislocation .................... 12.23 NA NA 9.80 10.22 1.73 NA NA 23.76 24.18 090

27570 ............ A Fixation of knee joint ............................ 1.74 NA NA 2.98 2.70 0.24 NA NA 4.96 4.68 010

27580 ............ A Fusion of knee ...................................... 19.37 NA NA 15.72 16.05 2.70 NA NA 37.79 38.12 090

27590 ............ A Amputate leg at thigh ........................... 12.03 NA NA 12.53 11.87 1.35 NA NA 25.91 25.25 090

27591 ............ A Amputate leg at thigh ........................... 12.68 NA NA 13.48 13.30 1.63 NA NA 27.79 27.61 090

27592 ............ A Amputate leg at thigh ........................... 10.02 NA NA 11.99 11.19 1.17 NA NA 23.18 22.38 090

27594 ............ A Amputation follow-up surgery ............... 6.92 NA NA 8.93 7.69 0.82 NA NA 16.67 15.43 090

27596 ............ A Amputation follow-up surgery ............... 10.60 NA NA 12.23 11.17 1.24 NA NA 24.07 23.01 090

27598 ............ A Amputate lower leg at knee ................. 10.53 NA NA 11.03 11.00 1.24 NA NA 22.80 22.77 090

27599 ............ C Leg surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

27600 ............ A Decompression of lower leg ................. 5.65 NA NA 8.30 7.15 0.68 NA NA 14.63 13.48 090

27601 ............ A Decompression of lower leg ................. 5.64 NA NA 7.26 6.36 0.69 NA NA 13.59 12.69 090

27602 ............ A Decompression of lower leg ................. 7.35 NA NA 8.37 7.38 0.85 NA NA 16.57 15.58 090

27603 ............ A Drain lower leg lesion ........................... 4.94 15.25 12.08 10.14 8.25 0.56 20.75 17.58 15.64 13.75 090

27604 ............ A Drain lower leg bursa ........................... 4.47 10.40 8.08 7.72 5.93 0.54 15.41 13.09 12.73 10.94 090

27605 ............ A Incision of achilles tendon .................... 2.87 9.66 7.57 3.62 3.04 0.38 12.91 10.82 6.87 6.29 010

27606 ............ A Incision of achilles tendon .................... 4.14 11.59 9.27 4.73 4.12 0.57 16.30 13.98 9.44 8.83 010

27607 ............ A Treat lower leg bone lesion .................. 7.97 NA NA 12.76 11.20 1.08 NA NA 21.81 20.25 090

27610 ............ A Explore/treat ankle joint ........................ 8.34 NA NA 9.82 9.38 1.15 NA NA 19.31 18.87 090

27612 ............ A Exploration of ankle joint ...................... 7.33 NA NA 7.55 7.83 1.01 NA NA 15.89 16.17 090

27613 ............ A Biopsy lower leg soft tissue ................. 2.17 5.55 4.35 3.04 2.37 0.16 7.88 6.68 5.37 4.70 010

27614 ............ A Biopsy lower leg soft tissue ................. 5.66 11.19 9.01 6.79 5.71 0.62 17.47 15.29 13.07 11.99 090

27615 ............ A Remove tumor, lower leg ..................... 12.56 NA NA 16.21 14.39 1.39 NA NA 30.16 28.34 090

27618 ............ A Remove lower leg lesion ...................... 5.09 10.82 8.69 6.35 5.33 0.54 16.45 14.32 11.98 10.96 090

27619 ............ A Remove lower leg lesion ...................... 8.40 13.17 11.00 8.85 7.76 1.01 22.58 20.41 18.26 17.17 090

27620 ............ A Explore/treat ankle joint ........................ 5.98 NA NA 7.30 7.11 0.83 NA NA 14.11 13.92 090

27625 ............ A Remove ankle joint lining ..................... 8.30 NA NA 9.11 9.20 1.16 NA NA 18.57 18.66 090

27626 ............ A Remove ankle joint lining ..................... 8.91 NA NA 9.78 10.00 1.23 NA NA 19.92 20.14 090

27630 ............ A Removal of tendon lesion .................... 4.80 11.16 9.21 6.56 5.76 0.60 16.56 14.61 11.96 11.16 090

27635 ............ A Remove lower leg bone lesion ............. 7.78 NA NA 10.30 9.91 1.06 NA NA 19.14 18.75 090

27637 ............ A Remove/graft leg bone lesion .............. 9.85 NA NA 11.57 10.98 1.38 NA NA 22.80 22.21 090

27638 ............ A Remove/graft leg bone lesion .............. 10.57 NA NA 12.06 11.53 1.47 NA NA 24.10 23.57 090

27640 ............ A Partial removal of tibia ......................... 11.37 NA NA 16.89 15.33 1.54 NA NA 29.80 28.24 090

27641 ............ A Partial removal of fibula ....................... 9.24 NA NA 14.87 13.09 1.22 NA NA 25.33 23.55 090

27645 ............ A Extensive lower leg surgery ................. 14.17 NA NA 16.86 15.80 1.98 NA NA 33.01 31.95 090

27646 ............ A Extensive lower leg surgery ................. 12.66 NA NA 15.44 14.50 1.55 NA NA 29.65 28.71 090

27647 ............ A Extensive ankle/heel surgery ............... 12.24 NA NA 10.73 10.75 1.64 NA NA 24.61 24.63 090

27648 ............ A Injection for ankle x-ray ........................ 0.96 8.98 6.88 0.35 0.40 0.05 9.99 7.89 1.36 1.41 000

27650 ............ A Repair achilles tendon .......................... 9.69 NA NA 8.93 9.14 1.35 NA NA 19.97 20.18 090

27652 ............ A Repair/graft achilles tendon ................. 10.33 NA NA 9.27 9.78 1.45 NA NA 21.05 21.56 090

27654 ............ A Repair of achilles tendon ..................... 10.02 NA NA 9.55 10.13 1.41 NA NA 20.98 21.56 090

27656 ............ A Repair leg fascia defect ....................... 4.57 12.31 10.10 6.00 5.36 0.48 17.36 15.15 11.05 10.41 090

27658 ............ A Repair of leg tendon, each ................... 4.98 14.14 11.70 8.23 7.26 0.68 19.80 17.36 13.89 12.92 090

27659 ............ A Repair of leg tendon, each ................... 6.81 16.73 14.14 9.20 8.49 0.96 24.50 21.91 16.97 16.26 090

27664 ............ A Repair of leg tendon, each ................... 4.59 11.88 9.84 8.14 7.03 0.63 17.10 15.06 13.36 12.25 090

27665 ............ A Repair of leg tendon, each ................... 5.40 13.35 11.36 8.23 7.52 0.75 19.50 17.51 14.38 13.67 090

27675 ............ A Repair lower leg tendons ..................... 7.18 NA NA 7.43 7.31 1.01 NA NA 15.62 15.50 090

27676 ............ A Repair lower leg tendons ..................... 8.42 NA NA 8.72 8.59 1.15 NA NA 18.29 18.16 090

27680 ............ A Release of lower leg tendon ................ 5.74 NA NA 7.46 6.71 0.80 NA NA 14.00 13.25 090

27681 ............ A Release of lower leg tendons .............. 6.82 NA NA 7.49 7.24 0.92 NA NA 15.23 14.98 090

27685 ............ A Revision of lower leg tendon ................ 6.50 10.15 8.65 7.65 6.78 0.91 17.56 16.06 15.06 14.19 090

27686 ............ A Revise lower leg tendons ..................... 7.46 16.51 14.16 9.24 8.71 1.05 25.02 22.67 17.75 17.22 090

27687 ............ A Revision of calf tendon ......................... 6.24 NA NA 7.74 7.28 0.88 NA NA 14.86 14.40 090

27690 ............ A Revise lower leg tendon ....................... 8.71 NA NA 8.69 8.35 1.22 NA NA 18.62 18.28 090

27691 ............ A Revise lower leg tendon ....................... 9.96 NA NA 10.27 9.84 1.40 NA NA 21.63 21.20 090

27692 ............ A Revise additional leg tendon ................ 1.87 NA NA 0.98 1.29 0.26 NA NA 3.11 3.42 ZZZ

27695 ............ A Repair of ankle ligament ...................... 6.51 NA NA 8.47 8.30 0.90 NA NA 15.88 15.71 090

27696 ............ A Repair of ankle ligaments .................... 8.27 NA NA 8.94 8.62 1.16 NA NA 18.37 18.05 090

27698 ............ A Repair of ankle ligament ...................... 9.36 NA NA 8.65 9.28 1.31 NA NA 19.32 19.95 090

27700 ............ A Revision of ankle joint .......................... 9.29 NA NA 7.33 8.27 1.24 NA NA 17.86 18.80 090

27702 ............ A Reconstruct ankle joint ......................... 13.67 NA NA 12.29 13.30 1.92 NA NA 27.88 28.89 090

27703 ............ A Reconstruction, ankle joint ................... 15.87 NA NA 13.62 13.97 2.24 NA NA 31.73 32.08 090

27704 ............ A Removal of ankle implant ..................... 7.62 NA NA 7.29 7.05 0.61 NA NA 15.52 15.28 090

27705 ............ A Incision of tibia ..................................... 10.38 NA NA 10.87 11.07 1.44 NA NA 22.69 22.89 090

27707 ............ A Incision of fibula ................................... 4.37 NA NA 7.71 7.07 0.60 NA NA 12.68 12.04 090

27709 ............ A Incision of tibia & fibula ........................ 9.95 NA NA 10.78 11.06 1.39 NA NA 22.12 22.40 090

65460

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

27712 ............ A Realignment of lower leg ..................... 14.25 NA NA 12.92 12.67 2.00 NA NA 29.17 28.92 090

27715 ............ A Revision of lower leg ............................ 14.39 NA NA 14.13 14.02 2.00 NA NA 30.52 30.41 090

27720 ............ A Repair of tibia ....................................... 11.79 NA NA 12.73 13.07 1.66 NA NA 26.18 26.52 090

27722 ............ A Repair/graft of tibia ............................... 11.82 NA NA 12.32 12.09 1.65 NA NA 25.79 25.56 090

27724 ............ A Repair/graft of tibia ............................... 14.99 NA NA 14.51 15.09 2.10 NA NA 31.60 32.18 090

27725 ............ A Repair of lower leg ............................... 15.59 NA NA 14.91 14.01 2.20 NA NA 32.70 31.80 090

27727 ............ A Repair of lower leg ............................... 14.01 NA NA 12.43 11.87 1.84 NA NA 28.28 27.72 090

27730 ............ A Repair of tibia epiphysis ....................... 7.41 14.49 11.84 9.62 8.19 0.75 22.65 20.00 17.78 16.35 090

27732 ............ A Repair of fibula epiphysis ..................... 5.32 11.89 10.23 8.26 7.51 0.63 17.84 16.18 14.21 13.46 090

27734 ............ A Repair lower leg epiphyses .................. 8.48 NA NA 9.04 8.83 0.85 NA NA 18.37 18.16 090

27740 ............ A Repair of leg epiphyses ....................... 9.30 15.25 13.71 10.51 10.15 1.31 25.86 24.32 21.12 20.76 090

27742 ............ A Repair of leg epiphyses ....................... 10.30 15.64 14.25 11.09 10.84 1.55 27.49 26.10 22.94 22.69 090

27745 ............ A Reinforce tibia ...................................... 10.07 NA NA 10.84 10.56 1.38 NA NA 22.29 22.01 090

27750 ............ A Treatment of tibia fracture .................... 3.19 5.51 5.07 3.89 3.85 0.43 9.13 8.69 7.51 7.47 090

27752 ............ A Treatment of tibia fracture .................... 5.84 7.97 7.36 5.99 5.87 0.82 14.63 14.02 12.65 12.53 090

27756 ............ A Treatment of tibia fracture .................... 6.78 NA NA 9.99 9.52 0.94 NA NA 17.71 17.24 090

27758 ............ A Treatment of tibia fracture .................... 11.67 NA NA 11.09 11.80 1.52 NA NA 24.28 24.99 090

27759 ............ A Treatment of tibia fracture .................... 13.76 NA NA 12.66 13.22 1.93 NA NA 28.35 28.91 090

27760 ............ A Treatment of ankle fracture .................. 3.01 5.29 4.67 3.76 3.17 0.39 8.69 8.07 7.16 6.57 090

27762 ............ A Treatment of ankle fracture .................. 5.25 7.52 6.55 5.57 5.09 0.71 13.48 12.51 11.53 11.05 090

27766 ............ A Treatment of ankle fracture .................. 8.36 NA NA 8.05 8.17 1.17 NA NA 17.58 17.70 090

27780 ............ A Treatment of fibula fracture .................. 2.65 5.23 4.46 3.56 2.94 0.33 8.21 7.44 6.54 5.92 090

27781 ............ A Treatment of fibula fracture .................. 4.40 6.42 5.71 4.48 4.25 0.57 11.39 10.68 9.45 9.22 090

27784 ............ A Treatment of fibula fracture .................. 7.11 NA NA 7.99 7.51 0.98 NA NA 16.08 15.60 090

27786 ............ A Treatment of ankle fracture .................. 2.84 5.26 4.63 3.68 3.10 0.37 8.47 7.84 6.89 6.31 090

27788 ............ A Treatment of ankle fracture .................. 4.45 6.42 5.70 4.52 3.84 0.61 11.48 10.76 9.58 8.90 090

27792 ............ A Treatment of ankle fracture .................. 7.66 NA NA 7.63 7.73 1.07 NA NA 16.36 16.46 090

27808 ............ A Treatment of ankle fracture .................. 2.83 6.23 5.43 4.35 4.02 0.38 9.44 8.64 7.56 7.23 090

27810 ............ A Treatment of ankle fracture .................. 5.13 7.49 6.99 5.55 5.53 0.71 13.33 12.83 11.39 11.37 090

27814 ............ A Treatment of ankle fracture .................. 10.68 NA NA 10.24 10.39 1.50 NA NA 22.42 22.57 090

27816 ............ A Treatment of ankle fracture .................. 2.89 5.84 5.32 4.38 4.15 0.37 9.10 8.58 7.64 7.41 090

27818 ............ A Treatment of ankle fracture .................. 5.50 7.69 7.41 5.72 5.93 0.74 13.93 13.65 11.96 12.17 090

27822 ............ A Treatment of ankle fracture .................. 9.20 NA NA 11.23 11.17 1.29 NA NA 21.72 21.66 090

27823 ............ A Treatment of ankle fracture .................. 11.80 NA NA 12.62 12.94 1.65 NA NA 26.07 26.39 090

27824 ............ A Treat lower leg fracture ........................ 2.89 6.25 5.63 4.35 4.13 0.39 9.53 8.91 7.63 7.41 090

27825 ............ A Treat lower leg fracture ........................ 6.19 8.07 7.82 6.16 6.39 0.85 15.11 14.86 13.20 13.43 090

27826 ............ A Treat lower leg fracture ........................ 8.54 NA NA 10.87 10.70 1.19 NA NA 20.60 20.43 090

27827 ............ A Treat lower leg fracture ........................ 14.06 NA NA 13.95 13.64 1.96 NA NA 29.97 29.66 090

27828 ............ A Treat lower leg fracture ........................ 16.23 NA NA 15.10 14.80 2.27 NA NA 33.60 33.30 090

27829 ............ A Treat lower leg joint .............................. 5.49 NA NA 7.87 7.54 0.77 NA NA 14.13 13.80 090

27830 ............ A Treat lower leg dislocation ................... 3.79 4.80 4.48 4.25 4.07 0.44 9.03 8.71 8.48 8.30 090

27831 ............ A Treat lower leg dislocation ................... 4.56 NA NA 4.96 4.80 0.61 NA NA 10.13 9.97 090

27832 ............ A Treat lower leg dislocation ................... 6.49 NA NA 7.75 7.36 0.91 NA NA 15.15 14.76 090

27840 ............ A Treat ankle dislocation ......................... 4.58 NA NA 5.55 4.67 0.47 NA NA 10.60 9.72 090

27842 ............ A Treat ankle dislocation ......................... 6.21 NA NA 4.89 4.27 0.76 NA NA 11.86 11.24 090

27846 ............ A Treat ankle dislocation ......................... 9.79 NA NA 9.76 9.65 1.36 NA NA 20.91 20.80 090

27848 ............ A Treat ankle dislocation ......................... 11.20 NA NA 10.89 10.44 1.55 NA NA 23.64 23.19 090

27860 ............ A Fixation of ankle joint ........................... 2.34 NA NA 3.48 2.99 0.31 NA NA 6.13 5.64 010

27870 ............ A Fusion of ankle joint ............................. 13.91 NA NA 12.91 13.30 1.95 NA NA 28.77 29.16 090

27871 ............ A Fusion of tibiofibular joint ..................... 9.17 NA NA 10.24 9.79 1.29 NA NA 20.70 20.25 090

27880 ............ A Amputation of lower leg ....................... 11.85 NA NA 11.75 11.08 1.38 NA NA 24.98 24.31 090

27881 ............ A Amputation of lower leg ....................... 12.34 NA NA 12.81 12.54 1.59 NA NA 26.74 26.47 090

27882 ............ A Amputation of lower leg ....................... 8.94 NA NA 12.92 11.69 1.03 NA NA 22.89 21.66 090

27884 ............ A Amputation follow-up surgery ............... 8.21 NA NA 10.37 8.69 0.95 NA NA 19.53 17.85 090

27886 ............ A Amputation follow-up surgery ............... 9.32 NA NA 10.99 10.19 1.13 NA NA 21.44 20.64 090

27888 ............ A Amputation of foot at ankle .................. 9.67 NA NA 10.32 10.32 1.26 NA NA 21.25 21.25 090

27889 ............ A Amputation of foot at ankle .................. 9.98 NA NA 10.65 10.28 1.19 NA NA 21.82 21.45 090

27892 ............ A Decompression of leg .......................... 7.39 NA NA 8.08 6.98 0.86 NA NA 16.33 15.23 090

27893 ............ A Decompression of leg .......................... 7.35 NA NA 8.38 7.20 0.90 NA NA 16.63 15.45 090

27894 ............ A Decompression of leg .......................... 10.49 NA NA 9.43 8.17 1.25 NA NA 21.17 19.91 090

27899 ............ C Leg/ankle surgery procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

28001 ............ A Drainage of bursa of foot ..................... 2.73 4.58 3.58 2.84 2.20 0.31 7.62 6.62 5.88 5.24 010

28002 ............ A Treatment of foot infection ................... 4.62 6.18 5.25 4.09 3.68 0.56 11.36 10.43 9.27 8.86 010

28003 ............ A Treatment of foot infection ................... 8.41 9.97 8.43 9.86 7.87 1.03 19.41 17.87 19.30 17.31 090

28005 ............ A Treat foot bone lesion .......................... 8.68 NA NA 9.49 8.23 1.14 NA NA 19.31 18.05 090

28008 ............ A Incision of foot fascia ........................... 4.45 6.80 5.83 5.72 5.02 0.56 11.81 10.84 10.73 10.03 090

28010 ............ A Incision of toe tendon ........................... 2.84 6.20 5.63 4.50 3.87 0.39 9.43 8.86 7.73 7.10 090

28011 ............ A Incision of toe tendons ......................... 4.14 8.18 6.62 6.03 4.76 0.58 12.90 11.34 10.75 9.48 090

28020 ............ A Exploration of foot joint ........................ 5.01 8.29 7.41 5.73 5.49 0.64 13.94 13.06 11.38 11.14 090

28022 ............ A Exploration of foot joint ........................ 4.67 7.49 6.36 5.57 4.55 0.62 12.78 11.65 10.86 9.84 090

28024 ............ A Exploration of toe joint ......................... 4.38 7.22 6.06 5.87 4.73 0.50 12.10 10.94 10.75 9.61 090

28030 ............ A Removal of foot nerve .......................... 6.15 NA NA 3.42 3.63 0.85 NA NA 10.42 10.63 090

28035 ............ A Decompression of tibia nerve .............. 5.09 8.79 8.27 4.93 5.22 0.71 14.59 14.07 10.73 11.02 090

28043 ............ A Excision of foot lesion .......................... 3.54 6.50 5.35 4.60 3.92 0.45 10.49 9.34 8.59 7.91 090

28045 ............ A Excision of foot lesion .......................... 4.72 6.87 6.24 5.17 4.96 0.62 12.21 11.58 10.51 10.30 090

28046 ............ A Resection of tumor, foot ....................... 10.18 11.78 10.29 10.23 9.13 1.13 23.09 21.60 21.54 20.44 090

28050 ............ A Biopsy of foot joint lining ...................... 4.25 5.95 5.51 5.18 4.93 0.55 10.75 10.31 9.98 9.73 090

28052 ............ A Biopsy of foot joint lining ...................... 3.94 7.42 6.60 5.25 4.46 0.51 11.87 11.05 9.70 8.91 090

28054 ............ A Biopsy of toe joint lining ....................... 3.45 7.01 5.87 4.99 4.35 0.45 10.91 9.77 8.89 8.25 090

28060 ............ A Partial removal, foot fascia ................... 5.23 7.61 6.85 5.82 5.51 0.69 13.53 12.77 11.74 11.43 090

28062 ............ A Removal of foot fascia ......................... 6.52 8.52 8.31 5.86 6.31 0.85 15.89 15.68 13.23 13.68 090

28070 ............ A Removal of foot joint lining ................... 5.10 7.75 7.03 5.38 5.25 0.68 13.53 12.81 11.16 11.03 090

28072 ............ A Removal of foot joint lining ................... 4.58 7.27 6.32 6.08 5.43 0.64 12.49 11.54 11.30 10.65 090

65461

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

28080 ............ A Removal of foot lesion ......................... 3.58 6.67 6.11 4.81 4.71 0.50 10.75 10.19 8.89 8.79 090

28086 ............ A Excise foot tendon sheath .................... 4.78 10.76 8.92 6.67 5.85 0.66 16.20 14.36 12.11 11.29 090

28088 ............ A Excise foot tendon sheath .................... 3.86 7.94 6.94 5.80 5.33 0.52 12.32 11.32 10.18 9.71 090

28090 ............ A Removal of foot lesion ......................... 4.41 6.96 6.04 5.03 4.59 0.57 11.94 11.02 10.01 9.57 090

28092 ............ A Removal of toe lesions ......................... 3.64 7.43 6.12 5.32 4.54 0.46 11.53 10.22 9.42 8.64 090

28100 ............ A Removal of ankle/heel lesion ............... 5.66 10.71 9.28 6.99 6.49 0.76 17.13 15.70 13.41 12.91 090

28102 ............ A Remove/graft foot lesion ...................... 7.73 NA NA 7.90 7.78 0.97 NA NA 16.60 16.48 090

28103 ............ A Remove/graft foot lesion ...................... 6.50 10.68 9.53 6.98 6.76 0.89 18.07 16.92 14.37 14.15 090

28104 ............ A Removal of foot lesion ......................... 5.12 8.02 7.19 6.16 5.80 0.69 13.83 13.00 11.97 11.61 090

28106 ............ A Remove/graft foot lesion ...................... 7.16 NA NA 5.83 6.12 1.01 NA NA 14.00 14.29 090

28107 ............ A Remove/graft foot lesion ...................... 5.56 8.54 7.72 6.23 5.99 0.74 14.84 14.02 12.53 12.29 090

28108 ............ A Removal of toe lesions ......................... 4.16 6.25 5.83 4.74 4.13 0.52 10.93 10.51 9.42 8.81 090

28110 ............ A Part removal of metatarsal ................... 4.08 7.68 6.71 5.99 5.44 0.49 12.25 11.28 10.56 10.01 090

28111 ............ A Part removal of metatarsal ................... 5.01 10.30 9.09 6.96 6.59 0.63 15.94 14.73 12.60 12.23 090

28112 ............ A Part removal of metatarsal ................... 4.49 9.00 7.83 6.61 6.03 0.60 14.09 12.92 11.70 11.12 090

28113 ............ A Part removal of metatarsal ................... 4.79 8.22 7.37 6.35 5.97 0.63 13.64 12.79 11.77 11.39 090

28114 ............ A Removal of metatarsal heads .............. 9.79 14.40 13.29 9.94 9.94 1.36 25.55 24.44 21.09 21.09 090

28116 ............ A Revision of foot .................................... 7.75 8.00 7.49 6.35 6.25 1.03 16.78 16.27 15.13 15.03 090

28118 ............ A Removal of heel bone .......................... 5.96 9.13 8.40 6.30 6.28 0.79 15.88 15.15 13.05 13.03 090

28119 ............ A Removal of heel spur ........................... 5.39 7.33 6.97 5.38 5.51 0.74 13.46 13.10 11.51 11.64 090

28120 ............ A Part removal of ankle/heel ................... 5.40 11.67 10.12 8.70 7.89 0.69 17.76 16.21 14.79 13.98 090

28122 ............ A Partial removal of foot bone ................. 7.29 10.13 8.81 8.40 7.52 0.96 18.38 17.06 16.65 15.77 090

28124 ............ A Partial removal of toe ........................... 4.81 7.79 6.96 6.63 5.53 0.65 13.25 12.42 12.09 10.99 090

28126 ............ A Partial removal of toe ........................... 3.52 6.68 6.09 6.12 5.13 0.49 10.69 10.10 10.13 9.14 090

28130 ............ A Removal of ankle bone ........................ 8.11 NA NA 7.84 7.79 1.11 NA NA 17.06 17.01 090

28140 ............ A Removal of metatarsal ......................... 6.91 10.71 9.37 7.47 6.94 0.84 18.46 17.12 15.22 14.69 090

28150 ............ A Removal of toe ..................................... 4.09 7.74 6.70 6.32 5.63 0.52 12.35 11.31 10.93 10.24 090

28153 ............ A Partial removal of toe ........................... 3.66 6.76 6.15 5.22 4.46 0.49 10.91 10.30 9.37 8.61 090

28160 ............ A Partial removal of toe ........................... 3.74 7.24 6.55 6.29 5.28 0.51 11.49 10.80 10.54 9.53 090

28171 ............ A Extensive foot surgery .......................... 9.60 NA NA 8.55 8.58 1.13 NA NA 19.28 19.31 090

28173 ............ A Extensive foot surgery .......................... 8.80 10.93 9.76 7.93 7.51 1.04 20.77 19.60 17.77 17.35 090

28175 ............ A Extensive foot surgery .......................... 6.05 7.97 7.44 6.18 6.10 0.75 14.77 14.24 12.98 12.90 090

28190 ............ A Removal of foot foreign body ............... 1.96 5.37 4.17 3.13 2.42 0.16 7.49 6.29 5.25 4.54 010

28192 ............ A Removal of foot foreign body ............... 4.64 6.87 5.68 5.06 4.33 0.52 12.03 10.84 10.22 9.49 090

28193 ............ A Removal of foot foreign body ............... 5.73 7.25 6.08 5.87 5.05 0.63 13.61 12.44 12.23 11.41 090

28200 ............ A Repair of foot tendon ........................... 4.60 7.40 6.92 5.45 5.46 0.59 12.59 12.11 10.64 10.65 090

28202 ............ A Repair/graft of foot tendon ................... 6.84 10.71 9.61 6.34 6.34 0.86 18.41 17.31 14.04 14.04 090

28208 ............ A Repair of foot tendon ........................... 4.37 7.15 6.13 5.54 4.92 0.59 12.11 11.09 10.50 9.88 090

28210 ............ A Repair/graft of foot tendon ................... 6.35 8.45 7.86 5.70 5.80 0.77 15.57 14.98 12.82 12.92 090

28220 ............ A Release of foot tendon ......................... 4.53 6.49 5.92 5.53 4.67 0.63 11.65 11.08 10.69 9.83 090

28222 ............ A Release of foot tendons ....................... 5.62 6.97 6.97 6.48 5.73 0.77 13.36 13.36 12.87 12.12 090

28225 ............ A Release of foot tendon ......................... 3.66 6.37 5.42 5.05 4.43 0.50 10.53 9.58 9.21 8.59 090

28226 ............ A Release of foot tendons ....................... 4.53 6.41 5.73 6.41 5.73 0.62 11.56 10.88 11.56 10.88 090

28230 ............ A Incision of foot tendon(s) ...................... 4.24 6.69 5.68 6.17 4.96 0.59 11.52 10.51 11.00 9.79 090

28232 ............ A Incision of toe tendon ........................... 3.39 6.66 5.43 5.78 4.55 0.48 10.53 9.30 9.65 8.42 090

28234 ............ A Incision of foot tendon .......................... 3.37 6.72 5.46 5.28 4.17 0.46 10.55 9.29 9.11 8.00 090

28238 ............ A Revision of foot tendon ........................ 7.73 10.27 9.67 6.87 7.12 1.08 19.08 18.48 15.68 15.93 090

28240 ............ A Release of big toe ................................ 4.36 6.66 5.57 5.67 4.83 0.61 11.63 10.54 10.64 9.80 090

28250 ............ A Revision of foot fascia .......................... 5.92 8.22 7.38 6.56 6.13 0.81 14.95 14.11 13.29 12.86 090

28260 ............ A Release of midfoot joint ....................... 7.96 7.81 7.06 6.77 6.28 1.08 16.85 16.10 15.81 15.32 090

28261 ............ A Revision of foot tendon ........................ 11.73 9.61 8.81 8.76 8.17 1.66 23.00 22.20 22.15 21.56 090

28262 ............ A Revision of foot and ankle ................... 15.83 16.96 15.95 14.47 14.09 2.22 35.01 34.00 32.52 32.14 090

28264 ............ A Release of midfoot joint ....................... 10.35 10.97 10.82 10.97 10.82 1.46 22.78 22.63 22.78 22.63 090

28270 ............ A Release of foot contracture .................. 4.76 7.16 6.08 6.31 5.09 0.67 12.59 11.51 11.74 10.52 090

28272 ............ A Release of toe joint, each .................... 3.80 6.16 5.17 4.71 3.81 0.52 10.48 9.49 9.03 8.13 090

28280 ............ A Fusion of toes ....................................... 5.19 8.67 7.11 6.23 5.28 0.72 14.58 13.02 12.14 11.19 090

28285 ............ A Repair of hammertoe ........................... 4.59 7.36 6.71 5.78 5.52 0.64 12.59 11.94 11.01 10.75 090

28286 ............ A Repair of hammertoe ........................... 4.56 7.03 6.25 5.83 5.35 0.64 12.23 11.45 11.03 10.55 090

28288 ............ A Partial removal of foot bone ................. 4.74 8.06 7.06 7.21 6.43 0.65 13.45 12.45 12.60 11.82 090

28289 ............ A Repair hallux rigidus ............................. 7.04 9.49 9.49 7.90 7.90 0.96 17.49 17.49 15.90 15.90 090

28290 ............ A Correction of bunion ............................. 5.66 8.97 8.18 7.98 7.44 0.79 15.42 14.63 14.43 13.89 090

28292 ............ A Correction of bunion ............................. 7.04 8.66 8.41 6.78 7.00 0.98 16.68 16.43 14.80 15.02 090

28293 ............ A Correction of bunion ............................. 9.15 9.77 9.92 7.07 7.89 1.28 20.20 20.35 17.50 18.32 090

28294 ............ A Correction of bunion ............................. 8.56 9.11 9.32 7.06 7.78 1.16 18.83 19.04 16.78 17.50 090

28296 ............ A Correction of bunion ............................. 9.18 9.80 9.74 7.71 8.17 1.28 20.26 20.20 18.17 18.63 090

28297 ............ A Correction of bunion ............................. 9.18 12.14 11.55 9.38 9.48 1.31 22.63 22.04 19.87 19.97 090

28298 ............ A Correction of bunion ............................. 7.94 8.69 8.89 7.42 7.93 1.12 17.75 17.95 16.48 16.99 090

28299 ............ A Correction of bunion ............................. 8.88 9.63 9.87 7.56 8.32 1.24 19.75 19.99 17.68 18.44 090

28300 ............ A Incision of heel bone ............................ 9.54 14.49 12.64 8.89 8.44 1.31 25.34 23.49 19.74 19.29 090

28302 ............ A Incision of ankle bone .......................... 9.55 18.57 16.34 8.64 8.89 1.15 29.27 27.04 19.34 19.59 090

28304 ............ A Incision of midfoot bones ..................... 9.16 9.14 8.60 7.05 7.04 1.00 19.30 18.76 17.21 17.20 090

28305 ............ A Incise/graft midfoot bones .................... 10.50 14.48 13.53 8.86 9.32 0.55 25.53 24.58 19.91 20.37 090

28306 ............ A Incision of metatarsal ........................... 5.86 9.15 8.10 5.74 5.55 0.81 15.82 14.77 12.41 12.22 090

28307 ............ A Incision of metatarsal ........................... 6.33 15.34 13.10 7.61 7.30 0.71 22.38 20.14 14.65 14.34 090

28308 ............ A Incision of metatarsal ........................... 5.29 6.77 6.63 4.85 5.19 0.74 12.80 12.66 10.88 11.22 090

28309 ............ A Incision of metatarsals ......................... 12.78 NA NA 10.35 9.63 1.64 NA NA 24.77 24.05 090

28310 ............ A Revision of big toe ............................... 5.43 7.96 7.10 6.04 5.66 0.76 14.15 13.29 12.23 11.85 090

28312 ............ A Revision of toe ..................................... 4.55 7.58 6.92 6.65 6.23 0.62 12.75 12.09 11.82 11.40 090

28313 ............ A Repair deformity of toe ......................... 5.01 7.96 6.67 7.96 6.32 0.68 13.65 12.36 13.65 12.01 090

28315 ............ A Removal of sesamoid bone ................. 4.86 6.62 6.12 4.98 4.89 0.66 12.14 11.64 10.50 10.41 090

28320 ............ A Repair of foot bones ............................. 9.18 NA NA 8.06 8.40 1.27 NA NA 18.51 18.85 090

28322 ............ A Repair of metatarsals ........................... 8.34 11.48 9.88 8.14 7.37 1.17 20.99 19.39 17.65 16.88 090

28340 ............ A Resect enlarged toe tissue .................. 6.98 8.72 8.26 5.63 5.94 0.98 16.68 16.22 13.59 13.90 090

65462

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

28341 ............ A Resect enlarged toe ............................. 8.41 8.00 8.08 6.47 6.93 1.18 17.59 17.67 16.06 16.52 090

28344 ............ A Repair extra toe(s) ............................... 4.26 12.28 10.22 4.98 4.74 0.60 17.14 15.08 9.84 9.60 090

28345 ............ A Repair webbed toe(s) ........................... 5.92 8.69 7.97 6.36 6.22 0.84 15.45 14.73 13.12 12.98 090

28360 ............ A Reconstruct cleft foot ........................... 13.34 NA NA 12.16 12.35 1.88 NA NA 27.38 27.57 090

28400 ............ A Treatment of heel fracture .................... 2.16 5.60 4.90 4.61 3.81 0.29 8.05 7.35 7.06 6.26 090

28405 ............ A Treatment of heel fracture .................... 4.57 6.56 5.98 5.71 5.34 0.63 11.76 11.18 10.91 10.54 090

28406 ............ A Treatment of heel fracture .................... 6.31 NA NA 8.06 7.70 0.87 NA NA 15.24 14.88 090

28415 ............ A Treat heel fracture ................................ 15.97 NA NA 14.47 13.30 2.24 NA NA 32.68 31.51 090

28420 ............ A Treat/graft heel fracture ........................ 16.64 NA NA 14.54 13.86 2.29 NA NA 33.47 32.79 090

28430 ............ A Treatment of ankle fracture .................. 2.09 5.19 4.56 4.13 3.43 0.27 7.55 6.92 6.49 5.79 090

28435 ............ A Treatment of ankle fracture .................. 3.40 5.78 5.25 4.59 4.36 0.47 9.65 9.12 8.46 8.23 090

28436 ............ A Treatment of ankle fracture .................. 4.71 NA NA 7.29 6.61 0.66 NA NA 12.66 11.98 090

28445 ............ A Treat ankle fracture .............................. 9.33 NA NA 9.62 9.60 1.29 NA NA 20.24 20.22 090

28450 ............ A Treat midfoot fracture, each ................. 1.90 5.06 4.30 3.98 3.24 0.25 7.21 6.45 6.13 5.39 090

28455 ............ A Treat midfoot fracture, each ................. 3.09 5.52 4.83 4.86 3.99 0.43 9.04 8.35 8.38 7.51 090

28456 ............ A Treat midfoot fracture ........................... 2.68 NA NA 5.60 4.82 0.36 NA NA 8.64 7.86 090

28465 ............ A Treat midfoot fracture, each ................. 7.01 NA NA 7.27 6.96 0.87 NA NA 15.15 14.84 090

28470 ............ A Treat metatarsal fracture ...................... 1.99 4.40 3.79 3.29 2.71 0.26 6.65 6.04 5.54 4.96 090

28475 ............ A Treat metatarsal fracture ...................... 2.97 5.06 4.43 4.26 3.51 0.41 8.44 7.81 7.64 6.89 090

28476 ............ A Treat metatarsal fracture ...................... 3.38 NA NA 5.90 5.34 0.46 NA NA 9.74 9.18 090

28485 ............ A Treat metatarsal fracture ...................... 5.71 NA NA 7.07 6.57 0.80 NA NA 13.58 13.08 090

28490 ............ A Treat big toe fracture ............................ 1.09 2.44 2.08 2.00 1.62 0.13 3.66 3.30 3.22 2.84 090

28495 ............ A Treat big toe fracture ............................ 1.58 2.56 2.23 2.04 1.68 0.19 4.33 4.00 3.81 3.45 090

28496 ............ A Treat big toe fracture ............................ 2.33 9.87 7.97 4.20 3.71 0.32 12.52 10.62 6.85 6.36 090

28505 ............ A Treat big toe fracture ............................ 3.81 10.36 8.58 5.93 5.26 0.50 14.67 12.89 10.24 9.57 090

28510 ............ A Treatment of toe fracture ..................... 1.09 2.16 1.86 1.97 1.60 0.13 3.38 3.08 3.19 2.82 090

28515 ............ A Treatment of toe fracture ..................... 1.46 2.39 2.10 1.99 1.65 0.17 4.02 3.73 3.62 3.28 090

28525 ............ A Treat toe fracture .................................. 3.32 9.94 8.02 5.74 4.87 0.44 13.70 11.78 9.50 8.63 090

28530 ............ A Treat sesamoid bone fracture .............. 1.06 2.69 2.29 2.32 1.88 0.13 3.88 3.48 3.51 3.07 090

28531 ............ A Treat sesamoid bone fracture .............. 2.35 11.17 8.90 3.34 3.02 0.33 13.85 11.58 6.02 5.70 090

28540 ............ A Treat foot dislocation ............................ 2.04 3.31 2.65 3.31 2.57 0.24 5.59 4.93 5.59 4.85 090

28545 ............ A Treat foot dislocation ............................ 2.45 3.58 3.04 3.58 3.04 0.33 6.36 5.82 6.36 5.82 090

28546 ............ A Treat foot dislocation ............................ 3.20 5.15 4.61 5.15 4.61 0.46 8.81 8.27 8.81 8.27 090

28555 ............ A Repair foot dislocation .......................... 6.30 13.54 11.67 7.83 7.39 0.88 20.72 18.85 15.01 14.57 090

28570 ............ A Treat foot dislocation ............................ 1.66 3.60 3.13 3.60 2.92 0.22 5.48 5.01 5.48 4.80 090

28575 ............ A Treat foot dislocation ............................ 3.31 6.00 5.25 4.92 4.44 0.45 9.76 9.01 8.68 8.20 090

28576 ............ A Treat foot dislocation ............................ 4.17 13.53 10.90 6.03 5.28 0.56 18.26 15.63 10.76 10.01 090

28585 ............ A Repair foot dislocation .......................... 7.99 8.46 7.69 7.57 7.02 1.13 17.58 16.81 16.69 16.14 090

28600 ............ A Treat foot dislocation ............................ 1.89 4.11 3.27 3.95 3.06 0.24 6.24 5.40 6.08 5.19 090

28605 ............ A Treat foot dislocation ............................ 2.71 4.47 3.97 4.47 3.97 0.35 7.53 7.03 7.53 7.03 090

28606 ............ A Treat foot dislocation ............................ 4.90 15.49 12.57 6.59 5.89 0.68 21.07 18.15 12.17 11.47 090

28615 ............ A Repair foot dislocation .......................... 7.77 NA NA 8.79 7.94 1.09 NA NA 17.65 16.80 090

28630 ............ A Treat toe dislocation ............................. 1.70 2.04 1.81 2.04 1.67 0.17 3.91 3.68 3.91 3.54 010

28635 ............ A Treat toe dislocation ............................. 1.91 2.40 2.19 2.40 2.00 0.24 4.55 4.34 4.55 4.15 010

28636 ............ A Treat toe dislocation ............................. 2.77 6.52 5.59 3.11 3.03 0.39 9.68 8.75 6.27 6.19 010

28645 ............ A Repair toe dislocation ........................... 4.22 5.87 5.28 3.96 3.85 0.58 10.67 10.08 8.76 8.65 090

28660 ............ A Treat toe dislocation ............................. 1.23 2.87 2.32 2.25 1.86 0.11 4.21 3.66 3.59 3.20 010

28665 ............ A Treat toe dislocation ............................. 1.92 2.53 2.16 2.53 2.03 0.24 4.69 4.32 4.69 4.19 010

28666 ............ A Treat toe dislocation ............................. 2.66 6.47 5.52 2.29 2.38 0.38 9.51 8.56 5.33 5.42 010

28675 ............ A Repair of toe dislocation ...................... 2.92 8.72 7.36 4.46 4.16 0.41 12.05 10.69 7.79 7.49 090

28705 ............ A Fusion of foot bones ............................ 15.21 NA NA 12.61 13.56 2.13 NA NA 29.95 30.90 090

28715 ............ A Fusion of foot bones ............................ 13.10 NA NA 11.78 12.18 1.84 NA NA 26.72 27.12 090

28725 ............ A Fusion of foot bones ............................ 11.61 NA NA 10.64 10.54 1.63 NA NA 23.88 23.78 090

28730 ............ A Fusion of foot bones ............................ 10.76 NA NA 9.92 9.88 1.51 NA NA 22.19 22.15 090

28735 ............ A Fusion of foot bones ............................ 10.85 NA NA 10.21 10.31 1.51 NA NA 22.57 22.67 090

28737 ............ A Revision of foot bones ......................... 9.64 NA NA 8.10 8.48 1.36 NA NA 19.10 19.48 090

28740 ............ A Fusion of foot bones ............................ 8.02 13.29 11.36 8.26 7.59 1.13 22.44 20.51 17.41 16.74 090

28750 ............ A Fusion of big toe joint ........................... 7.30 14.54 12.35 8.49 7.81 1.03 22.87 20.68 16.82 16.14 090

28755 ............ A Fusion of big toe joint ........................... 4.74 8.49 7.37 5.92 5.44 0.66 13.89 12.77 11.32 10.84 090

28760 ............ A Fusion of big toe joint ........................... 7.75 9.59 8.66 7.00 6.72 1.07 18.41 17.48 15.82 15.54 090

28800 ............ A Amputation of midfoot .......................... 8.21 NA NA 8.64 8.29 0.98 NA NA 17.83 17.48 090

28805 ............ A Amputation thru metatarsal .................. 8.39 NA NA 8.88 8.38 0.97 NA NA 18.24 17.74 090

28810 ............ A Amputation toe & metatarsal ................ 6.21 NA NA 7.69 6.83 0.70 NA NA 14.60 13.74 090

28820 ............ A Amputation of toe ................................. 4.41 10.94 8.91 6.78 5.79 0.51 15.86 13.83 11.70 10.71 090

28825 ............ A Partial amputation of toe ...................... 3.59 10.01 8.16 6.57 5.58 0.43 14.03 12.18 10.59 9.60 090

28899 ............ C Foot/toes surgery procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

29000 ............ A Application of body cast ....................... 2.25 2.69 2.52 1.33 1.50 0.30 5.24 5.07 3.88 4.05 000

29010 ............ A Application of body cast ....................... 2.06 2.54 2.54 1.26 1.56 0.27 4.87 4.87 3.59 3.89 000

29015 ............ A Application of body cast ....................... 2.41 2.54 2.54 1.15 1.18 0.21 5.16 5.16 3.77 3.80 000

29020 ............ A Application of body cast ....................... 2.11 2.47 2.35 0.97 0.98 0.16 4.74 4.62 3.24 3.25 000

29025 ............ A Application of body cast ....................... 2.40 2.84 2.33 1.44 1.18 0.26 5.50 4.99 4.10 3.84 000

29035 ............ A Application of body cast ....................... 1.77 2.50 2.41 1.08 1.08 0.24 4.51 4.42 3.09 3.09 000

29040 ............ A Application of body cast ....................... 2.22 1.57 1.73 1.38 1.58 0.35 4.14 4.30 3.95 4.15 000

29044 ............ A Application of body cast ....................... 2.12 2.71 2.60 1.31 1.55 0.29 5.12 5.01 3.72 3.96 000

29046 ............ A Application of body cast ....................... 2.41 2.86 2.75 1.38 1.64 0.34 5.61 5.50 4.13 4.39 000

29049 ............ A Application of figure eight ..................... 0.89 1.54 1.27 0.50 0.43 0.12 2.55 2.28 1.51 1.44 000

29055 ............ A Application of shoulder cast ................. 1.78 2.16 1.95 1.07 1.13 0.24 4.18 3.97 3.09 3.15 000

29058 ............ A Application of shoulder cast ................. 1.31 1.81 1.54 0.63 0.65 0.14 3.26 2.99 2.08 2.10 000

29065 ............ A Application of long arm cast ................. 0.87 1.30 1.19 0.54 0.52 0.12 2.29 2.18 1.53 1.51 000

29075 ............ A Application of forearm cast .................. 0.77 1.24 1.10 0.47 0.44 0.11 2.12 1.98 1.35 1.32 000

29085 ............ A Apply hand/wrist cast ........................... 0.87 1.29 1.10 0.47 0.42 0.11 2.27 2.08 1.45 1.40 000

29105 ............ A Apply long arm splint ............................ 0.87 1.29 1.10 0.40 0.37 0.11 2.27 2.08 1.38 1.35 000

29125 ............ A Apply forearm splint ............................. 0.59 1.14 0.96 0.29 0.27 0.06 1.79 1.61 0.94 0.92 000

65463

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

29126 ............ A Apply forearm splint ............................. 0.77 1.91 1.54 0.44 0.39 0.06 2.74 2.37 1.27 1.22 000

29130 ............ A Application of finger splint .................... 0.50 0.91 0.73 0.27 0.23 0.05 1.46 1.28 0.82 0.78 000

29131 ............ A Application of finger splint .................... 0.55 1.80 1.46 0.38 0.34 0.03 2.38 2.04 0.96 0.92 000

29200 ............ A Strapping of chest ................................ 0.65 1.36 1.09 0.29 0.26 0.04 2.05 1.78 0.98 0.95 000

29220 ............ A Strapping of low back ........................... 0.64 1.05 0.89 0.33 0.30 0.07 1.76 1.60 1.04 1.01 000

29240 ............ A Strapping of shoulder ........................... 0.71 1.43 1.15 0.31 0.31 0.05 2.19 1.91 1.07 1.07 000

29260 ............ A Strapping of elbow or wrist .................. 0.55 1.15 0.93 0.27 0.24 0.04 1.74 1.52 0.86 0.83 000

29280 ............ A Strapping of hand or finger .................. 0.51 1.30 1.03 0.27 0.23 0.04 1.85 1.58 0.82 0.78 000

29305 ............ A Application of hip cast .......................... 2.03 2.44 2.34 1.28 1.47 0.29 4.76 4.66 3.60 3.79 000

29325 ............ A Application of hip casts ........................ 2.32 2.59 2.47 1.43 1.60 0.31 5.22 5.10 4.06 4.23 000

29345 ............ A Application of long leg cast .................. 1.40 1.68 1.54 0.84 0.77 0.19 3.27 3.13 2.43 2.36 000

29355 ............ A Application of long leg cast .................. 1.53 1.69 1.57 0.87 0.80 0.20 3.42 3.30 2.60 2.53 000

29358 ............ A Apply long leg cast brace ..................... 1.43 1.86 1.82 0.93 0.91 0.19 3.48 3.44 2.55 2.53 000

29365 ............ A Application of long leg cast .................. 1.18 1.52 1.37 0.71 0.65 0.17 2.87 2.72 2.06 2.00 000

29405 ............ A Apply short leg cast .............................. 0.86 1.20 1.12 0.52 0.50 0.12 2.18 2.10 1.50 1.48 000

29425 ............ A Apply short leg cast .............................. 1.01 1.14 1.12 0.56 0.55 0.14 2.29 2.27 1.71 1.70 000

29435 ............ A Apply short leg cast .............................. 1.18 1.79 1.66 0.79 0.75 0.17 3.14 3.01 2.14 2.10 000

29440 ............ A Addition of walker to cast ..................... 0.57 0.91 0.75 0.32 0.27 0.07 1.55 1.39 0.96 0.91 000

29445 ............ A Apply rigid leg cast ............................... 1.78 2.00 1.96 0.86 1.11 0.24 4.02 3.98 2.88 3.13 000

29450 ............ A Application of leg cast .......................... 1.02 1.20 1.01 0.57 0.48 0.13 2.35 2.16 1.72 1.63 000

29505 ............ A Application, long leg splint ................... 0.69 1.60 1.36 0.42 0.47 0.06 2.35 2.11 1.17 1.22 000

29515 ............ A Application lower leg splint ................... 0.73 1.15 0.99 0.42 0.38 0.07 1.95 1.79 1.22 1.18 000

29520 ............ A Strapping of hip .................................... 0.54 1.54 1.25 0.38 0.34 0.02 2.10 1.81 0.94 0.90 000

29530 ............ A Strapping of knee ................................. 0.57 1.22 1.01 0.27 0.30 0.04 1.83 1.62 0.88 0.91 000

29540 ............ A Strapping of ankle ................................ 0.51 0.51 0.47 0.26 0.24 0.04 1.06 1.02 0.81 0.79 000

29550 ............ A Strapping of toes .................................. 0.47 0.49 0.44 0.23 0.21 0.05 1.01 0.96 0.75 0.73 000

29580 ............ A Application of paste boot ...................... 0.57 0.84 0.85 0.31 0.28 0.05 1.46 1.47 0.93 0.90 000

29590 ............ A Application of foot splint ....................... 0.76 0.77 0.65 0.41 0.35 0.06 1.59 1.47 1.23 1.17 000

29700 ............ A Removal/revision of cast ...................... 0.57 0.81 0.70 0.31 0.28 0.07 1.45 1.34 0.95 0.92 000

29705 ............ A Removal/revision of cast ...................... 0.76 0.98 0.83 0.41 0.36 0.10 1.84 1.69 1.27 1.22 000

29710 ............ A Removal/revision of cast ...................... 1.34 1.72 1.41 0.85 0.70 0.17 3.23 2.92 2.36 2.21 000

29715 ............ A Removal/revision of cast ...................... 0.94 3.64 2.96 0.69 0.64 0.08 4.66 3.98 1.71 1.66 000

29720 ............ A Repair of body cast .............................. 0.68 1.46 1.16 0.49 0.40 0.10 2.24 1.94 1.27 1.18 000

29730 ............ A Windowing of cast ................................ 0.75 0.93 0.77 0.39 0.33 0.10 1.78 1.62 1.24 1.18 000

29740 ............ A Wedging of cast ................................... 1.12 1.36 1.12 0.53 0.45 0.15 2.63 2.39 1.80 1.72 000

29750 ............ A Wedging of clubfoot cast ...................... 1.26 1.56 1.31 0.58 0.50 0.16 2.98 2.73 2.00 1.92 000

29799 ............ C Casting/strapping procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

29800 ............ A Jaw arthroscopy/surgery ...................... 6.43 NA NA 8.44 7.42 0.84 NA NA 15.71 14.69 090

29804 ............ A Jaw arthroscopy/surgery ...................... 8.14 NA NA 8.78 9.01 0.66 NA NA 17.58 17.81 090

29815 ............ A Shoulder arthroscopy ........................... 5.89 NA NA 7.32 6.80 0.83 NA NA 14.04 13.52 090

29819 ............ A Shoulder arthroscopy/surgery .............. 7.62 NA NA 9.18 9.16 1.07 NA NA 17.87 17.85 090

29820 ............ A Shoulder arthroscopy/surgery .............. 7.07 NA NA 8.81 8.72 0.99 NA NA 16.87 16.78 090

29821 ............ A Shoulder arthroscopy/surgery .............. 7.72 NA NA 9.18 9.19 1.08 NA NA 17.98 17.99 090

29822 ............ A Shoulder arthroscopy/surgery .............. 7.43 NA NA 9.08 9.03 1.04 NA NA 17.55 17.50 090

29823 ............ A Shoulder arthroscopy/surgery .............. 8.17 NA NA 9.43 9.51 1.15 NA NA 18.75 18.83 090

29825 ............ A Shoulder arthroscopy/surgery .............. 7.62 NA NA 9.19 9.17 1.06 NA NA 17.87 17.85 090

29826 ............ A Shoulder arthroscopy/surgery .............. 8.99 NA NA 9.92 10.12 1.26 NA NA 20.17 20.37 090

29830 ............ A Elbow arthroscopy ................................ 5.76 NA NA 5.70 5.72 0.79 NA NA 12.25 12.27 090

29834 ............ A Elbow arthroscopy/surgery ................... 6.28 NA NA 6.48 6.45 0.86 NA NA 13.62 13.59 090

29835 ............ A Elbow arthroscopy/surgery ................... 6.48 NA NA 6.47 6.49 0.88 NA NA 13.83 13.85 090

29836 ............ A Elbow arthroscopy/surgery ................... 7.55 NA NA 7.20 7.31 1.06 NA NA 15.81 15.92 090

29837 ............ A Elbow arthroscopy/surgery ................... 6.87 NA NA 6.78 6.82 0.96 NA NA 14.61 14.65 090

29838 ............ A Elbow arthroscopy/surgery ................... 7.71 NA NA 7.28 7.37 1.07 NA NA 16.06 16.15 090

29840 ............ A Wrist arthroscopy ................................. 5.54 NA NA 8.18 7.03 0.69 NA NA 14.41 13.26 090

29843 ............ A Wrist arthroscopy/surgery .................... 6.01 NA NA 7.93 7.47 0.82 NA NA 14.76 14.30 090

29844 ............ A Wrist arthroscopy/surgery .................... 6.37 NA NA 8.08 7.58 0.86 NA NA 15.31 14.81 090

29845 ............ A Wrist arthroscopy/surgery .................... 7.52 NA NA 8.52 8.29 0.84 NA NA 16.88 16.65 090

29846 ............ A Wrist arthroscopy/surgery .................... 6.75 NA NA 10.57 9.94 0.89 NA NA 18.21 17.58 090

29847 ............ A Wrist arthroscopy/surgery .................... 7.08 NA NA 10.51 9.72 0.91 NA NA 18.50 17.71 090

29848 ............ A Wrist endoscopy/surgery ...................... 5.44 NA NA 7.73 6.84 0.72 NA NA 13.89 13.00 090

29850 ............ A Knee arthroscopy/surgery .................... 8.19 NA NA 6.91 6.41 0.74 NA NA 15.84 15.34 090

29851 ............ A Knee arthroscopy/surgery .................... 13.10 NA NA 11.33 11.47 1.81 NA NA 26.24 26.38 090

29855 ............ A Tibial arthroscopy/surgery .................... 10.62 NA NA 9.99 10.66 1.50 NA NA 22.11 22.78 090

29856 ............ A Tibial arthroscopy/surgery .................... 14.14 NA NA 11.94 12.13 2.00 NA NA 28.08 28.27 090

29860 ............ A Hip arthroscopy, dx .............................. 8.05 NA NA 7.60 7.01 1.14 NA NA 16.79 16.20 090

29861 ............ A Hip arthroscopy/surgery ....................... 9.15 NA NA 8.74 9.10 1.29 NA NA 19.18 19.54 090

29862 ............ A Hip arthroscopy/surgery ....................... 9.90 NA NA 9.07 9.54 1.39 NA NA 20.36 20.83 090

29863 ............ A Hip arthroscopy/surgery ....................... 9.90 NA NA 9.71 9.65 1.40 NA NA 21.01 20.95 090

29870 ............ A Knee arthroscopy, dx ........................... 5.07 NA NA 5.79 5.43 0.67 NA NA 11.53 11.17 090

29871 ............ A Knee arthroscopy/drainage .................. 6.55 NA NA 7.75 7.65 0.88 NA NA 15.18 15.08 090

29874 ............ A Knee arthroscopy/surgery .................... 7.05 NA NA 7.42 7.67 0.87 NA NA 15.34 15.59 090

29875 ............ A Knee arthroscopy/surgery .................... 6.31 NA NA 7.15 7.25 0.88 NA NA 14.34 14.44 090

29876 ............ A Knee arthroscopy/surgery .................... 7.92 NA NA 8.57 8.79 1.11 NA NA 17.60 17.82 090

29877 ............ A Knee arthroscopy/surgery .................... 7.35 NA NA 7.74 8.00 1.03 NA NA 16.12 16.38 090

29879 ............ A Knee arthroscopy/surgery .................... 8.04 NA NA 8.12 8.49 1.13 NA NA 17.29 17.66 090

29880 ............ A Knee arthroscopy/surgery .................... 8.50 NA NA 8.38 8.82 1.19 NA NA 18.07 18.51 090

29881 ............ A Knee arthroscopy/surgery .................... 7.76 NA NA 7.96 8.29 1.09 NA NA 16.81 17.14 090

29882 ............ A Knee arthroscopy/surgery .................... 8.65 NA NA 7.96 8.55 1.09 NA NA 17.70 18.29 090

29883 ............ A Knee arthroscopy/surgery .................... 9.46 NA NA 8.91 9.51 1.33 NA NA 19.70 20.30 090

29884 ............ A Knee arthroscopy/surgery .................... 7.33 NA NA 8.25 8.38 1.03 NA NA 16.61 16.74 090

29885 ............ A Knee arthroscopy/surgery .................... 9.09 NA NA 9.19 9.13 1.27 NA NA 19.55 19.49 090

29886 ............ A Knee arthroscopy/surgery .................... 7.54 NA NA 8.36 8.12 1.06 NA NA 16.96 16.72 090

29887 ............ A Knee arthroscopy/surgery .................... 9.04 NA NA 9.19 9.59 1.27 NA NA 19.50 19.90 090

65464

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

29888 ............ A Knee arthroscopy/surgery .................... 13.90 NA NA 11.86 13.04 1.95 NA NA 27.71 28.89 090

29889 ............ A Knee arthroscopy/surgery .................... 15.13 NA NA 12.45 12.12 2.11 NA NA 29.69 29.36 090

29891 ............ A Ankle arthroscopy/surgery .................... 8.40 NA NA 8.72 8.95 1.17 NA NA 18.29 18.52 090

29892 ............ A Ankle arthroscopy/surgery .................... 9.00 NA NA 8.56 8.83 1.26 NA NA 18.82 19.09 090

29893 ............ A Scope, plantar fasciotomy .................... 5.22 NA NA 4.71 4.94 0.74 NA NA 10.67 10.90 090

29894 ............ A Ankle arthroscopy/surgery .................... 7.21 NA NA 7.36 7.67 1.01 NA NA 15.58 15.89 090

29895 ............ A Ankle arthroscopy/surgery .................... 6.99 NA NA 7.66 7.83 0.97 NA NA 15.62 15.79 090

29897 ............ A Ankle arthroscopy/surgery .................... 7.18 NA NA 8.29 8.36 1.01 NA NA 16.48 16.55 090

29898 ............ A Ankle arthroscopy/surgery .................... 8.32 NA NA 8.12 8.57 1.14 NA NA 17.58 18.03 090

29909 ............ C Arthroscopy of joint .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

30000 ............ A Drainage of nose lesion ....................... 1.43 2.41 1.97 1.46 1.18 0.10 3.94 3.50 2.99 2.71 010

30020 ............ A Drainage of nose lesion ....................... 1.43 2.66 2.16 1.53 1.23 0.08 4.17 3.67 3.04 2.74 010

30100 ............ A Intranasal biopsy .................................. 0.94 1.29 1.16 0.52 0.49 0.06 2.29 2.16 1.52 1.49 000

30110 ............ A Removal of nose polyp(s) .................... 1.63 2.68 2.36 0.89 0.84 0.12 4.43 4.11 2.64 2.59 010

30115 ............ A Removal of nose polyp(s) .................... 4.35 NA NA 4.38 4.05 0.31 NA NA 9.04 8.71 090

30117 ............ A Removal of intranasal lesion ................ 3.16 4.65 4.26 3.09 3.09 0.22 8.03 7.64 6.47 6.47 090

30118 ............ A Removal of intranasal lesion ................ 9.69 NA NA 7.44 7.75 0.66 NA NA 17.79 18.10 090

30120 ............ A Revision of nose ................................... 5.27 5.87 5.98 5.87 5.98 0.41 11.55 11.66 11.55 11.66 090

30124 ............ A Removal of nose lesion ........................ 3.10 NA NA 3.30 2.66 0.20 NA NA 6.60 5.96 090

30125 ............ A Removal of nose lesion ........................ 7.16 NA NA 6.31 6.24 0.54 NA NA 14.01 13.94 090

30130 ............ A Removal of turbinate bones ................. 3.38 NA NA 3.87 3.36 0.22 NA NA 7.47 6.96 090

30140 ............ A Removal of turbinate bones ................. 3.43 NA NA 4.42 4.14 0.24 NA NA 8.09 7.81 090

30150 ............ A Partial removal of nose ........................ 9.14 NA NA 8.45 8.49 0.76 NA NA 18.35 18.39 090

30160 ............ A Removal of nose .................................. 9.58 NA NA 8.31 9.09 0.78 NA NA 18.67 19.45 090

30200 ............ A Injection treatment of nose ................... 0.78 1.17 0.98 0.44 0.38 0.06 2.01 1.82 1.28 1.22 000

30210 ............ A Nasal sinus therapy .............................. 1.08 2.06 1.62 0.60 0.49 0.08 3.22 2.78 1.76 1.65 010

30220 ............ A Insert nasal septal button ..................... 1.54 2.38 2.20 0.86 0.85 0.11 4.03 3.85 2.51 2.50 010

30300 ............ A Remove nasal foreign body ................. 1.04 2.51 2.01 0.38 0.35 0.07 3.62 3.12 1.49 1.46 010

30310 ............ A Remove nasal foreign body ................. 1.96 NA NA 1.85 1.83 0.14 NA NA 3.95 3.93 010

30320 ............ A Remove nasal foreign body ................. 4.52 NA NA 5.32 5.16 0.36 NA NA 10.20 10.04 090

30400 ............ R Reconstruction of nose ........................ 9.83 NA NA 8.59 9.15 0.80 NA NA 19.22 19.78 090

30410 ............ R Reconstruction of nose ........................ 12.98 NA NA 10.43 11.70 1.08 NA NA 24.49 25.76 090

30420 ............ R Reconstruction of nose ........................ 15.88 NA NA 12.14 13.85 1.24 NA NA 29.26 30.97 090

30430 ............ R Revision of nose ................................... 7.21 NA NA 7.03 6.93 0.62 NA NA 14.86 14.76 090

30435 ............ R Revision of nose ................................... 11.71 NA NA 10.27 10.46 1.10 NA NA 23.08 23.27 090

30450 ............ R Revision of nose ................................... 18.65 NA NA 13.91 13.48 1.53 NA NA 34.09 33.66 090

30460 ............ A Revision of nose ................................... 9.96 NA NA 9.30 9.30 0.85 NA NA 20.11 20.11 090

30462 ............ A Revision of nose ................................... 19.57 NA NA 14.77 15.73 1.92 NA NA 36.26 37.22 090

30465 ............ A Repair nasal stenosis ........................... 11.64 NA NA 9.12 9.12 0.82 NA NA 21.58 21.58 090

30520 ............ A Repair of nasal septum ........................ 5.70 NA NA 5.71 5.98 0.41 NA NA 11.82 12.09 090

30540 ............ A Repair nasal defect .............................. 7.75 NA NA 6.38 6.59 0.53 NA NA 14.66 14.87 090

30545 ............ A Repair nasal defect .............................. 11.38 NA NA 8.21 9.10 0.80 NA NA 20.39 21.28 090

30560 ............ A Release of nasal adhesions ................. 1.26 2.26 1.85 1.46 1.17 0.09 3.61 3.20 2.81 2.52 010

30580 ............ A Repair upper jaw fistula ....................... 6.69 4.95 5.41 4.95 4.56 0.50 12.14 12.60 12.14 11.75 090

30600 ............ A Repair mouth/nose fistula .................... 6.02 5.14 4.88 5.14 4.88 0.70 11.86 11.60 11.86 11.60 090

30620 ............ A Intranasal reconstruction ...................... 5.97 NA NA 6.40 6.58 0.45 NA NA 12.82 13.00 090

30630 ............ A Repair nasal septum defect ................. 7.12 NA NA 6.86 6.84 0.51 NA NA 14.49 14.47 090

30801 ............ A Cauterization, inner nose ..................... 1.09 2.46 1.97 2.20 1.72 0.08 3.63 3.14 3.37 2.89 010

30802 ............ A Cauterization, inner nose ..................... 2.03 3.00 2.51 2.74 2.31 0.15 5.18 4.69 4.92 4.49 010

30901 ............ A Control of nosebleed ............................ 1.21 2.05 1.69 0.44 0.41 0.09 3.35 2.99 1.74 1.71 000

30903 ............ A Control of nosebleed ............................ 1.54 2.46 2.08 0.62 0.70 0.12 4.12 3.74 2.28 2.36 000

30905 ............ A Control of nosebleed ............................ 1.97 4.29 3.70 0.88 1.15 0.15 6.41 5.82 3.00 3.27 000

30906 ............ A Repeat control of nosebleed ................ 2.45 4.52 3.68 1.34 1.30 0.17 7.14 6.30 3.96 3.92 000

30915 ............ A Ligation, nasal sinus artery .................. 7.20 NA NA 6.86 6.49 0.50 NA NA 14.56 14.19 090

30920 ............ A Ligation, upper jaw artery ..................... 9.83 NA NA 8.32 8.83 0.69 NA NA 18.84 19.35 090

30930 ............ A Therapy, fracture of nose ..................... 1.26 NA NA 2.09 1.76 0.09 NA NA 3.44 3.11 010

30999 ............ C Nasal surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

31000 ............ A Irrigation, maxillary sinus ...................... 1.15 2.35 1.88 0.63 0.53 0.08 3.58 3.11 1.86 1.76 010

31002 ............ A Irrigation, sphenoid sinus ..................... 1.91 NA NA 1.96 1.53 0.14 NA NA 4.01 3.58 010

31020 ............ A Exploration, maxillary sinus .................. 2.94 4.24 3.90 3.54 3.38 0.20 7.38 7.04 6.68 6.52 090

31030 ............ A Exploration, maxillary sinus .................. 5.92 4.79 5.36 4.53 5.17 0.42 11.13 11.70 10.87 11.51 090

31032 ............ A Explore sinus,remove polyps ............... 6.57 NA NA 5.90 6.39 0.47 NA NA 12.94 13.43 090

31040 ............ A Exploration behind upper jaw ............... 9.42 NA NA 6.74 7.22 0.71 NA NA 16.87 17.35 090

31050 ............ A Exploration, sphenoid sinus ................. 5.28 NA NA 4.93 5.28 0.39 NA NA 10.60 10.95 090

31051 ............ A Sphenoid sinus surgery ........................ 7.11 NA NA 6.34 6.88 0.55 NA NA 14.00 14.54 090

31070 ............ A Exploration of frontal sinus ................... 4.28 NA NA 4.86 4.92 0.30 NA NA 9.44 9.50 090

31075 ............ A Exploration of frontal sinus ................... 9.16 NA NA 8.02 8.75 0.64 NA NA 17.82 18.55 090

31080 ............ A Removal of frontal sinus ...................... 11.42 NA NA 8.73 9.05 0.78 NA NA 20.93 21.25 090

31081 ............ A Removal of frontal sinus ...................... 12.75 NA NA 9.32 9.79 1.84 NA NA 23.91 24.38 090

31084 ............ A Removal of frontal sinus ...................... 13.51 NA NA 10.38 11.80 0.96 NA NA 24.85 26.27 090

31085 ............ A Removal of frontal sinus ...................... 14.20 NA NA 10.62 12.20 1.18 NA NA 26.00 27.58 090

31086 ............ A Removal of frontal sinus ...................... 12.86 NA NA 9.94 10.41 0.90 NA NA 23.70 24.17 090

31087 ............ A Removal of frontal sinus ...................... 13.10 NA NA 10.43 10.64 1.15 NA NA 24.68 24.89 090

31090 ............ A Exploration of sinuses .......................... 9.53 NA NA 8.66 9.34 0.66 NA NA 18.85 19.53 090

31200 ............ A Removal of ethmoid sinus .................... 4.97 NA NA 5.85 5.64 0.25 NA NA 11.07 10.86 090

31201 ............ A Removal of ethmoid sinus .................... 8.37 NA NA 7.60 7.60 0.58 NA NA 16.55 16.55 090

31205 ............ A Removal of ethmoid sinus .................... 10.24 NA NA 8.48 8.54 0.58 NA NA 19.30 19.36 090

31225 ............ A Removal of upper jaw .......................... 19.23 NA NA 14.86 16.42 1.38 NA NA 35.47 37.03 090

31230 ............ A Removal of upper jaw .......................... 21.94 NA NA 16.17 18.03 1.57 NA NA 39.68 41.54 090

31231 ............ A Nasal endoscopy, dx ............................ 1.10 1.90 1.80 0.59 0.82 0.08 3.08 2.98 1.77 2.00 000

31233 ............ A Nasal/sinus endoscopy, dx .................. 2.18 2.53 2.66 1.18 1.27 0.16 4.87 5.00 3.52 3.61 000

31235 ............ A Nasal/sinus endoscopy, dx .................. 2.64 2.80 2.75 1.47 1.43 0.18 5.62 5.57 4.29 4.25 000

31237 ............ A Nasal/sinus endoscopy, surg ............... 2.98 3.07 3.19 1.62 1.66 0.21 6.26 6.38 4.81 4.85 000

65465

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

31238 ............ A Nasal/sinus endoscopy, surg ............... 3.26 3.58 3.66 1.83 1.86 0.23 7.07 7.15 5.32 5.35 000

31239 ............ A Nasal/sinus endoscopy, surg ............... 8.70 NA NA 6.54 7.50 0.46 NA NA 15.70 16.66 010

31240 ............ A Nasal/sinus endoscopy, surg ............... 2.61 NA NA 1.57 1.96 0.18 NA NA 4.36 4.75 000

31254 ............ A Revision of ethmoid sinus .................... 4.65 NA NA 2.72 3.43 0.32 NA NA 7.69 8.40 000

31255 ............ A Removal of ethmoid sinus .................... 6.96 NA NA 4.02 5.09 0.49 NA NA 11.47 12.54 000

31256 ............ A Exploration maxillary sinus ................... 3.29 NA NA 1.95 2.45 0.23 NA NA 5.47 5.97 000

31267 ............ A Endoscopy, maxillary sinus .................. 5.46 NA NA 3.18 3.81 0.38 NA NA 9.02 9.65 000

31276 ............ A Sinus endoscopy, surgical ................... 8.85 NA NA 5.09 5.64 0.62 NA NA 14.56 15.11 000

31287 ............ A Nasal/sinus endoscopy, surg ............... 3.92 NA NA 2.31 2.90 0.27 NA NA 6.50 7.09 000

31288 ............ A Nasal/sinus endoscopy, surg ............... 4.58 NA NA 2.68 3.38 0.32 NA NA 7.58 8.28 000

31290 ............ A Nasal/sinus endoscopy, surg ............... 17.24 NA NA 11.57 13.15 1.20 NA NA 30.01 31.59 010

31291 ............ A Nasal/sinus endoscopy, surg ............... 18.19 NA NA 11.77 13.53 1.73 NA NA 31.69 33.45 010

31292 ............ A Nasal/sinus endoscopy, surg ............... 14.76 NA NA 9.98 11.12 0.99 NA NA 25.73 26.87 010

31293 ............ A Nasal/sinus endoscopy, surg ............... 16.21 NA NA 10.77 12.05 0.97 NA NA 27.95 29.23 010

31294 ............ A Nasal/sinus endoscopy, surg ............... 19.06 NA NA 11.64 13.27 1.04 NA NA 31.74 33.37 010

31299 ............ C Sinus surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

31300 ............ A Removal of larynx lesion ...................... 14.29 NA NA 16.61 15.60 0.99 NA NA 31.89 30.88 090

31320 ............ A Diagnostic incision, larynx .................... 5.26 NA NA 12.92 10.74 0.40 NA NA 18.58 16.40 090

31360 ............ A Removal of larynx ................................ 17.08 NA NA 18.44 18.93 1.20 NA NA 36.72 37.21 090

31365 ............ A Removal of larynx ................................ 24.16 NA NA 22.05 23.75 1.72 NA NA 47.93 49.63 090

31367 ............ A Partial removal of larynx ...................... 21.86 NA NA 22.72 21.71 1.57 NA NA 46.15 45.14 090

31368 ............ A Partial removal of larynx ...................... 27.09 NA NA 27.49 27.88 1.90 NA NA 56.48 56.87 090

31370 ............ A Partial removal of larynx ...................... 21.38 NA NA 22.64 21.64 1.51 NA NA 45.53 44.53 090

31375 ............ A Partial removal of larynx ...................... 20.21 NA NA 20.48 19.39 1.43 NA NA 42.12 41.03 090

31380 ............ A Partial removal of larynx ...................... 20.21 NA NA 20.06 19.73 1.40 NA NA 41.67 41.34 090

31382 ............ A Partial removal of larynx ...................... 20.52 NA NA 22.21 21.02 1.44 NA NA 44.17 42.98 090

31390 ............ A Removal of larynx & pharynx ............... 27.53 NA NA 27.91 28.28 1.95 NA NA 57.39 57.76 090

31395 ............ A Reconstruct larynx & pharynx .............. 31.09 NA NA 32.98 33.83 2.27 NA NA 66.34 67.19 090

31400 ............ A Revision of larynx ................................. 10.31 NA NA 15.04 13.40 0.72 NA NA 26.07 24.43 090

31420 ............ A Removal of epiglottis ............................ 10.22 NA NA 14.96 13.41 0.71 NA NA 25.89 24.34 090

31500 ............ A Insert emergency airway ...................... 2.33 NA NA 0.67 0.81 0.15 NA NA 3.15 3.29 000

31502 ............ A Change of windpipe airway .................. 0.65 1.82 1.52 0.26 0.35 0.04 2.51 2.21 0.95 1.04 000

31505 ............ A Diagnostic laryngoscopy ...................... 0.61 1.72 1.41 0.34 0.32 0.04 2.37 2.06 0.99 0.97 000

31510 ............ A Laryngoscopy with biopsy .................... 1.92 2.67 2.15 1.01 0.91 0.15 4.74 4.22 3.08 2.98 000

31511 ............ A Remove foreign body, larynx ............... 2.16 2.93 2.46 0.76 0.83 0.16 5.25 4.78 3.08 3.15 000

31512 ............ A Removal of larynx lesion ...................... 2.07 2.87 2.64 1.13 1.33 0.16 5.10 4.87 3.36 3.56 000

31513 ............ A Injection into vocal cord ....................... 2.10 NA NA 1.28 1.59 0.15 NA NA 3.53 3.84 000

31515 ............ A Laryngoscopy for aspiration ................. 1.80 2.35 2.07 0.84 0.94 0.12 4.27 3.99 2.76 2.86 000

31520 ............ A Diagnostic laryngoscopy ...................... 2.56 NA NA 1.40 1.50 0.17 NA NA 4.13 4.23 000

31525 ............ A Diagnostic laryngoscopy ...................... 2.63 2.80 2.70 1.49 1.42 0.18 5.61 5.51 4.30 4.23 000

31526 ............ A Diagnostic laryngoscopy ...................... 2.57 NA NA 1.54 1.92 0.18 NA NA 4.29 4.67 000

31527 ............ A Laryngoscopy for treatment ................. 3.27 NA NA 1.69 2.08 0.21 NA NA 5.17 5.56 000

31528 ............ A Laryngoscopy and dilatation ................ 2.37 NA NA 1.30 1.68 0.16 NA NA 3.83 4.21 000

31529 ............ A Laryngoscopy and dilatation ................ 2.68 NA NA 1.58 1.85 0.18 NA NA 4.44 4.71 000

31530 ............ A Operative laryngoscopy ........................ 3.39 NA NA 1.81 2.34 0.24 NA NA 5.44 5.97 000

31531 ............ A Operative laryngoscopy ........................ 3.59 NA NA 2.13 2.67 0.25 NA NA 5.97 6.51 000

31535 ............ A Operative laryngoscopy ........................ 3.16 NA NA 1.84 2.33 0.22 NA NA 5.22 5.71 000

31536 ............ A Operative laryngoscopy ........................ 3.56 NA NA 2.10 2.64 0.25 NA NA 5.91 6.45 000

31540 ............ A Operative laryngoscopy ........................ 4.13 NA NA 2.41 3.04 0.29 NA NA 6.83 7.46 000

31541 ............ A Operative laryngoscopy ........................ 4.53 NA NA 2.65 3.23 0.32 NA NA 7.50 8.08 000

31560 ............ A Operative laryngoscopy ........................ 5.46 NA NA 3.02 3.62 0.38 NA NA 8.86 9.46 000

31561 ............ A Operative laryngoscopy ........................ 6.00 NA NA 3.48 4.31 0.42 NA NA 9.90 10.73 000

31570 ............ A Laryngoscopy with injection ................. 3.87 4.07 4.21 2.25 2.27 0.24 8.18 8.32 6.36 6.38 000

31571 ............ A Laryngoscopy with injection ................. 4.27 NA NA 2.50 3.10 0.30 NA NA 7.07 7.67 000

31575 ............ A Diagnostic laryngoscopy ...................... 1.10 2.09 1.99 0.62 0.68 0.08 3.27 3.17 1.80 1.86 000

31576 ............ A Laryngoscopy with biopsy .................... 1.97 2.36 2.36 0.97 1.32 0.13 4.46 4.46 3.07 3.42 000

31577 ............ A Remove foreign body, larynx ............... 2.47 2.79 2.83 1.32 1.73 0.17 5.43 5.47 3.96 4.37 000

31578 ............ A Removal of larynx lesion ...................... 2.84 3.01 3.11 1.58 2.03 0.20 6.05 6.15 4.62 5.07 000

31579 ............ A Diagnostic laryngoscopy ...................... 2.26 2.83 2.76 1.21 1.23 0.16 5.25 5.18 3.63 3.65 000

31580 ............ A Revision of larynx ................................. 12.38 NA NA 15.79 15.54 0.87 NA NA 29.04 28.79 090

31582 ............ A Revision of larynx ................................. 21.62 NA NA 21.03 20.62 1.52 NA NA 44.17 43.76 090

31584 ............ A Treat larynx fracture ............................. 19.64 NA NA 18.35 17.21 1.42 NA NA 39.41 38.27 090

31585 ............ A Treat larynx fracture ............................. 4.64 NA NA 8.35 7.29 0.30 NA NA 13.29 12.23 090

31586 ............ A Treat larynx fracture ............................. 8.03 NA NA 11.96 10.75 0.56 NA NA 20.55 19.34 090

31587 ............ A Revision of larynx ................................. 11.99 NA NA 13.32 11.95 0.88 NA NA 26.19 24.82 090

31588 ............ A Revision of larynx ................................. 13.11 NA NA 16.47 15.26 0.92 NA NA 30.50 29.29 090

31590 ............ A Reinnervate larynx ............................... 6.97 NA NA 11.70 10.34 0.50 NA NA 19.17 17.81 090

31595 ............ A Larynx nerve surgery ........................... 8.34 NA NA 10.48 9.72 0.62 NA NA 19.44 18.68 090

31599 ............ C Larynx surgery procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

31600 ............ A Incision of windpipe .............................. 3.62 NA NA 1.63 2.30 0.34 NA NA 5.59 6.26 000

31601 ............ A Incision of windpipe .............................. 4.45 NA NA 2.15 2.94 0.39 NA NA 6.99 7.78 000

31603 ............ A Incision of windpipe .............................. 4.15 NA NA 1.72 2.44 0.35 NA NA 6.22 6.94 000

31605 ............ A Incision of windpipe .............................. 3.58 NA NA 1.30 2.05 0.33 NA NA 5.21 5.96 000

31610 ............ A Incision of windpipe .............................. 8.76 NA NA 10.55 9.72 0.69 NA NA 20.00 19.17 090

31611 ............ A Surgery/speech prosthesis ................... 5.64 NA NA 9.78 9.09 0.40 NA NA 15.82 15.13 090

31612 ............ A Puncture/clear windpipe ....................... 0.91 1.47 1.42 0.43 0.60 0.06 2.44 2.39 1.40 1.57 000

31613 ............ A Repair windpipe opening ...................... 4.59 NA NA 8.74 7.16 0.37 NA NA 13.70 12.12 090

31614 ............ A Repair windpipe opening ...................... 7.12 NA NA 11.76 10.65 0.51 NA NA 19.39 18.28 090

31615 ............ A Visualization of windpipe ...................... 2.09 3.49 3.15 1.19 1.42 0.14 5.72 5.38 3.42 3.65 000

31622 ............ A Dx bronchoscope/wash ........................ 2.78 3.21 3.24 1.17 1.71 0.14 6.13 6.16 4.09 4.63 000

31623 ............ A Dx bronchoscope/brush ....................... 2.88 3.10 3.16 1.17 1.71 0.14 6.12 6.18 4.19 4.73 000

31624 ............ A Dx bronchoscope/lavage ...................... 2.88 2.79 2.93 1.16 1.71 0.13 5.80 5.94 4.17 4.72 000

31625 ............ A Bronchoscopy with biopsy .................... 3.37 2.83 3.13 1.31 1.99 0.16 6.36 6.66 4.84 5.52 000

65466

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

31628 ............ A Bronchoscopy with biopsy .................... 3.81 3.13 3.49 1.37 2.17 0.14 7.08 7.44 5.32 6.12 000

31629 ............ A Bronchoscopy with biopsy .................... 3.37 NA NA 1.24 1.94 0.13 NA NA 4.74 5.44 000

31630 ............ A Bronchoscopy with repair ..................... 3.82 NA NA 2.13 2.61 0.30 NA NA 6.25 6.73 000

31631 ............ A Bronchoscopy with dilation ................... 4.37 NA NA 2.15 2.68 0.31 NA NA 6.83 7.36 000

31635 ............ A Remove foreign body, airway .............. 3.68 NA NA 1.74 2.41 0.21 NA NA 5.63 6.30 000

31640 ............ A Bronchoscopy & remove lesion ........... 4.94 NA NA 2.49 3.23 0.37 NA NA 7.80 8.54 000

31641 ............ A Bronchoscopy, treat blockage .............. 5.03 NA NA 2.23 3.17 0.30 NA NA 7.56 8.50 000

31643 ............ A Diag bronchoscope/catheter ................ 3.50 1.16 1.71 1.16 1.71 0.15 4.81 5.36 4.81 5.36 000

31645 ............ A Bronchoscopy, clear airways ............... 3.16 NA NA 1.21 1.85 0.13 NA NA 4.50 5.14 000

31646 ............ A Bronchoscopy, reclear airway .............. 2.72 NA NA 1.08 1.62 0.12 NA NA 3.92 4.46 000

31656 ............ A Bronchoscopy, inj for xray .................... 2.17 NA NA 0.92 1.34 0.10 NA NA 3.19 3.61 000

31700 ............ A Insertion of airway catheter .................. 1.34 2.42 2.19 0.73 0.92 0.07 3.83 3.60 2.14 2.33 000

31708 ............ A Instill airway contrast dye ..................... 1.41 NA NA 0.63 0.68 0.06 NA NA 2.10 2.15 000

31710 ............ A Insertion of airway catheter .................. 1.30 NA NA 0.71 0.78 0.06 NA NA 2.07 2.14 000

31715 ............ A Injection for bronchus x-ray .................. 1.11 NA NA 0.63 0.60 0.06 NA NA 1.80 1.77 000

31717 ............ A Bronchial brush biopsy ......................... 2.12 2.59 2.14 0.87 0.85 0.09 4.80 4.35 3.08 3.06 000

31720 ............ A Clearance of airways ............................ 1.06 1.83 1.57 0.33 0.45 0.06 2.95 2.69 1.45 1.57 000

31725 ............ A Clearance of airways ............................ 1.96 NA NA 0.61 0.84 0.10 NA NA 2.67 2.90 000

31730 ............ A Intro, windpipe wire/tube ...................... 2.85 2.34 2.43 1.10 1.50 0.15 5.34 5.43 4.10 4.50 000

31750 ............ A Repair of windpipe ............................... 13.02 NA NA 15.81 14.27 1.02 NA NA 29.85 28.31 090

31755 ............ A Repair of windpipe ............................... 15.93 NA NA 18.41 17.42 1.15 NA NA 35.49 34.50 090

31760 ............ A Repair of windpipe ............................... 22.35 NA NA 12.68 12.47 1.48 NA NA 36.51 36.30 090

31766 ............ A Reconstruction of windpipe .................. 30.43 NA NA 20.27 20.20 3.16 NA NA 53.86 53.79 090

31770 ............ A Repair/graft of bronchus ....................... 22.51 NA NA 17.92 17.53 2.27 NA NA 42.70 42.31 090

31775 ............ A Reconstruct bronchus .......................... 23.54 NA NA 16.73 16.99 2.91 NA NA 43.18 43.44 090

31780 ............ A Reconstruct windpipe ........................... 17.72 NA NA 14.13 15.30 1.55 NA NA 33.40 34.57 090

31781 ............ A Reconstruct windpipe ........................... 23.53 NA NA 15.44 16.16 2.04 NA NA 41.01 41.73 090

31785 ............ A Remove windpipe lesion ...................... 17.23 NA NA 13.28 12.38 1.36 NA NA 31.87 30.97 090

31786 ............ A Remove windpipe lesion ...................... 23.98 NA NA 16.25 15.80 2.20 NA NA 42.43 41.98 090

31800 ............ A Repair of windpipe injury ...................... 7.43 NA NA 7.82 7.20 0.67 NA NA 15.92 15.30 090

31805 ............ A Repair of windpipe injury ...................... 13.13 NA NA 11.99 11.66 1.45 NA NA 26.57 26.24 090

31820 ............ A Closure of windpipe lesion ................... 4.49 7.65 6.71 7.65 6.71 0.35 12.49 11.55 12.49 11.55 090

31825 ............ A Repair of windpipe defect .................... 6.81 11.20 9.76 10.88 9.52 0.50 18.51 17.07 18.19 16.83 090

31830 ............ A Revise windpipe scar ........................... 4.50 7.82 6.86 7.82 6.86 0.36 12.68 11.72 12.68 11.72 090

31899 ............ C Airways surgical procedure .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

32000 ............ A Drainage of chest ................................. 1.54 2.95 2.46 0.50 0.62 0.07 4.56 4.07 2.11 2.23 000

32002 ............ A Treatment of collapsed lung ................. 2.19 NA NA 0.86 1.01 0.11 NA NA 3.16 3.31 000

32005 ............ A Treat lung lining chemically .................. 2.19 NA NA 0.94 1.00 0.17 NA NA 3.30 3.36 000

32020 ............ A Insertion of chest tube .......................... 3.98 NA NA 1.60 1.91 0.36 NA NA 5.94 6.25 000

32035 ............ A Exploration of chest .............................. 8.67 NA NA 9.68 9.10 1.02 NA NA 19.37 18.79 090

32036 ............ A Exploration of chest .............................. 9.68 NA NA 11.37 10.46 1.20 NA NA 22.25 21.34 090

32095 ............ A Biopsy through chest wall .................... 8.36 NA NA 10.48 10.10 0.99 NA NA 19.83 19.45 090

32100 ............ A Exploration/biopsy of chest .................. 11.84 NA NA 11.72 11.84 1.45 NA NA 25.01 25.13 090

32110 ............ A Explore/repair chest ............................. 13.62 NA NA 12.70 12.65 1.63 NA NA 27.95 27.90 090

32120 ............ A Re-exploration of chest ........................ 11.54 NA NA 12.32 11.81 1.42 NA NA 25.28 24.77 090

32124 ............ A Explore chest free adhesions ............... 12.72 NA NA 11.69 11.74 1.51 NA NA 25.92 25.97 090

32140 ............ A Removal of lung lesion(s) .................... 13.93 NA NA 12.55 12.77 1.68 NA NA 28.16 28.38 090

32141 ............ A Remove/treat lung lesions .................... 14.00 NA NA 12.92 13.33 1.72 NA NA 28.64 29.05 090

32150 ............ A Removal of lung lesion(s) .................... 14.15 NA NA 11.89 11.72 1.60 NA NA 27.64 27.47 090

32151 ............ A Remove lung foreign body ................... 14.21 NA NA 12.91 12.17 1.49 NA NA 28.61 27.87 090

32160 ............ A Open chest heart massage .................. 9.30 NA NA 7.41 8.04 1.01 NA NA 17.72 18.35 090

32200 ............ A Drain, open, lung lesion ....................... 15.29 NA NA 12.13 10.97 1.46 NA NA 28.88 27.72 090

32201 ............ A Drain, percut, lung lesion ..................... 4.00 NA NA 6.55 5.74 0.18 NA NA 10.73 9.92 000

32215 ............ A Treat chest lining .................................. 11.33 NA NA 12.51 11.45 1.34 NA NA 25.18 24.12 090

32220 ............ A Release of lung .................................... 19.27 NA NA 15.39 15.83 2.39 NA NA 37.05 37.49 090

32225 ............ A Partial release of lung .......................... 13.96 NA NA 12.83 12.84 1.70 NA NA 28.49 28.50 090

32310 ............ A Removal of chest lining ........................ 13.44 NA NA 12.35 12.42 1.65 NA NA 27.44 27.51 090

32320 ............ A Free/remove chest lining ...................... 20.54 NA NA 14.95 16.12 2.50 NA NA 37.99 39.16 090

32400 ............ A Needle biopsy chest lining ................... 1.76 1.82 1.77 0.58 0.84 0.07 3.65 3.60 2.41 2.67 000

32402 ............ A Open biopsy chest lining ...................... 7.56 NA NA 10.59 10.00 0.91 NA NA 19.06 18.47 090

32405 ............ A Biopsy, lung or mediastinum ................ 1.93 2.23 2.25 0.68 1.09 0.09 4.25 4.27 2.70 3.11 000

32420 ............ A Puncture/clear lung .............................. 2.18 NA NA 0.85 1.05 0.11 NA NA 3.14 3.34 000

32440 ............ A Removal of lung ................................... 21.02 NA NA 15.56 16.71 2.56 NA NA 39.14 40.29 090

32442 ............ A Sleeve pneumonectomy ....................... 26.24 NA NA 19.00 19.12 3.12 NA NA 48.36 48.48 090

32445 ............ A Removal of lung ................................... 25.09 NA NA 16.73 18.10 3.11 NA NA 44.93 46.30 090

32480 ............ A Partial removal of lung ......................... 18.32 NA NA 13.52 14.79 2.24 NA NA 34.08 35.35 090

32482 ............ A Bilobectomy .......................................... 19.71 NA NA 14.63 15.63 2.35 NA NA 36.69 37.69 090

32484 ............ A Segmentectomy .................................... 20.69 NA NA 14.88 15.81 2.54 NA NA 38.11 39.04 090

32486 ............ A Sleeve lobectomy ................................. 23.92 NA NA 16.63 16.96 3.00 NA NA 43.55 43.88 090

32488 ............ A Completion pneumonectomy ................ 25.71 NA NA 17.76 18.13 3.18 NA NA 46.65 47.02 090

32491 ............ R Lung volume reduction ......................... 21.25 NA NA 17.23 17.12 2.66 NA NA 41.14 41.03 090

32500 ............ A Partial removal of lung ......................... 14.30 NA NA 13.15 13.52 1.77 NA NA 29.22 29.59 090

32501 ............ A Repair bronchus add-on ....................... 4.69 NA NA 1.89 2.59 0.56 NA NA 7.14 7.84 ZZZ

32520 ............ A Remove lung & revise chest ................ 21.68 NA NA 16.19 17.75 2.71 NA NA 40.58 42.14 090

32522 ............ A Remove lung & revise chest ................ 24.20 NA NA 16.48 18.30 2.84 NA NA 43.52 45.34 090

32525 ............ A Remove lung & revise chest ................ 26.50 NA NA 17.47 19.48 3.25 NA NA 47.22 49.23 090

32540 ............ A Removal of lung lesion ......................... 14.64 NA NA 13.36 13.19 1.84 NA NA 29.84 29.67 090

32601 ............ A Thoracoscopy, diagnostic ..................... 5.46 NA NA 4.57 4.37 0.63 NA NA 10.66 10.46 000

32602 ............ A Thoracoscopy, diagnostic ..................... 5.96 NA NA 4.81 4.66 0.70 NA NA 11.47 11.32 000

32603 ............ A Thoracoscopy, diagnostic ..................... 7.81 NA NA 5.08 4.75 0.76 NA NA 13.65 13.32 000

32604 ............ A Thoracoscopy, diagnostic ..................... 8.78 NA NA 5.98 5.54 0.97 NA NA 15.73 15.29 000

32605 ............ A Thoracoscopy, diagnostic ..................... 6.93 NA NA 5.55 5.11 0.86 NA NA 13.34 12.90 000

32606 ............ A Thoracoscopy, diagnostic ..................... 8.40 NA NA 5.65 5.29 0.99 NA NA 15.04 14.68 000

65467

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

32650 ............ A Thoracoscopy, surgical ........................ 10.75 NA NA 10.88 10.23 1.25 NA NA 22.88 22.23 090

32651 ............ A Thoracoscopy, surgical ........................ 12.91 NA NA 10.80 11.31 1.50 NA NA 25.21 25.72 090

32652 ............ A Thoracoscopy, surgical ........................ 18.66 NA NA 14.50 15.17 2.30 NA NA 35.46 36.13 090

32653 ............ A Thoracoscopy, surgical ........................ 12.87 NA NA 11.59 11.50 1.55 NA NA 26.01 25.92 090

32654 ............ A Thoracoscopy, surgical ........................ 12.44 NA NA 9.14 9.98 1.51 NA NA 23.09 23.93 090

32655 ............ A Thoracoscopy, surgical ........................ 13.10 NA NA 10.99 11.88 1.53 NA NA 25.62 26.51 090

32656 ............ A Thoracoscopy, surgical ........................ 12.91 NA NA 12.44 12.96 1.61 NA NA 26.96 27.48 090

32657 ............ A Thoracoscopy, surgical ........................ 13.65 NA NA 11.81 12.51 1.64 NA NA 27.10 27.80 090

32658 ............ A Thoracoscopy, surgical ........................ 11.63 NA NA 13.17 13.35 1.47 NA NA 26.27 26.45 090

32659 ............ A Thoracoscopy, surgical ........................ 11.59 NA NA 11.24 11.89 1.39 NA NA 24.22 24.87 090

32660 ............ A Thoracoscopy, surgical ........................ 17.43 NA NA 13.34 15.21 2.09 NA NA 32.86 34.73 090

32661 ............ A Thoracoscopy, surgical ........................ 13.25 NA NA 12.60 11.96 1.66 NA NA 27.51 26.87 090

32662 ............ A Thoracoscopy, surgical ........................ 16.44 NA NA 13.52 14.09 2.01 NA NA 31.97 32.54 090

32663 ............ A Thoracoscopy, surgical ........................ 18.47 NA NA 14.39 15.45 2.28 NA NA 35.14 36.20 090

32664 ............ A Thoracoscopy, surgical ........................ 14.20 NA NA 10.97 11.09 1.70 NA NA 26.87 26.99 090

32665 ............ A Thoracoscopy, surgical ........................ 15.54 NA NA 11.15 12.25 1.79 NA NA 28.48 29.58 090

32800 ............ A Repair lung hernia ................................ 13.69 NA NA 11.78 11.08 1.51 NA NA 26.98 26.28 090

32810 ............ A Close chest after drainage ................... 13.05 NA NA 11.97 10.74 1.55 NA NA 26.57 25.34 090

32815 ............ A Close bronchial fistula .......................... 23.15 NA NA 17.03 16.90 2.84 NA NA 43.02 42.89 090

32820 ............ A Reconstruct injured chest ..................... 21.48 NA NA 15.38 16.69 2.31 NA NA 39.17 40.48 090

32850 ............ X Donor pneumonectomy ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

32851 ............ A Lung transplant, single ......................... 38.63 NA NA 24.78 25.52 4.90 NA NA 68.31 69.05 090

32852 ............ A Lung transplant with bypass ................ 41.80 NA NA 27.82 28.38 5.17 NA NA 74.79 75.35 090

32853 ............ A Lung transplant, double ........................ 47.81 NA NA 29.36 30.69 6.13 NA NA 83.30 84.63 090

32854 ............ A Lung transplant with bypass ................ 50.98 NA NA 29.22 31.17 6.41 NA NA 86.61 88.56 090

32900 ............ A Removal of rib(s) .................................. 20.27 NA NA 14.52 13.19 2.42 NA NA 37.21 35.88 090

32905 ............ A Revise & repair chest wall ................... 20.75 NA NA 15.18 14.84 2.54 NA NA 38.47 38.13 090

32906 ............ A Revise & repair chest wall ................... 26.77 NA NA 18.98 18.42 3.30 NA NA 49.05 48.49 090

32940 ............ A Revision of lung .................................... 19.43 NA NA 15.29 14.55 2.47 NA NA 37.19 36.45 090

32960 ............ A Therapeutic pneumothorax .................. 1.84 1.47 1.36 0.61 0.71 0.12 3.43 3.32 2.57 2.67 000

32997 ............ A Total lung lavage .................................. 6.00 NA NA 2.32 2.32 0.55 NA NA 8.87 8.87 000

32999 ............ C Chest surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

33010 ............ A Drainage of heart sac ........................... 2.24 NA NA 1.03 1.19 0.13 NA NA 3.40 3.56 000

33011 ............ A Repeat drainage of heart sac .............. 2.24 NA NA 1.09 0.97 0.13 NA NA 3.46 3.34 000

33015 ............ A Incision of heart sac ............................. 6.80 NA NA 5.24 5.09 0.64 NA NA 12.68 12.53 090

33020 ............ A Incision of heart sac ............................. 12.61 NA NA 9.90 11.02 1.50 NA NA 24.01 25.13 090

33025 ............ A Incision of heart sac ............................. 12.09 NA NA 10.17 11.24 1.50 NA NA 23.76 24.83 090

33030 ............ A Partial removal of heart sac ................. 18.71 NA NA 16.32 17.82 2.40 NA NA 37.43 38.93 090

33031 ............ A Partial removal of heart sac ................. 21.79 NA NA 17.72 16.89 2.78 NA NA 42.29 41.46 090

33050 ............ A Removal of heart sac lesion ................ 14.36 NA NA 12.87 12.16 1.73 NA NA 28.96 28.25 090

33120 ............ A Removal of heart lesion ....................... 24.56 NA NA 20.91 23.01 3.06 NA NA 48.53 50.63 090

33130 ............ A Removal of heart lesion ....................... 21.39 NA NA 16.53 16.06 2.51 NA NA 40.43 39.96 090

33140 ............ A Heart revascularize (tmr) ...................... 20.00 NA NA 12.79 12.79 2.27 NA NA 35.06 35.06 090

33141 ............ A Heart tmr w/other procedure ................ 4.84 NA NA 1.97 1.97 0.60 NA NA 7.41 7.41 ZZZ

33200 ............ A Insertion of heart pacemaker ............... 12.48 NA NA 11.73 12.13 1.17 NA NA 25.38 25.78 090

33201 ............ A Insertion of heart pacemaker ............... 10.18 NA NA 12.53 12.43 1.21 NA NA 23.92 23.82 090

33206 ............ A Insertion of heart pacemaker ............... 6.67 NA NA 6.17 6.62 0.50 NA NA 13.34 13.79 090

33207 ............ A Insertion of heart pacemaker ............... 8.04 NA NA 6.62 7.36 0.57 NA NA 15.23 15.97 090

33208 ............ A Insertion of heart pacemaker ............... 8.13 NA NA 6.74 7.48 0.54 NA NA 15.41 16.15 090

33210 ............ A Insertion of heart electrode .................. 3.30 NA NA 1.38 1.93 0.17 NA NA 4.85 5.40 000

33211 ............ A Insertion of heart electrode .................. 3.40 NA NA 1.48 2.01 0.17 NA NA 5.05 5.58 000

33212 ............ A Insertion of pulse generator ................. 5.52 NA NA 5.00 5.21 0.44 NA NA 10.96 11.17 090

33213 ............ A Insertion of pulse generator ................. 6.37 NA NA 5.35 5.47 0.46 NA NA 12.18 12.30 090

33214 ............ A Upgrade of pacemaker system ............ 7.75 NA NA 6.50 6.34 0.52 NA NA 14.77 14.61 090

33216 ............ A Revise eltrd pacing-defib ...................... 5.39 NA NA 5.39 5.41 0.36 NA NA 11.14 11.16 090

33217 ............ A Revise eltrd pacing-defib ...................... 5.75 NA NA 5.73 5.66 0.36 NA NA 11.84 11.77 090

33218 ............ A Revise eltrd pacing-defib ...................... 5.44 NA NA 5.03 5.02 0.40 NA NA 10.87 10.86 090

33220 ............ A Revise eltrd pacing-defib ...................... 5.52 NA NA 5.09 5.06 0.39 NA NA 11.00 10.97 090

33222 ............ A Revise pocket, pacemaker ................... 4.96 NA NA 4.46 4.83 0.39 NA NA 9.81 10.18 090

33223 ............ A Revise pocket, pacing-defib ................. 6.46 NA NA 5.76 5.87 0.44 NA NA 12.66 12.77 090

33233 ............ A Removal of pacemaker system ............ 3.29 NA NA 4.33 3.97 0.22 NA NA 7.84 7.48 090

33234 ............ A Removal of pacemaker system ............ 7.82 NA NA 6.36 5.54 0.56 NA NA 14.74 13.92 090

33235 ............ A Removal pacemaker electrode ............ 9.40 NA NA 7.15 6.22 0.68 NA NA 17.23 16.30 090

33236 ............ A Remove electrode/thoracotomy ........... 12.60 NA NA 11.65 9.82 1.49 NA NA 25.74 23.91 090

33237 ............ A Remove electrode/thoracotomy ........... 13.71 NA NA 12.58 12.04 1.57 NA NA 27.86 27.32 090

33238 ............ A Remove electrode/thoracotomy ........... 15.22 NA NA 12.31 12.03 1.56 NA NA 29.09 28.81 090

33240 ............ A Insert pulse generator .......................... 7.60 NA NA 6.27 6.16 0.53 NA NA 14.40 14.29 090

33241 ............ A Remove pulse generator ...................... 3.24 NA NA 3.92 3.53 0.21 NA NA 7.37 6.98 090

33243 ............ A Remove eltrd/thoracotomy ................... 22.64 NA NA 13.30 12.42 2.53 NA NA 38.47 37.59 090

33244 ............ A Remove eltrd, transven ........................ 13.76 NA NA 9.41 9.51 1.05 NA NA 24.22 24.32 090

33245 ............ A Insert epic eltrd pace-defib ................... 14.30 NA NA 13.04 14.05 1.28 NA NA 28.62 29.63 090

33246 ............ A Insert epic eltrd/generator .................... 20.71 NA NA 17.92 19.08 2.22 NA NA 40.85 42.01 090

33249 ............ A Eltrd/insert pace-defib .......................... 14.23 NA NA 9.80 11.32 0.80 NA NA 24.83 26.35 090

33250 ............ A Ablate heart dysrhythm focus .............. 21.85 NA NA 14.70 14.16 1.01 NA NA 37.56 37.02 090

33251 ............ A Ablate heart dysrhythm focus .............. 24.88 NA NA 18.08 18.01 2.41 NA NA 45.37 45.30 090

33253 ............ A Reconstruct atria .................................. 31.06 NA NA 21.93 22.37 3.68 NA NA 56.67 57.11 090

33261 ............ A Ablate heart dysrhythm focus .............. 24.88 NA NA 18.85 17.93 2.82 NA NA 46.55 45.63 090

33282 ............ A Implant pat-active ht record ................. 4.17 NA NA 5.53 5.53 0.39 NA NA 10.09 10.09 090

33284 ............ A Remove pat-active ht record ................ 2.50 NA NA 5.06 5.06 0.23 NA NA 7.79 7.79 090

33300 ............ A Repair of heart wound .......................... 17.92 NA NA 15.10 15.22 1.91 NA NA 34.93 35.05 090

33305 ............ A Repair of heart wound .......................... 21.44 NA NA 17.60 17.92 2.68 NA NA 41.72 42.04 090

33310 ............ A Exploratory heart surgery ..................... 18.51 NA NA 16.13 15.16 2.26 NA NA 36.90 35.93 090

33315 ............ A Exploratory heart surgery ..................... 22.37 NA NA 18.07 17.48 2.90 NA NA 43.34 42.75 090

65468

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

33320 ............ A Repair major blood vessel(s) ............... 16.79 NA NA 13.82 14.20 1.66 NA NA 32.27 32.65 090

33321 ............ A Repair major vessel ............................. 20.20 NA NA 17.69 19.17 2.70 NA NA 40.59 42.07 090

33322 ............ A Repair major blood vessel(s) ............... 20.62 NA NA 17.11 18.73 2.51 NA NA 40.24 41.86 090

33330 ............ A Insert major vessel graft ....................... 21.43 NA NA 16.59 15.88 2.49 NA NA 40.51 39.80 090

33332 ............ A Insert major vessel graft ....................... 23.96 NA NA 16.63 16.56 2.45 NA NA 43.04 42.97 090

33335 ............ A Insert major vessel graft ....................... 30.01 NA NA 20.90 19.76 3.79 NA NA 54.70 53.56 090

33400 ............ A Repair of aortic valve ........................... 25.34 NA NA 22.51 23.99 3.09 NA NA 50.94 52.42 090

33401 ............ A Valvuloplasty, open .............................. 23.91 NA NA 20.65 22.60 2.71 NA NA 47.27 49.22 090

33403 ............ A Valvuloplasty, w/cp bypass .................. 24.89 NA NA 21.18 23.00 2.48 NA NA 48.55 50.37 090

33404 ............ A Prepare heart-aorta conduit ................. 28.54 NA NA 23.41 26.04 3.31 NA NA 55.26 57.89 090

33405 ............ A Replacement of aortic valve ................. 30.61 NA NA 21.49 24.39 3.86 NA NA 55.96 58.86 090

33406 ............ A Replacement of aortic valve ................. 32.30 NA NA 21.91 26.07 4.07 NA NA 58.28 62.44 090

33410 ............ A Replacement of aortic valve ................. 32.46 NA NA 22.25 22.25 4.11 NA NA 58.82 58.82 090

33411 ............ A Replacement of aortic valve ................. 32.47 NA NA 22.58 26.63 4.16 NA NA 59.21 63.26 090

33412 ............ A Replacement of aortic valve ................. 34.79 NA NA 28.65 31.87 4.66 NA NA 68.10 71.32 090

33413 ............ A Replacement of aortic valve ................. 35.24 NA NA 26.31 30.25 4.26 NA NA 65.81 69.75 090

33414 ............ A Repair of aortic valve ........................... 30.35 NA NA 25.53 28.21 3.79 NA NA 59.67 62.35 090

33415 ............ A Revision, subvalvular tissue ................. 27.15 NA NA 23.86 26.00 3.25 NA NA 54.26 56.40 090

33416 ............ A Revise ventricle muscle ....................... 30.35 NA NA 21.75 23.95 3.85 NA NA 55.95 58.15 090

33417 ............ A Repair of aortic valve ........................... 28.53 NA NA 25.27 27.47 3.58 NA NA 57.38 59.58 090

33420 ............ A Revision of mitral valve ........................ 22.70 NA NA 12.17 14.51 1.48 NA NA 36.35 38.69 090

33422 ............ A Revision of mitral valve ........................ 25.94 NA NA 19.49 22.36 3.30 NA NA 48.73 51.60 090

33425 ............ A Repair of mitral valve ........................... 27.00 NA NA 18.50 21.93 3.00 NA NA 48.50 51.93 090

33426 ............ A Repair of mitral valve ........................... 31.03 NA NA 21.66 24.92 3.87 NA NA 56.56 59.82 090

33427 ............ A Repair of mitral valve ........................... 33.72 NA NA 22.30 26.14 4.30 NA NA 60.32 64.16 090

33430 ............ A Replacement of mitral valve ................. 31.43 NA NA 21.86 25.78 3.95 NA NA 57.24 61.16 090

33460 ............ A Revision of tricuspid valve ................... 23.60 NA NA 18.75 21.11 3.02 NA NA 45.37 47.73 090

33463 ............ A Valvuloplasty, tricuspid ......................... 25.62 NA NA 19.45 22.23 3.17 NA NA 48.24 51.02 090

33464 ............ A Valvuloplasty, tricuspid ......................... 27.33 NA NA 20.33 23.40 3.47 NA NA 51.13 54.20 090

33465 ............ A Replace tricuspid valve ........................ 28.79 NA NA 20.51 23.98 3.61 NA NA 52.91 56.38 090

33468 ............ A Revision of tricuspid valve ................... 30.12 NA NA 29.92 31.43 4.00 NA NA 64.04 65.55 090

33470 ............ A Revision of pulmonary valve ................ 20.81 NA NA 17.43 18.45 2.81 NA NA 41.05 42.07 090

33471 ............ A Valvotomy, pulmonary valve ................ 22.25 NA NA 19.39 21.19 3.00 NA NA 44.64 46.44 090

33472 ............ A Revision of pulmonary valve ................ 22.25 NA NA 19.97 21.62 2.92 NA NA 45.14 46.79 090

33474 ............ A Revision of pulmonary valve ................ 23.04 NA NA 17.05 19.66 2.84 NA NA 42.93 45.54 090

33475 ............ A Replacement, pulmonary valve ............ 28.41 NA NA 23.92 26.42 2.64 NA NA 54.97 57.47 090

33476 ............ A Revision of heart chamber ................... 25.77 NA NA 19.07 21.94 2.40 NA NA 47.24 50.11 090

33478 ............ A Revision of heart chamber ................... 26.74 NA NA 20.54 23.39 3.56 NA NA 50.84 53.69 090

33496 ............ A Repair, prosth valve clot ...................... 27.25 NA NA 24.25 26.32 3.44 NA NA 54.94 57.01 090

33500 ............ A Repair heart vessel fistula .................... 25.55 NA NA 18.73 21.68 2.80 NA NA 47.08 50.03 090

33501 ............ A Repair heart vessel fistula .................... 17.78 NA NA 14.21 14.50 2.05 NA NA 34.04 34.33 090

33502 ............ A Coronary artery correction ................... 21.04 NA NA 23.73 21.64 2.51 NA NA 47.28 45.19 090

33503 ............ A Coronary artery graft ............................ 21.78 NA NA 14.77 17.58 1.42 NA NA 37.97 40.78 090

33504 ............ A Coronary artery graft ............................ 24.66 NA NA 23.74 25.17 3.04 NA NA 51.44 52.87 090

33505 ............ A Repair artery w/tunnel .......................... 26.84 NA NA 21.54 24.17 1.52 NA NA 49.90 52.53 090

33506 ............ A Repair artery, translocation .................. 26.71 NA NA 16.87 20.62 3.19 NA NA 46.77 50.52 090

33510 ............ A CABG, vein, single ............................... 25.12 NA NA 19.14 21.85 3.13 NA NA 47.39 50.10 090

33511 ............ A CABG, vein, two ................................... 27.40 NA NA 19.78 23.01 3.34 NA NA 50.52 53.75 090

33512 ............ A CABG, vein, three ................................ 29.67 NA NA 20.95 24.57 3.70 NA NA 54.32 57.94 090

33513 ............ A CABG, vein, four .................................. 31.95 NA NA 21.98 26.02 3.99 NA NA 57.92 61.96 090

33514 ............ A CABG, vein, five ................................... 35.00 NA NA 23.34 27.95 4.37 NA NA 62.71 67.32 090

33516 ............ A Cabg, vein, six or more ........................ 37.40 NA NA 24.31 29.40 4.62 NA NA 66.33 71.42 090

33517 ............ A CABG, artery-vein, single ..................... 2.57 NA NA 1.06 1.56 0.32 NA NA 3.95 4.45 ZZZ

33518 ............ A CABG, artery-vein, two ........................ 4.85 NA NA 1.99 2.94 0.61 NA NA 7.45 8.40 ZZZ

33519 ............ A CABG, artery-vein, three ...................... 7.12 NA NA 2.93 4.32 0.89 NA NA 10.94 12.33 ZZZ

33521 ............ A CABG, artery-vein, four ........................ 9.40 NA NA 3.88 5.72 1.18 NA NA 14.46 16.30 ZZZ

33522 ............ A CABG, artery-vein, five ........................ 11.67 NA NA 4.83 7.11 1.48 NA NA 17.98 20.26 ZZZ

33523 ............ A Cabg, art-vein, six or more .................. 13.95 NA NA 5.76 8.49 1.78 NA NA 21.49 24.22 ZZZ

33530 ............ A Coronary artery, bypass/reop ............... 5.86 NA NA 2.39 3.54 0.73 NA NA 8.98 10.13 ZZZ

33533 ............ A CABG, arterial, single ........................... 25.83 NA NA 19.44 22.29 3.24 NA NA 48.51 51.36 090

33534 ............ A CABG, arterial, two .............................. 28.82 NA NA 20.12 23.69 3.63 NA NA 52.57 56.14 090

33535 ............ A CABG, arterial, three ............................ 31.81 NA NA 21.05 25.28 3.97 NA NA 56.83 61.06 090

33536 ............ A Cabg, arterial, four or more .................. 34.79 NA NA 18.16 24.00 3.29 NA NA 56.24 62.08 090

33542 ............ A Removal of heart lesion ....................... 28.85 NA NA 22.87 25.49 3.61 NA NA 55.33 57.95 090

33545 ............ A Repair of heart damage ....................... 36.78 NA NA 25.64 28.71 4.40 NA NA 66.82 69.89 090

33572 ............ A Open coronary endarterectomy ........... 4.45 NA NA 1.83 2.25 0.55 NA NA 6.83 7.25 ZZZ

33600 ............ A Closure of valve ................................... 29.51 NA NA 20.22 23.97 2.30 NA NA 52.03 55.78 090

33602 ............ A Closure of valve ................................... 28.54 NA NA 16.17 20.40 2.90 NA NA 47.61 51.84 090

33606 ............ A Anastomosis/artery-aorta ..................... 30.74 NA NA 18.74 23.23 3.59 NA NA 53.07 57.56 090

33608 ............ A Repair anomaly w/conduit .................... 31.09 NA NA 26.78 29.37 4.17 NA NA 62.04 64.63 090

33610 ............ A Repair by enlargement ......................... 30.61 NA NA 26.03 28.66 4.02 NA NA 60.66 63.29 090

33611 ............ A Repair double ventricle ........................ 32.30 NA NA 24.45 27.98 3.28 NA NA 60.03 63.56 090

33612 ............ A Repair double ventricle ........................ 33.26 NA NA 27.40 30.48 4.44 NA NA 65.10 68.18 090

33615 ............ A Repair, modified fontan ........................ 32.06 NA NA 28.18 30.71 3.15 NA NA 63.39 65.92 090

33617 ............ A Repair single ventricle .......................... 34.03 NA NA 26.43 29.98 4.09 NA NA 64.55 68.10 090

33619 ............ A Repair single ventricle .......................... 37.57 NA NA 32.65 35.70 4.71 NA NA 74.93 77.98 090

33641 ............ A Repair heart septum defect .................. 21.39 NA NA 15.59 18.08 2.67 NA NA 39.65 42.14 090

33645 ............ A Revision of heart veins ......................... 24.82 NA NA 19.83 22.28 3.27 NA NA 47.92 50.37 090

33647 ............ A Repair heart septum defects ................ 28.73 NA NA 24.10 26.65 3.37 NA NA 56.20 58.75 090

33660 ............ A Repair of heart defects ......................... 25.54 NA NA 22.13 24.22 2.82 NA NA 50.49 52.58 090

33665 ............ A Repair of heart defects ......................... 28.60 NA NA 24.67 26.99 3.81 NA NA 57.08 59.40 090

33670 ............ A Repair of heart chambers .................... 32.73 NA NA 17.23 22.69 2.18 NA NA 52.14 57.60 090

33681 ............ A Repair heart septum defect .................. 27.67 NA NA 24.25 26.45 3.53 NA NA 55.45 57.65 090

65469

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

33684 ............ A Repair heart septum defect .................. 29.65 NA NA 22.78 25.94 3.77 NA NA 56.20 59.36 090

33688 ............ A Repair heart septum defect .................. 30.62 NA NA 17.23 22.06 3.89 NA NA 51.74 56.57 090

33690 ............ A Reinforce pulmonary artery .................. 19.55 NA NA 19.36 20.36 2.56 NA NA 41.47 42.47 090

33692 ............ A Repair of heart defects ......................... 30.75 NA NA 17.94 22.63 3.77 NA NA 52.46 57.15 090

33694 ............ A Repair of heart defects ......................... 31.73 NA NA 21.86 25.87 4.27 NA NA 57.86 61.87 090

33697 ............ A Repair of heart defects ......................... 33.71 NA NA 25.47 29.16 4.54 NA NA 63.72 67.41 090

33702 ............ A Repair of heart defects ......................... 26.54 NA NA 22.29 24.64 3.45 NA NA 52.28 54.63 090

33710 ............ A Repair of heart defects ......................... 29.71 NA NA 16.87 21.52 3.85 NA NA 50.43 55.08 090

33720 ............ A Repair of heart defect .......................... 26.56 NA NA 20.97 23.66 3.21 NA NA 50.74 53.43 090

33722 ............ A Repair of heart defect .......................... 28.41 NA NA 23.23 25.69 3.80 NA NA 55.44 57.90 090

33730 ............ A Repair heart-vein defect(s) ................... 31.67 NA NA 19.96 24.42 2.85 NA NA 54.48 58.94 090

33732 ............ A Repair heart-vein defect ....................... 28.16 NA NA 20.83 24.03 2.78 NA NA 51.77 54.97 090

33735 ............ A Revision of heart chamber ................... 21.39 NA NA 14.20 17.62 1.12 NA NA 36.71 40.13 090

33736 ............ A Revision of heart chamber ................... 23.52 NA NA 22.09 23.54 2.70 NA NA 48.31 49.76 090

33737 ............ A Revision of heart chamber ................... 21.76 NA NA 17.82 19.86 2.93 NA NA 42.51 44.55 090

33750 ............ A Major vessel shunt ............................... 21.41 NA NA 17.71 19.28 1.74 NA NA 40.86 42.43 090

33755 ............ A Major vessel shunt ............................... 21.79 NA NA 17.83 19.37 2.93 NA NA 42.55 44.09 090

33762 ............ A Major vessel shunt ............................... 21.79 NA NA 12.73 15.54 1.59 NA NA 36.11 38.92 090

33764 ............ A Major vessel shunt & graft ................... 21.79 NA NA 14.94 17.20 1.93 NA NA 38.66 40.92 090

33766 ............ A Major vessel shunt ............................... 22.76 NA NA 21.93 22.44 3.04 NA NA 47.73 48.24 090

33767 ............ A Major vessel shunt ............................... 24.50 NA NA 20.58 22.41 3.14 NA NA 48.22 50.05 090

33770 ............ A Repair great vessels defect ................. 33.29 NA NA 22.50 26.81 4.49 NA NA 60.28 64.59 090

33771 ............ A Repair great vessels defect ................. 34.65 NA NA 18.84 24.47 4.67 NA NA 58.16 63.79 090

33774 ............ A Repair great vessels defect ................. 30.98 NA NA 17.37 21.51 4.18 NA NA 52.53 56.67 090

33775 ............ A Repair great vessels defect ................. 32.20 NA NA 17.86 21.88 4.34 NA NA 54.40 58.42 090

33776 ............ A Repair great vessels defect ................. 34.04 NA NA 18.60 23.43 4.58 NA NA 57.22 62.05 090

33777 ............ A Repair great vessels defect ................. 33.46 NA NA 18.37 22.26 4.51 NA NA 56.34 60.23 090

33778 ............ A Repair great vessels defect ................. 35.82 NA NA 19.31 25.17 4.83 NA NA 59.96 65.82 090

33779 ............ A Repair great vessels defect ................. 36.21 NA NA 19.97 25.79 2.40 NA NA 58.58 64.40 090

33780 ............ A Repair great vessels defect ................. 36.94 NA NA 22.67 28.03 5.21 NA NA 64.82 70.18 090

33781 ............ A Repair great vessels defect ................. 36.45 NA NA 19.56 25.55 4.91 NA NA 60.92 66.91 090

33786 ............ A Repair arterial trunk .............................. 34.84 NA NA 23.12 27.74 4.69 NA NA 62.65 67.27 090

33788 ............ A Revision of pulmonary artery ............... 26.62 NA NA 19.10 22.27 3.32 NA NA 49.04 52.21 090

33800 ............ A Aortic suspension ................................. 16.24 NA NA 12.96 13.56 1.11 NA NA 30.31 30.91 090

33802 ............ A Repair vessel defect ............................. 17.66 NA NA 10.81 13.38 1.56 NA NA 30.03 32.60 090

33803 ............ A Repair vessel defect ............................. 19.60 NA NA 18.72 19.89 2.63 NA NA 40.95 42.12 090

33813 ............ A Repair septal defect ............................. 20.65 NA NA 17.37 19.02 2.78 NA NA 40.80 42.45 090

33814 ............ A Repair septal defect ............................. 25.77 NA NA 24.70 26.22 2.52 NA NA 52.99 54.51 090

33820 ............ A Revise major vessel ............................. 16.29 NA NA 16.79 17.46 2.10 NA NA 35.18 35.85 090

33822 ............ A Revise major vessel ............................. 17.32 NA NA 16.01 17.18 2.33 NA NA 35.66 36.83 090

33824 ............ A Revise major vessel ............................. 19.52 NA NA 16.13 17.92 2.61 NA NA 38.26 40.05 090

33840 ............ A Remove aorta constriction ................... 20.63 NA NA 17.46 19.25 2.36 NA NA 40.45 42.24 090

33845 ............ A Remove aorta constriction ................... 22.12 NA NA 20.75 22.16 2.90 NA NA 45.77 47.18 090

33851 ............ A Remove aorta constriction ................... 21.27 NA NA 17.62 19.57 2.86 NA NA 41.75 43.70 090

33852 ............ A Repair septal defect ............................. 23.71 NA NA 19.99 22.07 3.19 NA NA 46.89 48.97 090

33853 ............ A Repair septal defect ............................. 31.72 NA NA 24.96 28.19 4.23 NA NA 60.91 64.14 090

33860 ............ A Ascending aortic graft .......................... 33.96 NA NA 22.74 26.47 4.30 NA NA 61.00 64.73 090

33861 ............ A Ascending aortic graft .......................... 34.52 NA NA 22.77 26.50 4.24 NA NA 61.53 65.26 090

33863 ............ A Ascending aortic graft .......................... 36.47 NA NA 23.69 27.19 4.60 NA NA 64.76 68.26 090

33870 ............ A Transverse aortic arch graft ................. 40.31 NA NA 24.99 30.76 5.09 NA NA 70.39 76.16 090

33875 ............ A Thoracic aortic graft ............................. 33.06 NA NA 21.74 24.78 4.08 NA NA 58.88 61.92 090

33877 ............ A Thoracoabdominal graft ....................... 42.60 NA NA 26.54 31.87 5.07 NA NA 74.21 79.54 090

33910 ............ A Remove lung artery emboli .................. 24.59 NA NA 18.51 17.86 3.06 NA NA 46.16 45.51 090

33915 ............ A Remove lung artery emboli .................. 21.02 NA NA 13.32 13.25 1.20 NA NA 35.54 35.47 090

33916 ............ A Surgery of great vessel ........................ 25.83 NA NA 16.64 17.25 3.04 NA NA 45.51 46.12 090

33917 ............ A Repair pulmonary artery ....................... 24.50 NA NA 22.44 24.14 3.17 NA NA 50.11 51.81 090

33918 ............ A Repair pulmonary atresia ..................... 26.45 NA NA 15.57 19.57 3.42 NA NA 45.44 49.44 090

33919 ............ A Repair pulmonary atresia ..................... 32.67 NA NA 23.85 27.64 3.48 NA NA 60.00 63.79 090

33920 ............ A Repair pulmonary atresia ..................... 31.95 NA NA 18.94 23.74 3.61 NA NA 54.50 59.30 090

33922 ............ A Transect pulmonary artery ................... 23.52 NA NA 17.86 20.42 2.30 NA NA 43.68 46.24 090

33924 ............ A Remove pulmonary shunt .................... 5.50 NA NA 2.22 2.75 0.74 NA NA 8.46 8.99 ZZZ

33930 ............ X Removal of donor heart/lung ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

33935 ............ R Transplantation, heart/lung ................... 60.96 NA NA 34.74 44.25 8.15 NA NA 103.85 113.36 090

33940 ............ X Removal of donor heart ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

33945 ............ R Transplantation of heart ....................... 42.10 NA NA 27.22 32.98 5.42 NA NA 74.74 80.50 090

33960 ............ A External circulation assist ..................... 19.36 NA NA 7.48 7.51 2.14 NA NA 28.98 29.01 XXX

33961 ............ A External circulation assist ..................... 10.93 NA NA 4.50 5.28 1.47 NA NA 16.90 17.68 ZZZ

33968 ............ A Remove aortic assist device ................ 0.64 NA NA 0.26 0.26 0.07 NA NA 0.97 0.97 000

33970 ............ A Aortic circulation assist ......................... 6.75 NA NA 2.80 4.12 0.70 NA NA 10.25 11.57 000

33971 ............ A Aortic circulation assist ......................... 9.69 NA NA 9.88 8.81 0.97 NA NA 20.54 19.47 090

33973 ............ A Insert balloon device ............................ 9.76 NA NA 4.01 5.05 1.01 NA NA 14.78 15.82 000

33974 ............ A Remove intra-aortic balloon ................. 14.41 NA NA 13.34 11.51 1.48 NA NA 29.23 27.40 090

33975 ............ A Implant ventricular device .................... 21.00 NA NA 6.41 8.66 1.72 NA NA 29.13 31.38 XXX

33976 ............ A Implant ventricular device .................... 23.00 NA NA 9.37 12.27 2.82 NA NA 35.19 38.09 XXX

33977 ............ A Remove ventricular device ................... 19.29 NA NA 13.41 13.43 2.44 NA NA 35.14 35.16 090

33978 ............ A Remove ventricular device ................... 21.73 NA NA 14.89 15.02 2.66 NA NA 39.28 39.41 090

33999 ............ C Cardiac surgery procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

34001 ............ A Removal of artery clot .......................... 12.91 NA NA 6.28 7.31 1.46 NA NA 20.65 21.68 090

34051 ............ A Removal of artery clot .......................... 15.21 NA NA 8.20 8.54 1.90 NA NA 25.31 25.65 090

34101 ............ A Removal of artery clot .......................... 9.97 NA NA 5.17 6.14 1.11 NA NA 16.25 17.22 090

34111 ............ A Removal of arm artery clot ................... 8.07 NA NA 4.35 5.32 0.85 NA NA 13.27 14.24 090

34151 ............ A Removal of artery clot .......................... 16.86 NA NA 7.88 9.16 1.84 NA NA 26.58 27.86 090

34201 ............ A Removal of artery clot .......................... 9.13 NA NA 5.16 6.29 1.02 NA NA 15.31 16.44 090

65470

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

34203 ............ A Removal of leg artery clot .................... 12.21 NA NA 6.45 7.18 1.37 NA NA 20.03 20.76 090

34401 ............ A Removal of vein clot ............................. 12.86 NA NA 6.47 7.04 1.20 NA NA 20.53 21.10 090

34421 ............ A Removal of vein clot ............................. 9.93 NA NA 5.53 6.17 0.95 NA NA 16.41 17.05 090

34451 ............ A Removal of vein clot ............................. 14.44 NA NA 7.39 8.44 1.59 NA NA 23.42 24.47 090

34471 ............ A Removal of vein clot ............................. 10.18 NA NA 5.24 4.88 0.90 NA NA 16.32 15.96 090

34490 ............ A Removal of vein clot ............................. 7.60 NA NA 5.67 6.23 0.73 NA NA 14.00 14.56 090

34501 ............ A Repair valve, femoral vein ................... 10.93 NA NA 8.84 8.63 1.37 NA NA 21.14 20.93 090

34502 ............ A Reconstruct vena cava ......................... 26.95 NA NA 12.39 14.35 2.99 NA NA 42.33 44.29 090

34510 ............ A Transposition of vein valve .................. 13.25 NA NA 9.45 9.50 1.60 NA NA 24.30 24.35 090

34520 ............ A Cross-over vein graft ............................ 13.74 NA NA 8.07 8.59 1.41 NA NA 23.22 23.74 090

34530 ............ A Leg vein fusion ..................................... 17.61 NA NA 9.98 10.84 2.06 NA NA 29.65 30.51 090

34800 ............ A Endovasc abdo repair w/tube .............. 20.75 NA NA 9.72 9.72 1.49 NA NA 31.96 31.96 090

34802 ............ A Endovasc abdo repr w/device .............. 23.00 NA NA 10.62 10.62 1.65 NA NA 35.27 35.27 090

34804 ............ A Endovasc abdo repr w/device .............. 23.00 NA NA 10.62 10.62 1.65 NA NA 35.27 35.27 090

34808 ............ A Endovasc abdo occlud device ............. 4.13 NA NA 1.65 1.65 0.29 NA NA 6.07 6.07 ZZZ

34812 ............ A Xpose for endoprosth, aortic ................ 6.75 NA NA 2.70 2.70 0.49 NA NA 9.94 9.94 000

34813 ............ A Xpose for endoprosth, femorl ............... 4.80 NA NA 1.92 1.92 0.34 NA NA 7.06 7.06 ZZZ

34820 ............ A Xpose for endoprosth, iliac .................. 9.75 NA NA 3.90 3.90 0.70 NA NA 14.35 14.35 000

34825 ............ A Endovasc extend prosth, init ................ 12.00 NA NA 6.23 6.23 0.86 NA NA 19.09 19.09 090

34826 ............ A Endovasc exten prosth, addl ................ 4.13 NA NA 1.65 1.65 0.29 NA NA 6.07 6.07 ZZZ

34830 ............ A Open aortic tube prosth repr ................ 32.59 NA NA 14.81 14.81 2.34 NA NA 49.74 49.74 090

34831 ............ A Open aortoiliac prosth repr .................. 35.34 NA NA 15.90 15.90 2.53 NA NA 53.77 53.77 090

34832 ............ A Open aortofemor prosth repr ............... 35.34 NA NA 15.90 15.90 2.53 NA NA 53.77 53.77 090

35001 ............ A Repair defect of artery ......................... 19.64 NA NA 9.28 11.28 2.44 NA NA 31.36 33.36 090

35002 ............ A Repair artery rupture, neck .................. 21.00 NA NA 9.94 10.89 1.82 NA NA 32.76 33.71 090

35005 ............ A Repair defect of artery ......................... 18.12 NA NA 8.71 9.32 1.35 NA NA 28.18 28.79 090

35011 ............ A Repair defect of artery ......................... 11.65 NA NA 5.68 7.74 1.30 NA NA 18.63 20.69 090

35013 ............ A Repair artery rupture, arm .................... 17.40 NA NA 7.89 9.91 1.91 NA NA 27.20 29.22 090

35021 ............ A Repair defect of artery ......................... 19.65 NA NA 10.22 12.59 1.93 NA NA 31.80 34.17 090

35022 ............ A Repair artery rupture, chest ................. 23.18 NA NA 9.89 11.43 1.99 NA NA 35.06 36.60 090

35045 ............ A Repair defect of arm artery .................. 11.26 NA NA 7.02 8.62 1.25 NA NA 19.53 21.13 090

35081 ............ A Repair defect of artery ......................... 28.01 NA NA 12.75 15.38 3.20 NA NA 43.96 46.59 090

35082 ............ A Repair artery rupture, aorta .................. 36.35 NA NA 15.42 17.78 4.07 NA NA 55.84 58.20 090

35091 ............ A Repair defect of artery ......................... 35.40 NA NA 15.48 17.76 4.09 NA NA 54.97 57.25 090

35092 ............ A Repair artery rupture, aorta .................. 38.39 NA NA 16.20 19.28 4.31 NA NA 58.90 61.98 090

35102 ............ A Repair defect of artery ......................... 30.76 NA NA 13.54 16.17 3.44 NA NA 47.74 50.37 090

35103 ............ A Repair artery rupture, groin .................. 33.57 NA NA 14.25 17.79 3.79 NA NA 51.61 55.15 090

35111 ............ A Repair defect of artery ......................... 16.43 NA NA 7.81 10.63 1.81 NA NA 26.05 28.87 090

35112 ............ A Repair artery rupture,spleen ................ 18.69 NA NA 8.42 9.15 1.95 NA NA 29.06 29.79 090

35121 ............ A Repair defect of artery ......................... 25.99 NA NA 11.62 13.90 2.93 NA NA 40.54 42.82 090

35122 ............ A Repair artery rupture, belly .................. 33.45 NA NA 14.05 15.40 3.54 NA NA 51.04 52.39 090

35131 ............ A Repair defect of artery ......................... 18.55 NA NA 9.06 11.10 2.11 NA NA 29.72 31.76 090

35132 ............ A Repair artery rupture, groin .................. 21.95 NA NA 9.79 12.41 2.48 NA NA 34.22 36.84 090

35141 ............ A Repair defect of artery ......................... 14.46 NA NA 7.35 9.50 1.65 NA NA 23.46 25.61 090

35142 ............ A Repair artery rupture, thigh .................. 15.86 NA NA 7.62 10.08 1.75 NA NA 25.23 27.69 090

35151 ............ A Repair defect of artery ......................... 17.00 NA NA 8.27 10.37 1.93 NA NA 27.20 29.30 090

35152 ............ A Repair artery rupture, knee .................. 16.70 NA NA 8.25 8.70 1.93 NA NA 26.88 27.33 090

35161 ............ A Repair defect of artery ......................... 18.76 NA NA 9.88 11.72 2.21 NA NA 30.85 32.69 090

35162 ............ A Repair artery rupture ............................ 19.78 NA NA 10.07 12.62 2.21 NA NA 32.06 34.61 090

35180 ............ A Repair blood vessel lesion ................... 13.62 NA NA 6.23 6.67 1.44 NA NA 21.29 21.73 090

35182 ............ A Repair blood vessel lesion ................... 17.74 NA NA 9.01 9.65 1.88 NA NA 28.63 29.27 090

35184 ............ A Repair blood vessel lesion ................... 12.25 NA NA 6.25 7.33 1.34 NA NA 19.84 20.92 090

35188 ............ A Repair blood vessel lesion ................... 14.28 NA NA 7.04 7.48 1.53 NA NA 22.85 23.29 090

35189 ............ A Repair blood vessel lesion ................... 18.43 NA NA 9.21 9.98 2.12 NA NA 29.76 30.53 090

35190 ............ A Repair blood vessel lesion ................... 12.75 NA NA 6.16 7.43 1.33 NA NA 20.24 21.51 090

35201 ............ A Repair blood vessel lesion ................... 9.99 NA NA 5.31 6.72 1.17 NA NA 16.47 17.88 090

35206 ............ A Repair blood vessel lesion ................... 9.25 NA NA 6.55 7.67 1.04 NA NA 16.84 17.96 090

35207 ............ A Repair blood vessel lesion ................... 10.15 NA NA 9.28 9.89 1.15 NA NA 20.58 21.19 090

35211 ............ A Repair blood vessel lesion ................... 22.12 NA NA 18.24 17.31 2.83 NA NA 43.19 42.26 090

35216 ............ A Repair blood vessel lesion ................... 18.75 NA NA 14.34 13.65 2.17 NA NA 35.26 34.57 090

35221 ............ A Repair blood vessel lesion ................... 16.42 NA NA 7.82 8.88 1.79 NA NA 26.03 27.09 090

35226 ............ A Repair blood vessel lesion ................... 9.06 NA NA 7.19 8.10 0.84 NA NA 17.09 18.00 090

35231 ............ A Repair blood vessel lesion ................... 12.00 NA NA 6.52 8.47 1.32 NA NA 19.84 21.79 090

35236 ............ A Repair blood vessel lesion ................... 10.54 NA NA 7.03 8.42 1.19 NA NA 18.76 20.15 090

35241 ............ A Repair blood vessel lesion ................... 23.12 NA NA 19.27 18.11 2.90 NA NA 45.29 44.13 090

35246 ............ A Repair blood vessel lesion ................... 19.84 NA NA 14.83 15.72 2.22 NA NA 36.89 37.78 090

35251 ............ A Repair blood vessel lesion ................... 17.49 NA NA 8.06 8.65 1.87 NA NA 27.42 28.01 090

35256 ............ A Repair blood vessel lesion ................... 11.38 NA NA 7.60 9.07 1.32 NA NA 20.30 21.77 090

35261 ............ A Repair blood vessel lesion ................... 11.63 NA NA 5.81 7.83 1.34 NA NA 18.78 20.80 090

35266 ............ A Repair blood vessel lesion ................... 10.30 NA NA 7.08 8.39 1.16 NA NA 18.54 19.85 090

35271 ............ A Repair blood vessel lesion ................... 22.12 NA NA 17.24 16.33 2.77 NA NA 42.13 41.22 090

35276 ............ A Repair blood vessel lesion ................... 18.75 NA NA 15.47 14.55 2.37 NA NA 36.59 35.67 090

35281 ............ A Repair blood vessel lesion ................... 16.48 NA NA 7.90 10.61 1.82 NA NA 26.20 28.91 090

35286 ............ A Repair blood vessel lesion ................... 11.87 NA NA 7.81 9.04 1.36 NA NA 21.04 22.27 090

35301 ............ A Rechanneling of artery ......................... 18.70 NA NA 9.66 11.17 2.23 NA NA 30.59 32.10 090

35311 ............ A Rechanneling of artery ......................... 23.85 NA NA 12.08 15.05 2.75 NA NA 38.68 41.65 090

35321 ............ A Rechanneling of artery ......................... 11.97 NA NA 5.94 7.97 1.36 NA NA 19.27 21.30 090

35331 ............ A Rechanneling of artery ......................... 23.52 NA NA 10.93 11.82 2.71 NA NA 37.16 38.05 090

35341 ............ A Rechanneling of artery ......................... 25.11 NA NA 11.25 13.15 2.87 NA NA 39.23 41.13 090

35351 ............ A Rechanneling of artery ......................... 20.11 NA NA 9.42 11.12 2.29 NA NA 31.82 33.52 090

35355 ............ A Rechanneling of artery ......................... 16.09 NA NA 7.88 10.09 1.80 NA NA 25.77 27.98 090

35361 ............ A Rechanneling of artery ......................... 23.59 NA NA 10.67 13.26 2.66 NA NA 36.92 39.51 090

35363 ............ A Rechanneling of artery ......................... 24.66 NA NA 11.18 14.56 2.77 NA NA 38.61 41.99 090

65471

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

35371 ............ A Rechanneling of artery ......................... 11.64 NA NA 6.01 7.90 1.32 NA NA 18.97 20.86 090

35372 ............ A Rechanneling of artery ......................... 13.56 NA NA 6.73 8.09 1.53 NA NA 21.82 23.18 090

35381 ............ A Rechanneling of artery ......................... 15.81 NA NA 7.88 9.62 1.80 NA NA 25.49 27.23 090

35390 ............ A Reoperation, carotid add-on ................. 3.19 NA NA 1.22 1.37 0.38 NA NA 4.79 4.94 ZZZ

35400 ............ A Angioscopy ........................................... 3.00 NA NA 1.10 1.44 0.34 NA NA 4.44 4.78 ZZZ

35450 ............ A Repair arterial blockage ....................... 10.07 NA NA 3.91 5.94 0.84 NA NA 14.82 16.85 000

35452 ............ A Repair arterial blockage ....................... 6.91 NA NA 3.51 3.81 0.76 NA NA 11.18 11.48 000

35454 ............ A Repair arterial blockage ....................... 6.04 NA NA 3.05 4.09 0.67 NA NA 9.76 10.80 000

35456 ............ A Repair arterial blockage ....................... 7.35 NA NA 3.56 4.87 0.82 NA NA 11.73 13.04 000

35458 ............ A Repair arterial blockage ....................... 9.49 NA NA 4.39 6.04 1.09 NA NA 14.97 16.62 000

35459 ............ A Repair arterial blockage ....................... 8.63 NA NA 3.93 5.52 0.96 NA NA 13.52 15.11 000

35460 ............ A Repair venous blockage ....................... 6.04 NA NA 2.90 3.03 0.66 NA NA 9.60 9.73 000

35470 ............ A Repair arterial blockage ....................... 8.63 NA NA 4.09 5.64 0.50 NA NA 13.22 14.77 000

35471 ............ A Repair arterial blockage ....................... 10.07 NA NA 4.78 6.59 0.50 NA NA 15.35 17.16 000

35472 ............ A Repair arterial blockage ....................... 6.91 NA NA 3.46 3.58 0.39 NA NA 10.76 10.88 000

35473 ............ A Repair arterial blockage ....................... 6.04 NA NA 3.07 4.11 0.34 NA NA 9.45 10.49 000

35474 ............ A Repair arterial blockage ....................... 7.36 NA NA 3.60 4.90 0.40 NA NA 11.36 12.66 000

35475 ............ R Repair arterial blockage ....................... 9.49 NA NA 4.26 5.94 0.47 NA NA 14.22 15.90 000

35476 ............ A Repair venous blockage ....................... 6.04 NA NA 2.94 3.06 0.27 NA NA 9.25 9.37 000

35480 ............ A Atherectomy, open ............................... 11.08 NA NA 4.96 7.03 1.13 NA NA 17.17 19.24 000

35481 ............ A Atherectomy, open ............................... 7.61 NA NA 3.80 4.03 0.84 NA NA 12.25 12.48 000

35482 ............ A Atherectomy, open ............................... 6.65 NA NA 3.28 4.45 0.75 NA NA 10.68 11.85 000

35483 ............ A Atherectomy, open ............................... 8.10 NA NA 3.89 5.34 0.81 NA NA 12.80 14.25 000

35484 ............ A Atherectomy, open ............................... 10.44 NA NA 4.67 6.25 1.13 NA NA 16.24 17.82 000

35485 ............ A Atherectomy, open ............................... 9.49 NA NA 4.40 4.53 1.06 NA NA 14.95 15.08 000

35490 ............ A Atherectomy, percutaneous ................. 11.08 NA NA 5.04 7.09 0.55 NA NA 16.67 18.72 000

35491 ............ A Atherectomy, percutaneous ................. 7.61 NA NA 3.71 3.96 0.49 NA NA 11.81 12.06 000

35492 ............ A Atherectomy, percutaneous ................. 6.65 NA NA 3.36 4.51 0.43 NA NA 10.44 11.59 000

35493 ............ A Atherectomy, percutaneous ................. 8.10 NA NA 4.06 5.46 0.47 NA NA 12.63 14.03 000

35494 ............ A Atherectomy, percutaneous ................. 10.44 NA NA 4.68 6.26 0.48 NA NA 15.60 17.18 000

35495 ............ A Atherectomy, percutaneous ................. 9.49 NA NA 4.79 4.82 0.51 NA NA 14.79 14.82 000

35500 ............ A Harvest vein for bypass ....................... 6.45 NA NA 2.12 2.12 0.63 NA NA 9.20 9.20 ZZZ

35501 ............ A Artery bypass graft ............................... 19.19 NA NA 9.14 12.11 2.33 NA NA 30.66 33.63 090

35506 ............ A Artery bypass graft ............................... 19.67 NA NA 9.17 12.08 2.33 NA NA 31.17 34.08 090

35507 ............ A Artery bypass graft ............................... 19.67 NA NA 9.08 11.67 2.27 NA NA 31.02 33.61 090

35508 ............ A Artery bypass graft ............................... 18.65 NA NA 8.92 11.60 2.34 NA NA 29.91 32.59 090

35509 ............ A Artery bypass graft ............................... 18.07 NA NA 8.36 11.40 2.12 NA NA 28.55 31.59 090

35511 ............ A Artery bypass graft ............................... 16.83 NA NA 7.69 8.59 1.74 NA NA 26.26 27.16 090

35515 ............ A Artery bypass graft ............................... 18.65 NA NA 8.95 9.77 2.26 NA NA 29.86 30.68 090

35516 ............ A Artery bypass graft ............................... 16.32 NA NA 7.53 10.36 1.88 NA NA 25.73 28.56 090

35518 ............ A Artery bypass graft ............................... 15.42 NA NA 7.09 9.92 1.78 NA NA 24.29 27.12 090

35521 ............ A Artery bypass graft ............................... 16.17 NA NA 7.99 10.75 1.82 NA NA 25.98 28.74 090

35526 ............ A Artery bypass graft ............................... 20.00 NA NA 9.96 10.98 2.18 NA NA 32.14 33.16 090

35531 ............ A Artery bypass graft ............................... 25.61 NA NA 11.45 14.08 2.91 NA NA 39.97 42.60 090

35533 ............ A Artery bypass graft ............................... 20.52 NA NA 9.75 13.02 2.35 NA NA 32.62 35.89 090

35536 ............ A Artery bypass graft ............................... 23.11 NA NA 10.33 13.55 2.62 NA NA 36.06 39.28 090

35541 ............ A Artery bypass graft ............................... 25.80 NA NA 11.92 14.25 2.74 NA NA 40.46 42.79 090

35546 ............ A Artery bypass graft ............................... 25.54 NA NA 11.51 14.44 2.84 NA NA 39.89 42.82 090

35548 ............ A Artery bypass graft ............................... 21.57 NA NA 9.78 12.64 2.45 NA NA 33.80 36.66 090

35549 ............ A Artery bypass graft ............................... 23.35 NA NA 11.27 14.26 2.77 NA NA 37.39 40.38 090

35551 ............ A Artery bypass graft ............................... 26.67 NA NA 12.76 14.79 3.19 NA NA 42.62 44.65 090

35556 ............ A Artery bypass graft ............................... 21.76 NA NA 10.15 12.69 2.48 NA NA 34.39 36.93 090

35558 ............ A Artery bypass graft ............................... 14.04 NA NA 7.19 9.58 1.58 NA NA 22.81 25.20 090

35560 ............ A Artery bypass graft ............................... 23.56 NA NA 10.94 13.69 2.73 NA NA 37.23 39.98 090

35563 ............ A Artery bypass graft ............................... 15.14 NA NA 7.31 7.74 1.68 NA NA 24.13 24.56 090

35565 ............ A Artery bypass graft ............................... 15.14 NA NA 7.49 10.14 1.71 NA NA 24.34 26.99 090

35566 ............ A Artery bypass graft ............................... 26.92 NA NA 14.62 16.56 3.02 NA NA 44.56 46.50 090

35571 ............ A Artery bypass graft ............................... 18.58 NA NA 10.74 13.31 2.14 NA NA 31.46 34.03 090

35582 ............ A Vein bypass graft ................................. 27.13 NA NA 12.41 15.75 3.11 NA NA 42.65 45.99 090

35583 ............ A Vein bypass graft ................................. 22.37 NA NA 11.13 13.89 2.53 NA NA 36.03 38.79 090

35585 ............ A Vein bypass graft ................................. 28.39 NA NA 15.24 17.66 3.21 NA NA 46.84 49.26 090

35587 ............ A Vein bypass graft ................................. 19.05 NA NA 11.36 14.21 2.17 NA NA 32.58 35.43 090

35600 ............ A Harvest artery for cabg ........................ 4.95 NA NA 1.98 1.98 0.54 NA NA 7.47 7.47 ZZZ

35601 ............ A Artery bypass graft ............................... 17.50 NA NA 8.11 11.19 2.08 NA NA 27.69 30.77 090

35606 ............ A Artery bypass graft ............................... 18.71 NA NA 8.65 11.25 2.17 NA NA 29.53 32.13 090

35612 ............ A Artery bypass graft ............................... 15.76 NA NA 7.45 10.13 1.72 NA NA 24.93 27.61 090

35616 ............ A Artery bypass graft ............................... 15.70 NA NA 7.74 10.36 1.84 NA NA 25.28 27.90 090

35621 ............ A Artery bypass graft ............................... 14.54 NA NA 7.50 9.96 1.68 NA NA 23.72 26.18 090

35623 ............ A Bypass graft, not vein .......................... 16.62 NA NA 8.24 8.37 1.91 NA NA 26.77 26.90 090

35626 ............ A Artery bypass graft ............................... 23.63 NA NA 11.47 14.17 2.89 NA NA 37.99 40.69 090

35631 ............ A Artery bypass graft ............................... 24.60 NA NA 11.15 13.21 2.83 NA NA 38.58 40.64 090

35636 ............ A Artery bypass graft ............................... 22.46 NA NA 10.26 11.36 2.37 NA NA 35.09 36.19 090

35641 ............ A Artery bypass graft ............................... 24.57 NA NA 11.52 14.22 2.83 NA NA 38.92 41.62 090

35642 ............ A Artery bypass graft ............................... 17.98 NA NA 9.16 9.67 1.84 NA NA 28.98 29.49 090

35645 ............ A Artery bypass graft ............................... 17.47 NA NA 8.46 9.37 1.91 NA NA 27.84 28.75 090

35646 ............ A Artery bypass graft ............................... 25.81 NA NA 11.87 15.36 2.98 NA NA 40.66 44.15 090

35650 ............ A Artery bypass graft ............................... 14.36 NA NA 6.70 9.31 1.64 NA NA 22.70 25.31 090

35651 ............ A Artery bypass graft ............................... 25.04 NA NA 11.42 15.10 2.53 NA NA 38.99 42.67 090

35654 ............ A Artery bypass graft ............................... 18.61 NA NA 8.85 12.19 2.10 NA NA 29.56 32.90 090

35656 ............ A Artery bypass graft ............................... 19.53 NA NA 9.15 11.67 2.21 NA NA 30.89 33.41 090

35661 ............ A Artery bypass graft ............................... 13.18 NA NA 6.68 8.95 1.50 NA NA 21.36 23.63 090

35663 ............ A Artery bypass graft ............................... 14.17 NA NA 7.33 9.73 1.55 NA NA 23.05 25.45 090

35665 ............ A Artery bypass graft ............................... 15.40 NA NA 7.63 10.32 1.76 NA NA 24.79 27.48 090

65472

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

35666 ............ A Artery bypass graft ............................... 19.19 NA NA 11.57 14.12 2.19 NA NA 32.95 35.50 090

35671 ............ A Artery bypass graft ............................... 14.80 NA NA 9.48 11.34 1.68 NA NA 25.96 27.82 090

35681 ............ A Composite bypass graft ....................... 1.60 NA NA 2.44 4.24 0.18 NA NA 4.22 6.02 ZZZ

35682 ............ A Composite bypass graft ....................... 7.20 NA NA 2.67 4.41 0.83 NA NA 10.70 12.44 ZZZ

35683 ............ A Composite bypass graft ....................... 8.50 NA NA 3.18 4.79 0.98 NA NA 12.66 14.27 ZZZ

35691 ............ A Arterial transposition ............................. 18.05 NA NA 8.02 11.34 2.06 NA NA 28.13 31.45 090

35693 ............ A Arterial transposition ............................. 15.36 NA NA 7.67 8.30 1.80 NA NA 24.83 25.46 090

35694 ............ A Arterial transposition ............................. 19.16 NA NA 8.47 8.89 2.13 NA NA 29.76 30.18 090

35695 ............ A Arterial transposition ............................. 19.16 NA NA 8.45 8.87 2.19 NA NA 29.80 30.22 090

35700 ............ A Reoperation, bypass graft .................... 3.08 NA NA 3.14 2.79 0.36 NA NA 6.58 6.23 ZZZ

35701 ............ A Exploration, carotid artery .................... 5.55 NA NA 3.65 4.32 0.64 NA NA 9.84 10.51 090

35721 ............ A Exploration, femoral artery ................... 5.28 NA NA 4.88 5.17 0.59 NA NA 10.75 11.04 090

35741 ............ A Exploration popliteal artery ................... 5.37 NA NA 4.72 5.10 0.60 NA NA 10.69 11.07 090

35761 ............ A Exploration of artery/vein ..................... 5.37 NA NA 4.66 5.07 0.60 NA NA 10.63 11.04 090

35800 ............ A Explore neck vessels ........................... 7.02 NA NA 4.25 4.62 0.79 NA NA 12.06 12.43 090

35820 ............ A Explore chest vessels .......................... 12.88 NA NA 5.31 6.13 1.61 NA NA 19.80 20.62 090

35840 ............ A Explore abdominal vessels .................. 9.77 NA NA 5.47 6.07 1.06 NA NA 16.30 16.90 090

35860 ............ A Explore limb vessels ............................ 5.55 NA NA 3.80 4.43 0.63 NA NA 9.98 10.61 090

35870 ............ A Repair vessel graft defect .................... 22.17 NA NA 10.80 10.99 2.47 NA NA 35.44 35.63 090

35875 ............ A Removal of clot in graft ........................ 10.13 NA NA 6.85 7.37 0.97 NA NA 17.95 18.47 090

35876 ............ A Removal of clot in graft ........................ 17.00 NA NA 9.51 9.36 1.88 NA NA 28.39 28.24 090

35879 ............ A Revise graft w/vein ............................... 16.00 NA NA 8.58 8.58 1.35 NA NA 25.93 25.93 090

35881 ............ A Revise graft w/vein ............................... 18.00 NA NA 9.47 9.47 1.44 NA NA 28.91 28.91 090

35901 ............ A Excision, graft, neck ............................. 8.19 NA NA 5.81 6.31 0.90 NA NA 14.90 15.40 090

35903 ............ A Excision, graft, extremity ...................... 9.39 NA NA 8.43 8.27 1.03 NA NA 18.85 18.69 090

35905 ............ A Excision, graft, thorax ........................... 18.19 NA NA 12.88 11.61 2.15 NA NA 33.22 31.95 090

35907 ............ A Excision, graft, abdomen ...................... 19.24 NA NA 9.89 9.37 2.17 NA NA 31.30 30.78 090

36000 ............ A Place needle in vein ............................. 0.18 0.62 0.53 0.05 0.07 0.01 0.81 0.72 0.24 0.26 XXX

36005 ............ A Injection, venography ........................... 0.95 15.38 11.66 0.34 0.38 0.04 16.37 12.65 1.33 1.37 000

36010 ............ A Place catheter in vein ........................... 2.43 NA NA 0.88 1.23 0.16 NA NA 3.47 3.82 XXX

36011 ............ A Place catheter in vein ........................... 3.14 NA NA 1.16 1.39 0.17 NA NA 4.47 4.70 XXX

36012 ............ A Place catheter in vein ........................... 3.52 NA NA 1.29 1.69 0.17 NA NA 4.98 5.38 XXX

36013 ............ A Place catheter in artery ........................ 2.52 NA NA 0.81 1.18 0.17 NA NA 3.50 3.87 XXX

36014 ............ A Place catheter in artery ........................ 3.02 NA NA 1.11 1.45 0.14 NA NA 4.27 4.61 XXX

36015 ............ A Place catheter in artery ........................ 3.52 NA NA 1.29 1.69 0.16 NA NA 4.97 5.37 XXX

36100 ............ A Establish access to artery .................... 3.02 NA NA 1.26 1.65 0.18 NA NA 4.46 4.85 XXX

36120 ............ A Establish access to artery .................... 2.01 NA NA 0.73 1.15 0.11 NA NA 2.85 3.27 XXX

36140 ............ A Establish access to artery .................... 2.01 NA NA 0.72 0.92 0.12 NA NA 2.85 3.05 XXX

36145 ............ A Artery to vein shunt .............................. 2.01 NA NA 0.75 1.16 0.10 NA NA 2.86 3.27 XXX

36160 ............ A Establish access to aorta ..................... 2.52 NA NA 0.98 1.37 0.20 NA NA 3.70 4.09 XXX

36200 ............ A Place catheter in aorta ......................... 3.02 NA NA 1.11 1.57 0.15 NA NA 4.28 4.74 XXX

36215 ............ A Place catheter in artery ........................ 4.68 NA NA 1.72 2.05 0.22 NA NA 6.62 6.95 XXX

36216 ............ A Place catheter in artery ........................ 5.28 NA NA 1.95 2.36 0.24 NA NA 7.47 7.88 XXX

36217 ............ A Place catheter in artery ........................ 6.30 NA NA 2.36 2.83 0.32 NA NA 8.98 9.45 XXX

36218 ............ A Place catheter in artery ........................ 1.01 NA NA 0.41 0.48 0.05 NA NA 1.47 1.54 ZZZ

36245 ............ A Place catheter in artery ........................ 4.68 NA NA 1.86 2.25 0.23 NA NA 6.77 7.16 XXX

36246 ............ A Place catheter in artery ........................ 5.28 NA NA 1.98 2.38 0.26 NA NA 7.52 7.92 XXX

36247 ............ A Place catheter in artery ........................ 6.30 NA NA 2.33 2.81 0.32 NA NA 8.95 9.43 XXX

36248 ............ A Place catheter in artery ........................ 1.01 NA NA 0.42 0.48 0.06 NA NA 1.49 1.55 ZZZ

36260 ............ A Insertion of infusion pump .................... 9.71 NA NA 5.71 6.11 1.00 NA NA 16.42 16.82 090

36261 ............ A Revision of infusion pump .................... 5.45 NA NA 3.61 3.31 0.50 NA NA 9.56 9.26 090

36262 ............ A Removal of infusion pump ................... 4.02 NA NA 2.58 2.46 0.43 NA NA 7.03 6.91 090

36299 ............ C Vessel injection procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

36400 ............ A Drawing blood ...................................... 0.18 0.62 0.49 0.05 0.05 0.01 0.81 0.68 0.24 0.24 XXX

36405 ............ A Drawing blood ...................................... 0.18 0.55 0.54 0.06 0.11 0.01 0.74 0.73 0.25 0.30 XXX

36406 ............ A Drawing blood ...................................... 0.18 0.76 0.61 0.05 0.06 0.01 0.95 0.80 0.24 0.25 XXX

36410 ............ A Drawing blood ...................................... 0.18 0.48 0.42 0.05 0.07 0.01 0.67 0.61 0.24 0.26 XXX

36415 ............ I Drawing blood ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

36420 ............ A Establish access to vein ....................... 1.01 NA NA 0.32 0.38 0.09 NA NA 1.42 1.48 XXX

36425 ............ A Establish access to vein ....................... 0.76 3.22 2.44 0.17 0.15 0.05 4.03 3.25 0.98 0.96 XXX

36430 ............ A Blood transfusion service ..................... 0.00 1.00 1.01 1.00 0.88 0.05 1.05 1.06 1.05 0.93 XXX

36440 ............ A Blood transfusion service ..................... 1.03 NA NA 0.29 0.47 0.08 NA NA 1.40 1.58 XXX

36450 ............ A Exchange transfusion service .............. 2.23 NA NA 0.73 0.80 0.16 NA NA 3.12 3.19 XXX

36455 ............ A Exchange transfusion service .............. 2.43 NA NA 0.97 1.34 0.10 NA NA 3.50 3.87 XXX

36460 ............ A Transfusion service, fetal ..................... 6.59 NA NA 2.43 3.10 0.56 NA NA 9.58 10.25 XXX

36468 ............ R Injection(s), spider veins ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

36469 ............ R Injection(s), spider veins ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

36470 ............ A Injection therapy of vein ....................... 1.09 2.59 2.02 0.41 0.35 0.10 3.78 3.21 1.60 1.54 010

36471 ............ A Injection therapy of veins ..................... 1.57 3.23 2.53 0.60 0.50 0.15 4.95 4.25 2.32 2.22 010

36481 ............ A Insertion of catheter, vein ..................... 6.99 NA NA 2.88 3.60 0.40 NA NA 10.27 10.99 000

36488 ............ A Insertion of catheter, vein ..................... 1.35 NA NA 0.75 0.83 0.09 NA NA 2.19 2.27 000

36489 ............ A Insertion of catheter, vein ..................... 1.22 3.30 2.78 0.68 0.82 0.08 4.60 4.08 1.98 2.12 000

36490 ............ A Insertion of catheter, vein ..................... 1.67 NA NA 0.89 1.04 0.17 NA NA 2.73 2.88 000

36491 ............ A Insertion of catheter, vein ..................... 1.43 NA NA 0.78 1.01 0.13 NA NA 2.34 2.57 000

36493 ............ A Repositioning of cvc ............................. 1.21 NA NA 0.85 0.81 0.06 NA NA 2.12 2.08 000

36500 ............ A Insertion of catheter, vein ..................... 3.52 NA NA 1.32 1.01 0.14 NA NA 4.98 4.67 000

36510 ............ A Insertion of catheter, vein ..................... 1.09 NA NA 0.61 0.51 0.06 NA NA 1.76 1.66 000

36520 ............ A Plasma and/or cell exchange ............... 1.74 NA NA 0.98 1.25 0.06 NA NA 2.78 3.05 000

36521 ............ A Apheresis w/ adsorp/reinfuse ............... 1.74 NA NA 0.98 0.98 0.06 NA NA 2.78 2.78 000

36522 ............ A Photopheresis ....................................... 1.67 5.96 5.14 1.12 1.34 0.07 7.70 6.88 2.86 3.08 000

36530 ............ R Insertion of infusion pump .................... 6.20 NA NA 3.75 4.12 0.56 NA NA 10.51 10.88 010

36531 ............ R Revision of infusion pump .................... 4.87 NA NA 3.28 3.65 0.44 NA NA 8.59 8.96 010

36532 ............ R Removal of infusion pump ................... 3.30 NA NA 1.65 1.72 0.34 NA NA 5.29 5.36 010

65473

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

36533 ............ A Insertion of access device .................... 5.32 4.33 4.41 3.51 3.80 0.49 10.14 10.22 9.32 9.61 010

36534 ............ A Revision of access device .................... 2.80 NA NA 1.51 1.97 0.19 NA NA 4.50 4.96 010

36535 ............ A Removal of access device ................... 2.27 2.91 2.67 1.98 1.98 0.21 5.39 5.15 4.46 4.46 010

36540 ............ B Collect blood venous device ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

36550 ............ A Declot vascular device ......................... 0.00 0.37 0.37 0.06 0.06 0.31 0.68 0.68 0.37 0.37 XXX

36600 ............ A Withdrawal of arterial blood ................. 0.32 0.40 0.38 0.09 0.14 0.02 0.74 0.72 0.43 0.48 XXX

36620 ............ A Insertion catheter, artery ...................... 1.15 NA NA 0.25 0.37 0.06 NA NA 1.46 1.58 000

36625 ............ A Insertion catheter, artery ...................... 2.11 NA NA 0.61 0.69 0.16 NA NA 2.88 2.96 000

36640 ............ A Insertion catheter, artery ...................... 2.10 NA NA 0.78 1.21 0.18 NA NA 3.06 3.49 000

36660 ............ A Insertion catheter, artery ...................... 1.40 NA NA 0.46 0.48 0.08 NA NA 1.94 1.96 000

36680 ............ A Insert needle, bone cavity .................... 1.20 NA NA 0.60 0.79 0.08 NA NA 1.88 2.07 000

36800 ............ A Insertion of cannula .............................. 2.43 NA NA 1.67 1.86 0.17 NA NA 4.27 4.46 000

36810 ............ A Insertion of cannula .............................. 3.97 NA NA 2.49 3.05 0.40 NA NA 6.86 7.42 000

36815 ............ A Insertion of cannula .............................. 2.62 NA NA 1.81 2.14 0.26 NA NA 4.69 5.02 000

36819 ............ A Av fusion by basilic vein ....................... 14.00 NA NA 6.90 6.90 1.53 NA NA 22.43 22.43 090

36821 ............ A Av fusion direct any site ....................... 8.93 NA NA 5.23 5.89 0.97 NA NA 15.13 15.79 090

36822 ............ A Insertion of cannula(s) .......................... 5.42 NA NA 10.02 9.04 0.63 NA NA 16.07 15.09 090

36823 ............ A Insertion of cannula(s) .......................... 21.00 NA NA 11.80 11.80 2.18 NA NA 34.98 34.98 090

36825 ............ A Artery-vein graft .................................... 9.84 NA NA 5.91 7.37 1.09 NA NA 16.84 18.30 090

36830 ............ A Artery-vein graft .................................... 12.00 NA NA 6.51 7.59 1.32 NA NA 19.83 20.91 090

36831 ............ A Av fistula excision, open ...................... 8.00 2.95 2.95 2.95 2.95 0.79 11.74 11.74 11.74 11.74 090

36832 ............ A Av fistula revision, open ....................... 10.50 NA NA 5.90 6.35 1.13 NA NA 17.53 17.98 090

36833 ............ A Av fistula revision ................................. 11.95 4.49 4.49 4.49 4.49 1.29 17.73 17.73 17.73 17.73 090

36834 ............ A Repair A-V aneurysm ........................... 9.93 NA NA 4.09 5.19 1.06 NA NA 15.08 16.18 090

36835 ............ A Artery to vein shunt .............................. 7.15 NA NA 4.90 4.60 0.80 NA NA 12.85 12.55 090

36860 ............ A External cannula declotting .................. 2.01 2.31 2.43 1.64 1.83 0.10 4.42 4.54 3.75 3.94 000

36861 ............ A Cannula declotting ................................ 2.52 NA NA 1.80 2.10 0.14 NA NA 4.46 4.76 000

36870 ............ A Av fistula revision, open ....................... 5.16 30.67 30.67 2.51 2.51 0.40 36.23 36.23 8.07 8.07 090

37140 ............ A Revision of circulation .......................... 23.60 NA NA 10.58 12.36 1.21 NA NA 35.39 37.17 090

37145 ............ A Revision of circulation .......................... 24.61 NA NA 11.00 12.90 2.48 NA NA 38.09 39.99 090

37160 ............ A Revision of circulation .......................... 21.60 NA NA 9.52 11.95 2.16 NA NA 33.28 35.71 090

37180 ............ A Revision of circulation .......................... 24.61 NA NA 10.97 12.08 2.63 NA NA 38.21 39.32 090

37181 ............ A Splice spleen/kidney veins ................... 26.68 NA NA 11.74 13.26 2.67 NA NA 41.09 42.61 090

37195 ............ A Thrombolytic therapy, stroke ................ 0.00 7.99 8.08 7.99 8.08 0.38 8.37 8.46 8.37 8.46 XXX

37200 ............ A Transcatheter biopsy ............................ 4.56 NA NA 1.65 1.67 0.19 NA NA 6.40 6.42 000

37201 ............ A Transcatheter therapy infuse ............... 5.00 NA NA 2.59 3.44 0.24 NA NA 7.83 8.68 000

37202 ............ A Transcatheter therapy infuse ............... 5.68 NA NA 3.27 3.62 0.38 NA NA 9.33 9.68 000

37203 ............ A Transcatheter retrieval ......................... 5.03 NA NA 2.62 3.00 0.23 NA NA 7.88 8.26 000

37204 ............ A Transcatheter occlusion ....................... 18.14 NA NA 6.33 8.48 0.85 NA NA 25.32 27.47 000

37205 ............ A Transcatheter stent .............................. 8.28 NA NA 3.98 4.39 0.43 NA NA 12.69 13.10 000

37206 ............ A Transcatheter stent add-on .................. 4.13 NA NA 1.62 1.92 0.22 NA NA 5.97 6.27 ZZZ

37207 ............ A Transcatheter stent .............................. 8.28 NA NA 3.86 4.30 0.89 NA NA 13.03 13.47 000

37208 ............ A Transcatheter stent add-on .................. 4.13 NA NA 1.56 1.87 0.44 NA NA 6.13 6.44 ZZZ

37209 ............ A Exchange arterial catheter ................... 2.27 NA NA 0.85 1.02 0.11 NA NA 3.23 3.40 000

37250 ............ A Iv us first vessel add-on ....................... 2.10 NA NA 0.86 0.96 0.17 NA NA 3.13 3.23 ZZZ

37251 ............ A Iv us each add vessel add-on .............. 1.60 NA NA 0.63 0.71 0.14 NA NA 2.37 2.45 ZZZ

37565 ............ A Ligation of neck vein ............................ 4.44 NA NA 2.62 2.99 0.45 NA NA 7.51 7.88 090

37600 ............ A Ligation of neck artery .......................... 4.57 NA NA 3.34 3.86 0.40 NA NA 8.31 8.83 090

37605 ............ A Ligation of neck artery .......................... 6.19 NA NA 3.89 4.43 0.77 NA NA 10.85 11.39 090

37606 ............ A Ligation of neck artery .......................... 6.28 NA NA 3.93 4.55 0.79 NA NA 11.00 11.62 090

37607 ............ A Ligation of a-v fistula ............................ 6.16 NA NA 3.84 3.71 0.67 NA NA 10.67 10.54 090

37609 ............ A Temporal artery procedure ................... 2.30 6.20 5.25 2.30 2.33 0.21 8.71 7.76 4.81 4.84 010

37615 ............ A Ligation of neck artery .......................... 5.73 NA NA 3.71 4.31 0.57 NA NA 10.01 10.61 090

37616 ............ A Ligation of chest artery ......................... 16.49 NA NA 13.33 11.14 1.93 NA NA 31.75 29.56 090

37617 ............ A Ligation of abdomen artery .................. 15.95 NA NA 7.59 7.86 1.69 NA NA 25.23 25.50 090

37618 ............ A Ligation of extremity artery ................... 4.84 NA NA 3.64 4.08 0.54 NA NA 9.02 9.46 090

37620 ............ A Revision of major vein .......................... 10.56 NA NA 5.60 6.59 0.75 NA NA 16.91 17.90 090

37650 ............ A Revision of major vein .......................... 5.13 NA NA 3.96 4.06 0.56 NA NA 9.65 9.75 090

37660 ............ A Revision of major vein .......................... 10.61 NA NA 6.14 6.17 1.17 NA NA 17.92 17.95 090

37700 ............ A Revise leg vein ..................................... 3.73 NA NA 3.23 3.41 0.40 NA NA 7.36 7.54 090

37720 ............ A Removal of leg vein ............................. 5.66 NA NA 3.82 4.25 0.61 NA NA 10.09 10.52 090

37730 ............ A Removal of leg veins ............................ 7.33 NA NA 4.74 5.44 0.77 NA NA 12.84 13.54 090

37735 ............ A Removal of leg veins/lesion ................. 10.53 NA NA 5.99 6.76 1.17 NA NA 17.69 18.46 090

37760 ............ A Revision of leg veins ............................ 10.47 NA NA 6.06 6.58 1.11 NA NA 17.64 18.16 090

37780 ............ A Revision of leg vein .............................. 3.84 NA NA 2.97 2.74 0.41 NA NA 7.22 6.99 090

37785 ............ A Revise secondary varicosity ................. 3.88 6.89 5.43 2.95 2.48 0.41 11.18 9.72 7.24 6.77 090

37788 ............ A Revascularization, penis ...................... 22.01 NA NA 12.61 13.57 1.35 NA NA 35.97 36.93 090

37790 ............ A Penile venous occlusion ....................... 8.34 NA NA 7.23 6.97 0.63 NA NA 16.20 15.94 090

37799 ............ C Vascular surgery procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

38100 ............ A Removal of spleen, total ...................... 13.01 NA NA 6.36 7.09 1.30 NA NA 20.67 21.40 090

38101 ............ A Removal of spleen, partial ................... 13.74 NA NA 6.69 6.92 1.38 NA NA 21.81 22.04 090

38102 ............ A Removal of spleen, total ...................... 4.80 NA NA 1.82 2.05 0.49 NA NA 7.11 7.34 ZZZ

38115 ............ A Repair of ruptured spleen .................... 14.19 NA NA 6.81 7.18 1.40 NA NA 22.40 22.77 090

38120 ............ A Laparoscopy, splenectomy ................... 17.00 NA NA 7.79 7.79 1.73 NA NA 26.52 26.52 090

38129 ............ C Laparoscope proc, spleen .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

38200 ............ A Injection for spleen x-ray ...................... 2.64 NA NA 0.98 1.20 0.12 NA NA 3.74 3.96 000

38230 ............ R Bone marrow collection ........................ 4.54 NA NA 2.34 2.51 0.25 NA NA 7.13 7.30 010

38231 ............ R Stem cell collection .............................. 1.50 NA NA 0.59 0.82 0.05 NA NA 2.14 2.37 000

38240 ............ R Bone marrow/stem transplant .............. 2.24 NA NA 0.85 1.20 0.08 NA NA 3.17 3.52 XXX

38241 ............ R Bone marrow/stem transplant .............. 2.24 NA NA 0.84 1.18 0.08 NA NA 3.16 3.50 XXX

38300 ............ A Drainage, lymph node lesion ............... 1.53 4.31 3.39 2.52 1.97 0.15 5.99 5.07 4.20 3.65 010

38305 ............ A Drainage, lymph node lesion ............... 4.61 7.71 6.32 5.74 4.84 0.36 12.68 11.29 10.71 9.81 090

38308 ............ A Incision of lymph channels ................... 4.95 NA NA 5.10 4.74 0.51 NA NA 10.56 10.20 090

65474

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

38380 ............ A Thoracic duct procedure ...................... 7.46 NA NA 7.45 6.79 0.68 NA NA 15.59 14.93 090

38381 ............ A Thoracic duct procedure ...................... 12.88 NA NA 12.22 11.22 1.58 NA NA 26.68 25.68 090

38382 ............ A Thoracic duct procedure ...................... 10.08 NA NA 10.97 9.54 1.08 NA NA 22.13 20.70 090

38500 ............ A Biopsy/removal, lymph nodes .............. 2.88 2.64 2.41 2.30 2.16 0.28 5.80 5.57 5.46 5.32 010

38505 ............ A Needle biopsy, lymph nodes ................ 1.14 2.98 2.54 1.12 0.99 0.09 4.21 3.77 2.35 2.22 000

38510 ............ A Biopsy/removal, lymph nodes .............. 4.14 NA NA 4.40 3.99 0.38 NA NA 8.92 8.51 090

38520 ............ A Biopsy/removal, lymph nodes .............. 5.12 NA NA 5.25 4.75 0.52 NA NA 10.89 10.39 090

38525 ............ A Biopsy/removal, lymph nodes .............. 4.66 NA NA 3.93 3.65 0.48 NA NA 9.07 8.79 090

38530 ............ A Biopsy/removal, lymph nodes .............. 6.13 NA NA 5.36 4.88 0.63 NA NA 12.12 11.64 090

38542 ............ A Explore deep node(s), neck ................. 5.91 NA NA 5.99 5.65 0.50 NA NA 12.40 12.06 090

38550 ............ A Removal, neck/armpit lesion ................ 6.92 NA NA 4.94 4.58 0.69 NA NA 12.55 12.19 090

38555 ............ A Removal, neck/armpit lesion ................ 14.14 NA NA 11.79 10.82 1.46 NA NA 27.39 26.42 090

38562 ............ A Removal, pelvic lymph nodes .............. 10.49 NA NA 6.51 6.75 0.97 NA NA 17.97 18.21 090

38564 ............ A Removal, abdomen lymph nodes ........ 10.83 NA NA 6.51 6.89 1.06 NA NA 18.40 18.78 090

38570 ............ A Laparoscopy, lymph node biop ............ 9.25 NA NA 4.61 5.19 0.89 NA NA 14.75 15.33 010

38571 ............ A Laparoscopy, lymphadenectomy .......... 12.38 NA NA 5.48 6.43 0.80 NA NA 18.66 19.61 010

38572 ............ A Laparoscopy, lymphadenectomy .......... 14.32 NA NA 6.43 7.54 1.32 NA NA 22.07 23.18 010

38589 ............ C Laparoscope proc, lymphatic ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

38700 ............ A Removal of lymph nodes, neck ............ 8.24 NA NA 13.23 12.38 0.60 NA NA 22.07 21.22 090

38720 ............ A Removal of lymph nodes, neck ............ 13.61 NA NA 15.67 15.82 1.03 NA NA 30.31 30.46 090

38724 ............ A Removal of lymph nodes, neck ............ 14.54 NA NA 16.15 16.01 1.10 NA NA 31.79 31.65 090

38740 ............ A Remove armpit lymph nodes ............... 6.77 NA NA 4.73 4.83 0.69 NA NA 12.19 12.29 090

38745 ............ A Remove armpit lymph nodes ............... 8.84 NA NA 6.75 7.31 0.90 NA NA 16.49 17.05 090

38746 ............ A Remove thoracic lymph nodes ............. 4.39 NA NA 1.78 1.96 0.55 NA NA 6.72 6.90 ZZZ

38747 ............ A Remove abdominal lymph nodes ......... 4.89 NA NA 1.86 2.09 0.50 NA NA 7.25 7.48 ZZZ

38760 ............ A Remove groin lymph nodes ................. 8.74 NA NA 5.71 6.08 0.88 NA NA 15.33 15.70 090

38765 ............ A Remove groin lymph nodes ................. 16.06 NA NA 10.08 11.00 1.50 NA NA 27.64 28.56 090

38770 ............ A Remove pelvis lymph nodes ................ 13.23 NA NA 6.87 9.10 0.94 NA NA 21.04 23.27 090

38780 ............ A Remove abdomen lymph nodes .......... 16.59 NA NA 9.23 11.28 1.60 NA NA 27.42 29.47 090

38790 ............ A Inject for lymphatic x-ray ...................... 1.29 34.73 26.49 0.48 0.75 0.09 36.11 27.87 1.86 2.13 000

38792 ............ A Identify sentinel node ........................... 0.52 NA NA 0.20 0.20 0.04 NA NA 0.76 0.76 000

38794 ............ A Access thoracic lymph duct ................. 4.45 NA NA 1.69 2.04 0.17 NA NA 6.31 6.66 090

38999 ............ C Blood/lymph system procedure ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

39000 ............ A Exploration of chest .............................. 6.10 NA NA 9.67 8.90 0.73 NA NA 16.50 15.73 090

39010 ............ A Exploration of chest .............................. 11.79 NA NA 12.67 12.61 1.46 NA NA 25.92 25.86 090

39200 ............ A Removal chest lesion ........................... 13.62 NA NA 12.97 12.87 1.65 NA NA 28.24 28.14 090

39220 ............ A Removal chest lesion ........................... 17.42 NA NA 14.48 14.91 2.10 NA NA 34.00 34.43 090

39400 ............ A Visualization of chest ........................... 5.61 NA NA 9.43 8.46 0.69 NA NA 15.73 14.76 010

39499 ............ C Chest procedure ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

39501 ............ A Repair diaphragm laceration ................ 13.19 NA NA 8.44 9.22 1.38 NA NA 23.01 23.79 090

39502 ............ A Repair paraesophageal hernia ............. 16.33 NA NA 8.87 9.89 1.68 NA NA 26.88 27.90 090

39503 ............ A Repair of diaphragm hernia ................. 37.54 NA NA 16.79 19.43 3.52 NA NA 57.85 60.49 090

39520 ............ A Repair of diaphragm hernia ................. 16.10 NA NA 11.37 11.93 1.83 NA NA 29.30 29.86 090

39530 ............ A Repair of diaphragm hernia ................. 15.41 NA NA 9.56 10.99 1.66 NA NA 26.63 28.06 090

39531 ............ A Repair of diaphragm hernia ................. 16.42 NA NA 10.67 10.72 1.83 NA NA 28.92 28.97 090

39540 ............ A Repair of diaphragm hernia ................. 13.32 NA NA 8.54 9.66 1.38 NA NA 23.24 24.36 090

39541 ............ A Repair of diaphragm hernia ................. 14.41 NA NA 8.78 9.89 1.52 NA NA 24.71 25.82 090

39545 ............ A Revision of diaphragm ......................... 13.37 NA NA 11.72 10.93 1.55 NA NA 26.64 25.85 090

39560 ............ A Resect diaphragm, simple .................... 12.00 NA NA 8.97 8.97 1.35 NA NA 22.32 22.32 090

39561 ............ A Resect diaphragm, complex ................. 17.50 NA NA 11.08 11.08 1.97 NA NA 30.55 30.55 090

39599 ............ C Diaphragm surgery procedure ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

40490 ............ A Biopsy of lip .......................................... 1.22 1.63 1.42 0.62 0.57 0.06 2.91 2.70 1.90 1.85 000

40500 ............ A Partial excision of lip ............................ 4.28 5.61 5.49 5.49 5.40 0.31 10.20 10.08 10.08 9.99 090

40510 ............ A Partial excision of lip ............................ 4.70 6.59 6.35 6.33 6.15 0.38 11.67 11.43 11.41 11.23 090

40520 ............ A Partial excision of lip ............................ 4.67 7.58 6.91 6.71 6.25 0.42 12.67 12.00 11.80 11.34 090

40525 ............ A Reconstruct lip with flap ....................... 7.55 NA NA 8.21 8.41 0.68 NA NA 16.44 16.64 090

40527 ............ A Reconstruct lip with flap ....................... 9.13 NA NA 9.06 9.52 0.82 NA NA 19.01 19.47 090

40530 ............ A Partial removal of lip ............................ 5.40 6.38 6.17 6.18 6.02 0.47 12.25 12.04 12.05 11.89 090

40650 ............ A Repair lip .............................................. 3.64 5.38 5.12 4.52 4.48 0.31 9.33 9.07 8.47 8.43 090

40652 ............ A Repair lip .............................................. 4.26 6.34 6.03 6.34 6.03 0.39 10.99 10.68 10.99 10.68 090

40654 ............ A Repair lip .............................................. 5.31 7.61 7.29 7.37 7.11 0.48 13.40 13.08 13.16 12.90 090

40700 ............ A Repair cleft lip/nasal ............................. 12.79 NA NA 10.36 10.07 0.93 NA NA 24.08 23.79 090

40701 ............ A Repair cleft lip/nasal ............................. 15.85 NA NA 10.09 12.81 1.36 NA NA 27.30 30.02 090

40702 ............ A Repair cleft lip/nasal ............................. 13.04 NA NA 9.30 9.52 1.01 NA NA 23.35 23.57 090

40720 ............ A Repair cleft lip/nasal ............................. 13.55 NA NA 12.39 11.90 1.31 NA NA 27.25 26.76 090

40761 ............ A Repair cleft lip/nasal ............................. 14.72 NA NA 11.59 11.63 1.41 NA NA 27.72 27.76 090

40799 ............ C Lip surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

40800 ............ A Drainage of mouth lesion ..................... 1.17 1.91 1.63 0.46 0.45 0.09 3.17 2.89 1.72 1.71 010

40801 ............ A Drainage of mouth lesion ..................... 2.53 2.43 2.28 1.90 1.66 0.18 5.14 4.99 4.61 4.37 010

40804 ............ A Removal, foreign body, mouth ............. 1.24 2.56 2.08 2.16 1.70 0.09 3.89 3.41 3.49 3.03 010

40805 ............ A Removal, foreign body, mouth ............. 2.69 3.05 2.97 2.69 2.70 0.17 5.91 5.83 5.55 5.56 010

40806 ............ A Incision of lip fold ................................. 0.31 0.85 0.74 0.85 0.74 0.02 1.18 1.07 1.18 1.07 000

40808 ............ A Biopsy of mouth lesion ......................... 0.96 2.05 1.74 2.05 1.64 0.07 3.08 2.77 3.08 2.67 010

40810 ............ A Excision of mouth lesion ...................... 1.31 2.66 2.32 2.36 1.93 0.09 4.06 3.72 3.76 3.33 010

40812 ............ A Excise/repair mouth lesion ................... 2.31 2.87 2.56 2.87 2.36 0.17 5.35 5.04 5.35 4.84 010

40814 ............ A Excise/repair mouth lesion ................... 3.42 4.04 3.91 4.04 3.47 0.26 7.72 7.59 7.72 7.15 090

40816 ............ A Excision of mouth lesion ...................... 3.67 4.35 4.14 4.35 3.70 0.27 8.29 8.08 8.29 7.64 090

40818 ............ A Excise oral mucosa for graft ................ 2.41 4.02 3.63 4.02 3.63 0.14 6.57 6.18 6.57 6.18 090

40819 ............ A Excise lip or cheek fold ........................ 2.41 3.50 2.96 3.50 2.79 0.17 6.08 5.54 6.08 5.37 090

40820 ............ A Treatment of mouth lesion ................... 1.28 2.33 1.89 2.17 1.70 0.08 3.69 3.25 3.53 3.06 010

40830 ............ A Repair mouth laceration ....................... 1.76 2.46 2.03 2.41 1.99 0.14 4.36 3.93 4.31 3.89 010

40831 ............ A Repair mouth laceration ....................... 2.46 2.78 2.61 2.78 2.61 0.21 5.45 5.28 5.45 5.28 010

40840 ............ R Reconstruction of mouth ...................... 8.73 6.16 6.33 6.16 6.33 0.79 15.68 15.85 15.68 15.85 090

65475

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

40842 ............ R Reconstruction of mouth ...................... 8.73 5.98 6.19 5.98 6.19 0.65 15.36 15.57 15.36 15.57 090

40843 ............ R Reconstruction of mouth ...................... 12.10 8.47 8.74 8.47 8.74 0.84 21.41 21.68 21.41 21.68 090

40844 ............ R Reconstruction of mouth ...................... 16.01 8.95 9.87 8.41 9.46 1.63 26.59 27.51 26.05 27.10 090

40845 ............ R Reconstruction of mouth ...................... 18.58 10.53 13.44 10.53 13.44 1.47 30.58 33.49 30.58 33.49 090

40899 ............ C Mouth surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

41000 ............ A Drainage of mouth lesion ..................... 1.30 2.35 1.97 1.54 1.26 0.09 3.74 3.36 2.93 2.65 010

41005 ............ A Drainage of mouth lesion ..................... 1.26 2.09 1.74 1.24 1.10 0.09 3.44 3.09 2.59 2.45 010

41006 ............ A Drainage of mouth lesion ..................... 3.24 3.51 2.91 3.41 2.83 0.25 7.00 6.40 6.90 6.32 090

41007 ............ A Drainage of mouth lesion ..................... 3.10 3.32 3.28 3.04 3.07 0.22 6.64 6.60 6.36 6.39 090

41008 ............ A Drainage of mouth lesion ..................... 3.37 3.57 2.97 3.18 2.53 0.24 7.18 6.58 6.79 6.14 090

41009 ............ A Drainage of mouth lesion ..................... 3.59 3.59 3.59 3.19 3.29 0.25 7.43 7.43 7.03 7.13 090

41010 ............ A Incision of tongue fold .......................... 1.06 2.90 2.28 2.90 2.28 0.06 4.02 3.40 4.02 3.40 010

41015 ............ A Drainage of mouth lesion ..................... 3.96 4.35 3.50 3.21 2.64 0.29 8.60 7.75 7.46 6.89 090

41016 ............ A Drainage of mouth lesion ..................... 4.07 4.14 4.11 3.39 3.54 0.28 8.49 8.46 7.74 7.89 090

41017 ............ A Drainage of mouth lesion ..................... 4.07 4.02 3.40 3.30 2.86 0.32 8.41 7.79 7.69 7.25 090

41018 ............ A Drainage of mouth lesion ..................... 5.10 4.53 4.47 3.89 3.99 0.35 9.98 9.92 9.34 9.44 090

41100 ............ A Biopsy of tongue .................................. 1.63 2.59 2.16 2.57 2.04 0.12 4.34 3.91 4.32 3.79 010

41105 ............ A Biopsy of tongue .................................. 1.42 2.42 2.10 2.42 1.96 0.10 3.94 3.62 3.94 3.48 010

41108 ............ A Biopsy of floor of mouth ....................... 1.05 2.29 1.95 2.23 1.79 0.08 3.42 3.08 3.36 2.92 010

41110 ............ A Excision of tongue lesion ..................... 1.51 3.03 2.63 2.49 2.05 0.11 4.65 4.25 4.11 3.67 010

41112 ............ A Excision of tongue lesion ..................... 2.73 3.48 3.26 3.48 2.94 0.20 6.41 6.19 6.41 5.87 090

41113 ............ A Excision of tongue lesion ..................... 3.19 3.46 3.52 3.46 3.06 0.23 6.88 6.94 6.88 6.48 090

41114 ............ A Excision of tongue lesion ..................... 8.47 NA NA 6.36 6.50 0.64 NA NA 15.47 15.61 090

41115 ............ A Excision of tongue fold ......................... 1.74 2.31 2.22 2.31 2.22 0.13 4.18 4.09 4.18 4.09 010

41116 ............ A Excision of mouth lesion ...................... 2.44 3.36 3.20 3.36 3.20 0.17 5.97 5.81 5.97 5.81 090

41120 ............ A Partial removal of tongue ..................... 9.77 NA NA 8.68 8.49 0.70 NA NA 19.15 18.96 090

41130 ............ A Partial removal of tongue ..................... 11.15 NA NA 9.52 9.60 0.81 NA NA 21.48 21.56 090

41135 ............ A Tongue and neck surgery .................... 23.09 NA NA 15.84 16.85 1.66 NA NA 40.59 41.60 090

41140 ............ A Removal of tongue ............................... 25.50 NA NA 18.03 18.65 1.85 NA NA 45.38 46.00 090

41145 ............ A Tongue removal, neck surgery ............ 30.06 NA NA 21.43 22.26 2.11 NA NA 53.60 54.43 090

41150 ............ A Tongue, mouth, jaw surgery ................ 23.04 NA NA 17.05 17.93 1.67 NA NA 41.76 42.64 090

41153 ............ A Tongue, mouth, neck surgery .............. 23.77 NA NA 17.78 20.12 1.71 NA NA 43.26 45.60 090

41155 ............ A Tongue, jaw, & neck surgery ............... 27.72 NA NA 19.81 22.98 2.02 NA NA 49.55 52.72 090

41250 ............ A Repair tongue laceration ...................... 1.91 2.81 2.40 1.65 1.53 0.15 4.87 4.46 3.71 3.59 010

41251 ............ A Repair tongue laceration ...................... 2.27 2.73 2.61 2.24 2.24 0.18 5.18 5.06 4.69 4.69 010

41252 ............ A Repair tongue laceration ...................... 2.97 3.57 3.32 2.32 2.38 0.23 6.77 6.52 5.52 5.58 010

41500 ............ A Fixation of tongue ................................. 3.71 NA NA 4.28 4.10 0.26 NA NA 8.25 8.07 090

41510 ............ A Tongue to lip surgery ........................... 3.42 NA NA 4.47 4.04 0.24 NA NA 8.13 7.70 090

41520 ............ A Reconstruction, tongue fold ................. 2.73 3.16 3.15 3.16 3.15 0.19 6.08 6.07 6.08 6.07 090

41599 ............ C Tongue and mouth surgery .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

41800 ............ A Drainage of gum lesion ........................ 1.17 1.88 1.60 1.33 1.09 0.09 3.14 2.86 2.59 2.35 010

41805 ............ A Removal foreign body, gum ................. 1.24 1.90 1.65 1.90 1.65 0.09 3.23 2.98 3.23 2.98 010

41806 ............ A Removal foreign body,jawbone ............ 2.69 2.56 2.37 2.38 2.01 0.22 5.47 5.28 5.29 4.92 010

41820 ............ R Excision, gum, each quadrant .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

41821 ............ R Excision of gum flap ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

41822 ............ R Excision of gum lesion ......................... 2.31 2.84 2.95 0.91 1.51 0.24 5.39 5.50 3.46 4.06 010

41823 ............ R Excision of gum lesion ......................... 3.30 3.71 3.77 2.75 3.05 0.29 7.30 7.36 6.34 6.64 090

41825 ............ A Excision of gum lesion ......................... 1.31 2.34 2.16 2.27 1.91 0.10 3.75 3.57 3.68 3.32 010

41826 ............ A Excision of gum lesion ......................... 2.31 2.60 2.51 2.59 2.23 0.17 5.08 4.99 5.07 4.71 010

41827 ............ A Excision of gum lesion ......................... 3.42 3.55 3.68 3.55 3.17 0.25 7.22 7.35 7.22 6.84 090

41828 ............ R Excision of gum lesion ......................... 3.09 3.00 3.36 2.30 2.83 0.22 6.31 6.67 5.61 6.14 010

41830 ............ R Removal of gum tissue ........................ 3.35 3.15 3.36 3.15 3.36 0.23 6.73 6.94 6.73 6.94 010

41850 ............ R Treatment of gum lesion ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

41870 ............ R Gum graft ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

41872 ............ R Repair gum ........................................... 2.59 2.67 2.78 2.67 2.78 0.18 5.44 5.55 5.44 5.55 090

41874 ............ R Repair tooth socket .............................. 3.09 2.81 3.03 2.34 2.68 0.23 6.13 6.35 5.66 6.00 090

41899 ............ C Dental surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

42000 ............ A Drainage mouth roof lesion .................. 1.23 2.39 1.96 1.68 1.35 0.10 3.72 3.29 3.01 2.68 010

42100 ............ A Biopsy roof of mouth ............................ 1.31 2.36 1.99 2.36 1.88 0.10 3.77 3.40 3.77 3.29 010

42104 ............ A Excision lesion, mouth roof .................. 1.64 2.43 2.26 2.43 2.04 0.12 4.19 4.02 4.19 3.80 010

42106 ............ A Excision lesion, mouth roof .................. 2.10 2.60 2.55 2.60 2.25 0.16 4.86 4.81 4.86 4.51 010

42107 ............ A Excision lesion, mouth roof .................. 4.44 4.02 4.34 4.02 3.68 0.32 8.78 9.10 8.78 8.44 090

42120 ............ A Remove palate/lesion ........................... 6.17 NA NA 6.01 6.35 0.44 NA NA 12.62 12.96 090

42140 ............ A Excision of uvula .................................. 1.62 3.68 3.13 3.22 2.78 0.12 5.42 4.87 4.96 4.52 090

42145 ............ A Repair palate, pharynx/uvula ............... 8.05 NA NA 7.30 7.88 0.56 NA NA 15.91 16.49 090

42160 ............ A Treatment mouth roof lesion ................ 1.80 3.16 2.79 2.62 2.17 0.13 5.09 4.72 4.55 4.10 010

42180 ............ A Repair palate ........................................ 2.50 2.74 2.66 2.09 2.18 0.19 5.43 5.35 4.78 4.87 010

42182 ............ A Repair palate ........................................ 3.83 3.94 3.90 2.98 3.18 0.27 8.04 8.00 7.08 7.28 010

42200 ............ A Reconstruct cleft palate ........................ 12.00 NA NA 9.92 9.39 0.97 NA NA 22.89 22.36 090

42205 ............ A Reconstruct cleft palate ........................ 9.59 NA NA 7.65 8.60 0.82 NA NA 18.06 19.01 090

42210 ............ A Reconstruct cleft palate ........................ 14.50 NA NA 7.94 9.35 1.24 NA NA 23.68 25.09 090

42215 ............ A Reconstruct cleft palate ........................ 8.82 NA NA 7.36 7.60 0.96 NA NA 17.14 17.38 090

42220 ............ A Reconstruct cleft palate ........................ 7.02 NA NA 5.69 5.73 0.41 NA NA 13.12 13.16 090

42225 ............ A Reconstruct cleft palate ........................ 9.54 NA NA 8.87 8.53 0.75 NA NA 19.16 18.82 090

42226 ............ A Lengthening of palate ........................... 10.01 NA NA 9.15 9.00 0.73 NA NA 19.89 19.74 090

42227 ............ A Lengthening of palate ........................... 9.52 NA NA 6.69 7.03 0.70 NA NA 16.91 17.25 090

42235 ............ A Repair palate ........................................ 7.87 NA NA 5.75 5.82 0.49 NA NA 14.11 14.18 090

42260 ............ A Repair nose to lip fistula ...................... 9.80 7.33 6.58 7.33 6.58 0.85 17.98 17.23 17.98 17.23 090

42280 ............ A Preparation, palate mold ...................... 1.54 1.41 1.60 0.81 1.15 0.12 3.07 3.26 2.47 2.81 010

42281 ............ A Insertion, palate prosthesis .................. 1.93 2.01 1.91 1.03 1.17 0.14 4.08 3.98 3.10 3.24 010

42299 ............ C Palate/uvula surgery ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

42300 ............ A Drainage of salivary gland ................... 1.93 2.56 2.18 1.76 1.45 0.15 4.64 4.26 3.84 3.53 010

42305 ............ A Drainage of salivary gland ................... 6.07 NA NA 5.16 4.46 0.46 NA NA 11.69 10.99 090

65476

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

42310 ............ A Drainage of salivary gland ................... 1.56 2.24 1.96 1.67 1.39 0.11 3.91 3.63 3.34 3.06 010

42320 ............ A Drainage of salivary gland ................... 2.35 2.79 2.59 2.12 2.09 0.17 5.31 5.11 4.64 4.61 010

42325 ............ A Create salivary cyst drain ..................... 2.75 3.30 3.05 1.20 1.48 0.17 6.22 5.97 4.12 4.40 090

42326 ............ A Create salivary cyst drain ..................... 3.78 3.28 3.59 2.10 2.70 0.34 7.40 7.71 6.22 6.82 090

42330 ............ A Removal of salivary stone .................... 2.21 2.70 2.32 1.20 1.05 0.16 5.07 4.69 3.57 3.42 010

42335 ............ A Removal of salivary stone .................... 3.31 3.57 3.35 3.57 3.01 0.23 7.11 6.89 7.11 6.55 090

42340 ............ A Removal of salivary stone .................... 4.60 4.57 4.58 4.57 4.01 0.34 9.51 9.52 9.51 8.95 090

42400 ............ A Biopsy of salivary gland ....................... 0.78 2.34 1.97 0.39 0.40 0.06 3.18 2.81 1.23 1.24 000

42405 ............ A Biopsy of salivary gland ....................... 3.29 3.35 2.93 3.28 2.67 0.24 6.88 6.46 6.81 6.20 010

42408 ............ A Excision of salivary cyst ....................... 4.54 4.61 4.34 4.61 4.34 0.34 9.49 9.22 9.49 9.22 090

42409 ............ A Drainage of salivary cyst ...................... 2.81 3.44 3.34 3.44 3.34 0.20 6.45 6.35 6.45 6.35 090

42410 ............ A Excise parotid gland/lesion .................. 9.34 NA NA 7.78 7.45 0.77 NA NA 17.89 17.56 090

42415 ............ A Excise parotid gland/lesion .................. 16.89 NA NA 12.40 12.74 1.26 NA NA 30.55 30.89 090

42420 ............ A Excise parotid gland/lesion .................. 19.59 NA NA 13.97 14.50 1.45 NA NA 35.01 35.54 090

42425 ............ A Excise parotid gland/lesion .................. 13.02 NA NA 10.26 10.71 0.98 NA NA 24.26 24.71 090

42426 ............ A Excise parotid gland/lesion .................. 21.26 NA NA 14.79 17.44 1.57 NA NA 37.62 40.27 090

42440 ............ A Excise submaxillary gland .................... 6.97 NA NA 5.88 6.49 0.51 NA NA 13.36 13.97 090

42450 ............ A Excise sublingual gland ........................ 4.62 4.92 4.62 4.91 4.61 0.34 9.88 9.58 9.87 9.57 090

42500 ............ A Repair salivary duct .............................. 4.30 4.67 4.75 4.67 4.75 0.30 9.27 9.35 9.27 9.35 090

42505 ............ A Repair salivary duct .............................. 6.18 5.33 5.84 5.33 5.84 0.44 11.95 12.46 11.95 12.46 090

42507 ............ A Parotid duct diversion ........................... 6.11 NA NA 5.85 5.65 0.66 NA NA 12.62 12.42 090

42508 ............ A Parotid duct diversion ........................... 9.10 NA NA 7.96 8.04 0.64 NA NA 17.70 17.78 090

42509 ............ A Parotid duct diversion ........................... 11.54 NA NA 7.66 7.73 1.24 NA NA 20.44 20.51 090

42510 ............ A Parotid duct diversion ........................... 8.15 NA NA 7.44 7.66 0.57 NA NA 16.16 16.38 090

42550 ............ A Injection for salivary x-ray .................... 1.25 12.21 9.28 0.44 0.45 0.06 13.52 10.59 1.75 1.76 000

42600 ............ A Closure of salivary fistula ..................... 4.82 6.02 5.57 5.54 5.21 0.34 11.18 10.73 10.70 10.37 090

42650 ............ A Dilation of salivary duct ........................ 0.77 1.06 0.90 0.42 0.37 0.06 1.89 1.73 1.25 1.20 000

42660 ............ A Dilation of salivary duct ........................ 1.13 1.15 1.00 1.15 0.93 0.07 2.35 2.20 2.35 2.13 000

42665 ............ A Ligation of salivary duct ....................... 2.53 3.73 3.35 3.69 3.32 0.17 6.43 6.05 6.39 6.02 090

42699 ............ C Salivary surgery procedure .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

42700 ............ A Drainage of tonsil abscess ................... 1.62 3.09 2.55 1.80 1.47 0.12 4.83 4.29 3.54 3.21 010

42720 ............ A Drainage of throat abscess .................. 5.42 4.73 4.06 4.67 4.02 0.39 10.54 9.87 10.48 9.83 010

42725 ............ A Drainage of throat abscess .................. 10.72 NA NA 8.37 7.49 0.80 NA NA 19.89 19.01 090

42800 ............ A Biopsy of throat .................................... 1.39 2.91 2.38 2.50 1.98 0.10 4.40 3.87 3.99 3.47 010

42802 ............ A Biopsy of throat .................................... 1.54 3.01 2.54 2.60 2.23 0.11 4.66 4.19 4.25 3.88 010

42804 ............ A Biopsy of upper nose/throat ................. 1.24 2.87 2.45 2.45 2.13 0.09 4.20 3.78 3.78 3.46 010

42806 ............ A Biopsy of upper nose/throat ................. 1.58 3.29 2.85 2.63 2.35 0.12 4.99 4.55 4.33 4.05 010

42808 ............ A Excise pharynx lesion .......................... 2.30 4.66 4.18 3.04 2.96 0.17 7.13 6.65 5.51 5.43 010

42809 ............ A Remove pharynx foreign body ............. 1.81 3.34 2.73 1.67 1.48 0.13 5.28 4.67 3.61 3.42 010

42810 ............ A Excision of neck cyst ............................ 3.25 5.28 4.81 4.45 4.19 0.25 8.78 8.31 7.95 7.69 090

42815 ............ A Excision of neck cyst ............................ 7.07 NA NA 6.49 7.03 0.53 NA NA 14.09 14.63 090

42820 ............ A Remove tonsils and adenoids .............. 3.91 NA NA 3.89 3.77 0.28 NA NA 8.08 7.96 090

42821 ............ A Remove tonsils and adenoids .............. 4.29 NA NA 4.13 4.17 0.30 NA NA 8.72 8.76 090

42825 ............ A Removal of tonsils ................................ 3.42 NA NA 3.57 3.40 0.24 NA NA 7.23 7.06 090

42826 ............ A Removal of tonsils ................................ 3.38 NA NA 3.61 3.72 0.23 NA NA 7.22 7.33 090

42830 ............ A Removal of adenoids ........................... 2.57 NA NA 2.26 2.20 0.18 NA NA 5.01 4.95 090

42831 ............ A Removal of adenoids ........................... 2.71 NA NA 2.49 2.51 0.19 NA NA 5.39 5.41 090

42835 ............ A Removal of adenoids ........................... 2.30 NA NA 2.46 2.35 0.17 NA NA 4.93 4.82 090

42836 ............ A Removal of adenoids ........................... 3.18 NA NA 3.58 3.44 0.22 NA NA 6.98 6.84 090

42842 ............ A Extensive surgery of throat .................. 8.76 NA NA 7.71 7.60 0.61 NA NA 17.08 16.97 090

42844 ............ A Extensive surgery of throat .................. 14.31 NA NA 11.31 11.43 1.04 NA NA 26.66 26.78 090

42845 ............ A Extensive surgery of throat .................. 24.29 NA NA 17.47 18.16 1.76 NA NA 43.52 44.21 090

42860 ............ A Excision of tonsil tags .......................... 2.22 NA NA 3.01 2.77 0.16 NA NA 5.39 5.15 090

42870 ............ A Excision of lingual tonsil ....................... 5.40 NA NA 5.83 5.00 0.38 NA NA 11.61 10.78 090

42890 ............ A Partial removal of pharynx ................... 12.94 NA NA 10.62 10.41 0.91 NA NA 24.47 24.26 090

42892 ............ A Revision of pharyngeal walls ............... 15.83 NA NA 12.15 12.08 1.14 NA NA 29.12 29.05 090

42894 ............ A Revision of pharyngeal walls ............... 22.88 NA NA 16.83 16.98 1.64 NA NA 41.35 41.50 090

42900 ............ A Repair throat wound ............................. 5.25 NA NA 3.73 3.95 0.39 NA NA 9.37 9.59 010

42950 ............ A Reconstruction of throat ....................... 8.10 NA NA 7.40 7.97 0.58 NA NA 16.08 16.65 090

42953 ............ A Repair throat, esophagus ..................... 8.96 NA NA 8.96 8.44 0.73 NA NA 18.65 18.13 090

42955 ............ A Surgical opening of throat .................... 7.39 NA NA 6.48 5.76 0.63 NA NA 14.50 13.78 090

42960 ............ A Control throat bleeding ......................... 2.33 NA NA 2.08 1.85 0.17 NA NA 4.58 4.35 010

42961 ............ A Control throat bleeding ......................... 5.59 NA NA 5.22 4.39 0.40 NA NA 11.21 10.38 090

42962 ............ A Control throat bleeding ......................... 7.14 NA NA 6.25 6.31 0.51 NA NA 13.90 13.96 090

42970 ............ A Control nose/throat bleeding ................ 5.43 NA NA 3.77 3.11 0.37 NA NA 9.57 8.91 090

42971 ............ A Control nose/throat bleeding ................ 6.21 NA NA 5.69 5.06 0.45 NA NA 12.35 11.72 090

42972 ............ A Control nose/throat bleeding ................ 7.20 NA NA 5.29 5.20 0.54 NA NA 13.03 12.94 090

42999 ............ C Throat surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

43020 ............ A Incision of esophagus .......................... 8.09 NA NA 6.75 6.85 0.70 NA NA 15.54 15.64 090

43030 ............ A Throat muscle surgery ......................... 7.69 NA NA 6.94 7.50 0.60 NA NA 15.23 15.79 090

43045 ............ A Incision of esophagus .......................... 20.12 NA NA 12.66 12.87 2.15 NA NA 34.93 35.14 090

43100 ............ A Excision of esophagus lesion ............... 9.19 NA NA 7.55 7.34 0.79 NA NA 17.53 17.32 090

43101 ............ A Excision of esophagus lesion ............... 16.24 NA NA 9.82 9.94 1.81 NA NA 27.87 27.99 090

43107 ............ A Removal of esophagus ........................ 28.79 NA NA 16.92 18.80 3.29 NA NA 49.00 50.88 090

43108 ............ A Removal of esophagus ........................ 34.19 NA NA 17.66 20.10 3.78 NA NA 55.63 58.07 090

43112 ............ A Removal of esophagus ........................ 31.22 NA NA 18.18 19.51 3.67 NA NA 53.07 54.40 090

43113 ............ A Removal of esophagus ........................ 35.27 NA NA 19.43 21.43 4.33 NA NA 59.03 61.03 090

43116 ............ A Partial removal of esophagus .............. 31.22 NA NA 20.74 22.41 2.62 NA NA 54.58 56.25 090

43117 ............ A Partial removal of esophagus .............. 30.02 NA NA 17.49 19.97 3.51 NA NA 51.02 53.50 090

43118 ............ A Partial removal of esophagus .............. 33.20 NA NA 18.27 20.56 3.56 NA NA 55.03 57.32 090

43121 ............ A Partial removal of esophagus .............. 29.19 NA NA 17.45 18.88 3.44 NA NA 50.08 51.51 090

43122 ............ A Parital removal of esophagus .............. 29.11 NA NA 16.18 17.93 3.27 NA NA 48.56 50.31 090

43123 ............ A Partial removal of esophagus .............. 33.20 NA NA 19.65 21.59 3.96 NA NA 56.81 58.75 090

65477

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

43124 ............ A Removal of esophagus ........................ 27.32 NA NA 17.52 19.25 2.95 NA NA 47.79 49.52 090

43130 ............ A Removal of esophagus pouch ............. 11.75 NA NA 9.45 9.94 1.06 NA NA 22.26 22.75 090

43135 ............ A Removal of esophagus pouch ............. 16.10 NA NA 11.71 11.96 1.85 NA NA 29.66 29.91 090

43200 ............ A Esophagus endoscopy ......................... 1.59 6.74 5.61 1.18 1.36 0.11 8.44 7.31 2.88 3.06 000

43202 ............ A Esophagus endoscopy, biopsy ............ 1.89 5.35 4.67 1.13 1.41 0.12 7.36 6.68 3.14 3.42 000

43204 ............ A Esophagus endoscopy & inject ............ 3.77 NA NA 1.64 2.36 0.18 NA NA 5.59 6.31 000

43205 ............ A Esophagus endoscopy/ligation ............. 3.79 NA NA 1.65 1.97 0.17 NA NA 5.61 5.93 000

43215 ............ A Esophagus endoscopy ......................... 2.60 NA NA 1.25 1.71 0.17 NA NA 4.02 4.48 000

43216 ............ A Esophagus endoscopy/lesion ............... 2.40 NA NA 1.17 1.60 0.15 NA NA 3.72 4.15 000

43217 ............ A Esophagus endoscopy ......................... 2.90 NA NA 1.33 1.86 0.17 NA NA 4.40 4.93 000

43219 ............ A Esophagus endoscopy ......................... 2.80 NA NA 1.41 1.89 0.16 NA NA 4.37 4.85 000

43220 ............ A Esoph endoscopy, dilation ................... 2.10 NA NA 1.09 1.45 0.12 NA NA 3.31 3.67 000

43226 ............ A Esoph endoscopy, dilation ................... 2.34 NA NA 1.16 1.57 0.12 NA NA 3.62 4.03 000

43227 ............ A Esoph endoscopy, repair ..................... 3.60 NA NA 1.59 2.27 0.18 NA NA 5.37 6.05 000

43228 ............ A Esoph endoscopy, ablation .................. 3.77 NA NA 1.77 2.45 0.25 NA NA 5.79 6.47 000

43231 ............ A Esoph endoscopy w/us exam .............. 4.09 NA NA 1.84 1.84 0.24 NA NA 6.17 6.17 000

43232 ............ A Esoph endoscopy w/us fn bx ............... 4.71 NA NA 2.18 2.18 0.28 NA NA 7.17 7.17 000

43234 ............ A Upper GI endoscopy, exam ................. 2.01 3.65 3.44 1.04 1.38 0.13 5.79 5.58 3.18 3.52 000

43235 ............ A Uppr gi endoscopy, diagnosis .............. 2.39 4.79 4.43 1.17 1.59 0.13 7.31 6.95 3.69 4.11 000

43239 ............ A Upper GI endoscopy, biopsy ................ 2.69 4.96 4.65 1.28 1.76 0.14 7.79 7.48 4.11 4.59 000

43240 ............ A Esoph endoscope w/drain cyst ............ 7.39 NA NA 3.05 3.05 0.45 NA NA 10.89 10.89 000

43241 ............ A Upper GI endoscopy with tube ............ 2.59 NA NA 1.22 1.69 0.14 NA NA 3.95 4.42 000

43242 ............ A Uppr gi endoscopy w/us fn bx ............. 5.51 1.98 1.98 1.98 1.98 0.34 7.83 7.83 7.83 7.83 000

43243 ............ A Upper gi endoscopy & inject ................ 4.57 NA NA 1.93 2.81 0.21 NA NA 6.71 7.59 000

43244 ............ A Upper GI endoscopy/ligation ................ 4.59 NA NA 1.93 2.39 0.21 NA NA 6.73 7.19 000

43245 ............ A Operative upper GI endoscopy ............ 3.39 NA NA 1.50 2.14 0.18 NA NA 5.07 5.71 000

43246 ............ A Place gastrostomy tube ........................ 4.33 NA NA 1.80 2.64 0.24 NA NA 6.37 7.21 000

43247 ............ A Operative upper GI endoscopy ............ 3.39 NA NA 1.50 2.14 0.17 NA NA 5.06 5.70 000

43248 ............ A Uppr gi endoscopy/guide wire .............. 3.15 NA NA 1.42 2.01 0.15 NA NA 4.72 5.31 000

43249 ............ A Esoph endoscopy, dilation ................... 2.90 NA NA 1.33 1.86 0.15 NA NA 4.38 4.91 000

43250 ............ A Upper GI endoscopy/tumor .................. 3.20 NA NA 1.43 2.03 0.17 NA NA 4.80 5.40 000

43251 ............ A Operative upper GI endoscopy ............ 3.70 NA NA 1.61 2.31 0.19 NA NA 5.50 6.20 000

43255 ............ A Operative upper GI endoscopy ............ 4.40 NA NA 1.76 2.63 0.20 NA NA 6.36 7.23 000

43256 ............ A Uppr gi endoscopy w stent .................. 4.35 1.56 1.56 1.56 1.56 0.26 6.17 6.17 6.17 6.17 000

43258 ............ A Operative upper GI endoscopy ............ 4.55 NA NA 1.92 2.80 0.22 NA NA 6.69 7.57 000

43259 ............ A Endoscopic ultrasound exam ............... 4.89 NA NA 2.12 2.68 0.22 NA NA 7.23 7.79 000

43260 ............ A Endo cholangiopancreatograph ........... 5.96 NA NA 2.42 3.44 0.27 NA NA 8.65 9.67 000

43261 ............ A Endo cholangiopancreatograph ........... 6.27 NA NA 2.53 3.52 0.29 NA NA 9.09 10.08 000

43262 ............ A Endo cholangiopancreatograph ........... 7.39 NA NA 2.94 4.41 0.34 NA NA 10.67 12.14 000

43263 ............ A Endo cholangiopancreatograph ........... 6.19 NA NA 2.51 3.47 0.28 NA NA 8.98 9.94 000

43264 ............ A Endo cholangiopancreatograph ........... 8.90 NA NA 3.48 5.03 0.41 NA NA 12.79 14.34 000

43265 ............ A Endo cholangiopancreatograph ........... 8.90 NA NA 3.48 4.46 0.42 NA NA 12.80 13.78 000

43267 ............ A Endo cholangiopancreatograph ........... 7.39 NA NA 2.95 4.22 0.34 NA NA 10.68 11.95 000

43268 ............ A Endo cholangiopancreatograph ........... 7.39 NA NA 2.94 4.41 0.34 NA NA 10.67 12.14 000

43269 ............ A Endo cholangiopancreatograph ........... 6.04 NA NA 2.45 3.64 0.28 NA NA 8.77 9.96 000

43271 ............ A Endo cholangiopancreatograph ........... 7.39 NA NA 2.93 4.27 0.34 NA NA 10.66 12.00 000

43272 ............ A Endo cholangiopancreatograph ........... 7.39 NA NA 2.94 3.73 0.34 NA NA 10.67 11.46 000

43280 ............ A Laparoscopy, fundoplasty .................... 17.25 NA NA 8.77 9.80 1.76 NA NA 27.78 28.81 090

43289 ............ C Laparoscope proc, esoph ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

43300 ............ A Repair of esophagus ............................ 9.14 NA NA 7.63 8.45 0.85 NA NA 17.62 18.44 090

43305 ............ A Repair esophagus and fistula .............. 17.39 NA NA 13.14 13.58 1.36 NA NA 31.89 32.33 090

43310 ............ A Repair of esophagus ............................ 27.47 NA NA 18.38 18.40 3.18 NA NA 49.03 49.05 090

43312 ............ A Repair esophagus and fistula .............. 30.50 NA NA 23.31 21.21 3.38 NA NA 57.19 55.09 090

43320 ............ A Fuse esophagus & stomach ................ 16.07 NA NA 10.25 10.86 1.59 NA NA 27.91 28.52 090

43324 ............ A Revise esophagus & stomach ............. 16.58 NA NA 8.80 9.82 1.72 NA NA 27.10 28.12 090

43325 ............ A Revise esophagus & stomach ............. 16.17 NA NA 9.21 10.06 1.65 NA NA 27.03 27.88 090

43326 ............ A Revise esophagus & stomach ............. 15.91 NA NA 10.94 10.25 1.84 NA NA 28.69 28.00 090

43330 ............ A Repair of esophagus ............................ 15.94 NA NA 8.76 9.65 1.52 NA NA 26.22 27.11 090

43331 ............ A Repair of esophagus ............................ 16.23 NA NA 12.23 13.06 1.93 NA NA 30.39 31.22 090

43340 ............ A Fuse esophagus & intestine ................. 15.81 NA NA 10.07 10.93 1.53 NA NA 27.41 28.27 090

43341 ............ A Fuse esophagus & intestine ................. 16.81 NA NA 15.42 14.25 2.14 NA NA 34.37 33.20 090

43350 ............ A Surgical opening, esophagus ............... 12.72 NA NA 10.66 10.13 1.15 NA NA 24.53 24.00 090

43351 ............ A Surgical opening, esophagus ............... 14.79 NA NA 9.66 9.63 1.51 NA NA 25.96 25.93 090

43352 ............ A Surgical opening, esophagus ............... 12.30 NA NA 9.53 9.55 1.28 NA NA 23.11 23.13 090

43360 ............ A Gastrointestinal repair .......................... 28.78 NA NA 16.55 18.21 3.00 NA NA 48.33 49.99 090

43361 ............ A Gastrointestinal repair .......................... 32.65 NA NA 18.51 20.74 3.52 NA NA 54.68 56.91 090

43400 ............ A Ligate esophagus veins ....................... 17.09 NA NA 8.66 9.43 0.99 NA NA 26.74 27.51 090

43401 ............ A Esophagus surgery for veins ............... 17.81 NA NA 8.93 9.30 1.73 NA NA 28.47 28.84 090

43405 ............ A Ligate/staple esophagus ...................... 16.13 NA NA 9.39 10.93 1.63 NA NA 27.15 28.69 090

43410 ............ A Repair esophagus wound .................... 10.86 NA NA 9.11 9.25 1.15 NA NA 21.12 21.26 090

43415 ............ A Repair esophagus wound .................... 17.06 NA NA 11.23 11.88 1.92 NA NA 30.21 30.86 090

43420 ............ A Repair esophagus opening .................. 11.57 NA NA 8.87 8.25 0.86 NA NA 21.30 20.68 090

43425 ............ A Repair esophagus opening .................. 16.95 NA NA 11.97 11.68 2.03 NA NA 30.95 30.66 090

43450 ............ A Dilate esophagus .................................. 1.38 1.26 1.13 0.61 0.64 0.07 2.71 2.58 2.06 2.09 000

43453 ............ A Dilate esophagus .................................. 1.51 NA NA 0.65 0.90 0.08 NA NA 2.24 2.49 000

43456 ............ A Dilate esophagus .................................. 2.57 NA NA 1.05 1.46 0.14 NA NA 3.76 4.17 000

43458 ............ A Dilate esophagus .................................. 3.06 NA NA 1.24 1.34 0.17 NA NA 4.47 4.57 000

43460 ............ A Pressure treatment esophagus ............ 3.80 NA NA 1.51 1.59 0.21 NA NA 5.52 5.60 000

43496 ............ C Free jejunum flap, microvasc ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

43499 ............ C Esophagus surgery procedure ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

43500 ............ A Surgical opening of stomach ................ 8.44 NA NA 4.38 4.95 0.84 NA NA 13.66 14.23 090

43501 ............ A Surgical repair of stomach ................... 15.31 NA NA 7.32 7.82 1.55 NA NA 24.18 24.68 090

43502 ............ A Surgical repair of stomach ................... 17.67 NA NA 8.36 8.60 1.83 NA NA 27.86 28.10 090

65478

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

43510 ............ A Surgical opening of stomach ................ 9.99 NA NA 6.56 7.17 0.90 NA NA 17.45 18.06 090

43520 ............ A Incision of pyloric muscle ..................... 7.63 NA NA 5.72 5.51 0.84 NA NA 14.19 13.98 090

43600 ............ A Biopsy of stomach ................................ 1.91 NA NA 1.00 0.89 0.11 NA NA 3.02 2.91 000

43605 ............ A Biopsy of stomach ................................ 9.15 NA NA 4.59 5.05 0.93 NA NA 14.67 15.13 090

43610 ............ A Excision of stomach lesion ................... 11.15 NA NA 5.74 6.52 1.14 NA NA 18.03 18.81 090

43611 ............ A Excision of stomach lesion ................... 13.63 NA NA 6.78 7.30 1.38 NA NA 21.79 22.31 090

43620 ............ A Removal of stomach ............................ 22.54 NA NA 10.83 12.30 2.29 NA NA 35.66 37.13 090

43621 ............ A Removal of stomach ............................ 23.06 NA NA 10.89 12.34 2.36 NA NA 36.31 37.76 090

43622 ............ A Removal of stomach ............................ 24.41 NA NA 11.37 12.70 2.48 NA NA 38.26 39.59 090

43631 ............ A Removal of stomach, partial ................ 19.66 NA NA 8.97 10.10 1.99 NA NA 30.62 31.75 090

43632 ............ A Removal of stomach, partial ................ 19.66 NA NA 8.97 10.10 2.00 NA NA 30.63 31.76 090

43633 ............ A Removal of stomach, partial ................ 20.10 NA NA 9.15 10.23 2.05 NA NA 31.30 32.38 090

43634 ............ A Removal of stomach, partial ................ 21.86 NA NA 9.84 13.03 2.18 NA NA 33.88 37.07 090

43635 ............ A Removal of stomach, partial ................ 2.06 NA NA 0.78 0.88 0.21 NA NA 3.05 3.15 ZZZ

43638 ............ A Removal of stomach, partial ................ 21.76 NA NA 9.96 10.93 2.24 NA NA 33.96 34.93 090

43639 ............ A Removal of stomach, partial ................ 22.25 NA NA 10.30 11.19 2.31 NA NA 34.86 35.75 090

43640 ............ A Vagotomy & pylorus repair ................... 14.81 NA NA 7.14 8.16 1.51 NA NA 23.46 24.48 090

43641 ............ A Vagotomy & pylorus repair ................... 15.03 NA NA 7.24 8.24 1.53 NA NA 23.80 24.80 090

43651 ............ A Laparoscopy, vagus nerve ................... 10.15 NA NA 4.89 5.04 1.03 NA NA 16.07 16.22 090

43652 ............ A Laparoscopy, vagus nerve ................... 12.15 NA NA 5.65 5.89 1.25 NA NA 19.05 19.29 090

43653 ............ A Laparoscopy, gastrostomy ................... 7.73 NA NA 4.37 4.96 0.78 NA NA 12.88 13.47 090

43659 ............ C Laparoscope proc, stom ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

43750 ............ A Place gastrostomy tube ........................ 4.49 NA NA 2.61 3.14 0.33 NA NA 7.43 7.96 010

43752 ............ B Nasal/orogastric w/stent ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

43760 ............ A Change gastrostomy tube .................... 1.10 1.34 1.19 0.46 0.53 0.07 2.51 2.36 1.63 1.70 000

43761 ............ A Reposition gastrostomy tube ................ 2.01 NA NA 0.83 0.91 0.10 NA NA 2.94 3.02 000

43800 ............ A Reconstruction of pylorus ..................... 10.46 NA NA 5.64 6.09 1.07 NA NA 17.17 17.62 090

43810 ............ A Fusion of stomach and bowel .............. 11.19 NA NA 5.80 6.42 1.10 NA NA 18.09 18.71 090

43820 ............ A Fusion of stomach and bowel .............. 11.74 NA NA 5.98 6.74 1.18 NA NA 18.90 19.66 090

43825 ............ A Fusion of stomach and bowel .............. 14.68 NA NA 7.02 8.27 1.50 NA NA 23.20 24.45 090

43830 ............ A Place gastrostomy tube ........................ 7.28 NA NA 4.25 4.87 0.69 NA NA 12.22 12.84 090

43831 ............ A Place gastrostomy tube ........................ 7.84 NA NA 4.41 4.72 0.81 NA NA 13.06 13.37 090

43832 ............ A Place gastrostomy tube ........................ 11.92 NA NA 6.37 6.94 1.13 NA NA 19.42 19.99 090

43840 ............ A Repair of stomach lesion ..................... 11.89 NA NA 6.02 6.64 1.20 NA NA 19.11 19.73 090

43842 ............ A Gastroplasty for obesity ....................... 14.71 NA NA 10.07 11.28 1.51 NA NA 26.29 27.50 090

43843 ............ A Gastroplasty for obesity ....................... 14.85 NA NA 9.76 11.04 1.53 NA NA 26.14 27.42 090

43846 ............ A Gastric bypass for obesity .................... 19.15 NA NA 11.70 12.79 1.96 NA NA 32.81 33.90 090

43847 ............ A Gastric bypass for obesity .................... 21.44 NA NA 13.22 13.93 2.14 NA NA 36.80 37.51 090

43848 ............ A Revision gastroplasty ........................... 23.41 NA NA 14.07 14.57 2.39 NA NA 39.87 40.37 090

43850 ............ A Revise stomach-bowel fusion .............. 19.69 NA NA 8.94 9.86 1.97 NA NA 30.60 31.52 090

43855 ............ A Revise stomach-bowel fusion .............. 20.83 NA NA 9.60 10.03 2.01 NA NA 32.44 32.87 090

43860 ............ A Revise stomach-bowel fusion .............. 19.91 NA NA 9.09 9.93 2.03 NA NA 31.03 31.87 090

43865 ............ A Revise stomach-bowel fusion .............. 21.12 NA NA 9.57 10.81 2.15 NA NA 32.84 34.08 090

43870 ............ A Repair stomach opening ...................... 7.40 NA NA 4.37 4.84 0.71 NA NA 12.48 12.95 090

43880 ............ A Repair stomach-bowel fistula ............... 19.63 NA NA 9.42 9.30 1.94 NA NA 30.99 30.87 090

43999 ............ C Stomach surgery procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

44005 ............ A Freeing of bowel adhesion ................... 13.84 NA NA 6.71 7.28 1.39 NA NA 21.94 22.51 090

44010 ............ A Incision of small bowel ......................... 10.68 NA NA 5.93 6.32 1.05 NA NA 17.66 18.05 090

44015 ............ A Insert needle cath bowel ...................... 2.62 NA NA 0.99 1.53 0.25 NA NA 3.86 4.40 ZZZ

44020 ............ A Exploration of small bowel ................... 11.93 NA NA 5.97 6.60 1.20 NA NA 19.10 19.73 090

44021 ............ A Decompress small bowel ..................... 12.01 NA NA 6.37 6.68 1.18 NA NA 19.56 19.87 090

44025 ............ A Incision of large bowel ......................... 12.18 NA NA 6.08 6.66 1.21 NA NA 19.47 20.05 090

44050 ............ A Reduce bowel obstruction .................... 11.40 NA NA 5.77 6.44 1.15 NA NA 18.32 18.99 090

44055 ............ A Correct malrotation of bowel ................ 13.14 NA NA 6.43 6.90 1.32 NA NA 20.89 21.36 090

44100 ............ A Biopsy of bowel .................................... 2.01 NA NA 1.04 1.16 0.12 NA NA 3.17 3.29 000

44110 ............ A Excision of bowel lesion(s) ................... 10.07 NA NA 5.29 6.05 1.00 NA NA 16.36 17.12 090

44111 ............ A Excision of bowel lesion(s) ................... 12.19 NA NA 6.62 7.59 1.22 NA NA 20.03 21.00 090

44120 ............ A Removal of small intestine ................... 14.50 NA NA 6.94 7.77 1.46 NA NA 22.90 23.73 090

44121 ............ A Removal of small intestine ................... 4.45 NA NA 1.69 1.90 0.45 NA NA 6.59 6.80 ZZZ

44125 ............ A Removal of small intestine ................... 14.96 NA NA 7.10 8.24 1.49 NA NA 23.55 24.69 090

44130 ............ A Bowel to bowel fusion .......................... 12.36 NA NA 6.13 6.95 1.23 NA NA 19.72 20.54 090

44132 ............ N Enterectomy, cadaver donor ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44133 ............ N Enterectomy, live donor ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44135 ............ N Intestine transplnt, cadaver .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44136 ............ N Intestine transplant, live ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44139 ............ A Mobilization of colon ............................. 2.23 NA NA 0.85 0.96 0.21 NA NA 3.29 3.40 ZZZ

44140 ............ A Partial removal of colon ....................... 18.35 NA NA 8.82 9.70 1.83 NA NA 29.00 29.88 090

44141 ............ A Partial removal of colon ....................... 19.51 NA NA 11.83 12.09 1.95 NA NA 33.29 33.55 090

44143 ............ A Partial removal of colon ....................... 20.17 NA NA 12.04 12.36 2.02 NA NA 34.23 34.55 090

44144 ............ A Partial removal of colon ....................... 18.89 NA NA 10.80 11.37 1.89 NA NA 31.58 32.15 090

44145 ............ A Partial removal of colon ....................... 23.18 NA NA 11.03 11.87 2.22 NA NA 36.43 37.27 090

44146 ............ A Partial removal of colon ....................... 24.16 NA NA 13.79 14.41 2.20 NA NA 40.15 40.77 090

44147 ............ A Partial removal of colon ....................... 18.17 NA NA 9.52 11.30 1.74 NA NA 29.43 31.21 090

44150 ............ A Removal of colon ................................. 21.01 NA NA 12.92 13.72 2.05 NA NA 35.98 36.78 090

44151 ............ A Removal of colon/ileostomy ................. 20.04 NA NA 12.35 12.03 1.97 NA NA 34.36 34.04 090

44152 ............ A Removal of colon/ileostomy ................. 24.41 NA NA 15.55 15.85 2.36 NA NA 42.32 42.62 090

44153 ............ A Removal of colon/ileostomy ................. 26.83 NA NA 15.31 16.73 2.33 NA NA 44.47 45.89 090

44155 ............ A Removal of colon/ileostomy ................. 24.44 NA NA 14.08 15.08 2.26 NA NA 40.78 41.78 090

44156 ............ A Removal of colon/ileostomy ................. 23.01 NA NA 13.86 13.49 2.19 NA NA 39.06 38.69 090

44160 ............ A Removal of colon ................................. 15.88 NA NA 7.85 9.26 1.55 NA NA 25.28 26.69 090

44200 ............ A Laparoscopy, enterolysis ...................... 14.44 NA NA 6.98 7.48 1.46 NA NA 22.88 23.38 090

44201 ............ A Laparoscopy, jejunostomy .................... 9.78 NA NA 5.28 5.28 0.97 NA NA 16.03 16.03 090

44202 ............ A Laparo, resect intestine ........................ 22.04 NA NA 10.17 11.22 2.16 NA NA 34.37 35.42 090

65479

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

44209 ............ C Laparoscope proc, intestine ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

44300 ............ A Open bowel to skin .............................. 8.88 NA NA 5.58 5.82 0.88 NA NA 15.34 15.58 090

44310 ............ A Ileostomy/jejunostomy .......................... 11.70 NA NA 8.79 8.73 1.13 NA NA 21.62 21.56 090

44312 ............ A Revision of ileostomy ........................... 5.88 NA NA 4.26 4.03 0.54 NA NA 10.68 10.45 090

44314 ............ A Revision of ileostomy ........................... 11.04 NA NA 8.74 8.37 0.99 NA NA 20.77 20.40 090

44316 ............ A Devise bowel pouch ............................. 15.47 NA NA 12.23 11.79 1.41 NA NA 29.11 28.67 090

44320 ............ A Colostomy ............................................. 12.94 NA NA 10.11 9.61 1.28 NA NA 24.33 23.83 090

44322 ............ A Colostomy with biopsies ....................... 11.98 NA NA 9.84 9.84 1.18 NA NA 23.00 23.00 090

44340 ............ A Revision of colostomy .......................... 5.66 NA NA 3.99 3.45 0.56 NA NA 10.21 9.67 090

44345 ............ A Revision of colostomy .......................... 11.32 NA NA 6.81 6.42 1.11 NA NA 19.24 18.85 090

44346 ............ A Revision of colostomy .......................... 12.46 NA NA 7.25 7.24 1.20 NA NA 20.91 20.90 090

44360 ............ A Small bowel endoscopy ....................... 2.59 NA NA 1.31 1.85 0.14 NA NA 4.04 4.58 000

44361 ............ A Small bowel endoscopy/biopsy ............ 2.87 NA NA 1.41 2.02 0.15 NA NA 4.43 5.04 000

44363 ............ A Small bowel endoscopy ....................... 3.50 NA NA 1.60 2.01 0.19 NA NA 5.29 5.70 000

44364 ............ A Small bowel endoscopy ....................... 3.74 NA NA 1.73 2.56 0.21 NA NA 5.68 6.51 000

44365 ............ A Small bowel endoscopy ....................... 3.31 NA NA 1.58 2.30 0.18 NA NA 5.07 5.79 000

44366 ............ A Small bowel endoscopy ....................... 4.41 NA NA 1.96 2.96 0.22 NA NA 6.59 7.59 000

44369 ............ A Small bowel endoscopy ....................... 4.52 NA NA 1.95 2.98 0.23 NA NA 6.70 7.73 000

44370 ............ A Small bowel endoscopy/stent ............... 4.33 1.56 1.56 1.56 1.56 0.26 6.15 6.15 6.15 6.15 000

44372 ............ A Small bowel endoscopy ....................... 4.41 NA NA 1.99 2.98 0.27 NA NA 6.67 7.66 000

44373 ............ A Small bowel endoscopy ....................... 3.50 NA NA 1.70 2.45 0.19 NA NA 5.39 6.14 000

44376 ............ A Small bowel endoscopy ....................... 5.26 NA NA 2.28 2.81 0.29 NA NA 7.83 8.36 000

44377 ............ A Small bowel endoscopy/biopsy ............ 5.53 NA NA 2.38 2.94 0.28 NA NA 8.19 8.75 000

44378 ............ A Small bowel endoscopy ....................... 7.13 NA NA 2.95 3.64 0.37 NA NA 10.45 11.14 000

44379 ............ A S bowel endoscope w/stent ................. 7.07 2.52 2.52 2.52 2.52 0.45 10.04 10.04 10.04 10.04 000

44380 ............ A Small bowel endoscopy ....................... 1.05 NA NA 0.74 1.01 0.08 NA NA 1.87 2.14 000

44382 ............ A Small bowel endoscopy ....................... 1.27 NA NA 0.82 1.16 0.09 NA NA 2.18 2.52 000

44383 ............ A Ileoscopy w/stent .................................. 2.41 0.87 0.87 0.87 0.87 0.15 3.43 3.43 3.43 3.43 000

44385 ............ A Endoscopy of bowel pouch .................. 1.82 4.19 3.78 0.94 1.25 0.12 6.13 5.72 2.88 3.19 000

44386 ............ A Endoscopy, bowel pouch/biop ............. 2.12 5.12 4.26 1.09 1.24 0.15 7.39 6.53 3.36 3.51 000

44388 ............ A Colon endoscopy .................................. 2.50 5.48 5.09 1.26 1.79 0.18 8.16 7.77 3.94 4.47 000

44389 ............ A Colonoscopy with biopsy ...................... 2.77 5.92 5.53 1.37 1.96 0.18 8.87 8.48 4.32 4.91 000

44390 ............ A Colonoscopy for foreign body .............. 3.39 6.56 5.63 1.59 1.91 0.22 10.17 9.24 5.20 5.52 000

44391 ............ A Colonoscopy for bleeding ..................... 3.82 5.60 5.63 1.55 2.45 0.23 9.65 9.68 5.60 6.50 000

44392 ............ A Colonoscopy & polypectomy ................ 3.38 6.12 5.99 1.59 2.33 0.23 9.73 9.60 5.20 5.94 000

44393 ............ A Colonoscopy, lesion removal ............... 4.28 6.79 6.56 1.92 2.88 0.27 11.34 11.11 6.47 7.43 000

44394 ............ A Colonoscopy w/snare ........................... 3.92 6.54 6.31 1.79 2.67 0.26 10.72 10.49 5.97 6.85 000

44397 ............ A Colonoscopy w stent ............................ 4.23 NA NA 1.90 1.90 0.30 NA NA 6.43 6.43 000

44500 ............ A Intro, gastrointestinal tube .................... 0.49 NA NA 0.35 0.36 0.02 NA NA 0.86 0.87 000

44602 ............ A Suture, small intestine .......................... 10.61 NA NA 5.48 6.19 1.07 NA NA 17.16 17.87 090

44603 ............ A Suture, small intestine .......................... 14.00 NA NA 6.74 7.52 1.39 NA NA 22.13 22.91 090

44604 ............ A Suture, large intestine .......................... 14.28 NA NA 6.87 7.29 1.42 NA NA 22.57 22.99 090

44605 ............ A Repair of bowel lesion .......................... 15.37 NA NA 7.68 8.30 1.54 NA NA 24.59 25.21 090

44615 ............ A Intestinal stricturoplasty ........................ 14.19 NA NA 6.80 6.93 1.39 NA NA 22.38 22.51 090

44620 ............ A Repair bowel opening .......................... 10.87 NA NA 5.50 5.75 1.05 NA NA 17.42 17.67 090

44625 ............ A Repair bowel opening .......................... 13.41 NA NA 6.49 7.47 1.30 NA NA 21.20 22.18 090

44626 ............ A Repair bowel opening .......................... 22.59 NA NA 9.92 10.53 2.19 NA NA 34.70 35.31 090

44640 ............ A Repair bowel-skin fistula ...................... 14.83 NA NA 7.39 7.32 1.46 NA NA 23.68 23.61 090

44650 ............ A Repair bowel fistula .............................. 15.25 NA NA 7.55 7.65 1.49 NA NA 24.29 24.39 090

44660 ............ A Repair bowel-bladder fistula ................. 14.63 NA NA 7.18 7.65 1.14 NA NA 22.95 23.42 090

44661 ............ A Repair bowel-bladder fistula ................. 16.99 NA NA 8.03 9.81 1.53 NA NA 26.55 28.33 090

44680 ............ A Surgical revision, intestine ................... 13.72 NA NA 6.99 7.88 1.37 NA NA 22.08 22.97 090

44700 ............ A Suspend bowel w/prosthesis ................ 14.35 NA NA 7.01 8.34 1.21 NA NA 22.57 23.90 090

44799 ............ C Intestine surgery procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

44800 ............ A Excision of bowel pouch ...................... 11.23 NA NA 5.70 5.70 1.11 NA NA 18.04 18.04 090

44820 ............ A Excision of mesentery lesion ............... 10.31 NA NA 5.41 5.63 1.03 NA NA 16.75 16.97 090

44850 ............ A Repair of mesentery ............................. 9.57 NA NA 5.49 5.64 0.99 NA NA 16.05 16.20 090

44899 ............ C Bowel surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

44900 ............ A Drain app abscess, open ..................... 8.82 NA NA 5.44 5.24 0.84 NA NA 15.10 14.90 090

44901 ............ A Drain app abscess, percut ................... 3.38 NA NA 4.99 4.44 0.17 NA NA 8.54 7.99 000

44950 ............ A Appendectomy ...................................... 8.70 NA NA 4.93 5.03 0.88 NA NA 14.51 14.61 090

44955 ............ A Appendectomy add-on ......................... 1.53 NA NA 0.58 0.89 0.16 NA NA 2.27 2.58 ZZZ

44960 ............ A Appendectomy ...................................... 10.74 NA NA 6.01 6.11 1.09 NA NA 17.84 17.94 090

44970 ............ A Laparoscopy, appendectomy ............... 8.70 NA NA 4.31 4.56 0.88 NA NA 13.89 14.14 090

44979 ............ C Laparoscope proc, app ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

45000 ............ A Drainage of pelvic abscess .................. 4.52 NA NA 3.78 3.27 0.37 NA NA 8.67 8.16 090

45005 ............ A Drainage of rectal abscess .................. 1.99 4.22 3.52 1.59 1.54 0.18 6.39 5.69 3.76 3.71 010

45020 ............ A Drainage of rectal abscess .................. 4.72 NA NA 3.83 3.58 0.41 NA NA 8.96 8.71 090

45100 ............ A Biopsy of rectum .................................. 3.68 4.60 3.96 2.11 2.09 0.33 8.61 7.97 6.12 6.10 090

45108 ............ A Removal of anorectal lesion ................. 4.76 5.65 4.96 3.08 3.03 0.46 10.87 10.18 8.30 8.25 090

45110 ............ A Removal of rectum ............................... 23.80 NA NA 12.01 13.44 2.26 NA NA 38.07 39.50 090

45111 ............ A Partial removal of rectum ..................... 16.48 NA NA 8.87 9.85 1.60 NA NA 26.95 27.93 090

45112 ............ A Removal of rectum ............................... 25.96 NA NA 12.40 13.66 2.35 NA NA 40.71 41.97 090

45113 ............ A Partial proctectomy ............................... 25.99 NA NA 11.69 13.13 2.13 NA NA 39.81 41.25 090

45114 ............ A Partial removal of rectum ..................... 23.22 NA NA 11.38 12.71 2.28 NA NA 36.88 38.21 090

45116 ............ A Partial removal of rectum ..................... 20.89 NA NA 10.20 10.57 2.00 NA NA 33.09 33.46 090

45119 ............ A Remove rectum w/reservoir ................. 26.21 NA NA 12.21 13.52 2.13 NA NA 40.55 41.86 090

45120 ............ A Removal of rectum ............................... 25.00 NA NA 11.96 13.42 2.28 NA NA 39.24 40.70 090

45121 ............ A Removal of rectum and colon .............. 27.51 NA NA 12.97 12.66 2.66 NA NA 43.14 42.83 090

45123 ............ A Partial proctectomy ............................... 14.20 NA NA 6.89 8.36 1.04 NA NA 22.13 23.60 090

45126 ............ A Pelvic exenteration ............................... 38.39 NA NA 17.29 17.29 3.23 NA NA 58.91 58.91 090

45130 ............ A Excision of rectal prolapse ................... 13.97 NA NA 7.07 7.72 1.12 NA NA 22.16 22.81 090

45135 ............ A Excision of rectal prolapse ................... 16.39 NA NA 8.49 10.70 1.52 NA NA 26.40 28.61 090

65480

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

45150 ............ A Excision of rectal stricture .................... 5.67 5.01 4.68 3.16 3.29 0.46 11.14 10.81 9.29 9.42 090

45160 ............ A Excision of rectal lesion ....................... 13.02 NA NA 6.41 6.83 1.07 NA NA 20.50 20.92 090

45170 ............ A Excision of rectal lesion ....................... 9.77 NA NA 5.31 5.24 0.89 NA NA 15.97 15.90 090

45190 ............ A Destruction, rectal tumor ...................... 8.28 NA NA 4.74 4.94 0.76 NA NA 13.78 13.98 090

45300 ............ A Proctosigmoidoscopy dx ...................... 0.38 1.24 1.08 0.23 0.25 0.05 1.67 1.51 0.66 0.68 000

45303 ............ A Proctosigmoidoscopy dilate .................. 0.44 1.41 1.23 0.26 0.28 0.06 1.91 1.73 0.76 0.78 000

45305 ............ A Protosigmoidoscopy w/bx ..................... 0.56 1.34 1.23 0.30 0.34 0.09 1.99 1.88 0.95 0.99 000

45307 ............ A Protosigmoidoscopy fb ......................... 0.94 2.26 2.04 0.44 0.68 0.15 3.35 3.13 1.53 1.77 000

45308 ............ A Protosigmoidoscopy removal ............... 0.83 1.49 1.43 0.40 0.46 0.13 2.45 2.39 1.36 1.42 000

45309 ............ A Protosigmoidoscopy removal ............... 1.11 2.07 1.86 0.50 0.53 0.17 3.35 3.14 1.78 1.81 000

45315 ............ A Protosigmoidoscopy removal ............... 1.40 2.32 2.06 0.62 0.79 0.20 3.92 3.66 2.22 2.39 000

45317 ............ A Protosigmoidoscopy bleed ................... 1.50 1.76 1.66 0.65 0.83 0.20 3.46 3.36 2.35 2.53 000

45320 ............ A Protosigmoidoscopy ablate .................. 1.58 1.71 1.79 0.68 1.02 0.20 3.49 3.57 2.46 2.80 000

45321 ............ A Protosigmoidoscopy volvul ................... 1.17 NA NA 0.53 0.80 0.17 NA NA 1.87 2.14 000

45327 ............ A Proctosigmoidoscopy w/stent ............... 1.46 NA NA 0.83 0.83 0.12 NA NA 2.41 2.41 000

45330 ............ A Diagnostic sigmoidoscopy .................... 0.88 1.75 1.65 0.42 0.46 0.05 2.68 2.58 1.35 1.39 000

45331 ............ A Sigmoidoscopy and biopsy .................. 1.15 1.98 1.92 0.52 0.77 0.07 3.20 3.14 1.74 1.99 000

45332 ............ A Sigmoidoscopy w/fb removal ............... 1.79 3.54 3.13 0.75 1.04 0.11 5.44 5.03 2.65 2.94 000

45333 ............ A Sigmoidoscopy & polypectomy ............ 1.79 3.14 2.96 0.75 1.15 0.12 5.05 4.87 2.66 3.06 000

45334 ............ A Sigmoidoscopy for bleeding ................. 2.73 NA NA 1.09 1.55 0.16 NA NA 3.98 4.44 000

45337 ............ A Sigmoidoscopy & decompress ............. 2.15 NA NA 0.89 1.37 0.15 NA NA 3.19 3.67 000

45338 ............ A Sigmoidoscpy w/tumr remove .............. 2.34 3.67 3.36 0.95 1.32 0.15 6.16 5.85 3.44 3.81 000

45339 ............ A Sigmoidoscopy w/ablate tumr .............. 2.86 2.85 3.02 1.14 1.74 0.17 5.88 6.05 4.17 4.77 000

45341 ............ A Sigmoidoscopy w/ultrasound ................ 3.46 NA NA 1.66 1.66 0.24 NA NA 5.36 5.36 000

45342 ............ A Sigmoidoscopy w/us guide bx .............. 4.08 NA NA 1.81 1.81 0.29 NA NA 6.18 6.18 000

45345 ............ A Sigmodoscopy w/stent ......................... 2.66 NA NA 1.30 1.30 0.18 NA NA 4.14 4.14 000

45355 ............ A Surgical colonoscopy ........................... 3.52 NA NA 1.29 1.29 0.26 NA NA 5.07 5.07 000

45378 ............ A Diagnostic colonoscopy ........................ 3.68 6.60 6.07 1.70 2.38 0.20 10.48 9.95 5.58 6.26 000

45378 53 A Diagnostic colonoscopy ........................ 0.88 1.75 1.65 0.42 0.46 0.05 2.68 2.58 1.35 1.39 000

45379 ............ A Colonoscopy w/fb removal ................... 4.69 7.33 6.94 2.05 2.95 0.25 12.27 11.88 6.99 7.89 000

45380 ............ A Colonoscopy and biopsy ...................... 3.98 6.78 6.39 1.81 2.56 0.21 10.97 10.58 6.00 6.75 000

45382 ............ A Colonoscopy/control bleeding .............. 5.69 7.95 7.56 2.23 3.27 0.27 13.91 13.52 8.19 9.23 000

45383 ............ A Lesion removal colonoscopy ................ 5.83 7.82 7.47 2.48 3.47 0.32 13.97 13.62 8.63 9.62 000

45384 ............ A Lesion remove colonoscopy ................. 4.67 7.41 6.96 2.06 2.95 0.24 12.32 11.87 6.97 7.86 000

45385 ............ A Lesion removal colonoscopy ................ 5.27 7.57 7.48 2.28 3.30 0.28 13.12 13.03 7.83 8.85 000

45387 ............ A Colonoscopy w/stent ............................ 5.62 NA NA 2.41 2.41 0.36 NA NA 8.39 8.39 000

45500 ............ A Repair of rectum ................................... 7.29 NA NA 4.25 4.80 0.56 NA NA 12.10 12.65 090

45505 ............ A Repair of rectum ................................... 6.02 NA NA 3.27 4.16 0.50 NA NA 9.79 10.68 090

45520 ............ A Treatment of rectal prolapse ................ 0.55 0.73 0.71 0.19 0.23 0.04 1.32 1.30 0.78 0.82 000

45540 ............ A Correct rectal prolapse ......................... 12.92 NA NA 7.02 7.95 1.17 NA NA 21.11 22.04 090

45541 ............ A Correct rectal prolapse ......................... 10.64 NA NA 6.04 7.29 0.88 NA NA 17.56 18.81 090

45550 ............ A Repair rectum/remove sigmoid ............ 18.26 NA NA 8.91 9.80 1.58 NA NA 28.75 29.64 090

45560 ............ A Repair of rectocele ............................... 8.40 NA NA 5.04 5.08 0.73 NA NA 14.17 14.21 090

45562 ............ A Exploration/repair of rectum ................. 12.21 NA NA 6.33 6.94 1.15 NA NA 19.69 20.30 090

45563 ............ A Exploration/repair of rectum ................. 18.63 NA NA 9.56 10.64 1.84 NA NA 30.03 31.11 090

45800 ............ A Repair rect/bladder fistula .................... 14.11 NA NA 6.91 7.85 1.14 NA NA 22.16 23.10 090

45805 ............ A Repair fistula w/colostomy ................... 16.50 NA NA 8.59 9.79 1.47 NA NA 26.56 27.76 090

45820 ............ A Repair rectourethral fistula ................... 14.67 NA NA 7.24 7.87 1.17 NA NA 23.08 23.71 090

45825 ............ A Repair fistula w/colostomy ................... 16.87 NA NA 8.67 9.18 0.97 NA NA 26.51 27.02 090

45900 ............ A Reduction of rectal prolapse ................ 1.83 NA NA 0.78 0.74 0.17 NA NA 2.78 2.74 010

45905 ............ A Dilation of anal sphincter ...................... 1.61 3.06 2.49 0.72 0.73 0.14 4.81 4.24 2.47 2.48 010

45910 ............ A Dilation of rectal narrowing .................. 1.96 4.16 3.36 0.85 0.87 0.14 6.26 5.46 2.95 2.97 010

45915 ............ A Remove rectal obstruction ................... 2.20 4.10 3.29 0.84 0.84 0.17 6.47 5.66 3.21 3.21 010

45999 ............ C Rectum surgery procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

46030 ............ A Removal of rectal marker ..................... 1.23 3.22 2.52 1.21 1.02 0.11 4.56 3.86 2.55 2.36 010

46040 ............ A Incision of rectal abscess ..................... 4.96 5.27 4.41 3.09 2.78 0.48 10.71 9.85 8.53 8.22 090

46045 ............ A Incision of rectal abscess ..................... 4.32 NA NA 2.80 2.60 0.40 NA NA 7.52 7.32 090

46050 ............ A Incision of anal abscess ....................... 1.19 3.38 2.70 1.28 1.04 0.11 4.68 4.00 2.58 2.34 010

46060 ............ A Incision of rectal abscess ..................... 5.69 NA NA 3.80 4.30 0.52 NA NA 10.01 10.51 090

46070 ............ A Incision of anal septum ........................ 2.71 NA NA 2.45 2.21 0.27 NA NA 5.43 5.19 090

46080 ............ A Incision of anal sphincter ..................... 2.49 3.65 3.32 1.62 1.79 0.23 6.37 6.04 4.34 4.51 010

46083 ............ A Incise external hemorrhoid ................... 1.40 4.43 3.49 1.45 1.17 0.12 5.95 5.01 2.97 2.69 010

46200 ............ A Removal of anal fissure ....................... 3.42 3.81 3.75 2.38 2.68 0.30 7.53 7.47 6.10 6.40 090

46210 ............ A Removal of anal crypt .......................... 2.67 4.82 3.83 2.14 1.82 0.26 7.75 6.76 5.07 4.75 090

46211 ............ A Removal of anal crypts ........................ 4.25 5.33 4.51 2.92 2.71 0.37 9.95 9.13 7.54 7.33 090

46220 ............ A Removal of anal tab ............................. 1.56 1.25 1.11 0.59 0.61 0.14 2.95 2.81 2.29 2.31 010

46221 ............ A Ligation of hemorrhoid(s) ..................... 1.43 3.03 2.45 0.54 0.50 0.12 4.58 4.00 2.09 2.05 010

46230 ............ A Removal of anal tabs ........................... 2.57 4.03 3.25 1.69 1.38 0.22 6.82 6.04 4.48 4.17 010

46250 ............ A Hemorrhoidectomy ............................... 4.53 5.32 4.76 2.92 2.96 0.43 10.28 9.72 7.88 7.92 090

46255 ............ A Hemorrhoidectomy ............................... 5.36 5.97 5.76 3.21 3.69 0.51 11.84 11.63 9.08 9.56 090

46257 ............ A Remove hemorrhoids & fissure ............ 6.28 NA NA 3.46 4.02 0.59 NA NA 10.33 10.89 090

46258 ............ A Remove hemorrhoids & fistula ............. 6.67 NA NA 3.67 4.35 0.64 NA NA 10.98 11.66 090

46260 ............ A Hemorrhoidectomy ............................... 7.42 NA NA 4.41 4.96 0.68 NA NA 12.51 13.06 090

46261 ............ A Remove hemorrhoids & fissure ............ 8.24 NA NA 4.58 5.23 0.70 NA NA 13.52 14.17 090

46262 ............ A Remove hemorrhoids & fistula ............. 8.73 NA NA 4.85 5.46 0.76 NA NA 14.34 14.95 090

46270 ............ A Removal of anal fistula ......................... 3.72 4.74 4.06 2.56 2.43 0.36 8.82 8.14 6.64 6.51 090

46275 ............ A Removal of anal fistula ......................... 4.56 4.61 4.82 2.83 3.49 0.40 9.57 9.78 7.79 8.45 090

46280 ............ A Removal of anal fistula ......................... 5.98 NA NA 3.76 4.47 0.50 NA NA 10.24 10.95 090

46285 ............ A Removal of anal fistula ......................... 4.09 3.84 3.50 2.64 2.60 0.34 8.27 7.93 7.07 7.03 090

46288 ............ A Repair anal fistula ................................ 7.13 NA NA 4.23 4.14 0.60 NA NA 11.96 11.87 090

46320 ............ A Removal of hemorrhoid clot ................. 1.61 3.63 2.91 1.49 1.21 0.14 5.38 4.66 3.24 2.96 010

46500 ............ A Injection into hemorrhoids .................... 1.61 2.55 2.00 0.60 0.50 0.12 4.28 3.73 2.33 2.23 010

46600 ............ A Diagnostic anoscopy ............................ 0.50 0.77 0.65 0.15 0.15 0.04 1.31 1.19 0.69 0.69 000

65481

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

46604 ............ A Anoscopy and dilation .......................... 1.31 0.96 0.82 0.49 0.42 0.09 2.36 2.22 1.89 1.82 000

46606 ............ A Anoscopy and biopsy ........................... 0.81 0.88 0.76 0.31 0.28 0.07 1.76 1.64 1.19 1.16 000

46608 ............ A Anoscopy/ remove for body ................. 1.51 1.78 1.63 0.47 0.64 0.13 3.42 3.27 2.11 2.28 000

46610 ............ A Anoscopy/remove lesion ...................... 1.32 1.41 1.29 0.50 0.61 0.12 2.85 2.73 1.94 2.05 000

46611 ............ A Anoscopy .............................................. 1.81 1.96 1.70 0.68 0.63 0.15 3.92 3.66 2.64 2.59 000

46612 ............ A Anoscopy/ remove lesions ................... 2.34 2.29 2.10 0.88 1.04 0.18 4.81 4.62 3.40 3.56 000

46614 ............ A Anoscopy/control bleeding ................... 2.01 1.62 1.64 0.74 0.77 0.14 3.77 3.79 2.89 2.92 000

46615 ............ A Anoscopy .............................................. 2.68 1.75 1.73 1.01 0.97 0.23 4.66 4.64 3.92 3.88 000

46700 ............ A Repair of anal stricture ......................... 7.25 NA NA 4.12 4.76 0.56 NA NA 11.93 12.57 090

46705 ............ A Repair of anal stricture ......................... 7.17 NA NA 4.83 4.60 0.73 NA NA 12.73 12.50 090

46715 ............ A Repair of anovaginal fistula .................. 7.46 NA NA 4.63 4.43 0.76 NA NA 12.85 12.65 090

46716 ............ A Repair of anovaginal fistula .................. 12.85 NA NA 7.04 6.92 1.30 NA NA 21.19 21.07 090

46730 ............ A Construction of absent anus ................ 22.39 NA NA 10.92 11.11 2.03 NA NA 35.34 35.53 090

46735 ............ A Construction of absent anus ................ 27.02 NA NA 13.19 13.43 2.64 NA NA 42.85 43.09 090

46740 ............ A Construction of absent anus ................ 24.19 NA NA 11.01 11.39 1.99 NA NA 37.19 37.57 090

46742 ............ A Repair of imperforated anus ................ 29.67 NA NA 15.65 17.10 2.63 NA NA 47.95 49.40 090

46744 ............ A Repair of cloacal anomaly .................... 33.21 NA NA 14.55 16.93 2.27 NA NA 50.03 52.41 090

46746 ............ A Repair of cloacal anomaly .................... 36.74 NA NA 18.48 20.44 2.51 NA NA 57.73 59.69 090

46748 ............ A Repair of cloacal anomaly .................... 40.52 NA NA 19.99 22.33 2.77 NA NA 63.28 65.62 090

46750 ............ A Repair of anal sphincter ....................... 8.14 NA NA 4.84 5.26 0.69 NA NA 13.67 14.09 090

46751 ............ A Repair of anal sphincter ....................... 8.77 NA NA 6.22 5.77 0.78 NA NA 15.77 15.32 090

46753 ............ A Reconstruction of anus ........................ 6.58 NA NA 3.53 3.98 0.58 NA NA 10.69 11.14 090

46754 ............ A Removal of suture from anus ............... 1.54 4.98 4.14 1.09 1.22 0.12 6.64 5.80 2.75 2.88 010

46760 ............ A Repair of anal sphincter ....................... 11.46 NA NA 5.77 6.17 0.86 NA NA 18.09 18.49 090

46761 ............ A Repair of anal sphincter ....................... 10.99 NA NA 5.68 6.11 0.84 NA NA 17.51 17.94 090

46762 ............ A Implant artificial sphincter ..................... 10.09 NA NA 4.94 5.26 0.71 NA NA 15.74 16.06 090

46900 ............ A Destruction, anal lesion(s) .................... 1.91 3.19 2.50 0.78 0.64 0.13 5.23 4.54 2.82 2.68 010

46910 ............ A Destruction, anal lesion(s) .................... 1.86 3.44 2.75 1.48 1.20 0.14 5.44 4.75 3.48 3.20 010

46916 ............ A Cryosurgery, anal lesion(s) .................. 1.86 3.42 2.75 1.60 1.29 0.09 5.37 4.70 3.55 3.24 010

46917 ............ A Laser surgery, anal lesions .................. 1.86 4.24 3.71 1.54 1.42 0.16 6.26 5.73 3.56 3.44 010

46922 ............ A Excision of anal lesion(s) ..................... 1.86 3.68 3.11 1.43 1.42 0.17 5.71 5.14 3.46 3.45 010

46924 ............ A Destruction, anal lesion(s) .................... 2.76 4.91 4.38 1.73 1.99 0.20 7.87 7.34 4.69 4.95 010

46934 ............ A Destruction of hemorrhoids .................. 4.08 5.74 4.63 3.46 2.76 0.26 10.08 8.97 7.80 7.10 090

46935 ............ A Destruction of hemorrhoids .................. 2.43 3.91 3.37 0.90 0.90 0.17 6.51 5.97 3.50 3.50 010

46936 ............ A Destruction of hemorrhoids .................. 4.30 5.58 4.81 3.39 2.86 0.30 10.18 9.41 7.99 7.46 090

46937 ............ A Cryotherapy of rectal lesion ................. 2.69 4.05 3.68 2.40 2.44 0.12 6.86 6.49 5.21 5.25 010

46938 ............ A Cryotherapy of rectal lesion ................. 4.66 3.99 3.67 3.48 3.29 0.40 9.05 8.73 8.54 8.35 090

46940 ............ A Treatment of anal fissure ..................... 2.32 2.99 2.38 0.88 0.73 0.17 5.48 4.87 3.37 3.22 010

46942 ............ A Treatment of anal fissure ..................... 2.04 3.07 2.43 0.73 0.61 0.14 5.25 4.61 2.91 2.79 010

46945 ............ A Ligation of hemorrhoids ........................ 2.14 3.76 2.99 2.12 1.68 0.17 6.07 5.30 4.43 3.99 090

46946 ............ A Ligation of hemorrhoids ........................ 3.00 4.99 4.00 2.45 1.97 0.22 8.21 7.22 5.67 5.19 090

46999 ............ C Anus surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

47000 ............ A Needle biopsy of liver ........................... 1.90 8.46 6.73 0.68 0.89 0.09 10.45 8.72 2.67 2.88 000

47001 ............ A Needle biopsy, liver add-on ................. 1.90 NA NA 0.72 0.92 0.18 NA NA 2.80 3.00 ZZZ

47010 ............ A Open drainage, liver lesion .................. 10.28 NA NA 7.49 7.45 0.65 NA NA 18.42 18.38 090

47011 ............ A Percut drain, liver lesion ....................... 3.70 NA NA 6.00 5.26 0.17 NA NA 9.87 9.13 000

47015 ............ A Inject/aspirate liver cyst ........................ 9.70 NA NA 6.11 6.42 0.86 NA NA 16.67 16.98 090

47100 ............ A Wedge biopsy of liver ........................... 7.49 NA NA 4.96 4.61 0.75 NA NA 13.20 12.85 090

47120 ............ A Partial removal of liver ......................... 22.79 NA NA 12.56 12.68 2.29 NA NA 37.64 37.76 090

47122 ............ A Extensive removal of liver .................... 35.39 NA NA 17.25 17.71 3.60 NA NA 56.24 56.70 090

47125 ............ A Partial removal of liver ......................... 31.58 NA NA 15.87 16.63 3.18 NA NA 50.63 51.39 090

47130 ............ A Partial removal of liver ......................... 34.25 NA NA 17.03 17.98 3.47 NA NA 54.75 55.70 090

47133 ............ X Removal of donor liver ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

47134 ............ R Partial removal, donor liver .................. 39.15 NA NA 15.00 16.81 3.98 NA NA 58.13 59.94 XXX

47135 ............ R Transplantation of liver ......................... 81.52 NA NA 43.43 47.35 8.13 NA NA 133.08 137.00 090

47136 ............ R Transplantation of liver ......................... 68.60 NA NA 45.80 43.44 6.93 NA NA 121.33 118.97 090

47300 ............ A Surgery for liver lesion ......................... 9.68 NA NA 5.79 6.42 0.97 NA NA 16.44 17.07 090

47350 ............ A Repair liver wound ............................... 12.56 NA NA 7.01 7.28 1.25 NA NA 20.82 21.09 090

47360 ............ A Repair liver wound ............................... 17.28 NA NA 9.45 10.05 1.71 NA NA 28.44 29.04 090

47361 ............ A Repair liver wound ............................... 30.25 NA NA 14.47 14.83 3.11 NA NA 47.83 48.19 090

47362 ............ A Repair liver wound ............................... 11.88 NA NA 7.81 7.28 1.22 NA NA 20.91 20.38 090

47379 ............ C Laparoscope procedure, liver ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

47399 ............ C Liver surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

47400 ............ A Incision of liver duct ............................. 20.86 NA NA 10.90 10.49 1.82 NA NA 33.58 33.17 090

47420 ............ A Incision of bile duct .............................. 16.72 NA NA 8.42 8.89 1.70 NA NA 26.84 27.31 090

47425 ............ A Incision of bile duct .............................. 16.68 NA NA 8.62 9.64 1.60 NA NA 26.90 27.92 090

47460 ............ A Incise bile duct sphincter ...................... 15.17 NA NA 7.92 10.16 1.24 NA NA 24.33 26.57 090

47480 ............ A Incision of gallbladder .......................... 9.10 NA NA 5.98 6.55 0.85 NA NA 15.93 16.50 090

47490 ............ A Incision of gallbladder .......................... 7.23 NA NA 7.42 6.53 0.33 NA NA 14.98 14.09 090

47500 ............ A Injection for liver x-rays ........................ 1.96 NA NA 0.69 0.93 0.09 NA NA 2.74 2.98 000

47505 ............ A Injection for liver x-rays ........................ 0.76 14.97 11.49 0.27 0.43 0.03 15.76 12.28 1.06 1.22 000

47510 ............ A Insert catheter, bile duct ....................... 7.83 NA NA 8.81 7.39 0.36 NA NA 17.00 15.58 090

47511 ............ A Insert bile duct drain ............................. 10.50 NA NA 10.08 8.34 0.47 NA NA 21.05 19.31 090

47525 ............ A Change bile duct catheter .................... 5.55 NA NA 3.30 2.91 0.24 NA NA 9.09 8.70 010

47530 ............ A Revise/reinsert bile tube ....................... 5.85 NA NA 4.92 4.10 0.29 NA NA 11.06 10.24 090

47550 ............ A Bile duct endoscopy add-on ................. 3.02 NA NA 1.15 1.29 0.30 NA NA 4.47 4.61 ZZZ

47552 ............ A Biliary endoscopy thru skin .................. 6.04 NA NA 2.56 2.29 0.42 NA NA 9.02 8.75 000

47553 ............ A Biliary endoscopy thru skin .................. 6.35 NA NA 2.73 3.08 0.30 NA NA 9.38 9.73 000

47554 ............ A Biliary endoscopy thru skin .................. 9.06 NA NA 3.66 3.81 0.74 NA NA 13.46 13.61 000

47555 ............ A Biliary endoscopy thru skin .................. 7.56 NA NA 3.17 3.09 0.35 NA NA 11.08 11.00 000

47556 ............ A Biliary endoscopy thru skin .................. 8.56 NA NA 3.51 3.35 0.38 NA NA 12.45 12.29 000

47560 ............ A Laparoscopy w/cholangio ..................... 4.89 NA NA 1.98 2.24 0.49 NA NA 7.36 7.62 000

47561 ............ A Laparo w/cholangio/biopsy ................... 5.18 NA NA 2.26 2.76 0.49 NA NA 7.93 8.43 000

65482

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

47562 ............ A Laparoscopic cholecystectomy ............ 11.09 NA NA 5.04 5.95 1.13 NA NA 17.26 18.17 090

47563 ............ A Laparo cholecystectomy/graph ............ 11.94 NA NA 5.53 6.44 1.21 NA NA 18.68 19.59 090

47564 ............ A Laparo cholecystectomy/explr .............. 14.23 NA NA 7.17 7.92 1.44 NA NA 22.84 23.59 090

47570 ............ A Laparo cholecystoenterostomy ............ 12.58 NA NA 6.12 7.08 1.28 NA NA 19.98 20.94 090

47579 ............ C Laparoscope proc, biliary ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

47600 ............ A Removal of gallbladder ........................ 11.42 NA NA 6.16 6.66 1.16 NA NA 18.74 19.24 090

47605 ............ A Removal of gallbladder ........................ 12.36 NA NA 6.50 7.08 1.25 NA NA 20.11 20.69 090

47610 ............ A Removal of gallbladder ........................ 15.83 NA NA 7.94 8.50 1.61 NA NA 25.38 25.94 090

47612 ............ A Removal of gallbladder ........................ 15.80 NA NA 7.76 9.68 1.60 NA NA 25.16 27.08 090

47620 ............ A Removal of gallbladder ........................ 17.36 NA NA 8.39 9.34 1.77 NA NA 27.52 28.47 090

47630 ............ A Remove bile duct stone ....................... 9.11 NA NA 3.25 3.46 0.46 NA NA 12.82 13.03 090

47700 ............ A Exploration of bile ducts ....................... 15.62 NA NA 8.92 8.76 1.40 NA NA 25.94 25.78 090

47701 ............ A Bile duct revision .................................. 29.55 NA NA 14.49 13.10 3.00 NA NA 47.04 45.65 090

47711 ............ A Excision of bile duct tumor ................... 19.37 NA NA 10.19 10.92 1.98 NA NA 31.54 32.27 090

47712 ............ A Excision of bile duct tumor ................... 25.44 NA NA 12.89 12.94 2.67 NA NA 41.00 41.05 090

47715 ............ A Excision of bile duct cyst ...................... 15.81 NA NA 7.97 8.21 1.59 NA NA 25.37 25.61 090

47716 ............ A Fusion of bile duct cyst ........................ 13.83 NA NA 8.56 8.20 1.41 NA NA 23.80 23.44 090

47720 ............ A Fuse gallbladder & bowel ..................... 13.38 NA NA 7.95 8.45 1.37 NA NA 22.70 23.20 090

47721 ............ A Fuse upper gi structures ...................... 16.08 NA NA 8.89 9.77 1.63 NA NA 26.60 27.48 090

47740 ............ A Fuse gallbladder & bowel ..................... 15.54 NA NA 8.78 9.36 1.59 NA NA 25.91 26.49 090

47741 ............ A Fuse gallbladder & bowel ..................... 17.95 NA NA 9.55 11.06 1.82 NA NA 29.32 30.83 090

47760 ............ A Fuse bile ducts and bowel ................... 21.74 NA NA 10.99 11.39 2.21 NA NA 34.94 35.34 090

47765 ............ A Fuse liver ducts & bowel ...................... 20.93 NA NA 11.63 12.69 2.18 NA NA 34.74 35.80 090

47780 ............ A Fuse bile ducts and bowel ................... 22.29 NA NA 11.25 11.98 2.27 NA NA 35.81 36.54 090

47785 ............ A Fuse bile ducts and bowel ................... 26.23 NA NA 13.37 13.57 2.69 NA NA 42.29 42.49 090

47800 ............ A Reconstruction of bile ducts ................. 19.60 NA NA 10.17 11.22 1.95 NA NA 31.72 32.77 090

47801 ............ A Placement, bile duct support ................ 12.76 NA NA 9.34 8.49 0.69 NA NA 22.79 21.94 090

47802 ............ A Fuse liver duct & intestine .................... 18.13 NA NA 10.48 10.65 1.84 NA NA 30.45 30.62 090

47900 ............ A Suture bile duct injury .......................... 16.74 NA NA 9.16 10.46 1.65 NA NA 27.55 28.85 090

47999 ............ C Bile tract surgery procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

48000 ............ A Drainage of abdomen ........................... 14.91 NA NA 8.27 8.12 1.32 NA NA 24.50 24.35 090

48001 ............ A Placement of drain, pancreas .............. 18.83 NA NA 9.37 9.23 1.90 NA NA 30.10 29.96 090

48005 ............ A Resect/debride pancreas ..................... 22.40 NA NA 10.65 10.48 2.26 NA NA 35.31 35.14 090

48020 ............ A Removal of pancreatic stone ............... 14.22 NA NA 7.25 7.28 1.36 NA NA 22.83 22.86 090

48100 ............ A Biopsy of pancreas ............................... 11.08 NA NA 6.62 6.11 1.08 NA NA 18.78 18.27 090

48102 ............ A Needle biopsy, pancreas ...................... 4.68 8.31 6.89 2.41 2.46 0.20 13.19 11.77 7.29 7.34 010

48120 ............ A Removal of pancreas lesion ................. 14.36 NA NA 7.14 7.99 1.35 NA NA 22.85 23.70 090

48140 ............ A Partial removal of pancreas ................. 20.78 NA NA 10.29 11.32 2.12 NA NA 33.19 34.22 090

48145 ............ A Partial removal of pancreas ................. 21.76 NA NA 11.28 12.72 2.25 NA NA 35.29 36.73 090

48146 ............ A Pancreatectomy .................................... 23.91 NA NA 13.04 14.26 2.43 NA NA 39.38 40.60 090

48148 ............ A Removal of pancreatic duct ................. 15.71 NA NA 8.95 8.95 1.61 NA NA 26.27 26.27 090

48150 ............ A Partial removal of pancreas ................. 43.48 NA NA 21.07 21.92 4.43 NA NA 68.98 69.83 090

48152 ............ A Pancreatectomy .................................... 39.63 NA NA 19.66 20.86 4.07 NA NA 63.36 64.56 090

48153 ............ A Pancreatectomy .................................... 43.38 NA NA 20.98 21.85 4.40 NA NA 68.76 69.63 090

48154 ............ A Pancreatectomy .................................... 39.95 NA NA 19.94 21.07 4.10 NA NA 63.99 65.12 090

48155 ............ A Removal of pancreas ........................... 22.32 NA NA 13.25 15.47 2.30 NA NA 37.87 40.09 090

48160 ............ N Pancreas removal/transplant ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

48180 ............ A Fuse pancreas and bowel .................... 22.39 NA NA 10.69 11.44 2.24 NA NA 35.32 36.07 090

48400 ............ A Injection, intraop add-on ....................... 1.95 NA NA 0.70 0.81 0.10 NA NA 2.75 2.86 ZZZ

48500 ............ A Surgery of pancreas cyst ..................... 13.84 NA NA 7.28 7.78 1.35 NA NA 22.47 22.97 090

48510 ............ A Drain pancreatic pseudocyst ................ 12.96 NA NA 7.12 7.39 1.07 NA NA 21.15 21.42 090

48511 ............ A Drain pancreatic pseudocyst ................ 4.00 NA NA 4.57 4.25 0.17 NA NA 8.74 8.42 000

48520 ............ A Fuse pancreas cyst and bowel ............ 14.12 NA NA 6.98 8.30 1.41 NA NA 22.51 23.83 090

48540 ............ A Fuse pancreas cyst and bowel ............ 17.86 NA NA 8.45 9.77 1.82 NA NA 28.13 29.45 090

48545 ............ A Pancreatorrhaphy ................................. 16.47 NA NA 8.34 8.33 1.61 NA NA 26.42 26.41 090

48547 ............ A Duodenal exclusion .............................. 23.40 NA NA 10.50 10.88 2.30 NA NA 36.20 36.58 090

48550 ............ X Donor pancreatectomy ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

48554 ............ R Transpl allograft pancreas .................... 34.17 NA NA 12.84 14.48 3.30 NA NA 50.31 51.95 090

48556 ............ A Removal, allograft pancreas ................ 15.71 NA NA 8.75 8.53 1.52 NA NA 25.98 25.76 090

48999 ............ C Pancreas surgery procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

49000 ............ A Exploration of abdomen ....................... 11.68 NA NA 6.32 6.58 1.17 NA NA 19.17 19.43 090

49002 ............ A Reopening of abdomen ........................ 10.49 NA NA 6.21 6.30 1.06 NA NA 17.76 17.85 090

49010 ............ A Exploration behind abdomen ............... 12.28 NA NA 7.18 7.27 1.22 NA NA 20.68 20.77 090

49020 ............ A Drain abdominal abscess ..................... 16.79 NA NA 9.52 8.45 1.31 NA NA 27.62 26.55 090

49021 ............ A Drain abdominal abscess ..................... 3.38 NA NA 6.02 5.53 0.16 NA NA 9.56 9.07 000

49040 ............ A Drain, open, abdom abscess ............... 9.94 NA NA 6.81 6.88 0.84 NA NA 17.59 17.66 090

49041 ............ A Drain, percut, abdom abscess ............. 4.00 NA NA 6.23 5.50 0.18 NA NA 10.41 9.68 000

49060 ............ A Drain, open, retrop abscess ................. 11.66 NA NA 8.05 7.54 0.77 NA NA 20.48 19.97 090

49061 ............ A Drain, percut, retroper absc ................. 3.70 NA NA 6.15 5.37 0.17 NA NA 10.02 9.24 000

49062 ............ A Drain to peritoneal cavity ..................... 11.36 NA NA 7.40 7.74 1.08 NA NA 19.84 20.18 090

49080 ............ A Puncture, peritoneal cavity ................... 1.35 2.93 2.43 0.61 0.69 0.07 4.35 3.85 2.03 2.11 000

49081 ............ A Removal of abdominal fluid .................. 1.26 2.76 2.27 0.58 0.64 0.06 4.08 3.59 1.90 1.96 000

49085 ............ A Remove abdomen foreign body ........... 8.93 NA NA 5.60 5.14 0.88 NA NA 15.41 14.95 090

49180 ............ A Biopsy, abdominal mass ...................... 1.73 7.02 5.76 0.61 0.95 0.08 8.83 7.57 2.42 2.76 000

49200 ............ A Removal of abdominal lesion ............... 10.25 NA NA 6.45 7.11 0.89 NA NA 17.59 18.25 090

49201 ............ A Removal of abdominal lesion ............... 14.84 NA NA 8.70 9.81 1.44 NA NA 24.98 26.09 090

49215 ............ A Excise sacral spine tumor .................... 23.20 NA NA 11.20 10.71 2.48 NA NA 36.88 36.39 090

49220 ............ A Multiple surgery, abdomen ................... 14.88 NA NA 7.90 9.26 1.51 NA NA 24.29 25.65 090

49250 ............ A Excision of umbilicus ............................ 8.35 NA NA 5.15 5.09 0.84 NA NA 14.34 14.28 090

49255 ............ A Removal of omentum ........................... 11.14 NA NA 6.67 6.40 1.12 NA NA 18.93 18.66 090

49320 ............ A Diag laparo separate proc .................... 5.10 NA NA 3.04 3.49 0.50 NA NA 8.64 9.09 010

49321 ............ A Laparoscopy, biopsy ............................ 5.40 NA NA 3.12 3.67 0.53 NA NA 9.05 9.60 010

49322 ............ A Laparoscopy, aspiration ....................... 5.70 NA NA 3.40 3.87 0.57 NA NA 9.67 10.14 010

65483

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

49323 ............ A Laparo drain lymphocele ...................... 9.48 NA NA 4.14 4.93 0.88 NA NA 14.50 15.29 090

49329 ............ C Laparo proc, abdm/per/oment .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

49400 ............ A Air injection into abdomen .................... 1.88 NA NA 0.83 0.93 0.11 NA NA 2.82 2.92 000

49420 ............ A Insert abdominal drain .......................... 2.22 NA NA 0.97 1.16 0.13 NA NA 3.32 3.51 000

49421 ............ A Insert abdominal drain .......................... 5.54 NA NA 4.14 4.23 0.55 NA NA 10.23 10.32 090

49422 ............ A Remove perm cannula/catheter ........... 6.25 NA NA 3.06 3.42 0.63 NA NA 9.94 10.30 010

49423 ............ A Exchange drainage catheter ................ 1.46 NA NA 0.69 0.82 0.07 NA NA 2.22 2.35 000

49424 ............ A Assess cyst, contrast inject .................. 0.76 NA NA 0.44 0.49 0.03 NA NA 1.23 1.28 000

49425 ............ A Insert abdomen-venous drain .............. 11.37 NA NA 7.14 7.66 1.21 NA NA 19.72 20.24 090

49426 ............ A Revise abdomen-venous shunt ............ 9.63 NA NA 6.18 6.10 0.93 NA NA 16.74 16.66 090

49427 ............ A Injection, abdominal shunt ................... 0.89 NA NA 0.48 0.49 0.05 NA NA 1.42 1.43 000

49428 ............ A Ligation of shunt ................................... 2.38 NA NA 1.78 1.62 0.31 NA NA 4.47 4.31 010

49429 ............ A Removal of shunt ................................. 7.40 NA NA 3.70 3.68 0.81 NA NA 11.91 11.89 010

49495 ............ A Repair inguinal hernia, init ................... 5.84 NA NA 3.56 4.02 0.55 NA NA 9.95 10.41 090

49496 ............ A Repair inguinal hernia, init ................... 8.79 NA NA 6.55 6.28 0.89 NA NA 16.23 15.96 090

49500 ............ A Repair inguinal hernia .......................... 4.68 NA NA 3.13 3.70 0.46 NA NA 8.27 8.84 090

49501 ............ A Repair inguinal hernia, init ................... 7.58 NA NA 4.18 4.50 0.76 NA NA 12.52 12.84 090

49505 ............ A Repair inguinal hernia .......................... 6.49 4.17 4.35 3.73 4.02 0.65 11.31 11.49 10.87 11.16 090

49507 ............ A Repair inguinal hernia .......................... 8.17 NA NA 5.59 5.56 0.83 NA NA 14.59 14.56 090

49520 ............ A Rerepair inguinal hernia ....................... 8.22 NA NA 4.98 5.15 0.84 NA NA 14.04 14.21 090

49521 ............ A Repair inguinal hernia, rec ................... 10.22 NA NA 5.28 5.33 1.04 NA NA 16.54 16.59 090

49525 ............ A Repair inguinal hernia .......................... 7.32 NA NA 4.53 4.90 0.74 NA NA 12.59 12.96 090

49540 ............ A Repair lumbar hernia ............................ 8.87 NA NA 5.17 5.29 0.90 NA NA 14.94 15.06 090

49550 ............ A Repair femoral hernia ........................... 7.37 NA NA 4.12 4.34 0.75 NA NA 12.24 12.46 090

49553 ............ A Repair femoral hernia, init .................... 8.06 NA NA 4.51 4.63 0.83 NA NA 13.40 13.52 090

49555 ............ A Repair femoral hernia ........................... 7.71 NA NA 4.84 5.28 0.79 NA NA 13.34 13.78 090

49557 ............ A Repair femoral hernia, recur ................ 9.52 NA NA 5.04 5.43 0.97 NA NA 15.53 15.92 090

49560 ............ A Repair abdominal hernia ...................... 9.88 NA NA 5.54 5.69 1.00 NA NA 16.42 16.57 090

49561 ............ A Repair incisional hernia ........................ 12.17 NA NA 6.07 6.09 1.23 NA NA 19.47 19.49 090

49565 ............ A Rerepair abdominal hernia ................... 9.88 NA NA 5.70 6.02 1.00 NA NA 16.58 16.90 090

49566 ............ A Repair incisional hernia ........................ 12.30 NA NA 6.11 6.32 1.24 NA NA 19.65 19.86 090

49568 ............ A Hernia repair w/mesh ........................... 4.89 NA NA 1.86 2.09 0.50 NA NA 7.25 7.48 ZZZ

49570 ............ A Repair epigastric hernia ....................... 4.86 NA NA 3.21 3.60 0.50 NA NA 8.57 8.96 090

49572 ............ A Repair epigastric hernia ....................... 5.75 NA NA 3.65 4.26 0.58 NA NA 9.98 10.59 090

49580 ............ A Repair umbilical hernia ......................... 3.34 NA NA 2.66 3.04 0.34 NA NA 6.34 6.72 090

49582 ............ A Repair umbilical hernia ......................... 5.68 NA NA 4.45 4.59 0.57 NA NA 10.70 10.84 090

49585 ............ A Repair umbilical hernia ......................... 5.32 NA NA 3.76 4.02 0.53 NA NA 9.61 9.87 090

49587 ............ A Repair umbilical hernia ......................... 6.46 NA NA 3.88 4.11 0.65 NA NA 10.99 11.22 090

49590 ............ A Repair abdominal hernia ...................... 7.29 NA NA 4.49 4.90 0.74 NA NA 12.52 12.93 090

49600 ............ A Repair umbilical lesion ......................... 10.96 NA NA 6.48 6.29 1.13 NA NA 18.57 18.38 090

49605 ............ A Repair umbilical lesion ......................... 24.94 NA NA 12.36 11.60 2.57 NA NA 39.87 39.11 090

49606 ............ A Repair umbilical lesion ......................... 21.31 NA NA 10.56 10.18 2.22 NA NA 34.09 33.71 090

49610 ............ A Repair umbilical lesion ......................... 10.50 NA NA 6.60 6.44 0.77 NA NA 17.87 17.71 090

49611 ............ A Repair umbilical lesion ......................... 8.92 NA NA 6.46 7.29 0.65 NA NA 16.03 16.86 090

49650 ............ A Laparo hernia repair initial ................... 6.27 NA NA 3.39 3.77 0.64 NA NA 10.30 10.68 090

49651 ............ A Laparo hernia repair recur ................... 8.24 NA NA 4.48 4.78 0.84 NA NA 13.56 13.86 090

49659 ............ C Laparo proc, hernia repair .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

49900 ............ A Repair of abdominal wall ...................... 12.28 NA NA 6.91 6.18 1.23 NA NA 20.42 19.69 090

49905 ............ A Omental flap ......................................... 6.55 NA NA 2.43 2.75 0.61 NA NA 9.59 9.91 ZZZ

49906 ............ 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

49999 ............ C Abdomen surgery procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

50010 ............ A Exploration of kidney ............................ 10.98 NA NA 6.77 7.67 0.79 NA NA 18.54 19.44 090

50020 ............ A Renal abscess, open drain .................. 14.66 NA NA 13.15 11.71 0.80 NA NA 28.61 27.17 090

50021 ............ A Renal abscess, percut drain ................ 3.38 NA NA 11.64 9.43 0.15 NA NA 15.17 12.96 000

50040 ............ A Drainage of kidney ............................... 14.94 NA NA 11.09 10.27 0.82 NA NA 26.85 26.03 090

50045 ............ A Exploration of kidney ............................ 15.46 NA NA 8.14 8.77 1.06 NA NA 24.66 25.29 090

50060 ............ A Removal of kidney stone ...................... 19.30 NA NA 9.48 10.43 1.14 NA NA 29.92 30.87 090

50065 ............ A Incision of kidney .................................. 20.79 NA NA 7.49 9.40 1.13 NA NA 29.41 31.32 090

50070 ............ A Incision of kidney .................................. 20.32 NA NA 10.39 11.29 1.20 NA NA 31.91 32.81 090

50075 ............ A Removal of kidney stone ...................... 25.34 NA NA 12.20 13.73 1.51 NA NA 39.05 40.58 090

50080 ............ A Removal of kidney stone ...................... 14.71 NA NA 10.36 11.08 0.86 NA NA 25.93 26.65 090

50081 ............ A Removal of kidney stone ...................... 21.80 NA NA 12.45 13.40 1.30 NA NA 35.55 36.50 090

50100 ............ A Revise kidney blood vessels ................ 16.09 NA NA 9.74 10.11 1.64 NA NA 27.47 27.84 090

50120 ............ A Exploration of kidney ............................ 15.91 NA NA 8.51 9.34 1.04 NA NA 25.46 26.29 090

50125 ............ A Explore and drain kidney ..................... 16.52 NA NA 8.64 9.45 1.07 NA NA 26.23 27.04 090

50130 ............ A Removal of kidney stone ...................... 17.29 NA NA 8.81 10.08 1.04 NA NA 27.14 28.41 090

50135 ............ A Exploration of kidney ............................ 19.18 NA NA 9.41 11.68 1.18 NA NA 29.77 32.04 090

50200 ............ A Biopsy of kidney ................................... 2.63 NA NA 0.94 1.41 0.12 NA NA 3.69 4.16 000

50205 ............ A Biopsy of kidney ................................... 11.31 NA NA 6.41 6.34 0.94 NA NA 18.66 18.59 090

50220 ............ A Removal of kidney ................................ 17.15 NA NA 8.97 10.34 1.16 NA NA 27.28 28.65 090

50225 ............ A Removal of kidney ................................ 20.23 NA NA 9.89 11.90 1.26 NA NA 31.38 33.39 090

50230 ............ A Removal of kidney ................................ 22.07 NA NA 10.47 12.85 1.35 NA NA 33.89 36.27 090

50234 ............ A Removal of kidney & ureter ................. 22.40 NA NA 10.54 12.42 1.37 NA NA 34.31 36.19 090

50236 ............ A Removal of kidney & ureter ................. 24.86 NA NA 13.52 14.95 1.50 NA NA 39.88 41.31 090

50240 ............ A Partial removal of kidney ...................... 22.00 NA NA 12.56 13.76 1.36 NA NA 35.92 37.12 090

50280 ............ A Removal of kidney lesion ..................... 15.67 NA NA 8.32 9.19 0.99 NA NA 24.98 25.85 090

50290 ............ A Removal of kidney lesion ..................... 14.73 NA NA 8.19 8.55 1.11 NA NA 24.03 24.39 090

50300 ............ X Removal of donor kidney ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

50320 ............ A Removal of donor kidney ..................... 22.21 NA NA 10.49 12.34 1.78 NA NA 34.48 36.33 090

50340 ............ A Removal of kidney ................................ 12.15 NA NA 8.77 9.97 1.15 NA NA 22.07 23.27 090

50360 ............ A Transplantation of kidney ..................... 31.53 NA NA 17.74 19.94 2.97 NA NA 52.24 54.44 090

50365 ............ A Transplantation of kidney ..................... 36.81 NA NA 21.34 24.34 3.51 NA NA 61.66 64.66 090

50370 ............ A Remove transplanted kidney ................ 13.72 NA NA 9.66 10.25 1.26 NA NA 24.64 25.23 090

65484

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

50380 ............ A Reimplantation of kidney ...................... 20.76 NA NA 13.88 13.16 1.80 NA NA 36.44 35.72 090

50390 ............ A Drainage of kidney lesion ..................... 1.96 NA NA 0.69 0.98 0.09 NA NA 2.74 3.03 000

50392 ............ A Insert kidney drain ................................ 3.38 NA NA 1.19 1.53 0.15 NA NA 4.72 5.06 000

50393 ............ A Insert ureteral tube ............................... 4.16 NA NA 1.46 1.91 0.18 NA NA 5.80 6.25 000

50394 ............ A Injection for kidney x-ray ...................... 0.76 13.29 10.12 0.27 0.35 0.04 14.09 10.92 1.07 1.15 000

50395 ............ A Create passage to kidney .................... 3.38 NA NA 1.18 1.79 0.16 NA NA 4.72 5.33 000

50396 ............ A Measure kidney pressure ..................... 2.09 NA NA 0.88 0.80 0.10 NA NA 3.07 2.99 000

50398 ............ A Change kidney tube ............................. 1.46 1.30 1.12 0.51 0.53 0.07 2.83 2.65 2.04 2.06 000

50400 ............ A Revision of kidney/ureter ...................... 19.50 NA NA 9.59 10.90 1.21 NA NA 30.30 31.61 090

50405 ............ A Revision of kidney/ureter ...................... 23.93 NA NA 12.67 14.19 1.45 NA NA 38.05 39.57 090

50500 ............ A Repair of kidney wound ....................... 19.57 NA NA 11.12 11.72 1.45 NA NA 32.14 32.74 090

50520 ............ A Close kidney-skin fistula ....................... 17.23 NA NA 10.45 10.64 1.26 NA NA 28.94 29.13 090

50525 ............ A Repair renal-abdomen fistula ............... 22.27 NA NA 12.53 12.82 1.51 NA NA 36.31 36.60 090

50526 ............ A Repair renal-abdomen fistula ............... 24.02 NA NA 15.41 13.56 1.62 NA NA 41.05 39.20 090

50540 ............ A Revision of horseshoe kidney .............. 19.93 NA NA 11.82 12.50 1.28 NA NA 33.03 33.71 090

50541 ............ A Laparo ablate renal cyst ....................... 16.00 NA NA 6.61 6.61 0.99 NA NA 23.60 23.60 090

50544 ............ A Laparoscopy, pyeloplasty ..................... 22.40 NA NA 8.78 8.78 1.41 NA NA 32.59 32.59 090

50545 ............ A Laparo radical nephrectomy ................. 24.00 NA NA 9.41 9.41 1.81 NA NA 35.22 35.22 090

50546 ............ A Laparoscopic nephrectomy .................. 20.48 NA NA 8.31 8.31 1.37 NA NA 30.16 30.16 090

50547 ............ A Laparo removal donor kidney .............. 25.50 NA NA 10.99 10.99 2.04 NA NA 38.53 38.53 090

50548 ............ A Laparo remove k/ureter ........................ 24.40 NA NA 9.44 9.44 1.49 NA NA 35.33 35.33 090

50549 ............ C Laparoscope proc, renal ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

50551 ............ A Kidney endoscopy ................................ 5.60 4.54 4.00 1.86 1.99 0.33 10.47 9.93 7.79 7.92 000

50553 ............ A Kidney endoscopy ................................ 5.99 15.58 12.14 2.06 2.00 0.35 21.92 18.48 8.40 8.34 000

50555 ............ A Kidney endoscopy & biopsy ................. 6.53 18.16 14.90 2.20 2.93 0.38 25.07 21.81 9.11 9.84 000

50557 ............ A Kidney endoscopy & treatment ............ 6.62 18.28 14.99 2.21 2.94 0.39 25.29 22.00 9.22 9.95 000

50559 ............ A Renal endoscopy/radiotracer ............... 6.78 NA NA 2.37 2.14 0.27 NA NA 9.42 9.19 000

50561 ............ A Kidney endoscopy & treatment ............ 7.59 16.42 13.71 2.55 3.30 0.44 24.45 21.74 10.58 11.33 000

50570 ............ A Kidney endoscopy ................................ 9.54 NA NA 3.19 2.79 0.56 NA NA 13.29 12.89 000

50572 ............ A Kidney endoscopy ................................ 10.35 NA NA 3.44 4.55 0.64 NA NA 14.43 15.54 000

50574 ............ A Kidney endoscopy & biopsy ................. 11.02 NA NA 3.67 4.67 0.65 NA NA 15.34 16.34 000

50575 ............ A Kidney endoscopy ................................ 13.98 NA NA 4.67 6.20 0.84 NA NA 19.49 21.02 000

50576 ............ A Kidney endoscopy & treatment ............ 10.99 NA NA 3.64 5.09 0.66 NA NA 15.29 16.74 000

50578 ............ A Renal endoscopy/radiotracer ............... 11.35 NA NA 3.78 3.86 0.67 NA NA 15.80 15.88 000

50580 ............ A Kidney endoscopy & treatment ............ 11.86 NA NA 3.97 3.95 0.70 NA NA 16.53 16.51 000

50590 ............ A Fragmenting of kidney stone ................ 9.09 10.21 10.37 5.01 6.47 0.54 19.84 20.00 14.64 16.10 090

50600 ............ A Exploration of ureter ............................. 15.84 NA NA 8.38 8.92 0.99 NA NA 25.21 25.75 090

50605 ............ A Insert ureteral support .......................... 15.46 NA NA 8.64 8.14 1.13 NA NA 25.23 24.73 090

50610 ............ A Removal of ureter stone ....................... 15.92 NA NA 8.87 9.85 1.08 NA NA 25.87 26.85 090

50620 ............ A Removal of ureter stone ....................... 15.16 NA NA 8.00 9.12 0.91 NA NA 24.07 25.19 090

50630 ............ A Removal of ureter stone ....................... 14.94 NA NA 8.09 9.52 0.90 NA NA 23.93 25.36 090

50650 ............ A Removal of ureter ................................. 17.41 NA NA 9.15 10.14 1.07 NA NA 27.63 28.62 090

50660 ............ A Removal of ureter ................................. 19.55 NA NA 9.93 10.84 1.19 NA NA 30.67 31.58 090

50684 ............ A Injection for ureter x-ray ....................... 0.76 13.74 10.44 0.26 0.33 0.04 14.54 11.24 1.06 1.13 000

50686 ............ A Measure ureter pressure ...................... 1.51 4.64 3.58 0.70 0.63 0.09 6.24 5.18 2.30 2.23 000

50688 ............ A Change of ureter tube .......................... 1.17 NA NA 1.71 1.39 0.06 NA NA 2.94 2.62 010

50690 ............ A Injection for ureter x-ray ....................... 1.16 14.07 10.64 0.40 0.39 0.06 15.29 11.86 1.62 1.61 000

50700 ............ A Revision of ureter ................................. 15.21 NA NA 8.84 10.04 0.86 NA NA 24.91 26.11 090

50715 ............ A Release of ureter .................................. 18.90 NA NA 11.64 11.78 1.68 NA NA 32.22 32.36 090

50722 ............ A Release of ureter .................................. 16.35 NA NA 9.16 9.67 1.41 NA NA 26.92 27.43 090

50725 ............ A Release/revise ureter ........................... 18.49 NA NA 10.02 10.79 1.44 NA NA 29.95 30.72 090

50727 ............ A Revise ureter ........................................ 8.18 NA NA 6.12 6.05 0.51 NA NA 14.81 14.74 090

50728 ............ A Revise ureter ........................................ 12.02 NA NA 7.71 7.93 0.88 NA NA 20.61 20.83 090

50740 ............ A Fusion of ureter & kidney ..................... 18.42 NA NA 9.42 10.60 1.49 NA NA 29.33 30.51 090

50750 ............ A Fusion of ureter & kidney ..................... 19.51 NA NA 10.11 11.39 1.24 NA NA 30.86 32.14 090

50760 ............ A Fusion of ureters .................................. 18.42 NA NA 9.65 10.89 1.25 NA NA 29.32 30.56 090

50770 ............ A Splicing of ureters ................................ 19.51 NA NA 9.86 11.53 1.25 NA NA 30.62 32.29 090

50780 ............ A Reimplant ureter in bladder .................. 18.36 NA NA 9.56 10.91 1.20 NA NA 29.12 30.47 090

50782 ............ A Reimplant ureter in bladder .................. 19.54 NA NA 11.02 12.00 1.13 NA NA 31.69 32.67 090

50783 ............ A Reimplant ureter in bladder .................. 20.55 NA NA 10.55 11.65 1.35 NA NA 32.45 33.55 090

50785 ............ A Reimplant ureter in bladder .................. 20.52 NA NA 10.27 11.89 1.30 NA NA 32.09 33.71 090

50800 ............ A Implant ureter in bowel ......................... 14.52 NA NA 9.27 10.93 0.92 NA NA 24.71 26.37 090

50810 ............ A Fusion of ureter & bowel ...................... 20.05 NA NA 12.75 12.97 1.78 NA NA 34.58 34.80 090

50815 ............ A Urine shunt to bowel ............................ 19.93 NA NA 11.31 13.84 1.31 NA NA 32.55 35.08 090

50820 ............ A Construct bowel bladder ...................... 21.89 NA NA 11.14 13.50 1.38 NA NA 34.41 36.77 090

50825 ............ A Construct bowel bladder ...................... 28.18 NA NA 14.53 19.18 1.81 NA NA 44.52 49.17 090

50830 ............ A Revise urine flow .................................. 31.28 NA NA 15.27 17.13 2.20 NA NA 48.75 50.61 090

50840 ............ A Replace ureter by bowel ...................... 20.00 NA NA 11.48 12.23 1.26 NA NA 32.74 33.49 090

50845 ............ A Appendico-vesicostomy ........................ 20.89 NA NA 9.63 10.99 1.26 NA NA 31.78 33.14 090

50860 ............ A Transplant ureter to skin ...................... 15.36 NA NA 8.56 9.38 1.01 NA NA 24.93 25.75 090

50900 ............ A Repair of ureter .................................... 13.62 NA NA 7.81 8.57 0.98 NA NA 22.41 23.17 090

50920 ............ A Closure ureter/skin fistula ..................... 14.33 NA NA 8.70 9.11 0.84 NA NA 23.87 24.28 090

50930 ............ A Closure ureter/bowel fistula .................. 18.72 NA NA 9.73 10.69 1.57 NA NA 30.02 30.98 090

50940 ............ A Release of ureter .................................. 14.51 NA NA 8.08 8.75 1.04 NA NA 23.63 24.30 090

50945 ............ A Laparoscopy ureterolithotomy .............. 17.00 NA NA 7.36 7.36 1.15 NA NA 25.51 25.51 090

50947 ............ A Laparo new ureter/bladder ................... 24.50 NA NA 11.62 11.62 1.84 NA NA 37.96 37.96 090

50948 ............ A Laparo new ureter/bladder ................... 22.50 NA NA 10.51 10.51 1.70 NA NA 34.71 34.71 090

50949 ............ C Laparoscope proc, ureter ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

50951 ............ A Endoscopy of ureter ............................. 5.84 4.94 4.16 1.96 1.92 0.35 11.13 10.35 8.15 8.11 000

50953 ............ A Endoscopy of ureter ............................. 6.24 17.47 13.55 2.08 2.01 0.37 24.08 20.16 8.69 8.62 000

50955 ............ A Ureter endoscopy & biopsy .................. 6.75 18.19 14.34 2.29 2.41 0.38 25.32 21.47 9.42 9.54 000

50957 ............ A Ureter endoscopy & treatment ............. 6.79 17.76 14.00 2.28 2.39 0.40 24.95 21.19 9.47 9.58 000

50959 ............ A Ureter endoscopy & tracer ................... 4.40 NA NA 1.55 2.08 0.18 NA NA 6.13 6.66 000

65485

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

50961 ............ A Ureter endoscopy & treatment ............. 6.05 21.84 17.09 2.05 2.25 0.35 28.24 23.49 8.45 8.65 000

50970 ............ A Ureter endoscopy ................................. 7.14 NA NA 2.39 3.20 0.43 NA NA 9.96 10.77 000

50972 ............ A Ureter endoscopy & catheter ............... 6.89 NA NA 2.35 2.18 0.39 NA NA 9.63 9.46 000

50974 ............ A Ureter endoscopy & biopsy .................. 9.17 NA NA 3.01 4.16 0.53 NA NA 12.71 13.86 000

50976 ............ A Ureter endoscopy & treatment ............. 9.04 NA NA 3.01 4.00 0.53 NA NA 12.58 13.57 000

50978 ............ A Ureter endoscopy & tracer ................... 5.10 NA NA 1.75 2.41 0.30 NA NA 7.15 7.81 000

50980 ............ A Ureter endoscopy & treatment ............. 6.85 NA NA 2.30 2.58 0.41 NA NA 9.56 9.84 000

51000 ............ A Drainage of bladder .............................. 0.78 1.88 1.54 0.25 0.32 0.05 2.71 2.37 1.08 1.15 000

51005 ............ A Drainage of bladder .............................. 1.02 3.15 2.49 0.35 0.39 0.08 4.25 3.59 1.45 1.49 000

51010 ............ A Drainage of bladder .............................. 3.53 6.75 5.33 1.82 1.63 0.23 10.51 9.09 5.58 5.39 010

51020 ............ A Incise & treat bladder ........................... 6.71 NA NA 5.29 5.83 0.42 NA NA 12.42 12.96 090

51030 ............ A Incise & treat bladder ........................... 6.77 NA NA 5.34 5.24 0.42 NA NA 12.53 12.43 090

51040 ............ A Incise & drain bladder .......................... 4.40 NA NA 4.11 4.40 0.27 NA NA 8.78 9.07 090

51045 ............ A Incise bladder/drain ureter ................... 6.77 NA NA 5.59 5.54 0.47 NA NA 12.83 12.78 090

51050 ............ A Removal of bladder stone .................... 6.92 NA NA 4.90 5.61 0.42 NA NA 12.24 12.95 090

51060 ............ A Removal of ureter stone ....................... 8.85 NA NA 6.04 7.17 0.54 NA NA 15.43 16.56 090

51065 ............ A Removal of ureter stone ....................... 8.85 NA NA 5.89 6.34 0.53 NA NA 15.27 15.72 090

51080 ............ A Drainage of bladder abscess ............... 5.96 NA NA 5.32 5.40 0.35 NA NA 11.63 11.71 090

51500 ............ A Removal of bladder cyst ...................... 10.14 NA NA 5.95 6.32 0.88 NA NA 16.97 17.34 090

51520 ............ A Removal of bladder lesion ................... 9.29 NA NA 6.08 6.88 0.58 NA NA 15.95 16.75 090

51525 ............ A Removal of bladder lesion ................... 13.97 NA NA 7.68 8.66 0.85 NA NA 22.50 23.48 090

51530 ............ A Removal of bladder lesion ................... 12.38 NA NA 7.26 7.96 0.82 NA NA 20.46 21.16 090

51535 ............ A Repair of ureter lesion .......................... 12.57 NA NA 7.57 7.76 0.90 NA NA 21.04 21.23 090

51550 ............ A Partial removal of bladder .................... 15.66 NA NA 8.32 9.15 1.05 NA NA 25.03 25.86 090

51555 ............ A Partial removal of bladder .................... 21.23 NA NA 10.57 11.26 1.37 NA NA 33.17 33.86 090

51565 ............ A Revise bladder & ureter(s) ................... 21.62 NA NA 11.06 12.59 1.40 NA NA 34.08 35.61 090

51570 ............ A Removal of bladder .............................. 24.24 NA NA 12.23 13.42 1.59 NA NA 38.06 39.25 090

51575 ............ A Removal of bladder & nodes ............... 30.45 NA NA 14.70 17.23 1.88 NA NA 47.03 49.56 090

51580 ............ A Remove bladder/revise tract ................ 31.08 NA NA 15.23 16.84 1.94 NA NA 48.25 49.86 090

51585 ............ A Removal of bladder & nodes ............... 35.23 NA NA 16.48 19.18 2.18 NA NA 53.89 56.59 090

51590 ............ A Remove bladder/revise tract ................ 32.66 NA NA 15.38 18.19 2.01 NA NA 50.05 52.86 090

51595 ............ A Remove bladder/revise tract ................ 37.14 NA NA 16.80 21.77 2.23 NA NA 56.17 61.14 090

51596 ............ A Remove bladder/create pouch ............. 39.52 NA NA 18.04 23.00 2.39 NA NA 59.95 64.91 090

51597 ............ A Removal of pelvic structures ................ 38.35 NA NA 17.84 21.69 2.49 NA NA 58.68 62.53 090

51600 ............ A Injection for bladder x-ray .................... 0.88 14.30 10.80 0.31 0.31 0.04 15.22 11.72 1.23 1.23 000

51605 ............ A Preparation for bladder xray ................ 0.64 15.09 11.40 0.22 0.25 0.04 15.77 12.08 0.90 0.93 000

51610 ............ A Injection for bladder x-ray .................... 1.05 14.73 11.12 0.36 0.34 0.05 15.83 12.22 1.46 1.44 000

51700 ............ A Irrigation of bladder .............................. 0.88 3.63 2.78 0.33 0.28 0.05 4.56 3.71 1.26 1.21 000

51705 ............ A Change of bladder tube ....................... 1.02 2.45 1.94 1.23 0.98 0.06 3.53 3.02 2.31 2.06 010

51710 ............ A Change of bladder tube ....................... 1.49 4.60 3.61 1.37 1.11 0.09 6.18 5.19 2.95 2.69 010

51715 ............ A Endoscopic injection/implant ................ 3.74 4.09 3.79 1.27 1.67 0.24 8.07 7.77 5.25 5.65 000

51720 ............ A Treatment of bladder lesion ................. 1.96 3.93 3.07 0.66 0.56 0.12 6.01 5.15 2.74 2.64 000

51725 ............ A Simple cystometrogram ........................ 1.51 5.33 4.27 5.33 4.27 0.13 6.97 5.91 6.97 5.91 000

51725 26 A Simple cystometrogram ........................ 1.51 0.51 0.55 0.51 0.55 0.10 2.12 2.16 2.12 2.16 000

51725 TC A Simple cystometrogram ........................ 0.00 4.82 3.72 NA NA 0.03 4.85 3.75 NA NA 000

51726 ............ A Complex cystometrogram .................... 1.71 4.20 3.51 4.20 3.51 0.15 6.06 5.37 6.06 5.37 000

51726 26 A Complex cystometrogram .................... 1.71 0.58 0.66 0.58 0.66 0.11 2.40 2.48 2.40 2.48 000

51726 TC A Complex cystometrogram .................... 0.00 3.62 2.85 NA NA 0.04 3.66 2.89 NA NA 000

51736 ............ A Urine flow measurement ...................... 0.61 0.99 0.86 0.99 0.86 0.05 1.65 1.52 1.65 1.52 000

51736 26 A Urine flow measurement ...................... 0.61 0.21 0.23 0.21 0.23 0.04 0.86 0.88 0.86 0.88 000

51736 TC A Urine flow measurement ...................... 0.00 0.78 0.63 NA NA 0.01 0.79 0.64 NA NA 000

51741 ............ A Electro-uroflowmetry, first ..................... 1.14 1.74 1.46 1.74 1.46 0.09 2.97 2.69 2.97 2.69 000

51741 26 A Electro-uroflowmetry, first ..................... 1.14 0.39 0.39 0.39 0.39 0.07 1.60 1.60 1.60 1.60 000

51741 TC A Electro-uroflowmetry, first ..................... 0.00 1.35 1.07 NA NA 0.02 1.37 1.09 NA NA 000

51772 ............ A Urethra pressure profile ....................... 1.61 4.29 3.48 4.29 3.48 0.16 6.06 5.25 6.06 5.25 000

51772 26 A Urethra pressure profile ....................... 1.61 0.57 0.57 0.57 0.57 0.12 2.30 2.30 2.30 2.30 000

51772 TC A Urethra pressure profile ....................... 0.00 3.72 2.91 NA NA 0.04 3.76 2.95 NA NA 000

51784 ............ A Anal/urinary muscle study .................... 1.53 3.02 2.55 3.02 2.55 0.13 4.68 4.21 4.68 4.21 000

51784 26 A Anal/urinary muscle study .................... 1.53 0.52 0.57 0.52 0.57 0.10 2.15 2.20 2.15 2.20 000

51784 TC A Anal/urinary muscle study .................... 0.00 2.50 1.98 NA NA 0.03 2.53 2.01 NA NA 000

51785 ............ A Anal/urinary muscle study .................... 1.53 3.06 2.58 3.06 2.58 0.12 4.71 4.23 4.71 4.23 000

51785 26 A Anal/urinary muscle study .................... 1.53 0.52 0.57 0.52 0.57 0.09 2.14 2.19 2.14 2.19 000

51785 TC A Anal/urinary muscle study .................... 0.00 2.54 2.01 NA NA 0.03 2.57 2.04 NA NA 000

51792 ............ A Urinary reflex study .............................. 1.10 1.83 1.90 1.83 1.90 0.20 3.13 3.20 3.13 3.20 000

51792 26 A Urinary reflex study .............................. 1.10 0.44 0.49 0.44 0.49 0.09 1.63 1.68 1.63 1.68 000

51792 TC A Urinary reflex study .............................. 0.00 1.39 1.41 NA NA 0.11 1.50 1.52 NA NA 000

51795 ............ A Urine voiding pressure study ............... 1.53 4.39 3.69 4.39 3.69 0.18 6.10 5.40 6.10 5.40 000

51795 26 A Urine voiding pressure study ............... 1.53 0.52 0.55 0.52 0.55 0.10 2.15 2.18 2.15 2.18 000

51795 TC A Urine voiding pressure study ............... 0.00 3.87 3.14 NA NA 0.08 3.95 3.22 NA NA 000

51797 ............ A Intraabdominal pressure test ................ 1.60 4.38 3.55 4.38 3.55 0.14 6.12 5.29 6.12 5.29 000

51797 26 A Intraabdominal pressure test ................ 1.60 0.55 0.55 0.55 0.55 0.10 2.25 2.25 2.25 2.25 000

51797 TC A Intraabdominal pressure test ................ 0.00 3.83 3.00 NA NA 0.04 3.87 3.04 NA NA 000

51800 ............ A Revision of bladder/urethra .................. 17.42 NA NA 9.12 10.10 1.17 NA NA 27.71 28.69 090

51820 ............ A Revision of urinary tract ....................... 17.89 NA NA 10.45 9.84 1.45 NA NA 29.79 29.18 090

51840 ............ A Attach bladder/urethra .......................... 10.71 NA NA 6.41 7.31 0.87 NA NA 17.99 18.89 090

51841 ............ A Attach bladder/urethra .......................... 13.03 NA NA 8.03 9.01 1.04 NA NA 22.10 23.08 090

51845 ............ A Repair bladder neck ............................. 9.73 NA NA 6.40 7.70 0.62 NA NA 16.75 18.05 090

51860 ............ A Repair of bladder wound ...................... 12.02 NA NA 7.57 7.75 0.89 NA NA 20.48 20.66 090

51865 ............ A Repair of bladder wound ...................... 15.04 NA NA 8.46 9.32 1.01 NA NA 24.51 25.37 090

51880 ............ A Repair of bladder opening .................... 7.66 NA NA 5.43 5.42 0.54 NA NA 13.63 13.62 090

51900 ............ A Repair bladder/vagina lesion ................ 12.97 NA NA 7.81 9.02 0.87 NA NA 21.65 22.86 090

51920 ............ A Close bladder-uterus fistula ................. 11.81 NA NA 7.48 7.65 0.86 NA NA 20.15 20.32 090

51925 ............ A Hysterectomy/bladder repair ................ 15.58 NA NA 8.90 9.41 1.48 NA NA 25.96 26.47 090

65486

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

51940 ............ A Correction of bladder defect ................. 28.43 NA NA 14.24 15.82 1.97 NA NA 44.64 46.22 090

51960 ............ A Revision of bladder & bowel ................ 23.01 NA NA 12.44 15.14 1.41 NA NA 36.86 39.56 090

51980 ............ A Construct bladder opening ................... 11.36 NA NA 6.95 7.24 0.74 NA NA 19.05 19.34 090

51990 ............ A Laparo urethral suspension .................. 12.50 NA NA 6.28 6.28 1.02 NA NA 19.80 19.80 090

51992 ............ A Laparo sling operation .......................... 14.01 NA NA 6.39 6.39 0.93 NA NA 21.33 21.33 090

52000 ............ A Cystoscopy ........................................... 2.01 3.14 2.72 0.67 0.68 0.12 5.27 4.85 2.80 2.81 000

52005 ............ A Cystoscopy & ureter catheter ............... 2.37 4.86 4.24 0.79 1.19 0.15 7.38 6.76 3.31 3.71 000

52007 ............ A Cystoscopy and biopsy ........................ 3.02 NA NA 1.01 1.52 0.18 NA NA 4.21 4.72 000

52010 ............ A Cystoscopy & duct catheter ................. 3.02 5.21 4.42 1.01 1.02 0.18 8.41 7.62 4.21 4.22 000

52204 ............ A Cystoscopy ........................................... 2.37 5.57 4.82 0.79 1.24 0.15 8.09 7.34 3.31 3.76 000

52214 ............ A Cystoscopy and treatment ................... 3.71 5.94 5.22 1.24 1.69 0.22 9.87 9.15 5.17 5.62 000

52224 ............ A Cystoscopy and treatment ................... 3.14 5.79 5.13 1.05 1.58 0.18 9.11 8.45 4.37 4.90 000

52234 ............ A Cystoscopy and treatment ................... 4.63 6.70 6.30 1.55 2.44 0.27 11.60 11.20 6.45 7.34 000

52235 ............ A Cystoscopy and treatment ................... 5.45 6.99 6.87 1.82 2.99 0.32 12.76 12.64 7.59 8.76 000

52240 ............ A Cystoscopy and treatment ................... 9.72 8.41 9.20 3.24 5.32 0.58 18.71 19.50 13.54 15.62 000

52250 ............ A Cystoscopy and radiotracer ................. 4.50 NA NA 1.50 1.90 0.27 NA NA 6.27 6.67 000

52260 ............ A Cystoscopy and treatment ................... 3.92 NA NA 1.31 1.56 0.23 NA NA 5.46 5.71 000

52265 ............ A Cystoscopy and treatment ................... 2.94 3.55 3.03 0.99 0.93 0.18 6.67 6.15 4.11 4.05 000

52270 ............ A Cystoscopy & revise urethra ................ 3.37 6.32 5.68 1.13 1.79 0.20 9.89 9.25 4.70 5.36 000

52275 ............ A Cystoscopy & revise urethra ................ 4.70 6.81 6.04 1.56 2.10 0.28 11.79 11.02 6.54 7.08 000

52276 ............ A Cystoscopy and treatment ................... 5.00 6.92 6.43 1.66 2.49 0.30 12.22 11.73 6.96 7.79 000

52277 ............ A Cystoscopy and treatment ................... 6.17 NA NA 2.10 2.88 0.38 NA NA 8.65 9.43 000

52281 ............ A Cystoscopy and treatment ................... 2.80 3.56 3.30 0.93 1.01 0.17 6.53 6.27 3.90 3.98 000

52282 ............ A Cystoscopy, implant stent .................... 6.40 7.07 6.55 2.14 2.85 0.38 13.85 13.33 8.92 9.63 000

52283 ............ A Cystoscopy and treatment ................... 3.74 6.21 5.07 1.25 1.35 0.22 10.17 9.03 5.21 5.31 000

52285 ............ A Cystoscopy and treatment ................... 3.61 6.41 5.61 1.21 1.31 0.22 10.24 9.44 5.04 5.14 000

52290 ............ A Cystoscopy and treatment ................... 4.59 NA NA 1.54 1.79 0.27 NA NA 6.40 6.65 000

52300 ............ A Cystoscopy and treatment ................... 5.31 NA NA 1.77 2.27 0.32 NA NA 7.40 7.90 000

52301 ............ A Cystoscopy and treatment ................... 5.51 NA NA 1.78 2.28 0.39 NA NA 7.68 8.18 000

52305 ............ A Cystoscopy and treatment ................... 5.31 NA NA 1.77 2.28 0.31 NA NA 7.39 7.90 000

52310 ............ A Cystoscopy and treatment ................... 2.81 13.89 11.23 0.94 1.52 0.17 16.87 14.21 3.92 4.50 000

52315 ............ A Cystoscopy and treatment ................... 5.21 14.86 12.25 1.74 2.41 0.31 20.38 17.77 7.26 7.93 000

52317 ............ A Remove bladder stone ......................... 6.72 25.37 20.71 2.24 3.36 0.40 32.49 27.83 9.36 10.48 000

52318 ............ A Remove bladder stone ......................... 9.19 NA NA 3.07 4.44 0.54 NA NA 12.80 14.17 000

52320 ............ A Cystoscopy and treatment ................... 4.70 NA NA 1.57 2.50 0.28 NA NA 6.55 7.48 000

52325 ............ A Cystoscopy, stone removal .................. 6.16 NA NA 2.05 3.38 0.37 NA NA 8.58 9.91 000

52327 ............ A Cystoscopy, inject material .................. 5.19 NA NA 1.75 2.31 0.32 NA NA 7.26 7.82 000

52330 ............ A Cystoscopy and treatment ................... 5.04 18.77 15.02 1.68 2.20 0.30 24.11 20.36 7.02 7.54 000

52332 ............ A Cystoscopy and treatment ................... 2.83 28.13 21.97 0.95 1.56 0.17 31.13 24.97 3.95 4.56 000

52334 ............ A Create passage to kidney .................... 4.83 NA NA 1.62 2.12 0.28 NA NA 6.73 7.23 000

52335 ............ D Endoscopy of urinary tract ................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000

52336 ............ D Cystoscopy, stone removal .................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000

52337 ............ D Cystoscopy, stone removal .................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000

52338 ............ D Cystoscopy and treatment ................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000

52339 ............ D Cystoscopy and treatment ................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000

52340 ............ D Cystoscopy and treatment ................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 090

52341 ............ A Cysto w/ureter stricture tx .................... 6.00 NA NA 2.40 2.40 0.34 NA NA 8.74 8.74 000

52342 ............ A Cysto w/up stricture tx .......................... 6.50 NA NA 2.60 2.60 0.36 NA NA 9.46 9.46 000

52343 ............ A Cysto w/renal stricture tx ...................... 7.20 NA NA 2.88 2.88 0.40 NA NA 10.48 10.48 000

52344 ............ A Cysto/uretero, stone remove ................ 7.70 NA NA 3.08 3.08 0.42 NA NA 11.20 11.20 000

52345 ............ A Cysto/uretero w/up stricture ................. 8.20 NA NA 3.28 3.28 0.46 NA NA 11.94 11.94 000

52346 ............ A Cystouretero w/renal strict ................... 9.23 NA NA 3.69 3.69 0.51 NA NA 13.43 13.43 000

52351 ............ A Cystouretro & or pyeloscope ................ 5.86 NA NA 1.96 2.74 0.32 NA NA 8.14 8.92 000

52352 ............ A Cystouretro w/stone remove ................ 6.88 NA NA 2.30 3.78 0.38 NA NA 9.56 11.04 000

52353 ............ A Cystouretero w/lithotripsy ..................... 7.97 NA NA 2.66 4.38 0.44 NA NA 11.07 12.79 000

52354 ............ A Cystouretero w/biopsy .......................... 7.34 NA NA 2.45 3.44 0.41 NA NA 10.20 11.19 000

52355 ............ A Cystouretero w/excise tumor ................ 8.82 NA NA 2.95 3.82 0.50 NA NA 12.27 13.14 000

52400 ............ A Cystouretero w/congen repr ................. 9.68 NA NA 5.36 5.42 0.53 NA NA 15.57 15.63 090

52450 ............ A Incision of prostate ............................... 7.64 NA NA 6.05 5.89 0.46 NA NA 14.15 13.99 090

52500 ............ A Revision of bladder neck ...................... 8.47 NA NA 6.31 6.75 0.50 NA NA 15.28 15.72 090

52510 ............ A Dilation prostatic urethra ...................... 6.72 NA NA 5.39 6.05 0.40 NA NA 12.51 13.17 090

52601 ............ A Prostatectomy (TURP) ......................... 12.37 NA NA 7.63 8.94 0.74 NA NA 20.74 22.05 090

52606 ............ A Control postop bleeding ....................... 8.13 NA NA 5.82 5.27 0.49 NA NA 14.44 13.89 090

52612 ............ A Prostatectomy, first stage ..................... 7.98 NA NA 6.17 7.01 0.48 NA NA 14.63 15.47 090

52614 ............ A Prostatectomy, second stage ............... 6.84 NA NA 5.77 6.25 0.41 NA NA 13.02 13.50 090

52620 ............ A Remove residual prostate .................... 6.61 NA NA 5.71 5.73 0.39 NA NA 12.71 12.73 090

52630 ............ A Remove prostate regrowth ................... 7.26 NA NA 5.93 6.62 0.43 NA NA 13.62 14.31 090

52640 ............ A Relieve bladder contracture ................. 6.62 NA NA 5.29 5.71 0.39 NA NA 12.30 12.72 090

52647 ............ A Laser surgery of prostate ..................... 10.36 56.13 45.19 5.26 7.04 0.61 67.10 56.16 16.23 18.01 090

52648 ............ A Laser surgery of prostate ..................... 11.21 NA NA 7.26 8.67 0.66 NA NA 19.13 20.54 090

52700 ............ A Drainage of prostate abscess .............. 6.80 NA NA 5.85 5.28 0.41 NA NA 13.06 12.49 090

53000 ............ A Incision of urethra ................................. 2.28 7.09 5.80 2.42 2.29 0.13 9.50 8.21 4.83 4.70 010

53010 ............ A Incision of urethra ................................. 3.64 NA NA 3.89 3.87 0.20 NA NA 7.73 7.71 090

53020 ............ A Incision of urethra ................................. 1.77 3.78 3.06 0.65 0.71 0.11 5.66 4.94 2.53 2.59 000

53025 ............ A Incision of urethra ................................. 1.13 4.32 3.46 0.43 0.54 0.07 5.52 4.66 1.63 1.74 000

53040 ............ A Drainage of urethra abscess ................ 6.40 12.36 9.77 7.76 6.32 0.41 19.17 16.58 14.57 13.13 090

53060 ............ A Drainage of urethra abscess ................ 2.63 5.98 4.62 2.92 2.33 0.23 8.84 7.48 5.78 5.19 010

53080 ............ A Drainage of urinary leakage ................. 6.29 NA NA 7.62 6.80 0.42 NA NA 14.33 13.51 090

53085 ............ A Drainage of urinary leakage ................. 10.27 NA NA 9.13 8.68 0.67 NA NA 20.07 19.62 090

53200 ............ A Biopsy of urethra .................................. 2.59 5.09 4.12 0.95 1.01 0.17 7.85 6.88 3.71 3.77 000

53210 ............ A Removal of urethra ............................... 12.57 NA NA 7.58 7.49 0.81 NA NA 20.96 20.87 090

53215 ............ A Removal of urethra ............................... 15.58 NA NA 8.32 8.95 0.93 NA NA 24.83 25.46 090

53220 ............ A Treatment of urethra lesion .................. 7.00 NA NA 5.21 5.20 0.44 NA NA 12.65 12.64 090

65487

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

53230 ............ A Removal of urethra lesion .................... 9.58 NA NA 5.98 6.64 0.60 NA NA 16.16 16.82 090

53235 ............ A Removal of urethra lesion .................... 10.14 NA NA 6.17 5.99 0.60 NA NA 16.91 16.73 090

53240 ............ A Surgery for urethra pouch .................... 6.45 NA NA 4.83 4.80 0.42 NA NA 11.70 11.67 090

53250 ............ A Removal of urethra gland ..................... 5.89 NA NA 4.15 4.21 0.35 NA NA 10.39 10.45 090

53260 ............ A Treatment of urethra lesion .................. 2.98 5.60 4.51 2.27 2.01 0.23 8.81 7.72 5.48 5.22 010

53265 ............ A Treatment of urethra lesion .................. 3.12 5.98 5.00 2.24 2.19 0.20 9.30 8.32 5.56 5.51 010

53270 ............ A Removal of urethra gland ..................... 3.09 5.40 4.28 2.34 1.87 0.21 8.70 7.58 5.64 5.17 010

53275 ............ A Repair of urethra defect ....................... 4.53 NA NA 3.17 3.02 0.28 NA NA 7.98 7.83 010

53400 ............ A Revise urethra, stage 1 ........................ 12.77 NA NA 7.62 7.74 0.85 NA NA 21.24 21.36 090

53405 ............ A Revise urethra, stage 2 ........................ 14.48 NA NA 8.03 8.84 0.91 NA NA 23.42 24.23 090

53410 ............ A Reconstruction of urethra ..................... 16.44 NA NA 8.61 8.78 0.99 NA NA 26.04 26.21 090

53415 ............ A Reconstruction of urethra ..................... 19.41 NA NA 9.51 10.35 1.16 NA NA 30.08 30.92 090

53420 ............ A Reconstruct urethra, stage 1 ................ 14.08 NA NA 8.24 9.13 0.90 NA NA 23.22 24.11 090

53425 ............ A Reconstruct urethra, stage 2 ................ 15.98 NA NA 8.71 9.04 0.97 NA NA 25.66 25.99 090

53430 ............ A Reconstruction of urethra ..................... 16.34 NA NA 8.72 8.48 1.01 NA NA 26.07 25.83 090

53440 ............ A Correct bladder function ....................... 12.34 NA NA 7.55 9.23 0.73 NA NA 20.62 22.30 090

53442 ............ A Remove perineal prosthesis ................. 8.27 NA NA 5.68 5.85 0.55 NA NA 14.50 14.67 090

53443 ............ A Reconstruction of urethra ..................... 19.89 NA NA 9.33 9.72 1.25 NA NA 30.47 30.86 090

53445 ............ A Correct urine flow control ..................... 14.06 NA NA 8.14 10.30 0.84 NA NA 23.04 25.20 090

53447 ............ A Remove artificial sphincter ................... 13.17 NA NA 7.45 8.07 0.79 NA NA 21.41 22.03 090

53449 ............ A Correct artificial sphincter ..................... 9.70 NA NA 6.27 6.99 0.57 NA NA 16.54 17.26 090

53450 ............ A Revision of urethra ............................... 6.14 NA NA 4.76 4.31 0.37 NA NA 11.27 10.82 090

53460 ............ A Revision of urethra ............................... 7.12 NA NA 5.13 4.51 0.43 NA NA 12.68 12.06 090

53502 ............ A Repair of urethra injury ........................ 7.63 NA NA 5.31 5.33 0.50 NA NA 13.44 13.46 090

53505 ............ A Repair of urethra injury ........................ 7.63 NA NA 5.26 5.35 0.46 NA NA 13.35 13.44 090

53510 ............ A Repair of urethra injury ........................ 10.11 NA NA 6.33 6.64 0.60 NA NA 17.04 17.35 090

53515 ............ A Repair of urethra injury ........................ 13.31 NA NA 7.24 7.88 0.83 NA NA 21.38 22.02 090

53520 ............ A Repair of urethra defect ....................... 8.68 NA NA 5.72 5.89 0.53 NA NA 14.93 15.10 090

53600 ............ A Dilate urethra stricture .......................... 1.21 3.83 2.96 0.50 0.42 0.07 5.11 4.24 1.78 1.70 000

53601 ............ A Dilate urethra stricture .......................... 0.98 3.76 2.90 0.42 0.36 0.06 4.80 3.94 1.46 1.40 000

53605 ............ A Dilate urethra stricture .......................... 1.28 NA NA 0.43 0.45 0.08 NA NA 1.79 1.81 000

53620 ............ A Dilate urethra stricture .......................... 1.62 5.67 4.38 0.54 0.47 0.10 7.39 6.10 2.26 2.19 000

53621 ............ A Dilate urethra stricture .......................... 1.35 5.69 4.37 0.45 0.39 0.08 7.12 5.80 1.88 1.82 000

53660 ............ A Dilation of urethra ................................. 0.71 3.61 2.78 0.34 0.29 0.04 4.36 3.53 1.09 1.04 000

53661 ............ A Dilation of urethra ................................. 0.72 3.66 2.81 0.24 0.22 0.04 4.42 3.57 1.00 0.98 000

53665 ............ A Dilation of urethra ................................. 0.76 NA NA 0.26 0.29 0.05 NA NA 1.07 1.10 000

53670 ............ A Insert urinary catheter .......................... 0.50 3.37 2.59 0.21 0.19 0.03 3.90 3.12 0.74 0.72 000

53675 ............ A Insert urinary catheter .......................... 1.47 4.57 3.56 0.48 0.49 0.09 6.13 5.12 2.04 2.05 000

53850 ............ A Prostatic microwave thermotx .............. 9.45 80.63 62.29 4.92 5.51 0.56 90.64 72.30 14.93 15.52 090

53852 ............ A Prostatic rf thermotx ............................. 9.88 69.08 53.71 5.17 5.78 0.58 79.54 64.17 15.63 16.24 090

53899 ............ C Urology surgery procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

54000 ............ A Slitting of prepuce ................................ 1.54 5.25 4.11 1.37 1.20 0.10 6.89 5.75 3.01 2.84 010

54001 ............ A Slitting of prepuce ................................ 2.19 5.86 4.62 1.98 1.71 0.14 8.19 6.95 4.31 4.04 010

54015 ............ A Drain penis lesion ................................. 5.32 6.68 5.24 3.04 2.51 0.33 12.33 10.89 8.69 8.16 010

54050 ............ A Destruction, penis lesion(s) .................. 1.24 2.62 2.07 0.50 0.43 0.07 3.93 3.38 1.81 1.74 010

54055 ............ A Destruction, penis lesion(s) .................. 1.22 6.32 4.91 1.38 1.12 0.07 7.61 6.20 2.67 2.41 010

54056 ............ A Cryosurgery, penis lesion(s) ................ 1.24 2.95 2.36 0.53 0.47 0.06 4.25 3.66 1.83 1.77 010

54057 ............ A Laser surg, penis lesion(s) ................... 1.24 2.88 2.57 1.28 1.33 0.08 4.20 3.89 2.60 2.65 010

54060 ............ A Excision of penis lesion(s) ................... 1.93 5.24 4.25 1.54 1.47 0.12 7.29 6.30 3.59 3.52 010

54065 ............ A Destruction, penis lesion(s) .................. 2.42 5.25 4.61 2.05 1.87 0.13 7.80 7.16 4.60 4.42 010

54100 ............ A Biopsy of penis ..................................... 1.90 3.54 2.83 0.74 0.73 0.10 5.54 4.83 2.74 2.73 000

54105 ............ A Biopsy of penis ..................................... 3.50 6.09 4.84 2.06 1.82 0.21 9.80 8.55 5.77 5.53 010

54110 ............ A Treatment of penis lesion ..................... 10.13 NA NA 7.61 7.34 0.60 NA NA 18.34 18.07 090

54111 ............ A Treat penis lesion, graft ....................... 13.57 NA NA 8.67 8.99 0.79 NA NA 23.03 23.35 090

54112 ............ A Treat penis lesion, graft ....................... 15.86 NA NA 9.50 10.07 0.94 NA NA 26.30 26.87 090

54115 ............ A Treatment of penis lesion ..................... 6.15 10.02 8.65 6.35 5.90 0.39 16.56 15.19 12.89 12.44 090

54120 ............ A Partial removal of penis ....................... 9.97 NA NA 7.55 7.42 0.60 NA NA 18.12 17.99 090

54125 ............ A Removal of penis ................................. 13.53 NA NA 8.71 9.67 0.81 NA NA 23.05 24.01 090

54130 ............ A Remove penis & nodes ........................ 20.14 NA NA 11.19 12.37 1.19 NA NA 32.52 33.70 090

54135 ............ A Remove penis & nodes ........................ 26.36 NA NA 13.34 14.82 1.58 NA NA 41.28 42.76 090

54150 ............ A Circumcision ......................................... 1.81 7.59 5.84 1.81 1.51 0.17 9.57 7.82 3.79 3.49 010

54152 ............ A Circumcision ......................................... 2.31 NA NA 1.69 1.76 0.16 NA NA 4.16 4.23 010

54160 ............ A Circumcision ......................................... 2.48 5.72 4.74 1.68 1.71 0.16 8.36 7.38 4.32 4.35 010

54161 ............ A Circumcision ......................................... 3.27 NA NA 1.97 2.07 0.20 NA NA 5.44 5.54 010

54200 ............ A Treatment of penis lesion ..................... 1.06 2.56 2.01 0.37 0.32 0.06 3.68 3.13 1.49 1.44 010

54205 ............ A Treatment of penis lesion ..................... 7.93 NA NA 7.03 6.66 0.47 NA NA 15.43 15.06 090

54220 ............ A Treatment of penis lesion ..................... 2.42 1.91 1.86 0.99 1.17 0.15 4.48 4.43 3.56 3.74 000

54230 ............ A Prepare penis study ............................. 1.34 NA NA 0.45 0.52 0.08 NA NA 1.87 1.94 000

54231 ............ A Dynamic cavernosometry ..................... 2.04 2.13 1.99 0.79 0.98 0.14 4.31 4.17 2.97 3.16 000

54235 ............ A Penile injection ..................................... 1.19 1.09 0.94 0.40 0.36 0.07 2.35 2.20 1.66 1.62 000

54240 ............ A Penis study ........................................... 1.31 1.18 1.16 1.18 1.16 0.13 2.62 2.60 2.62 2.60 000

54240 26 A Penis study ........................................... 1.31 0.45 0.48 0.45 0.48 0.08 1.84 1.87 1.84 1.87 000

54240 TC A Penis study ........................................... 0.00 0.73 0.68 NA NA 0.05 0.78 0.73 NA NA 000

54250 ............ A Penis study ........................................... 2.22 3.51 2.85 3.51 2.85 0.16 5.89 5.23 5.89 5.23 000

54250 26 A Penis study ........................................... 2.22 0.75 0.70 0.75 0.70 0.14 3.11 3.06 3.11 3.06 000

54250 TC A Penis study ........................................... 0.00 2.76 2.15 NA NA 0.02 2.78 2.17 NA NA 000

54300 ............ A Revision of penis .................................. 10.41 NA NA 8.26 8.06 0.64 NA NA 19.31 19.11 090

54304 ............ A Revision of penis .................................. 12.49 NA NA 9.26 9.30 0.74 NA NA 22.49 22.53 090

54308 ............ A Reconstruction of urethra ..................... 11.83 NA NA 8.99 8.33 0.70 NA NA 21.52 20.86 090

54312 ............ A Reconstruction of urethra ..................... 13.57 NA NA 10.08 10.10 0.81 NA NA 24.46 24.48 090

54316 ............ A Reconstruction of urethra ..................... 16.82 NA NA 11.53 11.73 1.00 NA NA 29.35 29.55 090

54318 ............ A Reconstruction of urethra ..................... 11.25 NA NA 9.09 8.86 1.15 NA NA 21.49 21.26 090

54322 ............ A Reconstruction of urethra ..................... 13.01 NA NA 8.60 8.52 0.77 NA NA 22.38 22.30 090

65488

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

54324 ............ A Reconstruction of urethra ..................... 16.31 NA NA 11.30 11.46 1.03 NA NA 28.64 28.80 090

54326 ............ A Reconstruction of urethra ..................... 15.72 NA NA 9.93 10.30 0.93 NA NA 26.58 26.95 090

54328 ............ A Revise penis/urethra ............................ 15.65 NA NA 10.26 10.60 0.92 NA NA 26.83 27.17 090

54332 ............ A Revise penis/urethra ............................ 17.08 NA NA 11.62 12.11 1.01 NA NA 29.71 30.20 090

54336 ............ A Revise penis/urethra ............................ 20.04 NA NA 16.04 17.13 1.90 NA NA 37.98 39.07 090

54340 ............ A Secondary urethral surgery .................. 8.91 NA NA 7.65 7.39 0.72 NA NA 17.28 17.02 090

54344 ............ A Secondary urethral surgery .................. 15.94 NA NA 11.43 13.08 1.10 NA NA 28.47 30.12 090

54348 ............ A Secondary urethral surgery .................. 17.15 NA NA 12.49 12.52 1.02 NA NA 30.66 30.69 090

54352 ............ A Reconstruct urethra/penis .................... 24.74 NA NA 15.08 15.70 1.62 NA NA 41.44 42.06 090

54360 ............ A Penis plastic surgery ............................ 11.93 NA NA 8.13 8.00 0.72 NA NA 20.78 20.65 090

54380 ............ A Repair penis ......................................... 13.18 NA NA 9.10 9.38 1.16 NA NA 23.44 23.72 090

54385 ............ A Repair penis ......................................... 15.39 NA NA 11.08 11.15 0.71 NA NA 27.18 27.25 090

54390 ............ A Repair penis and bladder ..................... 21.61 NA NA 13.28 13.64 1.28 NA NA 36.17 36.53 090

54400 ............ A Insert semi-rigid prosthesis .................. 8.99 NA NA 6.01 7.19 0.53 NA NA 15.53 16.71 090

54401 ............ A Insert self-contd prosthesis .................. 10.28 NA NA 6.82 8.18 0.61 NA NA 17.71 19.07 090

54402 ............ A Remove penis prosthesis ..................... 9.21 NA NA 6.13 6.23 0.55 NA NA 15.89 15.99 090

54405 ............ A Insert multi-comp prosthesis ................ 13.43 NA NA 7.92 9.95 0.80 NA NA 22.15 24.18 090

54407 ............ A Remove multi-comp prosthesis ............ 13.34 NA NA 7.51 8.68 0.80 NA NA 21.65 22.82 090

54409 ............ A Revise penis prosthesis ....................... 12.20 NA NA 7.26 7.88 0.73 NA NA 20.19 20.81 090

54420 ............ A Revision of penis .................................. 11.42 NA NA 8.04 8.13 0.72 NA NA 20.18 20.27 090

54430 ............ A Revision of penis .................................. 10.15 NA NA 7.58 7.58 0.60 NA NA 18.33 18.33 090

54435 ............ A Revision of penis .................................. 6.12 NA NA 5.67 5.38 0.36 NA NA 12.15 11.86 090

54440 ............ C Repair of penis ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

54450 ............ A Preputial stretching ............................... 1.12 0.99 0.93 0.46 0.53 0.07 2.18 2.12 1.65 1.72 000

54500 ............ A Biopsy of testis ..................................... 1.31 5.92 4.56 0.45 0.46 0.08 7.31 5.95 1.84 1.85 000

54505 ............ A Biopsy of testis ..................................... 3.46 NA NA 2.53 2.40 0.21 NA NA 6.20 6.07 010

54510 ............ A Removal of testis lesion ....................... 5.45 NA NA 3.38 3.36 0.35 NA NA 9.18 9.16 090

54512 ............ A Excise lesion testis ............................... 8.58 NA NA 4.86 4.86 0.51 NA NA 13.95 13.95 090

54520 ............ A Removal of testis .................................. 5.23 NA NA 3.51 4.07 0.33 NA NA 9.07 9.63 090

54522 ............ A Orchiectomy, partial ............................. 9.50 NA NA 5.79 5.79 0.57 NA NA 15.86 15.86 090

54530 ............ A Removal of testis .................................. 8.58 NA NA 5.13 5.83 0.53 NA NA 14.24 14.94 090

54535 ............ A Extensive testis surgery ....................... 12.16 NA NA 7.00 7.57 0.83 NA NA 19.99 20.56 090

54550 ............ A Exploration for testis ............................. 7.78 NA NA 4.64 4.91 0.49 NA NA 12.91 13.18 090

54560 ............ A Exploration for testis ............................. 11.13 NA NA 6.75 7.03 0.79 NA NA 18.67 18.95 090

54600 ............ A Reduce testis torsion ............................ 7.01 NA NA 4.16 4.37 0.45 NA NA 11.62 11.83 090

54620 ............ A Suspension of testis ............................. 4.90 NA NA 3.01 3.16 0.31 NA NA 8.22 8.37 010

54640 ............ A Suspension of testis ............................. 6.90 NA NA 4.19 5.20 0.49 NA NA 11.58 12.59 090

54650 ............ A Orchiopexy (Fowler-Stephens) ............. 11.45 NA NA 7.03 7.40 0.81 NA NA 19.29 19.66 090

54660 ............ A Revision of testis .................................. 5.11 NA NA 3.22 3.34 0.35 NA NA 8.68 8.80 090

54670 ............ A Repair testis injury ................................ 6.41 NA NA 4.09 4.24 0.41 NA NA 10.91 11.06 090

54680 ............ A Relocation of testis(es) ......................... 12.65 NA NA 7.37 7.75 0.94 NA NA 20.96 21.34 090

54690 ............ A Laparoscopy, orchiectomy ................... 10.96 NA NA 6.44 6.79 0.99 NA NA 18.39 18.74 090

54692 ............ A Laparoscopy, orchiopexy ..................... 12.88 NA NA 5.68 5.68 0.87 NA NA 19.43 19.43 090

54699 ............ C Laparoscope proc, testis ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

54700 ............ A Drainage of scrotum ............................. 3.43 7.92 6.19 3.26 2.69 0.23 11.58 9.85 6.92 6.35 010

54800 ............ A Biopsy of epididymis ............................ 2.33 6.01 5.04 0.83 1.16 0.14 8.48 7.51 3.30 3.63 000

54820 ............ A Exploration of epididymis ..................... 5.14 NA NA 3.50 3.34 0.33 NA NA 8.97 8.81 090

54830 ............ A Remove epididymis lesion ................... 5.38 NA NA 3.59 3.65 0.34 NA NA 9.31 9.37 090

54840 ............ A Remove epididymis lesion ................... 5.20 NA NA 3.51 3.95 0.31 NA NA 9.02 9.46 090

54860 ............ A Removal of epididymis ......................... 6.32 NA NA 4.08 4.46 0.38 NA NA 10.78 11.16 090

54861 ............ A Removal of epididymis ......................... 8.90 NA NA 4.95 5.69 0.52 NA NA 14.37 15.11 090

54900 ............ A Fusion of spermatic ducts .................... 13.20 NA NA 7.13 7.78 1.34 NA NA 21.67 22.32 090

54901 ............ A Fusion of spermatic ducts .................... 17.94 NA NA 9.79 10.68 1.83 NA NA 29.56 30.45 090

55000 ............ A Drainage of hydrocele .......................... 1.43 2.06 1.65 0.50 0.43 0.10 3.59 3.18 2.03 1.96 000

55040 ............ A Removal of hydrocele .......................... 5.36 NA NA 3.36 3.85 0.35 NA NA 9.07 9.56 090

55041 ............ A Removal of hydroceles ......................... 7.74 NA NA 4.39 5.32 0.50 NA NA 12.63 13.56 090

55060 ............ A Repair of hydrocele .............................. 5.52 NA NA 3.41 3.68 0.37 NA NA 9.30 9.57 090

55100 ............ A Drainage of scrotum abscess .............. 2.13 9.03 6.94 3.48 2.78 0.15 11.31 9.22 5.76 5.06 010

55110 ............ A Explore scrotum ................................... 5.70 NA NA 3.51 3.58 0.36 NA NA 9.57 9.64 090

55120 ............ A Removal of scrotum lesion ................... 5.09 NA NA 3.28 2.95 0.33 NA NA 8.70 8.37 090

55150 ............ A Removal of scrotum ............................. 7.22 NA NA 4.46 4.82 0.47 NA NA 12.15 12.51 090

55175 ............ A Revision of scrotum .............................. 5.24 NA NA 3.60 3.92 0.33 NA NA 9.17 9.49 090

55180 ............ A Revision of scrotum .............................. 10.72 NA NA 6.28 6.56 0.72 NA NA 17.72 18.00 090

55200 ............ A Incision of sperm duct .......................... 4.24 NA NA 3.01 2.79 0.25 NA NA 7.50 7.28 090

55250 ............ A Removal of sperm duct(s) .................... 3.29 8.76 7.28 2.95 2.57 0.21 12.26 10.78 6.45 6.07 090

55300 ............ A Prepare, sperm duct x-ray ................... 3.51 NA NA 1.43 1.81 0.20 NA NA 5.14 5.52 000

55400 ............ A Repair of sperm duct ............................ 8.49 NA NA 5.10 5.61 0.50 NA NA 14.09 14.60 090

55450 ............ A Ligation of sperm duct .......................... 4.12 7.31 6.19 2.39 2.50 0.24 11.67 10.55 6.75 6.86 010

55500 ............ A Removal of hydrocele .......................... 5.59 NA NA 3.59 3.87 0.43 NA NA 9.61 9.89 090

55520 ............ A Removal of sperm cord lesion ............. 6.03 NA NA 3.75 3.66 0.56 NA NA 10.34 10.25 090

55530 ............ A Revise spermatic cord veins ................ 5.66 NA NA 3.69 4.18 0.36 NA NA 9.71 10.20 090

55535 ............ A Revise spermatic cord veins ................ 6.56 NA NA 4.01 4.20 0.42 NA NA 10.99 11.18 090

55540 ............ A Revise hernia & sperm veins ............... 7.67 NA NA 4.36 4.50 0.74 NA NA 12.77 12.91 090

55550 ............ A Laparo ligate spermatic vein ................ 6.57 NA NA 3.36 3.72 0.47 NA NA 10.40 10.76 090

55559 ............ C Laparo proc, spermatic cord ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

55600 ............ A Incise sperm duct pouch ...................... 6.38 NA NA 4.12 4.26 0.38 NA NA 10.88 11.02 090

55605 ............ A Incise sperm duct pouch ...................... 7.96 NA NA 5.00 5.27 0.54 NA NA 13.50 13.77 090

55650 ............ A Remove sperm duct pouch .................. 11.80 NA NA 6.10 6.54 0.72 NA NA 18.62 19.06 090

55680 ............ A Remove sperm pouch lesion ............... 5.19 NA NA 3.79 4.05 0.31 NA NA 9.29 9.55 090

55700 ............ A Biopsy of prostate ................................ 1.57 3.66 3.15 0.53 0.60 0.10 5.33 4.82 2.20 2.27 000

55705 ............ A Biopsy of prostate ................................ 4.57 NA NA 3.62 3.63 0.26 NA NA 8.45 8.46 010

55720 ............ A Drainage of prostate abscess .............. 7.64 NA NA 5.76 5.27 0.44 NA NA 13.84 13.35 090

55725 ............ A Drainage of prostate abscess .............. 8.68 NA NA 6.38 6.31 0.51 NA NA 15.57 15.50 090

65489

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

55801 ............ A Removal of prostate ............................. 17.80 NA NA 9.24 10.39 1.08 NA NA 28.12 29.27 090

55810 ............ A Extensive prostate surgery ................... 22.58 NA NA 11.24 13.28 1.35 NA NA 35.17 37.21 090

55812 ............ A Extensive prostate surgery ................... 27.51 NA NA 13.75 15.11 1.69 NA NA 42.95 44.31 090

55815 ............ A Extensive prostate surgery ................... 30.46 NA NA 14.27 17.54 1.84 NA NA 46.57 49.84 090

55821 ............ A Removal of prostate ............................. 14.25 NA NA 7.74 9.49 0.85 NA NA 22.84 24.59 090

55831 ............ A Removal of prostate ............................. 15.62 NA NA 8.22 10.12 0.94 NA NA 24.78 26.68 090

55840 ............ A Extensive prostate surgery ................... 22.69 NA NA 11.63 13.23 1.37 NA NA 35.69 37.29 090

55842 ............ A Extensive prostate surgery ................... 24.38 NA NA 12.25 14.39 1.48 NA NA 38.11 40.25 090

55845 ............ A Extensive prostate surgery ................... 28.55 NA NA 13.57 16.99 1.71 NA NA 43.83 47.25 090

55859 ............ A Percut/needle insert, pros .................... 12.52 NA NA 7.27 7.05 0.74 NA NA 20.53 20.31 090

55860 ............ A Surgical exposure, prostate ................. 14.45 NA NA 8.17 8.06 0.82 NA NA 23.44 23.33 090

55862 ............ A Extensive prostate surgery ................... 18.39 NA NA 9.40 10.22 1.14 NA NA 28.93 29.75 090

55865 ............ A Extensive prostate surgery ................... 22.87 NA NA 10.96 14.87 1.37 NA NA 35.20 39.11 090

55870 ............ A Electroejaculation ................................. 2.58 1.82 1.86 1.15 1.36 0.14 4.54 4.58 3.87 4.08 000

55873 ............ A Cryoablate prostate .............................. 17.80 NA NA 10.16 10.16 1.01 NA NA 28.97 28.97 090

55899 ............ C Genital surgery procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

55970 ............ N Sex transformation, M to F .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

55980 ............ N Sex transformation, F to M .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

56405 ............ A I & D of vulva/perineum ....................... 1.44 2.28 1.92 1.24 1.03 0.14 3.86 3.50 2.82 2.61 010

56420 ............ A Drainage of gland abscess .................. 1.39 2.26 1.91 1.20 1.01 0.13 3.78 3.43 2.72 2.53 010

56440 ............ A Surgery for vulva lesion ....................... 2.84 3.45 3.30 2.22 2.38 0.28 6.57 6.42 5.34 5.50 010

56441 ............ A Lysis of labial lesion(s) ......................... 1.97 2.48 2.31 1.95 1.91 0.17 4.62 4.45 4.09 4.05 010

56501 ............ A Destruction, vulva lesion(s) .................. 1.53 2.23 1.82 1.29 1.04 0.15 3.91 3.50 2.97 2.72 010

56515 ............ A Destruction, vulva lesion(s) .................. 1.88 2.64 2.62 1.90 1.99 0.18 4.70 4.68 3.96 4.05 010

56605 ............ A Biopsy of vulva/perineum ..................... 1.10 1.73 1.48 0.48 0.45 0.11 2.94 2.69 1.69 1.66 000

56606 ............ A Biopsy of vulva/perineum ..................... 0.55 1.50 1.22 0.22 0.21 0.06 2.11 1.83 0.83 0.82 ZZZ

56620 ............ A Partial removal of vulva ........................ 7.47 NA NA 4.80 5.36 0.76 NA NA 13.03 13.59 090

56625 ............ A Complete removal of vulva .................. 8.40 NA NA 5.69 6.78 0.84 NA NA 14.93 16.02 090

56630 ............ A Extensive vulva surgery ....................... 12.36 NA NA 7.56 9.32 1.23 NA NA 21.15 22.91 090

56631 ............ A Extensive vulva surgery ....................... 16.20 NA NA 10.15 12.45 1.63 NA NA 27.98 30.28 090

56632 ............ A Extensive vulva surgery ....................... 20.29 NA NA 11.82 14.65 2.03 NA NA 34.14 36.97 090

56633 ............ A Extensive vulva surgery ....................... 16.47 NA NA 9.20 11.23 1.66 NA NA 27.33 29.36 090

56634 ............ A Extensive vulva surgery ....................... 17.88 NA NA 10.82 13.45 1.78 NA NA 30.48 33.11 090

56637 ............ A Extensive vulva surgery ....................... 21.97 NA NA 12.51 15.20 2.18 NA NA 36.66 39.35 090

56640 ............ A Extensive vulva surgery ....................... 22.17 NA NA 12.32 14.65 2.26 NA NA 36.75 39.08 090

56700 ............ A Partial removal of hymen ..................... 2.52 2.80 2.60 1.98 1.98 0.24 5.56 5.36 4.74 4.74 010

56720 ............ A Incision of hymen ................................. 0.68 1.62 1.35 0.68 0.64 0.07 2.37 2.10 1.43 1.39 000

56740 ............ A Remove vagina gland lesion ................ 3.76 3.52 3.42 2.57 2.71 0.37 7.65 7.55 6.70 6.84 010

56800 ............ A Repair of vagina ................................... 3.89 NA NA 2.63 2.77 0.37 NA NA 6.89 7.03 010

56805 ............ A Repair clitoris ........................................ 18.86 NA NA 9.29 10.16 1.82 NA NA 29.97 30.84 090

56810 ............ A Repair of perineum ............................... 4.13 NA NA 2.73 2.76 0.41 NA NA 7.27 7.30 010

57000 ............ A Exploration of vagina ............................ 2.97 NA NA 2.27 2.25 0.28 NA NA 5.52 5.50 010

57010 ............ A Drainage of pelvic abscess .................. 6.03 NA NA 3.79 3.56 0.57 NA NA 10.39 10.16 090

57020 ............ A Drainage of pelvic fluid ......................... 1.50 1.56 1.35 0.63 0.65 0.15 3.21 3.00 2.28 2.30 000

57022 ............ A I &d vaginal hematoma, ob .................. 2.56 NA NA 1.60 1.60 0.14 NA NA 4.30 4.30 010

57023 ............ A I &d vag hematoma, trauma ................ 2.56 NA NA 1.60 1.60 0.14 NA NA 4.30 4.30 010

57061 ............ A Destruction vagina lesion(s) ................. 1.25 2.18 1.86 1.19 1.01 0.13 3.56 3.24 2.57 2.39 010

57065 ............ A Destruction vagina lesion(s) ................. 2.61 2.87 2.93 2.23 2.45 0.26 5.74 5.80 5.10 5.32 010

57100 ............ A Biopsy of vagina ................................... 0.97 1.42 1.23 0.42 0.40 0.10 2.49 2.30 1.49 1.47 000

57105 ............ A Biopsy of vagina ................................... 1.69 2.19 2.07 2.16 2.05 0.17 4.05 3.93 4.02 3.91 010

57106 ............ A Remove vagina wall, partial ................. 6.36 2.48 2.48 2.48 2.48 0.58 9.42 9.42 9.42 9.42 090

57107 ............ A Remove vagina tissue, part ................. 23.00 NA NA 10.32 10.32 2.17 NA NA 35.49 35.49 090

57109 ............ A Vaginectomy partial w/nodes ............... 27.00 NA NA 11.90 11.90 1.97 NA NA 40.87 40.87 090

57110 ............ A Remove vagina wall, complete ............ 14.29 NA NA 7.20 7.54 1.43 NA NA 22.92 23.26 090

57111 ............ A Remove vagina tissue, compl .............. 27.00 NA NA 12.17 12.17 2.71 NA NA 41.88 41.88 090

57112 ............ A Vaginectomy w/nodes, compl .............. 29.00 NA NA 12.77 12.77 2.19 NA NA 43.96 43.96 090

57120 ............ A Closure of vagina ................................. 7.41 NA NA 4.54 5.30 0.75 NA NA 12.70 13.46 090

57130 ............ A Remove vagina lesion .......................... 2.43 NA NA 2.07 2.26 0.23 NA NA 4.73 4.92 010

57135 ............ A Remove vagina lesion .......................... 2.67 2.85 2.66 2.17 2.15 0.26 5.78 5.59 5.10 5.08 010

57150 ............ A Treat vagina infection ........................... 0.55 0.98 0.79 0.21 0.19 0.06 1.59 1.40 0.82 0.80 000

57160 ............ A Insert pessary/other device .................. 0.89 1.34 1.07 0.35 0.30 0.09 2.32 2.05 1.33 1.28 000

57170 ............ A Fitting of diaphragm/cap ....................... 0.91 1.38 1.12 0.33 0.29 0.09 2.38 2.12 1.33 1.29 000

57180 ............ A Treat vaginal bleeding .......................... 1.58 2.21 1.81 1.43 1.15 0.16 3.95 3.55 3.17 2.89 010

57200 ............ A Repair of vagina ................................... 3.94 NA NA 2.93 2.93 0.38 NA NA 7.25 7.25 090

57210 ............ A Repair vagina/perineum ....................... 5.17 NA NA 3.41 3.45 0.50 NA NA 9.08 9.12 090

57220 ............ A Revision of urethra ............................... 4.31 NA NA 3.31 3.69 0.42 NA NA 8.04 8.42 090

57230 ............ A Repair of urethral lesion ....................... 5.64 NA NA 4.16 4.16 0.50 NA NA 10.30 10.30 090

57240 ............ A Repair bladder & vagina ...................... 6.07 NA NA 4.30 5.04 0.53 NA NA 10.90 11.64 090

57250 ............ A Repair rectum & vagina ....................... 5.53 NA NA 3.75 4.46 0.54 NA NA 9.82 10.53 090

57260 ............ A Repair of vagina ................................... 8.27 NA NA 4.85 5.99 0.83 NA NA 13.95 15.09 090

57265 ............ A Extensive repair of vagina .................... 11.34 NA NA 6.75 7.62 1.14 NA NA 19.23 20.10 090

57268 ............ A Repair of bowel bulge .......................... 6.76 NA NA 4.24 5.09 0.66 NA NA 11.66 12.51 090

57270 ............ A Repair of bowel pouch ......................... 12.11 NA NA 6.18 6.49 1.17 NA NA 19.46 19.77 090

57280 ............ A Suspension of vagina ........................... 15.04 NA NA 7.31 7.80 1.44 NA NA 23.79 24.28 090

57282 ............ A Repair of vaginal prolapse ................... 8.86 NA NA 5.09 6.18 0.86 NA NA 14.81 15.90 090

57284 ............ A Repair paravaginal defect .................... 12.70 NA NA 6.94 7.54 1.17 NA NA 20.81 21.41 090

57287 ............ A Revise/remove sling repair ................... 10.71 NA NA 7.02 7.02 0.64 NA NA 18.37 18.37 090

57288 ............ A Repair bladder defect ........................... 13.02 NA NA 6.80 8.01 0.86 NA NA 20.68 21.89 090

57289 ............ A Repair bladder & vagina ...................... 11.58 NA NA 6.62 7.19 0.95 NA NA 19.15 19.72 090

57291 ............ A Construction of vagina ......................... 7.95 NA NA 6.07 6.01 0.78 NA NA 14.80 14.74 090

57292 ............ A Construct vagina with graft .................. 13.09 NA NA 7.25 7.22 1.29 NA NA 21.63 21.60 090

57300 ............ A Repair rectum-vagina fistula ................ 7.61 NA NA 4.70 5.67 0.70 NA NA 13.01 13.98 090

57305 ............ A Repair rectum-vagina fistula ................ 13.77 NA NA 7.10 7.37 1.33 NA NA 22.20 22.47 090

65490

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

57307 ............ A Fistula repair & colostomy .................... 15.93 NA NA 7.77 7.49 1.59 NA NA 25.29 25.01 090

57308 ............ A Fistula repair, transperine .................... 9.94 NA NA 5.73 6.26 0.91 NA NA 16.58 17.11 090

57310 ............ A Repair urethrovaginal lesion ................ 6.78 NA NA 4.63 4.65 0.45 NA NA 11.86 11.88 090

57311 ............ A Repair urethrovaginal lesion ................ 7.98 NA NA 5.19 5.41 0.51 NA NA 13.68 13.90 090

57320 ............ A Repair bladder-vagina lesion ............... 8.01 NA NA 5.27 6.34 0.60 NA NA 13.88 14.95 090

57330 ............ A Repair bladder-vagina lesion ............... 12.35 NA NA 6.60 7.20 0.86 NA NA 19.81 20.41 090

57335 ............ A Repair vagina ....................................... 18.73 NA NA 9.15 8.74 1.66 NA NA 29.54 29.13 090

57400 ............ A Dilation of vagina .................................. 2.27 NA NA 1.29 1.06 0.22 NA NA 3.78 3.55 000

57410 ............ A Pelvic examination ............................... 1.75 2.60 2.05 1.07 0.90 0.14 4.49 3.94 2.96 2.79 000

57415 ............ A Remove vaginal foreign body .............. 2.17 3.37 2.63 2.00 1.60 0.19 5.73 4.99 4.36 3.96 010

57452 ............ A Examination of vagina .......................... 0.99 1.53 1.33 0.45 0.43 0.10 2.62 2.42 1.54 1.52 000

57454 ............ A Vagina examination & biopsy ............... 1.27 1.71 1.61 0.59 0.61 0.13 3.11 3.01 1.99 2.01 000

57460 ............ A Cervix excision ..................................... 2.83 2.05 2.09 1.13 1.12 0.28 5.16 5.20 4.24 4.23 000

57500 ............ A Biopsy of cervix .................................... 0.97 2.02 1.67 0.47 0.43 0.10 3.09 2.74 1.54 1.50 000

57505 ............ A Endocervical curettage ......................... 1.14 1.89 1.59 1.21 0.99 0.12 3.15 2.85 2.47 2.25 010

57510 ............ A Cauterization of cervix .......................... 1.90 3.07 2.44 1.52 1.21 0.18 5.15 4.52 3.60 3.29 010

57511 ............ A Cryocautery of cervix ........................... 1.90 2.35 1.99 0.74 0.67 0.18 4.43 4.07 2.82 2.75 010

57513 ............ A Laser surgery of cervix ......................... 1.90 2.50 2.44 1.49 1.69 0.19 4.59 4.53 3.58 3.78 010

57520 ............ A Conization of cervix .............................. 4.04 4.10 4.01 2.74 2.99 0.41 8.55 8.46 7.19 7.44 090

57522 ............ A Conization of cervix .............................. 3.36 3.65 3.67 2.47 2.79 0.34 7.35 7.37 6.17 6.49 090

57530 ............ A Removal of cervix ................................. 4.79 NA NA 3.52 3.62 0.48 NA NA 8.79 8.89 090

57531 ............ A Removal of cervix, radical .................... 28.00 NA NA 13.16 14.69 2.46 NA NA 43.62 45.15 090

57540 ............ A Removal of residual cervix ................... 12.22 NA NA 6.14 6.43 1.21 NA NA 19.57 19.86 090

57545 ............ A Remove cervix/repair pelvis ................. 13.03 NA NA 6.58 6.18 1.30 NA NA 20.91 20.51 090

57550 ............ A Removal of residual cervix ................... 5.53 NA NA 3.75 4.46 0.55 NA NA 9.83 10.54 090

57555 ............ A Remove cervix/repair vagina ................ 8.95 NA NA 5.48 6.78 0.89 NA NA 15.32 16.62 090

57556 ............ A Remove cervix, repair bowel ................ 8.37 NA NA 4.85 6.14 0.80 NA NA 14.02 15.31 090

57700 ............ A Revision of cervix ................................. 3.55 NA NA 2.44 2.48 0.33 NA NA 6.32 6.36 090

57720 ............ A Revision of cervix ................................. 4.13 NA NA 3.22 3.17 0.41 NA NA 7.76 7.71 090

57800 ............ A Dilation of cervical canal ...................... 0.77 1.15 0.99 0.35 0.33 0.08 2.00 1.84 1.20 1.18 000

57820 ............ A D & c of residual cervix ........................ 1.67 2.47 2.42 2.16 2.19 0.17 4.31 4.26 4.00 4.03 010

58100 ............ A Biopsy of uterus lining .......................... 0.71 1.99 1.67 0.28 0.30 0.07 2.77 2.45 1.06 1.08 000

58120 ............ A Dilation and curettage .......................... 3.27 3.72 3.52 2.36 2.50 0.33 7.32 7.12 5.96 6.10 010

58140 ............ A Removal of uterus lesion ..................... 14.60 NA NA 7.06 7.56 1.46 NA NA 23.12 23.62 090

58145 ............ A Removal of uterus lesion ..................... 8.04 NA NA 4.78 5.82 0.80 NA NA 13.62 14.66 090

58150 ............ A Total hysterectomy ............................... 15.24 NA NA 7.45 8.19 1.53 NA NA 24.22 24.96 090

58152 ............ A Total hysterectomy ............................... 15.09 NA NA 7.40 8.80 1.52 NA NA 24.01 25.41 090

58180 ............ A Partial hysterectomy ............................. 15.29 NA NA 7.44 8.23 1.54 NA NA 24.27 25.06 090

58200 ............ A Extensive hysterectomy ....................... 21.59 NA NA 11.04 11.80 2.15 NA NA 34.78 35.54 090

58210 ............ A Extensive hysterectomy ....................... 28.85 NA NA 13.89 15.24 2.91 NA NA 45.65 47.00 090

58240 ............ A Removal of pelvis contents .................. 38.39 NA NA 18.94 22.00 3.76 NA NA 61.09 64.15 090

58260 ............ A Vaginal hysterectomy ........................... 12.20 NA NA 5.92 6.99 1.23 NA NA 19.35 20.42 090

58262 ............ A Vaginal hysterectomy ........................... 13.99 NA NA 6.65 7.54 1.42 NA NA 22.06 22.95 090

58263 ............ A Vaginal hysterectomy ........................... 15.28 NA NA 7.16 8.17 1.55 NA NA 23.99 25.00 090

58267 ............ A Hysterectomy & vagina repair .............. 15.00 NA NA 7.04 8.41 1.51 NA NA 23.55 24.92 090

58270 ............ A Hysterectomy & vagina repair .............. 13.48 NA NA 6.45 7.64 1.37 NA NA 21.30 22.49 090

58275 ............ A Hysterectomy/revise vagina ................. 14.98 NA NA 7.01 8.25 1.51 NA NA 23.50 24.74 090

58280 ............ A Hysterectomy/revise vagina ................. 15.41 NA NA 7.13 8.20 1.54 NA NA 24.08 25.15 090

58285 ............ A Extensive hysterectomy ....................... 18.57 NA NA 9.80 10.50 1.88 NA NA 30.25 30.95 090

58300 ............ N Insert intrauterine device ...................... +1.01 1.39 1.25 0.40 0.51 0.10 2.50 2.36 1.51 1.62 XXX

58301 ............ A Remove intrauterine device ................. 1.27 1.53 1.27 0.50 0.44 0.13 2.93 2.67 1.90 1.84 000

58321 ............ A Artificial insemination ............................ 0.92 0.88 0.85 0.37 0.47 0.10 1.90 1.87 1.39 1.49 000

58322 ............ A Artificial insemination ............................ 1.10 1.01 0.95 0.42 0.51 0.11 2.22 2.16 1.63 1.72 000

58323 ............ A Sperm washing ..................................... 0.23 0.51 0.43 0.09 0.11 0.02 0.76 0.68 0.34 0.36 000

58340 ............ A Catheter for hysterography .................. 0.88 11.40 8.71 0.33 0.40 0.08 12.36 9.67 1.29 1.36 000

58345 ............ A Reopen fallopian tube .......................... 4.66 NA NA 1.80 2.30 0.36 NA NA 6.82 7.32 010

58350 ............ A Reopen fallopian tube .......................... 1.01 1.98 1.67 1.06 0.98 0.10 3.09 2.78 2.17 2.09 010

58353 ............ A Endometr ablate, thermal ..................... 3.56 NA NA 2.16 2.16 0.19 NA NA 5.91 5.91 010

58400 ............ A Suspension of uterus ........................... 6.36 NA NA 3.94 4.49 0.62 NA NA 10.92 11.47 090

58410 ............ A Suspension of uterus ........................... 12.73 NA NA 6.48 6.36 1.09 NA NA 20.30 20.18 090

58520 ............ A Repair of ruptured uterus ..................... 11.92 NA NA 5.87 5.55 1.17 NA NA 18.96 18.64 090

58540 ............ A Revision of uterus ................................ 14.64 NA NA 7.03 6.94 1.28 NA NA 22.95 22.86 090

58550 ............ A Laparo-asst vag hysterectomy ............. 14.19 NA NA 6.71 7.58 1.44 NA NA 22.34 23.21 010

58551 ............ A Laparoscopy, remove myoma .............. 14.21 NA NA 6.65 6.28 1.45 NA NA 22.31 21.94 010

58555 ............ A Hysteroscopy, dx, sep proc .................. 3.33 2.78 2.63 1.44 1.62 0.34 6.45 6.30 5.11 5.29 000

58558 ............ A Hysteroscopy, biopsy ........................... 4.75 3.36 3.06 2.02 2.06 0.49 8.60 8.30 7.26 7.30 000

58559 ............ A Hysteroscopy, lysis ............................... 6.17 2.45 2.86 2.45 2.86 0.62 9.24 9.65 9.24 9.65 000

58560 ............ A Hysteroscopy, resect septum ............... 7.00 2.84 3.15 2.84 3.15 0.71 10.55 10.86 10.55 10.86 000

58561 ............ A Hysteroscopy, remove myoma ............. 10.00 4.03 4.36 4.03 4.36 1.02 15.05 15.38 15.05 15.38 000

58562 ............ A Hysteroscopy, remove fb ..................... 5.21 NA NA 2.20 2.19 0.52 NA NA 7.93 7.92 000

58563 ............ A Hysteroscopy, ablation ......................... 6.17 2.47 3.04 2.47 3.04 0.62 9.26 9.83 9.26 9.83 000

58578 ............ C Laparo proc, uterus .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

58579 ............ C Hysteroscope procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

58600 ............ A Division of fallopian tube ...................... 3.84 NA NA 2.58 3.08 0.39 NA NA 6.81 7.31 090

58605 ............ A Division of fallopian tube ...................... 3.34 NA NA 2.40 2.80 0.33 NA NA 6.07 6.47 090

58611 ............ A Ligate oviduct(s) add-on ....................... 0.63 NA NA 0.25 0.32 0.07 NA NA 0.95 1.02 ZZZ

58615 ............ A Occlude fallopian tube(s) ..................... 3.90 NA NA 2.64 2.77 0.40 NA NA 6.94 7.07 010

58660 ............ A Laparoscopy, lysis ................................ 11.29 NA NA 5.46 5.62 1.14 NA NA 17.89 18.05 090

58661 ............ A Laparoscopy, remove adnexa .............. 11.05 NA NA 5.19 5.84 1.12 NA NA 17.36 18.01 010

58662 ............ A Laparoscopy, excise lesions ................ 11.79 NA NA 5.45 5.59 1.18 NA NA 18.42 18.56 090

58670 ............ A Laparoscopy, tubal cautery .................. 5.60 NA NA 3.49 3.90 0.55 NA NA 9.64 10.05 090

58671 ............ A Laparoscopy, tubal block ..................... 5.60 NA NA 3.55 4.09 0.56 NA NA 9.71 10.25 090

58672 ............ A Laparoscopy, fimbrioplasty ................... 12.88 NA NA 6.13 5.99 1.22 NA NA 20.23 20.09 090

65491

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

58673 ............ A Laparoscopy, salpingostomy ................ 13.74 NA NA 6.82 6.55 1.40 NA NA 21.96 21.69 090

58679 ............ C Laparo proc, oviduct-ovary ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

58700 ............ A Removal of fallopian tube .................... 6.49 NA NA 3.82 4.58 0.64 NA NA 10.95 11.71 090

58720 ............ A Removal of ovary/tube(s) ..................... 11.36 NA NA 5.77 6.36 1.14 NA NA 18.27 18.86 090

58740 ............ A Revise fallopian tube(s) ........................ 5.83 NA NA 3.71 4.52 0.59 NA NA 10.13 10.94 090

58750 ............ A Repair oviduct ...................................... 14.84 NA NA 7.24 7.14 1.52 NA NA 23.60 23.50 090

58752 ............ A Revise ovarian tube(s) ......................... 14.84 NA NA 7.62 7.54 1.51 NA NA 23.97 23.89 090

58760 ............ A Remove tubal obstruction .................... 13.13 NA NA 6.43 6.21 1.34 NA NA 20.90 20.68 090

58770 ............ A Create new tubal opening .................... 13.97 NA NA 6.95 6.65 1.42 NA NA 22.34 22.04 090

58800 ............ A Drainage of ovarian cyst(s) .................. 4.14 4.32 3.97 4.16 3.85 0.36 8.82 8.47 8.66 8.35 090

58805 ............ A Drainage of ovarian cyst(s) .................. 5.88 NA NA 3.52 4.37 0.56 NA NA 9.96 10.81 090

58820 ............ A Drain ovary abscess, open .................. 4.22 NA NA 3.26 3.20 0.29 NA NA 7.77 7.71 090

58822 ............ A Drain ovary abscess, percut ................ 10.13 NA NA 5.15 4.83 0.92 NA NA 16.20 15.88 090

58823 ............ A Drain pelvic abscess, percut ................ 3.38 NA NA 3.14 3.05 0.18 NA NA 6.70 6.61 000

58825 ............ A Transposition, ovary(s) ......................... 6.13 NA NA 3.88 4.00 0.62 NA NA 10.63 10.75 090

58900 ............ A Biopsy of ovary(s) ................................ 5.99 NA NA 3.59 4.10 0.56 NA NA 10.14 10.65 090

58920 ............ A Partial removal of ovary(s) ................... 6.78 NA NA 3.85 4.73 0.68 NA NA 11.31 12.19 090

58925 ............ A Removal of ovarian cyst(s) .................. 11.36 NA NA 5.66 6.03 1.14 NA NA 18.16 18.53 090

58940 ............ A Removal of ovary(s) ............................. 7.29 NA NA 4.05 4.80 0.73 NA NA 12.07 12.82 090

58943 ............ A Removal of ovary(s) ............................. 18.43 NA NA 9.53 10.43 1.86 NA NA 29.82 30.72 090

58950 ............ A Resect ovarian malignancy .................. 15.27 NA NA 8.36 9.32 1.55 NA NA 25.18 26.14 090

58951 ............ A Resect ovarian malignancy .................. 21.81 NA NA 11.01 13.23 2.20 NA NA 35.02 37.24 090

58952 ............ A Resect ovarian malignancy .................. 25.01 NA NA 12.32 14.15 2.50 NA NA 39.83 41.66 090

58960 ............ A Exploration of abdomen ....................... 14.65 NA NA 8.15 9.64 1.47 NA NA 24.27 25.76 090

58970 ............ A Retrieval of oocyte ............................... 3.53 8.65 7.17 1.80 2.03 0.36 12.54 11.06 5.69 5.92 000

58974 ............ C Transfer of embryo ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000

58976 ............ A Transfer of embryo ............................... 3.83 2.28 2.45 1.53 1.89 0.39 6.50 6.67 5.75 6.11 000

58999 ............ C Genital surgery procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

59000 ............ A Amniocentesis ...................................... 1.30 1.86 1.66 0.61 0.72 0.23 3.39 3.19 2.14 2.25 000

59012 ............ A Fetal cord puncture,prenatal ................ 3.45 NA NA 1.65 1.95 0.62 NA NA 5.72 6.02 000

59015 ............ A Chorion biopsy ..................................... 2.20 1.32 1.32 0.89 0.99 0.40 3.92 3.92 3.49 3.59 000

59020 ............ A Fetal contract stress test ...................... 0.66 0.78 0.92 0.78 0.92 0.20 1.64 1.78 1.64 1.78 000

59020 26 A Fetal contract stress test ...................... 0.66 0.26 0.39 0.26 0.39 0.12 1.04 1.17 1.04 1.17 000

59020 TC A Fetal contract stress test ...................... 0.00 0.52 0.53 NA NA 0.08 0.60 0.61 NA NA 000

59025 ............ A Fetal non-stress test ............................. 0.53 0.44 0.49 0.44 0.49 0.12 1.09 1.14 1.09 1.14 000

59025 26 A Fetal non-stress test ............................. 0.53 0.21 0.26 0.21 0.26 0.10 0.84 0.89 0.84 0.89 000

59025 TC A Fetal non-stress test ............................. 0.00 0.23 0.23 NA NA 0.02 0.25 0.25 NA NA 000

59030 ............ A Fetal scalp blood sample ..................... 1.99 NA NA 0.93 1.13 0.36 NA NA 3.28 3.48 000

59050 ............ A Fetal monitor w/report .......................... 0.89 NA NA 0.35 0.48 0.16 NA NA 1.40 1.53 XXX

59051 ............ A Fetal monitor/interpret only .................. 0.74 NA NA 0.28 0.43 0.14 NA NA 1.16 1.31 XXX

59100 ............ A Remove uterus lesion .......................... 12.35 NA NA 6.03 5.65 2.21 NA NA 20.59 20.21 090

59120 ............ A Treat ectopic pregnancy ....................... 11.49 NA NA 6.01 6.64 2.06 NA NA 19.56 20.19 090

59121 ............ A Treat ectopic pregnancy ....................... 11.67 NA NA 6.04 5.99 2.09 NA NA 19.80 19.75 090

59130 ............ A Treat ectopic pregnancy ....................... 14.22 NA NA 7.10 6.94 2.54 NA NA 23.86 23.70 090

59135 ............ A Treat ectopic pregnancy ....................... 13.88 NA NA 6.97 7.90 2.49 NA NA 23.34 24.27 090

59136 ............ A Treat ectopic pregnancy ....................... 13.18 NA NA 6.71 6.72 2.36 NA NA 22.25 22.26 090

59140 ............ A Treat ectopic pregnancy ....................... 5.46 NA NA 3.17 3.64 0.98 NA NA 9.61 10.08 090

59150 ............ A Treat ectopic pregnancy ....................... 6.89 NA NA 4.37 4.51 1.23 NA NA 12.49 12.63 090

59151 ............ A Treat ectopic pregnancy ....................... 7.86 NA NA 4.29 5.55 1.41 NA NA 13.56 14.82 090

59160 ............ A D & c after delivery .............................. 2.71 3.47 3.40 2.16 2.42 0.49 6.67 6.60 5.36 5.62 010

59200 ............ A Insert cervical dilator ............................ 0.79 1.31 1.13 0.31 0.31 0.15 2.25 2.07 1.25 1.25 000

59300 ............ A Episiotomy or vaginal repair ................. 2.41 2.14 1.87 0.96 0.86 0.43 4.98 4.71 3.80 3.70 000

59320 ............ A Revision of cervix ................................. 2.48 NA NA 1.40 1.53 0.45 NA NA 4.33 4.46 000

59325 ............ A Revision of cervix ................................. 4.07 NA NA 2.05 2.32 0.73 NA NA 6.85 7.12 000

59350 ............ A Repair of uterus .................................... 4.95 NA NA 1.95 2.42 0.88 NA NA 7.78 8.25 000

59400 ............ A Obstetrical care .................................... 23.06 NA NA 14.62 15.03 4.14 NA NA 41.82 42.23 MMM

59409 ............ A Obstetrical care .................................... 13.50 NA NA 5.29 6.54 2.42 NA NA 21.21 22.46 MMM

59410 ............ A Obstetrical care .................................... 14.78 NA NA 6.34 7.55 2.65 NA NA 23.77 24.98 MMM

59412 ............ A Antepartum manipulation ..................... 1.71 1.28 1.29 0.69 0.85 0.31 3.30 3.31 2.71 2.87 MMM

59414 ............ A Deliver placenta .................................... 1.61 NA NA 1.27 1.27 0.29 NA NA 3.17 3.17 MMM

59425 ............ A Antepartum care only ........................... 4.81 5.10 4.61 5.02 4.16 0.86 10.77 10.28 10.69 9.83 MMM

59426 ............ A Antepartum care only ........................... 8.28 8.72 7.88 8.72 7.21 1.49 18.49 17.65 18.49 16.98 MMM

59430 ............ A Care after delivery ................................ 2.13 1.22 1.02 1.21 0.96 0.38 3.73 3.53 3.72 3.47 MMM

59510 ............ A Cesarean delivery ................................ 26.22 NA NA 16.61 17.04 4.70 NA NA 47.53 47.96 MMM

59514 ............ A Cesarean delivery only ......................... 15.97 NA NA 6.22 7.65 2.86 NA NA 25.05 26.48 MMM

59515 ............ A Cesarean delivery ................................ 17.37 NA NA 7.99 9.20 3.12 NA NA 28.48 29.69 MMM

59525 ............ A Remove uterus after cesarean ............. 8.54 NA NA 3.33 3.53 1.53 NA NA 13.40 13.60 ZZZ

59610 ............ A Vbac delivery ........................................ 24.62 NA NA 15.08 15.38 4.41 NA NA 44.11 44.41 MMM

59612 ............ A Vbac delivery only ................................ 15.06 NA NA 6.03 7.10 2.70 NA NA 23.79 24.86 MMM

59614 ............ A Vbac care after delivery ....................... 16.34 NA NA 7.28 8.26 2.93 NA NA 26.55 27.53 MMM

59618 ............ A Attempted vbac delivery ....................... 27.78 NA NA 17.86 17.98 4.98 NA NA 50.62 50.74 MMM

59620 ............ A Attempted vbac delivery only ............... 17.53 NA NA 6.68 7.99 3.15 NA NA 27.36 28.67 MMM

59622 ............ A Attempted vbac after care .................... 18.93 NA NA 8.59 9.65 3.39 NA NA 30.91 31.97 MMM

59812 ............ A Treatment of miscarriage ..................... 3.25 3.27 3.43 2.12 2.56 0.58 7.10 7.26 5.95 6.39 090

59820 ............ A Care of miscarriage .............................. 4.01 3.58 3.70 2.63 2.99 0.72 8.31 8.43 7.36 7.72 090

59821 ............ A Treatment of miscarriage ..................... 4.47 3.72 3.53 2.82 2.85 0.80 8.99 8.80 8.09 8.12 090

59830 ............ A Treat uterus infection ........................... 6.11 NA NA 3.80 4.08 1.10 NA NA 11.01 11.29 090

59840 ............ R Abortion ................................................ 3.01 3.88 3.78 2.16 2.49 0.54 7.43 7.33 5.71 6.04 010

59841 ............ R Abortion ................................................ 5.24 5.56 5.19 3.49 3.64 0.94 11.74 11.37 9.67 9.82 010

59850 ............ R Abortion ................................................ 5.91 NA NA 2.76 3.16 1.06 NA NA 9.73 10.13 090

59851 ............ R Abortion ................................................ 5.93 NA NA 3.07 3.46 1.06 NA NA 10.06 10.45 090

59852 ............ R Abortion ................................................ 8.24 NA NA 4.35 4.76 1.48 NA NA 14.07 14.48 090

59855 ............ R Abortion ................................................ 6.12 NA NA 3.22 3.54 1.10 NA NA 10.44 10.76 090

65492

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

59856 ............ R Abortion ................................................ 7.48 NA NA 3.73 4.19 1.34 NA NA 12.55 13.01 090

59857 ............ R Abortion ................................................ 9.29 NA NA 4.45 5.03 1.66 NA NA 15.40 15.98 090

59866 ............ R Abortion (mpr) ...................................... 4.00 NA NA 1.60 1.98 0.72 NA NA 6.32 6.70 000

59870 ............ A Evacuate mole of uterus ...................... 4.28 NA NA 3.06 3.09 0.77 NA NA 8.11 8.14 090

59871 ............ A Remove cerclage suture ...................... 2.13 1.90 1.91 0.87 1.14 0.38 4.41 4.42 3.38 3.65 000

59898 ............ C Laparo proc, ob care/deliver ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

59899 ............ C Maternity care procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

60000 ............ A Drain thyroid/tongue cyst ..................... 1.76 2.36 1.93 2.31 1.82 0.14 4.26 3.83 4.21 3.72 010

60001 ............ A Aspirate/inject thyriod cyst ................... 0.97 1.54 1.44 0.37 0.56 0.06 2.57 2.47 1.40 1.59 000

60100 ............ A Biopsy of thyroid ................................... 0.97 2.32 2.03 0.35 0.41 0.05 3.34 3.05 1.37 1.43 000

60200 ............ A Remove thyroid lesion .......................... 9.55 NA NA 6.79 6.73 0.84 NA NA 17.18 17.12 090

60210 ............ A Partial thyroid excision ......................... 10.88 NA NA 6.69 7.37 1.01 NA NA 18.58 19.26 090

60212 ............ A Parital thyroid excision ......................... 16.03 NA NA 8.83 9.08 1.51 NA NA 26.37 26.62 090

60220 ............ A Partial removal of thyroid ..................... 10.53 NA NA 6.60 7.27 0.97 NA NA 18.10 18.77 090

60225 ............ A Partial removal of thyroid ..................... 14.19 NA NA 8.15 8.96 1.31 NA NA 23.65 24.46 090

60240 ............ A Removal of thyroid ............................... 16.06 NA NA 9.33 9.87 1.50 NA NA 26.89 27.43 090

60252 ............ A Removal of thyroid ............................... 18.20 NA NA 10.78 11.79 1.63 NA NA 30.61 31.62 090

60254 ............ A Extensive thyroid surgery ..................... 23.88 NA NA 14.52 16.10 1.96 NA NA 40.36 41.94 090

60260 ............ A Repeat thyroid surgery ......................... 15.46 NA NA 9.68 8.11 1.39 NA NA 26.53 24.96 090

60270 ............ A Removal of thyroid ............................... 17.94 NA NA 12.04 12.82 1.78 NA NA 31.76 32.54 090

60271 ............ A Removal of thyroid ............................... 14.89 NA NA 9.27 10.25 1.35 NA NA 25.51 26.49 090

60280 ............ A Remove thyroid duct lesion .................. 5.87 NA NA 5.11 5.65 0.45 NA NA 11.43 11.97 090

60281 ............ A Remove thyroid duct lesion .................. 8.53 NA NA 6.44 6.20 0.67 NA NA 15.64 15.40 090

60500 ............ A Explore parathyroid glands .................. 16.23 NA NA 8.11 9.17 1.61 NA NA 25.95 27.01 090

60502 ............ A Re-explore parathyroids ....................... 20.35 NA NA 9.94 10.55 2.00 NA NA 32.29 32.90 090

60505 ............ A Explore parathyroid glands .................. 21.49 NA NA 11.77 12.39 2.14 NA NA 35.40 36.02 090

60512 ............ A Autotransplant parathyroid ................... 4.45 NA NA 1.78 1.97 0.44 NA NA 6.67 6.86 ZZZ

60520 ............ A Removal of thymus gland .................... 16.81 NA NA 11.14 12.03 1.84 NA NA 29.79 30.68 090

60521 ............ A Removal of thymus gland .................... 18.87 NA NA 14.46 14.52 2.34 NA NA 35.67 35.73 090

60522 ............ A Removal of thymus gland .................... 23.09 NA NA 15.89 15.59 2.83 NA NA 41.81 41.51 090

60540 ............ A Explore adrenal gland .......................... 17.03 NA NA 8.03 9.29 1.42 NA NA 26.48 27.74 090

60545 ............ A Explore adrenal gland .......................... 19.88 NA NA 9.84 11.25 1.75 NA NA 31.47 32.88 090

60600 ............ A Remove carotid body lesion ................. 17.93 NA NA 14.03 13.63 1.87 NA NA 33.83 33.43 090

60605 ............ A Remove carotid body lesion ................. 20.24 NA NA 19.89 17.82 2.28 NA NA 42.41 40.34 090

60650 ............ A Laparoscopy adrenalectomy ................ 20.00 NA NA 8.60 8.60 1.98 NA NA 30.58 30.58 090

60659 ............ C Laparo proc, endocrine ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

60699 ............ C Endocrine surgery procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

61000 ............ A Remove cranial cavity fluid .................. 1.58 1.72 1.58 1.59 1.48 0.13 3.43 3.29 3.30 3.19 000

61001 ............ A Remove cranial cavity fluid .................. 1.49 1.88 1.65 1.38 1.16 0.15 3.52 3.29 3.02 2.80 000

61020 ............ A Remove brain cavity fluid ..................... 1.51 2.25 2.03 1.49 1.46 0.26 4.02 3.80 3.26 3.23 000

61026 ............ A Injection into brain canal ...................... 1.69 2.11 2.09 1.68 1.77 0.21 4.01 3.99 3.58 3.67 000

61050 ............ A Remove brain canal fluid ..................... 1.51 NA NA 1.54 1.49 0.13 NA NA 3.18 3.13 000

61055 ............ A Injection into brain canal ...................... 2.10 NA NA 1.71 1.79 0.13 NA NA 3.94 4.02 000

61070 ............ A Brain canal shunt procedure ................ 0.89 6.61 5.09 1.16 0.94 0.09 7.59 6.07 2.14 1.92 000

61105 ............ A Twist drill hole ...................................... 5.14 NA NA 3.62 4.25 1.05 NA NA 9.81 10.44 090

61107 ............ A Drill skull for implantation ..................... 5.00 NA NA 3.13 3.84 1.02 NA NA 9.15 9.86 000

61108 ............ A Drill skull for drainage .......................... 10.19 NA NA 6.93 8.24 2.04 NA NA 19.16 20.47 090

61120 ............ A Burr hole for puncture .......................... 8.76 NA NA 5.79 5.96 1.81 NA NA 16.36 16.53 090

61140 ............ A Pierce skull for biopsy .......................... 15.90 NA NA 9.85 11.22 3.15 NA NA 28.90 30.27 090

61150 ............ A Pierce skull for drainage ...................... 17.57 NA NA 10.56 11.90 3.52 NA NA 31.65 32.99 090

61151 ............ A Pierce skull for drainage ...................... 12.42 NA NA 8.20 6.73 2.45 NA NA 23.07 21.60 090

61154 ............ A Pierce skull & remove clot ................... 14.99 NA NA 9.42 11.54 3.05 NA NA 27.46 29.58 090

61156 ............ A Pierce skull for drainage ...................... 16.32 NA NA 10.26 12.09 3.42 NA NA 30.00 31.83 090

61210 ............ A Pierce skull, implant device .................. 5.84 NA NA 3.50 4.26 1.16 NA NA 10.50 11.26 000

61215 ............ A Insert brain-fluid device ........................ 4.89 NA NA 4.19 4.60 0.99 NA NA 10.07 10.48 090

61250 ............ A Pierce skull & explore .......................... 10.42 NA NA 6.68 7.19 2.02 NA NA 19.12 19.63 090

61253 ............ A Pierce skull & explore .......................... 12.36 NA NA 7.31 8.09 2.26 NA NA 21.93 22.71 090

61304 ............ A Open skull for exploration .................... 21.96 NA NA 12.56 15.98 4.33 NA NA 38.85 42.27 090

61305 ............ A Open skull for exploration .................... 26.61 NA NA 14.90 19.07 5.25 NA NA 46.76 50.93 090

61312 ............ A Open skull for drainage ........................ 24.57 NA NA 14.32 17.29 4.99 NA NA 43.88 46.85 090

61313 ............ A Open skull for drainage ........................ 24.93 NA NA 14.54 17.43 5.07 NA NA 44.54 47.43 090

61314 ............ A Open skull for drainage ........................ 24.23 NA NA 12.38 16.24 4.00 NA NA 40.61 44.47 090

61315 ............ A Open skull for drainage ........................ 27.68 NA NA 15.98 18.61 5.62 NA NA 49.28 51.91 090

61320 ............ A Open skull for drainage ........................ 25.62 NA NA 14.92 16.26 5.20 NA NA 45.74 47.08 090

61321 ............ A Open skull for drainage ........................ 28.50 NA NA 15.99 17.37 5.35 NA NA 49.84 51.22 090

61330 ............ A Decompress eye socket ....................... 23.32 NA NA 17.09 16.34 2.58 NA NA 42.99 42.24 090

61332 ............ A Explore/biopsy eye socket ................... 27.28 NA NA 19.47 20.23 4.15 NA NA 50.90 51.66 090

61333 ............ A Explore orbit/remove lesion .................. 27.95 NA NA 16.46 17.90 2.24 NA NA 46.65 48.09 090

61334 ............ A Explore orbit/remove object ................. 18.27 NA NA 11.80 12.83 3.02 NA NA 33.09 34.12 090

61340 ............ A Relieve cranial pressure ....................... 18.66 NA NA 11.49 12.63 3.66 NA NA 33.81 34.95 090

61343 ............ A Incise skull (press relief) ...................... 29.77 NA NA 17.69 21.42 6.04 NA NA 53.50 57.23 090

61345 ............ A Relieve cranial pressure ....................... 27.20 NA NA 16.30 17.43 5.23 NA NA 48.73 49.86 090

61440 ............ A Incise skull for surgery ......................... 26.63 NA NA 16.08 17.69 5.57 NA NA 48.28 49.89 090

61450 ............ A Incise skull for surgery ......................... 25.95 NA NA 14.62 16.51 5.11 NA NA 45.68 47.57 090

61458 ............ A Incise skull for brain wound ................. 27.29 NA NA 15.66 19.15 5.28 NA NA 48.23 51.72 090

61460 ............ A Incise skull for surgery ......................... 28.39 NA NA 16.67 19.30 5.13 NA NA 50.19 52.82 090

61470 ............ A Incise skull for surgery ......................... 26.06 NA NA 14.09 14.33 4.65 NA NA 44.80 45.04 090

61480 ............ A Incise skull for surgery ......................... 26.49 NA NA 13.98 14.57 5.54 NA NA 46.01 46.60 090

61490 ............ A Incise skull for surgery ......................... 25.66 NA NA 14.93 14.38 5.37 NA NA 45.96 45.41 090

61500 ............ A Removal of skull lesion ........................ 17.92 NA NA 10.93 13.55 3.26 NA NA 32.11 34.73 090

61501 ............ A Remove infected skull bone ................. 14.84 NA NA 9.13 11.28 2.63 NA NA 26.60 28.75 090

61510 ............ A Removal of brain lesion ....................... 28.45 NA NA 16.32 19.58 5.77 NA NA 50.54 53.80 090

61512 ............ A Remove brain lining lesion ................... 35.09 NA NA 19.84 22.75 7.14 NA NA 62.07 64.98 090

65493

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

61514 ............ A Removal of brain abscess .................... 25.26 NA NA 14.53 17.82 5.12 NA NA 44.91 48.20 090

61516 ............ A Removal of brain lesion ....................... 24.61 NA NA 14.70 18.21 4.94 NA NA 44.25 47.76 090

61518 ............ A Removal of brain lesion ....................... 37.32 NA NA 21.97 24.62 7.53 NA NA 66.82 69.47 090

61519 ............ A Remove brain lining lesion ................... 41.39 NA NA 23.83 26.34 8.15 NA NA 73.37 75.88 090

61520 ............ A Removal of brain lesion ....................... 54.84 NA NA 31.48 32.80 10.10 NA NA 96.42 97.74 090

61521 ............ A Removal of brain lesion ....................... 44.48 NA NA 25.81 28.30 8.85 NA NA 79.14 81.63 090

61522 ............ A Removal of brain abscess .................... 29.45 NA NA 16.95 18.13 5.30 NA NA 51.70 52.88 090

61524 ............ A Removal of brain lesion ....................... 27.86 NA NA 16.43 19.77 5.01 NA NA 49.30 52.64 090

61526 ............ A Removal of brain lesion ....................... 52.17 NA NA 30.05 31.77 6.72 NA NA 88.94 90.66 090

61530 ............ A Removal of brain lesion ....................... 43.86 NA NA 26.95 29.44 6.17 NA NA 76.98 79.47 090

61531 ............ A Implant brain electrodes ....................... 14.63 NA NA 9.16 10.94 2.84 NA NA 26.63 28.41 090

61533 ............ A Implant brain electrodes ....................... 19.71 NA NA 11.98 13.60 3.80 NA NA 35.49 37.11 090

61534 ............ A Removal of brain lesion ....................... 20.97 NA NA 12.97 11.46 4.15 NA NA 38.09 36.58 090

61535 ............ A Remove brain electrodes ..................... 11.63 NA NA 7.75 7.89 2.29 NA NA 21.67 21.81 090

61536 ............ A Removal of brain lesion ....................... 35.52 NA NA 20.35 21.22 6.68 NA NA 62.55 63.42 090

61538 ............ A Removal of brain tissue ....................... 26.81 NA NA 16.00 19.89 5.38 NA NA 48.19 52.08 090

61539 ............ A Removal of brain tissue ....................... 32.08 NA NA 18.89 20.40 6.62 NA NA 57.59 59.10 090

61541 ............ A Incision of brain tissue ......................... 28.85 NA NA 16.34 17.63 5.50 NA NA 50.69 51.98 090

61542 ............ A Removal of brain tissue ....................... 31.02 NA NA 18.75 19.47 6.49 NA NA 56.26 56.98 090

61543 ............ A Removal of brain tissue ....................... 29.22 NA NA 17.80 18.03 6.11 NA NA 53.13 53.36 090

61544 ............ A Remove & treat brain lesion ................ 25.50 NA NA 12.17 16.74 4.91 NA NA 42.58 47.15 090

61545 ............ A Excision of brain tumor ........................ 43.80 NA NA 24.52 25.35 8.88 NA NA 77.20 78.03 090

61546 ............ A Removal of pituitary gland ................... 31.30 NA NA 18.13 20.93 6.06 NA NA 55.49 58.29 090

61548 ............ A Removal of pituitary gland ................... 21.53 NA NA 13.47 16.53 3.63 NA NA 38.63 41.69 090

61550 ............ A Release of skull seams ........................ 14.65 NA NA 7.52 8.85 1.14 NA NA 23.31 24.64 090

61552 ............ A Release of skull seams ........................ 19.56 NA NA 10.70 11.78 0.88 NA NA 31.14 32.22 090

61556 ............ A Incise skull/sutures ............................... 22.26 NA NA 12.44 13.54 3.57 NA NA 38.27 39.37 090

61557 ............ A Incise skull/sutures ............................... 22.38 NA NA 12.84 13.87 4.68 NA NA 39.90 40.93 090

61558 ............ A Excision of skull/sutures ....................... 25.58 NA NA 12.59 14.26 2.61 NA NA 40.78 42.45 090

61559 ............ A Excision of skull/sutures ....................... 32.79 NA NA 18.98 20.48 6.86 NA NA 58.63 60.13 090

61563 ............ A Excision of skull tumor ......................... 26.83 NA NA 15.92 17.04 4.46 NA NA 47.21 48.33 090

61564 ............ A Excision of skull tumor ......................... 33.83 NA NA 19.23 20.86 7.08 NA NA 60.14 61.77 090

61570 ............ A Remove foreign body, brain ................. 24.60 NA NA 13.38 14.51 4.60 NA NA 42.58 43.71 090

61571 ............ A Incise skull for brain wound ................. 26.39 NA NA 14.97 16.20 5.23 NA NA 46.59 47.82 090

61575 ............ A Skull base/brainstem surgery ............... 34.36 NA NA 20.91 24.63 5.02 NA NA 60.29 64.01 090

61576 ............ A Skull base/brainstem surgery ............... 52.43 NA NA 29.71 29.94 4.68 NA NA 86.82 87.05 090

61580 ............ A Craniofacial approach, skull ................. 30.35 NA NA 19.34 20.21 2.75 NA NA 52.44 53.31 090

61581 ............ A Craniofacial approach, skull ................. 34.60 NA NA 21.58 22.65 3.37 NA NA 59.55 60.62 090

61582 ............ A Craniofacial approach, skull ................. 31.66 NA NA 19.27 20.33 6.30 NA NA 57.23 58.29 090

61583 ............ A Craniofacial approach, skull ................. 36.21 NA NA 22.22 23.37 6.94 NA NA 65.37 66.52 090

61584 ............ A Orbitocranial approach/skull ................. 34.65 NA NA 20.79 22.08 6.53 NA NA 61.97 63.26 090

61585 ............ A Orbitocranial approach/skull ................. 38.61 NA NA 22.70 24.28 6.19 NA NA 67.50 69.08 090

61586 ............ A Resect nasopharynx, skull ................... 25.10 NA NA 15.96 17.77 3.52 NA NA 44.58 46.39 090

61590 ............ A Infratemporal approach/skull ................ 41.78 NA NA 25.53 27.04 4.28 NA NA 71.59 73.10 090

61591 ............ A Infratemporal approach/skull ................ 43.68 NA NA 26.58 28.22 5.26 NA NA 75.52 77.16 090

61592 ............ A Orbitocranial approach/skull ................. 39.64 NA NA 23.29 24.98 7.55 NA NA 70.48 72.17 090

61595 ............ A Transtemporal approach/skull .............. 29.57 NA NA 19.23 19.97 3.05 NA NA 51.85 52.59 090

61596 ............ A Transcochlear approach/skull .............. 35.63 NA NA 22.03 23.26 4.25 NA NA 61.91 63.14 090

61597 ............ A Transcondylar approach/skull .............. 37.96 NA NA 21.88 23.54 6.65 NA NA 66.49 68.15 090

61598 ............ A Transpetrosal approach/skull ............... 33.41 NA NA 20.63 21.75 4.60 NA NA 58.64 59.76 090

61600 ............ A Resect/excise cranial lesion ................. 25.85 NA NA 16.56 17.23 3.12 NA NA 45.53 46.20 090

61601 ............ A Resect/excise cranial lesion ................. 27.89 NA NA 17.07 17.97 5.29 NA NA 50.25 51.15 090

61605 ............ A Resect/excise cranial lesion ................. 29.33 NA NA 18.45 19.29 2.51 NA NA 50.29 51.13 090

61606 ............ A Resect/excise cranial lesion ................. 38.83 NA NA 23.10 24.62 6.81 NA NA 68.74 70.26 090

61607 ............ A Resect/excise cranial lesion ................. 36.27 NA NA 21.76 23.14 5.69 NA NA 63.72 65.10 090

61608 ............ A Resect/excise cranial lesion ................. 42.10 NA NA 24.41 26.24 8.31 NA NA 74.82 76.65 090

61609 ............ A Transect artery, sinus ........................... 9.89 NA NA 4.60 5.40 2.07 NA NA 16.56 17.36 ZZZ

61610 ............ A Transect artery, sinus ........................... 29.67 NA NA 12.44 15.18 3.52 NA NA 45.63 48.37 ZZZ

61611 ............ A Transect artery, sinus ........................... 7.42 NA NA 2.97 3.69 1.55 NA NA 11.94 12.66 ZZZ

61612 ............ A Transect artery, sinus ........................... 27.88 NA NA 14.40 16.30 3.55 NA NA 45.83 47.73 ZZZ

61613 ............ A Remove aneurysm, sinus ..................... 40.86 NA NA 23.85 25.67 8.32 NA NA 73.03 74.85 090

61615 ............ A Resect/excise lesion, skull ................... 32.07 NA NA 20.34 21.24 4.64 NA NA 57.05 57.95 090

61616 ............ A Resect/excise lesion, skull ................... 43.33 NA NA 26.84 28.28 7.02 NA NA 77.19 78.63 090

61618 ............ A Repair dura ........................................... 16.99 NA NA 11.19 11.47 2.92 NA NA 31.10 31.38 090

61619 ............ A Repair dura ........................................... 20.71 NA NA 13.21 13.76 3.42 NA NA 37.34 37.89 090

61624 ............ A Occlusion/embolization cath ................. 20.15 NA NA 7.37 9.67 1.15 NA NA 28.67 30.97 000

61626 ............ A Occlusion/embolization cath ................. 16.62 NA NA 5.97 7.90 0.84 NA NA 23.43 25.36 000

61680 ............ A Intracranial vessel surgery ................... 30.71 NA NA 18.38 22.21 6.04 NA NA 55.13 58.96 090

61682 ............ A Intracranial vessel surgery ................... 61.57 NA NA 33.79 34.92 12.69 NA NA 108.05 109.18 090

61684 ............ A Intracranial vessel surgery ................... 39.81 NA NA 21.84 24.46 7.87 NA NA 69.52 72.14 090

61686 ............ A Intracranial vessel surgery ................... 64.49 NA NA 35.92 36.70 13.20 NA NA 113.61 114.39 090

61690 ............ A Intracranial vessel surgery ................... 29.31 NA NA 17.53 20.60 5.51 NA NA 52.35 55.42 090

61692 ............ A Intracranial vessel surgery ................... 51.87 NA NA 29.08 29.62 10.17 NA NA 91.12 91.66 090

61697 ............ A Brain aneurysm repr, complx ............... 50.52 NA NA 27.76 27.76 9.57 NA NA 87.85 87.85 090

61698 ............ A Brain aneurysm repr, complx ............... 48.41 NA NA 26.87 26.87 9.28 NA NA 84.56 84.56 090

61700 ............ A Brain aneurysm repr , simple ............... 50.52 NA NA 27.76 29.42 10.18 NA NA 88.46 90.12 090

61702 ............ A Inner skull vessel surgery .................... 48.41 NA NA 26.87 30.01 9.75 NA NA 85.03 88.17 090

61703 ............ A Clamp neck artery ................................ 17.47 NA NA 10.99 11.56 3.62 NA NA 32.08 32.65 090

61705 ............ A Revise circulation to head .................... 36.20 NA NA 20.20 23.40 6.67 NA NA 63.07 66.27 090

61708 ............ A Revise circulation to head .................... 35.30 NA NA 16.08 18.90 2.18 NA NA 53.56 56.38 090

61710 ............ A Revise circulation to head .................... 29.67 NA NA 14.40 15.31 2.42 NA NA 46.49 47.40 090

61711 ............ A Fusion of skull arteries ......................... 36.33 NA NA 20.00 23.97 7.39 NA NA 63.72 67.69 090

61720 ............ A Incise skull/brain surgery ...................... 16.77 NA NA 10.72 13.05 3.51 NA NA 31.00 33.33 090

65494

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

61735 ............ A Incise skull/brain surgery ...................... 20.43 NA NA 12.60 12.97 4.16 NA NA 37.19 37.56 090

61750 ............ A Incise skull/brain biopsy ....................... 18.20 NA NA 11.02 11.94 3.71 NA NA 32.93 33.85 090

61751 ............ A Brain biopsy w/ ct/mr guide .................. 17.62 NA NA 10.75 13.32 3.57 NA NA 31.94 34.51 090

61760 ............ A Implant brain electrodes ....................... 22.27 NA NA 13.16 13.94 4.59 NA NA 40.02 40.80 090

61770 ............ A Incise skull for treatment ...................... 21.44 NA NA 12.79 14.85 4.09 NA NA 38.32 40.38 090

61790 ............ A Treat trigeminal nerve .......................... 10.86 NA NA 6.12 7.83 1.82 NA NA 18.80 20.51 090

61791 ............ A Treat trigeminal tract ............................ 14.61 NA NA 9.28 9.61 3.03 NA NA 26.92 27.25 090

61793 ............ A Focus radiation beam ........................... 17.24 NA NA 10.87 13.30 3.51 NA NA 31.62 34.05 090

61795 ............ A Brain surgery using computer .............. 4.04 NA NA 2.09 2.77 0.81 NA NA 6.94 7.62 ZZZ

61850 ............ A Implant neuroelectrodes ....................... 12.39 NA NA 7.94 9.11 2.23 NA NA 22.56 23.73 090

61860 ............ A Implant neuroelectrodes ....................... 20.87 NA NA 12.74 11.76 4.04 NA NA 37.65 36.67 090

61862 ............ A Implant neurostimul, subcort ................ 19.34 NA NA 11.99 11.99 3.97 NA NA 35.30 35.30 090

61870 ............ A Implant neuroelectrodes ....................... 14.94 NA NA 11.36 9.66 1.70 NA NA 28.00 26.30 090

61875 ............ A Implant neuroelectrodes ....................... 15.06 NA NA 10.00 9.32 2.42 NA NA 27.48 26.80 090

61880 ............ A Revise/remove neuroelectrode ............ 6.29 NA NA 5.24 5.23 1.31 NA NA 12.84 12.83 090

61885 ............ A Implant neurostim one array ................ 5.85 NA NA 4.29 3.75 1.22 NA NA 11.36 10.82 090

61886 ............ A Implant neurostim arrays ...................... 8.00 NA NA 6.09 6.09 1.64 NA NA 15.73 15.73 090

61888 ............ A Revise/remove neuroreceiver .............. 5.07 NA NA 3.88 3.52 1.04 NA NA 9.99 9.63 010

62000 ............ A Treat skull fracture ............................... 12.53 NA NA 5.41 5.61 0.87 NA NA 18.81 19.01 090

62005 ............ A Treat skull fracture ............................... 16.17 NA NA 8.93 9.70 2.33 NA NA 27.43 28.20 090

62010 ............ A Treatment of head injury ...................... 19.81 NA NA 11.61 13.92 4.05 NA NA 35.47 37.78 090

62100 ............ A Repair brain fluid leakage .................... 22.03 NA NA 13.94 16.32 4.07 NA NA 40.04 42.42 090

62115 ............ A Reduction of skull defect ...................... 21.66 NA NA 10.63 12.18 4.53 NA NA 36.82 38.37 090

62116 ............ A Reduction of skull defect ...................... 23.59 NA NA 13.78 14.94 4.85 NA NA 42.22 43.38 090

62117 ............ A Reduction of skull defect ...................... 26.60 NA NA 15.18 16.60 5.56 NA NA 47.34 48.76 090

62120 ............ A Repair skull cavity lesion ...................... 23.35 NA NA 14.18 15.22 3.07 NA NA 40.60 41.64 090

62121 ............ A Incise skull repair ................................. 21.58 NA NA 13.78 15.09 2.47 NA NA 37.83 39.14 090

62140 ............ A Repair of skull defect ........................... 13.51 NA NA 8.54 10.05 2.60 NA NA 24.65 26.16 090

62141 ............ A Repair of skull defect ........................... 14.91 NA NA 9.70 11.73 2.85 NA NA 27.46 29.49 090

62142 ............ A Remove skull plate/flap ........................ 10.79 NA NA 7.20 8.62 2.10 NA NA 20.09 21.51 090

62143 ............ A Replace skull plate/flap ........................ 13.05 NA NA 8.67 8.99 2.55 NA NA 24.27 24.59 090

62145 ............ A Repair of skull & brain .......................... 18.82 NA NA 11.29 12.04 3.81 NA NA 33.92 34.67 090

62146 ............ A Repair of skull with graft ...................... 16.12 NA NA 10.39 10.78 2.94 NA NA 29.45 29.84 090

62147 ............ A Repair of skull with graft ...................... 19.34 NA NA 12.21 12.73 3.64 NA NA 35.19 35.71 090

62180 ............ A Establish brain cavity shunt ................. 21.06 NA NA 12.86 13.50 4.32 NA NA 38.24 38.88 090

62190 ............ A Establish brain cavity shunt ................. 11.07 NA NA 7.65 9.04 2.18 NA NA 20.90 22.29 090

62192 ............ A Establish brain cavity shunt ................. 12.25 NA NA 8.21 9.82 2.46 NA NA 22.92 24.53 090

62194 ............ A Replace/irrigate catheter ...................... 5.03 NA NA 2.08 2.07 0.50 NA NA 7.61 7.60 010

62200 ............ A Establish brain cavity shunt ................. 18.32 NA NA 11.41 13.16 3.70 NA NA 33.43 35.18 090

62201 ............ A Establish brain cavity shunt ................. 14.86 NA NA 9.18 9.27 2.52 NA NA 26.56 26.65 090

62220 ............ A Establish brain cavity shunt ................. 13.00 NA NA 8.63 10.35 2.53 NA NA 24.16 25.88 090

62223 ............ A Establish brain cavity shunt ................. 12.87 NA NA 8.45 10.18 2.58 NA NA 23.90 25.63 090

62225 ............ A Replace/irrigate catheter ...................... 5.41 NA NA 4.06 4.35 1.09 NA NA 10.56 10.85 090

62230 ............ A Replace/revise brain shunt ................... 10.54 NA NA 6.59 7.61 2.10 NA NA 19.23 20.25 090

62252 ............ A Csf shunt reprogram ............................ 0.74 1.40 1.40 1.40 1.40 0.04 2.18 2.18 2.18 2.18 XXX

62252 26 A Csf shunt reprogram ............................ 0.74 0.30 0.30 0.30 0.30 0.02 1.06 1.06 1.06 1.06 XXX

62252 TC A Csf shunt reprogram ............................ 0.00 1.10 1.10 NA NA 0.02 1.12 1.12 NA NA XXX

62256 ............ A Remove brain cavity shunt ................... 6.60 NA NA 5.34 5.74 1.34 NA NA 13.28 13.68 090

62258 ............ A Replace brain cavity shunt ................... 14.54 NA NA 8.65 10.50 2.91 NA NA 26.10 27.95 090

62263 ............ A Lysis epidural adhesions ...................... 6.14 5.70 5.70 2.29 2.29 0.42 12.26 12.26 8.85 8.85 010

62268 ............ A Drain spinal cord cyst ........................... 4.74 NA NA 2.71 2.84 0.29 NA NA 7.74 7.87 000

62269 ............ A Needle biopsy, spinal cord ................... 5.02 NA NA 2.33 2.22 0.29 NA NA 7.64 7.53 000

62270 ............ A Spinal fluid tap, diagnostic ................... 1.13 3.49 2.81 0.46 0.54 0.06 4.68 4.00 1.65 1.73 000

62272 ............ A Drain spinal fluid ................................... 1.35 3.00 2.53 0.61 0.73 0.13 4.48 4.01 2.09 2.21 000

62273 ............ A Treat epidural spine lesion ................... 2.15 1.31 1.29 1.25 1.24 0.14 3.60 3.58 3.54 3.53 000

62280 ............ A Treat spinal cord lesion ........................ 2.63 3.44 2.77 0.70 0.72 0.17 6.24 5.57 3.50 3.52 010

62281 ............ A Treat spinal cord lesion ........................ 2.66 3.76 3.06 0.61 0.69 0.16 6.58 5.88 3.43 3.51 010

62282 ............ A Treat spinal canal lesion ...................... 2.33 5.24 4.39 0.61 0.92 0.14 7.71 6.86 3.08 3.39 010

62284 ............ A Injection for myelogram ........................ 1.54 4.04 3.57 0.70 0.98 0.10 5.68 5.21 2.34 2.62 000

62287 ............ A Percutaneous diskectomy .................... 8.08 NA NA 4.70 5.41 0.66 NA NA 13.44 14.15 090

62290 ............ A Inject for spine disk x-ray ..................... 3.00 5.20 4.41 1.27 1.46 0.20 8.40 7.61 4.47 4.66 000

62291 ............ A Inject for spine disk x-ray ..................... 2.91 5.29 4.45 1.16 1.35 0.17 8.37 7.53 4.24 4.43 000

62292 ............ A Injection into disk lesion ....................... 7.86 NA NA 4.74 5.90 0.65 NA NA 13.25 14.41 090

62294 ............ A Injection into spinal artery .................... 11.83 NA NA 6.08 6.15 0.85 NA NA 18.76 18.83 090

62310 ............ A Inject spine c/t ...................................... 1.91 3.60 3.60 0.43 0.43 0.11 5.62 5.62 2.45 2.45 000

62311 ............ A Inject spine l/s (cd) ............................... 1.54 3.88 3.88 0.37 0.37 0.09 5.51 5.51 2.00 2.00 000

62318 ............ A Inject spine w/cath, c/t .......................... 2.04 3.66 3.66 0.46 0.46 0.12 5.82 5.82 2.62 2.62 000

62319 ............ A Inject spine w/cath l/s (cd) ................... 1.87 3.14 3.14 0.39 0.39 0.11 5.12 5.12 2.37 2.37 000

62350 ............ A Implant spinal canal cath ..................... 6.87 NA NA 3.66 3.69 0.64 NA NA 11.17 11.20 090

62351 ............ A Implant spinal canal cath ..................... 10.00 NA NA 6.78 6.49 1.79 NA NA 18.57 18.28 090

62355 ............ A Remove spinal canal catheter .............. 5.45 NA NA 2.77 3.03 0.47 NA NA 8.69 8.95 090

62360 ............ A Insert spine infusion device .................. 2.62 NA NA 2.19 1.95 0.21 NA NA 5.02 4.78 090

62361 ............ A Implant spine infusion pump ................ 5.42 NA NA 3.53 3.38 0.50 NA NA 9.45 9.30 090

62362 ............ A Implant spine infusion pump ................ 7.04 NA NA 4.07 4.01 0.86 NA NA 11.97 11.91 090

62365 ............ A Remove spine infusion device ............. 5.42 NA NA 3.04 3.22 0.58 NA NA 9.04 9.22 090

62367 ............ C Analyze spine infusion pump ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

62367 26 A Analyze spine infusion pump ............... 0.48 0.14 0.20 0.14 0.20 0.03 0.65 0.71 0.65 0.71 XXX

62367 TC C Analyze spine infusion pump ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

62368 ............ C Analyze spine infusion pump ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

62368 26 A Analyze spine infusion pump ............... 0.75 0.20 0.30 0.20 0.30 0.05 1.00 1.10 1.00 1.10 XXX

62368 TC C Analyze spine infusion pump ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

63001 ............ A Removal of spinal lamina ..................... 15.82 NA NA 11.50 13.35 3.03 NA NA 30.35 32.20 090

63003 ............ A Removal of spinal lamina ..................... 15.95 NA NA 11.65 13.50 2.98 NA NA 30.58 32.43 090

65495

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

63005 ............ A Removal of spinal lamina ..................... 14.92 NA NA 11.12 12.79 2.62 NA NA 28.66 30.33 090

63011 ............ A Removal of spinal lamina ..................... 14.52 NA NA 9.27 9.66 1.43 NA NA 25.22 25.61 090

63012 ............ A Removal of spinal lamina ..................... 15.40 NA NA 10.09 12.16 2.71 NA NA 28.20 30.27 090

63015 ............ A Removal of spinal lamina ..................... 19.35 NA NA 13.36 15.78 3.84 NA NA 36.55 38.97 090

63016 ............ A Removal of spinal lamina ..................... 19.20 NA NA 13.34 15.74 3.62 NA NA 36.16 38.56 090

63017 ............ A Removal of spinal lamina ..................... 15.94 NA NA 11.64 13.49 2.91 NA NA 30.49 32.34 090

63020 ............ A Neck spine disk surgery ....................... 14.81 NA NA 11.05 12.64 2.89 NA NA 28.75 30.34 090

63030 ............ A Low back disk surgery ......................... 12.00 NA NA 9.62 10.80 2.21 NA NA 23.83 25.01 090

63035 ............ A Spinal disk surgery add-on .................. 3.15 NA NA 1.64 2.17 0.57 NA NA 5.36 5.89 ZZZ

63040 ............ A Laminotomy, single cervical ................. 18.81 NA NA 12.98 15.35 3.36 NA NA 35.15 37.52 090

63042 ............ A Laminotomy, single lumbar .................. 17.47 NA NA 12.60 14.67 3.11 NA NA 33.18 35.25 090

63043 ............ B Laminotomy, addl cervical .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

63044 ............ B Laminotomy, addl lumbar ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

63045 ............ A Removal of spinal lamina ..................... 16.50 NA NA 11.95 13.89 3.19 NA NA 31.64 33.58 090

63046 ............ A Removal of spinal lamina ..................... 15.80 NA NA 11.60 13.42 2.89 NA NA 30.29 32.11 090

63047 ............ A Removal of spinal lamina ..................... 14.61 NA NA 11.05 12.65 2.61 NA NA 28.27 29.87 090

63048 ............ A Remove spinal lamina add-on ............. 3.26 NA NA 1.73 2.27 0.58 NA NA 5.57 6.11 ZZZ

63055 ............ A Decompress spinal cord ....................... 21.99 NA NA 14.74 17.49 4.09 NA NA 40.82 43.57 090

63056 ............ A Decompress spinal cord ....................... 20.36 NA NA 14.01 16.43 3.34 NA NA 37.71 40.13 090

63057 ............ A Decompress spine cord add-on ........... 5.26 NA NA 2.66 3.04 0.81 NA NA 8.73 9.11 ZZZ

63064 ............ A Decompress spinal cord ....................... 24.61 NA NA 16.68 18.98 4.72 NA NA 46.01 48.31 090

63066 ............ A Decompress spine cord add-on ........... 3.26 NA NA 1.74 1.98 0.63 NA NA 5.63 5.87 ZZZ

63075 ............ A Neck spine disk surgery ....................... 19.41 NA NA 13.50 14.89 3.73 NA NA 36.64 38.03 090

63076 ............ A Neck spine disk surgery ....................... 4.05 NA NA 2.13 2.81 0.78 NA NA 6.96 7.64 ZZZ

63077 ............ A Spine disk surgery, thorax ................... 21.44 NA NA 15.13 16.35 3.44 NA NA 40.01 41.23 090

63078 ............ A Spine disk surgery, thorax ................... 3.28 NA NA 1.70 1.98 0.50 NA NA 5.48 5.76 ZZZ

63081 ............ A Removal of vertebral body ................... 23.73 NA NA 16.33 19.33 4.46 NA NA 44.52 47.52 090

63082 ............ A Remove vertebral body add-on ............ 4.37 NA NA 2.31 3.04 0.82 NA NA 7.50 8.23 ZZZ

63085 ............ A Removal of vertebral body ................... 26.92 NA NA 18.32 21.17 4.70 NA NA 49.94 52.79 090

63086 ............ A Remove vertebral body add-on ............ 3.19 NA NA 1.66 2.20 0.55 NA NA 5.40 5.94 ZZZ

63087 ............ A Removal of vertebral body ................... 35.57 NA NA 22.20 24.32 5.87 NA NA 63.64 65.76 090

63088 ............ A Remove vertebral body add-on ............ 4.33 NA NA 2.28 3.00 0.77 NA NA 7.38 8.10 ZZZ

63090 ............ A Removal of vertebral body ................... 28.16 NA NA 18.11 21.51 4.27 NA NA 50.54 53.94 090

63091 ............ A Remove vertebral body add-on ............ 3.03 NA NA 1.53 1.89 0.45 NA NA 5.01 5.37 ZZZ

63170 ............ A Incise spinal cord tract(s) ..................... 19.83 NA NA 13.58 15.31 3.89 NA NA 37.30 39.03 090

63172 ............ A Drainage of spinal cyst ......................... 17.66 NA NA 13.03 15.05 3.46 NA NA 34.15 36.17 090

63173 ............ A Drainage of spinal cyst ......................... 21.99 NA NA 14.78 15.28 4.14 NA NA 40.91 41.41 090

63180 ............ A Revise spinal cord ligaments ............... 18.27 NA NA 12.42 12.47 3.83 NA NA 34.52 34.57 090

63182 ............ A Revise spinal cord ligaments ............... 20.50 NA NA 12.87 14.11 3.48 NA NA 36.85 38.09 090

63185 ............ A Incise spinal column/nerves ................. 15.04 NA NA 9.73 11.52 2.08 NA NA 26.85 28.64 090

63190 ............ A Incise spinal column/nerves ................. 17.45 NA NA 12.03 14.23 2.88 NA NA 32.36 34.56 090

63191 ............ A Incise spinal column/nerves ................. 17.54 NA NA 12.37 12.82 3.50 NA NA 33.41 33.86 090

63194 ............ A Incise spinal column & cord ................. 19.19 NA NA 13.11 13.37 4.01 NA NA 36.31 36.57 090

63195 ............ A Incise spinal column & cord ................. 18.84 NA NA 12.13 12.86 3.44 NA NA 34.41 35.14 090

63196 ............ A Incise spinal column & cord ................. 22.30 NA NA 12.37 13.51 4.66 NA NA 39.33 40.47 090

63197 ............ A Incise spinal column & cord ................. 21.11 NA NA 13.71 14.18 4.42 NA NA 39.24 39.71 090

63198 ............ A Incise spinal column & cord ................. 25.38 NA NA 13.60 14.63 5.31 NA NA 44.29 45.32 090

63199 ............ A Incise spinal column & cord ................. 26.89 NA NA 14.20 16.46 5.62 NA NA 46.71 48.97 090

63200 ............ A Release of spinal cord ......................... 19.18 NA NA 13.09 13.21 3.61 NA NA 35.88 36.00 090

63250 ............ A Revise spinal cord vessels ................... 40.76 NA NA 20.95 23.31 7.65 NA NA 69.36 71.72 090

63251 ............ A Revise spinal cord vessels ................... 41.20 NA NA 23.04 23.45 7.98 NA NA 72.22 72.63 090

63252 ............ A Revise spinal cord vessels ................... 41.19 NA NA 22.40 24.47 7.75 NA NA 71.34 73.41 090

63265 ............ A Excise intraspinal lesion ....................... 21.56 NA NA 13.17 15.85 4.29 NA NA 39.02 41.70 090

63266 ............ A Excise intraspinal lesion ....................... 22.30 NA NA 13.51 16.79 4.47 NA NA 40.28 43.56 090

63267 ............ A Excise intraspinal lesion ....................... 17.95 NA NA 11.32 13.85 3.50 NA NA 32.77 35.30 090

63268 ............ A Excise intraspinal lesion ....................... 18.52 NA NA 10.83 11.53 3.18 NA NA 32.53 33.23 090

63270 ............ A Excise intraspinal lesion ....................... 26.80 NA NA 15.90 16.85 5.41 NA NA 48.11 49.06 090

63271 ............ A Excise intraspinal lesion ....................... 26.92 NA NA 16.01 19.23 5.56 NA NA 48.49 51.71 090

63272 ............ A Excise intraspinal lesion ....................... 25.32 NA NA 15.17 17.66 5.07 NA NA 45.56 48.05 090

63273 ............ A Excise intraspinal lesion ....................... 24.29 NA NA 14.60 15.72 5.08 NA NA 43.97 45.09 090

63275 ............ A Biopsy/excise spinal tumor ................... 23.68 NA NA 14.12 17.66 4.68 NA NA 42.48 46.02 090

63276 ............ A Biopsy/excise spinal tumor ................... 23.45 NA NA 14.04 17.40 4.63 NA NA 42.12 45.48 090

63277 ............ A Biopsy/excise spinal tumor ................... 20.83 NA NA 12.82 15.83 4.03 NA NA 37.68 40.69 090

63278 ............ A Biopsy/excise spinal tumor ................... 20.56 NA NA 12.48 15.50 4.02 NA NA 37.06 40.08 090

63280 ............ A Biopsy/excise spinal tumor ................... 28.35 NA NA 16.64 20.10 5.80 NA NA 50.79 54.25 090

63281 ............ A Biopsy/excise spinal tumor ................... 28.05 NA NA 16.39 19.80 5.67 NA NA 50.11 53.52 090

63282 ............ A Biopsy/excise spinal tumor ................... 26.39 NA NA 15.60 18.24 5.33 NA NA 47.32 49.96 090

63283 ............ A Biopsy/excise spinal tumor ................... 25.00 NA NA 14.83 16.22 5.12 NA NA 44.95 46.34 090

63285 ............ A Biopsy/excise spinal tumor ................... 36.00 NA NA 20.26 21.84 7.31 NA NA 63.57 65.15 090

63286 ............ A Biopsy/excise spinal tumor ................... 35.63 NA NA 20.36 23.07 7.07 NA NA 63.06 65.77 090

63287 ............ A Biopsy/excise spinal tumor ................... 36.70 NA NA 20.74 22.53 7.48 NA NA 64.92 66.71 090

63290 ............ A Biopsy/excise spinal tumor ................... 37.38 NA NA 21.36 23.39 7.65 NA NA 66.39 68.42 090

63300 ............ A Removal of vertebral body ................... 24.43 NA NA 14.84 15.82 4.78 NA NA 44.05 45.03 090

63301 ............ A Removal of vertebral body ................... 27.60 NA NA 16.07 17.06 5.03 NA NA 48.70 49.69 090

63302 ............ A Removal of vertebral body ................... 27.81 NA NA 16.16 17.92 5.25 NA NA 49.22 50.98 090

63303 ............ A Removal of vertebral body ................... 30.50 NA NA 17.50 18.15 5.21 NA NA 53.21 53.86 090

63304 ............ A Removal of vertebral body ................... 30.33 NA NA 16.19 17.93 4.72 NA NA 51.24 52.98 090

63305 ............ A Removal of vertebral body ................... 32.03 NA NA 19.10 20.43 5.39 NA NA 56.52 57.85 090

63306 ............ A Removal of vertebral body ................... 32.22 NA NA 16.63 18.65 2.39 NA NA 51.24 53.26 090

63307 ............ A Removal of vertebral body ................... 31.63 NA NA 18.42 20.44 4.23 NA NA 54.28 56.30 090

63308 ............ A Remove vertebral body add-on ............ 5.25 NA NA 2.74 3.16 1.01 NA NA 9.00 9.42 ZZZ

63600 ............ A Remove spinal cord lesion ................... 14.02 NA NA 5.90 7.33 1.22 NA NA 21.14 22.57 090

63610 ............ A Stimulation of spinal cord ..................... 8.73 NA NA 5.09 5.64 0.43 NA NA 14.25 14.80 000

65496

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

63615 ............ A Remove lesion of spinal cord ............... 16.28 NA NA 10.42 10.95 2.85 NA NA 29.55 30.08 090

63650 ............ A Implant neuroelectrodes ....................... 6.74 NA NA 2.99 4.25 0.48 NA NA 10.21 11.47 090

63655 ............ A Implant neuroelectrodes ....................... 10.29 NA NA 7.12 8.41 1.85 NA NA 19.26 20.55 090

63660 ............ A Revise/remove neuroelectrode ............ 6.16 NA NA 3.63 4.56 0.65 NA NA 10.44 11.37 090

63685 ............ A Implant neuroreceiver ........................... 7.04 NA NA 4.41 5.32 0.96 NA NA 12.41 13.32 090

63688 ............ A Revise/remove neuroreceiver .............. 5.39 NA NA 3.67 4.36 0.70 NA NA 9.76 10.45 090

63700 ............ A Repair of spinal herniation ................... 16.53 NA NA 10.39 10.87 2.69 NA NA 29.61 30.09 090

63702 ............ A Repair of spinal herniation ................... 18.48 NA NA 10.46 11.31 1.36 NA NA 30.30 31.15 090

63704 ............ A Repair of spinal herniation ................... 21.18 NA NA 12.22 13.02 3.84 NA NA 37.24 38.04 090

63706 ............ A Repair of spinal herniation ................... 24.11 NA NA 13.91 14.86 4.73 NA NA 42.75 43.70 090

63707 ............ A Repair spinal fluid leakage ................... 11.26 NA NA 7.85 9.25 1.96 NA NA 21.07 22.47 090

63709 ............ A Repair spinal fluid leakage ................... 14.32 NA NA 9.61 11.48 2.49 NA NA 26.42 28.29 090

63710 ............ A Graft repair of spine defect .................. 14.07 NA NA 9.34 9.65 2.61 NA NA 26.02 26.33 090

63740 ............ A Install spinal shunt ................................ 11.36 NA NA 7.54 9.05 2.15 NA NA 21.05 22.56 090

63741 ............ A Install spinal shunt ................................ 8.25 NA NA 4.70 5.99 1.05 NA NA 14.00 15.29 090

63744 ............ A Revision of spinal shunt ....................... 8.10 NA NA 5.48 6.32 1.51 NA NA 15.09 15.93 090

63746 ............ A Removal of spinal shunt ....................... 6.43 NA NA 4.55 4.91 1.15 NA NA 12.13 12.49 090

64400 ............ A Injection for nerve block ....................... 1.11 2.71 2.16 0.27 0.27 0.06 3.88 3.33 1.44 1.44 000

64402 ............ A Injection for nerve block ....................... 1.25 3.91 3.10 0.45 0.51 0.07 5.23 4.42 1.77 1.83 000

64405 ............ A Injection for nerve block ....................... 1.32 2.52 2.06 0.31 0.32 0.08 3.92 3.46 1.71 1.72 000

64408 ............ A Injection for nerve block ....................... 1.41 2.94 2.49 0.69 0.66 0.09 4.44 3.99 2.19 2.16 000

64410 ............ A Injection for nerve block ....................... 1.43 2.53 2.09 0.30 0.42 0.08 4.04 3.60 1.81 1.93 000

64412 ............ A Injection for nerve block ....................... 1.18 2.67 2.17 0.27 0.29 0.08 3.93 3.43 1.53 1.55 000

64413 ............ A Injection for nerve block ....................... 1.40 2.85 2.34 0.36 0.37 0.09 4.34 3.83 1.85 1.86 000

64415 ............ A Injection for nerve block ....................... 1.48 2.64 2.05 0.31 0.30 0.08 4.20 3.61 1.87 1.86 000

64417 ............ A Injection for nerve block ....................... 1.44 2.68 2.18 0.33 0.42 0.09 4.21 3.71 1.86 1.95 000

64418 ............ A Injection for nerve block ....................... 1.32 2.46 2.08 0.29 0.33 0.07 3.85 3.47 1.68 1.72 000

64420 ............ A Injection for nerve block ....................... 1.18 2.46 2.02 0.27 0.38 0.07 3.71 3.27 1.52 1.63 000

64421 ............ A Injection for nerve block ....................... 1.68 2.86 2.37 0.39 0.52 0.10 4.64 4.15 2.17 2.30 000

64425 ............ A Injection for nerve block ....................... 1.75 2.40 1.96 0.40 0.46 0.11 4.26 3.82 2.26 2.32 000

64430 ............ A Injection for nerve block ....................... 1.46 2.66 2.19 0.43 0.51 0.11 4.23 3.76 2.00 2.08 000

64435 ............ A Injection for nerve block ....................... 1.45 2.94 2.33 0.54 0.47 0.15 4.54 3.93 2.14 2.07 000

64445 ............ A Injection for nerve block ....................... 1.48 3.41 2.69 0.34 0.32 0.08 4.97 4.25 1.90 1.88 000

64450 ............ A Injection for nerve block ....................... 1.27 1.69 1.41 0.33 0.32 0.08 3.04 2.76 1.68 1.67 000

64470 ............ A Inj paravertebral c/t .............................. 1.85 3.94 3.94 0.50 0.50 0.12 5.91 5.91 2.47 2.47 000

64472 ............ A Inj paravertebral c/t add-on .................. 1.29 3.63 3.63 0.35 0.35 0.09 5.01 5.01 1.73 1.73 ZZZ

64475 ............ A Inj paravertebral l/s ............................... 1.41 3.77 3.77 0.38 0.38 0.09 5.27 5.27 1.88 1.88 000

64476 ............ A Inj paravertebral l/s add-on .................. 0.98 4.16 4.16 0.26 0.26 0.06 5.20 5.20 1.30 1.30 ZZZ

64479 ............ A Inj foramen epidural c/t ........................ 2.20 4.04 4.04 0.62 0.62 0.14 6.38 6.38 2.96 2.96 000

64480 ............ A Inj foramen epidural add-on ................. 1.54 4.23 4.23 0.43 0.43 0.09 5.86 5.86 2.06 2.06 ZZZ

64483 ............ A Inj foramen epidural l/s ......................... 1.90 3.92 3.92 0.54 0.54 0.12 5.94 5.94 2.56 2.56 000

64484 ............ A Inj foramen epidural add-on ................. 1.33 4.15 4.15 0.37 0.37 0.08 5.56 5.56 1.78 1.78 ZZZ

64505 ............ A Injection for nerve block ....................... 1.36 2.40 1.97 0.35 0.35 0.08 3.84 3.41 1.79 1.79 000

64508 ............ A Injection for nerve block ....................... 1.12 2.94 2.49 0.39 0.44 0.06 4.12 3.67 1.57 1.62 000

64510 ............ A Injection for nerve block ....................... 1.22 2.63 2.17 0.26 0.39 0.07 3.92 3.46 1.55 1.68 000

64520 ............ A Injection for nerve block ....................... 1.35 3.51 2.83 0.29 0.41 0.08 4.94 4.26 1.72 1.84 000

64530 ............ A Injection for nerve block ....................... 1.58 3.23 2.74 0.36 0.59 0.09 4.90 4.41 2.03 2.26 000

64550 ............ A Apply neurostimulator ........................... 0.18 0.52 0.51 0.05 0.10 0.01 0.71 0.70 0.24 0.29 000

64553 ............ A Implant neuroelectrodes ....................... 2.31 4.85 3.92 1.27 1.09 0.17 7.33 6.40 3.75 3.57 010

64555 ............ A Implant neuroelectrodes ....................... 2.27 2.40 1.92 0.71 0.59 0.11 4.78 4.30 3.09 2.97 010

64560 ............ A Implant neuroelectrodes ....................... 2.36 2.42 2.21 0.87 0.85 0.17 4.95 4.74 3.40 3.38 010

64565 ............ A Implant neuroelectrodes ....................... 1.76 3.06 2.50 0.63 0.58 0.08 4.90 4.34 2.47 2.42 010

64573 ............ A Implant neuroelectrodes ....................... 7.50 NA NA 5.46 4.95 1.48 NA NA 14.44 13.93 090

64575 ............ A Implant neuroelectrodes ....................... 4.35 NA NA 3.15 3.20 0.37 NA NA 7.87 7.92 090

64577 ............ A Implant neuroelectrodes ....................... 4.62 NA NA 3.56 3.42 0.50 NA NA 8.68 8.54 090

64580 ............ A Implant neuroelectrodes ....................... 4.12 NA NA 4.21 3.95 0.21 NA NA 8.54 8.28 090

64585 ............ A Revise/remove neuroelectrode ............ 2.06 2.82 2.38 2.18 1.90 0.29 5.17 4.73 4.53 4.25 010

64590 ............ A Implant neuroreceiver ........................... 2.40 NA NA 2.37 2.28 0.40 NA NA 5.17 5.08 010

64595 ............ A Revise/remove neuroreceiver .............. 1.73 NA NA 2.06 1.85 0.22 NA NA 4.01 3.80 010

64600 ............ A Injection treatment of nerve ................. 3.45 3.11 2.79 2.05 2.00 0.28 6.84 6.52 5.78 5.73 010

64605 ............ A Injection treatment of nerve ................. 5.61 4.18 3.56 2.78 2.51 0.53 10.32 9.70 8.92 8.65 010

64610 ............ A Injection treatment of nerve ................. 7.16 NA NA 3.77 4.80 1.12 NA NA 12.05 13.08 010

64612 ............ A Destroy nerve, face muscle ................. 1.96 2.95 2.61 1.65 1.44 0.09 5.00 4.66 3.70 3.49 010

64613 ............ A Destroy nerve, spine muscle ................ 1.96 1.61 1.60 1.37 1.23 0.10 3.67 3.66 3.43 3.29 010

64614 ............ A Destroy nerve, extrem musc ................ 2.20 3.37 3.37 0.81 0.81 0.16 5.73 5.73 3.17 3.17 010

64620 ............ A Injection treatment of nerve ................. 2.84 3.10 2.60 0.70 0.80 0.17 6.11 5.61 3.71 3.81 010

64622 ............ A Destr paravertebrl nerve l/s .................. 3.00 4.47 3.85 0.73 1.04 0.17 7.64 7.02 3.90 4.21 010

64623 ............ A Destr paravertebral n add-on ............... 0.99 3.54 2.89 0.24 0.41 0.06 4.59 3.94 1.29 1.46 ZZZ

64626 ............ A Destr paravertebrl nerve c/t ................. 3.28 3.95 3.95 0.88 0.88 0.22 7.45 7.45 4.38 4.38 010

64627 ............ A Destr paravertebral n add-on ............... 1.16 3.30 3.30 0.31 0.31 0.08 4.54 4.54 1.55 1.55 ZZZ

64630 ............ A Injection treatment of nerve ................. 3.00 3.54 3.13 0.81 1.08 0.16 6.70 6.29 3.97 4.24 010

64640 ............ A Injection treatment of nerve ................. 2.76 5.75 4.56 1.02 1.02 0.11 8.62 7.43 3.89 3.89 010

64680 ............ A Injection treatment of nerve ................. 2.62 2.99 2.66 0.66 0.92 0.15 5.76 5.43 3.43 3.69 010

64702 ............ A Revise finger/toe nerve ........................ 4.23 NA NA 3.76 3.97 0.51 NA NA 8.50 8.71 090

64704 ............ A Revise hand/foot nerve ........................ 4.57 NA NA 3.13 3.71 0.59 NA NA 8.29 8.87 090

64708 ............ A Revise arm/leg nerve ........................... 6.12 NA NA 4.92 5.52 0.82 NA NA 11.86 12.46 090

64712 ............ A Revision of sciatic nerve ...................... 7.75 NA NA 4.96 6.04 0.54 NA NA 13.25 14.33 090

64713 ............ A Revision of arm nerve(s) ...................... 11.00 NA NA 5.90 6.98 1.01 NA NA 17.91 18.99 090

64714 ............ A Revise low back nerve(s) ..................... 10.33 NA NA 3.92 4.60 0.64 NA NA 14.89 15.57 090

64716 ............ A Revision of cranial nerve ...................... 6.31 NA NA 5.02 5.08 0.59 NA NA 11.92 11.98 090

64718 ............ A Revise ulnar nerve at elbow ................ 5.99 NA NA 5.01 5.55 0.87 NA NA 11.87 12.41 090

64719 ............ A Revise ulnar nerve at wrist .................. 4.85 NA NA 4.50 4.72 0.63 NA NA 9.98 10.20 090

64721 ............ A Carpal tunnel surgery ........................... 4.29 5.93 5.73 5.62 5.50 0.59 10.81 10.61 10.50 10.38 090

65497

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

64722 ............ A Relieve pressure on nerve(s) ............... 4.70 NA NA 2.97 3.63 0.32 NA NA 7.99 8.65 090

64726 ............ A Release foot/toe nerve ......................... 4.18 NA NA 3.03 2.47 0.57 NA NA 7.78 7.22 090

64727 ............ A Internal nerve revision .......................... 3.10 NA NA 1.62 2.10 0.40 NA NA 5.12 5.60 ZZZ

64732 ............ A Incision of brow nerve .......................... 4.41 NA NA 3.49 3.79 0.77 NA NA 8.67 8.97 090

64734 ............ A Incision of cheek nerve ........................ 4.92 NA NA 3.54 3.91 0.83 NA NA 9.29 9.66 090

64736 ............ A Incision of chin nerve ........................... 4.60 NA NA 2.99 3.45 0.71 NA NA 8.30 8.76 090

64738 ............ A Incision of jaw nerve ............................ 5.73 NA NA 3.64 4.11 0.84 NA NA 10.21 10.68 090

64740 ............ A Incision of tongue nerve ....................... 5.59 NA NA 4.09 4.47 0.43 NA NA 10.11 10.49 090

64742 ............ A Incision of facial nerve ......................... 6.22 NA NA 4.91 5.04 0.69 NA NA 11.82 11.95 090

64744 ............ A Incise nerve, back of head ................... 5.24 NA NA 3.93 4.51 0.98 NA NA 10.15 10.73 090

64746 ............ A Incise diaphragm nerve ........................ 5.93 NA NA 5.78 5.36 0.75 NA NA 12.46 12.04 090

64752 ............ A Incision of vagus nerve ........................ 7.06 NA NA 5.34 5.07 0.83 NA NA 13.23 12.96 090

64755 ............ A Incision of stomach nerves .................. 13.52 NA NA 6.35 7.60 1.16 NA NA 21.03 22.28 090

64760 ............ A Incision of vagus nerve ........................ 6.96 NA NA 4.04 4.84 0.51 NA NA 11.51 12.31 090

64761 ............ A Incision of pelvis nerve ......................... 6.41 NA NA 3.14 3.62 0.26 NA NA 9.81 10.29 090

64763 ............ A Incise hip/thigh nerve ........................... 6.93 NA NA 6.23 5.98 0.77 NA NA 13.93 13.68 090

64766 ............ A Incise hip/thigh nerve ........................... 8.67 NA NA 6.14 6.42 0.99 NA NA 15.80 16.08 090

64771 ............ A Sever cranial nerve .............................. 7.35 NA NA 5.56 5.91 1.32 NA NA 14.23 14.58 090

64772 ............ A Incision of spinal nerve ........................ 7.21 NA NA 5.01 5.60 1.20 NA NA 13.42 14.01 090

64774 ............ A Remove skin nerve lesion .................... 5.17 NA NA 3.67 3.50 0.60 NA NA 9.44 9.27 090

64776 ............ A Remove digit nerve lesion .................... 5.12 NA NA 3.78 3.59 0.63 NA NA 9.53 9.34 090

64778 ............ A Digit nerve surgery add-on ................... 3.11 NA NA 1.51 1.87 0.38 NA NA 5.00 5.36 ZZZ

64782 ............ A Remove limb nerve lesion .................... 6.23 NA NA 3.63 4.00 0.79 NA NA 10.65 11.02 090

64783 ............ A Limb nerve surgery add-on .................. 3.72 NA NA 2.02 2.40 0.48 NA NA 6.22 6.60 ZZZ

64784 ............ A Remove nerve lesion ........................... 9.82 NA NA 6.40 6.33 1.17 NA NA 17.39 17.32 090

64786 ............ A Remove sciatic nerve lesion ................ 15.46 NA NA 10.34 11.19 2.22 NA NA 28.02 28.87 090

64787 ............ A Implant nerve end ................................ 4.30 NA NA 2.21 2.60 0.56 NA NA 7.07 7.46 ZZZ

64788 ............ A Remove skin nerve lesion .................... 4.61 NA NA 3.32 3.48 0.54 NA NA 8.47 8.63 090

64790 ............ A Removal of nerve lesion ...................... 11.31 NA NA 7.17 7.31 1.68 NA NA 20.16 20.30 090

64792 ............ A Removal of nerve lesion ...................... 14.92 NA NA 9.13 9.29 1.88 NA NA 25.93 26.09 090

64795 ............ A Biopsy of nerve .................................... 3.01 NA NA 1.86 2.04 0.40 NA NA 5.27 5.45 000

64802 ............ A Remove sympathetic nerves ................ 9.15 NA NA 5.72 5.76 0.87 NA NA 15.74 15.78 090

64804 ............ A Remove sympathetic nerves ................ 14.64 NA NA 8.75 10.03 1.79 NA NA 25.18 26.46 090

64809 ............ A Remove sympathetic nerves ................ 13.67 NA NA 5.41 6.92 0.96 NA NA 20.04 21.55 090

64818 ............ A Remove sympathetic nerves ................ 10.30 NA NA 6.28 7.04 1.08 NA NA 17.66 18.42 090

64820 ............ A Remove sympathetic nerves ................ 10.37 NA NA 7.81 7.83 1.17 NA NA 19.35 19.37 090

64831 ............ A Repair of digit nerve ............................. 9.44 NA NA 7.11 6.25 1.14 NA NA 17.69 16.83 090

64832 ............ A Repair nerve add-on ............................ 5.66 NA NA 3.13 2.73 0.68 NA NA 9.47 9.07 ZZZ

64834 ............ A Repair of hand or foot nerve ................ 10.19 NA NA 7.16 6.32 1.23 NA NA 18.58 17.74 090

64835 ............ A Repair of hand or foot nerve ................ 10.94 NA NA 7.77 7.45 1.36 NA NA 20.07 19.75 090

64836 ............ A Repair of hand or foot nerve ................ 10.94 NA NA 7.67 7.57 1.32 NA NA 19.93 19.83 090

64837 ............ A Repair nerve add-on ............................ 6.26 NA NA 3.40 3.76 0.80 NA NA 10.46 10.82 ZZZ

64840 ............ A Repair of leg nerve ............................... 13.02 NA NA 9.27 9.76 0.86 NA NA 23.15 23.64 090

64856 ............ A Repair/transpose nerve ........................ 13.80 NA NA 9.34 9.23 1.71 NA NA 24.85 24.74 090

64857 ............ A Repair arm/leg nerve ............................ 14.49 NA NA 9.71 9.87 1.76 NA NA 25.96 26.12 090

64858 ............ A Repair sciatic nerve .............................. 16.49 NA NA 10.28 10.69 2.78 NA NA 29.55 29.96 090

64859 ............ A Nerve surgery ....................................... 4.26 NA NA 2.32 2.69 0.50 NA NA 7.08 7.45 ZZZ

64861 ............ A Repair of arm nerves ........................... 19.24 NA NA 13.02 13.41 2.45 NA NA 34.71 35.10 090

64862 ............ A Repair of low back nerves ................... 19.44 NA NA 9.71 13.13 2.47 NA NA 31.62 35.04 090

64864 ............ A Repair of facial nerve ........................... 12.55 NA NA 8.69 8.65 1.13 NA NA 22.37 22.33 090

64865 ............ A Repair of facial nerve ........................... 15.24 NA NA 9.97 10.83 1.37 NA NA 26.58 27.44 090

64866 ............ A Fusion of facial/other nerve .................. 15.74 NA NA 9.80 10.39 1.06 NA NA 26.60 27.19 090

64868 ............ A Fusion of facial/other nerve .................. 14.04 NA NA 9.38 10.07 1.40 NA NA 24.82 25.51 090

64870 ............ A Fusion of facial/other nerve .................. 15.99 NA NA 8.04 9.81 1.08 NA NA 25.11 26.88 090

64872 ............ A Subsequent repair of nerve .................. 1.99 NA NA 1.10 1.22 0.24 NA NA 3.33 3.45 ZZZ

64874 ............ A Repair & revise nerve add-on .............. 2.98 NA NA 1.58 1.78 0.34 NA NA 4.90 5.10 ZZZ

64876 ............ A Repair nerve/shorten bone ................... 3.38 NA NA 1.35 1.68 0.39 NA NA 5.12 5.45 ZZZ

64885 ............ A Nerve graft, head or neck .................... 17.53 NA NA 11.18 11.83 1.51 NA NA 30.22 30.87 090

64886 ............ A Nerve graft, head or neck .................... 20.75 NA NA 13.03 13.88 1.73 NA NA 35.51 36.36 090

64890 ............ A Nerve graft, hand or foot ...................... 15.15 NA NA 10.09 10.90 1.74 NA NA 26.98 27.79 090

64891 ............ A Nerve graft, hand or foot ...................... 16.14 NA NA 7.51 8.46 1.38 NA NA 25.03 25.98 090

64892 ............ A Nerve graft, arm or leg ......................... 14.65 NA NA 8.75 9.56 1.65 NA NA 25.05 25.86 090

64893 ............ A Nerve graft, arm or leg ......................... 15.60 NA NA 10.29 11.50 1.77 NA NA 27.66 28.87 090

64895 ............ A Nerve graft, hand or foot ...................... 19.25 NA NA 11.20 11.97 2.04 NA NA 32.49 33.26 090

64896 ............ A Nerve graft, hand or foot ...................... 20.49 NA NA 9.31 11.74 1.85 NA NA 31.65 34.08 090

64897 ............ A Nerve graft, arm or leg ......................... 18.24 NA NA 11.13 11.78 2.64 NA NA 32.01 32.66 090

64898 ............ A Nerve graft, arm or leg ......................... 19.50 NA NA 12.26 13.10 2.71 NA NA 34.47 35.31 090

64901 ............ A Nerve graft add-on ............................... 10.22 NA NA 5.36 6.78 0.99 NA NA 16.57 17.99 ZZZ

64902 ............ A Nerve graft add-on ............................... 11.83 NA NA 5.98 7.72 1.10 NA NA 18.91 20.65 ZZZ

64905 ............ A Nerve pedicle transfer .......................... 14.02 NA NA 8.60 9.00 1.52 NA NA 24.14 24.54 090

64907 ............ A Nerve pedicle transfer .......................... 18.83 NA NA 11.65 12.27 1.79 NA NA 32.27 32.89 090

64999 ............ C Nervous system surgery ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

65091 ............ A Revise eye ............................................ 6.46 NA NA 9.55 9.09 0.26 NA NA 16.27 15.81 090

65093 ............ A Revise eye with implant ....................... 6.87 NA NA 9.76 9.37 0.28 NA NA 16.91 16.52 090

65101 ............ A Removal of eye .................................... 7.03 NA NA 9.61 9.31 0.28 NA NA 16.92 16.62 090

65103 ............ A Remove eye/insert implant ................... 7.57 NA NA 9.97 9.74 0.30 NA NA 17.84 17.61 090

65105 ............ A Remove eye/attach implant .................. 8.49 NA NA 10.51 10.42 0.34 NA NA 19.34 19.25 090

65110 ............ A Removal of eye .................................... 13.95 NA NA 14.10 14.74 0.68 NA NA 28.73 29.37 090

65112 ............ A Remove eye/revise socket ................... 16.38 NA NA 17.24 16.23 0.96 NA NA 34.58 33.57 090

65114 ............ A Remove eye/revise socket ................... 17.53 NA NA 16.37 15.82 0.94 NA NA 34.84 34.29 090

65125 ............ A Revise ocular implant ........................... 3.12 4.92 4.36 1.53 1.82 0.15 8.19 7.63 4.80 5.09 090

65130 ............ A Insert ocular implant ............................. 7.15 NA NA 9.68 9.40 0.28 NA NA 17.11 16.83 090

65135 ............ A Insert ocular implant ............................. 7.33 NA NA 9.45 8.56 0.29 NA NA 17.07 16.18 090

65498

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

65140 ............ A Attach ocular implant ............................ 8.02 NA NA 9.88 9.10 0.31 NA NA 18.21 17.43 090

65150 ............ A Revise ocular implant ........................... 6.26 NA NA 9.12 8.71 0.25 NA NA 15.63 15.22 090

65155 ............ A Reinsert ocular implant ........................ 8.66 NA NA 11.19 10.98 0.40 NA NA 20.25 20.04 090

65175 ............ A Removal of ocular implant ................... 6.28 NA NA 9.12 8.72 0.26 NA NA 15.66 15.26 090

65205 ............ A Remove foreign body from eye ............ 0.71 5.07 3.90 0.20 0.20 0.03 5.81 4.64 0.94 0.94 000

65210 ............ A Remove foreign body from eye ............ 0.84 5.26 4.07 0.31 0.30 0.03 6.13 4.94 1.18 1.17 000

65220 ............ A Remove foreign body from eye ............ 0.71 6.55 5.05 0.19 0.21 0.05 7.31 5.81 0.95 0.97 000

65222 ............ A Remove foreign body from eye ............ 0.93 5.20 4.06 0.28 0.29 0.04 6.17 5.03 1.25 1.26 000

65235 ............ A Remove foreign body from eye ............ 7.57 NA NA 6.82 6.64 0.30 NA NA 14.69 14.51 090

65260 ............ A Remove foreign body from eye ............ 10.96 NA NA 11.80 11.19 0.43 NA NA 23.19 22.58 090

65265 ............ A Remove foreign body from eye ............ 12.59 NA NA 13.36 12.75 0.50 NA NA 26.45 25.84 090

65270 ............ A Repair of eye wound ............................ 1.90 3.60 3.02 2.01 1.83 0.08 5.58 5.00 3.99 3.81 010

65272 ............ A Repair of eye wound ............................ 3.82 5.00 4.20 3.86 3.34 0.16 8.98 8.18 7.84 7.32 090

65273 ............ A Repair of eye wound ............................ 4.36 NA NA 4.34 4.13 0.17 NA NA 8.87 8.66 090

65275 ............ A Repair of eye wound ............................ 5.34 5.04 3.96 4.66 3.68 0.27 10.65 9.57 10.27 9.29 090

65280 ............ A Repair of eye wound ............................ 7.66 NA NA 7.28 7.75 0.30 NA NA 15.24 15.71 090

65285 ............ A Repair of eye wound ............................ 12.90 NA NA 13.37 13.36 0.51 NA NA 26.78 26.77 090

65286 ............ A Repair of eye wound ............................ 5.51 7.90 7.23 6.73 5.70 0.21 13.62 12.95 12.45 11.42 090

65290 ............ A Repair of eye socket wound ................ 5.41 NA NA 6.78 6.70 0.26 NA NA 12.45 12.37 090

65400 ............ A Removal of eye lesion .......................... 6.06 7.91 7.69 6.51 6.64 0.24 14.21 13.99 12.81 12.94 090

65410 ............ A Biopsy of cornea .................................. 1.47 1.69 1.70 0.67 0.94 0.06 3.22 3.23 2.20 2.47 000

65420 ............ A Removal of eye lesion .......................... 4.17 7.06 6.46 6.04 5.69 0.17 11.40 10.80 10.38 10.03 090

65426 ............ A Removal of eye lesion .......................... 5.25 7.28 7.03 6.11 6.15 0.20 12.73 12.48 11.56 11.60 090

65430 ............ A Corneal smear ...................................... 1.47 5.79 4.49 0.72 0.62 0.06 7.32 6.02 2.25 2.15 000

65435 ............ A Curette/treat cornea ............................. 0.92 1.33 1.21 0.42 0.42 0.04 2.29 2.17 1.38 1.38 000

65436 ............ A Curette/treat cornea ............................. 4.19 5.23 4.34 4.32 3.45 0.17 9.59 8.70 8.68 7.81 090

65450 ............ A Treatment of corneal lesion ................. 3.27 6.80 5.99 5.62 5.11 0.13 10.20 9.39 9.02 8.51 090

65600 ............ A Revision of cornea ............................... 3.40 4.77 4.29 1.49 1.47 0.14 8.31 7.83 5.03 5.01 090

65710 ............ A Corneal transplant ................................ 12.35 NA NA 12.84 13.01 0.49 NA NA 25.68 25.85 090

65730 ............ A Corneal transplant ................................ 14.25 NA NA 12.30 13.33 0.56 NA NA 27.11 28.14 090

65750 ............ A Corneal transplant ................................ 15.00 NA NA 14.14 14.97 0.59 NA NA 29.73 30.56 090

65755 ............ A Corneal transplant ................................ 14.89 NA NA 14.05 14.91 0.58 NA NA 29.52 30.38 090

65760 ............ N Revision of cornea ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65765 ............ N Revision of cornea ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65767 ............ N Corneal tissue transplant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65770 ............ A Revise cornea with implant .................. 17.56 NA NA 15.10 15.07 0.69 NA NA 33.35 33.32 090

65771 ............ N Radial keratotomy ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65772 ............ A Correction of astigmatism .................... 4.29 6.30 6.01 5.34 4.65 0.17 10.76 10.47 9.80 9.11 090

65775 ............ A Correction of astigmatism .................... 5.79 NA NA 8.26 7.92 0.22 NA NA 14.27 13.93 090

65800 ............ A Drainage of eye .................................... 1.91 2.21 2.13 1.40 1.52 0.08 4.20 4.12 3.39 3.51 000

65805 ............ A Drainage of eye .................................... 1.91 2.21 2.15 1.41 1.30 0.08 4.20 4.14 3.40 3.29 000

65810 ............ A Drainage of eye .................................... 4.87 NA NA 7.41 7.01 0.19 NA NA 12.47 12.07 090

65815 ............ A Drainage of eye .................................... 5.05 8.10 7.29 6.94 6.42 0.20 13.35 12.54 12.19 11.67 090

65820 ............ A Relieve inner eye pressure .................. 8.13 NA NA 9.29 9.56 0.32 NA NA 17.74 18.01 090

65850 ............ A Incision of eye ...................................... 10.52 NA NA 9.63 10.36 0.41 NA NA 20.56 21.29 090

65855 ............ A Laser surgery of eye ............................ 4.30 5.15 5.49 3.86 3.71 0.17 9.62 9.96 8.33 8.18 090

65860 ............ A Incise inner eye adhesions .................. 3.55 3.80 3.91 3.01 2.79 0.14 7.49 7.60 6.70 6.48 090

65865 ............ A Incise inner eye adhesions .................. 5.60 NA NA 6.26 6.37 0.22 NA NA 12.08 12.19 090

65870 ............ A Incise inner eye adhesions .................. 6.27 NA NA 6.61 6.55 0.24 NA NA 13.12 13.06 090

65875 ............ A Incise inner eye adhesions .................. 6.54 NA NA 6.73 6.75 0.25 NA NA 13.52 13.54 090

65880 ............ A Incise inner eye adhesions .................. 7.09 NA NA 6.97 7.09 0.28 NA NA 14.34 14.46 090

65900 ............ A Remove eye lesion ............................... 10.93 NA NA 12.07 11.20 0.46 NA NA 23.46 22.59 090

65920 ............ A Remove implant from eye .................... 8.40 NA NA 7.65 8.01 0.33 NA NA 16.38 16.74 090

65930 ............ A Remove blood clot from eye ................ 7.44 NA NA 8.08 8.14 0.29 NA NA 15.81 15.87 090

66020 ............ A Injection treatment of eye ..................... 1.59 2.28 2.19 1.49 1.59 0.07 3.94 3.85 3.15 3.25 010

66030 ............ A Injection treatment of eye ..................... 1.25 2.12 1.74 1.32 1.07 0.05 3.42 3.04 2.62 2.37 010

66130 ............ A Remove eye lesion ............................... 7.69 6.91 6.62 6.05 5.97 0.31 14.91 14.62 14.05 13.97 090

66150 ............ A Glaucoma surgery ................................ 8.30 NA NA 10.25 10.17 0.33 NA NA 18.88 18.80 090

66155 ............ A Glaucoma surgery ................................ 8.29 NA NA 10.21 10.13 0.32 NA NA 18.82 18.74 090

66160 ............ A Glaucoma surgery ................................ 10.17 NA NA 11.16 11.29 0.41 NA NA 21.74 21.87 090

66165 ............ A Glaucoma surgery ................................ 8.01 NA NA 10.18 10.03 0.31 NA NA 18.50 18.35 090

66170 ............ A Glaucoma surgery ................................ 12.16 NA NA 12.17 12.43 0.48 NA NA 24.81 25.07 090

66172 ............ A Incision of eye ...................................... 15.04 NA NA 15.09 14.62 0.59 NA NA 30.72 30.25 090

66180 ............ A Implant eye shunt ................................. 14.55 NA NA 12.32 13.58 0.57 NA NA 27.44 28.70 090

66185 ............ A Revise eye shunt .................................. 8.14 NA NA 8.40 8.73 0.32 NA NA 16.86 17.19 090

66220 ............ A Repair eye lesion ................................. 7.77 NA NA 10.01 9.12 0.32 NA NA 18.10 17.21 090

66225 ............ A Repair/graft eye lesion ......................... 11.05 NA NA 9.73 10.60 0.44 NA NA 21.22 22.09 090

66250 ............ A Follow-up surgery of eye ...................... 5.98 7.92 7.73 6.47 6.64 0.23 14.13 13.94 12.68 12.85 090

66500 ............ A Incision of iris ....................................... 3.71 NA NA 4.08 4.17 0.15 NA NA 7.94 8.03 090

66505 ............ A Incision of iris ....................................... 4.08 NA NA 4.29 4.11 0.17 NA NA 8.54 8.36 090

66600 ............ A Remove iris and lesion ......................... 8.68 NA NA 9.28 9.50 0.34 NA NA 18.30 18.52 090

66605 ............ A Removal of iris ..................................... 12.79 NA NA 12.61 12.68 0.61 NA NA 26.01 26.08 090

66625 ............ A Removal of iris ..................................... 5.13 7.97 7.51 6.99 6.77 0.20 13.30 12.84 12.32 12.10 090

66630 ............ A Removal of iris ..................................... 6.16 NA NA 8.04 7.87 0.24 NA NA 14.44 14.27 090

66635 ............ A Removal of iris ..................................... 6.25 NA NA 6.59 6.81 0.24 NA NA 13.08 13.30 090

66680 ............ A Repair iris & ciliary body ...................... 5.44 NA NA 6.18 6.26 0.21 NA NA 11.83 11.91 090

66682 ............ A Repair iris & ciliary body ...................... 6.21 NA NA 8.08 7.91 0.24 NA NA 14.53 14.36 090

66700 ............ A Destruction, ciliary body ....................... 4.78 7.67 7.18 6.35 6.19 0.19 12.64 12.15 11.32 11.16 090

66710 ............ A Destruction, ciliary body ....................... 4.78 7.64 7.16 6.37 6.21 0.18 12.60 12.12 11.33 11.17 090

66720 ............ A Destruction, ciliary body ....................... 4.78 7.46 7.02 6.32 6.17 0.19 12.43 11.99 11.29 11.14 090

66740 ............ A Destruction, ciliary body ....................... 4.78 NA NA 5.87 5.83 0.18 NA NA 10.83 10.79 090

66761 ............ A Revision of iris ...................................... 4.07 5.23 5.14 4.12 3.70 0.16 9.46 9.37 8.35 7.93 090

66762 ............ A Revision of iris ...................................... 4.58 5.37 5.40 4.30 3.91 0.18 10.13 10.16 9.06 8.67 090

65499

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

66770 ............ A Removal of inner eye lesion ................ 5.18 5.68 5.81 4.55 4.19 0.20 11.06 11.19 9.93 9.57 090

66820 ............ A Incision, secondary cataract ................. 3.89 NA NA 6.97 6.39 0.16 NA NA 11.02 10.44 090

66821 ............ A After cataract laser surgery .................. 2.35 3.56 3.37 3.17 3.08 0.10 6.01 5.82 5.62 5.53 090

66825 ............ A Reposition intraocular lens ................... 8.23 NA NA 9.04 8.77 0.32 NA NA 17.59 17.32 090

66830 ............ A Removal of lens lesion ......................... 8.20 NA NA 6.80 7.18 0.32 NA NA 15.32 15.70 090

66840 ............ A Removal of lens material ..................... 7.91 NA NA 6.76 7.43 0.31 NA NA 14.98 15.65 090

66850 ............ A Removal of lens material ..................... 9.11 NA NA 7.30 8.19 0.36 NA NA 16.77 17.66 090

66852 ............ A Removal of lens material ..................... 9.97 NA NA 7.79 8.82 0.39 NA NA 18.15 19.18 090

66920 ............ A Extraction of lens .................................. 8.86 NA NA 7.26 8.09 0.35 NA NA 16.47 17.30 090

66930 ............ A Extraction of lens .................................. 10.18 NA NA 8.76 9.42 0.41 NA NA 19.35 20.01 090

66940 ............ A Extraction of lens .................................. 8.93 NA NA 8.16 8.79 0.35 NA NA 17.44 18.07 090

66982 ............ A Cataract surgery, complex ................... 13.50 NA NA 9.09 9.09 0.55 NA NA 23.14 23.14 090

66983 ............ A Cataract surg w/iol, 1 stage ................. 8.99 NA NA 5.69 6.95 0.37 NA NA 15.05 16.31 090

66984 ............ A Cataract surg w/iol, i stage .................. 10.23 NA NA 7.60 8.77 0.41 NA NA 18.24 19.41 090

66985 ............ A Insert lens prosthesis ........................... 8.39 NA NA 6.75 7.57 0.33 NA NA 15.47 16.29 090

66986 ............ A Exchange lens prosthesis .................... 12.28 NA NA 8.89 9.98 0.49 NA NA 21.66 22.75 090

66999 ............ C Eye surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

67005 ............ A Partial removal of eye fluid .................. 5.70 NA NA 2.80 3.80 0.22 NA NA 8.72 9.72 090

67010 ............ A Partial removal of eye fluid .................. 6.87 NA NA 3.41 4.61 0.27 NA NA 10.55 11.75 090

67015 ............ A Release of eye fluid ............................. 6.92 NA NA 7.78 7.59 0.27 NA NA 14.97 14.78 090

67025 ............ A Replace eye fluid .................................. 6.84 14.70 12.86 7.25 7.27 0.27 21.81 19.97 14.36 14.38 090

67027 ............ A Implant eye drug system ...................... 10.85 16.42 14.77 8.56 8.87 0.46 27.73 26.08 19.87 20.18 090

67028 ............ A Injection eye drug ................................. 2.52 8.04 6.90 1.24 1.68 0.11 10.67 9.53 3.87 4.31 000

67030 ............ A Incise inner eye strands ....................... 4.84 NA NA 6.32 6.18 0.19 NA NA 11.35 11.21 090

67031 ............ A Laser surgery, eye strands .................. 3.67 3.89 4.01 3.08 2.86 0.15 7.71 7.83 6.90 6.68 090

67036 ............ A Removal of inner eye fluid ................... 11.89 NA NA 9.05 10.34 0.47 NA NA 21.41 22.70 090

67038 ............ A Strip retinal membrane ......................... 21.24 NA NA 15.54 17.99 0.84 NA NA 37.62 40.07 090

67039 ............ A Laser treatment of retina ...................... 14.52 NA NA 12.20 13.48 0.57 NA NA 27.29 28.57 090

67040 ............ A Laser treatment of retina ...................... 17.23 NA NA 13.57 15.32 0.68 NA NA 31.48 33.23 090

67101 ............ A Repair detached retina ......................... 7.53 10.69 10.27 8.67 7.63 0.29 18.51 18.09 16.49 15.45 090

67105 ............ A Repair detached retina ......................... 7.41 7.41 8.04 5.62 5.46 0.29 15.11 15.74 13.32 13.16 090

67107 ............ A Repair detached retina ......................... 14.84 NA NA 13.10 14.25 0.58 NA NA 28.52 29.67 090

67108 ............ A Repair detached retina ......................... 20.82 NA NA 17.42 19.28 0.82 NA NA 39.06 40.92 090

67110 ............ A Repair detached retina ......................... 8.81 18.19 16.27 10.08 10.19 0.35 27.35 25.43 19.24 19.35 090

67112 ............ A Rerepair detached retina ...................... 16.86 NA NA 15.43 16.05 0.66 NA NA 32.95 33.57 090

67115 ............ A Release encircling material .................. 4.99 NA NA 6.42 6.31 0.19 NA NA 11.60 11.49 090

67120 ............ A Remove eye implant material .............. 5.98 14.09 12.35 6.82 6.90 0.23 20.30 18.56 13.03 13.11 090

67121 ............ A Remove eye implant material .............. 10.67 NA NA 11.60 11.26 0.42 NA NA 22.69 22.35 090

67141 ............ A Treatment of retina ............................... 5.20 7.62 7.27 6.58 5.71 0.20 13.02 12.67 11.98 11.11 090

67145 ............ A Treatment of retina ............................... 5.37 5.21 5.67 4.21 4.04 0.21 10.79 11.25 9.79 9.62 090

67208 ............ A Treatment of retinal lesion ................... 6.70 8.02 8.02 6.75 6.06 0.26 14.98 14.98 13.71 13.02 090

67210 ............ A Treatment of retinal lesion ................... 8.82 7.24 7.88 5.87 5.63 0.35 16.41 17.05 15.04 14.80 090

67218 ............ A Treatment of retinal lesion ................... 13.52 NA NA 13.04 13.39 0.53 NA NA 27.09 27.44 090

67220 ............ A Treatment of choroid lesion ................. 13.13 11.21 11.21 10.05 10.05 0.51 24.85 24.85 23.69 23.69 090

67221 ............ A Ocular photodynamic ther .................... 4.01 4.40 4.40 2.00 2.00 0.50 8.91 8.91 6.51 6.51 000

67227 ............ A Treatment of retinal lesion ................... 6.58 8.60 8.42 6.87 7.12 0.26 15.44 15.26 13.71 13.96 090

67228 ............ A Treatment of retinal lesion ................... 12.74 9.89 9.97 7.47 6.88 0.50 23.13 23.21 20.71 20.12 090

67250 ............ A Reinforce eye wall ................................ 8.66 NA NA 10.22 9.56 0.36 NA NA 19.24 18.58 090

67255 ............ A Reinforce/graft eye wall ........................ 8.90 NA NA 10.31 10.39 0.35 NA NA 19.56 19.64 090

67299 ............ C Eye surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

67311 ............ A Revise eye muscle ............................... 6.65 NA NA 6.37 6.76 0.27 NA NA 13.29 13.68 090

67312 ............ A Revise two eye muscles ...................... 8.54 NA NA 7.38 8.08 0.35 NA NA 16.27 16.97 090

67314 ............ A Revise eye muscle ............................... 7.52 NA NA 6.86 7.39 0.30 NA NA 14.68 15.21 090

67316 ............ A Revise two eye muscles ...................... 9.66 NA NA 7.88 8.70 0.40 NA NA 17.94 18.76 090

67318 ............ A Revise eye muscle(s) ........................... 7.85 NA NA 7.31 7.17 0.31 NA NA 15.47 15.33 090

67320 ............ A Revise eye muscle(s) add-on .............. 4.33 NA NA 6.87 7.74 0.17 NA NA 11.37 12.24 ZZZ

67331 ............ A Eye surgery follow-up add-on .............. 4.06 NA NA 5.26 6.37 0.17 NA NA 9.49 10.60 ZZZ

67332 ............ A Rerevise eye muscles add-on .............. 4.49 NA NA 5.93 7.13 0.18 NA NA 10.60 11.80 ZZZ

67334 ............ A Revise eye muscle w/suture ................ 3.98 NA NA 5.43 5.78 0.16 NA NA 9.57 9.92 ZZZ

67335 ............ A Eye suture during surgery .................... 2.49 NA NA 1.22 1.66 0.10 NA NA 3.81 4.25 ZZZ

67340 ............ A Revise eye muscle add-on ................... 4.93 NA NA 7.20 7.54 0.19 NA NA 12.32 12.66 ZZZ

67343 ............ A Release eye tissue ............................... 7.35 NA NA 7.25 7.02 0.30 NA NA 14.90 14.67 090

67345 ............ A Destroy nerve of eye muscle ............... 2.96 4.22 3.77 1.43 1.38 0.13 7.31 6.86 4.52 4.47 010

67350 ............ A Biopsy eye muscle ............................... 2.87 NA NA 2.46 2.49 0.13 NA NA 5.46 5.49 000

67399 ............ C Eye muscle surgery procedure ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

67400 ............ A Explore/biopsy eye socket ................... 9.76 NA NA 11.86 11.81 0.43 NA NA 22.05 22.00 090

67405 ............ A Explore/drain eye socket ...................... 7.93 NA NA 10.65 10.35 0.36 NA NA 18.94 18.64 090

67412 ............ A Explore/treat eye socket ....................... 9.50 NA NA 13.04 12.62 0.41 NA NA 22.95 22.53 090

67413 ............ A Explore/treat eye socket ....................... 10.00 NA NA 11.47 10.80 0.43 NA NA 21.90 21.23 090

67414 ............ A Explr/decompress eye socket .............. 11.13 NA NA 13.69 12.55 0.48 NA NA 25.30 24.16 090

67415 ............ A Aspiration, orbital contents ................... 1.76 NA NA 0.85 1.17 0.09 NA NA 2.70 3.02 000

67420 ............ A Explore/treat eye socket ....................... 20.06 NA NA 17.54 17.71 0.84 NA NA 38.44 38.61 090

67430 ............ A Explore/treat eye socket ....................... 13.39 NA NA 18.61 16.85 0.97 NA NA 32.97 31.21 090

67440 ............ A Explore/drain eye socket ...................... 13.09 NA NA 14.36 14.68 0.58 NA NA 28.03 28.35 090

67445 ............ A Explr/decompress eye socket .............. 14.42 NA NA 15.68 14.78 0.63 NA NA 30.73 29.83 090

67450 ............ A Explore/biopsy eye socket ................... 13.51 NA NA 14.19 14.68 0.56 NA NA 28.26 28.75 090

67500 ............ A Inject/treat eye socket .......................... 0.79 2.29 1.92 0.20 0.35 0.04 3.12 2.75 1.03 1.18 000

67505 ............ A Inject/treat eye socket .......................... 0.82 0.92 0.97 0.21 0.28 0.04 1.78 1.83 1.07 1.14 000

67515 ............ A Inject/treat eye socket .......................... 0.61 0.81 0.76 0.30 0.30 0.02 1.44 1.39 0.93 0.93 000

67550 ............ A Insert eye socket implant ..................... 10.19 NA NA 11.90 11.54 0.50 NA NA 22.59 22.23 090

67560 ............ A Revise eye socket implant ................... 10.60 NA NA 11.57 10.93 0.47 NA NA 22.64 22.00 090

67570 ............ A Decompress optic nerve ...................... 13.58 NA NA 14.86 13.20 0.69 NA NA 29.13 27.47 090

67599 ............ C Orbit surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

65500

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

67700 ............ A Drainage of eyelid abscess .................. 1.35 5.31 4.12 0.62 0.53 0.06 6.72 5.53 2.03 1.94 010

67710 ............ A Incision of eyelid ................................... 1.02 5.48 4.39 0.51 0.52 0.04 6.54 5.45 1.57 1.58 010

67715 ............ A Incision of eyelid fold ............................ 1.22 NA NA 0.61 0.82 0.05 NA NA 1.88 2.09 010

67800 ............ A Remove eyelid lesion ........................... 1.38 2.26 1.95 0.68 0.64 0.06 3.70 3.39 2.12 2.08 010

67801 ............ A Remove eyelid lesions ......................... 1.88 5.70 4.65 0.93 0.89 0.08 7.66 6.61 2.89 2.85 010

67805 ............ A Remove eyelid lesions ......................... 2.22 5.90 4.80 1.10 1.01 0.09 8.21 7.11 3.41 3.32 010

67808 ............ A Remove eyelid lesion(s) ....................... 3.80 NA NA 3.86 3.47 0.17 NA NA 7.83 7.44 090

67810 ............ A Biopsy of eyelid .................................... 1.48 4.41 3.53 0.73 0.66 0.06 5.95 5.07 2.27 2.20 000

67820 ............ A Revise eyelashes ................................. 0.89 1.56 1.27 0.38 0.34 0.04 2.49 2.20 1.31 1.27 000

67825 ............ A Revise eyelashes ................................. 1.38 6.95 5.46 1.68 1.38 0.06 8.39 6.90 3.12 2.82 010

67830 ............ A Revise eyelashes ................................. 1.70 8.17 6.70 1.90 1.93 0.07 9.94 8.47 3.67 3.70 010

67835 ............ A Revise eyelashes ................................. 5.56 NA NA 4.64 5.14 0.22 NA NA 10.42 10.92 090

67840 ............ A Remove eyelid lesion ........................... 2.04 5.77 4.66 1.01 0.92 0.08 7.89 6.78 3.13 3.04 010

67850 ............ A Treat eyelid lesion ................................ 1.69 7.01 5.48 1.78 1.45 0.07 8.77 7.24 3.54 3.21 010

67875 ............ A Closure of eyelid by suture .................. 1.35 8.33 6.72 1.84 1.79 0.06 9.74 8.13 3.25 3.20 000

67880 ............ A Revision of eyelid ................................. 3.80 9.26 8.02 2.96 3.29 0.16 13.22 11.98 6.92 7.25 090

67882 ............ A Revision of eyelid ................................. 5.07 12.04 10.55 4.44 4.85 0.21 17.32 15.83 9.72 10.13 090

67900 ............ A Repair brow defect ............................... 6.14 10.06 8.57 6.31 5.76 0.30 16.50 15.01 12.75 12.20 090

67901 ............ A Repair eyelid defect ............................. 6.97 NA NA 6.55 6.99 0.32 NA NA 13.84 14.28 090

67902 ............ A Repair eyelid defect ............................. 7.03 NA NA 6.64 7.08 0.34 NA NA 14.01 14.45 090

67903 ............ A Repair eyelid defect ............................. 6.37 11.55 10.57 7.12 7.24 0.39 18.31 17.33 13.88 14.00 090

67904 ............ A Repair eyelid defect ............................. 6.26 12.65 11.36 7.45 7.46 0.26 19.17 17.88 13.97 13.98 090

67906 ............ A Repair eyelid defect ............................. 6.79 7.32 6.97 6.35 6.25 0.42 14.53 14.18 13.56 13.46 090

67908 ............ A Repair eyelid defect ............................. 5.13 8.40 7.83 5.93 5.98 0.20 13.73 13.16 11.26 11.31 090

67909 ............ A Revise eyelid defect ............................. 5.40 9.39 8.66 6.51 6.50 0.25 15.04 14.31 12.16 12.15 090

67911 ............ A Revise eyelid defect ............................. 5.27 NA NA 6.37 6.35 0.23 NA NA 11.87 11.85 090

67914 ............ A Repair eyelid defect ............................. 3.68 9.75 8.41 3.36 3.62 0.16 13.59 12.25 7.20 7.46 090

67915 ............ A Repair eyelid defect ............................. 3.18 8.51 6.72 1.60 1.37 0.13 11.82 10.03 4.91 4.68 090

67916 ............ A Repair eyelid defect ............................. 5.31 13.00 11.34 5.07 5.39 0.22 18.53 16.87 10.60 10.92 090

67917 ............ A Repair eyelid defect ............................. 6.02 9.39 8.84 6.44 6.63 0.25 15.66 15.11 12.71 12.90 090

67921 ............ A Repair eyelid defect ............................. 3.40 9.40 8.07 3.12 3.36 0.14 12.94 11.61 6.66 6.90 090

67922 ............ A Repair eyelid defect ............................. 3.06 8.46 6.67 2.94 2.37 0.13 11.65 9.86 6.13 5.56 090

67923 ............ A Repair eyelid defect ............................. 5.88 12.99 11.50 5.24 5.69 0.24 19.11 17.62 11.36 11.81 090

67924 ............ A Repair eyelid defect ............................. 5.79 8.77 8.31 5.79 6.07 0.23 14.79 14.33 11.81 12.09 090

67930 ............ A Repair eyelid wound ............................. 3.61 9.24 7.28 2.92 2.36 0.17 13.02 11.06 6.70 6.14 010

67935 ............ A Repair eyelid wound ............................. 6.22 13.75 11.34 5.23 4.95 0.29 20.26 17.85 11.74 11.46 090

67938 ............ A Remove eyelid foreign body ................ 1.33 6.56 5.06 0.54 0.48 0.06 7.95 6.45 1.93 1.87 010

67950 ............ A Revision of eyelid ................................. 5.82 8.38 8.02 7.07 7.04 0.30 14.50 14.14 13.19 13.16 090

67961 ............ A Revision of eyelid ................................. 5.69 8.77 8.28 5.99 6.19 0.26 14.72 14.23 11.94 12.14 090

67966 ............ A Revision of eyelid ................................. 6.57 8.49 8.33 6.19 6.61 0.33 15.39 15.23 13.09 13.51 090

67971 ............ A Reconstruction of eyelid ....................... 9.79 NA NA 7.91 8.83 0.42 NA NA 18.12 19.04 090

67973 ............ A Reconstruction of eyelid ....................... 12.87 NA NA 10.06 11.22 0.59 NA NA 23.52 24.68 090

67974 ............ A Reconstruction of eyelid ....................... 12.84 NA NA 10.00 11.32 0.54 NA NA 23.38 24.70 090

67975 ............ A Reconstruction of eyelid ....................... 9.13 NA NA 7.56 6.80 0.38 NA NA 17.07 16.31 090

67999 ............ C Revision of eyelid ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

68020 ............ A Incise/drain eyelid lining ....................... 1.37 5.27 4.09 0.68 0.58 0.06 6.70 5.52 2.11 2.01 010

68040 ............ A Treatment of eyelid lesions .................. 0.85 5.14 3.98 0.42 0.38 0.03 6.02 4.86 1.30 1.26 000

68100 ............ A Biopsy of eyelid lining .......................... 1.35 5.61 4.48 0.66 0.63 0.06 7.02 5.89 2.07 2.04 000

68110 ............ A Remove eyelid lining lesion ................. 1.77 6.37 5.12 1.39 1.21 0.07 8.21 6.96 3.23 3.05 010

68115 ............ A Remove eyelid lining lesion ................. 2.36 5.93 4.97 1.16 1.39 0.10 8.39 7.43 3.62 3.85 010

68130 ............ A Remove eyelid lining lesion ................. 4.93 NA NA 2.44 2.94 0.19 NA NA 7.56 8.06 090

68135 ............ A Remove eyelid lining lesion ................. 1.84 5.67 4.45 0.91 0.78 0.07 7.58 6.36 2.82 2.69 010

68200 ............ A Treat eyelid by injection ....................... 0.49 5.23 4.06 0.24 0.25 0.02 5.74 4.57 0.75 0.76 000

68320 ............ A Revise/graft eyelid lining ...................... 5.37 5.30 5.58 5.30 5.58 0.21 10.88 11.16 10.88 11.16 090

68325 ............ A Revise/graft eyelid lining ...................... 7.36 NA NA 6.42 7.01 0.30 NA NA 14.08 14.67 090

68326 ............ A Revise/graft eyelid lining ...................... 7.15 NA NA 6.32 6.88 0.30 NA NA 13.77 14.33 090

68328 ............ A Revise/graft eyelid lining ...................... 8.18 NA NA 7.06 7.74 0.40 NA NA 15.64 16.32 090

68330 ............ A Revise eyelid lining .............................. 4.83 6.79 6.53 5.10 5.27 0.19 11.81 11.55 10.12 10.29 090

68335 ............ A Revise/graft eyelid lining ...................... 7.19 NA NA 5.29 6.11 0.29 NA NA 12.77 13.59 090

68340 ............ A Separate eyelid adhesions ................... 4.17 11.81 9.71 3.96 3.82 0.17 16.15 14.05 8.30 8.16 090

68360 ............ A Revise eyelid lining .............................. 4.37 6.09 5.87 4.87 4.96 0.17 10.63 10.41 9.41 9.50 090

68362 ............ A Revise eyelid lining .............................. 7.34 NA NA 7.58 7.86 0.29 NA NA 15.21 15.49 090

68399 ............ C Eyelid lining surgery ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

68400 ............ A Incise/drain tear gland .......................... 1.69 8.26 6.47 1.89 1.56 0.07 10.02 8.23 3.65 3.32 010

68420 ............ A Incise/drain tear sac ............................. 2.30 8.41 6.59 2.20 1.79 0.10 10.81 8.99 4.60 4.19 010

68440 ............ A Incise tear duct opening ....................... 0.94 5.27 4.16 0.47 0.46 0.04 6.25 5.14 1.45 1.44 010

68500 ............ A Removal of tear gland .......................... 11.02 NA NA 10.08 9.63 0.60 NA NA 21.70 21.25 090

68505 ............ A Partial removal, tear gland ................... 10.94 NA NA 10.35 10.12 0.57 NA NA 21.86 21.63 090

68510 ............ A Biopsy of tear gland ............................. 4.61 9.91 8.43 2.24 2.68 0.19 14.71 13.23 7.04 7.48 000

68520 ............ A Removal of tear sac ............................. 7.51 NA NA 6.82 7.36 0.33 NA NA 14.66 15.20 090

68525 ............ A Biopsy of tear sac ................................ 4.43 NA NA 2.20 2.65 0.18 NA NA 6.81 7.26 000

68530 ............ A Clearance of tear duct .......................... 3.66 11.04 9.05 2.83 2.51 0.16 14.86 12.87 6.65 6.33 010

68540 ............ A Remove tear gland lesion .................... 10.60 NA NA 8.50 8.63 0.46 NA NA 19.56 19.69 090

68550 ............ A Remove tear gland lesion .................... 13.26 NA NA 10.41 10.89 0.66 NA NA 24.33 24.81 090

68700 ............ A Repair tear ducts .................................. 6.60 NA NA 6.21 5.39 0.27 NA NA 13.08 12.26 090

68705 ............ A Revise tear duct opening ..................... 2.06 5.92 4.72 1.02 0.91 0.08 8.06 6.86 3.16 3.05 010

68720 ............ A Create tear sac drain ........................... 8.96 NA NA 7.37 8.20 0.38 NA NA 16.71 17.54 090

68745 ............ A Create tear duct drain .......................... 8.63 NA NA 7.32 7.27 0.38 NA NA 16.33 16.28 090

68750 ............ A Create tear duct drain .......................... 8.66 NA NA 7.79 8.43 0.37 NA NA 16.82 17.46 090

68760 ............ A Close tear duct opening ....................... 1.73 5.54 4.41 0.85 0.76 0.07 7.34 6.21 2.65 2.56 010

68761 ............ A Close tear duct opening ....................... 1.36 6.29 4.97 0.65 0.61 0.06 7.71 6.39 2.07 2.03 010

68770 ............ A Close tear system fistula ...................... 7.02 13.61 11.36 5.67 4.83 0.28 20.91 18.66 12.97 12.13 090

68801 ............ A Dilate tear duct opening ....................... 0.94 6.39 4.91 0.45 0.40 0.04 7.37 5.89 1.43 1.38 010

65501

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

68810 ............ A Probe nasolacrimal duct ....................... 1.90 8.09 6.22 1.92 1.52 0.08 10.07 8.20 3.90 3.50 010

68811 ............ A Probe nasolacrimal duct ....................... 2.35 NA NA 2.18 2.04 0.10 NA NA 4.63 4.49 010

68815 ............ A Probe nasolacrimal duct ....................... 3.20 9.94 7.98 2.66 2.26 0.14 13.28 11.32 6.00 5.60 010

68840 ............ A Explore/irrigate tear ducts .................... 1.25 7.01 5.39 0.61 0.53 0.05 8.31 6.69 1.91 1.83 010

68850 ............ A Injection for tear sac x-ray ................... 0.80 12.26 9.33 0.32 0.38 0.03 13.09 10.16 1.15 1.21 000

68899 ............ C Tear duct system surgery .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

69000 ............ A Drain external ear lesion ...................... 1.45 2.04 1.63 0.58 0.48 0.10 3.59 3.18 2.13 2.03 010

69005 ............ A Drain external ear lesion ...................... 2.11 2.46 2.16 2.06 1.70 0.16 4.73 4.43 4.33 3.97 010

69020 ............ A Drain outer ear canal lesion ................. 1.48 2.14 1.73 0.74 0.62 0.11 3.73 3.32 2.33 2.21 010

69090 ............ N Pierce earlobes .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

69100 ............ A Biopsy of external ear .......................... 0.81 1.48 1.29 0.41 0.40 0.04 2.33 2.14 1.26 1.25 000

69105 ............ A Biopsy of external ear canal ................ 0.85 1.46 1.31 0.97 0.84 0.06 2.37 2.22 1.88 1.75 000

69110 ............ A Remove external ear, partial ................ 3.44 3.44 3.29 2.77 2.79 0.24 7.12 6.97 6.45 6.47 090

69120 ............ A Removal of external ear ....................... 4.05 NA NA 4.38 3.50 0.31 NA NA 8.74 7.86 090

69140 ............ A Remove ear canal lesion(s) ................. 7.97 NA NA 7.92 8.11 0.56 NA NA 16.45 16.64 090

69145 ............ A Remove ear canal lesion(s) ................. 2.62 3.27 3.13 2.45 2.52 0.18 6.07 5.93 5.25 5.32 090

69150 ............ A Extensive ear canal surgery ................. 13.43 NA NA 11.09 11.16 1.07 NA NA 25.59 25.66 090

69155 ............ A Extensive ear/neck surgery .................. 20.80 NA NA 15.15 15.68 1.51 NA NA 37.46 37.99 090

69200 ............ A Clear outer ear canal ........................... 0.77 1.39 1.16 0.73 0.61 0.05 2.21 1.98 1.55 1.43 000

69205 ............ A Clear outer ear canal ........................... 1.20 NA NA 1.52 1.43 0.09 NA NA 2.81 2.72 010

69210 ............ A Remove impacted ear wax .................. 0.61 1.26 1.01 0.24 0.21 0.04 1.91 1.66 0.89 0.86 000

69220 ............ A Clean out mastoid cavity ...................... 0.83 1.46 1.23 0.42 0.38 0.06 2.35 2.12 1.31 1.27 000

69222 ............ A Clean out mastoid cavity ...................... 1.40 2.14 1.81 1.65 1.34 0.10 3.64 3.31 3.15 2.84 010

69300 ............ R Revise external ear .............................. 6.36 NA NA 4.35 4.70 0.43 NA NA 11.14 11.49 YYY

69310 ............ A Rebuild outer ear canal ........................ 10.79 NA NA 9.46 9.77 0.77 NA NA 21.02 21.33 090

69320 ............ A Rebuild outer ear canal ........................ 16.96 NA NA 13.64 14.21 1.17 NA NA 31.77 32.34 090

69399 ............ C Outer ear surgery procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

69400 ............ A Inflate middle ear canal ........................ 0.83 1.45 1.21 0.45 0.40 0.06 2.34 2.10 1.34 1.29 000

69401 ............ A Inflate middle ear canal ........................ 0.63 1.35 1.08 0.36 0.31 0.04 2.02 1.75 1.03 0.98 000

69405 ............ A Catheterize middle ear canal ............... 2.63 2.98 2.37 1.47 1.17 0.18 5.79 5.18 4.28 3.98 010

69410 ............ A Inset middle ear (baffle) ....................... 0.33 1.39 1.21 0.16 0.20 0.02 1.74 1.56 0.51 0.55 000

69420 ............ A Incision of eardrum ............................... 1.33 2.24 1.87 0.71 0.63 0.10 3.67 3.30 2.14 2.06 010

69421 ............ A Incision of eardrum ............................... 1.73 2.50 2.19 1.85 1.70 0.13 4.36 4.05 3.71 3.56 010

69424 ............ A Remove ventilating tube ....................... 0.85 1.60 1.36 0.89 0.75 0.06 2.51 2.27 1.80 1.66 000

69433 ............ A Create eardrum opening ...................... 1.52 2.22 2.03 0.85 0.82 0.11 3.85 3.66 2.48 2.45 010

69436 ............ A Create eardrum opening ...................... 1.96 NA NA 1.98 2.06 0.14 NA NA 4.08 4.16 010

69440 ............ A Exploration of middle ear ..................... 7.57 NA NA 7.12 7.60 0.53 NA NA 15.22 15.70 090

69450 ............ A Eardrum revision .................................. 5.57 NA NA 5.93 6.11 0.39 NA NA 11.89 12.07 090

69501 ............ A Mastoidectomy ..................................... 9.07 NA NA 7.90 8.63 0.65 NA NA 17.62 18.35 090

69502 ............ A Mastoidectomy ..................................... 12.38 NA NA 10.47 11.48 0.86 NA NA 23.71 24.72 090

69505 ............ A Remove mastoid structures ................. 12.99 NA NA 10.64 11.86 0.92 NA NA 24.55 25.77 090

69511 ............ A Extensive mastoid surgery ................... 13.52 NA NA 11.02 12.30 0.96 NA NA 25.50 26.78 090

69530 ............ A Extensive mastoid surgery ................... 19.19 NA NA 14.59 15.48 1.32 NA NA 35.10 35.99 090

69535 ............ A Remove part of temporal bone ............ 36.14 NA NA 24.08 24.92 2.59 NA NA 62.81 63.65 090

69540 ............ A Remove ear lesion ............................... 1.20 2.15 1.96 1.54 1.33 0.09 3.44 3.25 2.83 2.62 010

69550 ............ A Remove ear lesion ............................... 10.99 NA NA 9.68 10.54 0.80 NA NA 21.47 22.33 090

69552 ............ A Remove ear lesion ............................... 19.46 NA NA 14.24 15.22 1.36 NA NA 35.06 36.04 090

69554 ............ A Remove ear lesion ............................... 33.16 NA NA 21.65 22.44 2.32 NA NA 57.13 57.92 090

69601 ............ A Mastoid surgery revision ...................... 13.24 NA NA 11.61 12.51 0.92 NA NA 25.77 26.67 090

69602 ............ A Mastoid surgery revision ...................... 13.58 NA NA 11.16 12.42 0.94 NA NA 25.68 26.94 090

69603 ............ A Mastoid surgery revision ...................... 14.02 NA NA 11.44 12.76 1.00 NA NA 26.46 27.78 090

69604 ............ A Mastoid surgery revision ...................... 14.02 NA NA 11.24 12.61 0.98 NA NA 26.24 27.61 090

69605 ............ A Mastoid surgery revision ...................... 18.49 NA NA 13.92 14.50 1.29 NA NA 33.70 34.28 090

69610 ............ A Repair of eardrum ................................ 4.43 4.09 3.32 3.37 2.66 0.31 8.83 8.06 8.11 7.40 010

69620 ............ A Repair of eardrum ................................ 5.89 6.64 6.74 2.91 3.94 0.40 12.93 13.03 9.20 10.23 090

69631 ............ A Repair eardrum structures ................... 9.86 NA NA 9.05 9.73 0.69 NA NA 19.60 20.28 090

69632 ............ A Rebuild eardrum structures .................. 12.75 NA NA 11.28 12.27 0.89 NA NA 24.92 25.91 090

69633 ............ A Rebuild eardrum structures .................. 12.10 NA NA 10.92 11.80 0.84 NA NA 23.86 24.74 090

69635 ............ A Repair eardrum structures ................... 13.33 NA NA 9.40 11.03 0.87 NA NA 23.60 25.23 090

69636 ............ A Rebuild eardrum structures .................. 15.22 NA NA 12.78 14.13 1.07 NA NA 29.07 30.42 090

69637 ............ A Rebuild eardrum structures .................. 15.11 NA NA 12.72 14.05 1.06 NA NA 28.89 30.22 090

69641 ............ A Revise middle ear & mastoid ............... 12.71 NA NA 10.62 11.76 0.89 NA NA 24.22 25.36 090

69642 ............ A Revise middle ear & mastoid ............... 16.84 NA NA 13.63 15.25 1.18 NA NA 31.65 33.27 090

69643 ............ A Revise middle ear & mastoid ............... 15.32 NA NA 12.77 14.15 1.08 NA NA 29.17 30.55 090

69644 ............ A Revise middle ear & mastoid ............... 16.97 NA NA 13.71 15.35 1.19 NA NA 31.87 33.51 090

69645 ............ A Revise middle ear & mastoid ............... 16.38 NA NA 13.34 14.90 1.16 NA NA 30.88 32.44 090

69646 ............ A Revise middle ear & mastoid ............... 17.99 NA NA 14.29 16.09 1.26 NA NA 33.54 35.34 090

69650 ............ A Release middle ear bone ..................... 9.66 NA NA 8.28 9.10 0.68 NA NA 18.62 19.44 090

69660 ............ A Revise middle ear bone ....................... 11.90 NA NA 9.51 10.69 0.84 NA NA 22.25 23.43 090

69661 ............ A Revise middle ear bone ....................... 15.74 NA NA 12.28 13.91 1.10 NA NA 29.12 30.75 090

69662 ............ A Revise middle ear bone ....................... 15.44 NA NA 12.14 13.71 1.08 NA NA 28.66 30.23 090

69666 ............ A Repair middle ear structures ................ 9.75 NA NA 8.33 9.16 0.68 NA NA 18.76 19.59 090

69667 ............ A Repair middle ear structures ................ 9.76 NA NA 8.28 9.13 0.72 NA NA 18.76 19.61 090

69670 ............ A Remove mastoid air cells ..................... 11.51 NA NA 9.93 10.21 0.78 NA NA 22.22 22.50 090

69676 ............ A Remove middle ear nerve .................... 9.52 NA NA 8.64 8.80 0.69 NA NA 18.85 19.01 090

69700 ............ A Close mastoid fistula ............................ 8.23 NA NA 5.24 6.06 0.55 NA NA 14.02 14.84 090

69710 ............ N Implant/replace hearing aid .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

69711 ............ A Remove/repair hearing aid ................... 10.44 NA NA 9.42 9.36 0.62 NA NA 20.48 20.42 090

69714 ............ A Implant temple bone w/stimul .............. 14.00 NA NA 8.71 8.71 0.97 NA NA 23.68 23.68 090

69715 ............ A Temple bne implnt w/stimulat .............. 18.25 NA NA 10.49 10.49 1.25 NA NA 29.99 29.99 090

69717 ............ A Temple bone implant revision .............. 14.98 NA NA 8.37 8.37 1.04 NA NA 24.39 24.39 090

69718 ............ A Revise temple bone implant ................. 18.50 NA NA 10.58 10.58 1.27 NA NA 30.35 30.35 090

69720 ............ A Release facial nerve ............................. 14.38 NA NA 12.04 13.32 1.03 NA NA 27.45 28.73 090

65502

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

69725 ............ A Release facial nerve ............................. 25.38 NA NA 18.07 17.53 1.78 NA NA 45.23 44.69 090

69740 ............ A Repair facial nerve ............................... 15.96 NA NA 11.48 11.82 1.13 NA NA 28.57 28.91 090

69745 ............ A Repair facial nerve ............................... 16.69 NA NA 12.11 13.41 1.00 NA NA 29.80 31.10 090

69799 ............ C Middle ear surgery procedure .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

69801 ............ A Incise inner ear ..................................... 8.56 NA NA 7.68 8.32 0.60 NA NA 16.84 17.48 090

69802 ............ A Incise inner ear ..................................... 13.10 NA NA 10.95 11.26 0.91 NA NA 24.96 25.27 090

69805 ............ A Explore inner ear .................................. 13.82 NA NA 10.69 11.58 0.97 NA NA 25.48 26.37 090

69806 ............ A Explore inner ear .................................. 12.35 NA NA 10.49 11.56 0.86 NA NA 23.70 24.77 090

69820 ............ A Establish inner ear window .................. 10.34 NA NA 9.08 9.21 0.66 NA NA 20.08 20.21 090

69840 ............ A Revise inner ear window ...................... 10.26 NA NA 10.00 9.80 0.64 NA NA 20.90 20.70 090

69905 ............ A Remove inner ear ................................. 11.10 NA NA 9.33 10.31 0.77 NA NA 21.20 22.18 090

69910 ............ A Remove inner ear & mastoid ............... 13.63 NA NA 10.96 12.29 0.94 NA NA 25.53 26.86 090

69915 ............ A Incise inner ear nerve .......................... 21.23 NA NA 15.22 16.22 1.54 NA NA 37.99 38.99 090

69930 ............ A Implant cochlear device ....................... 16.81 NA NA 12.44 14.35 1.19 NA NA 30.44 32.35 090

69949 ............ C Inner ear surgery procedure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

69950 ............ A Incise inner ear nerve .......................... 25.64 NA NA 16.01 16.89 2.90 NA NA 44.55 45.43 090

69955 ............ A Release facial nerve ............................. 27.04 NA NA 18.34 19.26 1.89 NA NA 47.27 48.19 090

69960 ............ A Release inner ear canal ....................... 27.04 NA NA 17.85 18.23 2.43 NA NA 47.32 47.70 090

69970 ............ A Remove inner ear lesion ...................... 30.04 NA NA 19.00 19.59 2.34 NA NA 51.38 51.97 090

69979 ............ C Temporal bone surgery ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

69990 ............ R Microsurgery add-on ............................ 3.47 NA NA 1.86 1.86 0.56 NA NA 5.89 5.89 ZZZ

70010 ............ A Contrast x-ray of brain ......................... 1.19 4.73 4.81 4.73 4.81 0.24 6.16 6.24 6.16 6.24 XXX

70010 26 A Contrast x-ray of brain ......................... 1.19 0.43 0.46 0.43 0.46 0.06 1.68 1.71 1.68 1.71 XXX

70010 TC A Contrast x-ray of brain ......................... 0.00 4.30 4.35 NA NA 0.18 4.48 4.53 NA NA XXX

70015 ............ A Contrast x-ray of brain ......................... 1.19 1.79 1.83 1.79 1.83 0.12 3.10 3.14 3.10 3.14 XXX

70015 26 A Contrast x-ray of brain ......................... 1.19 0.44 0.47 0.44 0.47 0.05 1.68 1.71 1.68 1.71 XXX

70015 TC A Contrast x-ray of brain ......................... 0.00 1.35 1.36 NA NA 0.07 1.42 1.43 NA NA XXX

70030 ............ A X-ray eye for foreign body ................... 0.17 0.47 0.49 0.47 0.49 0.03 0.67 0.69 0.67 0.69 XXX

70030 26 A X-ray eye for foreign body ................... 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

70030 TC A X-ray eye for foreign body ................... 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

70100 ............ A X-ray exam of jaw ................................ 0.18 0.58 0.60 0.58 0.60 0.03 0.79 0.81 0.79 0.81 XXX

70100 26 A X-ray exam of jaw ................................ 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

70100 TC A X-ray exam of jaw ................................ 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

70110 ............ A X-ray exam of jaw ................................ 0.25 0.70 0.72 0.70 0.72 0.04 0.99 1.01 0.99 1.01 XXX

70110 26 A X-ray exam of jaw ................................ 0.25 0.09 0.10 0.09 0.10 0.01 0.35 0.36 0.35 0.36 XXX

70110 TC A X-ray exam of jaw ................................ 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

70120 ............ A X-ray exam of mastoids ....................... 0.18 0.67 0.69 0.67 0.69 0.04 0.89 0.91 0.89 0.91 XXX

70120 26 A X-ray exam of mastoids ....................... 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

70120 TC A X-ray exam of mastoids ....................... 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

70130 ............ A X-ray exam of mastoids ....................... 0.34 0.90 0.92 0.90 0.92 0.05 1.29 1.31 1.29 1.31 XXX

70130 26 A X-ray exam of mastoids ....................... 0.34 0.12 0.13 0.12 0.13 0.01 0.47 0.48 0.47 0.48 XXX

70130 TC A X-ray exam of mastoids ....................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

70134 ............ A X-ray exam of middle ear ..................... 0.34 0.85 0.87 0.85 0.87 0.05 1.24 1.26 1.24 1.26 XXX

70134 26 A X-ray exam of middle ear ..................... 0.34 0.12 0.13 0.12 0.13 0.01 0.47 0.48 0.47 0.48 XXX

70134 TC A X-ray exam of middle ear ..................... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

70140 ............ A X-ray exam of facial bones .................. 0.19 0.68 0.70 0.68 0.70 0.04 0.91 0.93 0.91 0.93 XXX

70140 26 A X-ray exam of facial bones .................. 0.19 0.07 0.08 0.07 0.08 0.01 0.27 0.28 0.27 0.28 XXX

70140 TC A X-ray exam of facial bones .................. 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

70150 ............ A X-ray exam of facial bones .................. 0.26 0.87 0.89 0.87 0.89 0.05 1.18 1.20 1.18 1.20 XXX

70150 26 A X-ray exam of facial bones .................. 0.26 0.09 0.10 0.09 0.10 0.01 0.36 0.37 0.36 0.37 XXX

70150 TC A X-ray exam of facial bones .................. 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

70160 ............ A X-ray exam of nasal bones .................. 0.17 0.58 0.60 0.58 0.60 0.03 0.78 0.80 0.78 0.80 XXX

70160 26 A X-ray exam of nasal bones .................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

70160 TC A X-ray exam of nasal bones .................. 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

70170 ............ A X-ray exam of tear duct ....................... 0.30 1.05 1.07 1.05 1.07 0.06 1.41 1.43 1.41 1.43 XXX

70170 26 A X-ray exam of tear duct ....................... 0.30 0.11 0.12 0.11 0.12 0.01 0.42 0.43 0.42 0.43 XXX

70170 TC A X-ray exam of tear duct ....................... 0.00 0.94 0.95 NA NA 0.05 0.99 1.00 NA NA XXX

70190 ............ A X-ray exam of eye sockets .................. 0.21 0.68 0.70 0.68 0.70 0.04 0.93 0.95 0.93 0.95 XXX

70190 26 A X-ray exam of eye sockets .................. 0.21 0.07 0.08 0.07 0.08 0.01 0.29 0.30 0.29 0.30 XXX

70190 TC A X-ray exam of eye sockets .................. 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

70200 ............ A X-ray exam of eye sockets .................. 0.28 0.88 0.90 0.88 0.90 0.05 1.21 1.23 1.21 1.23 XXX

70200 26 A X-ray exam of eye sockets .................. 0.28 0.10 0.11 0.10 0.11 0.01 0.39 0.40 0.39 0.40 XXX

70200 TC A X-ray exam of eye sockets .................. 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

70210 ............ A X-ray exam of sinuses ......................... 0.17 0.67 0.69 0.67 0.69 0.04 0.88 0.90 0.88 0.90 XXX

70210 26 A X-ray exam of sinuses ......................... 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

70210 TC A X-ray exam of sinuses ......................... 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

70220 ............ A X-ray exam of sinuses ......................... 0.25 0.87 0.89 0.87 0.89 0.05 1.17 1.19 1.17 1.19 XXX

70220 26 A X-ray exam of sinuses ......................... 0.25 0.09 0.10 0.09 0.10 0.01 0.35 0.36 0.35 0.36 XXX

70220 TC A X-ray exam of sinuses ......................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

70240 ............ A X-ray exam, pituitary saddle ................ 0.19 0.48 0.50 0.48 0.50 0.03 0.70 0.72 0.70 0.72 XXX

70240 26 A X-ray exam, pituitary saddle ................ 0.19 0.07 0.08 0.07 0.08 0.01 0.27 0.28 0.27 0.28 XXX

70240 TC A X-ray exam, pituitary saddle ................ 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

70250 ............ A X-ray exam of skull .............................. 0.24 0.70 0.72 0.70 0.72 0.04 0.98 1.00 0.98 1.00 XXX

70250 26 A X-ray exam of skull .............................. 0.24 0.09 0.10 0.09 0.10 0.01 0.34 0.35 0.34 0.35 XXX

70250 TC A X-ray exam of skull .............................. 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

70260 ............ A X-ray exam of skull .............................. 0.34 1.00 1.02 1.00 1.02 0.06 1.40 1.42 1.40 1.42 XXX

70260 26 A X-ray exam of skull .............................. 0.34 0.12 0.13 0.12 0.13 0.01 0.47 0.48 0.47 0.48 XXX

70260 TC A X-ray exam of skull .............................. 0.00 0.88 0.89 NA NA 0.05 0.93 0.94 NA NA XXX

70300 ............ A X-ray exam of teeth .............................. 0.10 0.30 0.30 0.30 0.30 0.03 0.43 0.43 0.43 0.43 XXX

70300 26 A X-ray exam of teeth .............................. 0.10 0.04 0.04 0.04 0.04 0.01 0.15 0.15 0.15 0.15 XXX

70300 TC A X-ray exam of teeth .............................. 0.00 0.26 0.26 NA NA 0.02 0.28 0.28 NA NA XXX

70310 ............ A X-ray exam of teeth .............................. 0.16 0.47 0.49 0.47 0.49 0.03 0.66 0.68 0.66 0.68 XXX

70310 26 A X-ray exam of teeth .............................. 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

65503

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

70310 TC A X-ray exam of teeth .............................. 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

70320 ............ A Full mouth x-ray of teeth ...................... 0.22 0.86 0.88 0.86 0.88 0.05 1.13 1.15 1.13 1.15 XXX

70320 26 A Full mouth x-ray of teeth ...................... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

70320 TC A Full mouth x-ray of teeth ...................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

70328 ............ A X-ray exam of jaw joint ........................ 0.18 0.55 0.57 0.55 0.57 0.03 0.76 0.78 0.76 0.78 XXX

70328 26 A X-ray exam of jaw joint ........................ 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

70328 TC A X-ray exam of jaw joint ........................ 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

70330 ............ A X-ray exam of jaw joints ....................... 0.24 0.93 0.95 0.93 0.95 0.05 1.22 1.24 1.22 1.24 XXX

70330 26 A X-ray exam of jaw joints ....................... 0.24 0.09 0.10 0.09 0.10 0.01 0.34 0.35 0.34 0.35 XXX

70330 TC A X-ray exam of jaw joints ....................... 0.00 0.84 0.85 NA NA 0.04 0.88 0.89 NA NA XXX

70332 ............ A X-ray exam of jaw joint ........................ 0.54 2.28 2.32 2.28 2.32 0.12 2.94 2.98 2.94 2.98 XXX

70332 26 A X-ray exam of jaw joint ........................ 0.54 0.20 0.22 0.20 0.22 0.02 0.76 0.78 0.76 0.78 XXX

70332 TC A X-ray exam of jaw joint ........................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

70336 ............ A Magnetic image, jaw joint ..................... 1.48 11.66 11.77 11.66 11.77 0.56 13.70 13.81 13.70 13.81 XXX

70336 26 A Magnetic image, jaw joint ..................... 1.48 0.53 0.52 0.53 0.52 0.07 2.08 2.07 2.08 2.07 XXX

70336 TC A Magnetic image, jaw joint ..................... 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

70350 ............ A X-ray head for orthodontia ................... 0.17 0.43 0.45 0.43 0.45 0.03 0.63 0.65 0.63 0.65 XXX

70350 26 A X-ray head for orthodontia ................... 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

70350 TC A X-ray head for orthodontia ................... 0.00 0.37 0.38 NA NA 0.02 0.39 0.40 NA NA XXX

70355 ............ A Panoramic x-ray of jaws ....................... 0.20 0.64 0.66 0.64 0.66 0.04 0.88 0.90 0.88 0.90 XXX

70355 26 A Panoramic x-ray of jaws ....................... 0.20 0.07 0.08 0.07 0.08 0.01 0.28 0.29 0.28 0.29 XXX

70355 TC A Panoramic x-ray of jaws ....................... 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

70360 ............ A X-ray exam of neck .............................. 0.17 0.47 0.49 0.47 0.49 0.03 0.67 0.69 0.67 0.69 XXX

70360 26 A X-ray exam of neck .............................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

70360 TC A X-ray exam of neck .............................. 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

70370 ............ A Throat x-ray & fluoroscopy ................... 0.32 1.41 1.43 1.41 1.43 0.07 1.80 1.82 1.80 1.82 XXX

70370 26 A Throat x-ray & fluoroscopy ................... 0.32 0.11 0.12 0.11 0.12 0.01 0.44 0.45 0.44 0.45 XXX

70370 TC A Throat x-ray & fluoroscopy ................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

70371 ............ A Speech evaluation, complex ................ 0.84 2.38 2.43 2.38 2.43 0.14 3.36 3.41 3.36 3.41 XXX

70371 26 A Speech evaluation, complex ................ 0.84 0.30 0.33 0.30 0.33 0.04 1.18 1.21 1.18 1.21 XXX

70371 TC A Speech evaluation, complex ................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

70373 ............ A Contrast x-ray of larynx ........................ 0.44 1.93 1.97 1.93 1.97 0.11 2.48 2.52 2.48 2.52 XXX

70373 26 A Contrast x-ray of larynx ........................ 0.44 0.16 0.18 0.16 0.18 0.02 0.62 0.64 0.62 0.64 XXX

70373 TC A Contrast x-ray of larynx ........................ 0.00 1.77 1.79 NA NA 0.09 1.86 1.88 NA NA XXX

70380 ............ A X-ray exam of salivary gland ............... 0.17 0.72 0.74 0.72 0.74 0.04 0.93 0.95 0.93 0.95 XXX

70380 26 A X-ray exam of salivary gland ............... 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

70380 TC A X-ray exam of salivary gland ............... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

70390 ............ A X-ray exam of salivary duct ................. 0.38 1.90 1.93 1.90 1.93 0.11 2.39 2.42 2.39 2.42 XXX

70390 26 A X-ray exam of salivary duct ................. 0.38 0.13 0.14 0.13 0.14 0.02 0.53 0.54 0.53 0.54 XXX

70390 TC A X-ray exam of salivary duct ................. 0.00 1.77 1.79 NA NA 0.09 1.86 1.88 NA NA XXX

70450 ............ A Ct head/brain w/o dye .......................... 0.85 4.99 5.07 4.99 5.07 0.25 6.09 6.17 6.09 6.17 XXX

70450 26 A Ct head/brain w/o dye .......................... 0.85 0.30 0.33 0.30 0.33 0.04 1.19 1.22 1.19 1.22 XXX

70450 TC A Ct head/brain w/o dye .......................... 0.00 4.69 4.74 NA NA 0.21 4.90 4.95 NA NA XXX

70460 ............ A Ct head/brain w/dye ............................. 1.13 6.01 6.11 6.01 6.11 0.30 7.44 7.54 7.44 7.54 XXX

70460 26 A Ct head/brain w/dye ............................. 1.13 0.40 0.44 0.40 0.44 0.05 1.58 1.62 1.58 1.62 XXX

70460 TC A Ct head/brain w/dye ............................. 0.00 5.61 5.67 NA NA 0.25 5.86 5.92 NA NA XXX

70470 ............ A Ct head/brain w/o&w dye ..................... 1.27 7.46 7.58 7.46 7.58 0.37 9.10 9.22 9.10 9.22 XXX

70470 26 A Ct head/brain w/o&w dye ..................... 1.27 0.45 0.49 0.45 0.49 0.06 1.78 1.82 1.78 1.82 XXX

70470 TC A Ct head/brain w/o&w dye ..................... 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

70480 ............ A Ct orbit/ear/fossa w/o dye .................... 1.28 5.14 5.23 5.14 5.23 0.27 6.69 6.78 6.69 6.78 XXX

70480 26 A Ct orbit/ear/fossa w/o dye .................... 1.28 0.45 0.49 0.45 0.49 0.06 1.79 1.83 1.79 1.83 XXX

70480 TC A Ct orbit/ear/fossa w/o dye .................... 0.00 4.69 4.74 NA NA 0.21 4.90 4.95 NA NA XXX

70481 ............ A Ct orbit/ear/fossa w/dye ....................... 1.38 6.10 6.20 6.10 6.20 0.31 7.79 7.89 7.79 7.89 XXX

70481 26 A Ct orbit/ear/fossa w/dye ....................... 1.38 0.49 0.53 0.49 0.53 0.06 1.93 1.97 1.93 1.97 XXX

70481 TC A Ct orbit/ear/fossa w/dye ....................... 0.00 5.61 5.67 NA NA 0.25 5.86 5.92 NA NA XXX

70482 ............ A Ct orbit/ear/fossa w/o&w dye ............... 1.45 7.53 7.65 7.53 7.65 0.37 9.35 9.47 9.35 9.47 XXX

70482 26 A Ct orbit/ear/fossa w/o&w dye ............... 1.45 0.52 0.56 0.52 0.56 0.06 2.03 2.07 2.03 2.07 XXX

70482 TC A Ct orbit/ear/fossa w/o&w dye ............... 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

70486 ............ A Ct maxillofacial w/o dye ....................... 1.14 5.10 5.18 5.10 5.18 0.26 6.50 6.58 6.50 6.58 XXX

70486 26 A Ct maxillofacial w/o dye ....................... 1.14 0.41 0.44 0.41 0.44 0.05 1.60 1.63 1.60 1.63 XXX

70486 TC A Ct maxillofacial w/o dye ....................... 0.00 4.69 4.74 NA NA 0.21 4.90 4.95 NA NA XXX

70487 ............ A Ct maxillofacial w/dye ........................... 1.30 6.07 6.17 6.07 6.17 0.31 7.68 7.78 7.68 7.78 XXX

70487 26 A Ct maxillofacial w/dye ........................... 1.30 0.46 0.50 0.46 0.50 0.06 1.82 1.86 1.82 1.86 XXX

70487 TC A Ct maxillofacial w/dye ........................... 0.00 5.61 5.67 NA NA 0.25 5.86 5.92 NA NA XXX

70488 ............ A Ct maxillofacial w/o&w dye .................. 1.42 7.51 7.64 7.51 7.64 0.37 9.30 9.43 9.30 9.43 XXX

70488 26 A Ct maxillofacial w/o&w dye .................. 1.42 0.50 0.55 0.50 0.55 0.06 1.98 2.03 1.98 2.03 XXX

70488 TC A Ct maxillofacial w/o&w dye .................. 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

70490 ............ A Ct soft tissue neck w/o dye .................. 1.28 5.14 5.23 5.14 5.23 0.27 6.69 6.78 6.69 6.78 XXX

70490 26 A Ct soft tissue neck w/o dye .................. 1.28 0.45 0.49 0.45 0.49 0.06 1.79 1.83 1.79 1.83 XXX

70490 TC A Ct soft tissue neck w/o dye .................. 0.00 4.69 4.74 NA NA 0.21 4.90 4.95 NA NA XXX

70491 ............ A Ct soft tissue neck w/dye ..................... 1.38 6.10 6.20 6.10 6.20 0.31 7.79 7.89 7.79 7.89 XXX

70491 26 A Ct soft tissue neck w/dye ..................... 1.38 0.49 0.53 0.49 0.53 0.06 1.93 1.97 1.93 1.97 XXX

70491 TC A Ct soft tissue neck w/dye ..................... 0.00 5.61 5.67 NA NA 0.25 5.86 5.92 NA NA XXX

70492 ............ A Ct sft tsue nck w/o & w/dye ................. 1.45 7.53 7.65 7.53 7.65 0.37 9.35 9.47 9.35 9.47 XXX

70492 26 A Ct sft tsue nck w/o & w/dye ................. 1.45 0.52 0.56 0.52 0.56 0.06 2.03 2.07 2.03 2.07 XXX

70492 TC A Ct sft tsue nck w/o & w/dye ................. 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

70496 ............ A Ct angiography, head ........................... 1.75 7.71 7.71 7.71 7.71 0.54 10.00 10.00 10.00 10.00 XXX

70496 26 A Ct angiography, head ........................... 1.75 0.70 0.70 0.70 0.70 0.06 2.51 2.51 2.51 2.51 XXX

70496 TC A Ct angiography, head ........................... 0.00 7.01 7.01 NA NA 0.48 7.49 7.49 NA NA XXX

70498 ............ A Ct angiography, neck ........................... 1.75 7.71 7.71 7.71 7.71 0.54 10.00 10.00 10.00 10.00 XXX

70498 26 A Ct angiography, neck ........................... 1.75 0.70 0.70 0.70 0.70 0.06 2.51 2.51 2.51 2.51 XXX

70498 TC A Ct angiography, neck ........................... 0.00 7.01 7.01 NA NA 0.48 7.49 7.49 NA NA XXX

70540 ............ A Mri orbit/face/neck w/o dye .................. 0.98 11.48 11.69 11.48 11.69 0.36 12.82 13.03 12.82 13.03 XXX

65504

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

70540 26 A Mri orbit/face/neck w/o dye .................. 0.98 0.35 0.44 0.35 0.44 0.04 1.37 1.46 1.37 1.46 XXX

70540 TC A Mri orbit/face/neck w/o dye .................. 0.00 11.13 11.25 NA NA 0.32 11.45 11.57 NA NA XXX

70541 ............ D Magnetic image, head (MRA) .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

70541 26 D Magnetic image, head (MRA) .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

70541 TC D Magnetic image, head (MRA) .............. 0.00 0.00 0.00 NA NA 0.00 0.00 0.00 NA NA XXX

70542 ............ A Mri orbit/face/neck w/dye ..................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

70542 26 A Mri orbit/face/neck w/dye ..................... 1.17 0.42 0.42 0.42 0.42 0.04 1.63 1.63 1.63 1.63 XXX

70542 TC A Mri orbit/face/neck w/dye ..................... 0.00 13.34 13.34 NA NA 0.39 13.73 13.73 NA NA XXX

70543 ............ A Mri orbt/fac/nck w/o&w dye .................. 1.56 25.27 25.27 25.27 25.27 0.78 27.61 27.61 27.61 27.61 XXX

70543 26 A Mri orbt/fac/nck w/o&w dye .................. 1.56 0.56 0.56 0.56 0.56 0.08 2.20 2.20 2.20 2.20 XXX

70543 TC A Mri orbt/fac/nck w/o&w dye .................. 0.00 24.71 24.71 NA NA 0.70 25.41 25.41 NA NA XXX

70544 ............ A Mr angiography head w/o dye ............. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70544 26 A Mr angiography head w/o dye ............. 1.20 0.43 0.43 0.43 0.43 0.07 1.70 1.70 1.70 1.70 XXX

70544 TC A Mr angiography head w/o dye ............. 0.00 11.13 11.13 NA NA 0.49 11.62 11.62 NA NA XXX

70545 ............ A Mr angiography head w/dye ................. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70545 26 A Mr angiography head w/dye ................. 1.20 0.43 0.43 0.43 0.43 0.07 1.70 1.70 1.70 1.70 XXX

70545 TC A Mr angiography head w/dye ................. 0.00 11.13 11.13 NA NA 0.49 11.62 11.62 NA NA XXX

70546 ............ A Mr angiograph head w/o&w dye .......... 1.80 22.89 22.89 22.89 22.89 0.56 25.25 25.25 25.25 25.25 XXX

70546 26 A Mr angiograph head w/o&w dye .......... 1.80 0.64 0.64 0.64 0.64 0.07 2.51 2.51 2.51 2.51 XXX

70546 TC A Mr angiograph head w/o&w dye .......... 0.00 22.25 22.25 NA NA 0.49 22.74 22.74 NA NA XXX

70547 ............ A Mr angiography neck w/o dye .............. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70547 26 A Mr angiography neck w/o dye .............. 1.20 0.43 0.43 0.43 0.43 0.07 1.70 1.70 1.70 1.70 XXX

70547 TC A Mr angiography neck w/o dye .............. 0.00 11.13 11.13 NA NA 0.49 11.62 11.62 NA NA XXX

70548 ............ A Mr angiography neck w/dye ................. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70548 26 A Mr angiography neck w/dye ................. 1.20 0.43 0.43 0.43 0.43 0.07 1.70 1.70 1.70 1.70 XXX

70548 TC A Mr angiography neck w/dye ................. 0.00 11.13 11.13 NA NA 0.49 11.62 11.62 NA NA XXX

70549 ............ A Mr angiograph neck w/o&w dye ........... 1.80 22.89 22.89 22.89 22.89 0.56 25.25 25.25 25.25 25.25 XXX

70549 26 A Mr angiograph neck w/o&w dye ........... 1.80 0.64 0.64 0.64 0.64 0.07 2.51 2.51 2.51 2.51 XXX

70549 TC A Mr angiograph neck w/o&w dye ........... 0.00 22.25 22.25 NA NA 0.49 22.74 22.74 NA NA XXX

70551 ............ A Mri brain w/o dye .................................. 1.48 11.66 11.83 11.66 11.83 0.56 13.70 13.87 13.70 13.87 XXX

70551 26 A Mri brain w/o dye .................................. 1.48 0.53 0.58 0.53 0.58 0.07 2.08 2.13 2.08 2.13 XXX

70551 TC A Mri brain w/o dye .................................. 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

70552 ............ A Mri brain w/dye ..................................... 1.78 13.98 14.18 13.98 14.18 0.66 16.42 16.62 16.42 16.62 XXX

70552 26 A Mri brain w/dye ..................................... 1.78 0.64 0.70 0.64 0.70 0.08 2.50 2.56 2.50 2.56 XXX

70552 TC A Mri brain w/dye ..................................... 0.00 13.34 13.48 NA NA 0.58 13.92 14.06 NA NA XXX

70553 ............ A Mri brain w/o&w dye ............................. 2.36 25.55 25.89 25.55 25.89 1.19 29.10 29.44 29.10 29.44 XXX

70553 26 A Mri brain w/o&w dye ............................. 2.36 0.84 0.92 0.84 0.92 0.10 3.30 3.38 3.30 3.38 XXX

70553 TC A Mri brain w/o&w dye ............................. 0.00 24.71 24.97 NA NA 1.09 25.80 26.06 NA NA XXX

71010 ............ A Chest x-ray ........................................... 0.18 0.53 0.55 0.53 0.55 0.03 0.74 0.76 0.74 0.76 XXX

71010 26 A Chest x-ray ........................................... 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

71010 TC A Chest x-ray ........................................... 0.00 0.47 0.48 NA NA 0.02 0.49 0.50 NA NA XXX

71015 ............ A Chest x-ray ........................................... 0.21 0.60 0.62 0.60 0.62 0.03 0.84 0.86 0.84 0.86 XXX

71015 26 A Chest x-ray ........................................... 0.21 0.08 0.09 0.08 0.09 0.01 0.30 0.31 0.30 0.31 XXX

71015 TC A Chest x-ray ........................................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

71020 ............ A Chest x-ray ........................................... 0.22 0.69 0.71 0.69 0.71 0.04 0.95 0.97 0.95 0.97 XXX

71020 26 A Chest x-ray ........................................... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

71020 TC A Chest x-ray ........................................... 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

71021 ............ A Chest x-ray ........................................... 0.27 0.83 0.85 0.83 0.85 0.05 1.15 1.17 1.15 1.17 XXX

71021 26 A Chest x-ray ........................................... 0.27 0.10 0.11 0.10 0.11 0.01 0.38 0.39 0.38 0.39 XXX

71021 TC A Chest x-ray ........................................... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

71022 ............ A Chest x-ray ........................................... 0.31 0.84 0.86 0.84 0.86 0.06 1.21 1.23 1.21 1.23 XXX

71022 26 A Chest x-ray ........................................... 0.31 0.11 0.12 0.11 0.12 0.02 0.44 0.45 0.44 0.45 XXX

71022 TC A Chest x-ray ........................................... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

71023 ............ A Chest x-ray and fluoroscopy ................ 0.38 0.92 0.94 0.92 0.94 0.06 1.36 1.38 1.36 1.38 XXX

71023 26 A Chest x-ray and fluoroscopy ................ 0.38 0.14 0.15 0.14 0.15 0.02 0.54 0.55 0.54 0.55 XXX

71023 TC A Chest x-ray and fluoroscopy ................ 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

71030 ............ A Chest x-ray ........................................... 0.31 0.89 0.91 0.89 0.91 0.05 1.25 1.27 1.25 1.27 XXX

71030 26 A Chest x-ray ........................................... 0.31 0.11 0.12 0.11 0.12 0.01 0.43 0.44 0.43 0.44 XXX

71030 TC A Chest x-ray ........................................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

71034 ............ A Chest x-ray and fluoroscopy ................ 0.46 1.61 1.64 1.61 1.64 0.09 2.16 2.19 2.16 2.19 XXX

71034 26 A Chest x-ray and fluoroscopy ................ 0.46 0.18 0.19 0.18 0.19 0.02 0.66 0.67 0.66 0.67 XXX

71034 TC A Chest x-ray and fluoroscopy ................ 0.00 1.43 1.45 NA NA 0.07 1.50 1.52 NA NA XXX

71035 ............ A Chest x-ray ........................................... 0.18 0.58 0.60 0.58 0.60 0.03 0.79 0.81 0.79 0.81 XXX

71035 26 A Chest x-ray ........................................... 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

71035 TC A Chest x-ray ........................................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

71036 ............ D X-ray guidance for biopsy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

71036 26 D X-ray guidance for biopsy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

71036 TC D X-ray guidance for biopsy .................... 0.00 0.00 0.00 NA NA 0.00 0.00 0.00 NA NA XXX

71040 ............ A Contrast x-ray of bronchi ...................... 0.58 1.66 1.70 1.66 1.70 0.10 2.34 2.38 2.34 2.38 XXX

71040 26 A Contrast x-ray of bronchi ...................... 0.58 0.21 0.23 0.21 0.23 0.03 0.82 0.84 0.82 0.84 XXX

71040 TC A Contrast x-ray of bronchi ...................... 0.00 1.45 1.47 NA NA 0.07 1.52 1.54 NA NA XXX

71060 ............ A Contrast x-ray of bronchi ...................... 0.74 2.45 2.50 2.45 2.50 0.14 3.33 3.38 3.33 3.38 XXX

71060 26 A Contrast x-ray of bronchi ...................... 0.74 0.26 0.29 0.26 0.29 0.03 1.03 1.06 1.03 1.06 XXX

71060 TC A Contrast x-ray of bronchi ...................... 0.00 2.19 2.21 NA NA 0.11 2.30 2.32 NA NA XXX

71090 ............ A X-ray & pacemaker insertion ................ 0.54 1.90 1.93 1.90 1.93 0.11 2.55 2.58 2.55 2.58 XXX

71090 26 A X-ray & pacemaker insertion ................ 0.54 0.23 0.24 0.23 0.24 0.02 0.79 0.80 0.79 0.80 XXX

71090 TC A X-ray & pacemaker insertion ................ 0.00 1.67 1.69 NA NA 0.09 1.76 1.78 NA NA XXX

71100 ............ A X-ray exam of ribs ................................ 0.22 0.65 0.67 0.65 0.67 0.04 0.91 0.93 0.91 0.93 XXX

71100 26 A X-ray exam of ribs ................................ 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

71100 TC A X-ray exam of ribs ................................ 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

71101 ............ A X-ray exam of ribs/chest ...................... 0.27 0.76 0.78 0.76 0.78 0.04 1.07 1.09 1.07 1.09 XXX

71101 26 A X-ray exam of ribs/chest ...................... 0.27 0.10 0.11 0.10 0.11 0.01 0.38 0.39 0.38 0.39 XXX

71101 TC A X-ray exam of ribs/chest ...................... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

65505

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

71110 ............ A X-ray exam of ribs ................................ 0.27 0.88 0.90 0.88 0.90 0.05 1.20 1.22 1.20 1.22 XXX

71110 26 A X-ray exam of ribs ................................ 0.27 0.10 0.11 0.10 0.11 0.01 0.38 0.39 0.38 0.39 XXX

71110 TC A X-ray exam of ribs ................................ 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

71111 ............ A X-ray exam of ribs/ chest ..................... 0.32 0.99 1.01 0.99 1.01 0.06 1.37 1.39 1.37 1.39 XXX

71111 26 A X-ray exam of ribs/ chest ..................... 0.32 0.11 0.12 0.11 0.12 0.01 0.44 0.45 0.44 0.45 XXX

71111 TC A X-ray exam of ribs/ chest ..................... 0.00 0.88 0.89 NA NA 0.05 0.93 0.94 NA NA XXX

71120 ............ A X-ray exam of breastbone .................... 0.20 0.71 0.73 0.71 0.73 0.04 0.95 0.97 0.95 0.97 XXX

71120 26 A X-ray exam of breastbone .................... 0.20 0.07 0.08 0.07 0.08 0.01 0.28 0.29 0.28 0.29 XXX

71120 TC A X-ray exam of breastbone .................... 0.00 0.64 0.65 NA NA 0.03 0.67 0.68 NA NA XXX

71130 ............ A X-ray exam of breastbone .................... 0.22 0.78 0.80 0.78 0.80 0.04 1.04 1.06 1.04 1.06 XXX

71130 26 A X-ray exam of breastbone .................... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

71130 TC A X-ray exam of breastbone .................... 0.00 0.70 0.71 NA NA 0.03 0.73 0.74 NA NA XXX

71250 ............ A Ct thorax w/o dye ................................. 1.16 6.27 6.37 6.27 6.37 0.31 7.74 7.84 7.74 7.84 XXX

71250 26 A Ct thorax w/o dye ................................. 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

71250 TC A Ct thorax w/o dye ................................. 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

71260 ............ A Ct thorax w/dye .................................... 1.24 7.45 7.57 7.45 7.57 0.36 9.05 9.17 9.05 9.17 XXX

71260 26 A Ct thorax w/dye .................................... 1.24 0.44 0.48 0.44 0.48 0.05 1.73 1.77 1.73 1.77 XXX

71260 TC A Ct thorax w/dye .................................... 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

71270 ............ A Ct thorax w/o&w dye ............................ 1.38 9.27 9.40 9.27 9.40 0.44 11.09 11.22 11.09 11.22 XXX

71270 26 A Ct thorax w/o&w dye ............................ 1.38 0.49 0.53 0.49 0.53 0.06 1.93 1.97 1.93 1.97 XXX

71270 TC A Ct thorax w/o&w dye ............................ 0.00 8.78 8.87 NA NA 0.38 9.16 9.25 NA NA XXX

71275 ............ A Ct angiography, chest .......................... 1.20 9.26 9.26 9.26 9.26 0.37 10.83 10.83 10.83 10.83 XXX

71275 26 A Ct angiography, chest .......................... 1.20 0.48 0.48 0.48 0.48 0.05 1.73 1.73 1.73 1.73 XXX

71275 TC A Ct angiography, chest .......................... 0.00 8.78 8.78 NA NA 0.32 9.10 9.10 NA NA XXX

71550 ............ A Mri chest w/o dye ................................. 1.10 11.52 11.74 11.52 11.74 0.41 13.03 13.25 13.03 13.25 XXX

71550 26 A Mri chest w/o dye ................................. 1.10 0.39 0.49 0.39 0.49 0.04 1.53 1.63 1.53 1.63 XXX

71550 TC A Mri chest w/o dye ................................. 0.00 11.13 11.25 NA NA 0.37 11.50 11.62 NA NA XXX

71551 ............ A Mri chest w/dye .................................... 1.30 13.80 13.80 13.80 13.80 0.48 15.58 15.58 15.58 15.58 XXX

71551 26 A Mri chest w/dye .................................... 1.30 0.46 0.46 0.46 0.46 0.05 1.81 1.81 1.81 1.81 XXX

71551 TC A Mri chest w/dye .................................... 0.00 13.34 13.34 NA NA 0.43 13.77 13.77 NA NA XXX

71552 ............ A Mri chest w/o&w dye ............................ 1.70 25.31 25.31 25.31 25.31 0.63 27.64 27.64 27.64 27.64 XXX

71552 26 A Mri chest w/o&w dye ............................ 1.70 0.60 0.60 0.60 0.60 0.07 2.37 2.37 2.37 2.37 XXX

71552 TC A Mri chest w/o&w dye ............................ 0.00 24.71 24.71 NA NA 0.56 25.27 25.27 NA NA XXX

71555 ............ R Mri angio chest w or w/o dye ............... 1.81 11.78 11.93 11.78 11.93 0.57 14.16 14.31 14.16 14.31 XXX

71555 26 R Mri angio chest w or w/o dye ............... 1.81 0.65 0.68 0.65 0.68 0.08 2.54 2.57 2.54 2.57 XXX

71555 TC R Mri angio chest w or w/o dye ............... 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

72010 ............ A X-ray exam of spine ............................. 0.45 1.18 1.21 1.18 1.21 0.08 1.71 1.74 1.71 1.74 XXX

72010 26 A X-ray exam of spine ............................. 0.45 0.16 0.18 0.16 0.18 0.03 0.64 0.66 0.64 0.66 XXX

72010 TC A X-ray exam of spine ............................. 0.00 1.02 1.03 NA NA 0.05 1.07 1.08 NA NA XXX

72020 ............ A X-ray exam of spine ............................. 0.15 0.46 0.48 0.46 0.48 0.03 0.64 0.66 0.64 0.66 XXX

72020 26 A X-ray exam of spine ............................. 0.15 0.05 0.06 0.05 0.06 0.01 0.21 0.22 0.21 0.22 XXX

72020 TC A X-ray exam of spine ............................. 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

72040 ............ A X-ray exam of neck spine .................... 0.22 0.68 0.70 0.68 0.70 0.04 0.94 0.96 0.94 0.96 XXX

72040 26 A X-ray exam of neck spine .................... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

72040 TC A X-ray exam of neck spine .................... 0.00 0.60 0.61 NA NA 0.03 0.63 0.64 NA NA XXX

72050 ............ A X-ray exam of neck spine .................... 0.31 0.99 1.01 0.99 1.01 0.07 1.37 1.39 1.37 1.39 XXX

72050 26 A X-ray exam of neck spine .................... 0.31 0.11 0.12 0.11 0.12 0.02 0.44 0.45 0.44 0.45 XXX

72050 TC A X-ray exam of neck spine .................... 0.00 0.88 0.89 NA NA 0.05 0.93 0.94 NA NA XXX

72052 ............ A X-ray exam of neck spine .................... 0.36 1.25 1.27 1.25 1.27 0.07 1.68 1.70 1.68 1.70 XXX

72052 26 A X-ray exam of neck spine .................... 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

72052 TC A X-ray exam of neck spine .................... 0.00 1.12 1.13 NA NA 0.05 1.17 1.18 NA NA XXX

72069 ............ A X-ray exam of trunk spine .................... 0.22 0.57 0.59 0.57 0.59 0.04 0.83 0.85 0.83 0.85 XXX

72069 26 A X-ray exam of trunk spine .................... 0.22 0.08 0.09 0.08 0.09 0.02 0.32 0.33 0.32 0.33 XXX

72069 TC A X-ray exam of trunk spine .................... 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

72070 ............ A X-ray exam of thoracic spine ............... 0.22 0.72 0.74 0.72 0.74 0.04 0.98 1.00 0.98 1.00 XXX

72070 26 A X-ray exam of thoracic spine ............... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

72070 TC A X-ray exam of thoracic spine ............... 0.00 0.64 0.65 NA NA 0.03 0.67 0.68 NA NA XXX

72072 ............ A X-ray exam of thoracic spine ............... 0.22 0.81 0.83 0.81 0.83 0.05 1.08 1.10 1.08 1.10 XXX

72072 26 A X-ray exam of thoracic spine ............... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

72072 TC A X-ray exam of thoracic spine ............... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

72074 ............ A X-ray exam of thoracic spine ............... 0.22 0.98 1.00 0.98 1.00 0.06 1.26 1.28 1.26 1.28 XXX

72074 26 A X-ray exam of thoracic spine ............... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

72074 TC A X-ray exam of thoracic spine ............... 0.00 0.90 0.91 NA NA 0.05 0.95 0.96 NA NA XXX

72080 ............ A X-ray exam of trunk spine .................... 0.22 0.74 0.76 0.74 0.76 0.05 1.01 1.03 1.01 1.03 XXX

72080 26 A X-ray exam of trunk spine .................... 0.22 0.08 0.09 0.08 0.09 0.02 0.32 0.33 0.32 0.33 XXX

72080 TC A X-ray exam of trunk spine .................... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

72090 ............ A X-ray exam of trunk spine .................... 0.28 0.76 0.78 0.76 0.78 0.05 1.09 1.11 1.09 1.11 XXX

72090 26 A X-ray exam of trunk spine .................... 0.28 0.10 0.11 0.10 0.11 0.02 0.40 0.41 0.40 0.41 XXX

72090 TC A X-ray exam of trunk spine .................... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

72100 ............ A X-ray exam of lower spine ................... 0.22 0.74 0.76 0.74 0.76 0.05 1.01 1.03 1.01 1.03 XXX

72100 26 A X-ray exam of lower spine ................... 0.22 0.08 0.09 0.08 0.09 0.02 0.32 0.33 0.32 0.33 XXX

72100 TC A X-ray exam of lower spine ................... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

72110 ............ A X-ray exam of lower spine ................... 0.31 1.01 1.03 1.01 1.03 0.07 1.39 1.41 1.39 1.41 XXX

72110 26 A X-ray exam of lower spine ................... 0.31 0.11 0.12 0.11 0.12 0.02 0.44 0.45 0.44 0.45 XXX

72110 TC A X-ray exam of lower spine ................... 0.00 0.90 0.91 NA NA 0.05 0.95 0.96 NA NA XXX

72114 ............ A X-ray exam of lower spine ................... 0.36 1.31 1.33 1.31 1.33 0.08 1.75 1.77 1.75 1.77 XXX

72114 26 A X-ray exam of lower spine ................... 0.36 0.13 0.14 0.13 0.14 0.03 0.52 0.53 0.52 0.53 XXX

72114 TC A X-ray exam of lower spine ................... 0.00 1.18 1.19 NA NA 0.05 1.23 1.24 NA NA XXX

72120 ............ A X-ray exam of lower spine ................... 0.22 0.96 0.98 0.96 0.98 0.07 1.25 1.27 1.25 1.27 XXX

72120 26 A X-ray exam of lower spine ................... 0.22 0.08 0.09 0.08 0.09 0.02 0.32 0.33 0.32 0.33 XXX

72120 TC A X-ray exam of lower spine ................... 0.00 0.88 0.89 NA NA 0.05 0.93 0.94 NA NA XXX

72125 ............ A Ct neck spine w/o dye .......................... 1.16 6.27 6.37 6.27 6.37 0.31 7.74 7.84 7.74 7.84 XXX

72125 26 A Ct neck spine w/o dye .......................... 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

65506

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

72125 TC A Ct neck spine w/o dye .......................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

72126 ............ A Ct neck spine w/dye ............................. 1.22 7.44 7.56 7.44 7.56 0.36 9.02 9.14 9.02 9.14 XXX

72126 26 A Ct neck spine w/dye ............................. 1.22 0.43 0.47 0.43 0.47 0.05 1.70 1.74 1.70 1.74 XXX

72126 TC A Ct neck spine w/dye ............................. 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

72127 ............ A Ct neck spine w/o&w dye ..................... 1.27 9.23 9.36 9.23 9.36 0.44 10.94 11.07 10.94 11.07 XXX

72127 26 A Ct neck spine w/o&w dye ..................... 1.27 0.45 0.49 0.45 0.49 0.06 1.78 1.82 1.78 1.82 XXX

72127 TC A Ct neck spine w/o&w dye ..................... 0.00 8.78 8.87 NA NA 0.38 9.16 9.25 NA NA XXX

72128 ............ A Ct chest spine w/o dye ......................... 1.16 6.27 6.37 6.27 6.37 0.31 7.74 7.84 7.74 7.84 XXX

72128 26 A Ct chest spine w/o dye ......................... 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

72128 TC A Ct chest spine w/o dye ......................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

72129 ............ A Ct chest spine w/dye ............................ 1.22 7.44 7.56 7.44 7.56 0.36 9.02 9.14 9.02 9.14 XXX

72129 26 A Ct chest spine w/dye ............................ 1.22 0.43 0.47 0.43 0.47 0.05 1.70 1.74 1.70 1.74 XXX

72129 TC A Ct chest spine w/dye ............................ 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

72130 ............ A Ct chest spine w/o&w dye .................... 1.27 9.23 9.36 9.23 9.36 0.44 10.94 11.07 10.94 11.07 XXX

72130 26 A Ct chest spine w/o&w dye .................... 1.27 0.45 0.49 0.45 0.49 0.06 1.78 1.82 1.78 1.82 XXX

72130 TC A Ct chest spine w/o&w dye .................... 0.00 8.78 8.87 NA NA 0.38 9.16 9.25 NA NA XXX

72131 ............ A Ct lumbar spine w/o dye ...................... 1.16 6.27 6.37 6.27 6.37 0.31 7.74 7.84 7.74 7.84 XXX

72131 26 A Ct lumbar spine w/o dye ...................... 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

72131 TC A Ct lumbar spine w/o dye ...................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

72132 ............ A Ct lumbar spine w/dye ......................... 1.22 7.44 7.56 7.44 7.56 0.37 9.03 9.15 9.03 9.15 XXX

72132 26 A Ct lumbar spine w/dye ......................... 1.22 0.43 0.47 0.43 0.47 0.06 1.71 1.75 1.71 1.75 XXX

72132 TC A Ct lumbar spine w/dye ......................... 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

72133 ............ A Ct lumbar spine w/o&w dye ................. 1.27 9.24 9.37 9.24 9.37 0.44 10.95 11.08 10.95 11.08 XXX

72133 26 A Ct lumbar spine w/o&w dye ................. 1.27 0.46 0.50 0.46 0.50 0.06 1.79 1.83 1.79 1.83 XXX

72133 TC A Ct lumbar spine w/o&w dye ................. 0.00 8.78 8.87 NA NA 0.38 9.16 9.25 NA NA XXX

72141 ............ A Mri neck spine w/o dye ........................ 1.60 11.70 11.87 11.70 11.87 0.56 13.86 14.03 13.86 14.03 XXX

72141 26 A Mri neck spine w/o dye ........................ 1.60 0.57 0.62 0.57 0.62 0.07 2.24 2.29 2.24 2.29 XXX

72141 TC A Mri neck spine w/o dye ........................ 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

72142 ............ A Mri neck spine w/dye ........................... 1.92 14.04 14.24 14.04 14.24 0.67 16.63 16.83 16.63 16.83 XXX

72142 26 A Mri neck spine w/dye ........................... 1.92 0.70 0.76 0.70 0.76 0.09 2.71 2.77 2.71 2.77 XXX

72142 TC A Mri neck spine w/dye ........................... 0.00 13.34 13.48 NA NA 0.58 13.92 14.06 NA NA XXX

72146 ............ A Mri chest spine w/o dye ....................... 1.60 12.93 13.11 12.93 13.11 0.60 15.13 15.31 15.13 15.31 XXX

72146 26 A Mri chest spine w/o dye ....................... 1.60 0.57 0.62 0.57 0.62 0.07 2.24 2.29 2.24 2.29 XXX

72146 TC A Mri chest spine w/o dye ....................... 0.00 12.36 12.49 NA NA 0.53 12.89 13.02 NA NA XXX

72147 ............ A Mri chest spine w/dye .......................... 1.92 14.03 14.23 14.03 14.23 0.67 16.62 16.82 16.62 16.82 XXX

72147 26 A Mri chest spine w/dye .......................... 1.92 0.69 0.75 0.69 0.75 0.09 2.70 2.76 2.70 2.76 XXX

72147 TC A Mri chest spine w/dye .......................... 0.00 13.34 13.48 NA NA 0.58 13.92 14.06 NA NA XXX

72148 ............ A Mri lumbar spine w/o dye ..................... 1.48 12.89 13.07 12.89 13.07 0.60 14.97 15.15 14.97 15.15 XXX

72148 26 A Mri lumbar spine w/o dye ..................... 1.48 0.53 0.58 0.53 0.58 0.07 2.08 2.13 2.08 2.13 XXX

72148 TC A Mri lumbar spine w/o dye ..................... 0.00 12.36 12.49 NA NA 0.53 12.89 13.02 NA NA XXX

72149 ............ A Mri lumbar spine w/dye ........................ 1.78 13.99 14.19 13.99 14.19 0.67 16.44 16.64 16.44 16.64 XXX

72149 26 A Mri lumbar spine w/dye ........................ 1.78 0.65 0.71 0.65 0.71 0.09 2.52 2.58 2.52 2.58 XXX

72149 TC A Mri lumbar spine w/dye ........................ 0.00 13.34 13.48 NA NA 0.58 13.92 14.06 NA NA XXX

72156 ............ A Mri neck spine w/o&w dye ................... 2.57 25.63 25.97 25.63 25.97 1.20 29.40 29.74 29.40 29.74 XXX

72156 26 A Mri neck spine w/o&w dye ................... 2.57 0.92 1.00 0.92 1.00 0.11 3.60 3.68 3.60 3.68 XXX

72156 TC A Mri neck spine w/o&w dye ................... 0.00 24.71 24.97 NA NA 1.09 25.80 26.06 NA NA XXX

72157 ............ A Mri chest spine w/o&w dye .................. 2.57 25.63 25.97 25.63 25.97 1.20 29.40 29.74 29.40 29.74 XXX

72157 26 A Mri chest spine w/o&w dye .................. 2.57 0.92 1.00 0.92 1.00 0.11 3.60 3.68 3.60 3.68 XXX

72157 TC A Mri chest spine w/o&w dye .................. 0.00 24.71 24.97 NA NA 1.09 25.80 26.06 NA NA XXX

72158 ............ A Mri lumbar spine w/o&w dye ................ 2.36 25.55 25.89 25.55 25.89 1.20 29.11 29.45 29.11 29.45 XXX

72158 26 A Mri lumbar spine w/o&w dye ................ 2.36 0.84 0.92 0.84 0.92 0.11 3.31 3.39 3.31 3.39 XXX

72158 TC A Mri lumbar spine w/o&w dye ................ 0.00 24.71 24.97 NA NA 1.09 25.80 26.06 NA NA XXX

72159 ............ N Mr angio spine w/o&w dye ................... +1.80 13.08 13.21 13.08 13.21 0.61 15.49 15.62 15.49 15.62 XXX

72159 26 N Mr angio spine w/o&w dye ................... +1.80 0.72 0.72 0.72 0.72 0.08 2.60 2.60 2.60 2.60 XXX

72159 TC N Mr angio spine w/o&w dye ................... +0.00 12.36 12.49 NA NA 0.53 12.89 13.02 NA NA XXX

72170 ............ A X-ray exam of pelvis ............................ 0.17 0.58 0.60 0.58 0.60 0.03 0.78 0.80 0.78 0.80 XXX

72170 26 A X-ray exam of pelvis ............................ 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

72170 TC A X-ray exam of pelvis ............................ 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

72190 ............ A X-ray exam of pelvis ............................ 0.21 0.74 0.76 0.74 0.76 0.04 0.99 1.01 0.99 1.01 XXX

72190 26 A X-ray exam of pelvis ............................ 0.21 0.08 0.09 0.08 0.09 0.01 0.30 0.31 0.30 0.31 XXX

72190 TC A X-ray exam of pelvis ............................ 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

72191 ............ A Ct angiograph pelv w/o&w dye ............ 1.20 8.91 8.91 8.91 8.91 0.37 10.48 10.48 10.48 10.48 XXX

72191 26 A Ct angiograph pelv w/o&w dye ............ 1.20 0.48 0.48 0.48 0.48 0.05 1.73 1.73 1.73 1.73 XXX

72191 TC A Ct angiograph pelv w/o&w dye ............ 0.00 8.43 8.43 NA NA 0.32 8.75 8.75 NA NA XXX

72192 ............ A Ct pelvis w/o dye .................................. 1.09 6.25 6.34 6.25 6.34 0.31 7.65 7.74 7.65 7.74 XXX

72192 26 A Ct pelvis w/o dye .................................. 1.09 0.39 0.42 0.39 0.42 0.05 1.53 1.56 1.53 1.56 XXX

72192 TC A Ct pelvis w/o dye .................................. 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

72193 ............ A Ct pelvis w/dye ..................................... 1.16 7.20 7.31 7.20 7.31 0.35 8.71 8.82 8.71 8.82 XXX

72193 26 A Ct pelvis w/dye ..................................... 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

72193 TC A Ct pelvis w/dye ..................................... 0.00 6.79 6.86 NA NA 0.30 7.09 7.16 NA NA XXX

72194 ............ A Ct pelvis w/o&w dye ............................. 1.22 8.86 8.99 8.86 8.99 0.41 10.49 10.62 10.49 10.62 XXX

72194 26 A Ct pelvis w/o&w dye ............................. 1.22 0.43 0.47 0.43 0.47 0.05 1.70 1.74 1.70 1.74 XXX

72194 TC A Ct pelvis w/o&w dye ............................. 0.00 8.43 8.52 NA NA 0.36 8.79 8.88 NA NA XXX

72195 ............ A Mri pelvis w/o dye ................................ 1.10 11.52 11.52 11.52 11.52 0.41 13.03 13.03 13.03 13.03 XXX

72195 26 A Mri pelvis w/o dye ................................ 1.10 0.39 0.39 0.39 0.39 0.04 1.53 1.53 1.53 1.53 XXX

72195 TC A Mri pelvis w/o dye ................................ 0.00 11.13 11.13 NA NA 0.37 11.50 11.50 NA NA XXX

72196 ............ A Mri pelvis w/dye .................................... 1.30 13.80 13.44 13.80 13.44 0.48 15.58 15.22 15.58 15.22 XXX

72196 26 A Mri pelvis w/dye .................................... 1.30 0.46 0.54 0.46 0.54 0.05 1.81 1.89 1.81 1.89 XXX

72196 TC A Mri pelvis w/dye .................................... 0.00 13.34 12.90 NA NA 0.43 13.77 13.33 NA NA XXX

72197 ............ A Mri pelvis w/o & w dye ......................... 1.70 25.31 25.31 25.31 25.31 0.85 27.86 27.86 27.86 27.86 XXX

72197 26 A Mri pelvis w/o & w dye ......................... 1.70 0.60 0.60 0.60 0.60 0.09 2.39 2.39 2.39 2.39 XXX

72197 TC A Mri pelvis w/o & w dye ......................... 0.00 24.71 24.71 NA NA 0.76 25.47 25.47 NA NA XXX

72198 ............ N Mr angio pelvis w/o&w dye .................. +1.80 11.85 11.99 11.85 11.99 0.57 14.22 14.36 14.22 14.36 XXX

65507

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

72198 26 N Mr angio pelvis w/o&w dye .................. +1.80 0.72 0.74 0.72 0.74 0.08 2.60 2.62 2.60 2.62 XXX

72198 TC N Mr angio pelvis w/o&w dye .................. +0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

72200 ............ A X-ray exam sacroiliac joints ................. 0.17 0.58 0.60 0.58 0.60 0.03 0.78 0.80 0.78 0.80 XXX

72200 26 A X-ray exam sacroiliac joints ................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

72200 TC A X-ray exam sacroiliac joints ................. 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

72202 ............ A X-ray exam sacroiliac joints ................. 0.19 0.68 0.70 0.68 0.70 0.04 0.91 0.93 0.91 0.93 XXX

72202 26 A X-ray exam sacroiliac joints ................. 0.19 0.07 0.08 0.07 0.08 0.01 0.27 0.28 0.27 0.28 XXX

72202 TC A X-ray exam sacroiliac joints ................. 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

72220 ............ A X-ray exam of tailbone ......................... 0.17 0.63 0.65 0.63 0.65 0.04 0.84 0.86 0.84 0.86 XXX

72220 26 A X-ray exam of tailbone ......................... 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

72220 TC A X-ray exam of tailbone ......................... 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

72240 ............ A Contrast x-ray of neck spine ................ 0.91 5.03 5.11 5.03 5.11 0.25 6.19 6.27 6.19 6.27 XXX

72240 26 A Contrast x-ray of neck spine ................ 0.91 0.31 0.34 0.31 0.34 0.04 1.26 1.29 1.26 1.29 XXX

72240 TC A Contrast x-ray of neck spine ................ 0.00 4.72 4.77 NA NA 0.21 4.93 4.98 NA NA XXX

72255 ............ A Contrast x-ray, thorax spine ................. 0.91 4.59 4.68 4.59 4.68 0.22 5.72 5.81 5.72 5.81 XXX

72255 26 A Contrast x-ray, thorax spine ................. 0.91 0.29 0.33 0.29 0.33 0.04 1.24 1.28 1.24 1.28 XXX

72255 TC A Contrast x-ray, thorax spine ................. 0.00 4.30 4.35 NA NA 0.18 4.48 4.53 NA NA XXX

72265 ............ A Contrast x-ray, lower spine .................. 0.83 4.31 4.39 4.31 4.39 0.22 5.36 5.44 5.36 5.44 XXX

72265 26 A Contrast x-ray, lower spine .................. 0.83 0.27 0.31 0.27 0.31 0.04 1.14 1.18 1.14 1.18 XXX

72265 TC A Contrast x-ray, lower spine .................. 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

72270 ............ A Contrast x-ray of spine ......................... 1.33 6.49 6.61 6.49 6.61 0.34 8.16 8.28 8.16 8.28 XXX

72270 26 A Contrast x-ray of spine ......................... 1.33 0.44 0.49 0.44 0.49 0.07 1.84 1.89 1.84 1.89 XXX

72270 TC A Contrast x-ray of spine ......................... 0.00 6.05 6.12 NA NA 0.27 6.32 6.39 NA NA XXX

72275 ............ A Epidurography ...................................... 0.76 2.33 2.33 2.33 2.33 0.21 3.30 3.30 3.30 3.30 XXX

72275 26 A Epidurography ...................................... 0.76 0.25 0.25 0.25 0.25 0.03 1.04 1.04 1.04 1.04 XXX

72275 TC A Epidurography ...................................... 0.00 2.08 2.08 NA NA 0.18 2.26 2.26 NA NA XXX

72285 ............ A X-ray c/t spine disk ............................... 1.16 8.71 8.81 8.71 8.81 0.42 10.29 10.39 10.29 10.39 XXX

72285 26 A X-ray c/t spine disk ............................... 1.16 0.39 0.40 0.39 0.40 0.06 1.61 1.62 1.61 1.62 XXX

72285 TC A X-ray c/t spine disk ............................... 0.00 8.32 8.41 NA NA 0.36 8.68 8.77 NA NA XXX

72295 ............ A X-ray of lower spine disk ...................... 0.83 8.09 8.20 8.09 8.20 0.37 9.29 9.40 9.29 9.40 XXX

72295 26 A X-ray of lower spine disk ...................... 0.83 0.29 0.32 0.29 0.32 0.04 1.16 1.19 1.16 1.19 XXX

72295 TC A X-ray of lower spine disk ...................... 0.00 7.80 7.88 NA NA 0.33 8.13 8.21 NA NA XXX

73000 ............ A X-ray exam of collar bone .................... 0.16 0.58 0.60 0.58 0.60 0.03 0.77 0.79 0.77 0.79 XXX

73000 26 A X-ray exam of collar bone .................... 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73000 TC A X-ray exam of collar bone .................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73010 ............ A X-ray exam of shoulder blade .............. 0.17 0.58 0.60 0.58 0.60 0.03 0.78 0.80 0.78 0.80 XXX

73010 26 A X-ray exam of shoulder blade .............. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73010 TC A X-ray exam of shoulder blade .............. 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73020 ............ A X-ray exam of shoulder ........................ 0.15 0.52 0.54 0.52 0.54 0.03 0.70 0.72 0.70 0.72 XXX

73020 26 A X-ray exam of shoulder ........................ 0.15 0.05 0.06 0.05 0.06 0.01 0.21 0.22 0.21 0.22 XXX

73020 TC A X-ray exam of shoulder ........................ 0.00 0.47 0.48 NA NA 0.02 0.49 0.50 NA NA XXX

73030 ............ A X-ray exam of shoulder ........................ 0.18 0.63 0.65 0.63 0.65 0.04 0.85 0.87 0.85 0.87 XXX

73030 26 A X-ray exam of shoulder ........................ 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

73030 TC A X-ray exam of shoulder ........................ 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73040 ............ A Contrast x-ray of shoulder .................... 0.54 2.27 2.31 2.27 2.31 0.13 2.94 2.98 2.94 2.98 XXX

73040 26 A Contrast x-ray of shoulder .................... 0.54 0.19 0.21 0.19 0.21 0.03 0.76 0.78 0.76 0.78 XXX

73040 TC A Contrast x-ray of shoulder .................... 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

73050 ............ A X-ray exam of shoulders ...................... 0.20 0.73 0.75 0.73 0.75 0.05 0.98 1.00 0.98 1.00 XXX

73050 26 A X-ray exam of shoulders ...................... 0.20 0.07 0.08 0.07 0.08 0.02 0.29 0.30 0.29 0.30 XXX

73050 TC A X-ray exam of shoulders ...................... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

73060 ............ A X-ray exam of humerus ........................ 0.17 0.63 0.65 0.63 0.65 0.04 0.84 0.86 0.84 0.86 XXX

73060 26 A X-ray exam of humerus ........................ 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73060 TC A X-ray exam of humerus ........................ 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73070 ............ A X-ray exam of elbow ............................ 0.15 0.57 0.59 0.57 0.59 0.03 0.75 0.77 0.75 0.77 XXX

73070 26 A X-ray exam of elbow ............................ 0.15 0.05 0.06 0.05 0.06 0.01 0.21 0.22 0.21 0.22 XXX

73070 TC A X-ray exam of elbow ............................ 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73080 ............ A X-ray exam of elbow ............................ 0.17 0.63 0.65 0.63 0.65 0.04 0.84 0.86 0.84 0.86 XXX

73080 26 A X-ray exam of elbow ............................ 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73080 TC A X-ray exam of elbow ............................ 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73085 ............ A Contrast x-ray of elbow ........................ 0.54 2.28 2.32 2.28 2.32 0.13 2.95 2.99 2.95 2.99 XXX

73085 26 A Contrast x-ray of elbow ........................ 0.54 0.20 0.22 0.20 0.22 0.03 0.77 0.79 0.77 0.79 XXX

73085 TC A Contrast x-ray of elbow ........................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

73090 ............ A X-ray exam of forearm ......................... 0.16 0.58 0.60 0.58 0.60 0.03 0.77 0.79 0.77 0.79 XXX

73090 26 A X-ray exam of forearm ......................... 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73090 TC A X-ray exam of forearm ......................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73092 ............ A X-ray exam of arm, infant .................... 0.16 0.55 0.57 0.55 0.57 0.03 0.74 0.76 0.74 0.76 XXX

73092 26 A X-ray exam of arm, infant .................... 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73092 TC A X-ray exam of arm, infant .................... 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73100 ............ A X-ray exam of wrist .............................. 0.16 0.55 0.57 0.55 0.57 0.04 0.75 0.77 0.75 0.77 XXX

73100 26 A X-ray exam of wrist .............................. 0.16 0.06 0.07 0.06 0.07 0.02 0.24 0.25 0.24 0.25 XXX

73100 TC A X-ray exam of wrist .............................. 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73110 ............ A X-ray exam of wrist .............................. 0.17 0.59 0.61 0.59 0.61 0.03 0.79 0.81 0.79 0.81 XXX

73110 26 A X-ray exam of wrist .............................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73110 TC A X-ray exam of wrist .............................. 0.00 0.53 0.54 NA NA 0.02 0.55 0.56 NA NA XXX

73115 ............ A Contrast x-ray of wrist .......................... 0.54 1.77 1.81 1.77 1.81 0.11 2.42 2.46 2.42 2.46 XXX

73115 26 A Contrast x-ray of wrist .......................... 0.54 0.20 0.22 0.20 0.22 0.03 0.77 0.79 0.77 0.79 XXX

73115 TC A Contrast x-ray of wrist .......................... 0.00 1.57 1.59 NA NA 0.08 1.65 1.67 NA NA XXX

73120 ............ A X-ray exam of hand .............................. 0.16 0.55 0.57 0.55 0.57 0.03 0.74 0.76 0.74 0.76 XXX

73120 26 A X-ray exam of hand .............................. 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73120 TC A X-ray exam of hand .............................. 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73130 ............ A X-ray exam of hand .............................. 0.17 0.59 0.61 0.59 0.61 0.03 0.79 0.81 0.79 0.81 XXX

73130 26 A X-ray exam of hand .............................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73130 TC A X-ray exam of hand .............................. 0.00 0.53 0.54 NA NA 0.02 0.55 0.56 NA NA XXX

65508

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

73140 ............ A X-ray exam of finger(s) ........................ 0.13 0.46 0.48 0.46 0.48 0.03 0.62 0.64 0.62 0.64 XXX

73140 26 A X-ray exam of finger(s) ........................ 0.13 0.05 0.06 0.05 0.06 0.01 0.19 0.20 0.19 0.20 XXX

73140 TC A X-ray exam of finger(s) ........................ 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

73200 ............ A Ct upper extremity w/o dye .................. 1.09 5.32 5.40 5.32 5.40 0.26 6.67 6.75 6.67 6.75 XXX

73200 26 A Ct upper extremity w/o dye .................. 1.09 0.39 0.42 0.39 0.42 0.05 1.53 1.56 1.53 1.56 XXX

73200 TC A Ct upper extremity w/o dye .................. 0.00 4.93 4.98 NA NA 0.21 5.14 5.19 NA NA XXX

73201 ............ A Ct upper extremity w/dye ..................... 1.16 6.27 6.37 6.27 6.37 0.31 7.74 7.84 7.74 7.84 XXX

73201 26 A Ct upper extremity w/dye ..................... 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

73201 TC A Ct upper extremity w/dye ..................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

73202 ............ A Ct uppr extremity w/o&w dye ............... 1.22 7.81 7.93 7.81 7.93 0.38 9.41 9.53 9.41 9.53 XXX

73202 26 A Ct uppr extremity w/o&w dye ............... 1.22 0.44 0.48 0.44 0.48 0.06 1.72 1.76 1.72 1.76 XXX

73202 TC A Ct uppr extremity w/o&w dye ............... 0.00 7.37 7.45 NA NA 0.32 7.69 7.77 NA NA XXX

73206 ............ A Ct angio upr extrm w/o&w dye ............. 1.20 7.85 7.85 7.85 7.85 0.37 9.42 9.42 9.42 9.42 XXX

73206 26 A Ct angio upr extrm w/o&w dye ............. 1.20 0.48 0.48 0.48 0.48 0.05 1.73 1.73 1.73 1.73 XXX

73206 TC A Ct angio upr extrm w/o&w dye ............. 0.00 7.37 7.37 NA NA 0.32 7.69 7.69 NA NA XXX

73218 ............ A Mri upper extremity w/o dye ................. 0.98 11.48 11.48 11.48 11.48 0.36 12.82 12.82 12.82 12.82 XXX

73218 26 A Mri upper extremity w/o dye ................. 0.98 0.35 0.35 0.35 0.35 0.04 1.37 1.37 1.37 1.37 XXX

73218 TC A Mri upper extremity w/o dye ................. 0.00 11.13 11.13 NA NA 0.32 11.45 11.45 NA NA XXX

73219 ............ A Mri upper extremity w/dye .................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73219 26 A Mri upper extremity w/dye .................... 1.17 0.42 0.42 0.42 0.42 0.04 1.63 1.63 1.63 1.63 XXX

73219 TC A Mri upper extremity w/dye .................... 0.00 13.34 13.34 NA NA 0.39 13.73 13.73 NA NA XXX

73220 ............ A Mri uppr extremity w/o&w dye .............. 1.56 25.27 22.03 25.27 22.03 0.78 27.61 24.37 27.61 24.37 XXX

73220 26 A Mri uppr extremity w/o&w dye .............. 1.56 0.56 0.60 0.56 0.60 0.08 2.20 2.24 2.20 2.24 XXX

73220 TC A Mri uppr extremity w/o&w dye .............. 0.00 24.71 21.43 NA NA 0.70 25.41 22.13 NA NA XXX

73221 ............ A Mri joint upr extrem w/o dye ................ 0.98 11.48 11.63 11.48 11.63 0.36 12.82 12.97 12.82 12.97 XXX

73221 26 A Mri joint upr extrem w/o dye ................ 0.98 0.35 0.38 0.35 0.38 0.04 1.37 1.40 1.37 1.40 XXX

73221 TC A Mri joint upr extrem w/o dye ................ 0.00 11.13 11.25 NA NA 0.32 11.45 11.57 NA NA XXX

73222 ............ A Mri joint upr extrem w/ dye .................. 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73222 26 A Mri joint upr extrem w/ dye .................. 1.17 0.42 0.42 0.42 0.42 0.04 1.63 1.63 1.63 1.63 XXX

73222 TC A Mri joint upr extrem w/ dye .................. 0.00 13.34 13.34 NA NA 0.39 13.73 13.73 NA NA XXX

73223 ............ A Mri joint upr extr w/o&w dye ................ 1.56 25.27 25.27 25.27 25.27 0.78 27.61 27.61 27.61 27.61 XXX

73223 26 A Mri joint upr extr w/o&w dye ................ 1.56 0.56 0.56 0.56 0.56 0.08 2.20 2.20 2.20 2.20 XXX

73223 TC A Mri joint upr extr w/o&w dye ................ 0.00 24.71 24.71 NA NA 0.70 25.41 25.41 NA NA XXX

73225 ............ N Mr angio upr extr w/o&w dye ............... +1.73 11.82 11.95 11.82 11.95 0.57 14.12 14.25 14.12 14.25 XXX

73225 26 N Mr angio upr extr w/o&w dye ............... +1.73 0.69 0.70 0.69 0.70 0.08 2.50 2.51 2.50 2.51 XXX

73225 TC N Mr angio upr extr w/o&w dye ............... +0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

73500 ............ A X-ray exam of hip ................................. 0.17 0.53 0.55 0.53 0.55 0.03 0.73 0.75 0.73 0.75 XXX

73500 26 A X-ray exam of hip ................................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73500 TC A X-ray exam of hip ................................. 0.00 0.47 0.48 NA NA 0.02 0.49 0.50 NA NA XXX

73510 ............ A X-ray exam of hip ................................. 0.21 0.65 0.67 0.65 0.67 0.05 0.91 0.93 0.91 0.93 XXX

73510 26 A X-ray exam of hip ................................. 0.21 0.08 0.09 0.08 0.09 0.02 0.31 0.32 0.31 0.32 XXX

73510 TC A X-ray exam of hip ................................. 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73520 ............ A X-ray exam of hips ............................... 0.26 0.75 0.77 0.75 0.77 0.05 1.06 1.08 1.06 1.08 XXX

73520 26 A X-ray exam of hips ............................... 0.26 0.09 0.10 0.09 0.10 0.02 0.37 0.38 0.37 0.38 XXX

73520 TC A X-ray exam of hips ............................... 0.00 0.66 0.67 NA NA 0.03 0.69 0.70 NA NA XXX

73525 ............ A Contrast x-ray of hip ............................. 0.54 2.27 2.31 2.27 2.31 0.13 2.94 2.98 2.94 2.98 XXX

73525 26 A Contrast x-ray of hip ............................. 0.54 0.19 0.21 0.19 0.21 0.03 0.76 0.78 0.76 0.78 XXX

73525 TC A Contrast x-ray of hip ............................. 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

73530 ............ A X-ray exam of hip ................................. 0.29 0.62 0.64 0.62 0.64 0.03 0.94 0.96 0.94 0.96 XXX

73530 26 A X-ray exam of hip ................................. 0.29 0.10 0.11 0.10 0.11 0.01 0.40 0.41 0.40 0.41 XXX

73530 TC A X-ray exam of hip ................................. 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73540 ............ A X-ray exam of pelvis & hips ................. 0.20 0.64 0.66 0.64 0.66 0.05 0.89 0.91 0.89 0.91 XXX

73540 26 A X-ray exam of pelvis & hips ................. 0.20 0.07 0.08 0.07 0.08 0.02 0.29 0.30 0.29 0.30 XXX

73540 TC A X-ray exam of pelvis & hips ................. 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73542 ............ A X-ray exam, sacroiliac joint .................. 0.59 2.29 2.29 2.29 2.29 0.13 3.01 3.01 3.01 3.01 XXX

73542 26 A X-ray exam, sacroiliac joint .................. 0.59 0.21 0.21 0.21 0.21 0.03 0.83 0.83 0.83 0.83 XXX

73542 TC A X-ray exam, sacroiliac joint .................. 0.00 2.08 2.08 NA NA 0.10 2.18 2.18 NA NA XXX

73550 ............ A X-ray exam of thigh .............................. 0.17 0.63 0.65 0.63 0.65 0.04 0.84 0.86 0.84 0.86 XXX

73550 26 A X-ray exam of thigh .............................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73550 TC A X-ray exam of thigh .............................. 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73560 ............ A X-ray exam of knee, 1 or 2 .................. 0.17 0.58 0.60 0.58 0.60 0.04 0.79 0.81 0.79 0.81 XXX

73560 26 A X-ray exam of knee, 1 or 2 .................. 0.17 0.06 0.07 0.06 0.07 0.02 0.25 0.26 0.25 0.26 XXX

73560 TC A X-ray exam of knee, 1 or 2 .................. 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73562 ............ A X-ray exam of knee, 3 .......................... 0.18 0.64 0.66 0.64 0.66 0.05 0.87 0.89 0.87 0.89 XXX

73562 26 A X-ray exam of knee, 3 .......................... 0.18 0.07 0.08 0.07 0.08 0.02 0.27 0.28 0.27 0.28 XXX

73562 TC A X-ray exam of knee, 3 .......................... 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

73564 ............ A X-ray exam, knee, 4 or more ............... 0.22 0.69 0.71 0.69 0.71 0.05 0.96 0.98 0.96 0.98 XXX

73564 26 A X-ray exam, knee, 4 or more ............... 0.22 0.08 0.09 0.08 0.09 0.02 0.32 0.33 0.32 0.33 XXX

73564 TC A X-ray exam, knee, 4 or more ............... 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

73565 ............ A X-ray exam of knees ............................ 0.17 0.56 0.57 0.56 0.57 0.04 0.77 0.78 0.77 0.78 XXX

73565 26 A X-ray exam of knees ............................ 0.17 0.07 0.07 0.07 0.07 0.02 0.26 0.26 0.26 0.26 XXX

73565 TC A X-ray exam of knees ............................ 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73580 ............ A Contrast x-ray of knee joint .................. 0.54 2.79 2.84 2.79 2.84 0.15 3.48 3.53 3.48 3.53 XXX

73580 26 A Contrast x-ray of knee joint .................. 0.54 0.19 0.21 0.19 0.21 0.03 0.76 0.78 0.76 0.78 XXX

73580 TC A Contrast x-ray of knee joint .................. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

73590 ............ A X-ray exam of lower leg ....................... 0.17 0.58 0.60 0.58 0.60 0.03 0.78 0.80 0.78 0.80 XXX

73590 26 A X-ray exam of lower leg ....................... 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73590 TC A X-ray exam of lower leg ....................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

73592 ............ A X-ray exam of leg, infant ...................... 0.16 0.55 0.57 0.55 0.57 0.03 0.74 0.76 0.74 0.76 XXX

73592 26 A X-ray exam of leg, infant ...................... 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73592 TC A X-ray exam of leg, infant ...................... 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73600 ............ A X-ray exam of ankle ............................. 0.16 0.55 0.57 0.55 0.57 0.03 0.74 0.76 0.74 0.76 XXX

73600 26 A X-ray exam of ankle ............................. 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

65509

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

73600 TC A X-ray exam of ankle ............................. 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73610 ............ A X-ray exam of ankle ............................. 0.17 0.59 0.61 0.59 0.61 0.03 0.79 0.81 0.79 0.81 XXX

73610 26 A X-ray exam of ankle ............................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73610 TC A X-ray exam of ankle ............................. 0.00 0.53 0.54 NA NA 0.02 0.55 0.56 NA NA XXX

73615 ............ A Contrast x-ray of ankle ......................... 0.54 2.28 2.32 2.28 2.32 0.13 2.95 2.99 2.95 2.99 XXX

73615 26 A Contrast x-ray of ankle ......................... 0.54 0.20 0.22 0.20 0.22 0.03 0.77 0.79 0.77 0.79 XXX

73615 TC A Contrast x-ray of ankle ......................... 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

73620 ............ A X-ray exam of foot ................................ 0.16 0.55 0.57 0.55 0.57 0.03 0.74 0.76 0.74 0.76 XXX

73620 26 A X-ray exam of foot ................................ 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73620 TC A X-ray exam of foot ................................ 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX

73630 ............ A X-ray exam of foot ................................ 0.17 0.59 0.61 0.59 0.61 0.03 0.79 0.81 0.79 0.81 XXX

73630 26 A X-ray exam of foot ................................ 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX

73630 TC A X-ray exam of foot ................................ 0.00 0.53 0.54 NA NA 0.02 0.55 0.56 NA NA XXX

73650 ............ A X-ray exam of heel ............................... 0.16 0.53 0.55 0.53 0.55 0.03 0.72 0.74 0.72 0.74 XXX

73650 26 A X-ray exam of heel ............................... 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

73650 TC A X-ray exam of heel ............................... 0.00 0.47 0.48 NA NA 0.02 0.49 0.50 NA NA XXX

73660 ............ A X-ray exam of toe(s) ............................ 0.13 0.46 0.48 0.46 0.48 0.03 0.62 0.64 0.62 0.64 XXX

73660 26 A X-ray exam of toe(s) ............................ 0.13 0.05 0.06 0.05 0.06 0.01 0.19 0.20 0.19 0.20 XXX

73660 TC A X-ray exam of toe(s) ............................ 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

73700 ............ A Ct lower extremity w/o dye ................... 1.09 5.32 5.40 5.32 5.40 0.26 6.67 6.75 6.67 6.75 XXX

73700 26 A Ct lower extremity w/o dye ................... 1.09 0.39 0.42 0.39 0.42 0.05 1.53 1.56 1.53 1.56 XXX

73700 TC A Ct lower extremity w/o dye ................... 0.00 4.93 4.98 NA NA 0.21 5.14 5.19 NA NA XXX

73701 ............ A Ct lower extremity w/dye ...................... 1.16 6.27 6.37 6.27 6.37 0.31 7.74 7.84 7.74 7.84 XXX

73701 26 A Ct lower extremity w/dye ...................... 1.16 0.41 0.45 0.41 0.45 0.05 1.62 1.66 1.62 1.66 XXX

73701 TC A Ct lower extremity w/dye ...................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

73702 ............ A Ct lwr extremity w/o&w dye .................. 1.22 7.80 7.92 7.80 7.92 0.37 9.39 9.51 9.39 9.51 XXX

73702 26 A Ct lwr extremity w/o&w dye .................. 1.22 0.43 0.47 0.43 0.47 0.05 1.70 1.74 1.70 1.74 XXX

73702 TC A Ct lwr extremity w/o&w dye .................. 0.00 7.37 7.45 NA NA 0.32 7.69 7.77 NA NA XXX

73706 ............ A Ct angio lwr extr w/o&w dye ................ 1.20 7.85 7.85 7.85 7.85 0.37 9.42 9.42 9.42 9.42 XXX

73706 26 A Ct angio lwr extr w/o&w dye ................ 1.20 0.48 0.48 0.48 0.48 0.05 1.73 1.73 1.73 1.73 XXX

73706 TC A Ct angio lwr extr w/o&w dye ................ 0.00 7.37 7.37 NA NA 0.32 7.69 7.69 NA NA XXX

73718 ............ A Mri lower extremity w/o dye ................. 0.98 11.48 11.48 11.48 11.48 0.36 12.82 12.82 12.82 12.82 XXX

73718 26 A Mri lower extremity w/o dye ................. 0.98 0.35 0.35 0.35 0.35 0.04 1.37 1.37 1.37 1.37 XXX

73718 TC A Mri lower extremity w/o dye ................. 0.00 11.13 11.13 NA NA 0.32 11.45 11.45 NA NA XXX

73719 ............ A Mri lower extremity w/dye .................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73719 26 A Mri lower extremity w/dye .................... 1.17 0.42 0.42 0.42 0.42 0.04 1.63 1.63 1.63 1.63 XXX

73719 TC A Mri lower extremity w/dye .................... 0.00 13.34 13.34 NA NA 0.39 13.73 13.73 NA NA XXX

73720 ............ A Mri lwr extremity w/o&w dye ................ 1.56 25.26 22.02 25.26 22.02 0.78 27.60 24.36 27.60 24.36 XXX

73720 26 A Mri lwr extremity w/o&w dye ................ 1.56 0.55 0.59 0.55 0.59 0.08 2.19 2.23 2.19 2.23 XXX

73720 TC A Mri lwr extremity w/o&w dye ................ 0.00 24.71 21.43 NA NA 0.70 25.41 22.13 NA NA XXX

73721 ............ A Mri joint of lwr extre w/o d .................... 0.98 11.48 11.63 11.48 11.63 0.36 12.82 12.97 12.82 12.97 XXX

73721 26 A Mri joint of lwr extre w/o d .................... 0.98 0.35 0.38 0.35 0.38 0.04 1.37 1.40 1.37 1.40 XXX

73721 TC A Mri joint of lwr extre w/o d .................... 0.00 11.13 11.25 NA NA 0.32 11.45 11.57 NA NA XXX

73722 ............ A Mri joint of lwr extr w/dye ..................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73722 26 A Mri joint of lwr extr w/dye ..................... 1.17 0.42 0.42 0.42 0.42 0.04 1.63 1.63 1.63 1.63 XXX

73722 TC A Mri joint of lwr extr w/dye ..................... 0.00 13.34 13.34 NA NA 0.39 13.73 13.73 NA NA XXX

73723 ............ A Mri joint lwr extr w/o&w dye ................. 1.56 25.27 25.27 25.27 25.27 0.78 27.61 27.61 27.61 27.61 XXX

73723 26 A Mri joint lwr extr w/o&w dye ................. 1.56 0.56 0.56 0.56 0.56 0.08 2.20 2.20 2.20 2.20 XXX

73723 TC A Mri joint lwr extr w/o&w dye ................. 0.00 24.71 24.71 NA NA 0.70 25.41 25.41 NA NA XXX

73725 ............ R Mr ang lwr ext w or w/o dye ................ 1.82 11.78 11.92 11.78 11.92 0.57 14.17 14.31 14.17 14.31 XXX

73725 26 R Mr ang lwr ext w or w/o dye ................ 1.82 0.65 0.67 0.65 0.67 0.08 2.55 2.57 2.55 2.57 XXX

73725 TC R Mr ang lwr ext w or w/o dye ................ 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

74000 ............ A X-ray exam of abdomen ....................... 0.18 0.58 0.60 0.58 0.60 0.03 0.79 0.81 0.79 0.81 XXX

74000 26 A X-ray exam of abdomen ....................... 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

74000 TC A X-ray exam of abdomen ....................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

74010 ............ A X-ray exam of abdomen ....................... 0.23 0.65 0.67 0.65 0.67 0.04 0.92 0.94 0.92 0.94 XXX

74010 26 A X-ray exam of abdomen ....................... 0.23 0.08 0.09 0.08 0.09 0.01 0.32 0.33 0.32 0.33 XXX

74010 TC A X-ray exam of abdomen ....................... 0.00 0.57 0.58 NA NA 0.03 0.60 0.61 NA NA XXX

74020 ............ A X-ray exam of abdomen ....................... 0.27 0.71 0.73 0.71 0.73 0.04 1.02 1.04 1.02 1.04 XXX

74020 26 A X-ray exam of abdomen ....................... 0.27 0.10 0.11 0.10 0.11 0.01 0.38 0.39 0.38 0.39 XXX

74020 TC A X-ray exam of abdomen ....................... 0.00 0.61 0.62 NA NA 0.03 0.64 0.65 NA NA XXX

74022 ............ A X-ray exam series, abdomen ............... 0.32 0.84 0.86 0.84 0.86 0.05 1.21 1.23 1.21 1.23 XXX

74022 26 A X-ray exam series, abdomen ............... 0.32 0.11 0.12 0.11 0.12 0.01 0.44 0.45 0.44 0.45 XXX

74022 TC A X-ray exam series, abdomen ............... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

74150 ............ A Ct abdomen w/o dye ............................ 1.19 6.03 6.13 6.03 6.13 0.30 7.52 7.62 7.52 7.62 XXX

74150 26 A Ct abdomen w/o dye ............................ 1.19 0.42 0.46 0.42 0.46 0.05 1.66 1.70 1.66 1.70 XXX

74150 TC A Ct abdomen w/o dye ............................ 0.00 5.61 5.67 NA NA 0.25 5.86 5.92 NA NA XXX

74160 ............ A Ct abdomen w/dye ............................... 1.27 7.24 7.35 7.24 7.35 0.36 8.87 8.98 8.87 8.98 XXX

74160 26 A Ct abdomen w/dye ............................... 1.27 0.45 0.49 0.45 0.49 0.06 1.78 1.82 1.78 1.82 XXX

74160 TC A Ct abdomen w/dye ............................... 0.00 6.79 6.86 NA NA 0.30 7.09 7.16 NA NA XXX

74170 ............ A Ct abdomen w/o&w dye ....................... 1.40 8.93 9.06 8.93 9.06 0.42 10.75 10.88 10.75 10.88 XXX

74170 26 A Ct abdomen w/o&w dye ....................... 1.40 0.50 0.54 0.50 0.54 0.06 1.96 2.00 1.96 2.00 XXX

74170 TC A Ct abdomen w/o&w dye ....................... 0.00 8.43 8.52 NA NA 0.36 8.79 8.88 NA NA XXX

74175 ............ A Ct angio abdom w/o&w dye ................. 1.20 8.91 8.91 8.91 8.91 0.37 10.48 10.48 10.48 10.48 XXX

74175 26 A Ct angio abdom w/o&w dye ................. 1.20 0.48 0.48 0.48 0.48 0.05 1.73 1.73 1.73 1.73 XXX

74175 TC A Ct angio abdom w/o&w dye ................. 0.00 8.43 8.43 NA NA 0.32 8.75 8.75 NA NA XXX

74181 ............ A Mri abdomen w/o dye ........................... 1.10 11.52 11.74 11.52 11.74 0.41 13.03 13.25 13.03 13.25 XXX

74181 26 A Mri abdomen w/o dye ........................... 1.10 0.39 0.49 0.39 0.49 0.04 1.53 1.63 1.53 1.63 XXX

74181 TC A Mri abdomen w/o dye ........................... 0.00 11.13 11.25 NA NA 0.37 11.50 11.62 NA NA XXX

74182 ............ A Mri abdomen w/dye .............................. 1.30 13.80 13.80 13.80 13.80 0.48 15.58 15.58 15.58 15.58 XXX

74182 26 A Mri abdomen w/dye .............................. 1.30 0.46 0.46 0.46 0.46 0.05 1.81 1.81 1.81 1.81 XXX

74182 TC A Mri abdomen w/dye .............................. 0.00 13.34 13.34 NA NA 0.43 13.77 13.77 NA NA XXX

74183 ............ A Mri abdomen w/o&w dye ...................... 1.70 25.31 25.31 25.31 25.31 0.85 27.86 27.86 27.86 27.86 XXX

65510

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

74183 26 A Mri abdomen w/o&w dye ...................... 1.70 0.60 0.60 0.60 0.60 0.09 2.39 2.39 2.39 2.39 XXX

74183 TC A Mri abdomen w/o&w dye ...................... 0.00 24.71 24.71 NA NA 0.76 25.47 25.47 NA NA XXX

74185 ............ R Mri angio, abdom w or w/o dy ............. 1.80 11.77 11.93 11.77 11.93 0.57 14.14 14.30 14.14 14.30 XXX

74185 26 R Mri angio, abdom w or w/o dy ............. 1.80 0.64 0.68 0.64 0.68 0.08 2.52 2.56 2.52 2.56 XXX

74185 TC R Mri angio, abdom w or w/o dy ............. 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

74190 ............ A X-ray exam of peritoneum .................... 0.48 1.47 1.47 1.47 1.47 0.08 2.03 2.03 2.03 2.03 XXX

74190 26 A X-ray exam of peritoneum .................... 0.48 0.17 0.16 0.17 0.16 0.02 0.67 0.66 0.67 0.66 XXX

74190 TC A X-ray exam of peritoneum .................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

74210 ............ A Contrst x-ray exam of throat ................ 0.36 1.31 1.33 1.31 1.33 0.07 1.74 1.76 1.74 1.76 XXX

74210 26 A Contrst x-ray exam of throat ................ 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

74210 TC A Contrst x-ray exam of throat ................ 0.00 1.18 1.19 NA NA 0.05 1.23 1.24 NA NA XXX

74220 ............ A Contrast x-ray, esophagus ................... 0.46 1.34 1.37 1.34 1.37 0.07 1.87 1.90 1.87 1.90 XXX

74220 26 A Contrast x-ray, esophagus ................... 0.46 0.16 0.18 0.16 0.18 0.02 0.64 0.66 0.64 0.66 XXX

74220 TC A Contrast x-ray, esophagus ................... 0.00 1.18 1.19 NA NA 0.05 1.23 1.24 NA NA XXX

74230 ............ A Cinema x-ray, throat/esoph .................. 0.53 1.49 1.52 1.49 1.52 0.08 2.10 2.13 2.10 2.13 XXX

74230 26 A Cinema x-ray, throat/esoph .................. 0.53 0.19 0.21 0.19 0.21 0.02 0.74 0.76 0.74 0.76 XXX

74230 TC A Cinema x-ray, throat/esoph .................. 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

74235 ............ A Remove esophagus obstruction ........... 1.19 3.02 3.09 3.02 3.09 0.17 4.38 4.45 4.38 4.45 XXX

74235 26 A Remove esophagus obstruction ........... 1.19 0.42 0.46 0.42 0.46 0.05 1.66 1.70 1.66 1.70 XXX

74235 TC A Remove esophagus obstruction ........... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

74240 ............ A X-ray exam, upper gi tract ................... 0.69 1.69 1.74 1.69 1.74 0.10 2.48 2.53 2.48 2.53 XXX

74240 26 A X-ray exam, upper gi tract ................... 0.69 0.24 0.27 0.24 0.27 0.03 0.96 0.99 0.96 0.99 XXX

74240 TC A X-ray exam, upper gi tract ................... 0.00 1.45 1.47 NA NA 0.07 1.52 1.54 NA NA XXX

74241 ............ A X-ray exam, upper gi tract ................... 0.69 1.72 1.77 1.72 1.77 0.10 2.51 2.56 2.51 2.56 XXX

74241 26 A X-ray exam, upper gi tract ................... 0.69 0.24 0.27 0.24 0.27 0.03 0.96 0.99 0.96 0.99 XXX

74241 TC A X-ray exam, upper gi tract ................... 0.00 1.48 1.50 NA NA 0.07 1.55 1.57 NA NA XXX

74245 ............ A X-ray exam, upper gi tract ................... 0.91 2.68 2.74 2.68 2.74 0.15 3.74 3.80 3.74 3.80 XXX

74245 26 A X-ray exam, upper gi tract ................... 0.91 0.32 0.35 0.32 0.35 0.04 1.27 1.30 1.27 1.30 XXX

74245 TC A X-ray exam, upper gi tract ................... 0.00 2.36 2.39 NA NA 0.11 2.47 2.50 NA NA XXX

74246 ............ A Contrst x-ray uppr gi tract .................... 0.69 1.87 1.92 1.87 1.92 0.11 2.67 2.72 2.67 2.72 XXX

74246 26 A Contrst x-ray uppr gi tract .................... 0.69 0.24 0.27 0.24 0.27 0.03 0.96 0.99 0.96 0.99 XXX

74246 TC A Contrst x-ray uppr gi tract .................... 0.00 1.63 1.65 NA NA 0.08 1.71 1.73 NA NA XXX

74247 ............ A Contrst x-ray uppr gi tract .................... 0.69 1.92 1.97 1.92 1.97 0.12 2.73 2.78 2.73 2.78 XXX

74247 26 A Contrst x-ray uppr gi tract .................... 0.69 0.25 0.28 0.25 0.28 0.03 0.97 1.00 0.97 1.00 XXX

74247 TC A Contrst x-ray uppr gi tract .................... 0.00 1.67 1.69 NA NA 0.09 1.76 1.78 NA NA XXX

74249 ............ A Contrst x-ray uppr gi tract .................... 0.91 2.88 2.94 2.88 2.94 0.16 3.95 4.01 3.95 4.01 XXX

74249 26 A Contrst x-ray uppr gi tract .................... 0.91 0.32 0.35 0.32 0.35 0.04 1.27 1.30 1.27 1.30 XXX

74249 TC A Contrst x-ray uppr gi tract .................... 0.00 2.56 2.59 NA NA 0.12 2.68 2.71 NA NA XXX

74250 ............ A X-ray exam of small bowel ................... 0.47 1.47 1.50 1.47 1.50 0.08 2.02 2.05 2.02 2.05 XXX

74250 26 A X-ray exam of small bowel ................... 0.47 0.17 0.19 0.17 0.19 0.02 0.66 0.68 0.66 0.68 XXX

74250 TC A X-ray exam of small bowel ................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

74251 ............ A X-ray exam of small bowel ................... 0.69 1.54 1.55 1.54 1.55 0.09 2.32 2.33 2.32 2.33 XXX

74251 26 A X-ray exam of small bowel ................... 0.69 0.24 0.24 0.24 0.24 0.03 0.96 0.96 0.96 0.96 XXX

74251 TC A X-ray exam of small bowel ................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

74260 ............ A X-ray exam of small bowel ................... 0.50 1.66 1.70 1.66 1.70 0.09 2.25 2.29 2.25 2.29 XXX

74260 26 A X-ray exam of small bowel ................... 0.50 0.18 0.20 0.18 0.20 0.02 0.70 0.72 0.70 0.72 XXX

74260 TC A X-ray exam of small bowel ................... 0.00 1.48 1.50 NA NA 0.07 1.55 1.57 NA NA XXX

74270 ............ A Contrast x-ray exam of colon ............... 0.69 1.93 1.98 1.93 1.98 0.12 2.74 2.79 2.74 2.79 XXX

74270 26 A Contrast x-ray exam of colon ............... 0.69 0.24 0.27 0.24 0.27 0.03 0.96 0.99 0.96 0.99 XXX

74270 TC A Contrast x-ray exam of colon ............... 0.00 1.69 1.71 NA NA 0.09 1.78 1.80 NA NA XXX

74280 ............ A Contrast x-ray exam of colon ............... 0.99 2.57 2.63 2.57 2.63 0.15 3.71 3.77 3.71 3.77 XXX

74280 26 A Contrast x-ray exam of colon ............... 0.99 0.35 0.39 0.35 0.39 0.04 1.38 1.42 1.38 1.42 XXX

74280 TC A Contrast x-ray exam of colon ............... 0.00 2.22 2.24 NA NA 0.11 2.33 2.35 NA NA XXX

74283 ............ A Contrast x-ray exam of colon ............... 2.02 3.27 3.37 3.27 3.37 0.21 5.50 5.60 5.50 5.60 XXX

74283 26 A Contrast x-ray exam of colon ............... 2.02 0.72 0.79 0.72 0.79 0.09 2.83 2.90 2.83 2.90 XXX

74283 TC A Contrast x-ray exam of colon ............... 0.00 2.55 2.58 NA NA 0.12 2.67 2.70 NA NA XXX

74290 ............ A Contrast x-ray, gallbladder ................... 0.32 0.84 0.86 0.84 0.86 0.05 1.21 1.23 1.21 1.23 XXX

74290 26 A Contrast x-ray, gallbladder ................... 0.32 0.11 0.12 0.11 0.12 0.01 0.44 0.45 0.44 0.45 XXX

74290 TC A Contrast x-ray, gallbladder ................... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

74291 ............ A Contrast x-rays, gallbladder ................. 0.20 0.48 0.50 0.48 0.50 0.03 0.71 0.73 0.71 0.73 XXX

74291 26 A Contrast x-rays, gallbladder ................. 0.20 0.07 0.08 0.07 0.08 0.01 0.28 0.29 0.28 0.29 XXX

74291 TC A Contrast x-rays, gallbladder ................. 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

74300 ............ C X-ray bile ducts/pancreas ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

74300 26 A X-ray bile ducts/pancreas ..................... 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

74300 TC C X-ray bile ducts/pancreas ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

74301 ............ C X-rays at surgery add-on ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

74301 26 A X-rays at surgery add-on ..................... 0.21 0.07 0.08 0.07 0.08 0.01 0.29 0.30 0.29 0.30 ZZZ

74301 TC C X-rays at surgery add-on ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

74305 ............ A X-ray bile ducts/pancreas ..................... 0.42 0.93 0.96 0.93 0.96 0.06 1.41 1.44 1.41 1.44 XXX

74305 26 A X-ray bile ducts/pancreas ..................... 0.42 0.15 0.17 0.15 0.17 0.02 0.59 0.61 0.59 0.61 XXX

74305 TC A X-ray bile ducts/pancreas ..................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

74320 ............ A Contrast x-ray of bile ducts .................. 0.54 3.32 3.37 3.32 3.37 0.16 4.02 4.07 4.02 4.07 XXX

74320 26 A Contrast x-ray of bile ducts .................. 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

74320 TC A Contrast x-ray of bile ducts .................. 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74327 ............ A X-ray bile stone removal ...................... 0.70 2.00 2.05 2.00 2.05 0.12 2.82 2.87 2.82 2.87 XXX

74327 26 A X-ray bile stone removal ...................... 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

74327 TC A X-ray bile stone removal ...................... 0.00 1.75 1.77 NA NA 0.09 1.84 1.86 NA NA XXX

74328 ............ A Xray bile duct endoscopy ..................... 0.70 3.38 3.44 3.38 3.44 0.17 4.25 4.31 4.25 4.31 XXX

74328 26 A Xray bile duct endoscopy ..................... 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

74328 TC A Xray bile duct endoscopy ..................... 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74329 ............ A X-ray for pancreas endoscopy ............. 0.70 3.38 3.44 3.38 3.44 0.17 4.25 4.31 4.25 4.31 XXX

74329 26 A X-ray for pancreas endoscopy ............. 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

74329 TC A X-ray for pancreas endoscopy ............. 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

65511

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

74330 ............ A X-ray bile/panc endoscopy ................... 0.90 3.45 3.49 3.45 3.49 0.18 4.53 4.57 4.53 4.57 XXX

74330 26 A X-ray bile/panc endoscopy ................... 0.90 0.32 0.33 0.32 0.33 0.04 1.26 1.27 1.26 1.27 XXX

74330 TC A X-ray bile/panc endoscopy ................... 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74340 ............ A X-ray guide for GI tube ........................ 0.54 2.79 2.84 2.79 2.84 0.14 3.47 3.52 3.47 3.52 XXX

74340 26 A X-ray guide for GI tube ........................ 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

74340 TC A X-ray guide for GI tube ........................ 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

74350 ............ A X-ray guide, stomach tube ................... 0.76 3.40 3.46 3.40 3.46 0.17 4.33 4.39 4.33 4.39 XXX

74350 26 A X-ray guide, stomach tube ................... 0.76 0.27 0.30 0.27 0.30 0.03 1.06 1.09 1.06 1.09 XXX

74350 TC A X-ray guide, stomach tube ................... 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74355 ............ A X-ray guide, intestinal tube .................. 0.76 2.87 2.93 2.87 2.93 0.15 3.78 3.84 3.78 3.84 XXX

74355 26 A X-ray guide, intestinal tube .................. 0.76 0.27 0.30 0.27 0.30 0.03 1.06 1.09 1.06 1.09 XXX

74355 TC A X-ray guide, intestinal tube .................. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

74360 ............ A X-ray guide, GI dilation ........................ 0.54 3.32 3.37 3.32 3.37 0.16 4.02 4.07 4.02 4.07 XXX

74360 26 A X-ray guide, GI dilation ........................ 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

74360 TC A X-ray guide, GI dilation ........................ 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74363 ............ A X-ray, bile duct dilation ......................... 0.88 6.36 6.46 6.36 6.46 0.31 7.55 7.65 7.55 7.65 XXX

74363 26 A X-ray, bile duct dilation ......................... 0.88 0.31 0.34 0.31 0.34 0.04 1.23 1.26 1.23 1.26 XXX

74363 TC A X-ray, bile duct dilation ......................... 0.00 6.05 6.12 NA NA 0.27 6.32 6.39 NA NA XXX

74400 ............ A Contrst x-ray, urinary tract ................... 0.49 1.84 1.88 1.84 1.88 0.11 2.44 2.48 2.44 2.48 XXX

74400 26 A Contrst x-ray, urinary tract ................... 0.49 0.17 0.19 0.17 0.19 0.02 0.68 0.70 0.68 0.70 XXX

74400 TC A Contrst x-ray, urinary tract ................... 0.00 1.67 1.69 NA NA 0.09 1.76 1.78 NA NA XXX

74410 ............ A Contrst x-ray, urinary tract ................... 0.49 2.11 2.15 2.11 2.15 0.11 2.71 2.75 2.71 2.75 XXX

74410 26 A Contrst x-ray, urinary tract ................... 0.49 0.17 0.19 0.17 0.19 0.02 0.68 0.70 0.68 0.70 XXX

74410 TC A Contrst x-ray, urinary tract ................... 0.00 1.94 1.96 NA NA 0.09 2.03 2.05 NA NA XXX

74415 ............ A Contrst x-ray, urinary tract ................... 0.49 2.27 2.31 2.27 2.31 0.12 2.88 2.92 2.88 2.92 XXX

74415 26 A Contrst x-ray, urinary tract ................... 0.49 0.17 0.19 0.17 0.19 0.02 0.68 0.70 0.68 0.70 XXX

74415 TC A Contrst x-ray, urinary tract ................... 0.00 2.10 2.12 NA NA 0.10 2.20 2.22 NA NA XXX

74420 ............ A Contrst x-ray, urinary tract ................... 0.36 2.73 2.77 2.73 2.77 0.14 3.23 3.27 3.23 3.27 XXX

74420 26 A Contrst x-ray, urinary tract ................... 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

74420 TC A Contrst x-ray, urinary tract ................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

74425 ............ A Contrst x-ray, urinary tract ................... 0.36 1.43 1.45 1.43 1.45 0.08 1.87 1.89 1.87 1.89 XXX

74425 26 A Contrst x-ray, urinary tract ................... 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

74425 TC A Contrst x-ray, urinary tract ................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

74430 ............ A Contrast x-ray, bladder ......................... 0.32 1.16 1.18 1.16 1.18 0.07 1.55 1.57 1.55 1.57 XXX

74430 26 A Contrast x-ray, bladder ......................... 0.32 0.11 0.12 0.11 0.12 0.02 0.45 0.46 0.45 0.46 XXX

74430 TC A Contrast x-ray, bladder ......................... 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

74440 ............ A X-ray, male genital tract ....................... 0.38 1.25 1.27 1.25 1.27 0.07 1.70 1.72 1.70 1.72 XXX

74440 26 A X-ray, male genital tract ....................... 0.38 0.13 0.14 0.13 0.14 0.02 0.53 0.54 0.53 0.54 XXX

74440 TC A X-ray, male genital tract ....................... 0.00 1.12 1.13 NA NA 0.05 1.17 1.18 NA NA XXX

74445 ............ A X-ray exam of penis ............................. 1.14 1.52 1.57 1.52 1.57 0.10 2.76 2.81 2.76 2.81 XXX

74445 26 A X-ray exam of penis ............................. 1.14 0.40 0.44 0.40 0.44 0.05 1.59 1.63 1.59 1.63 XXX

74445 TC A X-ray exam of penis ............................. 0.00 1.12 1.13 NA NA 0.05 1.17 1.18 NA NA XXX

74450 ............ A X-ray, urethra/bladder .......................... 0.33 1.57 1.60 1.57 1.60 0.09 1.99 2.02 1.99 2.02 XXX

74450 26 A X-ray, urethra/bladder .......................... 0.33 0.12 0.13 0.12 0.13 0.02 0.47 0.48 0.47 0.48 XXX

74450 TC A X-ray, urethra/bladder .......................... 0.00 1.45 1.47 NA NA 0.07 1.52 1.54 NA NA XXX

74455 ............ A X-ray, urethra/bladder .......................... 0.33 1.69 1.72 1.69 1.72 0.10 2.12 2.15 2.12 2.15 XXX

74455 26 A X-ray, urethra/bladder .......................... 0.33 0.12 0.13 0.12 0.13 0.02 0.47 0.48 0.47 0.48 XXX

74455 TC A X-ray, urethra/bladder .......................... 0.00 1.57 1.59 NA NA 0.08 1.65 1.67 NA NA XXX

74470 ............ A X-ray exam of kidney lesion ................. 0.54 1.43 1.46 1.43 1.46 0.08 2.05 2.08 2.05 2.08 XXX

74470 26 A X-ray exam of kidney lesion ................. 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

74470 TC A X-ray exam of kidney lesion ................. 0.00 1.24 1.25 NA NA 0.06 1.30 1.31 NA NA XXX

74475 ............ A X-ray control, cath insert ...................... 0.54 4.23 4.29 4.23 4.29 0.20 4.97 5.03 4.97 5.03 XXX

74475 26 A X-ray control, cath insert ...................... 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

74475 TC A X-ray control, cath insert ...................... 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

74480 ............ A X-ray control, cath insert ...................... 0.54 4.23 4.29 4.23 4.29 0.20 4.97 5.03 4.97 5.03 XXX

74480 26 A X-ray control, cath insert ...................... 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

74480 TC A X-ray control, cath insert ...................... 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

74485 ............ A X-ray guide, GU dilation ....................... 0.54 3.32 3.37 3.32 3.37 0.17 4.03 4.08 4.03 4.08 XXX

74485 26 A X-ray guide, GU dilation ....................... 0.54 0.19 0.21 0.19 0.21 0.03 0.76 0.78 0.76 0.78 XXX

74485 TC A X-ray guide, GU dilation ....................... 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74710 ............ A X-ray measurement of pelvis ............... 0.34 1.17 1.19 1.17 1.19 0.07 1.58 1.60 1.58 1.60 XXX

74710 26 A X-ray measurement of pelvis ............... 0.34 0.12 0.13 0.12 0.13 0.02 0.48 0.49 0.48 0.49 XXX

74710 TC A X-ray measurement of pelvis ............... 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

74740 ............ A X-ray, female genital tract .................... 0.38 1.44 1.46 1.44 1.46 0.08 1.90 1.92 1.90 1.92 XXX

74740 26 A X-ray, female genital tract .................... 0.38 0.14 0.15 0.14 0.15 0.02 0.54 0.55 0.54 0.55 XXX

74740 TC A X-ray, female genital tract .................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

74742 ............ A X-ray, fallopian tube ............................. 0.61 3.36 3.40 3.36 3.40 0.16 4.13 4.17 4.13 4.17 XXX

74742 26 A X-ray, fallopian tube ............................. 0.61 0.23 0.24 0.23 0.24 0.02 0.86 0.87 0.86 0.87 XXX

74742 TC A X-ray, fallopian tube ............................. 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

74775 ............ A X-ray exam of perineum ....................... 0.62 1.67 1.71 1.67 1.71 0.10 2.39 2.43 2.39 2.43 XXX

74775 26 A X-ray exam of perineum ....................... 0.62 0.22 0.24 0.22 0.24 0.03 0.87 0.89 0.87 0.89 XXX

74775 TC A X-ray exam of perineum ....................... 0.00 1.45 1.47 NA NA 0.07 1.52 1.54 NA NA XXX

75552 ............ A Heart mri for morph w/o dye ................ 1.60 11.70 11.87 11.70 11.87 0.56 13.86 14.03 13.86 14.03 XXX

75552 26 A Heart mri for morph w/o dye ................ 1.60 0.57 0.62 0.57 0.62 0.07 2.24 2.29 2.24 2.29 XXX

75552 TC A Heart mri for morph w/o dye ................ 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

75553 ............ A Heart mri for morph w/dye ................... 2.00 11.84 11.98 11.84 11.98 0.58 14.42 14.56 14.42 14.56 XXX

75553 26 A Heart mri for morph w/dye ................... 2.00 0.71 0.73 0.71 0.73 0.09 2.80 2.82 2.80 2.82 XXX

75553 TC A Heart mri for morph w/dye ................... 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

75554 ............ A Cardiac MRI/function ............................ 1.83 11.84 11.98 11.84 11.98 0.56 14.23 14.37 14.23 14.37 XXX

75554 26 A Cardiac MRI/function ............................ 1.83 0.71 0.73 0.71 0.73 0.07 2.61 2.63 2.61 2.63 XXX

75554 TC A Cardiac MRI/function ............................ 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

75555 ............ A Cardiac MRI/limited study .................... 1.74 11.82 11.96 11.82 11.96 0.56 14.12 14.26 14.12 14.26 XXX

75555 26 A Cardiac MRI/limited study .................... 1.74 0.69 0.71 0.69 0.71 0.07 2.50 2.52 2.50 2.52 XXX

65512

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

75555 TC A Cardiac MRI/limited study .................... 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

75556 ............ N Cardiac MRI/flow mapping ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

75600 ............ A Contrast x-ray exam of aorta ............... 0.49 12.72 12.86 12.72 12.86 0.56 13.77 13.91 13.77 13.91 XXX

75600 26 A Contrast x-ray exam of aorta ............... 0.49 0.21 0.22 0.21 0.22 0.02 0.72 0.73 0.72 0.73 XXX

75600 TC A Contrast x-ray exam of aorta ............... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75605 ............ A Contrast x-ray exam of aorta ............... 1.14 12.95 13.11 12.95 13.11 0.59 14.68 14.84 14.68 14.84 XXX

75605 26 A Contrast x-ray exam of aorta ............... 1.14 0.44 0.47 0.44 0.47 0.05 1.63 1.66 1.63 1.66 XXX

75605 TC A Contrast x-ray exam of aorta ............... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75625 ............ A Contrast x-ray exam of aorta ............... 1.14 12.92 13.08 12.92 13.08 0.59 14.65 14.81 14.65 14.81 XXX

75625 26 A Contrast x-ray exam of aorta ............... 1.14 0.41 0.44 0.41 0.44 0.05 1.60 1.63 1.60 1.63 XXX

75625 TC A Contrast x-ray exam of aorta ............... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75630 ............ A X-ray aorta, leg arteries ....................... 1.79 13.72 13.85 13.72 13.85 0.65 16.16 16.29 16.16 16.29 XXX

75630 26 A X-ray aorta, leg arteries ....................... 1.79 0.68 0.67 0.68 0.67 0.08 2.55 2.54 2.55 2.54 XXX

75630 TC A X-ray aorta, leg arteries ....................... 0.00 13.04 13.18 NA NA 0.57 13.61 13.75 NA NA XXX

75635 ............ A Ct angio abdominal arteries ................. 1.89 9.19 9.19 9.19 9.19 0.37 11.45 11.45 11.45 11.45 XXX

75635 26 A Ct angio abdominal arteries ................. 1.89 0.76 0.76 0.76 0.76 0.05 2.70 2.70 2.70 2.70 XXX

75635 TC A Ct angio abdominal arteries ................. 0.00 8.43 8.43 NA NA 0.32 8.75 8.75 NA NA XXX

75650 ............ A Artery x-rays, head & neck .................. 1.49 13.04 13.22 13.04 13.22 0.61 15.14 15.32 15.14 15.32 XXX

75650 26 A Artery x-rays, head & neck .................. 1.49 0.53 0.58 0.53 0.58 0.07 2.09 2.14 2.09 2.14 XXX

75650 TC A Artery x-rays, head & neck .................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75658 ............ A Artery x-rays, arm ................................. 1.31 13.04 13.20 13.04 13.20 0.60 14.95 15.11 14.95 15.11 XXX

75658 26 A Artery x-rays, arm ................................. 1.31 0.53 0.56 0.53 0.56 0.06 1.90 1.93 1.90 1.93 XXX

75658 TC A Artery x-rays, arm ................................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75660 ............ A Artery x-rays, head & neck .................. 1.31 13.00 13.17 13.00 13.17 0.60 14.91 15.08 14.91 15.08 XXX

75660 26 A Artery x-rays, head & neck .................. 1.31 0.49 0.53 0.49 0.53 0.06 1.86 1.90 1.86 1.90 XXX

75660 TC A Artery x-rays, head & neck .................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75662 ............ A Artery x-rays, head & neck .................. 1.66 13.16 13.33 13.16 13.33 0.62 15.44 15.61 15.44 15.61 XXX

75662 26 A Artery x-rays, head & neck .................. 1.66 0.65 0.69 0.65 0.69 0.08 2.39 2.43 2.39 2.43 XXX

75662 TC A Artery x-rays, head & neck .................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75665 ............ A Artery x-rays, head & neck .................. 1.31 12.99 13.16 12.99 13.16 0.61 14.91 15.08 14.91 15.08 XXX

75665 26 A Artery x-rays, head & neck .................. 1.31 0.48 0.52 0.48 0.52 0.07 1.86 1.90 1.86 1.90 XXX

75665 TC A Artery x-rays, head & neck .................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75671 ............ A Artery x-rays, head & neck .................. 1.66 13.11 13.29 13.11 13.29 0.62 15.39 15.57 15.39 15.57 XXX

75671 26 A Artery x-rays, head & neck .................. 1.66 0.60 0.65 0.60 0.65 0.08 2.34 2.39 2.34 2.39 XXX

75671 TC A Artery x-rays, head & neck .................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75676 ............ A Artery x-rays, neck ............................... 1.31 12.99 13.16 12.99 13.16 0.61 14.91 15.08 14.91 15.08 XXX

75676 26 A Artery x-rays, neck ............................... 1.31 0.48 0.52 0.48 0.52 0.07 1.86 1.90 1.86 1.90 XXX

75676 TC A Artery x-rays, neck ............................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75680 ............ A Artery x-rays, neck ............................... 1.66 13.11 13.29 13.11 13.29 0.62 15.39 15.57 15.39 15.57 XXX

75680 26 A Artery x-rays, neck ............................... 1.66 0.60 0.65 0.60 0.65 0.08 2.34 2.39 2.34 2.39 XXX

75680 TC A Artery x-rays, neck ............................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75685 ............ A Artery x-rays, spine .............................. 1.31 12.98 13.15 12.98 13.15 0.60 14.89 15.06 14.89 15.06 XXX

75685 26 A Artery x-rays, spine .............................. 1.31 0.47 0.51 0.47 0.51 0.06 1.84 1.88 1.84 1.88 XXX

75685 TC A Artery x-rays, spine .............................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75705 ............ A Artery x-rays, spine .............................. 2.18 13.29 13.49 13.29 13.49 0.65 16.12 16.32 16.12 16.32 XXX

75705 26 A Artery x-rays, spine .............................. 2.18 0.78 0.85 0.78 0.85 0.11 3.07 3.14 3.07 3.14 XXX

75705 TC A Artery x-rays, spine .............................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75710 ............ A Artery x-rays, arm/leg ........................... 1.14 12.93 13.09 12.93 13.09 0.60 14.67 14.83 14.67 14.83 XXX

75710 26 A Artery x-rays, arm/leg ........................... 1.14 0.42 0.45 0.42 0.45 0.06 1.62 1.65 1.62 1.65 XXX

75710 TC A Artery x-rays, arm/leg ........................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75716 ............ A Artery x-rays, arms/legs ....................... 1.31 12.98 13.15 12.98 13.15 0.60 14.89 15.06 14.89 15.06 XXX

75716 26 A Artery x-rays, arms/legs ....................... 1.31 0.47 0.51 0.47 0.51 0.06 1.84 1.88 1.84 1.88 XXX

75716 TC A Artery x-rays, arms/legs ....................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75722 ............ A Artery x-rays, kidney ............................ 1.14 12.95 13.11 12.95 13.11 0.59 14.68 14.84 14.68 14.84 XXX

75722 26 A Artery x-rays, kidney ............................ 1.14 0.44 0.47 0.44 0.47 0.05 1.63 1.66 1.63 1.66 XXX

75722 TC A Artery x-rays, kidney ............................ 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75724 ............ A Artery x-rays, kidneys ........................... 1.49 13.13 13.29 13.13 13.29 0.59 15.21 15.37 15.21 15.37 XXX

75724 26 A Artery x-rays, kidneys ........................... 1.49 0.62 0.65 0.62 0.65 0.05 2.16 2.19 2.16 2.19 XXX

75724 TC A Artery x-rays, kidneys ........................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75726 ............ A Artery x-rays, abdomen ........................ 1.14 12.92 13.08 12.92 13.08 0.59 14.65 14.81 14.65 14.81 XXX

75726 26 A Artery x-rays, abdomen ........................ 1.14 0.41 0.44 0.41 0.44 0.05 1.60 1.63 1.60 1.63 XXX

75726 TC A Artery x-rays, abdomen ........................ 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75731 ............ A Artery x-rays, adrenal gland ................. 1.14 12.92 13.08 12.92 13.08 0.59 14.65 14.81 14.65 14.81 XXX

75731 26 A Artery x-rays, adrenal gland ................. 1.14 0.41 0.44 0.41 0.44 0.05 1.60 1.63 1.60 1.63 XXX

75731 TC A Artery x-rays, adrenal gland ................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75733 ............ A Artery x-rays, adrenals ......................... 1.31 12.99 13.16 12.99 13.16 0.60 14.90 15.07 14.90 15.07 XXX

75733 26 A Artery x-rays, adrenals ......................... 1.31 0.48 0.52 0.48 0.52 0.06 1.85 1.89 1.85 1.89 XXX

75733 TC A Artery x-rays, adrenals ......................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75736 ............ A Artery x-rays, pelvis .............................. 1.14 12.92 13.08 12.92 13.08 0.59 14.65 14.81 14.65 14.81 XXX

75736 26 A Artery x-rays, pelvis .............................. 1.14 0.41 0.44 0.41 0.44 0.05 1.60 1.63 1.60 1.63 XXX

75736 TC A Artery x-rays, pelvis .............................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75741 ............ A Artery x-rays, lung ................................ 1.31 12.98 13.15 12.98 13.15 0.60 14.89 15.06 14.89 15.06 XXX

75741 26 A Artery x-rays, lung ................................ 1.31 0.47 0.51 0.47 0.51 0.06 1.84 1.88 1.84 1.88 XXX

75741 TC A Artery x-rays, lung ................................ 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75743 ............ A Artery x-rays, lungs .............................. 1.66 13.10 13.28 13.10 13.28 0.61 15.37 15.55 15.37 15.55 XXX

75743 26 A Artery x-rays, lungs .............................. 1.66 0.59 0.64 0.59 0.64 0.07 2.32 2.37 2.32 2.37 XXX

75743 TC A Artery x-rays, lungs .............................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75746 ............ A Artery x-rays, lung ................................ 1.14 12.92 13.08 12.92 13.08 0.59 14.65 14.81 14.65 14.81 XXX

75746 26 A Artery x-rays, lung ................................ 1.14 0.41 0.44 0.41 0.44 0.05 1.60 1.63 1.60 1.63 XXX

75746 TC A Artery x-rays, lung ................................ 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75756 ............ A Artery x-rays, chest .............................. 1.14 13.00 13.14 13.00 13.14 0.58 14.72 14.86 14.72 14.86 XXX

75756 26 A Artery x-rays, chest .............................. 1.14 0.49 0.50 0.49 0.50 0.04 1.67 1.68 1.67 1.68 XXX

75756 TC A Artery x-rays, chest .............................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

65513

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

75774 ............ A Artery x-ray, each vessel ..................... 0.36 12.65 12.79 12.65 12.79 0.56 13.57 13.71 13.57 13.71 ZZZ

75774 26 A Artery x-ray, each vessel ..................... 0.36 0.14 0.15 0.14 0.15 0.02 0.52 0.53 0.52 0.53 ZZZ

75774 TC A Artery x-ray, each vessel ..................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA ZZZ

75790 ............ A Visualize A-V shunt .............................. 1.84 2.00 2.07 2.00 2.07 0.16 4.00 4.07 4.00 4.07 XXX

75790 26 A Visualize A-V shunt .............................. 1.84 0.65 0.71 0.65 0.71 0.09 2.58 2.64 2.58 2.64 XXX

75790 TC A Visualize A-V shunt .............................. 0.00 1.35 1.36 NA NA 0.07 1.42 1.43 NA NA XXX

75801 ............ A Lymph vessel x-ray, arm/leg ................ 0.81 5.66 5.75 5.66 5.75 0.29 6.76 6.85 6.76 6.85 XXX

75801 26 A Lymph vessel x-ray, arm/leg ................ 0.81 0.29 0.32 0.29 0.32 0.05 1.15 1.18 1.15 1.18 XXX

75801 TC A Lymph vessel x-ray, arm/leg ................ 0.00 5.37 5.43 NA NA 0.24 5.61 5.67 NA NA XXX

75803 ............ A Lymph vessel x-ray,arms/legs .............. 1.17 5.79 5.88 5.79 5.88 0.29 7.25 7.34 7.25 7.34 XXX

75803 26 A Lymph vessel x-ray,arms/legs .............. 1.17 0.42 0.45 0.42 0.45 0.05 1.64 1.67 1.64 1.67 XXX

75803 TC A Lymph vessel x-ray,arms/legs .............. 0.00 5.37 5.43 NA NA 0.24 5.61 5.67 NA NA XXX

75805 ............ A Lymph vessel x-ray, trunk .................... 0.81 6.34 6.44 6.34 6.44 0.31 7.46 7.56 7.46 7.56 XXX

75805 26 A Lymph vessel x-ray, trunk .................... 0.81 0.29 0.32 0.29 0.32 0.04 1.14 1.17 1.14 1.17 XXX

75805 TC A Lymph vessel x-ray, trunk .................... 0.00 6.05 6.12 NA NA 0.27 6.32 6.39 NA NA XXX

75807 ............ A Lymph vessel x-ray, trunk .................... 1.17 6.47 6.57 6.47 6.57 0.32 7.96 8.06 7.96 8.06 XXX

75807 26 A Lymph vessel x-ray, trunk .................... 1.17 0.42 0.45 0.42 0.45 0.05 1.64 1.67 1.64 1.67 XXX

75807 TC A Lymph vessel x-ray, trunk .................... 0.00 6.05 6.12 NA NA 0.27 6.32 6.39 NA NA XXX

75809 ............ A Nonvascular shunt, x-ray ..................... 0.47 0.95 0.97 0.95 0.97 0.06 1.48 1.50 1.48 1.50 XXX

75809 26 A Nonvascular shunt, x-ray ..................... 0.47 0.17 0.18 0.17 0.18 0.02 0.66 0.67 0.66 0.67 XXX

75809 TC A Nonvascular shunt, x-ray ..................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

75810 ............ A Vein x-ray, spleen/liver ......................... 1.14 12.91 13.08 12.91 13.08 0.60 14.65 14.82 14.65 14.82 XXX

75810 26 A Vein x-ray, spleen/liver ......................... 1.14 0.40 0.44 0.40 0.44 0.06 1.60 1.64 1.60 1.64 XXX

75810 TC A Vein x-ray, spleen/liver ......................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75820 ............ A Vein x-ray, arm/leg ............................... 0.70 1.19 1.23 1.19 1.23 0.08 1.97 2.01 1.97 2.01 XXX

75820 26 A Vein x-ray, arm/leg ............................... 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

75820 TC A Vein x-ray, arm/leg ............................... 0.00 0.94 0.95 NA NA 0.05 0.99 1.00 NA NA XXX

75822 ............ A Vein x-ray, arms/legs ........................... 1.06 1.85 1.90 1.85 1.90 0.12 3.03 3.08 3.03 3.08 XXX

75822 26 A Vein x-ray, arms/legs ........................... 1.06 0.38 0.41 0.38 0.41 0.05 1.49 1.52 1.49 1.52 XXX

75822 TC A Vein x-ray, arms/legs ........................... 0.00 1.47 1.49 NA NA 0.07 1.54 1.56 NA NA XXX

75825 ............ A Vein x-ray, trunk ................................... 1.14 12.92 13.08 12.92 13.08 0.60 14.66 14.82 14.66 14.82 XXX

75825 26 A Vein x-ray, trunk ................................... 1.14 0.41 0.44 0.41 0.44 0.06 1.61 1.64 1.61 1.64 XXX

75825 TC A Vein x-ray, trunk ................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75827 ............ A Vein x-ray, chest .................................. 1.14 12.91 13.08 12.91 13.08 0.59 14.64 14.81 14.64 14.81 XXX

75827 26 A Vein x-ray, chest .................................. 1.14 0.40 0.44 0.40 0.44 0.05 1.59 1.63 1.59 1.63 XXX

75827 TC A Vein x-ray, chest .................................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75831 ............ A Vein x-ray, kidney ................................. 1.14 12.91 13.08 12.91 13.08 0.59 14.64 14.81 14.64 14.81 XXX

75831 26 A Vein x-ray, kidney ................................. 1.14 0.40 0.44 0.40 0.44 0.05 1.59 1.63 1.59 1.63 XXX

75831 TC A Vein x-ray, kidney ................................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75833 ............ A Vein x-ray, kidneys ............................... 1.49 13.04 13.22 13.04 13.22 0.61 15.14 15.32 15.14 15.32 XXX

75833 26 A Vein x-ray, kidneys ............................... 1.49 0.53 0.58 0.53 0.58 0.07 2.09 2.14 2.09 2.14 XXX

75833 TC A Vein x-ray, kidneys ............................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75840 ............ A Vein x-ray, adrenal gland ..................... 1.14 12.92 13.08 12.92 13.08 0.61 14.67 14.83 14.67 14.83 XXX

75840 26 A Vein x-ray, adrenal gland ..................... 1.14 0.41 0.44 0.41 0.44 0.07 1.62 1.65 1.62 1.65 XXX

75840 TC A Vein x-ray, adrenal gland ..................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75842 ............ A Vein x-ray, adrenal glands ................... 1.49 13.03 13.21 13.03 13.21 0.61 15.13 15.31 15.13 15.31 XXX

75842 26 A Vein x-ray, adrenal glands ................... 1.49 0.52 0.57 0.52 0.57 0.07 2.08 2.13 2.08 2.13 XXX

75842 TC A Vein x-ray, adrenal glands ................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75860 ............ A Vein x-ray, neck ................................... 1.14 12.94 13.10 12.94 13.10 0.60 14.68 14.84 14.68 14.84 XXX

75860 26 A Vein x-ray, neck ................................... 1.14 0.43 0.46 0.43 0.46 0.06 1.63 1.66 1.63 1.66 XXX

75860 TC A Vein x-ray, neck ................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75870 ............ A Vein x-ray, skull .................................... 1.14 12.93 13.09 12.93 13.09 0.60 14.67 14.83 14.67 14.83 XXX

75870 26 A Vein x-ray, skull .................................... 1.14 0.42 0.45 0.42 0.45 0.06 1.62 1.65 1.62 1.65 XXX

75870 TC A Vein x-ray, skull .................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75872 ............ A Vein x-ray, skull .................................... 1.14 12.91 13.08 12.91 13.08 0.59 14.64 14.81 14.64 14.81 XXX

75872 26 A Vein x-ray, skull .................................... 1.14 0.40 0.44 0.40 0.44 0.05 1.59 1.63 1.59 1.63 XXX

75872 TC A Vein x-ray, skull .................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75880 ............ A Vein x-ray, eye socket .......................... 0.70 1.19 1.23 1.19 1.23 0.08 1.97 2.01 1.97 2.01 XXX

75880 26 A Vein x-ray, eye socket .......................... 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

75880 TC A Vein x-ray, eye socket .......................... 0.00 0.94 0.95 NA NA 0.05 0.99 1.00 NA NA XXX

75885 ............ A Vein x-ray, liver .................................... 1.44 13.02 13.20 13.02 13.20 0.60 15.06 15.24 15.06 15.24 XXX

75885 26 A Vein x-ray, liver .................................... 1.44 0.51 0.56 0.51 0.56 0.06 2.01 2.06 2.01 2.06 XXX

75885 TC A Vein x-ray, liver .................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75887 ............ A Vein x-ray, liver .................................... 1.44 13.02 13.20 13.02 13.20 0.60 15.06 15.24 15.06 15.24 XXX

75887 26 A Vein x-ray, liver .................................... 1.44 0.51 0.56 0.51 0.56 0.06 2.01 2.06 2.01 2.06 XXX

75887 TC A Vein x-ray, liver .................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75889 ............ A Vein x-ray, liver .................................... 1.14 12.91 13.08 12.91 13.08 0.59 14.64 14.81 14.64 14.81 XXX

75889 26 A Vein x-ray, liver .................................... 1.14 0.40 0.44 0.40 0.44 0.05 1.59 1.63 1.59 1.63 XXX

75889 TC A Vein x-ray, liver .................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75891 ............ A Vein x-ray, liver .................................... 1.14 12.91 13.08 12.91 13.08 0.59 14.64 14.81 14.64 14.81 XXX

75891 26 A Vein x-ray, liver .................................... 1.14 0.40 0.44 0.40 0.44 0.05 1.59 1.63 1.59 1.63 XXX

75891 TC A Vein x-ray, liver .................................... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75893 ............ A Venous sampling by catheter ............... 0.54 12.70 12.85 12.70 12.85 0.56 13.80 13.95 13.80 13.95 XXX

75893 26 A Venous sampling by catheter ............... 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

75893 TC A Venous sampling by catheter ............... 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75894 ............ A X-rays, transcath therapy ..................... 1.31 24.43 24.72 24.43 24.72 1.12 26.86 27.15 26.86 27.15 XXX

75894 26 A X-rays, transcath therapy ..................... 1.31 0.47 0.51 0.47 0.51 0.07 1.85 1.89 1.85 1.89 XXX

75894 TC A X-rays, transcath therapy ..................... 0.00 23.96 24.21 NA NA 1.05 25.01 25.26 NA NA XXX

75896 ............ A X-rays, transcath therapy ..................... 1.31 21.32 21.58 21.32 21.58 0.97 23.60 23.86 23.60 23.86 XXX

75896 26 A X-rays, transcath therapy ..................... 1.31 0.48 0.52 0.48 0.52 0.06 1.85 1.89 1.85 1.89 XXX

75896 TC A X-rays, transcath therapy ..................... 0.00 20.84 21.06 NA NA 0.91 21.75 21.97 NA NA XXX

75898 ............ A Follow-up angiogram ............................ 1.65 1.65 1.71 1.65 1.71 0.12 3.42 3.48 3.42 3.48 XXX

75898 26 A Follow-up angiogram ............................ 1.65 0.60 0.65 0.60 0.65 0.07 2.32 2.37 2.32 2.37 XXX

65514

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

75898 TC A Follow-up angiogram ............................ 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

75900 ............ A Arterial catheter exchange ................... 0.49 21.00 21.24 21.00 21.24 0.94 22.43 22.67 22.43 22.67 XXX

75900 26 A Arterial catheter exchange ................... 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

75900 TC A Arterial catheter exchange ................... 0.00 20.82 21.04 NA NA 0.92 21.74 21.96 NA NA XXX

75940 ............ A X-ray placement, vein filter .................. 0.54 12.70 12.85 12.70 12.85 0.57 13.81 13.96 13.81 13.96 XXX

75940 26 A X-ray placement, vein filter .................. 0.54 0.19 0.21 0.19 0.21 0.03 0.76 0.78 0.76 0.78 XXX

75940 TC A X-ray placement, vein filter .................. 0.00 12.51 12.64 NA NA 0.54 13.05 13.18 NA NA XXX

75945 ............ A Intravascular us .................................... 0.40 4.68 4.75 4.68 4.75 0.23 5.31 5.38 5.31 5.38 XXX

75945 26 A Intravascular us .................................... 0.40 0.15 0.17 0.15 0.17 0.03 0.58 0.60 0.58 0.60 XXX

75945 TC A Intravascular us .................................... 0.00 4.53 4.58 NA NA 0.20 4.73 4.78 NA NA XXX

75946 ............ A Intravascular us add-on ........................ 0.40 2.43 2.47 2.43 2.47 0.14 2.97 3.01 2.97 3.01 ZZZ

75946 26 A Intravascular us add-on ........................ 0.40 0.15 0.17 0.15 0.17 0.03 0.58 0.60 0.58 0.60 ZZZ

75946 TC A Intravascular us add-on ........................ 0.00 2.28 2.30 NA NA 0.11 2.39 2.41 NA NA ZZZ

75952 ............ A Endovasc repair abdom aorta .............. 4.00 1.60 1.60 1.60 1.60 0.68 6.28 6.28 6.28 6.28 XXX

75953 ............ A Abdom aneurysm endovas rpr ............. 1.36 0.54 0.54 0.54 0.54 0.68 2.58 2.58 2.58 2.58 XXX

75960 ............ A Transcatheter intro, stent ..................... 0.82 15.11 15.28 15.11 15.28 0.68 16.61 16.78 16.61 16.78 XXX

75960 26 A Transcatheter intro, stent ..................... 0.82 0.31 0.33 0.31 0.33 0.04 1.17 1.19 1.17 1.19 XXX

75960 TC A Transcatheter intro, stent ..................... 0.00 14.80 14.95 NA NA 0.64 15.44 15.59 NA NA XXX

75961 ............ A Retrieval, broken catheter .................... 4.25 11.94 12.19 11.94 12.19 0.64 16.83 17.08 16.83 17.08 XXX

75961 26 A Retrieval, broken catheter .................... 4.25 1.52 1.66 1.52 1.66 0.18 5.95 6.09 5.95 6.09 XXX

75961 TC A Retrieval, broken catheter .................... 0.00 10.42 10.53 NA NA 0.46 10.88 10.99 NA NA XXX

75962 ............ A Repair arterial blockage ....................... 0.54 15.82 16.01 15.82 16.01 0.72 17.08 17.27 17.08 17.27 XXX

75962 26 A Repair arterial blockage ....................... 0.54 0.20 0.22 0.20 0.22 0.03 0.77 0.79 0.77 0.79 XXX

75962 TC A Repair arterial blockage ....................... 0.00 15.62 15.79 NA NA 0.69 16.31 16.48 NA NA XXX

75964 ............ A Repair artery blockage, each ............... 0.36 8.46 8.56 8.46 8.56 0.38 9.20 9.30 9.20 9.30 ZZZ

75964 26 A Repair artery blockage, each ............... 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 ZZZ

75964 TC A Repair artery blockage, each ............... 0.00 8.33 8.42 NA NA 0.36 8.69 8.78 NA NA ZZZ

75966 ............ A Repair arterial blockage ....................... 1.31 16.13 16.33 16.13 16.33 0.75 18.19 18.39 18.19 18.39 XXX

75966 26 A Repair arterial blockage ....................... 1.31 0.51 0.54 0.51 0.54 0.06 1.88 1.91 1.88 1.91 XXX

75966 TC A Repair arterial blockage ....................... 0.00 15.62 15.79 NA NA 0.69 16.31 16.48 NA NA XXX

75968 ............ A Repair artery blockage, each ............... 0.36 8.47 8.57 8.47 8.57 0.37 9.20 9.30 9.20 9.30 ZZZ

75968 26 A Repair artery blockage, each ............... 0.36 0.14 0.15 0.14 0.15 0.01 0.51 0.52 0.51 0.52 ZZZ

75968 TC A Repair artery blockage, each ............... 0.00 8.33 8.42 NA NA 0.36 8.69 8.78 NA NA ZZZ

75970 ............ A Vascular biopsy .................................... 0.83 11.76 11.91 11.76 11.91 0.54 13.13 13.28 13.13 13.28 XXX

75970 26 A Vascular biopsy .................................... 0.83 0.30 0.33 0.30 0.33 0.04 1.17 1.20 1.17 1.20 XXX

75970 TC A Vascular biopsy .................................... 0.00 11.46 11.58 NA NA 0.50 11.96 12.08 NA NA XXX

75978 ............ A Repair venous blockage ....................... 0.54 15.81 16.06 15.81 16.06 0.71 17.06 17.31 17.06 17.31 XXX

75978 26 A Repair venous blockage ....................... 0.54 0.19 0.27 0.19 0.27 0.02 0.75 0.83 0.75 0.83 XXX

75978 TC A Repair venous blockage ....................... 0.00 15.62 15.79 NA NA 0.69 16.31 16.48 NA NA XXX

75980 ............ A Contrast xray exam bile duct ............... 1.44 5.88 5.99 5.88 5.99 0.30 7.62 7.73 7.62 7.73 XXX

75980 26 A Contrast xray exam bile duct ............... 1.44 0.51 0.56 0.51 0.56 0.06 2.01 2.06 2.01 2.06 XXX

75980 TC A Contrast xray exam bile duct ............... 0.00 5.37 5.43 NA NA 0.24 5.61 5.67 NA NA XXX

75982 ............ A Contrast xray exam bile duct ............... 1.44 6.56 6.68 6.56 6.68 0.33 8.33 8.45 8.33 8.45 XXX

75982 26 A Contrast xray exam bile duct ............... 1.44 0.51 0.56 0.51 0.56 0.06 2.01 2.06 2.01 2.06 XXX

75982 TC A Contrast xray exam bile duct ............... 0.00 6.05 6.12 NA NA 0.27 6.32 6.39 NA NA XXX

75984 ............ A Xray control catheter change ............... 0.72 2.19 2.24 2.19 2.24 0.12 3.03 3.08 3.03 3.08 XXX

75984 26 A Xray control catheter change ............... 0.72 0.25 0.28 0.25 0.28 0.03 1.00 1.03 1.00 1.03 XXX

75984 TC A Xray control catheter change ............... 0.00 1.94 1.96 NA NA 0.09 2.03 2.05 NA NA XXX

75989 ............ A Abscess drainage under x-ray ............. 1.19 3.55 3.62 3.55 3.62 0.19 4.93 5.00 4.93 5.00 XXX

75989 26 A Abscess drainage under x-ray ............. 1.19 0.42 0.46 0.42 0.46 0.05 1.66 1.70 1.66 1.70 XXX

75989 TC A Abscess drainage under x-ray ............. 0.00 3.13 3.16 NA NA 0.14 3.27 3.30 NA NA XXX

75992 ............ A Atherectomy, x-ray exam ..................... 0.54 15.83 16.02 15.83 16.02 0.71 17.08 17.27 17.08 17.27 XXX

75992 26 A Atherectomy, x-ray exam ..................... 0.54 0.21 0.23 0.21 0.23 0.02 0.77 0.79 0.77 0.79 XXX

75992 TC A Atherectomy, x-ray exam ..................... 0.00 15.62 15.79 NA NA 0.69 16.31 16.48 NA NA XXX

75993 ............ A Atherectomy, x-ray exam ..................... 0.36 8.48 8.58 8.48 8.58 0.37 9.21 9.31 9.21 9.31 ZZZ

75993 26 A Atherectomy, x-ray exam ..................... 0.36 0.15 0.16 0.15 0.16 0.01 0.52 0.53 0.52 0.53 ZZZ

75993 TC A Atherectomy, x-ray exam ..................... 0.00 8.33 8.42 NA NA 0.36 8.69 8.78 NA NA ZZZ

75994 ............ A Atherectomy, x-ray exam ..................... 1.31 16.13 16.33 16.13 16.33 0.75 18.19 18.39 18.19 18.39 XXX

75994 26 A Atherectomy, x-ray exam ..................... 1.31 0.51 0.54 0.51 0.54 0.06 1.88 1.91 1.88 1.91 XXX

75994 TC A Atherectomy, x-ray exam ..................... 0.00 15.62 15.79 NA NA 0.69 16.31 16.48 NA NA XXX

75995 ............ A Atherectomy, x-ray exam ..................... 1.31 16.08 16.29 16.08 16.29 0.75 18.14 18.35 18.14 18.35 XXX

75995 26 A Atherectomy, x-ray exam ..................... 1.31 0.46 0.50 0.46 0.50 0.06 1.83 1.87 1.83 1.87 XXX

75995 TC A Atherectomy, x-ray exam ..................... 0.00 15.62 15.79 NA NA 0.69 16.31 16.48 NA NA XXX

75996 ............ A Atherectomy, x-ray exam ..................... 0.36 8.47 8.57 8.47 8.57 0.37 9.20 9.30 9.20 9.30 ZZZ

75996 26 A Atherectomy, x-ray exam ..................... 0.36 0.14 0.15 0.14 0.15 0.01 0.51 0.52 0.51 0.52 ZZZ

75996 TC A Atherectomy, x-ray exam ..................... 0.00 8.33 8.42 NA NA 0.36 8.69 8.78 NA NA ZZZ

76000 ............ A Fluoroscope examination ..................... 0.17 1.35 1.37 1.35 1.37 0.07 1.59 1.61 1.59 1.61 XXX

76000 26 A Fluoroscope examination ..................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX

76000 TC A Fluoroscope examination ..................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76001 ............ A Fluoroscope exam, extensive .............. 0.67 2.84 2.90 2.84 2.90 0.15 3.66 3.72 3.66 3.72 XXX

76001 26 A Fluoroscope exam, extensive .............. 0.67 0.24 0.27 0.24 0.27 0.03 0.94 0.97 0.94 0.97 XXX

76001 TC A Fluoroscope exam, extensive .............. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

76003 ............ A Needle localization by x-ray ................. 0.54 1.48 1.51 1.48 1.51 0.09 2.11 2.14 2.11 2.14 XXX

76003 26 A Needle localization by x-ray ................. 0.54 0.18 0.20 0.18 0.20 0.03 0.75 0.77 0.75 0.77 XXX

76003 TC A Needle localization by x-ray ................. 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76005 ............ A Fluoroguide for spine inject .................. 0.60 1.49 1.49 1.49 1.49 0.09 2.18 2.18 2.18 2.18 XXX

76005 26 A Fluoroguide for spine inject .................. 0.60 0.19 0.19 0.19 0.19 0.03 0.82 0.82 0.82 0.82 XXX

76005 TC A Fluoroguide for spine inject .................. 0.00 1.30 1.30 NA NA 0.06 1.36 1.36 NA NA XXX

76006 ............ A X-ray stress view .................................. 0.41 0.19 0.19 0.19 0.19 0.04 0.64 0.64 0.64 0.64 XXX

76010 ............ A X-ray, nose to rectum ........................... 0.18 0.58 0.60 0.58 0.60 0.03 0.79 0.81 0.79 0.81 XXX

76010 26 A X-ray, nose to rectum ........................... 0.18 0.06 0.07 0.06 0.07 0.01 0.25 0.26 0.25 0.26 XXX

76010 TC A X-ray, nose to rectum ........................... 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

76012 ............ A Percut vertebroplasty fluor ................... 1.31 0.49 0.49 0.49 0.49 1.10 2.90 2.90 2.90 2.90 XXX

65515

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

76013 ............ A Percut vertebroplasty, ct ...................... 1.38 0.52 0.52 0.52 0.52 0.48 2.38 2.38 2.38 2.38 XXX

76020 ............ A X-rays for bone age ............................. 0.19 0.59 0.61 0.59 0.61 0.03 0.81 0.83 0.81 0.83 XXX

76020 26 A X-rays for bone age ............................. 0.19 0.07 0.08 0.07 0.08 0.01 0.27 0.28 0.27 0.28 XXX

76020 TC A X-rays for bone age ............................. 0.00 0.52 0.53 NA NA 0.02 0.54 0.55 NA NA XXX

76040 ............ A X-rays, bone evaluation ....................... 0.27 0.88 0.90 0.88 0.90 0.07 1.22 1.24 1.22 1.24 XXX

76040 26 A X-rays, bone evaluation ....................... 0.27 0.10 0.11 0.10 0.11 0.03 0.40 0.41 0.40 0.41 XXX

76040 TC A X-rays, bone evaluation ....................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA XXX

76061 ............ A X-rays, bone survey ............................. 0.45 1.15 1.18 1.15 1.18 0.07 1.67 1.70 1.67 1.70 XXX

76061 26 A X-rays, bone survey ............................. 0.45 0.16 0.18 0.16 0.18 0.02 0.63 0.65 0.63 0.65 XXX

76061 TC A X-rays, bone survey ............................. 0.00 0.99 1.00 NA NA 0.05 1.04 1.05 NA NA XXX

76062 ............ A X-rays, bone survey ............................. 0.54 1.62 1.66 1.62 1.66 0.09 2.25 2.29 2.25 2.29 XXX

76062 26 A X-rays, bone survey ............................. 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

76062 TC A X-rays, bone survey ............................. 0.00 1.43 1.45 NA NA 0.07 1.50 1.52 NA NA XXX

76065 ............ A X-rays, bone evaluation ....................... 0.28 0.83 0.85 0.83 0.85 0.05 1.16 1.18 1.16 1.18 XXX

76065 26 A X-rays, bone evaluation ....................... 0.28 0.10 0.11 0.10 0.11 0.01 0.39 0.40 0.39 0.40 XXX

76065 TC A X-rays, bone evaluation ....................... 0.00 0.73 0.74 NA NA 0.04 0.77 0.78 NA NA XXX

76066 ............ A Joint(s) survey, single film .................... 0.31 1.21 1.23 1.21 1.23 0.07 1.59 1.61 1.59 1.61 XXX

76066 26 A Joint(s) survey, single film .................... 0.31 0.11 0.12 0.11 0.12 0.02 0.44 0.45 0.44 0.45 XXX

76066 TC A Joint(s) survey, single film .................... 0.00 1.10 1.11 NA NA 0.05 1.15 1.16 NA NA XXX

76070 ............ I CT scan, bone density study ............... +0.25 3.03 3.07 3.03 3.07 0.14 3.42 3.46 3.42 3.46 XXX

76070 26 I CT scan, bone density study ............... +0.25 0.10 0.11 0.10 0.11 0.01 0.36 0.37 0.36 0.37 XXX

76070 TC I CT scan, bone density study ............... +0.00 2.93 2.96 NA NA 0.13 3.06 3.09 NA NA XXX

76075 ............ A Dual energy x-ray study ....................... 0.30 3.18 3.22 3.18 3.22 0.15 3.63 3.67 3.63 3.67 XXX

76075 26 A Dual energy x-ray study ....................... 0.30 0.11 0.12 0.11 0.12 0.01 0.42 0.43 0.42 0.43 XXX

76075 TC A Dual energy x-ray study ....................... 0.00 3.07 3.10 NA NA 0.14 3.21 3.24 NA NA XXX

76076 ............ A Dual energy x-ray study ....................... 0.22 0.83 0.85 0.83 0.85 0.05 1.10 1.12 1.10 1.12 XXX

76076 26 A Dual energy x-ray study ....................... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

76076 TC A Dual energy x-ray study ....................... 0.00 0.75 0.76 NA NA 0.04 0.79 0.80 NA NA XXX

76078 ............ A Photodensitometry ................................ 0.20 0.83 0.85 0.83 0.85 0.05 1.08 1.10 1.08 1.10 XXX

76078 26 A Photodensitometry ................................ 0.20 0.08 0.09 0.08 0.09 0.01 0.29 0.30 0.29 0.30 XXX

76078 TC A Photodensitometry ................................ 0.00 0.75 0.76 NA NA 0.04 0.79 0.80 NA NA XXX

76080 ............ A X-ray exam of fistula ............................ 0.54 1.24 1.27 1.24 1.27 0.07 1.85 1.88 1.85 1.88 XXX

76080 26 A X-ray exam of fistula ............................ 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

76080 TC A X-ray exam of fistula ............................ 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

76086 ............ A X-ray of mammary duct ........................ 0.36 2.73 2.77 2.73 2.77 0.14 3.23 3.27 3.23 3.27 XXX

76086 26 A X-ray of mammary duct ........................ 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

76086 TC A X-ray of mammary duct ........................ 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

76088 ............ A X-ray of mammary ducts ...................... 0.45 3.80 3.86 3.80 3.86 0.18 4.43 4.49 4.43 4.49 XXX

76088 26 A X-ray of mammary ducts ...................... 0.45 0.16 0.18 0.16 0.18 0.02 0.63 0.65 0.63 0.65 XXX

76088 TC A X-ray of mammary ducts ...................... 0.00 3.64 3.68 NA NA 0.16 3.80 3.84 NA NA XXX

76090 ............ A Mammogram, one breast ..................... 0.58 1.26 1.25 1.26 1.25 0.08 1.92 1.91 1.92 1.91 XXX

76090 26 A Mammogram, one breast ..................... 0.58 0.21 0.19 0.21 0.19 0.03 0.82 0.80 0.82 0.80 XXX

76090 TC A Mammogram, one breast ..................... 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

76091 ............ A Mammogram, both breasts .................. 0.69 1.55 1.55 1.55 1.55 0.09 2.33 2.33 2.33 2.33 XXX

76091 26 A Mammogram, both breasts .................. 0.69 0.25 0.24 0.25 0.24 0.03 0.97 0.96 0.97 0.96 XXX

76091 TC A Mammogram, both breasts .................. 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76092 ............ X Mammogram, screening ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76093 ............ A Magnetic image, breast ........................ 1.63 18.07 18.31 18.07 18.31 0.83 20.53 20.77 20.53 20.77 XXX

76093 26 A Magnetic image, breast ........................ 1.63 0.58 0.63 0.58 0.63 0.07 2.28 2.33 2.28 2.33 XXX

76093 TC A Magnetic image, breast ........................ 0.00 17.49 17.68 NA NA 0.76 18.25 18.44 NA NA XXX

76094 ............ A Magnetic image, both breasts .............. 1.63 24.32 24.62 24.32 24.62 1.10 27.05 27.35 27.05 27.35 XXX

76094 26 A Magnetic image, both breasts .............. 1.63 0.58 0.63 0.58 0.63 0.07 2.28 2.33 2.28 2.33 XXX

76094 TC A Magnetic image, both breasts .............. 0.00 23.74 23.99 NA NA 1.03 24.77 25.02 NA NA XXX

76095 ............ A Stereotactic breast biopsy .................... 1.59 7.68 7.81 7.68 7.81 0.40 9.67 9.80 9.67 9.80 XXX

76095 26 A Stereotactic breast biopsy .................... 1.59 0.57 0.62 0.57 0.62 0.09 2.25 2.30 2.25 2.30 XXX

76095 TC A Stereotactic breast biopsy .................... 0.00 7.11 7.19 NA NA 0.31 7.42 7.50 NA NA XXX

76096 ............ A X-ray of needle wire, breast ................. 0.56 1.50 1.53 1.50 1.53 0.09 2.15 2.18 2.15 2.18 XXX

76096 26 A X-ray of needle wire, breast ................. 0.56 0.20 0.22 0.20 0.22 0.03 0.79 0.81 0.79 0.81 XXX

76096 TC A X-ray of needle wire, breast ................. 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76098 ............ A X-ray exam, breast specimen .............. 0.16 0.47 0.49 0.47 0.49 0.03 0.66 0.68 0.66 0.68 XXX

76098 26 A X-ray exam, breast specimen .............. 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

76098 TC A X-ray exam, breast specimen .............. 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

76100 ............ A X-ray exam of body section ................. 0.58 1.45 1.48 1.45 1.48 0.09 2.12 2.15 2.12 2.15 XXX

76100 26 A X-ray exam of body section ................. 0.58 0.21 0.23 0.21 0.23 0.03 0.82 0.84 0.82 0.84 XXX

76100 TC A X-ray exam of body section ................. 0.00 1.24 1.25 NA NA 0.06 1.30 1.31 NA NA XXX

76101 ............ A Complex body section x-ray ................. 0.58 1.62 1.66 1.62 1.66 0.10 2.30 2.34 2.30 2.34 XXX

76101 26 A Complex body section x-ray ................. 0.58 0.21 0.23 0.21 0.23 0.03 0.82 0.84 0.82 0.84 XXX

76101 TC A Complex body section x-ray ................. 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76102 ............ A Complex body section x-rays ............... 0.58 1.93 1.97 1.93 1.97 0.12 2.63 2.67 2.63 2.67 XXX

76102 26 A Complex body section x-rays ............... 0.58 0.21 0.23 0.21 0.23 0.03 0.82 0.84 0.82 0.84 XXX

76102 TC A Complex body section x-rays ............... 0.00 1.72 1.74 NA NA 0.09 1.81 1.83 NA NA XXX

76120 ............ A Cinematic x-rays ................................... 0.38 1.19 1.21 1.19 1.21 0.07 1.64 1.66 1.64 1.66 XXX

76120 26 A Cinematic x-rays ................................... 0.38 0.14 0.15 0.14 0.15 0.02 0.54 0.55 0.54 0.55 XXX

76120 TC A Cinematic x-rays ................................... 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

76125 ............ A Cinematic x-rays add-on ...................... 0.27 0.88 0.90 0.88 0.90 0.05 1.20 1.22 1.20 1.22 ZZZ

76125 26 A Cinematic x-rays add-on ...................... 0.27 0.10 0.11 0.10 0.11 0.01 0.38 0.39 0.38 0.39 ZZZ

76125 TC A Cinematic x-rays add-on ...................... 0.00 0.78 0.79 NA NA 0.04 0.82 0.83 NA NA ZZZ

76140 ............ I X-ray consultation ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76150 ............ A X-ray exam, dry process ...................... 0.00 0.41 0.42 NA NA 0.02 0.43 0.44 NA NA XXX

76350 ............ C Special x-ray contrast study ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76355 ............ A CAT scan for localization ..................... 1.21 8.62 8.75 8.62 8.75 0.41 10.24 10.37 10.24 10.37 XXX

76355 26 A CAT scan for localization ..................... 1.21 0.43 0.47 0.43 0.47 0.06 1.70 1.74 1.70 1.74 XXX

76355 TC A CAT scan for localization ..................... 0.00 8.19 8.28 NA NA 0.35 8.54 8.63 NA NA XXX

65516

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

76360 ............ A CAT scan for needle biopsy ................. 1.16 8.60 8.72 8.60 8.72 0.40 10.16 10.28 10.16 10.28 XXX

76360 26 A CAT scan for needle biopsy ................. 1.16 0.41 0.44 0.41 0.44 0.05 1.62 1.65 1.62 1.65 XXX

76360 TC A CAT scan for needle biopsy ................. 0.00 8.19 8.28 NA NA 0.35 8.54 8.63 NA NA XXX

76365 ............ D CAT scan for cyst aspiration ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76365 26 D CAT scan for cyst aspiration ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76365 TC D CAT scan for cyst aspiration ................ 0.00 0.00 0.00 NA NA 0.00 0.00 0.00 NA NA XXX

76370 ............ A CAT scan for therapy guide ................. 0.85 3.23 3.29 3.23 3.29 0.17 4.25 4.31 4.25 4.31 XXX

76370 26 A CAT scan for therapy guide ................. 0.85 0.30 0.33 0.30 0.33 0.04 1.19 1.22 1.19 1.22 XXX

76370 TC A CAT scan for therapy guide ................. 0.00 2.93 2.96 NA NA 0.13 3.06 3.09 NA NA XXX

76375 ............ A 3d/holograph reconstr add-on .............. 0.16 3.58 3.63 3.58 3.63 0.16 3.90 3.95 3.90 3.95 XXX

76375 26 A 3d/holograph reconstr add-on .............. 0.16 0.06 0.07 0.06 0.07 0.01 0.23 0.24 0.23 0.24 XXX

76375 TC A 3d/holograph reconstr add-on .............. 0.00 3.52 3.56 NA NA 0.15 3.67 3.71 NA NA XXX

76380 ............ A CAT scan follow-up study .................... 0.98 3.83 3.90 3.83 3.90 0.19 5.00 5.07 5.00 5.07 XXX

76380 26 A CAT scan follow-up study .................... 0.98 0.35 0.38 0.35 0.38 0.04 1.37 1.40 1.37 1.40 XXX

76380 TC A CAT scan follow-up study .................... 0.00 3.48 3.52 NA NA 0.15 3.63 3.67 NA NA XXX

76390 ............ A Mr spectroscopy ................................... 1.40 11.63 11.81 11.63 11.81 0.55 13.58 13.76 13.58 13.76 XXX

76390 26 A Mr spectroscopy ................................... 1.40 0.50 0.56 0.50 0.56 0.06 1.96 2.02 1.96 2.02 XXX

76390 TC A Mr spectroscopy ................................... 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

76393 ............ A Mr guidance for needle place .............. 1.50 11.66 11.66 11.66 11.66 0.52 13.68 13.68 13.68 13.68 XXX

76393 26 A Mr guidance for needle place .............. 1.50 0.53 0.53 0.53 0.53 0.06 2.09 2.09 2.09 2.09 XXX

76393 TC A Mr guidance for needle place .............. 0.00 11.13 11.13 NA NA 0.46 11.59 11.59 NA NA XXX

76400 ............ A Magnetic image, bone marrow ............. 1.60 11.70 11.87 11.70 11.87 0.56 13.86 14.03 13.86 14.03 XXX

76400 26 A Magnetic image, bone marrow ............. 1.60 0.57 0.62 0.57 0.62 0.07 2.24 2.29 2.24 2.29 XXX

76400 TC A Magnetic image, bone marrow ............. 0.00 11.13 11.25 NA NA 0.49 11.62 11.74 NA NA XXX

76499 ............ C Radiographic procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76499 26 C Radiographic procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76499 TC C Radiographic procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76506 ............ A Echo exam of head .............................. 0.63 1.67 1.70 1.67 1.70 0.10 2.40 2.43 2.40 2.43 XXX

76506 26 A Echo exam of head .............................. 0.63 0.26 0.27 0.26 0.27 0.03 0.92 0.93 0.92 0.93 XXX

76506 TC A Echo exam of head .............................. 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76511 ............ A Echo exam of eye ................................ 0.94 1.78 1.73 1.78 1.73 0.08 2.80 2.75 2.80 2.75 XXX

76511 26 A Echo exam of eye ................................ 0.94 0.44 0.40 0.44 0.40 0.02 1.40 1.36 1.40 1.36 XXX

76511 TC A Echo exam of eye ................................ 0.00 1.34 1.33 NA NA 0.06 1.40 1.39 NA NA XXX

76512 ............ A Echo exam of eye ................................ 0.66 1.86 1.87 1.86 1.87 0.09 2.61 2.62 2.61 2.62 XXX

76512 26 A Echo exam of eye ................................ 0.66 0.32 0.32 0.32 0.32 0.01 0.99 0.99 0.99 0.99 XXX

76512 TC A Echo exam of eye ................................ 0.00 1.54 1.55 NA NA 0.08 1.62 1.63 NA NA XXX

76513 ............ A Echo exam of eye, water bath ............. 0.66 2.28 2.19 2.28 2.19 0.09 3.03 2.94 3.03 2.94 XXX

76513 26 A Echo exam of eye, water bath ............. 0.66 0.33 0.33 0.33 0.33 0.01 1.00 1.00 1.00 1.00 XXX

76513 TC A Echo exam of eye, water bath ............. 0.00 1.95 1.86 NA NA 0.08 2.03 1.94 NA NA XXX

76516 ............ A Echo exam of eye ................................ 0.54 1.36 1.41 1.36 1.41 0.07 1.97 2.02 1.97 2.02 XXX

76516 26 A Echo exam of eye ................................ 0.54 0.27 0.27 0.27 0.27 0.01 0.82 0.82 0.82 0.82 XXX

76516 TC A Echo exam of eye ................................ 0.00 1.09 1.14 NA NA 0.06 1.15 1.20 NA NA XXX

76519 ............ A Echo exam of eye ................................ 0.54 1.51 1.52 1.51 1.52 0.07 2.12 2.13 2.12 2.13 XXX

76519 26 A Echo exam of eye ................................ 0.54 0.27 0.27 0.27 0.27 0.01 0.82 0.82 0.82 0.82 XXX

76519 TC A Echo exam of eye ................................ 0.00 1.24 1.25 NA NA 0.06 1.30 1.31 NA NA XXX

76529 ............ A Echo exam of eye ................................ 0.57 2.04 1.95 2.04 1.95 0.08 2.69 2.60 2.69 2.60 XXX

76529 26 A Echo exam of eye ................................ 0.57 0.27 0.27 0.27 0.27 0.01 0.85 0.85 0.85 0.85 XXX

76529 TC A Echo exam of eye ................................ 0.00 1.77 1.68 NA NA 0.07 1.84 1.75 NA NA XXX

76536 ............ A Echo exam of head and neck .............. 0.56 1.61 1.65 1.61 1.65 0.09 2.26 2.30 2.26 2.30 XXX

76536 26 A Echo exam of head and neck .............. 0.56 0.20 0.22 0.20 0.22 0.02 0.78 0.80 0.78 0.80 XXX

76536 TC A Echo exam of head and neck .............. 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76604 ............ A Echo exam of chest ............................. 0.55 1.50 1.53 1.50 1.53 0.08 2.13 2.16 2.13 2.16 XXX

76604 26 A Echo exam of chest ............................. 0.55 0.20 0.22 0.20 0.22 0.02 0.77 0.79 0.77 0.79 XXX

76604 TC A Echo exam of chest ............................. 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76645 ............ A Echo exam of breast(s) ........................ 0.54 1.24 1.27 1.24 1.27 0.08 1.86 1.89 1.86 1.89 XXX

76645 26 A Echo exam of breast(s) ........................ 0.54 0.19 0.21 0.19 0.21 0.03 0.76 0.78 0.76 0.78 XXX

76645 TC A Echo exam of breast(s) ........................ 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

76700 ............ A Echo exam of abdomen ....................... 0.81 2.25 2.30 2.25 2.30 0.13 3.19 3.24 3.19 3.24 XXX

76700 26 A Echo exam of abdomen ....................... 0.81 0.29 0.32 0.29 0.32 0.04 1.14 1.17 1.14 1.17 XXX

76700 TC A Echo exam of abdomen ....................... 0.00 1.96 1.98 NA NA 0.09 2.05 2.07 NA NA XXX

76705 ............ A Echo exam of abdomen ....................... 0.59 1.62 1.66 1.62 1.66 0.10 2.31 2.35 2.31 2.35 XXX

76705 26 A Echo exam of abdomen ....................... 0.59 0.21 0.23 0.21 0.23 0.03 0.83 0.85 0.83 0.85 XXX

76705 TC A Echo exam of abdomen ....................... 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76770 ............ A Echo exam abdomen back wall ........... 0.74 2.22 2.27 2.22 2.27 0.12 3.08 3.13 3.08 3.13 XXX

76770 26 A Echo exam abdomen back wall ........... 0.74 0.26 0.29 0.26 0.29 0.03 1.03 1.06 1.03 1.06 XXX

76770 TC A Echo exam abdomen back wall ........... 0.00 1.96 1.98 NA NA 0.09 2.05 2.07 NA NA XXX

76775 ............ A Echo exam abdomen back wall ........... 0.58 1.62 1.66 1.62 1.66 0.10 2.30 2.34 2.30 2.34 XXX

76775 26 A Echo exam abdomen back wall ........... 0.58 0.21 0.23 0.21 0.23 0.03 0.82 0.84 0.82 0.84 XXX

76775 TC A Echo exam abdomen back wall ........... 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76778 ............ A Echo exam kidney transplant ............... 0.74 2.22 2.27 2.22 2.27 0.12 3.08 3.13 3.08 3.13 XXX

76778 26 A Echo exam kidney transplant ............... 0.74 0.26 0.29 0.26 0.29 0.03 1.03 1.06 1.03 1.06 XXX

76778 TC A Echo exam kidney transplant ............... 0.00 1.96 1.98 NA NA 0.09 2.05 2.07 NA NA XXX

76800 ............ A Echo exam spinal canal ....................... 1.13 1.74 1.81 1.74 1.81 0.11 2.98 3.05 2.98 3.05 XXX

76800 26 A Echo exam spinal canal ....................... 1.13 0.33 0.38 0.33 0.38 0.04 1.50 1.55 1.50 1.55 XXX

76800 TC A Echo exam spinal canal ....................... 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76805 ............ A Echo exam of pregnant uterus ............. 0.99 2.44 2.49 2.44 2.49 0.14 3.57 3.62 3.57 3.62 XXX

76805 26 A Echo exam of pregnant uterus ............. 0.99 0.36 0.39 0.36 0.39 0.04 1.39 1.42 1.39 1.42 XXX

76805 TC A Echo exam of pregnant uterus ............. 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

76810 ............ A Echo exam of pregnant uterus ............. 1.97 4.90 5.00 4.90 5.00 0.25 7.12 7.22 7.12 7.22 XXX

76810 26 A Echo exam of pregnant uterus ............. 1.97 0.73 0.79 0.73 0.79 0.07 2.77 2.83 2.77 2.83 XXX

76810 TC A Echo exam of pregnant uterus ............. 0.00 4.17 4.21 NA NA 0.18 4.35 4.39 NA NA XXX

76815 ............ A Echo exam of pregnant uterus ............. 0.65 1.65 1.69 1.65 1.69 0.09 2.39 2.43 2.39 2.43 XXX

76815 26 A Echo exam of pregnant uterus ............. 0.65 0.24 0.26 0.24 0.26 0.02 0.91 0.93 0.91 0.93 XXX

65517

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

76815 TC A Echo exam of pregnant uterus ............. 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76816 ............ A Echo exam follow-up/repeat ................. 0.57 1.32 1.35 1.32 1.35 0.07 1.96 1.99 1.96 1.99 XXX

76816 26 A Echo exam follow-up/repeat ................. 0.57 0.22 0.24 0.22 0.24 0.02 0.81 0.83 0.81 0.83 XXX

76816 TC A Echo exam follow-up/repeat ................. 0.00 1.10 1.11 NA NA 0.05 1.15 1.16 NA NA XXX

76818 ............ A Fetl biophys profil w/stress ................... 0.86 1.93 1.96 1.93 1.96 0.12 2.91 2.94 2.91 2.94 XXX

76818 26 A Fetl biophys profil w/stress ................... 0.86 0.33 0.34 0.33 0.34 0.04 1.23 1.24 1.23 1.24 XXX

76818 TC A Fetl biophys profil w/stress ................... 0.00 1.60 1.62 NA NA 0.08 1.68 1.70 NA NA XXX

76819 ............ A Fetl biophys profil w/o strs ................... 0.63 1.84 1.84 1.84 1.84 0.11 2.58 2.58 2.58 2.58 XXX

76819 26 A Fetl biophys profil w/o strs ................... 0.63 0.24 0.24 0.24 0.24 0.03 0.90 0.90 0.90 0.90 XXX

76819 TC A Fetl biophys profil w/o strs ................... 0.00 1.60 1.60 NA NA 0.08 1.68 1.68 NA NA XXX

76825 ............ A Echo exam of fetal heart ...................... 1.67 2.57 2.53 2.57 2.53 0.15 4.39 4.35 4.39 4.35 XXX

76825 26 A Echo exam of fetal heart ...................... 1.67 0.61 0.55 0.61 0.55 0.06 2.34 2.28 2.34 2.28 XXX

76825 TC A Echo exam of fetal heart ...................... 0.00 1.96 1.98 NA NA 0.09 2.05 2.07 NA NA XXX

76826 ............ A Echo exam of fetal heart ...................... 0.83 1.00 1.12 1.00 1.12 0.07 1.90 2.02 1.90 2.02 XXX

76826 26 A Echo exam of fetal heart ...................... 0.83 0.30 0.41 0.30 0.41 0.03 1.16 1.27 1.16 1.27 XXX

76826 TC A Echo exam of fetal heart ...................... 0.00 0.70 0.71 NA NA 0.04 0.74 0.75 NA NA XXX

76827 ............ A Echo exam of fetal heart ...................... 0.58 1.93 2.07 1.93 2.07 0.12 2.63 2.77 2.63 2.77 XXX

76827 26 A Echo exam of fetal heart ...................... 0.58 0.22 0.34 0.22 0.34 0.02 0.82 0.94 0.82 0.94 XXX

76827 TC A Echo exam of fetal heart ...................... 0.00 1.71 1.73 NA NA 0.10 1.81 1.83 NA NA XXX

76828 ............ A Echo exam of fetal heart ...................... 0.56 1.32 1.35 1.32 1.35 0.09 1.97 2.00 1.97 2.00 XXX

76828 26 A Echo exam of fetal heart ...................... 0.56 0.22 0.24 0.22 0.24 0.02 0.80 0.82 0.80 0.82 XXX

76828 TC A Echo exam of fetal heart ...................... 0.00 1.10 1.11 NA NA 0.07 1.17 1.18 NA NA XXX

76830 ............ A Echo exam, transvaginal ...................... 0.69 1.76 1.81 1.76 1.81 0.11 2.56 2.61 2.56 2.61 XXX

76830 26 A Echo exam, transvaginal ...................... 0.69 0.25 0.28 0.25 0.28 0.03 0.97 1.00 0.97 1.00 XXX

76830 TC A Echo exam, transvaginal ...................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76831 ............ A Echo exam, uterus ............................... 0.72 1.78 1.82 1.78 1.82 0.10 2.60 2.64 2.60 2.64 XXX

76831 26 A Echo exam, uterus ............................... 0.72 0.27 0.29 0.27 0.29 0.02 1.01 1.03 1.01 1.03 XXX

76831 TC A Echo exam, uterus ............................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76856 ............ A Echo exam of pelvis ............................. 0.69 1.76 1.81 1.76 1.81 0.11 2.56 2.61 2.56 2.61 XXX

76856 26 A Echo exam of pelvis ............................. 0.69 0.25 0.28 0.25 0.28 0.03 0.97 1.00 0.97 1.00 XXX

76856 TC A Echo exam of pelvis ............................. 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76857 ............ A Echo exam of pelvis ............................. 0.38 1.18 1.20 1.18 1.20 0.07 1.63 1.65 1.63 1.65 XXX

76857 26 A Echo exam of pelvis ............................. 0.38 0.13 0.14 0.13 0.14 0.02 0.53 0.54 0.53 0.54 XXX

76857 TC A Echo exam of pelvis ............................. 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

76870 ............ A Echo exam of scrotum ......................... 0.64 1.74 1.78 1.74 1.78 0.11 2.49 2.53 2.49 2.53 XXX

76870 26 A Echo exam of scrotum ......................... 0.64 0.23 0.25 0.23 0.25 0.03 0.90 0.92 0.90 0.92 XXX

76870 TC A Echo exam of scrotum ......................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76872 ............ A Echo exam, transrectal ........................ 0.69 1.75 1.80 1.75 1.80 0.12 2.56 2.61 2.56 2.61 XXX

76872 26 A Echo exam, transrectal ........................ 0.69 0.24 0.27 0.24 0.27 0.04 0.97 1.00 0.97 1.00 XXX

76872 TC A Echo exam, transrectal ........................ 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76873 ............ A Echograp trans r, pros study ................ 1.55 2.61 2.61 2.61 2.61 0.21 4.37 4.37 4.37 4.37 XXX

76873 26 A Echograp trans r, pros study ................ 1.55 0.53 0.53 0.53 0.53 0.08 2.16 2.16 2.16 2.16 XXX

76873 TC A Echograp trans r, pros study ................ 0.00 2.08 2.08 NA NA 0.13 2.21 2.21 NA NA XXX

76880 ............ A Echo exam of extremity ....................... 0.59 1.62 1.66 1.62 1.66 0.10 2.31 2.35 2.31 2.35 XXX

76880 26 A Echo exam of extremity ....................... 0.59 0.21 0.23 0.21 0.23 0.03 0.83 0.85 0.83 0.85 XXX

76880 TC A Echo exam of extremity ....................... 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76885 ............ A Echo exam, infant hips ......................... 0.74 1.77 1.81 1.77 1.81 0.11 2.62 2.66 2.62 2.66 XXX

76885 26 A Echo exam, infant hips ......................... 0.74 0.26 0.28 0.26 0.28 0.03 1.03 1.05 1.03 1.05 XXX

76885 TC A Echo exam, infant hips ......................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76886 ............ A Echo exam, infant hips ......................... 0.62 1.63 1.67 1.63 1.67 0.10 2.35 2.39 2.35 2.39 XXX

76886 26 A Echo exam, infant hips ......................... 0.62 0.22 0.24 0.22 0.24 0.03 0.87 0.89 0.87 0.89 XXX

76886 TC A Echo exam, infant hips ......................... 0.00 1.41 1.43 NA NA 0.07 1.48 1.50 NA NA XXX

76930 ............ A Echo guide, cardiocentesis .................. 0.67 1.79 1.83 1.79 1.83 0.10 2.56 2.60 2.56 2.60 XXX

76930 26 A Echo guide, cardiocentesis .................. 0.67 0.28 0.30 0.28 0.30 0.02 0.97 0.99 0.97 0.99 XXX

76930 TC A Echo guide, cardiocentesis .................. 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76932 ............ A Echo guide for heart biopsy ................. 0.67 1.79 1.83 1.79 1.83 0.10 2.56 2.60 2.56 2.60 XXX

76932 26 A Echo guide for heart biopsy ................. 0.67 0.28 0.30 0.28 0.30 0.02 0.97 0.99 0.97 0.99 XXX

76932 TC A Echo guide for heart biopsy ................. 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76934 ............ A Echo guide for chest tap ...................... 0.67 1.75 1.80 1.75 1.80 0.11 2.53 2.58 2.53 2.58 XXX

76934 26 A Echo guide for chest tap ...................... 0.67 0.24 0.27 0.24 0.27 0.03 0.94 0.97 0.94 0.97 XXX

76934 TC A Echo guide for chest tap ...................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76936 ............ A Echo guide for artery repair ................. 1.99 6.96 7.19 6.96 7.19 0.39 9.34 9.57 9.34 9.57 XXX

76936 26 A Echo guide for artery repair ................. 1.99 0.72 0.88 0.72 0.88 0.11 2.82 2.98 2.82 2.98 XXX

76936 TC A Echo guide for artery repair ................. 0.00 6.24 6.31 NA NA 0.28 6.52 6.59 NA NA XXX

76938 ............ A Echo exam for drainage ....................... 0.67 1.75 1.80 1.75 1.80 0.12 2.54 2.59 2.54 2.59 XXX

76938 26 A Echo exam for drainage ....................... 0.67 0.24 0.27 0.24 0.27 0.04 0.95 0.98 0.95 0.98 XXX

76938 TC A Echo exam for drainage ....................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76941 ............ A Echo guide for transfusion ................... 1.34 2.02 2.08 2.02 2.08 0.13 3.49 3.55 3.49 3.55 XXX

76941 26 A Echo guide for transfusion ................... 1.34 0.50 0.54 0.50 0.54 0.06 1.90 1.94 1.90 1.94 XXX

76941 TC A Echo guide for transfusion ................... 0.00 1.52 1.54 NA NA 0.07 1.59 1.61 NA NA XXX

76942 ............ A Echo guide for biopsy .......................... 0.67 1.74 1.79 1.74 1.79 0.12 2.53 2.58 2.53 2.58 XXX

76942 26 A Echo guide for biopsy .......................... 0.67 0.23 0.26 0.23 0.26 0.04 0.94 0.97 0.94 0.97 XXX

76942 TC A Echo guide for biopsy .......................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76945 ............ A Echo guide, villus sampling .................. 0.67 1.76 1.89 1.76 1.89 0.10 2.53 2.66 2.53 2.66 XXX

76945 26 A Echo guide, villus sampling .................. 0.67 0.24 0.35 0.24 0.35 0.03 0.94 1.05 0.94 1.05 XXX

76945 TC A Echo guide, villus sampling .................. 0.00 1.52 1.54 NA NA 0.07 1.59 1.61 NA NA XXX

76946 ............ A Echo guide for amniocentesis .............. 0.38 1.65 1.68 1.65 1.68 0.09 2.12 2.15 2.12 2.15 XXX

76946 26 A Echo guide for amniocentesis .............. 0.38 0.14 0.15 0.14 0.15 0.01 0.53 0.54 0.53 0.54 XXX

76946 TC A Echo guide for amniocentesis .............. 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76948 ............ A Echo guide, ova aspiration ................... 0.38 1.65 1.68 1.65 1.68 0.10 2.13 2.16 2.13 2.16 XXX

76948 26 A Echo guide, ova aspiration ................... 0.38 0.14 0.15 0.14 0.15 0.02 0.54 0.55 0.54 0.55 XXX

76948 TC A Echo guide, ova aspiration ................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76950 ............ A Echo guidance radiotherapy ................ 0.58 1.50 1.53 1.50 1.53 0.09 2.17 2.20 2.17 2.20 XXX

65518

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

76950 26 A Echo guidance radiotherapy ................ 0.58 0.20 0.22 0.20 0.22 0.03 0.81 0.83 0.81 0.83 XXX

76950 TC A Echo guidance radiotherapy ................ 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76960 ............ A Echo guidance radiotherapy ................ 0.58 1.50 1.53 1.50 1.53 0.09 2.17 2.20 2.17 2.20 XXX

76960 26 A Echo guidance radiotherapy ................ 0.58 0.20 0.22 0.20 0.22 0.03 0.81 0.83 0.81 0.83 XXX

76960 TC A Echo guidance radiotherapy ................ 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

76965 ............ A Echo guidance radiotherapy ................ 1.34 5.97 6.32 5.97 6.32 0.31 7.62 7.97 7.62 7.97 XXX

76965 26 A Echo guidance radiotherapy ................ 1.34 0.45 0.74 0.45 0.74 0.07 1.86 2.15 1.86 2.15 XXX

76965 TC A Echo guidance radiotherapy ................ 0.00 5.52 5.58 NA NA 0.24 5.76 5.82 NA NA XXX

76970 ............ A Ultrasound exam follow-up ................... 0.40 1.19 1.22 1.19 1.22 0.07 1.66 1.69 1.66 1.69 XXX

76970 26 A Ultrasound exam follow-up ................... 0.40 0.14 0.16 0.14 0.16 0.02 0.56 0.58 0.56 0.58 XXX

76970 TC A Ultrasound exam follow-up ................... 0.00 1.05 1.06 NA NA 0.05 1.10 1.11 NA NA XXX

76975 ............ A GI endoscopic ultrasound .................... 0.81 1.80 1.84 1.80 1.84 0.11 2.72 2.76 2.72 2.76 XXX

76975 26 A GI endoscopic ultrasound .................... 0.81 0.29 0.31 0.29 0.31 0.03 1.13 1.15 1.13 1.15 XXX

76975 TC A GI endoscopic ultrasound .................... 0.00 1.51 1.53 NA NA 0.08 1.59 1.61 NA NA XXX

76977 ............ A Us bone density measure .................... 0.05 1.43 1.43 1.43 1.43 0.05 1.53 1.53 1.53 1.53 XXX

76977 26 A Us bone density measure .................... 0.05 0.02 0.02 0.02 0.02 0.01 0.08 0.08 0.08 0.08 XXX

76977 TC A Us bone density measure .................... 0.00 1.41 1.41 NA NA 0.04 1.45 1.45 NA NA XXX

76986 ............ A Ultrasound guide intraoper ................... 1.20 3.03 3.10 3.03 3.10 0.19 4.42 4.49 4.42 4.49 XXX

76986 26 A Ultrasound guide intraoper ................... 1.20 0.43 0.47 0.43 0.47 0.07 1.70 1.74 1.70 1.74 XXX

76986 TC A Ultrasound guide intraoper ................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

76999 ............ C Echo examination procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76999 26 C Echo examination procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

76999 TC C Echo examination procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77261 ............ A Radiation therapy planning .................. 1.39 0.55 0.58 0.55 0.58 0.06 2.00 2.03 2.00 2.03 XXX

77262 ............ A Radiation therapy planning .................. 2.11 0.82 0.87 0.82 0.87 0.09 3.02 3.07 3.02 3.07 XXX

77263 ............ A Radiation therapy planning .................. 3.14 1.21 1.29 1.21 1.29 0.13 4.48 4.56 4.48 4.56 XXX

77280 ............ A Set radiation therapy field .................... 0.70 3.70 3.77 3.70 3.77 0.18 4.58 4.65 4.58 4.65 XXX

77280 26 A Set radiation therapy field .................... 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

77280 TC A Set radiation therapy field .................... 0.00 3.45 3.49 NA NA 0.15 3.60 3.64 NA NA XXX

77285 ............ A Set radiation therapy field .................... 1.05 5.89 5.98 5.89 5.98 0.29 7.23 7.32 7.23 7.32 XXX

77285 26 A Set radiation therapy field .................... 1.05 0.37 0.40 0.37 0.40 0.04 1.46 1.49 1.46 1.49 XXX

77285 TC A Set radiation therapy field .................... 0.00 5.52 5.58 NA NA 0.25 5.77 5.83 NA NA XXX

77290 ............ A Set radiation therapy field .................... 1.56 7.01 7.13 7.01 7.13 0.35 8.92 9.04 8.92 9.04 XXX

77290 26 A Set radiation therapy field .................... 1.56 0.55 0.60 0.55 0.60 0.06 2.17 2.22 2.17 2.22 XXX

77290 TC A Set radiation therapy field .................... 0.00 6.46 6.53 NA NA 0.29 6.75 6.82 NA NA XXX

77295 ............ A Set radiation therapy field .................... 4.57 29.34 29.79 29.34 29.79 1.41 35.32 35.77 35.32 35.77 XXX

77295 26 A Set radiation therapy field .................... 4.57 1.61 1.77 1.61 1.77 0.18 6.36 6.52 6.36 6.52 XXX

77295 TC A Set radiation therapy field .................... 0.00 27.73 28.02 NA NA 1.23 28.96 29.25 NA NA XXX

77299 ............ C Radiation therapy planning .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77299 26 C Radiation therapy planning .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77299 TC C Radiation therapy planning .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77300 ............ A Radiation therapy dose plan ................ 0.62 1.56 1.59 1.56 1.59 0.09 2.27 2.30 2.27 2.30 XXX

77300 26 A Radiation therapy dose plan ................ 0.62 0.22 0.24 0.22 0.24 0.03 0.87 0.89 0.87 0.89 XXX

77300 TC A Radiation therapy dose plan ................ 0.00 1.34 1.35 NA NA 0.06 1.40 1.41 NA NA XXX

77305 ............ A Radiation therapy dose plan ................ 0.70 2.09 2.14 2.09 2.14 0.12 2.91 2.96 2.91 2.96 XXX

77305 26 A Radiation therapy dose plan ................ 0.70 0.25 0.28 0.25 0.28 0.03 0.98 1.01 0.98 1.01 XXX

77305 TC A Radiation therapy dose plan ................ 0.00 1.84 1.86 NA NA 0.09 1.93 1.95 NA NA XXX

77310 ............ A Radiation therapy dose plan ................ 1.05 2.69 2.74 2.69 2.74 0.15 3.89 3.94 3.89 3.94 XXX

77310 26 A Radiation therapy dose plan ................ 1.05 0.37 0.40 0.37 0.40 0.04 1.46 1.49 1.46 1.49 XXX

77310 TC A Radiation therapy dose plan ................ 0.00 2.32 2.34 NA NA 0.11 2.43 2.45 NA NA XXX

77315 ............ A Radiation therapy dose plan ................ 1.56 3.19 3.27 3.19 3.27 0.18 4.93 5.01 4.93 5.01 XXX

77315 26 A Radiation therapy dose plan ................ 1.56 0.55 0.60 0.55 0.60 0.06 2.17 2.22 2.17 2.22 XXX

77315 TC A Radiation therapy dose plan ................ 0.00 2.64 2.67 NA NA 0.12 2.76 2.79 NA NA XXX

77321 ............ A Radiation therapy port plan .................. 0.95 4.35 4.43 4.35 4.43 0.21 5.51 5.59 5.51 5.59 XXX

77321 26 A Radiation therapy port plan .................. 0.95 0.33 0.37 0.33 0.37 0.04 1.32 1.36 1.32 1.36 XXX

77321 TC A Radiation therapy port plan .................. 0.00 4.02 4.06 NA NA 0.17 4.19 4.23 NA NA XXX

77326 ............ A Radiation therapy dose plan ................ 0.93 2.67 2.73 2.67 2.73 0.15 3.75 3.81 3.75 3.81 XXX

77326 26 A Radiation therapy dose plan ................ 0.93 0.33 0.36 0.33 0.36 0.04 1.30 1.33 1.30 1.33 XXX

77326 TC A Radiation therapy dose plan ................ 0.00 2.34 2.37 NA NA 0.11 2.45 2.48 NA NA XXX

77327 ............ A Radiation therapy dose plan ................ 1.39 3.94 4.03 3.94 4.03 0.21 5.54 5.63 5.54 5.63 XXX

77327 26 A Radiation therapy dose plan ................ 1.39 0.49 0.54 0.49 0.54 0.06 1.94 1.99 1.94 1.99 XXX

77327 TC A Radiation therapy dose plan ................ 0.00 3.45 3.49 NA NA 0.15 3.60 3.64 NA NA XXX

77328 ............ A Radiation therapy dose plan ................ 2.09 5.67 5.79 5.67 5.79 0.30 8.06 8.18 8.06 8.18 XXX

77328 26 A Radiation therapy dose plan ................ 2.09 0.74 0.81 0.74 0.81 0.09 2.92 2.99 2.92 2.99 XXX

77328 TC A Radiation therapy dose plan ................ 0.00 4.93 4.98 NA NA 0.21 5.14 5.19 NA NA XXX

77331 ............ A Special radiation dosimetry .................. 0.87 0.81 0.85 0.81 0.85 0.06 1.74 1.78 1.74 1.78 XXX

77331 26 A Special radiation dosimetry .................. 0.87 0.31 0.34 0.31 0.34 0.04 1.22 1.25 1.22 1.25 XXX

77331 TC A Special radiation dosimetry .................. 0.00 0.50 0.51 NA NA 0.02 0.52 0.53 NA NA XXX

77332 ............ A Radiation treatment aid(s) .................... 0.54 1.53 1.56 1.53 1.56 0.08 2.15 2.18 2.15 2.18 XXX

77332 26 A Radiation treatment aid(s) .................... 0.54 0.19 0.21 0.19 0.21 0.02 0.75 0.77 0.75 0.77 XXX

77332 TC A Radiation treatment aid(s) .................... 0.00 1.34 1.35 NA NA 0.06 1.40 1.41 NA NA XXX

77333 ............ A Radiation treatment aid(s) .................... 0.84 2.18 2.23 2.18 2.23 0.13 3.15 3.20 3.15 3.20 XXX

77333 26 A Radiation treatment aid(s) .................... 0.84 0.30 0.33 0.30 0.33 0.04 1.18 1.21 1.18 1.21 XXX

77333 TC A Radiation treatment aid(s) .................... 0.00 1.88 1.90 NA NA 0.09 1.97 1.99 NA NA XXX

77334 ............ A Radiation treatment aid(s) .................... 1.24 3.67 3.74 3.67 3.74 0.19 5.10 5.17 5.10 5.17 XXX

77334 26 A Radiation treatment aid(s) .................... 1.24 0.44 0.48 0.44 0.48 0.05 1.73 1.77 1.73 1.77 XXX

77334 TC A Radiation treatment aid(s) .................... 0.00 3.23 3.26 NA NA 0.14 3.37 3.40 NA NA XXX

77336 ............ A Radiation physics consult ..................... 0.00 2.96 2.99 NA NA 0.13 3.09 3.12 NA NA XXX

77370 ............ A Radiation physics consult ..................... 0.00 3.47 3.51 NA NA 0.15 3.62 3.66 NA NA XXX

77399 ............ C External radiation dosimetry ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77399 26 C External radiation dosimetry ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77399 TC C External radiation dosimetry ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77401 ............ A Radiation treatment delivery ................ 0.00 1.76 1.78 NA NA 0.09 1.85 1.87 NA NA XXX

65519

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

77402 ............ A Radiation treatment delivery ................ 0.00 1.76 1.78 NA NA 0.09 1.85 1.87 NA NA XXX

77403 ............ A Radiation treatment delivery ................ 0.00 1.76 1.78 NA NA 0.09 1.85 1.87 NA NA XXX

77404 ............ A Radiation treatment delivery ................ 0.00 1.76 1.78 NA NA 0.09 1.85 1.87 NA NA XXX

77406 ............ A Radiation treatment delivery ................ 0.00 1.76 1.78 NA NA 0.09 1.85 1.87 NA NA XXX

77407 ............ A Radiation treatment delivery ................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

77408 ............ A Radiation treatment delivery ................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

77409 ............ A Radiation treatment delivery ................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

77411 ............ A Radiation treatment delivery ................ 0.00 2.08 2.10 NA NA 0.10 2.18 2.20 NA NA XXX

77412 ............ A Radiation treatment delivery ................ 0.00 2.32 2.34 NA NA 0.11 2.43 2.45 NA NA XXX

77413 ............ A Radiation treatment delivery ................ 0.00 2.32 2.34 NA NA 0.11 2.43 2.45 NA NA XXX

77414 ............ A Radiation treatment delivery ................ 0.00 2.32 2.34 NA NA 0.11 2.43 2.45 NA NA XXX

77416 ............ A Radiation treatment delivery ................ 0.00 2.32 2.34 NA NA 0.11 2.43 2.45 NA NA XXX

77417 ............ A Radiology port film(s) ........................... 0.00 0.59 0.60 NA NA 0.03 0.62 0.63 NA NA XXX

77427 ............ A Radiation tx management, x5 .............. 3.31 1.17 1.17 1.17 1.17 0.14 4.62 4.62 4.62 4.62 XXX

77431 ............ A Radiation therapy management ........... 1.81 0.73 0.77 0.73 0.77 0.07 2.61 2.65 2.61 2.65 XXX

77432 ............ A Stereotactic radiation trmt .................... 7.93 3.21 3.75 3.21 3.75 0.33 11.47 12.01 11.47 12.01 XXX

77470 ............ A Special radiation treatment .................. 2.09 11.80 11.99 11.80 11.99 0.58 14.47 14.66 14.47 14.66 XXX

77470 26 A Special radiation treatment .................. 2.09 0.73 0.80 0.73 0.80 0.09 2.91 2.98 2.91 2.98 XXX

77470 TC A Special radiation treatment .................. 0.00 11.07 11.19 NA NA 0.49 11.56 11.68 NA NA XXX

77499 ............ C Radiation therapy management ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77499 26 C Radiation therapy management ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77499 TC C Radiation therapy management ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77520 ............ C Proton trmt, simple w/o comp .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77522 ............ C Proton trmt, simple w/comp ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77523 ............ C Proton trmt, intermediate ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77525 ............ C Proton treatment, complex ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77600 ............ R Hyperthermia treatment ........................ 1.56 3.58 3.66 3.58 3.66 0.21 5.35 5.43 5.35 5.43 XXX

77600 26 R Hyperthermia treatment ........................ 1.56 0.55 0.60 0.55 0.60 0.08 2.19 2.24 2.19 2.24 XXX

77600 TC R Hyperthermia treatment ........................ 0.00 3.03 3.06 NA NA 0.13 3.16 3.19 NA NA XXX

77605 ............ R Hyperthermia treatment ........................ 2.09 4.77 4.88 4.77 4.88 0.31 7.17 7.28 7.17 7.28 XXX

77605 26 R Hyperthermia treatment ........................ 2.09 0.73 0.80 0.73 0.80 0.13 2.95 3.02 2.95 3.02 XXX

77605 TC R Hyperthermia treatment ........................ 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

77610 ............ R Hyperthermia treatment ........................ 1.56 3.58 3.66 3.58 3.66 0.20 5.34 5.42 5.34 5.42 XXX

77610 26 R Hyperthermia treatment ........................ 1.56 0.55 0.60 0.55 0.60 0.07 2.18 2.23 2.18 2.23 XXX

77610 TC R Hyperthermia treatment ........................ 0.00 3.03 3.06 NA NA 0.13 3.16 3.19 NA NA XXX

77615 ............ R Hyperthermia treatment ........................ 2.09 4.77 4.88 4.77 4.88 0.27 7.13 7.24 7.13 7.24 XXX

77615 26 R Hyperthermia treatment ........................ 2.09 0.73 0.80 0.73 0.80 0.09 2.91 2.98 2.91 2.98 XXX

77615 TC R Hyperthermia treatment ........................ 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

77620 ............ R Hyperthermia treatment ........................ 1.56 3.60 3.68 3.60 3.68 0.19 5.35 5.43 5.35 5.43 XXX

77620 26 R Hyperthermia treatment ........................ 1.56 0.57 0.62 0.57 0.62 0.06 2.19 2.24 2.19 2.24 XXX

77620 TC R Hyperthermia treatment ........................ 0.00 3.03 3.06 NA NA 0.13 3.16 3.19 NA NA XXX

77750 ............ A Infuse radioactive materials ................. 4.91 3.06 3.19 3.06 3.19 0.23 8.20 8.33 8.20 8.33 090

77750 26 A Infuse radioactive materials ................. 4.91 1.73 1.85 1.73 1.85 0.17 6.81 6.93 6.81 6.93 090

77750 TC A Infuse radioactive materials ................. 0.00 1.33 1.34 NA NA 0.06 1.39 1.40 NA NA 090

77761 ............ A Apply intrcav radiat simple ................... 3.81 3.74 3.89 3.74 3.89 0.28 7.83 7.98 7.83 7.98 090

77761 26 A Apply intrcav radiat simple ................... 3.81 1.25 1.37 1.25 1.37 0.16 5.22 5.34 5.22 5.34 090

77761 TC A Apply intrcav radiat simple ................... 0.00 2.49 2.52 NA NA 0.12 2.61 2.64 NA NA 090

77762 ............ A Apply intrcav radiat interm ................... 5.72 5.62 5.80 5.62 5.80 0.38 11.72 11.90 11.72 11.90 090

77762 26 A Apply intrcav radiat interm ................... 5.72 2.04 2.18 2.04 2.18 0.22 7.98 8.12 7.98 8.12 090

77762 TC A Apply intrcav radiat interm ................... 0.00 3.58 3.62 NA NA 0.16 3.74 3.78 NA NA 090

77763 ............ A Apply intrcav radiat compl .................... 8.57 7.49 7.76 7.49 7.76 0.53 16.59 16.86 16.59 16.86 090

77763 26 A Apply intrcav radiat compl .................... 8.57 3.03 3.25 3.03 3.25 0.34 11.94 12.16 11.94 12.16 090

77763 TC A Apply intrcav radiat compl .................... 0.00 4.46 4.51 NA NA 0.19 4.65 4.70 NA NA 090

77776 ............ A Apply interstit radiat simpl .................... 4.66 3.30 3.60 3.30 3.60 0.35 8.31 8.61 8.31 8.61 XXX

77776 26 A Apply interstit radiat simpl .................... 4.66 1.14 1.42 1.14 1.42 0.24 6.04 6.32 6.04 6.32 XXX

77776 TC A Apply interstit radiat simpl .................... 0.00 2.16 2.18 NA NA 0.11 2.27 2.29 NA NA XXX

77777 ............ A Apply interstit radiat inter ..................... 7.48 6.86 7.09 6.86 7.09 0.50 14.84 15.07 14.84 15.07 090

77777 26 A Apply interstit radiat inter ..................... 7.48 2.65 2.84 2.65 2.84 0.32 10.45 10.64 10.45 10.64 090

77777 TC A Apply interstit radiat inter ..................... 0.00 4.21 4.25 NA NA 0.18 4.39 4.43 NA NA 090

77778 ............ A Apply iterstit radiat compl ..................... 11.19 9.01 9.36 9.01 9.36 0.69 20.89 21.24 20.89 21.24 090

77778 26 A Apply iterstit radiat compl ..................... 11.19 3.91 4.21 3.91 4.21 0.47 15.57 15.87 15.57 15.87 090

77778 TC A Apply iterstit radiat compl ..................... 0.00 5.10 5.15 NA NA 0.22 5.32 5.37 NA NA 090

77781 ............ A High intensity brachytherapy ................ 1.66 20.75 21.00 20.75 21.00 0.95 23.36 23.61 23.36 23.61 090

77781 26 A High intensity brachytherapy ................ 1.66 0.59 0.63 0.59 0.63 0.07 2.32 2.36 2.32 2.36 090

77781 TC A High intensity brachytherapy ................ 0.00 20.16 20.37 NA NA 0.88 21.04 21.25 NA NA 090

77782 ............ A High intensity brachytherapy ................ 2.49 21.04 21.32 21.04 21.32 0.98 24.51 24.79 24.51 24.79 090

77782 26 A High intensity brachytherapy ................ 2.49 0.88 0.95 0.88 0.95 0.10 3.47 3.54 3.47 3.54 090

77782 TC A High intensity brachytherapy ................ 0.00 20.16 20.37 NA NA 0.88 21.04 21.25 NA NA 090

77783 ............ A High intensity brachytherapy ................ 3.73 21.47 21.77 21.47 21.77 1.03 26.23 26.53 26.23 26.53 090

77783 26 A High intensity brachytherapy ................ 3.73 1.31 1.40 1.31 1.40 0.15 5.19 5.28 5.19 5.28 090

77783 TC A High intensity brachytherapy ................ 0.00 20.16 20.37 NA NA 0.88 21.04 21.25 NA NA 090

77784 ............ A High intensity brachytherapy ................ 5.61 22.13 22.48 22.13 22.48 1.10 28.84 29.19 28.84 29.19 090

77784 26 A High intensity brachytherapy ................ 5.61 1.97 2.11 1.97 2.11 0.22 7.80 7.94 7.80 7.94 090

77784 TC A High intensity brachytherapy ................ 0.00 20.16 20.37 NA NA 0.88 21.04 21.25 NA NA 090

77789 ............ A Apply surface radiation ......................... 1.12 0.85 0.89 0.85 0.89 0.05 2.02 2.06 2.02 2.06 090

77789 26 A Apply surface radiation ......................... 1.12 0.40 0.43 0.40 0.43 0.03 1.55 1.58 1.55 1.58 090

77789 TC A Apply surface radiation ......................... 0.00 0.45 0.46 NA NA 0.02 0.47 0.48 NA NA 090

77790 ............ A Radiation handling ................................ 1.05 0.87 0.91 0.87 0.91 0.06 1.98 2.02 1.98 2.02 XXX

77790 26 A Radiation handling ................................ 1.05 0.37 0.40 0.37 0.40 0.04 1.46 1.49 1.46 1.49 XXX

77790 TC A Radiation handling ................................ 0.00 0.50 0.51 NA NA 0.02 0.52 0.53 NA NA XXX

77799 ............ C Radium/radioisotope therapy ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77799 26 C Radium/radioisotope therapy ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77799 TC C Radium/radioisotope therapy ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65520

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

78000 ............ A Thyroid, single uptake .......................... 0.19 1.03 1.05 1.03 1.05 0.06 1.28 1.30 1.28 1.30 XXX

78000 26 A Thyroid, single uptake .......................... 0.19 0.07 0.08 0.07 0.08 0.01 0.27 0.28 0.27 0.28 XXX

78000 TC A Thyroid, single uptake .......................... 0.00 0.96 0.97 NA NA 0.05 1.01 1.02 NA NA XXX

78001 ............ A Thyroid, multiple uptakes ..................... 0.26 1.40 1.42 1.40 1.42 0.07 1.73 1.75 1.73 1.75 XXX

78001 26 A Thyroid, multiple uptakes ..................... 0.26 0.10 0.11 0.10 0.11 0.01 0.37 0.38 0.37 0.38 XXX

78001 TC A Thyroid, multiple uptakes ..................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

78003 ............ A Thyroid suppress/stimul ....................... 0.33 1.08 1.10 1.08 1.10 0.06 1.47 1.49 1.47 1.49 XXX

78003 26 A Thyroid suppress/stimul ....................... 0.33 0.12 0.13 0.12 0.13 0.01 0.46 0.47 0.46 0.47 XXX

78003 TC A Thyroid suppress/stimul ....................... 0.00 0.96 0.97 NA NA 0.05 1.01 1.02 NA NA XXX

78006 ............ A Thyroid imaging with uptake ................ 0.49 2.54 2.59 2.54 2.59 0.13 3.16 3.21 3.16 3.21 XXX

78006 26 A Thyroid imaging with uptake ................ 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78006 TC A Thyroid imaging with uptake ................ 0.00 2.36 2.39 NA NA 0.11 2.47 2.50 NA NA XXX

78007 ............ A Thyroid image, mult uptakes ................ 0.50 2.74 2.79 2.74 2.79 0.14 3.38 3.43 3.38 3.43 XXX

78007 26 A Thyroid image, mult uptakes ................ 0.50 0.18 0.20 0.18 0.20 0.02 0.70 0.72 0.70 0.72 XXX

78007 TC A Thyroid image, mult uptakes ................ 0.00 2.56 2.59 NA NA 0.12 2.68 2.71 NA NA XXX

78010 ............ A Thyroid imaging .................................... 0.39 1.95 1.98 1.95 1.98 0.11 2.45 2.48 2.45 2.48 XXX

78010 26 A Thyroid imaging .................................... 0.39 0.14 0.15 0.14 0.15 0.02 0.55 0.56 0.55 0.56 XXX

78010 TC A Thyroid imaging .................................... 0.00 1.81 1.83 NA NA 0.09 1.90 1.92 NA NA XXX

78011 ............ A Thyroid imaging with flow ..................... 0.45 2.56 2.61 2.56 2.61 0.13 3.14 3.19 3.14 3.19 XXX

78011 26 A Thyroid imaging with flow ..................... 0.45 0.17 0.19 0.17 0.19 0.02 0.64 0.66 0.64 0.66 XXX

78011 TC A Thyroid imaging with flow ..................... 0.00 2.39 2.42 NA NA 0.11 2.50 2.53 NA NA XXX

78015 ............ A Thyroid met imaging ............................. 0.67 2.80 2.86 2.80 2.86 0.15 3.62 3.68 3.62 3.68 XXX

78015 26 A Thyroid met imaging ............................. 0.67 0.24 0.27 0.24 0.27 0.03 0.94 0.97 0.94 0.97 XXX

78015 TC A Thyroid met imaging ............................. 0.00 2.56 2.59 NA NA 0.12 2.68 2.71 NA NA XXX

78016 ............ A Thyroid met imaging/studies ................ 0.82 3.77 3.84 3.77 3.84 0.18 4.77 4.84 4.77 4.84 XXX

78016 26 A Thyroid met imaging/studies ................ 0.82 0.31 0.34 0.31 0.34 0.03 1.16 1.19 1.16 1.19 XXX

78016 TC A Thyroid met imaging/studies ................ 0.00 3.46 3.50 NA NA 0.15 3.61 3.65 NA NA XXX

78018 ............ A Thyroid met imaging, body ................... 0.86 5.70 5.80 5.70 5.80 0.27 6.83 6.93 6.83 6.93 XXX

78018 26 A Thyroid met imaging, body ................... 0.86 0.32 0.36 0.32 0.36 0.03 1.21 1.25 1.21 1.25 XXX

78018 TC A Thyroid met imaging, body ................... 0.00 5.38 5.44 NA NA 0.24 5.62 5.68 NA NA XXX

78020 ............ A Thyroid met uptake .............................. 0.60 1.53 1.53 1.53 1.53 0.14 2.27 2.27 2.27 2.27 ZZZ

78020 26 A Thyroid met uptake .............................. 0.60 0.23 0.23 0.23 0.23 0.02 0.85 0.85 0.85 0.85 ZZZ

78020 TC A Thyroid met uptake .............................. 0.00 1.30 1.30 NA NA 0.12 1.42 1.42 NA NA ZZZ

78070 ............ A Parathyroid nuclear imaging ................ 0.82 2.11 2.12 2.11 2.12 0.12 3.05 3.06 3.05 3.06 XXX

78070 26 A Parathyroid nuclear imaging ................ 0.82 0.30 0.29 0.30 0.29 0.03 1.15 1.14 1.15 1.14 XXX

78070 TC A Parathyroid nuclear imaging ................ 0.00 1.81 1.83 NA NA 0.09 1.90 1.92 NA NA XXX

78075 ............ A Adrenal nuclear imaging ...................... 0.74 5.66 5.74 5.66 5.74 0.27 6.67 6.75 6.67 6.75 XXX

78075 26 A Adrenal nuclear imaging ...................... 0.74 0.28 0.30 0.28 0.30 0.03 1.05 1.07 1.05 1.07 XXX

78075 TC A Adrenal nuclear imaging ...................... 0.00 5.38 5.44 NA NA 0.24 5.62 5.68 NA NA XXX

78099 ............ C Endocrine nuclear procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78099 26 C Endocrine nuclear procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78099 TC C Endocrine nuclear procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78102 ............ A Bone marrow imaging, ltd .................... 0.55 2.24 2.28 2.24 2.28 0.12 2.91 2.95 2.91 2.95 XXX

78102 26 A Bone marrow imaging, ltd .................... 0.55 0.21 0.23 0.21 0.23 0.02 0.78 0.80 0.78 0.80 XXX

78102 TC A Bone marrow imaging, ltd .................... 0.00 2.03 2.05 NA NA 0.10 2.13 2.15 NA NA XXX

78103 ............ A Bone marrow imaging, mult ................. 0.75 3.43 3.48 3.43 3.48 0.17 4.35 4.40 4.35 4.40 XXX

78103 26 A Bone marrow imaging, mult ................. 0.75 0.28 0.30 0.28 0.30 0.03 1.06 1.08 1.06 1.08 XXX

78103 TC A Bone marrow imaging, mult ................. 0.00 3.15 3.18 NA NA 0.14 3.29 3.32 NA NA XXX

78104 ............ A Bone marrow imaging, body ................ 0.80 4.33 4.40 4.33 4.40 0.21 5.34 5.41 5.34 5.41 XXX

78104 26 A Bone marrow imaging, body ................ 0.80 0.29 0.32 0.29 0.32 0.03 1.12 1.15 1.12 1.15 XXX

78104 TC A Bone marrow imaging, body ................ 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

78110 ............ A Plasma volume, single ......................... 0.19 1.02 1.04 1.02 1.04 0.06 1.27 1.29 1.27 1.29 XXX

78110 26 A Plasma volume, single ......................... 0.19 0.08 0.09 0.08 0.09 0.01 0.28 0.29 0.28 0.29 XXX

78110 TC A Plasma volume, single ......................... 0.00 0.94 0.95 NA NA 0.05 0.99 1.00 NA NA XXX

78111 ............ A Plasma volume, multiple ...................... 0.22 2.64 2.68 2.64 2.68 0.13 2.99 3.03 2.99 3.03 XXX

78111 26 A Plasma volume, multiple ...................... 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

78111 TC A Plasma volume, multiple ...................... 0.00 2.56 2.59 NA NA 0.12 2.68 2.71 NA NA XXX

78120 ............ A Red cell mass, single ........................... 0.23 1.81 1.84 1.81 1.84 0.10 2.14 2.17 2.14 2.17 XXX

78120 26 A Red cell mass, single ........................... 0.23 0.09 0.10 0.09 0.10 0.01 0.33 0.34 0.33 0.34 XXX

78120 TC A Red cell mass, single ........................... 0.00 1.72 1.74 NA NA 0.09 1.81 1.83 NA NA XXX

78121 ............ A Red cell mass, multiple ........................ 0.32 3.01 3.05 3.01 3.05 0.13 3.46 3.50 3.46 3.50 XXX

78121 26 A Red cell mass, multiple ........................ 0.32 0.12 0.13 0.12 0.13 0.01 0.45 0.46 0.45 0.46 XXX

78121 TC A Red cell mass, multiple ........................ 0.00 2.89 2.92 NA NA 0.12 3.01 3.04 NA NA XXX

78122 ............ A Blood volume ........................................ 0.45 4.74 4.80 4.74 4.80 0.22 5.41 5.47 5.41 5.47 XXX

78122 26 A Blood volume ........................................ 0.45 0.17 0.18 0.17 0.18 0.02 0.64 0.65 0.64 0.65 XXX

78122 TC A Blood volume ........................................ 0.00 4.57 4.62 NA NA 0.20 4.77 4.82 NA NA XXX

78130 ............ A Red cell survival study ......................... 0.61 3.06 3.11 3.06 3.11 0.15 3.82 3.87 3.82 3.87 XXX

78130 26 A Red cell survival study ......................... 0.61 0.23 0.25 0.23 0.25 0.03 0.87 0.89 0.87 0.89 XXX

78130 TC A Red cell survival study ......................... 0.00 2.83 2.86 NA NA 0.12 2.95 2.98 NA NA XXX

78135 ............ A Red cell survival kinetics ...................... 0.64 5.07 5.14 5.07 5.14 0.24 5.95 6.02 5.95 6.02 XXX

78135 26 A Red cell survival kinetics ...................... 0.64 0.23 0.25 0.23 0.25 0.03 0.90 0.92 0.90 0.92 XXX

78135 TC A Red cell survival kinetics ...................... 0.00 4.84 4.89 NA NA 0.21 5.05 5.10 NA NA XXX

78140 ............ A Red cell sequestration .......................... 0.61 4.13 4.19 4.13 4.19 0.20 4.94 5.00 4.94 5.00 XXX

78140 26 A Red cell sequestration .......................... 0.61 0.22 0.24 0.22 0.24 0.03 0.86 0.88 0.86 0.88 XXX

78140 TC A Red cell sequestration .......................... 0.00 3.91 3.95 NA NA 0.17 4.08 4.12 NA NA XXX

78160 ............ A Plasma iron turnover ............................ 0.33 3.79 3.83 3.79 3.83 0.19 4.31 4.35 4.31 4.35 XXX

78160 26 A Plasma iron turnover ............................ 0.33 0.15 0.15 0.15 0.15 0.03 0.51 0.51 0.51 0.51 XXX

78160 TC A Plasma iron turnover ............................ 0.00 3.64 3.68 NA NA 0.16 3.80 3.84 NA NA XXX

78162 ............ A Iron absorption exam ........................... 0.45 3.36 3.40 3.36 3.40 0.15 3.96 4.00 3.96 4.00 XXX

78162 26 A Iron absorption exam ........................... 0.45 0.18 0.19 0.18 0.19 0.01 0.64 0.65 0.64 0.65 XXX

78162 TC A Iron absorption exam ........................... 0.00 3.18 3.21 NA NA 0.14 3.32 3.35 NA NA XXX

78170 ............ A Red cell iron utilization ......................... 0.41 5.41 5.48 5.41 5.48 0.27 6.09 6.16 6.09 6.16 XXX

78170 26 A Red cell iron utilization ......................... 0.41 0.15 0.16 0.15 0.16 0.04 0.60 0.61 0.60 0.61 XXX

65521

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

78170 TC A Red cell iron utilization ......................... 0.00 5.26 5.32 NA NA 0.23 5.49 5.55 NA NA XXX

78172 ............ C Total body iron estimation .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78172 26 A Total body iron estimation .................... 0.53 0.19 0.21 0.19 0.21 0.02 0.74 0.76 0.74 0.76 XXX

78172 TC C Total body iron estimation .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78185 ............ A Spleen imaging ..................................... 0.40 2.48 2.53 2.48 2.53 0.13 3.01 3.06 3.01 3.06 XXX

78185 26 A Spleen imaging ..................................... 0.40 0.14 0.16 0.14 0.16 0.02 0.56 0.58 0.56 0.58 XXX

78185 TC A Spleen imaging ..................................... 0.00 2.34 2.37 NA NA 0.11 2.45 2.48 NA NA XXX

78190 ............ A Platelet survival, kinetics ...................... 1.09 6.06 6.15 6.06 6.15 0.31 7.46 7.55 7.46 7.55 XXX

78190 26 A Platelet survival, kinetics ...................... 1.09 0.39 0.42 0.39 0.42 0.06 1.54 1.57 1.54 1.57 XXX

78190 TC A Platelet survival, kinetics ...................... 0.00 5.67 5.73 NA NA 0.25 5.92 5.98 NA NA XXX

78191 ............ A Platelet survival .................................... 0.61 7.50 7.60 7.50 7.60 0.34 8.45 8.55 8.45 8.55 XXX

78191 26 A Platelet survival .................................... 0.61 0.22 0.24 0.22 0.24 0.03 0.86 0.88 0.86 0.88 XXX

78191 TC A Platelet survival .................................... 0.00 7.28 7.36 NA NA 0.31 7.59 7.67 NA NA XXX

78195 ............ A Lymph system imaging ........................ 1.20 4.48 4.50 4.48 4.50 0.23 5.91 5.93 5.91 5.93 XXX

78195 26 A Lymph system imaging ........................ 1.20 0.44 0.42 0.44 0.42 0.05 1.69 1.67 1.69 1.67 XXX

78195 TC A Lymph system imaging ........................ 0.00 4.04 4.08 NA NA 0.18 4.22 4.26 NA NA XXX

78199 ............ C Blood/lymph nuclear exam ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78199 26 C Blood/lymph nuclear exam ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78199 TC C Blood/lymph nuclear exam ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78201 ............ A Liver imaging ........................................ 0.44 2.50 2.54 2.50 2.54 0.13 3.07 3.11 3.07 3.11 XXX

78201 26 A Liver imaging ........................................ 0.44 0.16 0.17 0.16 0.17 0.02 0.62 0.63 0.62 0.63 XXX

78201 TC A Liver imaging ........................................ 0.00 2.34 2.37 NA NA 0.11 2.45 2.48 NA NA XXX

78202 ............ A Liver imaging with flow ......................... 0.51 3.05 3.10 3.05 3.10 0.14 3.70 3.75 3.70 3.75 XXX

78202 26 A Liver imaging with flow ......................... 0.51 0.19 0.21 0.19 0.21 0.02 0.72 0.74 0.72 0.74 XXX

78202 TC A Liver imaging with flow ......................... 0.00 2.86 2.89 NA NA 0.12 2.98 3.01 NA NA XXX

78205 ............ A Liver imaging (3D) ................................ 0.71 6.12 6.21 6.12 6.21 0.29 7.12 7.21 7.12 7.21 XXX

78205 26 A Liver imaging (3D) ................................ 0.71 0.26 0.29 0.26 0.29 0.03 1.00 1.03 1.00 1.03 XXX

78205 TC A Liver imaging (3D) ................................ 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

78206 ............ A Liver image (3d) w/flow ........................ 0.96 6.22 6.22 6.22 6.22 0.13 7.31 7.31 7.31 7.31 XXX

78206 26 A Liver image (3d) w/flow ........................ 0.96 0.36 0.36 0.36 0.36 0.04 1.36 1.36 1.36 1.36 XXX

78206 TC A Liver image (3d) w/flow ........................ 0.00 5.86 5.86 NA NA 0.09 5.95 5.95 NA NA XXX

78215 ............ A Liver and spleen imaging ..................... 0.49 3.10 3.15 3.10 3.15 0.14 3.73 3.78 3.73 3.78 XXX

78215 26 A Liver and spleen imaging ..................... 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78215 TC A Liver and spleen imaging ..................... 0.00 2.92 2.95 NA NA 0.12 3.04 3.07 NA NA XXX

78216 ............ A Liver & spleen image/flow .................... 0.57 3.67 3.73 3.67 3.73 0.17 4.41 4.47 4.41 4.47 XXX

78216 26 A Liver & spleen image/flow .................... 0.57 0.21 0.23 0.21 0.23 0.02 0.80 0.82 0.80 0.82 XXX

78216 TC A Liver & spleen image/flow .................... 0.00 3.46 3.50 NA NA 0.15 3.61 3.65 NA NA XXX

78220 ............ A Liver function study .............................. 0.49 3.88 3.94 3.88 3.94 0.18 4.55 4.61 4.55 4.61 XXX

78220 26 A Liver function study .............................. 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78220 TC A Liver function study .............................. 0.00 3.70 3.74 NA NA 0.16 3.86 3.90 NA NA XXX

78223 ............ A Hepatobiliary imaging ........................... 0.84 3.94 4.01 3.94 4.01 0.20 4.98 5.05 4.98 5.05 XXX

78223 26 A Hepatobiliary imaging ........................... 0.84 0.30 0.33 0.30 0.33 0.04 1.18 1.21 1.18 1.21 XXX

78223 TC A Hepatobiliary imaging ........................... 0.00 3.64 3.68 NA NA 0.16 3.80 3.84 NA NA XXX

78230 ............ A Salivary gland imaging ......................... 0.45 2.32 2.36 2.32 2.36 0.13 2.90 2.94 2.90 2.94 XXX

78230 26 A Salivary gland imaging ......................... 0.45 0.16 0.18 0.16 0.18 0.02 0.63 0.65 0.63 0.65 XXX

78230 TC A Salivary gland imaging ......................... 0.00 2.16 2.18 NA NA 0.11 2.27 2.29 NA NA XXX

78231 ............ A Serial salivary imaging ......................... 0.52 3.35 3.40 3.35 3.40 0.16 4.03 4.08 4.03 4.08 XXX

78231 26 A Serial salivary imaging ......................... 0.52 0.20 0.22 0.20 0.22 0.02 0.74 0.76 0.74 0.76 XXX

78231 TC A Serial salivary imaging ......................... 0.00 3.15 3.18 NA NA 0.14 3.29 3.32 NA NA XXX

78232 ............ A Salivary gland function exam ............... 0.47 3.70 3.76 3.70 3.76 0.16 4.33 4.39 4.33 4.39 XXX

78232 26 A Salivary gland function exam ............... 0.47 0.18 0.20 0.18 0.20 0.01 0.66 0.68 0.66 0.68 XXX

78232 TC A Salivary gland function exam ............... 0.00 3.52 3.56 NA NA 0.15 3.67 3.71 NA NA XXX

78258 ............ A Esophageal motility study .................... 0.74 3.13 3.19 3.13 3.19 0.15 4.02 4.08 4.02 4.08 XXX

78258 26 A Esophageal motility study .................... 0.74 0.27 0.30 0.27 0.30 0.03 1.04 1.07 1.04 1.07 XXX

78258 TC A Esophageal motility study .................... 0.00 2.86 2.89 NA NA 0.12 2.98 3.01 NA NA XXX

78261 ............ A Gastric mucosa imaging ....................... 0.69 4.34 4.40 4.34 4.40 0.21 5.24 5.30 5.24 5.30 XXX

78261 26 A Gastric mucosa imaging ....................... 0.69 0.27 0.29 0.27 0.29 0.03 0.99 1.01 0.99 1.01 XXX

78261 TC A Gastric mucosa imaging ....................... 0.00 4.07 4.11 NA NA 0.18 4.25 4.29 NA NA XXX

78262 ............ A Gastroesophageal reflux exam ............ 0.68 4.49 4.55 4.49 4.55 0.21 5.38 5.44 5.38 5.44 XXX

78262 26 A Gastroesophageal reflux exam ............ 0.68 0.26 0.28 0.26 0.28 0.03 0.97 0.99 0.97 0.99 XXX

78262 TC A Gastroesophageal reflux exam ............ 0.00 4.23 4.27 NA NA 0.18 4.41 4.45 NA NA XXX

78264 ............ A Gastric emptying study ......................... 0.78 4.38 4.45 4.38 4.45 0.21 5.37 5.44 5.37 5.44 XXX

78264 26 A Gastric emptying study ......................... 0.78 0.28 0.31 0.28 0.31 0.03 1.09 1.12 1.09 1.12 XXX

78264 TC A Gastric emptying study ......................... 0.00 4.10 4.14 NA NA 0.18 4.28 4.32 NA NA XXX

78267 ............ X Breath tst attain/anal c-14 .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78268 ............ X Breath test analysis, c-14 ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78270 ............ A Vit B-12 absorption exam ..................... 0.20 1.61 1.64 1.61 1.64 0.09 1.90 1.93 1.90 1.93 XXX

78270 26 A Vit B-12 absorption exam ..................... 0.20 0.07 0.08 0.07 0.08 0.01 0.28 0.29 0.28 0.29 XXX

78270 TC A Vit B-12 absorption exam ..................... 0.00 1.54 1.56 NA NA 0.08 1.62 1.64 NA NA XXX

78271 ............ A Vit B-12 absorp exam, IF ..................... 0.20 1.70 1.73 1.70 1.73 0.09 1.99 2.02 1.99 2.02 XXX

78271 26 A Vit B-12 absorp exam, IF ..................... 0.20 0.07 0.08 0.07 0.08 0.01 0.28 0.29 0.28 0.29 XXX

78271 TC A Vit B-12 absorp exam, IF ..................... 0.00 1.63 1.65 NA NA 0.08 1.71 1.73 NA NA XXX

78272 ............ A Vit B-12 absorp, combined ................... 0.27 2.41 2.44 2.41 2.44 0.12 2.80 2.83 2.80 2.83 XXX

78272 26 A Vit B-12 absorp, combined ................... 0.27 0.10 0.11 0.10 0.11 0.01 0.38 0.39 0.38 0.39 XXX

78272 TC A Vit B-12 absorp, combined ................... 0.00 2.31 2.33 NA NA 0.11 2.42 2.44 NA NA XXX

78278 ............ A Acute GI blood loss imaging ................ 0.99 5.20 5.28 5.20 5.28 0.25 6.44 6.52 6.44 6.52 XXX

78278 26 A Acute GI blood loss imaging ................ 0.99 0.36 0.39 0.36 0.39 0.04 1.39 1.42 1.39 1.42 XXX

78278 TC A Acute GI blood loss imaging ................ 0.00 4.84 4.89 NA NA 0.21 5.05 5.10 NA NA XXX

78282 ............ C GI protein loss exam ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78282 26 A GI protein loss exam ............................ 0.38 0.14 0.15 0.14 0.15 0.02 0.54 0.55 0.54 0.55 XXX

78282 TC C GI protein loss exam ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78290 ............ A Meckel’s divert exam ............................ 0.68 3.27 3.33 3.27 3.33 0.16 4.11 4.17 4.11 4.17 XXX

78290 26 A Meckel’s divert exam ............................ 0.68 0.24 0.27 0.24 0.27 0.03 0.95 0.98 0.95 0.98 XXX

65522

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

78290 TC A Meckel’s divert exam ............................ 0.00 3.03 3.06 NA NA 0.13 3.16 3.19 NA NA XXX

78291 ............ A Leveen/shunt patency exam ................ 0.88 3.37 3.43 3.37 3.43 0.17 4.42 4.48 4.42 4.48 XXX

78291 26 A Leveen/shunt patency exam ................ 0.88 0.32 0.35 0.32 0.35 0.04 1.24 1.27 1.24 1.27 XXX

78291 TC A Leveen/shunt patency exam ................ 0.00 3.05 3.08 NA NA 0.13 3.18 3.21 NA NA XXX

78299 ............ C GI nuclear procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78299 26 C GI nuclear procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78299 TC C GI nuclear procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78300 ............ A Bone imaging, limited area .................. 0.62 2.69 2.74 2.69 2.74 0.15 3.46 3.51 3.46 3.51 XXX

78300 26 A Bone imaging, limited area .................. 0.62 0.22 0.24 0.22 0.24 0.03 0.87 0.89 0.87 0.89 XXX

78300 TC A Bone imaging, limited area .................. 0.00 2.47 2.50 NA NA 0.12 2.59 2.62 NA NA XXX

78305 ............ A Bone imaging, multiple areas ............... 0.83 3.94 4.01 3.94 4.01 0.19 4.96 5.03 4.96 5.03 XXX

78305 26 A Bone imaging, multiple areas ............... 0.83 0.30 0.33 0.30 0.33 0.03 1.16 1.19 1.16 1.19 XXX

78305 TC A Bone imaging, multiple areas ............... 0.00 3.64 3.68 NA NA 0.16 3.80 3.84 NA NA XXX

78306 ............ A Bone imaging, whole body ................... 0.86 4.56 4.63 4.56 4.63 0.22 5.64 5.71 5.64 5.71 XXX

78306 26 A Bone imaging, whole body ................... 0.86 0.31 0.34 0.31 0.34 0.04 1.21 1.24 1.21 1.24 XXX

78306 TC A Bone imaging, whole body ................... 0.00 4.25 4.29 NA NA 0.18 4.43 4.47 NA NA XXX

78315 ............ A Bone imaging, 3 phase ........................ 1.02 5.12 5.20 5.12 5.20 0.25 6.39 6.47 6.39 6.47 XXX

78315 26 A Bone imaging, 3 phase ........................ 1.02 0.37 0.40 0.37 0.40 0.04 1.43 1.46 1.43 1.46 XXX

78315 TC A Bone imaging, 3 phase ........................ 0.00 4.75 4.80 NA NA 0.21 4.96 5.01 NA NA XXX

78320 ............ A Bone imaging (3D) ............................... 1.04 6.25 6.34 6.25 6.34 0.30 7.59 7.68 7.59 7.68 XXX

78320 26 A Bone imaging (3D) ............................... 1.04 0.39 0.42 0.39 0.42 0.04 1.47 1.50 1.47 1.50 XXX

78320 TC A Bone imaging (3D) ............................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

78350 ............ A Bone mineral, single photon ................ 0.22 0.83 0.85 0.83 0.85 0.05 1.10 1.12 1.10 1.12 XXX

78350 26 A Bone mineral, single photon ................ 0.22 0.08 0.09 0.08 0.09 0.01 0.31 0.32 0.31 0.32 XXX

78350 TC A Bone mineral, single photon ................ 0.00 0.75 0.76 NA NA 0.04 0.79 0.80 NA NA XXX

78351 ............ N Bone mineral, dual photon ................... +0.30 1.55 1.22 0.12 0.14 0.01 1.86 1.53 0.43 0.45 XXX

78399 ............ C Musculoskeletal nuclear exam ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78399 26 C Musculoskeletal nuclear exam ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78399 TC C Musculoskeletal nuclear exam ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78414 ............ C Non-imaging heart function .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78414 26 A Non-imaging heart function .................. 0.45 0.17 0.18 0.17 0.18 0.02 0.64 0.65 0.64 0.65 XXX

78414 TC C Non-imaging heart function .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78428 ............ A Cardiac shunt imaging ......................... 0.78 2.57 2.61 2.57 2.61 0.14 3.49 3.53 3.49 3.53 XXX

78428 26 A Cardiac shunt imaging ......................... 0.78 0.33 0.35 0.33 0.35 0.03 1.14 1.16 1.14 1.16 XXX

78428 TC A Cardiac shunt imaging ......................... 0.00 2.24 2.26 NA NA 0.11 2.35 2.37 NA NA XXX

78445 ............ A Vascular flow imaging .......................... 0.49 2.02 2.06 2.02 2.06 0.11 2.62 2.66 2.62 2.66 XXX

78445 26 A Vascular flow imaging .......................... 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78445 TC A Vascular flow imaging .......................... 0.00 1.84 1.86 NA NA 0.09 1.93 1.95 NA NA XXX

78455 ............ A Venous thrombosis study ..................... 0.73 4.23 4.29 4.23 4.29 0.20 5.16 5.22 5.16 5.22 XXX

78455 26 A Venous thrombosis study ..................... 0.73 0.27 0.29 0.27 0.29 0.03 1.03 1.05 1.03 1.05 XXX

78455 TC A Venous thrombosis study ..................... 0.00 3.96 4.00 NA NA 0.17 4.13 4.17 NA NA XXX

78456 ............ A Acute venous thrombus image ............ 1.00 4.33 4.33 4.33 4.33 0.28 5.61 5.61 5.61 5.61 XXX

78456 26 A Acute venous thrombus image ............ 1.00 0.37 0.37 0.37 0.37 0.04 1.41 1.41 1.41 1.41 XXX

78456 TC A Acute venous thrombus image ............ 0.00 3.96 3.96 NA NA 0.24 4.20 4.20 NA NA XXX

78457 ............ A Venous thrombosis imaging ................. 0.77 2.92 2.98 2.92 2.98 0.15 3.84 3.90 3.84 3.90 XXX

78457 26 A Venous thrombosis imaging ................. 0.77 0.28 0.31 0.28 0.31 0.03 1.08 1.11 1.08 1.11 XXX

78457 TC A Venous thrombosis imaging ................. 0.00 2.64 2.67 NA NA 0.12 2.76 2.79 NA NA XXX

78458 ............ A Ven thrombosis images, bilat ............... 0.90 4.34 4.40 4.34 4.40 0.20 5.44 5.50 5.44 5.50 XXX

78458 26 A Ven thrombosis images, bilat ............... 0.90 0.34 0.36 0.34 0.36 0.03 1.27 1.29 1.27 1.29 XXX

78458 TC A Ven thrombosis images, bilat ............... 0.00 4.00 4.04 NA NA 0.17 4.17 4.21 NA NA XXX

78459 ............ I Heart muscle imaging (PET) ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78459 26 I Heart muscle imaging (PET) ................ +1.88 0.75 0.93 0.75 0.93 0.08 2.71 2.89 2.71 2.89 XXX

78459 TC I Heart muscle imaging (PET) ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78460 ............ A Heart muscle blood, single ................... 0.86 2.66 2.72 2.66 2.72 0.14 3.66 3.72 3.66 3.72 XXX

78460 26 A Heart muscle blood, single ................... 0.86 0.32 0.35 0.32 0.35 0.03 1.21 1.24 1.21 1.24 XXX

78460 TC A Heart muscle blood, single ................... 0.00 2.34 2.37 NA NA 0.11 2.45 2.48 NA NA XXX

78461 ............ A Heart muscle blood, multiple ................ 1.23 5.16 5.24 5.16 5.24 0.26 6.65 6.73 6.65 6.73 XXX

78461 26 A Heart muscle blood, multiple ................ 1.23 0.47 0.50 0.47 0.50 0.05 1.75 1.78 1.75 1.78 XXX

78461 TC A Heart muscle blood, multiple ................ 0.00 4.69 4.74 NA NA 0.21 4.90 4.95 NA NA XXX

78464 ............ A Heart image (3d), single ....................... 1.09 7.42 7.53 7.42 7.53 0.35 8.86 8.97 8.86 8.97 XXX

78464 26 A Heart image (3d), single ....................... 1.09 0.41 0.44 0.41 0.44 0.04 1.54 1.57 1.54 1.57 XXX

78464 TC A Heart image (3d), single ....................... 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

78465 ............ A Heart image (3d), multiple .................... 1.46 12.28 12.44 12.28 12.44 0.56 14.30 14.46 14.30 14.46 XXX

78465 26 A Heart image (3d), multiple .................... 1.46 0.57 0.61 0.57 0.61 0.05 2.08 2.12 2.08 2.12 XXX

78465 TC A Heart image (3d), multiple .................... 0.00 11.71 11.83 NA NA 0.51 12.22 12.34 NA NA XXX

78466 ............ A Heart infarct image ............................... 0.69 2.87 2.92 2.87 2.92 0.15 3.71 3.76 3.71 3.76 XXX

78466 26 A Heart infarct image ............................... 0.69 0.27 0.29 0.27 0.29 0.03 0.99 1.01 0.99 1.01 XXX

78466 TC A Heart infarct image ............................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

78468 ............ A Heart infarct image (ef) ........................ 0.80 3.94 4.00 3.94 4.00 0.19 4.93 4.99 4.93 4.99 XXX

78468 26 A Heart infarct image (ef) ........................ 0.80 0.30 0.32 0.30 0.32 0.03 1.13 1.15 1.13 1.15 XXX

78468 TC A Heart infarct image (ef) ........................ 0.00 3.64 3.68 NA NA 0.16 3.80 3.84 NA NA XXX

78469 ............ A Heart infarct image (3D) ....................... 0.92 5.53 5.61 5.53 5.61 0.26 6.71 6.79 6.71 6.79 XXX

78469 26 A Heart infarct image (3D) ....................... 0.92 0.34 0.37 0.34 0.37 0.03 1.29 1.32 1.29 1.32 XXX

78469 TC A Heart infarct image (3D) ....................... 0.00 5.19 5.24 NA NA 0.23 5.42 5.47 NA NA XXX

78472 ............ A Gated heart, planar, single ................... 0.98 5.84 5.93 5.84 5.93 0.29 7.11 7.20 7.11 7.20 XXX

78472 26 A Gated heart, planar, single ................... 0.98 0.37 0.40 0.37 0.40 0.04 1.39 1.42 1.39 1.42 XXX

78472 TC A Gated heart, planar, single ................... 0.00 5.47 5.53 NA NA 0.25 5.72 5.78 NA NA XXX

78473 ............ A Gated heart, multiple ............................ 1.47 8.75 8.88 8.75 8.88 0.40 10.62 10.75 10.62 10.75 XXX

78473 26 A Gated heart, multiple ............................ 1.47 0.56 0.60 0.56 0.60 0.05 2.08 2.12 2.08 2.12 XXX

78473 TC A Gated heart, multiple ............................ 0.00 8.19 8.28 NA NA 0.35 8.54 8.63 NA NA XXX

78478 ............ A Heart wall motion add-on ..................... 0.62 1.80 1.83 1.80 1.83 0.10 2.52 2.55 2.52 2.55 ZZZ

78478 26 A Heart wall motion add-on ..................... 0.62 0.25 0.26 0.25 0.26 0.02 0.89 0.90 0.89 0.90 ZZZ

78478 TC A Heart wall motion add-on ..................... 0.00 1.55 1.57 NA NA 0.08 1.63 1.65 NA NA ZZZ

65523

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

78480 ............ A Heart function add-on ........................... 0.62 1.80 1.83 1.80 1.83 0.10 2.52 2.55 2.52 2.55 ZZZ

78480 26 A Heart function add-on ........................... 0.62 0.25 0.26 0.25 0.26 0.02 0.89 0.90 0.89 0.90 ZZZ

78480 TC A Heart function add-on ........................... 0.00 1.55 1.57 NA NA 0.08 1.63 1.65 NA NA ZZZ

78481 ............ A Heart first pass, single ......................... 0.98 5.59 5.66 5.59 5.66 0.26 6.83 6.90 6.83 6.90 XXX

78481 26 A Heart first pass, single ......................... 0.98 0.40 0.42 0.40 0.42 0.03 1.41 1.43 1.41 1.43 XXX

78481 TC A Heart first pass, single ......................... 0.00 5.19 5.24 NA NA 0.23 5.42 5.47 NA NA XXX

78483 ............ A Heart first pass, multiple ...................... 1.47 8.40 8.51 8.40 8.51 0.39 10.26 10.37 10.26 10.37 XXX

78483 26 A Heart first pass, multiple ...................... 1.47 0.59 0.62 0.59 0.62 0.05 2.11 2.14 2.11 2.14 XXX

78483 TC A Heart first pass, multiple ...................... 0.00 7.81 7.89 NA NA 0.34 8.15 8.23 NA NA XXX

78491 ............ I Heart image (pet), single ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78491 26 I Heart image (pet), single ...................... +1.50 0.60 0.81 0.60 0.81 0.05 2.15 2.36 2.15 2.36 XXX

78491 TC I Heart image (pet), single ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78492 ............ I Heart image (pet), multiple ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78492 26 I Heart image (pet), multiple ................... +1.87 0.75 0.93 0.75 0.93 0.06 2.68 2.86 2.68 2.86 XXX

78492 TC I Heart image (pet), multiple ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78494 ............ A Heart image, spect ............................... 1.19 7.46 7.46 7.46 7.46 0.29 8.94 8.94 8.94 8.94 XXX

78494 26 A Heart image, spect ............................... 1.19 0.45 0.45 0.45 0.45 0.04 1.68 1.68 1.68 1.68 XXX

78494 TC A Heart image, spect ............................... 0.00 7.01 7.01 NA NA 0.25 7.26 7.26 NA NA XXX

78496 ............ A Heart first pass add-on ......................... 0.50 7.21 7.21 7.21 7.21 0.27 7.98 7.98 7.98 7.98 ZZZ

78496 26 A Heart first pass add-on ......................... 0.50 0.20 0.20 0.20 0.20 0.02 0.72 0.72 0.72 0.72 ZZZ

78496 TC A Heart first pass add-on ......................... 0.00 7.01 7.01 NA NA 0.25 7.26 7.26 NA NA ZZZ

78499 ............ C Cardiovascular nuclear exam ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78499 26 C Cardiovascular nuclear exam ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78499 TC C Cardiovascular nuclear exam ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78580 ............ A Lung perfusion imaging ........................ 0.74 3.68 3.75 3.68 3.75 0.18 4.60 4.67 4.60 4.67 XXX

78580 26 A Lung perfusion imaging ........................ 0.74 0.27 0.30 0.27 0.30 0.03 1.04 1.07 1.04 1.07 XXX

78580 TC A Lung perfusion imaging ........................ 0.00 3.41 3.45 NA NA 0.15 3.56 3.60 NA NA XXX

78584 ............ A Lung V/Q image single breath ............. 0.99 3.53 3.60 3.53 3.60 0.18 4.70 4.77 4.70 4.77 XXX

78584 26 A Lung V/Q image single breath ............. 0.99 0.35 0.39 0.35 0.39 0.04 1.38 1.42 1.38 1.42 XXX

78584 TC A Lung V/Q image single breath ............. 0.00 3.18 3.21 NA NA 0.14 3.32 3.35 NA NA XXX

78585 ............ A Lung V/Q imaging ................................ 1.09 5.98 6.07 5.98 6.07 0.30 7.37 7.46 7.37 7.46 XXX

78585 26 A Lung V/Q imaging ................................ 1.09 0.39 0.42 0.39 0.42 0.05 1.53 1.56 1.53 1.56 XXX

78585 TC A Lung V/Q imaging ................................ 0.00 5.59 5.65 NA NA 0.25 5.84 5.90 NA NA XXX

78586 ............ A Aerosol lung image, single ................... 0.40 2.71 2.76 2.71 2.76 0.14 3.25 3.30 3.25 3.30 XXX

78586 26 A Aerosol lung image, single ................... 0.40 0.14 0.16 0.14 0.16 0.02 0.56 0.58 0.56 0.58 XXX

78586 TC A Aerosol lung image, single ................... 0.00 2.57 2.60 NA NA 0.12 2.69 2.72 NA NA XXX

78587 ............ A Aerosol lung image, multiple ................ 0.49 2.97 3.02 2.97 3.02 0.14 3.60 3.65 3.60 3.65 XXX

78587 26 A Aerosol lung image, multiple ................ 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78587 TC A Aerosol lung image, multiple ................ 0.00 2.79 2.82 NA NA 0.12 2.91 2.94 NA NA XXX

78588 ............ A Perfusion lung image ........................... 1.09 3.58 3.58 3.58 3.58 0.20 4.87 4.87 4.87 4.87 XXX

78588 26 A Perfusion lung image ........................... 1.09 0.40 0.40 0.40 0.40 0.05 1.54 1.54 1.54 1.54 XXX

78588 TC A Perfusion lung image ........................... 0.00 3.18 3.18 NA NA 0.15 3.33 3.33 NA NA XXX

78591 ............ A Vent image, 1 breath, 1 proj ................ 0.40 2.97 3.02 2.97 3.02 0.14 3.51 3.56 3.51 3.56 XXX

78591 26 A Vent image, 1 breath, 1 proj ................ 0.40 0.14 0.16 0.14 0.16 0.02 0.56 0.58 0.56 0.58 XXX

78591 TC A Vent image, 1 breath, 1 proj ................ 0.00 2.83 2.86 NA NA 0.12 2.95 2.98 NA NA XXX

78593 ............ A Vent image, 1 proj, gas ........................ 0.49 3.61 3.67 3.61 3.67 0.17 4.27 4.33 4.27 4.33 XXX

78593 26 A Vent image, 1 proj, gas ........................ 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78593 TC A Vent image, 1 proj, gas ........................ 0.00 3.43 3.47 NA NA 0.15 3.58 3.62 NA NA XXX

78594 ............ A Vent image, mult proj, gas ................... 0.53 5.14 5.21 5.14 5.21 0.23 5.90 5.97 5.90 5.97 XXX

78594 26 A Vent image, mult proj, gas ................... 0.53 0.19 0.21 0.19 0.21 0.02 0.74 0.76 0.74 0.76 XXX

78594 TC A Vent image, mult proj, gas ................... 0.00 4.95 5.00 NA NA 0.21 5.16 5.21 NA NA XXX

78596 ............ A Lung differential function ...................... 1.27 7.47 7.59 7.47 7.59 0.36 9.10 9.22 9.10 9.22 XXX

78596 26 A Lung differential function ...................... 1.27 0.46 0.50 0.46 0.50 0.05 1.78 1.82 1.78 1.82 XXX

78596 TC A Lung differential function ...................... 0.00 7.01 7.09 NA NA 0.31 7.32 7.40 NA NA XXX

78599 ............ C Respiratory nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78599 26 C Respiratory nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78599 TC C Respiratory nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78600 ............ A Brain imaging, ltd static ........................ 0.44 3.02 3.07 3.02 3.07 0.14 3.60 3.65 3.60 3.65 XXX

78600 26 A Brain imaging, ltd static ........................ 0.44 0.16 0.18 0.16 0.18 0.02 0.62 0.64 0.62 0.64 XXX

78600 TC A Brain imaging, ltd static ........................ 0.00 2.86 2.89 NA NA 0.12 2.98 3.01 NA NA XXX

78601 ............ A Brain imaging, ltd w/ flow ..................... 0.51 3.57 3.63 3.57 3.63 0.17 4.25 4.31 4.25 4.31 XXX

78601 26 A Brain imaging, ltd w/ flow ..................... 0.51 0.19 0.21 0.19 0.21 0.02 0.72 0.74 0.72 0.74 XXX

78601 TC A Brain imaging, ltd w/ flow ..................... 0.00 3.38 3.42 NA NA 0.15 3.53 3.57 NA NA XXX

78605 ............ A Brain imaging, complete ....................... 0.53 3.58 3.64 3.58 3.64 0.17 4.28 4.34 4.28 4.34 XXX

78605 26 A Brain imaging, complete ....................... 0.53 0.20 0.22 0.20 0.22 0.02 0.75 0.77 0.75 0.77 XXX

78605 TC A Brain imaging, complete ....................... 0.00 3.38 3.42 NA NA 0.15 3.53 3.57 NA NA XXX

78606 ............ A Brain imaging, compl w/flow ................ 0.64 4.07 4.13 4.07 4.13 0.20 4.91 4.97 4.91 4.97 XXX

78606 26 A Brain imaging, compl w/flow ................ 0.64 0.23 0.25 0.23 0.25 0.03 0.90 0.92 0.90 0.92 XXX

78606 TC A Brain imaging, compl w/flow ................ 0.00 3.84 3.88 NA NA 0.17 4.01 4.05 NA NA XXX

78607 ............ A Brain imaging (3D) ............................... 1.23 6.96 7.06 6.96 7.06 0.34 8.53 8.63 8.53 8.63 XXX

78607 26 A Brain imaging (3D) ............................... 1.23 0.46 0.49 0.46 0.49 0.05 1.74 1.77 1.74 1.77 XXX

78607 TC A Brain imaging (3D) ............................... 0.00 6.50 6.57 NA NA 0.29 6.79 6.86 NA NA XXX

78608 ............ N Brain imaging (PET) ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78609 ............ N Brain imaging (PET) ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78610 ............ A Brain flow imaging only ........................ 0.30 1.68 1.71 1.68 1.71 0.09 2.07 2.10 2.07 2.10 XXX

78610 26 A Brain flow imaging only ........................ 0.30 0.11 0.12 0.11 0.12 0.01 0.42 0.43 0.42 0.43 XXX

78610 TC A Brain flow imaging only ........................ 0.00 1.57 1.59 NA NA 0.08 1.65 1.67 NA NA XXX

78615 ............ A Cerebral blood flow imaging ................ 0.42 3.98 4.03 3.98 4.03 0.19 4.59 4.64 4.59 4.64 XXX

78615 26 A Cerebral blood flow imaging ................ 0.42 0.16 0.17 0.16 0.17 0.02 0.60 0.61 0.60 0.61 XXX

78615 TC A Cerebral blood flow imaging ................ 0.00 3.82 3.86 NA NA 0.17 3.99 4.03 NA NA XXX

78630 ............ A Cerebrospinal fluid scan ....................... 0.68 5.26 5.33 5.26 5.33 0.25 6.19 6.26 6.19 6.26 XXX

78630 26 A Cerebrospinal fluid scan ....................... 0.68 0.25 0.27 0.25 0.27 0.03 0.96 0.98 0.96 0.98 XXX

78630 TC A Cerebrospinal fluid scan ....................... 0.00 5.01 5.06 NA NA 0.22 5.23 5.28 NA NA XXX

65524

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

78635 ............ A CSF ventriculography ........................... 0.61 2.78 2.82 2.78 2.82 0.14 3.53 3.57 3.53 3.57 XXX

78635 26 A CSF ventriculography ........................... 0.61 0.25 0.26 0.25 0.26 0.02 0.88 0.89 0.88 0.89 XXX

78635 TC A CSF ventriculography ........................... 0.00 2.53 2.56 NA NA 0.12 2.65 2.68 NA NA XXX

78645 ............ A CSF shunt evaluation ........................... 0.57 3.62 3.68 3.62 3.68 0.17 4.36 4.42 4.36 4.42 XXX

78645 26 A CSF shunt evaluation ........................... 0.57 0.21 0.23 0.21 0.23 0.02 0.80 0.82 0.80 0.82 XXX

78645 TC A CSF shunt evaluation ........................... 0.00 3.41 3.45 NA NA 0.15 3.56 3.60 NA NA XXX

78647 ............ A Cerebrospinal fluid scan ....................... 0.90 6.21 6.29 6.21 6.29 0.29 7.40 7.48 7.40 7.48 XXX

78647 26 A Cerebrospinal fluid scan ....................... 0.90 0.35 0.37 0.35 0.37 0.03 1.28 1.30 1.28 1.30 XXX

78647 TC A Cerebrospinal fluid scan ....................... 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

78650 ............ A CSF leakage imaging ........................... 0.61 4.84 4.91 4.84 4.91 0.22 5.67 5.74 5.67 5.74 XXX

78650 26 A CSF leakage imaging ........................... 0.61 0.23 0.25 0.23 0.25 0.02 0.86 0.88 0.86 0.88 XXX

78650 TC A CSF leakage imaging ........................... 0.00 4.61 4.66 NA NA 0.20 4.81 4.86 NA NA XXX

78660 ............ A Nuclear exam of tear flow .................... 0.53 2.29 2.33 2.29 2.33 0.12 2.94 2.98 2.94 2.98 XXX

78660 26 A Nuclear exam of tear flow .................... 0.53 0.19 0.21 0.19 0.21 0.02 0.74 0.76 0.74 0.76 XXX

78660 TC A Nuclear exam of tear flow .................... 0.00 2.10 2.12 NA NA 0.10 2.20 2.22 NA NA XXX

78699 ............ C Nervous system nuclear exam ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78699 26 C Nervous system nuclear exam ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78699 TC C Nervous system nuclear exam ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78700 ............ A Kidney imaging, static .......................... 0.45 3.19 3.24 3.19 3.24 0.15 3.79 3.84 3.79 3.84 XXX

78700 26 A Kidney imaging, static .......................... 0.45 0.16 0.18 0.16 0.18 0.02 0.63 0.65 0.63 0.65 XXX

78700 TC A Kidney imaging, static .......................... 0.00 3.03 3.06 NA NA 0.13 3.16 3.19 NA NA XXX

78701 ............ A Kidney imaging with flow ...................... 0.49 3.72 3.78 3.72 3.78 0.17 4.38 4.44 4.38 4.44 XXX

78701 26 A Kidney imaging with flow ...................... 0.49 0.18 0.20 0.18 0.20 0.02 0.69 0.71 0.69 0.71 XXX

78701 TC A Kidney imaging with flow ...................... 0.00 3.54 3.58 NA NA 0.15 3.69 3.73 NA NA XXX

78704 ............ A Imaging renogram ................................ 0.74 4.20 4.27 4.20 4.27 0.20 5.14 5.21 5.14 5.21 XXX

78704 26 A Imaging renogram ................................ 0.74 0.27 0.30 0.27 0.30 0.03 1.04 1.07 1.04 1.07 XXX

78704 TC A Imaging renogram ................................ 0.00 3.93 3.97 NA NA 0.17 4.10 4.14 NA NA XXX

78707 ............ A Kidney flow/function image .................. 0.96 4.79 4.87 4.79 4.87 0.23 5.98 6.06 5.98 6.06 XXX

78707 26 A Kidney flow/function image .................. 0.96 0.35 0.38 0.35 0.38 0.04 1.35 1.38 1.35 1.38 XXX

78707 TC A Kidney flow/function image .................. 0.00 4.44 4.49 NA NA 0.19 4.63 4.68 NA NA XXX

78708 ............ A Kidney flow/function image .................. 1.21 4.88 4.94 4.88 4.94 0.24 6.33 6.39 6.33 6.39 XXX

78708 26 A Kidney flow/function image .................. 1.21 0.44 0.45 0.44 0.45 0.05 1.70 1.71 1.70 1.71 XXX

78708 TC A Kidney flow/function image .................. 0.00 4.44 4.49 NA NA 0.19 4.63 4.68 NA NA XXX

78709 ............ A Kidney flow/function image .................. 1.41 4.95 4.99 4.95 4.99 0.25 6.61 6.65 6.61 6.65 XXX

78709 26 A Kidney flow/function image .................. 1.41 0.51 0.50 0.51 0.50 0.06 1.98 1.97 1.98 1.97 XXX

78709 TC A Kidney flow/function image .................. 0.00 4.44 4.49 NA NA 0.19 4.63 4.68 NA NA XXX

78710 ............ A Kidney imaging (3D) ............................. 0.66 6.10 6.18 6.10 6.18 0.29 7.05 7.13 7.05 7.13 XXX

78710 26 A Kidney imaging (3D) ............................. 0.66 0.24 0.26 0.24 0.26 0.03 0.93 0.95 0.93 0.95 XXX

78710 TC A Kidney imaging (3D) ............................. 0.00 5.86 5.92 NA NA 0.26 6.12 6.18 NA NA XXX

78715 ............ A Renal vascular flow exam .................... 0.30 1.69 1.72 1.69 1.72 0.09 2.08 2.11 2.08 2.11 XXX

78715 26 A Renal vascular flow exam .................... 0.30 0.12 0.13 0.12 0.13 0.01 0.43 0.44 0.43 0.44 XXX

78715 TC A Renal vascular flow exam .................... 0.00 1.57 1.59 NA NA 0.08 1.65 1.67 NA NA XXX

78725 ............ A Kidney function study ........................... 0.38 1.91 1.94 1.91 1.94 0.10 2.39 2.42 2.39 2.42 XXX

78725 26 A Kidney function study ........................... 0.38 0.14 0.15 0.14 0.15 0.01 0.53 0.54 0.53 0.54 XXX

78725 TC A Kidney function study ........................... 0.00 1.77 1.79 NA NA 0.09 1.86 1.88 NA NA XXX

78730 ............ A Urinary bladder retention ...................... 0.36 1.58 1.61 1.58 1.61 0.09 2.03 2.06 2.03 2.06 XXX

78730 26 A Urinary bladder retention ...................... 0.36 0.13 0.14 0.13 0.14 0.02 0.51 0.52 0.51 0.52 XXX

78730 TC A Urinary bladder retention ...................... 0.00 1.45 1.47 NA NA 0.07 1.52 1.54 NA NA XXX

78740 ............ A Ureteral reflux study ............................. 0.57 2.30 2.34 2.30 2.34 0.12 2.99 3.03 2.99 3.03 XXX

78740 26 A Ureteral reflux study ............................. 0.57 0.20 0.22 0.20 0.22 0.02 0.79 0.81 0.79 0.81 XXX

78740 TC A Ureteral reflux study ............................. 0.00 2.10 2.12 NA NA 0.10 2.20 2.22 NA NA XXX

78760 ............ A Testicular imaging ................................ 0.66 2.90 2.95 2.90 2.95 0.15 3.71 3.76 3.71 3.76 XXX

78760 26 A Testicular imaging ................................ 0.66 0.24 0.26 0.24 0.26 0.03 0.93 0.95 0.93 0.95 XXX

78760 TC A Testicular imaging ................................ 0.00 2.66 2.69 NA NA 0.12 2.78 2.81 NA NA XXX

78761 ............ A Testicular imaging/flow ......................... 0.71 3.44 3.50 3.44 3.50 0.17 4.32 4.38 4.32 4.38 XXX

78761 26 A Testicular imaging/flow ......................... 0.71 0.26 0.29 0.26 0.29 0.03 1.00 1.03 1.00 1.03 XXX

78761 TC A Testicular imaging/flow ......................... 0.00 3.18 3.21 NA NA 0.14 3.32 3.35 NA NA XXX

78799 ............ C Genitourinary nuclear exam ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78799 26 C Genitourinary nuclear exam ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78799 TC C Genitourinary nuclear exam ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78800 ............ A Tumor imaging, limited area ................ 0.66 3.62 3.68 3.62 3.68 0.18 4.46 4.52 4.46 4.52 XXX

78800 26 A Tumor imaging, limited area ................ 0.66 0.24 0.26 0.24 0.26 0.03 0.93 0.95 0.93 0.95 XXX

78800 TC A Tumor imaging, limited area ................ 0.00 3.38 3.42 NA NA 0.15 3.53 3.57 NA NA XXX

78801 ............ A Tumor imaging, mult areas .................. 0.79 4.49 4.56 4.49 4.56 0.21 5.49 5.56 5.49 5.56 XXX

78801 26 A Tumor imaging, mult areas .................. 0.79 0.29 0.32 0.29 0.32 0.03 1.11 1.14 1.11 1.14 XXX

78801 TC A Tumor imaging, mult areas .................. 0.00 4.20 4.24 NA NA 0.18 4.38 4.42 NA NA XXX

78802 ............ A Tumor imaging, whole body ................. 0.86 5.81 5.90 5.81 5.90 0.28 6.95 7.04 6.95 7.04 XXX

78802 26 A Tumor imaging, whole body ................. 0.86 0.32 0.35 0.32 0.35 0.03 1.21 1.24 1.21 1.24 XXX

78802 TC A Tumor imaging, whole body ................. 0.00 5.49 5.55 NA NA 0.25 5.74 5.80 NA NA XXX

78803 ............ A Tumor imaging (3D) ............................. 1.09 6.91 7.01 6.91 7.01 0.33 8.33 8.43 8.33 8.43 XXX

78803 26 A Tumor imaging (3D) ............................. 1.09 0.41 0.44 0.41 0.44 0.04 1.54 1.57 1.54 1.57 XXX

78803 TC A Tumor imaging (3D) ............................. 0.00 6.50 6.57 NA NA 0.29 6.79 6.86 NA NA XXX

78805 ............ A Abscess imaging, ltd area .................... 0.73 3.65 3.71 3.65 3.71 0.18 4.56 4.62 4.56 4.62 XXX

78805 26 A Abscess imaging, ltd area .................... 0.73 0.27 0.29 0.27 0.29 0.03 1.03 1.05 1.03 1.05 XXX

78805 TC A Abscess imaging, ltd area .................... 0.00 3.38 3.42 NA NA 0.15 3.53 3.57 NA NA XXX

78806 ............ A Abscess imaging, whole body .............. 0.86 6.70 6.79 6.70 6.79 0.32 7.88 7.97 7.88 7.97 XXX

78806 26 A Abscess imaging, whole body .............. 0.86 0.32 0.34 0.32 0.34 0.03 1.21 1.23 1.21 1.23 XXX

78806 TC A Abscess imaging, whole body .............. 0.00 6.38 6.45 NA NA 0.29 6.67 6.74 NA NA XXX

78807 ............ A Nuclear localization/abscess ................ 1.09 6.92 7.02 6.92 7.02 0.33 8.34 8.44 8.34 8.44 XXX

78807 26 A Nuclear localization/abscess ................ 1.09 0.42 0.45 0.42 0.45 0.04 1.55 1.58 1.55 1.58 XXX

78807 TC A Nuclear localization/abscess ................ 0.00 6.50 6.57 NA NA 0.29 6.79 6.86 NA NA XXX

78810 ............ N Tumor imaging (PET) ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78810 26 N Tumor imaging (PET) ........................... +1.93 0.77 0.95 0.77 0.95 0.09 2.79 2.97 2.79 2.97 XXX

65525

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

78810 TC N Tumor imaging (PET) ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78890 ............ B Nuclear medicine data proc ................. +0.05 1.32 1.33 1.32 1.33 0.06 1.43 1.44 1.43 1.44 XXX

78890 26 B Nuclear medicine data proc ................. +0.05 0.02 0.02 0.02 0.02 0.01 0.08 0.08 0.08 0.08 XXX

78890 TC B Nuclear medicine data proc ................. +0.00 1.30 1.31 NA NA 0.05 1.35 1.36 NA NA XXX

78891 ............ B Nuclear med data proc ......................... +0.10 2.64 2.67 2.64 2.67 0.12 2.86 2.89 2.86 2.89 XXX

78891 26 B Nuclear med data proc ......................... +0.10 0.04 0.04 0.04 0.04 0.01 0.15 0.15 0.15 0.15 XXX

78891 TC B Nuclear med data proc ......................... +0.00 2.60 2.63 NA NA 0.11 2.71 2.74 NA NA XXX

78990 ............ I Provide diag radionuclide(s) ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78999 ............ C Nuclear diagnostic exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78999 26 C Nuclear diagnostic exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

78999 TC C Nuclear diagnostic exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79000 ............ A Init hyperthyroid therapy ....................... 1.80 3.25 3.34 3.25 3.34 0.19 5.24 5.33 5.24 5.33 XXX

79000 26 A Init hyperthyroid therapy ....................... 1.80 0.65 0.71 0.65 0.71 0.07 2.52 2.58 2.52 2.58 XXX

79000 TC A Init hyperthyroid therapy ....................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79001 ............ A Repeat hyperthyroid therapy ................ 1.05 1.68 1.72 1.68 1.72 0.10 2.83 2.87 2.83 2.87 XXX

79001 26 A Repeat hyperthyroid therapy ................ 1.05 0.38 0.41 0.38 0.41 0.04 1.47 1.50 1.47 1.50 XXX

79001 TC A Repeat hyperthyroid therapy ................ 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

79020 ............ A Thyroid ablation .................................... 1.81 3.24 3.33 3.24 3.33 0.19 5.24 5.33 5.24 5.33 XXX

79020 26 A Thyroid ablation .................................... 1.81 0.64 0.70 0.64 0.70 0.07 2.52 2.58 2.52 2.58 XXX

79020 TC A Thyroid ablation .................................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79030 ............ A Thyroid ablation, carcinoma ................. 2.10 3.37 3.46 3.37 3.46 0.20 5.67 5.76 5.67 5.76 XXX

79030 26 A Thyroid ablation, carcinoma ................. 2.10 0.77 0.83 0.77 0.83 0.08 2.95 3.01 2.95 3.01 XXX

79030 TC A Thyroid ablation, carcinoma ................. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79035 ............ A Thyroid metastatic therapy ................... 2.52 3.54 3.64 3.54 3.64 0.21 6.27 6.37 6.27 6.37 XXX

79035 26 A Thyroid metastatic therapy ................... 2.52 0.94 1.01 0.94 1.01 0.09 3.55 3.62 3.55 3.62 XXX

79035 TC A Thyroid metastatic therapy ................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79100 ............ A Hematopoetic nuclear therapy ............. 1.32 3.09 3.16 3.09 3.16 0.17 4.58 4.65 4.58 4.65 XXX

79100 26 A Hematopoetic nuclear therapy ............. 1.32 0.49 0.53 0.49 0.53 0.05 1.86 1.90 1.86 1.90 XXX

79100 TC A Hematopoetic nuclear therapy ............. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79200 ............ A Intracavitary nuclear trmt ...................... 1.99 3.35 3.44 3.35 3.44 0.19 5.53 5.62 5.53 5.62 XXX

79200 26 A Intracavitary nuclear trmt ...................... 1.99 0.75 0.81 0.75 0.81 0.07 2.81 2.87 2.81 2.87 XXX

79200 TC A Intracavitary nuclear trmt ...................... 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79300 ............ C Interstitial nuclear therapy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79300 26 A Interstitial nuclear therapy .................... 1.60 0.58 0.63 0.58 0.63 0.07 2.25 2.30 2.25 2.30 XXX

79300 TC C Interstitial nuclear therapy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79400 ............ A Nonhemato nuclear therapy ................. 1.96 3.33 3.41 3.33 3.41 0.20 5.49 5.57 5.49 5.57 XXX

79400 26 A Nonhemato nuclear therapy ................. 1.96 0.73 0.78 0.73 0.78 0.08 2.77 2.82 2.77 2.82 XXX

79400 TC A Nonhemato nuclear therapy ................. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79420 ............ C Intravascular nuclear ther ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79420 26 A Intravascular nuclear ther ..................... 1.51 0.54 0.59 0.54 0.59 0.06 2.11 2.16 2.11 2.16 XXX

79420 TC C Intravascular nuclear ther ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79440 ............ A Nuclear joint therapy ............................ 1.99 3.40 3.47 3.40 3.47 0.20 5.59 5.66 5.59 5.66 XXX

79440 26 A Nuclear joint therapy ............................ 1.99 0.80 0.84 0.80 0.84 0.08 2.87 2.91 2.87 2.91 XXX

79440 TC A Nuclear joint therapy ............................ 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

79900 ............ C Provide ther radiopharm(s) .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79999 ............ C Nuclear medicine therapy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79999 26 C Nuclear medicine therapy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

79999 TC C Nuclear medicine therapy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80048 ............ X Basic metabolic panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80050 ............ N General health panel ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80051 ............ X Electrolyte panel ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80053 ............ X Comprehen metabolic panel ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80055 ............ I Obstetric panel ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80061 ............ X Lipid panel ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80069 ............ X Renal function panel ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80072 ............ X Arthritis panel ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80074 ............ X Acute hepatitis panel ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80076 ............ X Hepatic function panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80090 ............ X Torch antibody panel ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80100 ............ X Drug screen, qualitate/multi ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80101 ............ X Drug screen, single .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80102 ............ X Drug confirmation ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80103 ............ X Drug analysis, tissue prep .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80150 ............ X Assay of amikacin ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80152 ............ X Assay of amitriptyline ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80154 ............ X Assay of benzodiazepines ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80156 ............ X Assay, carbamazepine, total ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80157 ............ X Assay, carbamazepine, free ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80158 ............ X Assay of cyclosporine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80160 ............ X Assay of desipramine ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80162 ............ X Assay of digoxin ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80164 ............ X Assay, dipropylacetic acid .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80166 ............ X Assay of doxepin .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80168 ............ X Assay of ethosuximide ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80170 ............ X Assay of gentamicin ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80172 ............ X Assay of gold ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80173 ............ X Assay of haloperidol ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80174 ............ X Assay of imipramine ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80176 ............ X Assay of lidocaine ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80178 ............ X Assay of lithium .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80182 ............ X Assay of nortriptyline ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80184 ............ X Assay of phenobarbital ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80185 ............ X Assay of phenytoin, total ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65526

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

80186 ............ X Assay of phenytoin, free ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80188 ............ X Assay of primidone ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80190 ............ X Assay of procainamide ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80192 ............ X Assay of procainamide ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80194 ............ X Assay of quinidine ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80196 ............ X Assay of salicylate ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80197 ............ X Assay of tacrolimus .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80198 ............ X Assay of theophylline ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80200 ............ X Assay of tobramycin ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80201 ............ X Assay of topiramate ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80202 ............ X Assay of vancomycin ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80299 ............ X Quantitative assay, drug ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80400 ............ X Acth stimulation panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80402 ............ X Acth stimulation panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80406 ............ X Acth stimulation panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80408 ............ X Aldosterone suppression eval .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80410 ............ X Calcitonin stimul panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80412 ............ X CRH stimulation panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80414 ............ X Testosterone response ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80415 ............ X Estradiol response panel ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80416 ............ X Renin stimulation panel ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80417 ............ X Renin stimulation panel ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80418 ............ X Pituitary evaluation panel ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80420 ............ X Dexamethasone panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80422 ............ X Glucagon tolerance panel .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80424 ............ X Glucagon tolerance panel .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80426 ............ X Gonadotropin hormone panel .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80428 ............ X Growth hormone panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80430 ............ X Growth hormone panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80432 ............ X Insulin suppression panel ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80434 ............ X Insulin tolerance panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80435 ............ X Insulin tolerance panel ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80436 ............ X Metyrapone panel ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80438 ............ X TRH stimulation panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80439 ............ X TRH stimulation panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80440 ............ X TRH stimulation panel .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

80500 ............ A Lab pathology consultation .................. 0.37 0.18 0.19 0.16 0.18 0.01 0.56 0.57 0.54 0.56 XXX

80502 ............ A Lab pathology consultation .................. 1.33 0.63 0.56 0.58 0.53 0.05 2.01 1.94 1.96 1.91 XXX

81000 ............ X Urinalysis, nonauto w/scope ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81001 ............ X Urinalysis, auto w/scope ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81002 ............ X Urinalysis nonauto w/o scope .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81003 ............ X Urinalysis, auto, w/o scope .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81005 ............ X Urinalysis .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81007 ............ X Urine screen for bacteria ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81015 ............ X Microscopic exam of urine ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81020 ............ X Urinalysis, glass test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81025 ............ X Urine pregnancy test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81050 ............ X Urinalysis, volume measure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

81099 ............ X Urinalysis test procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82000 ............ X Assay of blood acetaldehyde ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82003 ............ X Assay of acetaminophen ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82009 ............ X Test for acetone/ketones ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82010 ............ X Acetone assay ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82013 ............ X Acetylcholinesterase assay .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82016 ............ X Acylcarnitines, qual .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82017 ............ X Acylcarnitines, quant ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82024 ............ X Assay of acth ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82030 ............ X Assay of adp & amp ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82040 ............ X Assay of serum albumin ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82042 ............ X Assay of urine albumin ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82043 ............ X Microalbumin, quantitative .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82044 ............ X Microalbumin, semiquant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82055 ............ X Assay of ethanol ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82075 ............ X Assay of breath ethanol ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82085 ............ X Assay of aldolase ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82088 ............ X Assay of aldosterone ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82101 ............ X Assay of urine alkaloids ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82103 ............ X Alpha-1-antitrypsin, total ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82104 ............ X Alpha-1-antitrypsin, pheno ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82105 ............ X Alpha-fetoprotein, serum ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82106 ............ X Alpha-fetoprotein, amniotic ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82108 ............ X Assay of aluminum ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82120 ............ X Amines, vaginal fluid qual .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82127 ............ X Amino acid, single qual ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82128 ............ X Amino acids, mult qual ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82131 ............ X Amino acids, single quant .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82135 ............ X Assay, aminolevulinic acid ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82136 ............ X Amino acids, quant, 2-5 ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82139 ............ X Amino acids, quan, 6 or more .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82140 ............ X Assay of ammonia ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82143 ............ X Amniotic fluid scan ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82145 ............ X Assay of amphetamines ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82150 ............ X Assay of amylase ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65527

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

82154 ............ X Androstanediol glucuronide .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82157 ............ X Assay of androstenedione .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82160 ............ X Assay of androsterone ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82163 ............ X Assay of angiotensin II ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82164 ............ X Angiotensin I enzyme test .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82172 ............ X Assay of apolipoprotein ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82175 ............ X Assay of arsenic ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82180 ............ X Assay of ascorbic acid ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82190 ............ X Atomic absorption ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82205 ............ X Assay of barbiturates ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82232 ............ X Assay of beta-2 protein ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82239 ............ X Bile acids, total ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82240 ............ X Bile acids, cholylglycine ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82247 ............ X Bilirubin, total ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82248 ............ X Bilirubin, direct ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82251 ............ D Assay of bilirubin .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82252 ............ X Fecal bilirubin test ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82261 ............ X Assay of biotinidase ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82270 ............ X Test for blood, feces ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82273 ............ X Test for blood, other source ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82286 ............ X Assay of bradykinin .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82300 ............ X Assay of cadmium ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82306 ............ X Assay of vitamin D ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82307 ............ X Assay of vitamin D ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82308 ............ X Assay of calcitonin ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82310 ............ X Assay of calcium .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82330 ............ X Assay of calcium .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82331 ............ X Calcium infusion test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82340 ............ X Assay of calcium in urine ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82355 ............ X Calculus (stone) analysis ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82360 ............ X Calculus (stone) assay ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82365 ............ X Calculus (stone) assay ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82370 ............ X X-ray assay, calculus ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82373 ............ X Assay, c-d transfer measure ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82374 ............ X Assay, blood carbon dioxide ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82375 ............ X Assay, blood carbon monoxide ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82376 ............ X Test for carbon monoxide .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82378 ............ X Carcinoembryonic antigen .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82379 ............ X Assay of carnitine ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82380 ............ X Assay of carotene ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82382 ............ X Assay, urine catecholamines ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82383 ............ X Assay, blood catecholamines ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82384 ............ X Assay, three catecholamines ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82387 ............ X Assay of cathepsin-d ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82390 ............ X Assay of ceruloplasmin ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82397 ............ X Chemiluminescent assay ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82415 ............ X Assay of chloramphenicol .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82435 ............ X Assay of blood chloride ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82436 ............ X Assay of urine chloride ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82438 ............ X Assay, other fluid chlorides .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82441 ............ X Test for chlorohydrocarbons ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82465 ............ X Assay, bld/serum cholesterol ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82480 ............ X Assay, serum cholinesterase ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82482 ............ X Assay, rbc cholinesterase .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82485 ............ X Assay, chondroitin sulfate .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82486 ............ X Gas/liquid chromatography .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82487 ............ X Paper chromatography ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82488 ............ X Paper chromatography ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82489 ............ X Thin layer chromatography .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82491 ............ X Chromotography, quant, sing ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82492 ............ X Chromotography, quant, mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82495 ............ X Assay of chromium ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82507 ............ X Assay of citrate ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82520 ............ X Assay of cocaine .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82523 ............ X Collagen crosslinks .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82525 ............ X Assay of copper ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82528 ............ X Assay of corticosterone ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82530 ............ X Cortisol, free ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82533 ............ X Total cortisol ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82540 ............ X Assay of creatine .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82541 ............ X Column chromotography, qual ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82542 ............ X Column chromotography, quant ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82543 ............ X Column chromotograph/isotope ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82544 ............ X Column chromotograph/isotope ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82550 ............ X Assay of ck (cpk) .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82552 ............ X Assay of cpk in blood ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82553 ............ X Creatine, MB fraction ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82554 ............ X Creatine, isoforms ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82565 ............ X Assay of creatinine ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82570 ............ X Assay of urine creatinine ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82575 ............ X Creatinine clearance test ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82585 ............ X Assay of cryofibrinogen ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82595 ............ X Assay of cryoglobulin ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65528

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

82600 ............ X Assay of cyanide .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82607 ............ X Vitamin B-12 ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82608 ............ X B-12 binding capacity ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82615 ............ X Test for urine cystines .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82626 ............ X Dehydroepiandrosterone ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82627 ............ X Dehydroepiandrosterone ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82633 ............ X Desoxycorticosterone ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82634 ............ X Deoxycortisol ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82638 ............ X Assay of dibucaine number .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82646 ............ X Assay of dihydrocodeinone .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82649 ............ X Assay of dihydromorphinone ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82651 ............ X Assay of dihydrotestosterone ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82652 ............ X Assay of dihydroxyvitamin d ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82654 ............ X Assay of dimethadione ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82657 ............ X Enzyme cell activity .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82658 ............ X Enzyme cell activity, ra ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82664 ............ X Electrophoretic test ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82666 ............ X Assay of epiandrosterone .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82668 ............ X Assay of erythropoietin ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82670 ............ X Assay of estradiol ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82671 ............ X Assay of estrogens ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82672 ............ X Assay of estrogen ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82677 ............ X Assay of estriol ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82679 ............ X Assay of estrone .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82690 ............ X Assay of ethchlorvynol ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82693 ............ X Assay of ethylene glycol ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82696 ............ X Assay of etiocholanolone ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82705 ............ X Fats/lipids, feces, qual .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82710 ............ X Fats/lipids, feces, quant ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82715 ............ X Assay of fecal fat .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82725 ............ X Assay of blood fatty acids .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82726 ............ X Long chain fatty acids .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82728 ............ X Assay of ferritin .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82731 ............ X Assay of fetal fibronectin ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82735 ............ X Assay of fluoride ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82742 ............ X Assay of flurazepam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82746 ............ X Blood folic acid serum .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82747 ............ X Assay of folic acid, rbc ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82757 ............ X Assay of semen fructose ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82759 ............ X Assay of rbc galactokinase .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82760 ............ X Assay of galactose ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82775 ............ X Assay galactose transferase ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82776 ............ X Galactose transferase test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82784 ............ X Assay of gammaglobulin igm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82785 ............ X Assay of gammaglobulin ige ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82787 ............ X Igg 1, 2, 3 or 4, each ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82800 ............ X Blood pH ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82803 ............ X Blood gases: pH, pO2 & pCO2 ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82805 ............ X Blood gases W/02 saturation ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82810 ............ X Blood gases, O2 sat only ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82820 ............ X Hemoglobin-oxygen affinity .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82926 ............ X Assay of gastric acid ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82928 ............ X Assay of gastric acid ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82938 ............ X Gastrin test ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82941 ............ X Assay of gastrin .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82943 ............ X Assay of glucagon ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82945 ............ X Glucose other fluid ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82946 ............ X Glucagon tolerance test ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82947 ............ X Assay, glucose, blood quant ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82948 ............ X Reagent strip/blood glucose ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82950 ............ X Glucose test ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82951 ............ X Glucose tolerance test (GTT) ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82952 ............ X GTT-added samples ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82953 ............ X Glucose-tolbutamide test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82955 ............ X Assay of g6pd enzyme ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82960 ............ X Test for G6PD enzyme ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82962 ............ X Glucose blood test ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82963 ............ X Assay of glucosidase ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82965 ............ X Assay of gdh enzyme ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82975 ............ X Assay of glutamine ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82977 ............ X Assay of GGT ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82978 ............ X Assay of glutathione ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82979 ............ X Assay, rbc glutathione .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82980 ............ X Assay of glutethimide ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

82985 ............ X Glycated protein ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83001 ............ X Gonadotropin (FSH) ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83002 ............ X Gonadotropin (LH) ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83003 ............ X Assay, growth hormone (hgh) .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83008 ............ X Assay of guanosine .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83010 ............ X Assay of haptoglobin, quant ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83012 ............ X Assay of haptoglobins .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83013 ............ X H pylori analysis ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83014 ............ X H pylori drug admin/collect ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65529

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

83015 ............ X Heavy metal screen ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83018 ............ X Quantitative screen, metals .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83020 ............ X Hemoglobin electrophoresis ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83020 26 A Hemoglobin electrophoresis ................. 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

83021 ............ X Hemoglobin chromotography ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83026 ............ X Hemoglobin, copper sulfate ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83030 ............ X Fetal hemoglobin, chemical ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83033 ............ X Fetal hemoglobin assay, qual .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83036 ............ X Glycated hemoglobin test ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83045 ............ X Blood methemoglobin test .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83050 ............ X Blood methemoglobin assay ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83051 ............ X Assay of plasma hemoglobin ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83055 ............ X Blood sulfhemoglobin test .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83060 ............ X Blood sulfhemoglobin assay ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83065 ............ X Assay of hemoglobin heat .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83068 ............ X Hemoglobin stability screen ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83069 ............ X Assay of urine hemoglobin ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83070 ............ X Assay of hemosiderin, qual .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83071 ............ X Assay of hemosiderin, quant ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83080 ............ X Assay of b hexosaminidase ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83088 ............ X Assay of histamine ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83090 ............ X Assay of homocystine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83150 ............ X Assay of for hva ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83491 ............ X Assay of corticosteroids ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83497 ............ X Assay of 5-hiaa .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83498 ............ X Assay of progesterone ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83499 ............ X Assay of progesterone ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83500 ............ X Assay, free hydroxyproline ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83505 ............ X Assay, total hydroxyproline .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83516 ............ X Immunoassay, nonantibody ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83518 ............ X Immunoassay, dipstick ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83519 ............ X Immunoassay, nonantibody ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83520 ............ X Immunoassay, RIA ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83525 ............ X Assay of insulin .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83527 ............ X Assay of insulin .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83528 ............ X Assay of intrinsic factor ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83540 ............ X Assay of iron ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83550 ............ X Iron binding test .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83570 ............ X Assay of idh enzyme ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83582 ............ X Assay of ketogenic steroids ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83586 ............ X Assay 17- ketosteroids ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83593 ............ X Fractionation, ketosteroids ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83605 ............ X Assay of lactic acid .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83615 ............ X Lactate (LD) (LDH) enzyme ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83625 ............ X Assay of ldh enzymes .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83632 ............ X Placental lactogen ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83633 ............ X Test urine for lactose ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83634 ............ X Assay of urine for lactose .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83655 ............ X Assay of lead ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83661 ............ X L/s ratio, fetal lung ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83662 ............ X Foam stability, fetal lung ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83663 ............ X Fluoro polarize, fetal lung ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83664 ............ X Lamellar bdy, fetal lung ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83670 ............ X Assay of lap enzyme ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83690 ............ X Assay of lipase ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83715 ............ X Assay of blood lipoproteins .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83716 ............ X Assay of blood lipoproteins .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83718 ............ X Assay of lipoprotein .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83719 ............ X Assay of blood lipoprotein .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83721 ............ X Assay of blood lipoprotein .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83727 ............ X Assay of lrh hormone ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83735 ............ X Assay of magnesium ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83775 ............ X Assay of md enzyme ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83785 ............ X Assay of manganese ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83788 ............ X Mass spectrometry qual ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83789 ............ X Mass spectrometry quant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83805 ............ X Assay of meprobamate ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83825 ............ X Assay of mercury ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83835 ............ X Assay of metanephrines ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83840 ............ X Assay of methadone ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83857 ............ X Assay of methemalbumin ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83858 ............ X Assay of methsuximide ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83864 ............ X Mucopolysaccharides ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83866 ............ X Mucopolysaccharides screen ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83872 ............ X Assay synovial fluid mucin ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83873 ............ X Assay of csf protein .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83874 ............ X Assay of myoglobin .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83883 ............ X Assay, nephelometry not spec ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83885 ............ X Assay of nickel ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83887 ............ X Assay of nicotine .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83890 ............ X Molecule isolate .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83891 ............ X Molecule isolate nucleic ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83892 ............ X Molecular diagnostics ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65530

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

83893 ............ X Molecule dot/slot/blot ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83894 ............ X Molecule gel electrophor ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83896 ............ X Molecular diagnostics ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83897 ............ X Molecule nucleic transfer ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83898 ............ X Molecule nucleic ampli ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83901 ............ X Molecule nucleic ampli ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83902 ............ X Molecular diagnostics ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83903 ............ X Molecule mutation scan ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83904 ............ X Molecule mutation identify .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83905 ............ X Molecule mutation identify .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83906 ............ X Molecule mutation identify .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83912 ............ X Genetic examination ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83912 26 A Genetic examination ............................. 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

83915 ............ X Assay of nucleotidase .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83916 ............ X Oligoclonal bands ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83918 ............ X Organic acids, total, quant ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83919 ............ X Organic acids, qual, each .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83921 ............ X Organic acid, single, quant .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83925 ............ X Assay of opiates ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83930 ............ X Assay of blood osmolality .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83935 ............ X Assay of urine osmolality ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83937 ............ X Assay of osteocalcin ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83945 ............ X Assay of oxalate ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83970 ............ X Assay of parathormone ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83986 ............ X Assay of body fluid acidity ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

83992 ............ X Assay for phencyclidine ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84022 ............ X Assay of phenothiazine ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84030 ............ X Assay of blood pku ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84035 ............ X Assay of phenylketones ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84060 ............ X Assay acid phosphatase ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84061 ............ X Phosphatase, forensic exam ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84066 ............ X Assay prostate phosphatase ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84075 ............ X Assay alkaline phosphatase ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84078 ............ X Assay alkaline phosphatase ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84080 ............ X Assay alkaline phosphatases ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84081 ............ X Amniotic fluid enzyme test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84085 ............ X Assay of rbc pg6d enzyme .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84087 ............ X Assay phosphohexose enzymes .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84100 ............ X Assay of phosphorus ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84105 ............ X Assay of urine phosphorus .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84106 ............ X Test for porphobilinogen ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84110 ............ X Assay of porphobilinogen ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84119 ............ X Test urine for porphyrins ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84120 ............ X Assay of urine porphyrins .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84126 ............ X Assay of feces porphyrins .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84127 ............ X Assay of feces porphyrins .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84132 ............ X Assay of serum potassium ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84133 ............ X Assay of urine potassium ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84134 ............ X Assay of prealbumin ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84135 ............ X Assay of pregnanediol .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84138 ............ X Assay of pregnanetriol ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84140 ............ X Assay of pregnenolone ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84143 ............ X Assay of 17-hydroxypregneno ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84144 ............ X Assay of progesterone ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84146 ............ X Assay of prolactin ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84150 ............ X Assay of prostaglandin ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84152 ............ X Assay of psa, complexed ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84153 ............ X Assay of psa, total ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84154 ............ X Assay of psa, free ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84155 ............ X Assay of protein ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84160 ............ X Assay of serum protein ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84165 ............ X Assay of serum proteins ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84165 26 A Assay of serum proteins ...................... 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

84181 ............ X Western blot test .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84181 26 A Western blot test .................................. 0.37 0.14 0.16 0.14 0.16 0.01 0.52 0.54 0.52 0.54 XXX

84182 ............ X Protein, western blot test ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84182 26 A Protein, western blot test ..................... 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

84202 ............ X Assay RBC protoporphyrin ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84203 ............ X Test RBC protoporphyrin ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84206 ............ X Assay of proinsulin ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84207 ............ X Assay of vitamin b-6 ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84210 ............ X Assay of pyruvate ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84220 ............ X Assay of pyruvate kinase ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84228 ............ X Assay of quinine ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84233 ............ X Assay of estrogen ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84234 ............ X Assay of progesterone ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84235 ............ X Assay of endocrine hormone ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84238 ............ X Assay, nonendocrine receptor ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84244 ............ X Assay of renin ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84252 ............ X Assay of vitamin b-2 ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84255 ............ X Assay of selenium ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84260 ............ X Assay of serotonin ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84270 ............ X Assay of sex hormone globul ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65531

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

84275 ............ X Assay of sialic acid ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84285 ............ X Assay of silica ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84295 ............ X Assay of serum sodium ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84300 ............ X Assay of urine sodium .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84305 ............ X Assay of somatomedin ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84307 ............ X Assay of somatostatin .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84311 ............ X Spectrophotometry ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84315 ............ X Body fluid specific gravity ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84375 ............ X Chromatogram assay, sugars .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84376 ............ X Sugars, single, qual .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84377 ............ X Sugars, multiple, qual ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84378 ............ X Sugars single quant ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84379 ............ X Sugars multiple quant .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84392 ............ X Assay of urine sulfate ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84402 ............ X Assay of testosterone ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84403 ............ X Assay of total testosterone ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84425 ............ X Assay of vitamin b-1 ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84430 ............ X Assay of thiocyanate ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84432 ............ X Assay of thyroglobulin .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84436 ............ X Assay of total thyroxine ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84437 ............ X Assay of neonatal thyroxine ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84439 ............ X Assay of free thyroxine ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84442 ............ X Assay of thyroid activity ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84443 ............ X Assay thyroid stim hormone ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84445 ............ X Assay of tsi ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84446 ............ X Assay of vitamin e ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84449 ............ X Assay of transcortin .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84450 ............ X Transferase (AST) (SGOT) .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84460 ............ X Alanine amino (ALT) (SGPT) ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84466 ............ X Assay of transferrin .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84478 ............ X Assay of triglycerides ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84479 ............ X Assay of thyroid (t3 or t4) .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84480 ............ X Assay, triiodothyronine (t3) .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84481 ............ X Free assay (FT-3) ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84482 ............ X T3 reverse ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84484 ............ X Assay of troponin, quant ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84485 ............ X Assay duodenal fluid trypsin ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84488 ............ X Test feces for trypsin ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84490 ............ X Assay of feces for trypsin ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84510 ............ X Assay of tyrosine .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84512 ............ X Assay of troponin, qual ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84520 ............ X Assay of urea nitrogen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84525 ............ X Urea nitrogen semi-quant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84540 ............ X Assay of urine/urea-n ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84545 ............ X Urea-N clearance test .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84550 ............ X Assay of blood/uric acid ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84560 ............ X Assay of urine/uric acid ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84577 ............ X Assay of feces/urobilinogen ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84578 ............ X Test urine urobilinogen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84580 ............ X Assay of urine urobilinogen .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84583 ............ X Assay of urine urobilinogen .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84585 ............ X Assay of urine vma .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84586 ............ X Assay of vip .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84588 ............ X Assay of vasopressin ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84590 ............ X Assay of vitamin a ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84591 ............ X Assay of nos vitamin ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84597 ............ X Assay of vitamin k ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84600 ............ X Assay of volatiles ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84620 ............ X Xylose tolerance test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84630 ............ X Assay of zinc ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84681 ............ X Assay of c-peptide ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84702 ............ X Chorionic gonadotropin test ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84703 ............ X Chorionic gonadotropin assay .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84830 ............ X Ovulation tests ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

84999 ............ X Clinical chemistry test .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85002 ............ X Bleeding time test ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85007 ............ X Differential WBC count ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85008 ............ X Nondifferential WBC count ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85009 ............ X Differential WBC count ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85013 ............ X Hematocrit ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85014 ............ X Hematocrit ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85018 ............ X Hemoglobin .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85021 ............ X Automated hemogram .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85022 ............ X Automated hemogram .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85023 ............ X Automated hemogram .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85024 ............ X Automated hemogram .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85025 ............ X Automated hemogram .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85027 ............ X Automated hemogram .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85031 ............ X Manual hemogram, cbc ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85041 ............ X Red blood cell (RBC) count ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85044 ............ X Reticulocyte count ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85045 ............ X Reticulocyte count ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85046 ............ X Reticyte/hgb concentrate ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65532

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

85048 ............ X White blood cell (WBC) count .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85060 ............ A Blood smear interpretation ................... 0.45 0.19 0.20 0.19 0.20 0.02 0.66 0.67 0.66 0.67 XXX

85095 ............ A Bone marrow aspiration ....................... 1.08 4.47 3.54 0.43 0.51 0.03 5.58 4.65 1.54 1.62 XXX

85097 ............ A Bone marrow interpretation .................. 0.94 1.80 1.48 0.40 0.43 0.03 2.77 2.45 1.37 1.40 XXX

85102 ............ A Bone marrow biopsy ............................ 1.37 4.59 3.66 0.55 0.63 0.04 6.00 5.07 1.96 2.04 XXX

85130 ............ X Chromogenic substrate assay .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85170 ............ X Blood clot retraction ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85175 ............ X Blood clot lysis time ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85210 ............ X Blood clot factor II test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85220 ............ X Blood clot factor V test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85230 ............ X Blood clot factor VII test ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85240 ............ X Blood clot factor VIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85244 ............ X Blood clot factor VIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85245 ............ X Blood clot factor VIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85246 ............ X Blood clot factor VIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85247 ............ X Blood clot factor VIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85250 ............ X Blood clot factor IX test ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85260 ............ X Blood clot factor X test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85270 ............ X Blood clot factor XI test ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85280 ............ X Blood clot factor XII test ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85290 ............ X Blood clot factor XIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85291 ............ X Blood clot factor XIII test ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85292 ............ X Blood clot factor assay ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85293 ............ X Blood clot factor assay ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85300 ............ X Antithrombin III test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85301 ............ X Antithrombin III test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85302 ............ X Blood clot inhibitor antigen ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85303 ............ X Blood clot inhibitor test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85305 ............ X Blood clot inhibitor assay ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85306 ............ X Blood clot inhibitor test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85307 ............ X Assay activated protein c ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85335 ............ X Factor inhibitor test ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85337 ............ X Thrombomodulin ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85345 ............ X Coagulation time .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85347 ............ X Coagulation time .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85348 ............ X Coagulation time .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85360 ............ X Euglobulin lysis ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85362 ............ X Fibrin degradation products ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85366 ............ X Fibrinogen test ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85370 ............ X Fibrinogen test ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85378 ............ X Fibrin degradation ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85379 ............ X Fibrin degradation ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85384 ............ X Fibrinogen ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85385 ............ X Fibrinogen ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85390 ............ X Fibrinolysins screen .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85390 26 A Fibrinolysins screen .............................. 0.37 0.13 0.15 0.13 0.15 0.01 0.51 0.53 0.51 0.53 XXX

85400 ............ X Fibrinolytic plasmin ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85410 ............ X Fibrinolytic antiplasmin ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85415 ............ X Fibrinolytic plasminogen ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85420 ............ X Fibrinolytic plasminogen ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85421 ............ X Fibrinolytic plasminogen ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85441 ............ X Heinz bodies, direct .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85445 ............ X Heinz bodies, induced .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85460 ............ X Hemoglobin, fetal ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85461 ............ X Hemoglobin, fetal ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85475 ............ X Hemolysin ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85520 ............ X Heparin assay ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85525 ............ X Heparin ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85530 ............ X Heparin-protamine tolerance ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85535 ............ X Iron stain, blood cells ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85536 ............ X Iron stain peripheral blood ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85540 ............ X Wbc alkaline phosphatase ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85547 ............ X RBC mechanical fragility ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85549 ............ X Muramidase .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85555 ............ X RBC osmotic fragility ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85557 ............ X RBC osmotic fragility ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85576 ............ X Blood platelet aggregation ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85576 26 A Blood platelet aggregation ................... 0.37 0.16 0.18 0.15 0.17 0.01 0.54 0.56 0.53 0.55 XXX

85585 ............ X Blood platelet estimation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85590 ............ X Platelet count, manual .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85595 ............ X Platelet count, automated .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85597 ............ X Platelet neutralization ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85610 ............ X Prothrombin time .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85611 ............ X Prothrombin test ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85612 ............ X Viper venom prothrombin time ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85613 ............ X Russell viper venom, diluted ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85635 ............ X Reptilase test ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85651 ............ X Rbc sed rate, nonautomated ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85652 ............ X Rbc sed rate, automated ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85660 ............ X RBC sickle cell test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85670 ............ X Thrombin time, plasma ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85675 ............ X Thrombin time, titer .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85705 ............ X Thromboplastin inhibition ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65533

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

85730 ............ X Thromboplastin time, partial ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85732 ............ X Thromboplastin time, partial ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85810 ............ X Blood viscosity examination ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

85999 ............ X Hematology procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86000 ............ X Agglutinins, febrile ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86001 ............ X Allergen specific igg ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86003 ............ X Allergen specific IgE ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86005 ............ X Allergen specific IgE ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86021 ............ X WBC antibody identification ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86022 ............ X Platelet antibodies ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86023 ............ X Immunoglobulin assay .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86038 ............ X Antinuclear antibodies .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86039 ............ X Antinuclear antibodies (ANA) ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86060 ............ X Antistreptolysin o, titer .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86063 ............ X Antistreptolysin o, screen ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86077 ............ A Physician blood bank service ............... 0.94 0.48 0.44 0.40 0.38 0.03 1.45 1.41 1.37 1.35 XXX

86078 ............ A Physician blood bank service ............... 0.94 0.50 0.47 0.40 0.39 0.03 1.47 1.44 1.37 1.36 XXX

86079 ............ A Physician blood bank service ............... 0.94 0.50 0.47 0.41 0.40 0.03 1.47 1.44 1.38 1.37 XXX

86140 ............ X C-reactive protein ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86146 ............ X Glycoprotein antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86147 ............ X Cardiolipin antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86148 ............ X Phospholipid antibody .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86155 ............ X Chemotaxis assay ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86156 ............ X Cold agglutinin, screen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86157 ............ X Cold agglutinin, titer ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86160 ............ X Complement, antigen ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86161 ............ X Complement/function activity ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86162 ............ X Complement, total (CH50) ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86171 ............ X Complement fixation, each ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86185 ............ X Counterimmunoelectrophoresis ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86215 ............ X Deoxyribonuclease, antibody ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86225 ............ X DNA antibody ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86226 ............ X DNA antibody, single strand ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86235 ............ X Nuclear antigen antibody ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86243 ............ X Fc receptor ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86255 ............ X Fluorescent antibody, screen ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86255 26 A Fluorescent antibody, screen ............... 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

86256 ............ X Fluorescent antibody, titer .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86256 26 A Fluorescent antibody, titer .................... 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

86277 ............ X Growth hormone antibody .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86280 ............ X Hemagglutination inhibition .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86294 ............ X Immunoassay, tumor qual .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86300 ............ X Immunoassay, tumor ca 15-3 .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86301 ............ X Immunoassay, tumor, ca 19-9 ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86304 ............ X Immunoassay, tumor ca 125 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86308 ............ X Heterophile antibodies .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86309 ............ X Heterophile antibodies .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86310 ............ X Heterophile antibodies .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86316 ............ X Immunoassay, tumor other .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86317 ............ X Immunoassay,infectious agent ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86318 ............ X Immunoassay,infectious agent ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86320 ............ X Serum immunoelectrophoresis ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86320 26 A Serum immunoelectrophoresis ............. 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

86325 ............ X Other immunoelectrophoresis .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86325 26 A Other immunoelectrophoresis .............. 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

86327 ............ X Immunoelectrophoresis assay .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86327 26 A Immunoelectrophoresis assay .............. 0.42 0.18 0.19 0.18 0.19 0.01 0.61 0.62 0.61 0.62 XXX

86329 ............ X Immunodiffusion ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86331 ............ X Immunodiffusion ouchterlony ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86332 ............ X Immune complex assay ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86334 ............ X Immunofixation procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86334 26 A Immunofixation procedure .................... 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

86337 ............ X Insulin antibodies .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86340 ............ X Intrinsic factor antibody ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86341 ............ X Islet cell antibody .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86343 ............ X Leukocyte histamine release ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86344 ............ X Leukocyte phagocytosis ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86353 ............ X Lymphocyte transformation .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86359 ............ X T cells, total count ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86360 ............ X T cell, absolute count/ratio ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86361 ............ X T cell, absolute count ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86376 ............ X Microsomal antibody ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86378 ............ X Migration inhibitory factor ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86382 ............ X Neutralization test, viral ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86384 ............ X Nitroblue tetrazolium dye ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86403 ............ X Particle agglutination test ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86406 ............ X Particle agglutination test ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86430 ............ X Rheumatoid factor test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86431 ............ X Rheumatoid factor, quant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86485 ............ C Skin test, candida ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86490 ............ A Coccidioidomycosis skin test ............... 0.00 0.29 0.29 NA NA 0.02 0.31 0.31 NA NA XXX

86510 ............ A Histoplasmosis skin test ....................... 0.00 0.32 0.32 NA NA 0.02 0.34 0.34 NA NA XXX

86580 ............ A TB intradermal test ............................... 0.00 0.25 0.25 NA NA 0.02 0.27 0.27 NA NA XXX

65534

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

86585 ............ A TB tine test ........................................... 0.00 0.20 0.20 NA NA 0.01 0.21 0.21 NA NA XXX

86586 ............ C Skin test, unlisted ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86590 ............ X Streptokinase, antibody ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86592 ............ X Blood serology, qualitative ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86593 ............ X Blood serology, quantitative ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86602 ............ X Antinomyces antibody .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86603 ............ X Adenovirus antibody ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86606 ............ X Aspergillus antibody ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86609 ............ X Bacterium antibody ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86611 ............ X Bartonella antibody ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86612 ............ X Blastomyces antibody .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86615 ............ X Bordetella antibody ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86617 ............ X Lyme disease antibody ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86618 ............ X Lyme disease antibody ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86619 ............ X Borrelia antibody .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86622 ............ X Brucella antibody .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86625 ............ X Campylobacter antibody ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86628 ............ X Candida antibody ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86631 ............ X Chlamydia antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86632 ............ X Chlamydia igm antibody ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86635 ............ X Coccidioides antibody .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86638 ............ X Q fever antibody ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86641 ............ X Cryptococcus antibody ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86644 ............ X CMV antibody ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86645 ............ X CMV antibody, IgM ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86648 ............ X Diphtheria antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86651 ............ X Encephalitis antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86652 ............ X Encephalitis antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86653 ............ X Encephalitis antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86654 ............ X Encephalitis antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86658 ............ X Enterovirus antibody ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86663 ............ X Epstein-barr antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86664 ............ X Epstein-barr antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86665 ............ X Epstein-barr antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86666 ............ X Ehrlichia antibody ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86668 ............ X Francisella tularensis ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86671 ............ X Fungus antibody ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86674 ............ X Giardia lamblia antibody ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86677 ............ X Helicobacter pylori ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86682 ............ X Helminth antibody ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86683 ............ X Hemoglobin, fecal antibody .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86684 ............ X Hemophilus influenza ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86687 ............ X Htlv-i antibody ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86688 ............ X Htlv-ii antibody ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86689 ............ X HTLV/HIV confirmatory test ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86692 ............ X Hepatitis, delta agent ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86694 ............ X Herpes simplex test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86695 ............ X Herpes simplex test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86696 ............ X Herpes simplex type 2 ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86698 ............ X Histoplasma .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86701 ............ X HIV-1 .................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86702 ............ X HIV-2 .................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86703 ............ X HIV-1/HIV-2, single assay .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86704 ............ X Hep b core antibody, total .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86705 ............ X Hep b core antibody, igm ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86706 ............ X Hep b surface antibody ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86707 ............ X Hep be antibody ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86708 ............ X Hep a antibody, total ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86709 ............ X Hep a antibody, igm ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86710 ............ X Influenza virus antibody ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86713 ............ X Legionella antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86717 ............ X Leishmania antibody ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86720 ............ X Leptospira antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86723 ............ X Listeria monocytogenes ab .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86727 ............ X Lymph choriomeningitis ab .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86729 ............ X Lympho venereum antibody ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86732 ............ X Mucormycosis antibody ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86735 ............ X Mumps antibody ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86738 ............ X Mycoplasma antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86741 ............ X Neisseria meningitidis .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86744 ............ X Nocardia antibody ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86747 ............ X Parvovirus antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86750 ............ X Malaria antibody ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86753 ............ X Protozoa antibody nos ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86756 ............ X Respiratory virus antibody .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86757 ............ X Rickettsia antibody ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86759 ............ X Rotavirus antibody ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86762 ............ X Rubella antibody ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86765 ............ X Rubeola antibody ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86768 ............ X Salmonella antibody ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86771 ............ X Shigella antibody .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86774 ............ X Tetanus antibody .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86777 ............ X Toxoplasma antibody ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65535

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

86778 ............ X Toxoplasma antibody, igm ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86781 ............ X Treponema pallidum, confirm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86784 ............ X Trichinella antibody .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86787 ............ X Varicella-zoster antibody ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86790 ............ X Virus antibody nos ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86793 ............ X Yersinia antibody .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86800 ............ X Thyroglobulin antibody ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86803 ............ X Hepatitis c ab test ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86804 ............ X Hep c ab test, confirm .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86805 ............ X Lymphocytotoxicity assay ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86806 ............ X Lymphocytotoxicity assay ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86807 ............ X Cytotoxic antibody screening ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86808 ............ X Cytotoxic antibody screening ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86812 ............ X HLA typing, A, B, or C ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86813 ............ X HLA typing, A, B, or C ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86816 ............ X HLA typing, DR/DQ .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86817 ............ X HLA typing, DR/DQ .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86821 ............ X Lymphocyte culture, mixed .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86822 ............ X Lymphocyte culture, primed ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86849 ............ X Immunology procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86850 ............ X RBC antibody screen ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86860 ............ X RBC antibody elution ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86870 ............ X RBC antibody identification .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86880 ............ X Coombs test ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86885 ............ X Coombs test ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86886 ............ X Coombs test ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86890 ............ X Autologous blood process .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86891 ............ X Autologous blood, op salvage .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86900 ............ X Blood typing, ABO ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86901 ............ X Blood typing, Rh (D) ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86903 ............ X Blood typing, antigen screen ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86904 ............ X Blood typing, patient serum ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86905 ............ X Blood typing, RBC antigens ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86906 ............ X Blood typing, Rh phenotype ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86910 ............ N Blood typing, paternity test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86911 ............ N Blood typing, antigen system ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86915 ............ X Bone marrow/stem cell prep ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86920 ............ X Compatibility test .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86921 ............ X Compatibility test .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86922 ............ X Compatibility test .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86927 ............ X Plasma, fresh frozen ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86930 ............ X Frozen blood prep ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86931 ............ X Frozen blood thaw ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86932 ............ X Frozen blood freeze/thaw ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86940 ............ X Hemolysins/agglutinins, auto ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86941 ............ X Hemolysins/agglutinins ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86945 ............ X Blood product/irradiation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86950 ............ X Leukacyte transfusion .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86965 ............ X Pooling blood platelets ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86970 ............ X RBC pretreatment ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86971 ............ X RBC pretreatment ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86972 ............ X RBC pretreatment ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86975 ............ X RBC pretreatment, serum .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86976 ............ X RBC pretreatment, serum .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86977 ............ X RBC pretreatment, serum .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86978 ............ X RBC pretreatment, serum .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86985 ............ X Split blood or products ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

86999 ............ X Transfusion procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87001 ............ X Small animal inoculation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87003 ............ X Small animal inoculation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87015 ............ X Specimen concentration ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87040 ............ X Blood culture for bacteria ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87045 ............ X Stool culture, bacteria .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87046 ............ X Stool cultr, bacteria, each .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87060 ............ D Nose/throat culture, bact ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87070 ............ X Culture, bacteria, other ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87071 ............ X Culture bacteri aerobic othr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87072 ............ D Culture of specimen by kit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87073 ............ X Culture bacteria anaerobic ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87075 ............ X Culture bacteria anaerobic ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87076 ............ X Culture anaerobe ident, each ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87077 ............ X Culture aerobic identify ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87081 ............ X Culture screen only .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87082 ............ D Culture of specimen by kit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87083 ............ D Culture of specimen by kit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87084 ............ X Culture of specimen by kit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87085 ............ D Culture of specimen by kit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87086 ............ X Urine culture/colony count .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87087 ............ D Urine bacteria culture ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87088 ............ X Urine bacteria culture ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87101 ............ X Skin fungi culture .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87102 ............ X Fungus isolation culture ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87103 ............ X Blood fungus culture ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65536

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

87106 ............ X Fungi identification, yeast ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87107 ............ X Fungi identification, mold ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87109 ............ X Mycoplasma ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87110 ............ X Chlamydia culture ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87116 ............ X Mycobacteria culture ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87117 ............ D Mycobacteria culture ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87118 ............ X Mycobacteric identification ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87140 ............ X Cultur type immunofluoresc ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87143 ............ X Culture typing, glc/hplc ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87145 ............ X Culture typing, phage method .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87147 ............ X Culture type, immunologic .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87149 ............ X Culture type, nucleic acid ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87151 ............ D Culture typing, serologic ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87152 ............ X Culture type pulse field gel .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87155 ............ D Culture typing, precipitin ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87158 ............ X Culture typing, added method .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87163 ............ D Special microbiology culture ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87164 ............ X Dark field examination .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87164 26 A Dark field examination .......................... 0.37 0.17 0.18 0.16 0.18 0.01 0.55 0.56 0.54 0.56 XXX

87166 ............ X Dark field examination .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87168 ............ X Macroscopic exam arthropod ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87169 ............ X Macacroscopic exam parasite .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87172 ............ X Pinworm exam ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87174 ............ D Endotoxin, bacterial .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87175 ............ D Assay, endotoxin, bacterial .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87176 ............ X Tissue homogenization, cultr ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87177 ............ X Ova and parasites smears ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87181 ............ X Microbe susceptible, diffuse ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87184 ............ X Microbe susceptible, disk ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87185 ............ X Microbe susceptible, enzyme ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87186 ............ X Microbe susceptible, mic ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87187 ............ X Microbe susceptible, mlc ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87188 ............ X Microbe suscept, macrobroth ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87190 ............ X Microbe suscept, mycobacteri .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87192 ............ D Antibiotic sensitivity, each .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87197 ............ X Bactericidal level, serum ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87205 ............ X Smear, gram stain ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87206 ............ X Smear, fluorescent/acid stai ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87207 ............ X Smear, special stain ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87207 26 A Smear, special stain ............................. 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

87208 ............ X Smear, stain & interpret ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87210 ............ X Smear, wet mount, saline/ink ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87211 ............ D Smear, stain & interpret ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87220 ............ X Tissue exam for fungi ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87230 ............ X Assay, toxin or antitoxin ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87250 ............ X Virus inoculate, eggs/animal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87252 ............ X Virus inoculation, tissue ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87253 ............ X Virus inoculate tissue, addl .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87254 ............ X Virus inoculation, shell via .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87260 ............ X Adenovirus ag, if .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87265 ............ X Pertussis ag, if ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87270 ............ X Chlamydia trachomatis ag, if ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87272 ............ X Cryptosporidum/gardia ag, if ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87273 ............ X Herpes simplex 2, ag, if ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87274 ............ X Herpes simplex 1, ag, if ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87275 ............ X Influenza b, ag, if .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87276 ............ X Influenza a, ag, if .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87277 ............ X Legionella micdadei, ag, if ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87278 ............ X Legion pneumophilia ag, if ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87279 ............ X Parainfluenza, ag, if ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87280 ............ X Respiratory syncytial ag, if ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87281 ............ X Pneumocystis carinii, ag, if .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87283 ............ X Rubeola, ag, if ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87285 ............ X Treponema pallidum, ag, if .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87290 ............ X Varicella zoster, ag, if ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87299 ............ X Antibody detection, nos, if .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87300 ............ X Ag detection, polyval, if ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87301 ............ X Adenovirus ag, eia ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87320 ............ X Chylmd trach ag, eia ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87324 ............ X Clostridium ag, eia ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87327 ............ X Cryptococcus neoform ag, eia ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87328 ............ X Cryptospor ag, eia ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87332 ............ X Cytomegalovirus ag, eia ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87335 ............ X E coli 0157 ag, eia ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87336 ............ X Entamoeb hist dispr, ag, eia ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87337 ............ X Entamoeb hist group, ag, eia ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87338 ............ X Hpylori, stool, eia .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87339 ............ X Hpylori ag, eia ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87340 ............ X Hepatitis b surface ag, eia ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87341 ............ X Hepatitis b surface, ag, eia .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87350 ............ X Hepatitis be ag, eia .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87380 ............ X Hepatitis delta ag, eia .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87385 ............ X Histoplasma capsul ag, eia .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65537

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

87390 ............ X Hiv-1 ag, eia ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87391 ............ X Hiv-2 ag, eia ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87400 ............ X Influenza a/b, ag, eia ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87420 ............ X Resp syncytial ag, eia .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87425 ............ X Rotavirus ag, eia .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87427 ............ X Shiga-like toxin ag, eia ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87430 ............ X Strep a ag, eia ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87449 ............ X Ag detect nos, eia, mult ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87450 ............ X Ag detect nos, eia, single ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87451 ............ X Ag detect polyval, eia, mult .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87470 ............ X Bartonella, dna, dir probe ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87471 ............ X Bartonella, dna, amp probe .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87472 ............ X Bartonella, dna, quant .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87475 ............ X Lyme dis, dna, dir probe ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87476 ............ X Lyme dis, dna, amp probe ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87477 ............ X Lyme dis, dna, quant ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87480 ............ X Candida, dna, dir probe ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87481 ............ X Candida, dna, amp probe .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87482 ............ X Candida, dna, quant ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87485 ............ X Chylmd pneum, dna, dir probe ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87486 ............ X Chylmd pneum, dna, amp probe ......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87487 ............ X Chylmd pneum, dna, quant .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87490 ............ X Chylmd trach, dna, dir probe ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87491 ............ X Chylmd trach, dna, amp probe ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87492 ............ X Chylmd trach, dna, quant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87495 ............ X Cytomeg, dna, dir probe ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87496 ............ X Cytomeg, dna, amp probe ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87497 ............ X Cytomeg, dna, quant ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87510 ............ X Gardner vag, dna, dir probe ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87511 ............ X Gardner vag, dna, amp probe .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87512 ............ X Gardner vag, dna, quant ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87515 ............ X Hepatitis b, dna, dir probe .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87516 ............ X Hepatitis b , dna, amp probe ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87517 ............ X Hepatitis b , dna, quant ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87520 ............ X Hepatitis c , rna, dir probe ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87521 ............ X Hepatitis c , rna, amp probe ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87522 ............ X Hepatitis c, rna, quant .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87525 ............ X Hepatitis g , dna, dir probe .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87526 ............ X Hepatitis g, dna, amp probe ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87527 ............ X Hepatitis g, dna, quant ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87528 ............ X Hsv, dna, dir probe ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87529 ............ X Hsv, dna, amp probe ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87530 ............ X Hsv, dna, quant .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87531 ............ X Hhv-6, dna, dir probe ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87532 ............ X Hhv-6, dna, amp probe ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87533 ............ X Hhv-6, dna, quant ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87534 ............ X Hiv-1, dna, dir probe ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87535 ............ X Hiv-1, dna, amp probe ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87536 ............ X Hiv-1, dna, quant .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87537 ............ X Hiv-2, dna, dir probe ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87538 ............ X Hiv-2, dna, amp probe ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87539 ............ X Hiv-2, dna, quant .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87540 ............ X Legion pneumo, dna, dir prob .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87541 ............ X Legion pneumo, dna, amp prob ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87542 ............ X Legion pneumo, dna, quant ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87550 ............ X Mycobacteria, dna, dir probe ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87551 ............ X Mycobacteria, dna, amp probe ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87552 ............ X Mycobacteria, dna, quant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87555 ............ X M.tuberculo, dna, dir probe .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87556 ............ X M.tuberculo, dna, amp probe ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87557 ............ X M.tuberculo, dna, quant ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87560 ............ X M.avium-intra, dna, dir prob ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87561 ............ X M.avium-intra, dna, amp prob .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87562 ............ X M.avium-intra, dna, quant .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87580 ............ X M.pneumon, dna, dir probe .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87581 ............ X M.pneumon, dna, amp probe ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87582 ............ X M.pneumon, dna, quant ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87590 ............ X N.gonorrhoeae, dna, dir prob ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87591 ............ X N.gonorrhoeae, dna, amp prob ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87592 ............ X N.gonorrhoeae, dna, quant .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87620 ............ X Hpv, dna, dir probe .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87621 ............ X Hpv, dna, amp probe ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87622 ............ X Hpv, dna, quant .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87650 ............ X Strep a, dna, dir probe ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87651 ............ X Strep a, dna, amp probe ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87652 ............ X Strep a, dna, quant .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87797 ............ X Detect agent nos, dna, dir .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87798 ............ X Detect agent nos, dna, amp ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87799 ............ X Detect agent nos, dna, quant ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87800 ............ X Detect agnt mult, dna, direc ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87801 ............ X Detect agnt mult, dna, ampli ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87810 ............ X Chylmd trach assay w/optic ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87850 ............ X N. gonorrhoeae assay w/optic ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65538

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

87880 ............ X Strep a assay w/optic ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87899 ............ X Agent nos assay w/optic ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87901 ............ X Genotype, dna, hiv reverse t ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87903 ............ X Phenotype, dna hiv w/culture ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87904 ............ X Phenotype, dna hiv w/clt add ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

87999 ............ X Microbiology procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88000 ............ N Autopsy (necropsy), gross ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88005 ............ N Autopsy (necropsy), gross ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88007 ............ N Autopsy (necropsy), gross ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88012 ............ N Autopsy (necropsy), gross ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88014 ............ N Autopsy (necropsy), gross ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88016 ............ N Autopsy (necropsy), gross ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88020 ............ N Autopsy (necropsy), complete .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88025 ............ N Autopsy (necropsy), complete .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88027 ............ N Autopsy (necropsy), complete .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88028 ............ N Autopsy (necropsy), complete .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88029 ............ N Autopsy (necropsy), complete .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88036 ............ N Limited autopsy .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88037 ............ N Limited autopsy .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88040 ............ N Forensic autopsy (necropsy) ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88045 ............ N Coroner’s autopsy (necropsy) .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88099 ............ N Necropsy (autopsy) procedure ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88104 ............ A Cytopathology, fluids ............................ 0.56 0.79 0.71 0.79 0.71 0.04 1.39 1.31 1.39 1.31 XXX

88104 26 A Cytopathology, fluids ............................ 0.56 0.24 0.24 0.24 0.24 0.02 0.82 0.82 0.82 0.82 XXX

88104 TC A Cytopathology, fluids ............................ 0.00 0.55 0.47 NA NA 0.02 0.57 0.49 NA NA XXX

88106 ............ A Cytopathology, fluids ............................ 0.56 0.54 0.51 0.54 0.51 0.04 1.14 1.11 1.14 1.11 XXX

88106 26 A Cytopathology, fluids ............................ 0.56 0.24 0.24 0.24 0.24 0.02 0.82 0.82 0.82 0.82 XXX

88106 TC A Cytopathology, fluids ............................ 0.00 0.30 0.27 NA NA 0.02 0.32 0.29 NA NA XXX

88107 ............ A Cytopathology, fluids ............................ 0.76 0.87 0.78 0.87 0.78 0.05 1.68 1.59 1.68 1.59 XXX

88107 26 A Cytopathology, fluids ............................ 0.76 0.33 0.31 0.33 0.31 0.03 1.12 1.10 1.12 1.10 XXX

88107 TC A Cytopathology, fluids ............................ 0.00 0.54 0.47 NA NA 0.02 0.56 0.49 NA NA XXX

88108 ............ A Cytopath, concentrate tech .................. 0.56 0.70 0.66 0.70 0.66 0.04 1.30 1.26 1.30 1.26 XXX

88108 26 A Cytopath, concentrate tech .................. 0.56 0.24 0.25 0.24 0.25 0.02 0.82 0.83 0.82 0.83 XXX

88108 TC A Cytopath, concentrate tech .................. 0.00 0.46 0.41 NA NA 0.02 0.48 0.43 NA NA XXX

88125 ............ A Forensic cytopathology ........................ 0.26 0.32 0.27 0.32 0.27 0.02 0.60 0.55 0.60 0.55 XXX

88125 26 A Forensic cytopathology ........................ 0.26 0.11 0.10 0.11 0.10 0.01 0.38 0.37 0.38 0.37 XXX

88125 TC A Forensic cytopathology ........................ 0.00 0.21 0.17 NA NA 0.01 0.22 0.18 NA NA XXX

88130 ............ X Sex chromatin identification ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88140 ............ X Sex chromatin identification ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88141 ............ A Cytopath, c/v, interpret ......................... 0.42 0.18 0.22 0.18 0.22 0.01 0.61 0.65 0.61 0.65 XXX

88142 ............ X Cytopath, c/v, thin layer ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88143 ............ X Cytopath c/v thin layer redo ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88144 ............ X Cytopath, c/v thin lyr redo .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88145 ............ X Cytopath, c/v thin lyr sel ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88147 ............ X Cytopath, c/v, automated ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88148 ............ X Cytopath, c/v, auto rescreen ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88150 ............ X Cytopath, c/v, manual .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88152 ............ X Cytopath, c/v, auto redo ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88153 ............ X Cytopath, c/v, redo ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88154 ............ X Cytopath, c/v, select ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88155 ............ X Cytopath, c/v, index add-on ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88160 ............ A Cytopath smear, other source .............. 0.50 0.98 0.82 0.98 0.82 0.04 1.52 1.36 1.52 1.36 XXX

88160 26 A Cytopath smear, other source .............. 0.50 0.22 0.21 0.22 0.21 0.02 0.74 0.73 0.74 0.73 XXX

88160 TC A Cytopath smear, other source .............. 0.00 0.76 0.61 NA NA 0.02 0.78 0.63 NA NA XXX

88161 ............ A Cytopath smear, other source .............. 0.50 0.97 0.83 0.97 0.83 0.04 1.51 1.37 1.51 1.37 XXX

88161 26 A Cytopath smear, other source .............. 0.50 0.21 0.21 0.21 0.21 0.02 0.73 0.73 0.73 0.73 XXX

88161 TC A Cytopath smear, other source .............. 0.00 0.76 0.62 NA NA 0.02 0.78 0.64 NA NA XXX

88162 ............ A Cytopath smear, other source .............. 0.76 0.84 0.85 0.84 0.85 0.05 1.65 1.66 1.65 1.66 XXX

88162 26 A Cytopath smear, other source .............. 0.76 0.33 0.36 0.33 0.36 0.03 1.12 1.15 1.12 1.15 XXX

88162 TC A Cytopath smear, other source .............. 0.00 0.51 0.49 NA NA 0.02 0.53 0.51 NA NA XXX

88164 ............ X Cytopath tbs, c/v, manual .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88165 ............ X Cytopath tbs, c/v, redo ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88166 ............ X Cytopath tbs, c/v, auto redo ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88167 ............ X Cytopath tbs, c/v, select ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88170 ............ A Fine needle aspiration .......................... 1.27 0.86 0.92 0.86 0.92 0.10 2.23 2.29 2.23 2.29 XXX

88170 26 A Fine needle aspiration .......................... 1.27 0.53 0.54 0.53 0.54 0.07 1.87 1.88 1.87 1.88 XXX

88170 TC A Fine needle aspiration .......................... 0.00 0.33 0.38 NA NA 0.03 0.36 0.41 NA NA XXX

88171 ............ A Fine needle aspiration .......................... 1.27 0.72 0.91 0.72 0.91 0.08 2.07 2.26 2.07 2.26 XXX

88171 26 A Fine needle aspiration .......................... 1.27 0.49 0.56 0.49 0.56 0.05 1.81 1.88 1.81 1.88 XXX

88171 TC A Fine needle aspiration .......................... 0.00 0.23 0.35 NA NA 0.03 0.26 0.38 NA NA XXX

88172 ............ A Cytopathology eval of fna .................... 0.60 1.09 1.01 1.09 1.01 0.04 1.73 1.65 1.73 1.65 XXX

88172 26 A Cytopathology eval of fna .................... 0.60 0.26 0.29 0.26 0.29 0.02 0.88 0.91 0.88 0.91 XXX

88172 TC A Cytopathology eval of fna .................... 0.00 0.83 0.72 NA NA 0.02 0.85 0.74 NA NA XXX

88173 ............ A Cytopath eval, fna, report ..................... 1.39 1.31 1.22 1.31 1.22 0.07 2.77 2.68 2.77 2.68 XXX

88173 26 A Cytopath eval, fna, report ..................... 1.39 0.60 0.57 0.60 0.57 0.05 2.04 2.01 2.04 2.01 XXX

88173 TC A Cytopath eval, fna, report ..................... 0.00 0.71 0.65 NA NA 0.02 0.73 0.67 NA NA XXX

88180 ............ A Cell marker study ................................. 0.36 0.65 0.58 0.65 0.58 0.03 1.04 0.97 1.04 0.97 XXX

88180 26 A Cell marker study ................................. 0.36 0.15 0.16 0.15 0.16 0.01 0.52 0.53 0.52 0.53 XXX

88180 TC A Cell marker study ................................. 0.00 0.50 0.42 NA NA 0.02 0.52 0.44 NA NA XXX

88182 ............ A Cell marker study ................................. 0.77 1.69 1.51 1.69 1.51 0.06 2.52 2.34 2.52 2.34 XXX

88182 26 A Cell marker study ................................. 0.77 0.33 0.37 0.33 0.37 0.03 1.13 1.17 1.13 1.17 XXX

88182 TC A Cell marker study ................................. 0.00 1.36 1.14 NA NA 0.03 1.39 1.17 NA NA XXX

88199 ............ C Cytopathology procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65539

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

88199 26 C Cytopathology procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88199 TC C Cytopathology procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88230 ............ X Tissue culture, lymphocyte ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88233 ............ X Tissue culture, skin/biopsy ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88235 ............ X Tissue culture, placenta ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88237 ............ X Tissue culture, bone marrow ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88239 ............ X Tissue culture, tumor ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88240 ............ X Cell cryopreserve/storage .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88241 ............ X Frozen cell preparation ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88245 ............ X Chromosome analysis, 20-25 .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88248 ............ X Chromosome analysis, 50-100 ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88249 ............ X Chromosome analysis, 100 .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88261 ............ X Chromosome analysis, 5 ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88262 ............ X Chromosome analysis, 15-20 .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88263 ............ X Chromosome analysis, 45 .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88264 ............ X Chromosome analysis, 20-25 .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88267 ............ X Chromosome analys, placenta ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88269 ............ X Chromosome analys, amniotic ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88271 ............ X Cytogenetics, dna probe ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88272 ............ X Cytogenetics, 3-5 ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88273 ............ X Cytogenetics, 10-30 ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88274 ............ X Cytogenetics, 25-99 ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88275 ............ X Cytogenetics, 100-300 ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88280 ............ X Chromosome karyotype study ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88283 ............ X Chromosome banding study ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88285 ............ X Chromosome count, additional ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88289 ............ X Chromosome study, additional ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88291 ............ A Cyto/molecular report ........................... 0.52 0.22 0.22 0.22 0.22 0.02 0.76 0.76 0.76 0.76 XXX

88299 ............ C Cytogenetic study ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88300 ............ A Surgical path, gross ............................. 0.08 0.42 0.37 0.42 0.37 0.02 0.52 0.47 0.52 0.47 XXX

88300 26 A Surgical path, gross ............................. 0.08 0.03 0.05 0.03 0.05 0.01 0.12 0.14 0.12 0.14 XXX

88300 TC A Surgical path, gross ............................. 0.00 0.39 0.32 NA NA 0.01 0.40 0.33 NA NA XXX

88302 ............ A Tissue exam by pathologist ................. 0.13 1.11 0.94 1.11 0.94 0.03 1.27 1.10 1.27 1.10 XXX

88302 26 A Tissue exam by pathologist ................. 0.13 0.06 0.09 0.06 0.09 0.01 0.20 0.23 0.20 0.23 XXX

88302 TC A Tissue exam by pathologist ................. 0.00 1.05 0.85 NA NA 0.02 1.07 0.87 NA NA XXX

88304 ............ A Tissue exam by pathologist ................. 0.22 0.89 0.82 0.89 0.82 0.03 1.14 1.07 1.14 1.07 XXX

88304 26 A Tissue exam by pathologist ................. 0.22 0.10 0.14 0.10 0.14 0.01 0.33 0.37 0.33 0.37 XXX

88304 TC A Tissue exam by pathologist ................. 0.00 0.79 0.68 NA NA 0.02 0.81 0.70 NA NA XXX

88305 ............ A Tissue exam by pathologist ................. 0.75 1.64 1.51 1.64 1.51 0.05 2.44 2.31 2.44 2.31 XXX

88305 26 A Tissue exam by pathologist ................. 0.75 0.33 0.39 0.33 0.39 0.02 1.10 1.16 1.10 1.16 XXX

88305 TC A Tissue exam by pathologist ................. 0.00 1.31 1.12 NA NA 0.03 1.34 1.15 NA NA XXX

88307 ............ A Tissue exam by pathologist ................. 1.59 2.45 2.25 2.45 2.25 0.11 4.15 3.95 4.15 3.95 XXX

88307 26 A Tissue exam by pathologist ................. 1.59 0.69 0.73 0.69 0.73 0.06 2.34 2.38 2.34 2.38 XXX

88307 TC A Tissue exam by pathologist ................. 0.00 1.76 1.52 NA NA 0.05 1.81 1.57 NA NA XXX

88309 ............ A Tissue exam by pathologist ................. 2.28 3.46 3.12 3.46 3.12 0.13 5.87 5.53 5.87 5.53 XXX

88309 26 A Tissue exam by pathologist ................. 2.28 0.99 1.01 0.99 1.01 0.08 3.35 3.37 3.35 3.37 XXX

88309 TC A Tissue exam by pathologist ................. 0.00 2.47 2.11 NA NA 0.05 2.52 2.16 NA NA XXX

88311 ............ A Decalcify tissue .................................... 0.24 0.18 0.20 0.18 0.20 0.02 0.44 0.46 0.44 0.46 XXX

88311 26 A Decalcify tissue .................................... 0.24 0.10 0.11 0.10 0.11 0.01 0.35 0.36 0.35 0.36 XXX

88311 TC A Decalcify tissue .................................... 0.00 0.08 0.09 NA NA 0.01 0.09 0.10 NA NA XXX

88312 ............ A Special stains ....................................... 0.54 1.59 1.26 1.59 1.26 0.03 2.16 1.83 2.16 1.83 XXX

88312 26 A Special stains ....................................... 0.54 0.23 0.21 0.23 0.21 0.02 0.79 0.77 0.79 0.77 XXX

88312 TC A Special stains ....................................... 0.00 1.36 1.05 NA NA 0.01 1.37 1.06 NA NA XXX

88313 ............ A Special stains ....................................... 0.24 1.10 0.89 1.10 0.89 0.02 1.36 1.15 1.36 1.15 XXX

88313 26 A Special stains ....................................... 0.24 0.10 0.11 0.10 0.11 0.01 0.35 0.36 0.35 0.36 XXX

88313 TC A Special stains ....................................... 0.00 1.00 0.78 NA NA 0.01 1.01 0.79 NA NA XXX

88314 ............ A Histochemical stain .............................. 0.45 1.04 0.95 1.04 0.95 0.04 1.53 1.44 1.53 1.44 XXX

88314 26 A Histochemical stain .............................. 0.45 0.19 0.24 0.19 0.24 0.02 0.66 0.71 0.66 0.71 XXX

88314 TC A Histochemical stain .............................. 0.00 0.85 0.71 NA NA 0.02 0.87 0.73 NA NA XXX

88318 ............ A Chemical histochemistry ...................... 0.42 1.72 1.36 1.72 1.36 0.02 2.16 1.80 2.16 1.80 XXX

88318 26 A Chemical histochemistry ...................... 0.42 0.18 0.17 0.18 0.17 0.01 0.61 0.60 0.61 0.60 XXX

88318 TC A Chemical histochemistry ...................... 0.00 1.54 1.19 NA NA 0.01 1.55 1.20 NA NA XXX

88319 ............ A Enzyme histochemistry ........................ 0.53 1.68 1.39 1.68 1.39 0.04 2.25 1.96 2.25 1.96 XXX

88319 26 A Enzyme histochemistry ........................ 0.53 0.23 0.24 0.23 0.24 0.02 0.78 0.79 0.78 0.79 XXX

88319 TC A Enzyme histochemistry ........................ 0.00 1.45 1.15 NA NA 0.02 1.47 1.17 NA NA XXX

88321 ............ A Microslide consultation ......................... 1.30 0.61 0.57 0.56 0.53 0.04 1.95 1.91 1.90 1.87 XXX

88323 ............ A Microslide consultation ......................... 1.35 2.19 1.84 2.19 1.84 0.07 3.61 3.26 3.61 3.26 XXX

88323 26 A Microslide consultation ......................... 1.35 0.59 0.55 0.59 0.55 0.05 1.99 1.95 1.99 1.95 XXX

88323 TC A Microslide consultation ......................... 0.00 1.60 1.29 NA NA 0.02 1.62 1.31 NA NA XXX

88325 ............ A Comprehensive review of data ............ 2.22 0.94 0.83 0.94 0.83 0.08 3.24 3.13 3.24 3.13 XXX

88329 ............ A Path consult introp ............................... 0.67 0.39 0.39 0.29 0.32 0.02 1.08 1.08 0.98 1.01 XXX

88331 ............ A Path consult intraop, 1 bloc ................. 1.19 0.81 0.91 0.81 0.91 0.07 2.07 2.17 2.07 2.17 XXX

88331 26 A Path consult intraop, 1 bloc ................. 1.19 0.52 0.54 0.52 0.54 0.04 1.75 1.77 1.75 1.77 XXX

88331 TC A Path consult intraop, 1 bloc ................. 0.00 0.29 0.37 NA NA 0.03 0.32 0.40 NA NA XXX

88332 ............ A Path consult intraop, addl .................... 0.59 0.44 0.48 0.44 0.48 0.04 1.07 1.11 1.07 1.11 XXX

88332 26 A Path consult intraop, addl .................... 0.59 0.26 0.27 0.26 0.27 0.02 0.87 0.88 0.87 0.88 XXX

88332 TC A Path consult intraop, addl .................... 0.00 0.18 0.21 NA NA 0.02 0.20 0.23 NA NA XXX

88342 ............ A Immunocytochemistry ........................... 0.85 1.31 1.16 1.31 1.16 0.05 2.21 2.06 2.21 2.06 XXX

88342 26 A Immunocytochemistry ........................... 0.85 0.37 0.37 0.37 0.37 0.03 1.25 1.25 1.25 1.25 XXX

88342 TC A Immunocytochemistry ........................... 0.00 0.94 0.79 NA NA 0.02 0.96 0.81 NA NA XXX

88346 ............ A Immunofluorescent study ..................... 0.86 1.31 1.14 1.31 1.14 0.05 2.22 2.05 2.22 2.05 XXX

88346 26 A Immunofluorescent study ..................... 0.86 0.37 0.36 0.37 0.36 0.03 1.26 1.25 1.26 1.25 XXX

88346 TC A Immunofluorescent study ..................... 0.00 0.94 0.78 NA NA 0.02 0.96 0.80 NA NA XXX

65540

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

88347 ............ A Immunofluorescent study ..................... 0.86 1.82 1.48 1.82 1.48 0.05 2.73 2.39 2.73 2.39 XXX

88347 26 A Immunofluorescent study ..................... 0.86 0.37 0.32 0.37 0.32 0.03 1.26 1.21 1.26 1.21 XXX

88347 TC A Immunofluorescent study ..................... 0.00 1.45 1.16 NA NA 0.02 1.47 1.18 NA NA XXX

88348 ............ A Electron microscopy ............................. 1.51 6.22 5.28 6.22 5.28 0.11 7.84 6.90 7.84 6.90 XXX

88348 26 A Electron microscopy ............................. 1.51 0.65 0.81 0.65 0.81 0.05 2.21 2.37 2.21 2.37 XXX

88348 TC A Electron microscopy ............................. 0.00 5.57 4.47 NA NA 0.06 5.63 4.53 NA NA XXX

88349 ............ A Scanning electron microscopy ............. 0.76 7.77 6.25 7.77 6.25 0.08 8.61 7.09 8.61 7.09 XXX

88349 26 A Scanning electron microscopy ............. 0.76 0.33 0.46 0.33 0.46 0.03 1.12 1.25 1.12 1.25 XXX

88349 TC A Scanning electron microscopy ............. 0.00 7.44 5.79 NA NA 0.05 7.49 5.84 NA NA XXX

88355 ............ A Analysis, skeletal muscle ..................... 1.85 3.92 3.41 3.92 3.41 0.12 5.89 5.38 5.89 5.38 XXX

88355 26 A Analysis, skeletal muscle ..................... 1.85 0.80 0.85 0.80 0.85 0.07 2.72 2.77 2.72 2.77 XXX

88355 TC A Analysis, skeletal muscle ..................... 0.00 3.12 2.56 NA NA 0.05 3.17 2.61 NA NA XXX

88356 ............ A Analysis, nerve ..................................... 3.02 4.42 4.04 4.42 4.04 0.16 7.60 7.22 7.60 7.22 XXX

88356 26 A Analysis, nerve ..................................... 3.02 1.30 1.35 1.30 1.35 0.10 4.42 4.47 4.42 4.47 XXX

88356 TC A Analysis, nerve ..................................... 0.00 3.12 2.69 NA NA 0.06 3.18 2.75 NA NA XXX

88358 ............ A Analysis, tumor ..................................... 2.82 1.67 1.88 1.67 1.88 0.16 4.65 4.86 4.65 4.86 XXX

88358 26 A Analysis, tumor ..................................... 2.82 1.22 1.23 1.22 1.23 0.10 4.14 4.15 4.14 4.15 XXX

88358 TC A Analysis, tumor ..................................... 0.00 0.45 0.65 NA NA 0.06 0.51 0.71 NA NA XXX

88362 ............ A Nerve teasing preparations .................. 2.17 2.71 2.57 2.71 2.57 0.12 5.00 4.86 5.00 4.86 XXX

88362 26 A Nerve teasing preparations .................. 2.17 0.93 0.97 0.93 0.97 0.07 3.17 3.21 3.17 3.21 XXX

88362 TC A Nerve teasing preparations .................. 0.00 1.78 1.60 NA NA 0.05 1.83 1.65 NA NA XXX

88365 ............ A Tissue hybridization .............................. 0.93 1.60 1.41 1.60 1.41 0.05 2.58 2.39 2.58 2.39 XXX

88365 26 A Tissue hybridization .............................. 0.93 0.39 0.40 0.39 0.40 0.03 1.35 1.36 1.35 1.36 XXX

88365 TC A Tissue hybridization .............................. 0.00 1.21 1.01 NA NA 0.02 1.23 1.03 NA NA XXX

88371 ............ X Protein, western blot tissue .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88371 26 A Protein, western blot tissue .................. 0.37 0.14 0.16 0.14 0.16 0.01 0.52 0.54 0.52 0.54 XXX

88372 ............ X Protein analysis w/probe ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88372 26 A Protein analysis w/probe ...................... 0.37 0.15 0.17 0.15 0.17 0.01 0.53 0.55 0.53 0.55 XXX

88399 ............ C Surgical pathology procedure .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88399 26 C Surgical pathology procedure .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88399 TC C Surgical pathology procedure .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

88400 ............ X Bilirubin total transcut ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89050 ............ X Body fluid cell count ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89051 ............ X Body fluid cell count ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89060 ............ X Exam,synovial fluid crystals ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89060 26 A Exam,synovial fluid crystals ................. 0.37 0.17 0.18 0.16 0.18 0.01 0.55 0.56 0.54 0.56 XXX

89100 ............ A Sample intestinal contents ................... 0.60 1.88 1.53 0.22 0.28 0.02 2.50 2.15 0.84 0.90 XXX

89105 ............ A Sample intestinal contents ................... 0.50 2.16 1.73 0.18 0.24 0.02 2.68 2.25 0.70 0.76 XXX

89125 ............ X Specimen fat stain ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89130 ............ A Sample stomach contents .................... 0.45 1.72 1.40 0.12 0.20 0.02 2.19 1.87 0.59 0.67 XXX

89132 ............ A Sample stomach contents .................... 0.19 1.79 1.40 0.08 0.11 0.01 1.99 1.60 0.28 0.31 XXX

89135 ............ A Sample stomach contents .................... 0.79 1.83 1.53 0.28 0.37 0.03 2.65 2.35 1.10 1.19 XXX

89136 ............ A Sample stomach contents .................... 0.21 1.38 1.10 0.08 0.12 0.01 1.60 1.32 0.30 0.34 XXX

89140 ............ A Sample stomach contents .................... 0.94 2.20 1.87 0.27 0.42 0.03 3.17 2.84 1.24 1.39 XXX

89141 ............ A Sample stomach contents .................... 0.85 2.67 2.20 0.34 0.45 0.03 3.55 3.08 1.22 1.33 XXX

89160 ............ X Exam feces for meat fibers .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89190 ............ X Nasal smear for eosinophils ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89250 ............ X Fertilization of oocyte ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89251 ............ X Culture oocyte w/embryos .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89252 ............ X Assist oocyte fertilization ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89253 ............ X Embryo hatching .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89254 ............ X Oocyte identification ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89255 ............ X Prepare embryo for transfer ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89256 ............ X Prepare cryopreserved embryo ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89257 ............ X Sperm identification .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89258 ............ X Cryopreservation, embryo .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89259 ............ X Cryopreservation, sperm ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89260 ............ X Sperm isolation, simple ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89261 ............ X Sperm isolation, complex ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89264 ............ X Identify sperm tissue ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89300 ............ X Semen analysis .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89310 ............ X Semen analysis .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89320 ............ X Semen analysis .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89321 ............ X Semen analysis .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89325 ............ X Sperm antibody test ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89329 ............ X Sperm evaluation test .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89330 ............ X Evaluation, cervical mucus ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89350 ............ A Sputum specimen collection ................ 0.00 0.40 0.41 NA NA 0.02 0.42 0.43 NA NA XXX

89355 ............ X Exam feces for starch .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89360 ............ A Collect sweat for test ............................ 0.00 0.45 0.46 NA NA 0.02 0.47 0.48 NA NA XXX

89365 ............ X Water load test ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89399 ............ C Pathology lab procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89399 26 C Pathology lab procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

89399 TC C Pathology lab procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90281 ............ I Human ig, im ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90283 ............ I Human ig, iv ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90287 ............ I Botulinum antitoxin ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90288 ............ I Botulism ig, iv ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90291 ............ I Cmv ig, iv ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90296 ............ E Diphtheria antitoxin ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90371 ............ E Hep b ig, im .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90375 ............ E Rabies ig, im/sc .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90376 ............ E Rabies ig, heat treated ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65541

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

90378 ............ X Rsv ig, im, 50mg .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90379 ............ E Rsv ig, iv ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90384 ............ I Rh ig, full-dose, im ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90385 ............ E Rh ig, minidose, im .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90386 ............ I Rh ig, iv ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90389 ............ E Tetanus ig, im ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90393 ............ E Vaccina ig, im ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90396 ............ E Varicella-zoster ig, im ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90399 ............ I Immune globulin ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90471 ............ N Immunization admin ............................. 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 XXX

90472 ............ N Immunization admin, each add ............ 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 XXX

90476 ............ E Adenovirus vaccine, type 4 .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90477 ............ E Adenovirus vaccine, type 7 .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90581 ............ E Anthrax vaccine, sc .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90585 ............ E Bcg vaccine, percut .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90586 ............ E Bcg vaccine, intravesical ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90632 ............ E Hep a vaccine, adult im ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90633 ............ E Hep a vacc, ped/adol, 2 dose .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90634 ............ E Hep a vacc, ped/adol, 3 dose .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90636 ............ E Hep a/hep b vacc, adult im .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90645 ............ E Hib vaccine, hboc, im ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90646 ............ E Hib vaccine, prp-d, im .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90647 ............ E Hib vaccine, prp-omp, im ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90648 ............ E Hib vaccine, prp-t, im ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90657 ............ X Flu vaccine, 6-35 mo, im ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90658 ............ X Flu vaccine, 3 yrs, im ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90659 ............ X Flu vaccine, whole, im .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90660 ............ X Flu vaccine, nasal ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90665 ............ E Lyme disease vaccine, im .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90669 ............ N Pneumococcal vacc, ped<5 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90675 ............ E Rabies vaccine, im ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90676 ............ E Rabies vaccine, id ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90680 ............ E Rotovirus vaccine, oral ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90690 ............ E Typhoid vaccine, oral ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90691 ............ E Typhoid vaccine, im ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90692 ............ E Typhoid vaccine, h-p, sc/id .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90693 ............ E Typhoid vaccine, akd, sc ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90700 ............ E Dtap vaccine, im ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90701 ............ E Dtp vaccine, im ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90702 ............ E Dt vaccine < 7, im ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90703 ............ E Tetanus vaccine, im ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90704 ............ E Mumps vaccine, sc ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90705 ............ E Measles vaccine, sc ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90706 ............ E Rubella vaccine, sc .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90707 ............ E Mmr vaccine, sc ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90708 ............ E Measles-rubella vaccine, sc ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90709 ............ E Rubella & mumps vaccine, sc .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90710 ............ E Mmrv vaccine, sc ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90712 ............ E Oral poliovirus vaccine ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90713 ............ E Poliovirus, ipv, sc ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90716 ............ E Chicken pox vaccine, sc ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90717 ............ E Yellow fever vaccine, sc ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90718 ............ E Td vaccine > 7, im ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90719 ............ E Diphtheria vaccine, im .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90720 ............ E Dtp/hib vaccine, im ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90721 ............ E Dtap/hib vaccine, im ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90723 ............ X Dtap-hep b-ipv vaccine, im .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90725 ............ E Cholera vaccine, injectable .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90727 ............ E Plague vaccine, im ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90732 ............ X Pneumococcal vacc, adult/ill ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90733 ............ E Meningococcal vaccine, sc .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90735 ............ E Encephalitis vaccine, sc ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90740 ............ X Hepb vacc, ill pat 3 dose im ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90743 ............ X Hep b vacc, adol, 2 dose, im ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90744 ............ X Hepb vacc ped/adol 3 dose im ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90746 ............ X Hep b vaccine, adult, im ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90747 ............ X Hepb vacc, ill pat 4 dose im ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90748 ............ E Hep b/hib vaccine, im ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90749 ............ E Vaccine toxoid ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90780 ............ A IV infusion therapy, 1 hour ................... 0.00 1.10 1.11 1.10 1.11 0.06 1.16 1.17 1.16 1.17 XXX

90781 ............ A IV infusion, additional hour ................... 0.00 0.56 0.57 0.56 0.57 0.03 0.59 0.60 0.59 0.60 ZZZ

90782 ............ T Injection, sc/im ...................................... 0.00 0.11 0.11 0.11 0.11 0.01 0.12 0.12 0.12 0.12 XXX

90783 ............ T Injection, ia ........................................... 0.00 0.40 0.41 0.40 0.41 0.02 0.42 0.43 0.42 0.43 XXX

90784 ............ T Injection, iv ........................................... 0.00 0.47 0.48 0.47 0.48 0.03 0.50 0.51 0.50 0.51 XXX

90788 ............ T Injection of antibiotic ............................. 0.00 0.12 0.12 0.12 0.12 0.01 0.13 0.13 0.13 0.13 XXX

90799 ............ C Ther/prophylactic/dx inject .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90801 ............ A Psy dx interview ................................... 2.80 1.16 1.05 0.93 0.88 0.06 4.02 3.91 3.79 3.74 XXX

90802 ............ A Intac psy dx interview ........................... 3.01 1.17 0.98 0.99 0.85 0.07 4.25 4.06 4.07 3.93 XXX

90804 ............ A Psytx, office, 20-30 min ........................ 1.21 0.54 0.50 0.40 0.40 0.03 1.78 1.74 1.64 1.64 XXX

90805 ............ A Psytx, off, 20-30 min w/e&m ................ 1.37 0.60 0.55 0.44 0.43 0.03 2.00 1.95 1.84 1.83 XXX

90806 ............ A Psytx, off, 45-50 min ............................ 1.86 0.77 0.73 0.62 0.61 0.04 2.67 2.63 2.52 2.51 XXX

90807 ............ A Psytx, off, 45-50 min w/e&m ................ 2.02 0.80 0.75 0.66 0.64 0.05 2.87 2.82 2.73 2.71 XXX

90808 ............ A Psytx, office, 75-80 min ........................ 2.79 1.09 1.10 0.93 0.98 0.07 3.95 3.96 3.79 3.84 XXX

65542

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

90809 ............ A Psytx, off, 75-80, w/e&m ...................... 2.95 1.13 1.13 0.96 1.01 0.07 4.15 4.15 3.98 4.03 XXX

90810 ............ A Intac psytx, off, 20-30 min .................... 1.32 0.56 0.58 0.44 0.49 0.03 1.91 1.93 1.79 1.84 XXX

90811 ............ A Intac psytx, 20-30, w/e&m .................... 1.48 0.64 0.64 0.48 0.52 0.03 2.15 2.15 1.99 2.03 XXX

90812 ............ A Intac psytx, off, 45-50 min .................... 1.97 0.83 0.78 0.65 0.65 0.05 2.85 2.80 2.67 2.67 XXX

90813 ............ A Intac psytx, 45-50 min w/e&m .............. 2.13 0.87 0.81 0.70 0.69 0.05 3.05 2.99 2.88 2.87 XXX

90814 ............ A Intac psytx, off, 75-80 min .................... 2.90 1.20 1.06 1.14 1.02 0.07 4.17 4.03 4.11 3.99 XXX

90815 ............ A Intac psytx, 75-80 w/e&m ..................... 3.06 1.21 1.07 0.98 0.90 0.07 4.34 4.20 4.11 4.03 XXX

90816 ............ A Psytx, hosp, 20-30 min ........................ 1.25 0.58 0.53 0.43 0.42 0.03 1.86 1.81 1.71 1.70 XXX

90817 ............ A Psytx, hosp, 20-30 min w/e&m ............ 1.41 0.63 0.57 0.46 0.44 0.03 2.07 2.01 1.90 1.88 XXX

90818 ............ A Psytx, hosp, 45-50 min ........................ 1.89 0.82 0.76 0.65 0.64 0.04 2.75 2.69 2.58 2.57 XXX

90819 ............ A Psytx, hosp, 45-50 min w/e&m ............ 2.05 0.83 0.77 0.66 0.64 0.05 2.93 2.87 2.76 2.74 XXX

90821 ............ A Psytx, hosp, 75-80 min ........................ 2.83 1.14 1.14 0.97 1.01 0.06 4.03 4.03 3.86 3.90 XXX

90822 ............ A Psytx, hosp, 75-80 min w/e&m ............ 2.99 1.13 1.13 0.97 1.01 0.07 4.19 4.19 4.03 4.07 XXX

90823 ............ A Intac psytx, hosp, 20-30 min ................ 1.36 0.68 0.67 0.45 0.50 0.03 2.07 2.06 1.84 1.89 XXX

90824 ............ A Intac psytx, hsp 20-30 w/e&m .............. 1.52 0.72 0.70 0.49 0.53 0.03 2.27 2.25 2.04 2.08 XXX

90826 ............ A Intac psytx, hosp, 45-50 min ................ 2.01 0.91 0.84 0.69 0.68 0.04 2.96 2.89 2.74 2.73 XXX

90827 ............ A Intac psytx, hsp 45-50 w/e&m .............. 2.16 0.94 0.87 0.69 0.68 0.05 3.15 3.08 2.90 2.89 XXX

90828 ............ A Intac psytx, hosp, 75-80 min ................ 2.94 1.23 1.08 1.02 0.93 0.07 4.24 4.09 4.03 3.94 XXX

90829 ............ A Intac psytx, hsp 75-80 w/e&m .............. 3.10 1.26 1.11 1.00 0.91 0.07 4.43 4.28 4.17 4.08 XXX

90845 ............ A Psychoanalysis ..................................... 1.79 0.70 0.64 0.59 0.55 0.04 2.53 2.47 2.42 2.38 XXX

90846 ............ R Family psytx w/o patient ....................... 1.83 0.74 0.72 0.62 0.63 0.04 2.61 2.59 2.49 2.50 XXX

90847 ............ R Family psytx w/patient .......................... 2.21 0.87 0.81 0.75 0.72 0.05 3.13 3.07 3.01 2.98 XXX

90849 ............ R Multiple family group psytx ................... 0.59 0.37 0.35 0.20 0.22 0.01 0.97 0.95 0.80 0.82 XXX

90853 ............ A Group psychotherapy ........................... 0.59 0.35 0.33 0.20 0.22 0.01 0.95 0.93 0.80 0.82 XXX

90857 ............ A Intac group psytx .................................. 0.63 0.38 0.33 0.23 0.21 0.02 1.03 0.98 0.88 0.86 XXX

90862 ............ A Medication management ...................... 0.95 0.44 0.43 0.31 0.33 0.02 1.41 1.40 1.28 1.30 XXX

90865 ............ A Narcosynthesis ..................................... 2.84 1.63 1.36 0.93 0.83 0.07 4.54 4.27 3.84 3.74 XXX

90870 ............ A Electroconvulsive therapy .................... 1.88 0.75 0.71 0.75 0.71 0.04 2.67 2.63 2.67 2.63 000

90871 ............ A Electroconvulsive therapy .................... 2.72 NA NA 1.03 1.00 0.06 NA NA 3.81 3.78 000

90875 ............ N Psychophysiological therapy ................ +1.20 0.88 0.88 0.48 0.48 0.03 2.11 2.11 1.71 1.71 XXX

90876 ............ N Psychophysiological therapy ................ +1.90 1.16 1.16 0.76 0.76 0.04 3.10 3.10 2.70 2.70 XXX

90880 ............ A Hypnotherapy ....................................... 2.19 0.89 0.84 0.71 0.71 0.05 3.13 3.08 2.95 2.95 XXX

90882 ............ N Environmental manipulation ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90885 ............ B Psy evaluation of records ..................... +0.97 0.39 0.38 0.39 0.38 0.02 1.38 1.37 1.38 1.37 XXX

90887 ............ B Consultation with family ....................... +1.48 0.82 0.71 0.59 0.53 0.03 2.33 2.22 2.10 2.04 XXX

90889 ............ B Preparation of report ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90899 ............ C Psychiatric service/therapy ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90901 ............ A Biofeedback train, any meth ................ 0.41 0.72 0.80 0.18 0.40 0.02 1.15 1.23 0.61 0.83 000

90911 ............ A Biofeedback peri/uro/rectal ................... 0.89 0.87 0.96 0.37 0.59 0.04 1.80 1.89 1.30 1.52 000

90918 ............ A ESRD related services, month ............. 11.18 5.30 4.57 5.30 4.57 0.30 16.78 16.05 16.78 16.05 XXX

90919 ............ A ESRD related services, month ............. 8.54 4.32 3.84 4.32 3.84 0.24 13.10 12.62 13.10 12.62 XXX

90920 ............ A ESRD related services, month ............. 7.27 3.77 3.42 3.77 3.42 0.19 11.23 10.88 11.23 10.88 XXX

90921 ............ A ESRD related services, month ............. 4.47 2.70 2.62 2.70 2.62 0.12 7.29 7.21 7.29 7.21 XXX

90922 ............ A ESRD related services, day ................. 0.37 0.16 0.14 0.16 0.14 0.01 0.54 0.52 0.54 0.52 XXX

90923 ............ A Esrd related services, day .................... 0.28 0.14 0.13 0.14 0.13 0.01 0.43 0.42 0.43 0.42 XXX

90924 ............ A Esrd related services, day .................... 0.24 0.12 0.11 0.12 0.11 0.01 0.37 0.36 0.37 0.36 XXX

90925 ............ A Esrd related services, day .................... 0.15 0.09 0.09 0.09 0.09 0.01 0.25 0.25 0.25 0.25 XXX

90935 ............ A Hemodialysis, one evaluation .............. 1.22 NA NA 0.78 0.95 0.03 NA NA 2.03 2.20 000

90937 ............ A Hemodialysis, repeated eval ................ 2.11 NA NA 1.10 1.46 0.06 NA NA 3.27 3.63 000

90940 ............ X Hemodialysis access study .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90945 ............ A Dialysis, one evaluation ....................... 1.28 NA NA 0.81 0.95 0.04 NA NA 2.13 2.27 000

90947 ............ A Dialysis, repeated eval ......................... 2.16 NA NA 1.12 1.41 0.06 NA NA 3.34 3.63 000

90989 ............ X Dialysis training, complete ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90993 ............ X Dialysis training, incompl ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90997 ............ A Hemoperfusion ..................................... 1.84 NA NA 1.01 1.31 0.05 NA NA 2.90 3.20 000

90999 ............ C Dialysis procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91000 ............ A Esophageal intubation .......................... 0.73 0.35 0.44 0.35 0.44 0.04 1.12 1.21 1.12 1.21 000

91000 26 A Esophageal intubation .......................... 0.73 0.27 0.36 0.27 0.36 0.03 1.03 1.12 1.03 1.12 000

91000 TC A Esophageal intubation .......................... 0.00 0.08 0.08 NA NA 0.01 0.09 0.09 NA NA 000

91010 ............ A Esophagus motility study ..................... 1.25 1.27 1.54 1.27 1.54 0.10 2.62 2.89 2.62 2.89 000

91010 26 A Esophagus motility study ..................... 1.25 0.45 0.71 0.45 0.71 0.05 1.75 2.01 1.75 2.01 000

91010 TC A Esophagus motility study ..................... 0.00 0.82 0.83 NA NA 0.05 0.87 0.88 NA NA 000

91011 ............ A Esophagus motility study ..................... 1.50 1.57 1.89 1.57 1.89 0.10 3.17 3.49 3.17 3.49 000

91011 26 A Esophagus motility study ..................... 1.50 0.55 0.86 0.55 0.86 0.05 2.10 2.41 2.10 2.41 000

91011 TC A Esophagus motility study ..................... 0.00 1.02 1.03 NA NA 0.05 1.07 1.08 NA NA 000

91012 ............ A Esophagus motility study ..................... 1.46 1.67 1.99 1.67 1.99 0.12 3.25 3.57 3.25 3.57 000

91012 26 A Esophagus motility study ..................... 1.46 0.53 0.84 0.53 0.84 0.06 2.05 2.36 2.05 2.36 000

91012 TC A Esophagus motility study ..................... 0.00 1.14 1.15 NA NA 0.06 1.20 1.21 NA NA 000

91020 ............ A Gastric motility ...................................... 1.44 1.26 1.57 1.26 1.57 0.11 2.81 3.12 2.81 3.12 000

91020 26 A Gastric motility ...................................... 1.44 0.50 0.80 0.50 0.80 0.06 2.00 2.30 2.00 2.30 000

91020 TC A Gastric motility ...................................... 0.00 0.76 0.77 NA NA 0.05 0.81 0.82 NA NA 000

91030 ............ A Acid perfusion of esophagus ................ 0.91 0.55 0.56 0.55 0.56 0.05 1.51 1.52 1.51 1.52 000

91030 26 A Acid perfusion of esophagus ................ 0.91 0.33 0.34 0.33 0.34 0.03 1.27 1.28 1.27 1.28 000

91030 TC A Acid perfusion of esophagus ................ 0.00 0.22 0.22 NA NA 0.02 0.24 0.24 NA NA 000

91032 ............ A Esophagus, acid reflux test .................. 1.21 1.17 1.41 1.17 1.41 0.10 2.48 2.72 2.48 2.72 000

91032 26 A Esophagus, acid reflux test .................. 1.21 0.43 0.66 0.43 0.66 0.05 1.69 1.92 1.69 1.92 000

91032 TC A Esophagus, acid reflux test .................. 0.00 0.74 0.75 NA NA 0.05 0.79 0.80 NA NA 000

91033 ............ A Prolonged acid reflux test .................... 1.30 1.81 2.09 1.81 2.09 0.14 3.25 3.53 3.25 3.53 000

91033 26 A Prolonged acid reflux test .................... 1.30 0.47 0.74 0.47 0.74 0.05 1.82 2.09 1.82 2.09 000

91033 TC A Prolonged acid reflux test .................... 0.00 1.34 1.35 NA NA 0.09 1.43 1.44 NA NA 000

91052 ............ A Gastric analysis test ............................. 0.79 0.62 0.69 0.62 0.69 0.05 1.46 1.53 1.46 1.53 000

91052 26 A Gastric analysis test ............................. 0.79 0.28 0.35 0.28 0.35 0.03 1.10 1.17 1.10 1.17 000

91052 TC A Gastric analysis test ............................. 0.00 0.34 0.34 NA NA 0.02 0.36 0.36 NA NA 000

65543

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

91055 ............ A Gastric intubation for smear ................. 0.94 0.58 0.65 0.58 0.65 0.06 1.58 1.65 1.58 1.65 000

91055 26 A Gastric intubation for smear ................. 0.94 0.28 0.35 0.28 0.35 0.04 1.26 1.33 1.26 1.33 000

91055 TC A Gastric intubation for smear ................. 0.00 0.30 0.30 NA NA 0.02 0.32 0.32 NA NA 000

91060 ............ A Gastric saline load test ......................... 0.45 0.35 0.45 0.35 0.45 0.04 0.84 0.94 0.84 0.94 000

91060 26 A Gastric saline load test ......................... 0.45 0.13 0.23 0.13 0.23 0.02 0.60 0.70 0.60 0.70 000

91060 TC A Gastric saline load test ......................... 0.00 0.22 0.22 NA NA 0.02 0.24 0.24 NA NA 000

91065 ............ A Breath hydrogen test ............................ 0.20 0.43 0.47 0.43 0.47 0.03 0.66 0.70 0.66 0.70 000

91065 26 A Breath hydrogen test ............................ 0.20 0.07 0.11 0.07 0.11 0.01 0.28 0.32 0.28 0.32 000

91065 TC A Breath hydrogen test ............................ 0.00 0.36 0.36 NA NA 0.02 0.38 0.38 NA NA 000

91100 ............ A Pass intestine bleeding tube ................ 1.08 NA NA 0.46 0.50 0.06 NA NA 1.60 1.64 000

91105 ............ A Gastric intubation treatment ................. 0.37 NA NA 0.20 0.26 0.02 NA NA 0.59 0.65 000

91122 ............ A Anal pressure record ............................ 1.77 1.35 1.49 1.35 1.49 0.17 3.29 3.43 3.29 3.43 000

91122 26 A Anal pressure record ............................ 1.77 0.65 0.78 0.65 0.78 0.10 2.52 2.65 2.52 2.65 000

91122 TC A Anal pressure record ............................ 0.00 0.70 0.71 NA NA 0.07 0.77 0.78 NA NA 000

91132 ............ C Electrogastrography ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91132 26 C Electrogastrography ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91132 TC C Electrogastrography ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91133 ............ C Electrogastrography w/test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91133 26 C Electrogastrography w/test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91133 TC C Electrogastrography w/test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91299 ............ C Gastroenterology procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91299 26 C Gastroenterology procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91299 TC C Gastroenterology procedure ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92002 ............ A Eye exam, new patient ......................... 0.88 1.10 0.96 0.36 0.34 0.02 2.00 1.86 1.26 1.24 XXX

92004 ............ A Eye exam, new patient ......................... 1.67 1.73 1.45 0.72 0.62 0.03 3.43 3.15 2.42 2.32 XXX

92012 ............ A Eye exam established pat .................... 0.67 1.05 0.91 0.31 0.29 0.01 1.73 1.59 0.99 0.97 XXX

92014 ............ A Eye exam & treatment ......................... 1.10 1.36 1.17 0.51 0.46 0.02 2.48 2.29 1.63 1.58 XXX

92015 ............ N Refraction ............................................. +0.38 1.40 1.14 0.15 0.20 0.01 1.79 1.53 0.54 0.59 XXX

92018 ............ A New eye exam & treatment ................. 1.51 NA NA 0.72 0.67 0.03 NA NA 2.26 2.21 XXX

92019 ............ A Eye exam & treatment ......................... 1.31 NA NA 0.62 0.53 0.03 NA NA 1.96 1.87 XXX

92020 ............ A Special eye evaluation ......................... 0.37 0.70 0.60 0.17 0.17 0.01 1.08 0.98 0.55 0.55 XXX

92060 ............ A Special eye evaluation ......................... 0.69 1.53 1.25 1.53 1.25 0.02 2.24 1.96 2.24 1.96 XXX

92060 26 A Special eye evaluation ......................... 0.69 0.30 0.28 0.30 0.28 0.01 1.00 0.98 1.00 0.98 XXX

92060 TC A Special eye evaluation ......................... 0.00 1.23 0.97 NA NA 0.01 1.24 0.98 NA NA XXX

92065 ............ A Orthoptic/pleoptic training ..................... 0.37 0.80 0.70 0.80 0.70 0.02 1.19 1.09 1.19 1.09 XXX

92065 26 A Orthoptic/pleoptic training ..................... 0.37 0.16 0.18 0.16 0.18 0.01 0.54 0.56 0.54 0.56 XXX

92065 TC A Orthoptic/pleoptic training ..................... 0.00 0.64 0.52 NA NA 0.01 0.65 0.53 NA NA XXX

92070 ............ A Fitting of contact lens ........................... 0.70 1.03 1.10 0.34 0.42 0.01 1.74 1.81 1.05 1.13 XXX

92081 ............ A Visual field examination(s) ................... 0.36 1.42 1.16 1.42 1.16 0.02 1.80 1.54 1.80 1.54 XXX

92081 26 A Visual field examination(s) ................... 0.36 0.16 0.17 0.16 0.17 0.01 0.53 0.54 0.53 0.54 XXX

92081 TC A Visual field examination(s) ................... 0.00 1.26 0.99 NA NA 0.01 1.27 1.00 NA NA XXX

92082 ............ A Visual field examination(s) ................... 0.44 1.25 1.07 1.25 1.07 0.02 1.71 1.53 1.71 1.53 XXX

92082 26 A Visual field examination(s) ................... 0.44 0.20 0.23 0.20 0.23 0.01 0.65 0.68 0.65 0.68 XXX

92082 TC A Visual field examination(s) ................... 0.00 1.05 0.84 NA NA 0.01 1.06 0.85 NA NA XXX

92083 ............ A Visual field examination(s) ................... 0.50 1.23 1.15 1.23 1.15 0.02 1.75 1.67 1.75 1.67 XXX

92083 26 A Visual field examination(s) ................... 0.50 0.23 0.32 0.23 0.32 0.01 0.74 0.83 0.74 0.83 XXX

92083 TC A Visual field examination(s) ................... 0.00 1.00 0.83 NA NA 0.01 1.01 0.84 NA NA XXX

92100 ............ A Serial tonometry exam(s) ..................... 0.92 0.79 0.66 0.40 0.34 0.02 1.73 1.60 1.34 1.28 XXX

92120 ............ A Tonography & eye evaluation .............. 0.81 0.77 0.66 0.32 0.28 0.02 1.60 1.49 1.15 1.11 XXX

92130 ............ A Water provocation tonography ............. 0.81 0.87 0.79 0.40 0.37 0.02 1.70 1.62 1.23 1.20 XXX

92135 ............ A Opthalmic dx imaging ........................... 0.35 1.19 1.19 1.19 1.19 0.02 1.56 1.56 1.56 1.56 XXX

92135 26 A Opthalmic dx imaging ........................... 0.35 0.16 0.16 0.16 0.16 0.01 0.52 0.52 0.52 0.52 XXX

92135 TC A Opthalmic dx imaging ........................... 0.00 1.03 1.03 NA NA 0.01 1.04 1.04 NA NA XXX

92140 ............ A Glaucoma provocative tests ................. 0.50 0.95 0.80 0.22 0.21 0.01 1.46 1.31 0.73 0.72 XXX

92225 ............ A Special eye exam, initial ...................... 0.38 1.64 1.35 0.16 0.18 0.01 2.03 1.74 0.55 0.57 XXX

92226 ............ A Special eye exam, subsequent ............ 0.33 1.73 1.41 0.15 0.17 0.01 2.07 1.75 0.49 0.51 XXX

92230 ............ A Eye exam with photos .......................... 0.60 1.28 1.15 0.19 0.24 0.02 1.90 1.77 0.81 0.86 XXX

92235 ............ A Eye exam with photos .......................... 0.81 2.31 2.16 2.31 2.16 0.07 3.19 3.04 3.19 3.04 XXX

92235 26 A Eye exam with photos .......................... 0.81 0.40 0.46 0.40 0.46 0.02 1.23 1.29 1.23 1.29 XXX

92235 TC A Eye exam with photos .......................... 0.00 1.91 1.70 NA NA 0.05 1.96 1.75 NA NA XXX

92240 ............ A Icg angiography .................................... 1.10 2.75 2.49 2.75 2.49 0.07 3.92 3.66 3.92 3.66 XXX

92240 26 A Icg angiography .................................... 1.10 0.53 0.56 0.53 0.56 0.02 1.65 1.68 1.65 1.68 XXX

92240 TC A Icg angiography .................................... 0.00 2.22 1.93 NA NA 0.05 2.27 1.98 NA NA XXX

92250 ............ A Eye exam with photos .......................... 0.44 1.75 1.43 1.75 1.43 0.02 2.21 1.89 2.21 1.89 XXX

92250 26 A Eye exam with photos .......................... 0.44 0.21 0.23 0.21 0.23 0.01 0.66 0.68 0.66 0.68 XXX

92250 TC A Eye exam with photos .......................... 0.00 1.54 1.20 NA NA 0.01 1.55 1.21 NA NA XXX

92260 ............ A Ophthalmoscopy/dynamometry ............ 0.20 0.22 0.31 0.10 0.15 0.01 0.43 0.52 0.31 0.36 XXX

92265 ............ A Eye muscle evaluation ......................... 0.81 1.27 1.04 1.27 1.04 0.04 2.12 1.89 2.12 1.89 XXX

92265 26 A Eye muscle evaluation ......................... 0.81 0.33 0.27 0.33 0.27 0.02 1.16 1.10 1.16 1.10 XXX

92265 TC A Eye muscle evaluation ......................... 0.00 0.94 0.77 NA NA 0.02 0.96 0.79 NA NA XXX

92270 ............ A Electro-oculography .............................. 0.81 1.03 0.95 1.03 0.95 0.05 1.89 1.81 1.89 1.81 XXX

92270 26 A Electro-oculography .............................. 0.81 0.35 0.36 0.35 0.36 0.03 1.19 1.20 1.19 1.20 XXX

92270 TC A Electro-oculography .............................. 0.00 0.68 0.59 NA NA 0.02 0.70 0.61 NA NA XXX

92275 ............ A Electroretinography .............................. 1.01 1.17 1.13 1.17 1.13 0.04 2.22 2.18 2.22 2.18 XXX

92275 26 A Electroretinography .............................. 1.01 0.45 0.48 0.45 0.48 0.02 1.48 1.51 1.48 1.51 XXX

92275 TC A Electroretinography .............................. 0.00 0.72 0.65 NA NA 0.02 0.74 0.67 NA NA XXX

92283 ............ A Color vision examination ...................... 0.17 0.65 0.57 0.65 0.57 0.02 0.84 0.76 0.84 0.76 XXX

92283 26 A Color vision examination ...................... 0.17 0.07 0.10 0.07 0.10 0.01 0.25 0.28 0.25 0.28 XXX

92283 TC A Color vision examination ...................... 0.00 0.58 0.47 NA NA 0.01 0.59 0.48 NA NA XXX

92284 ............ A Dark adaptation eye exam ................... 0.24 1.98 1.61 1.98 1.61 0.02 2.24 1.87 2.24 1.87 XXX

92284 26 A Dark adaptation eye exam ................... 0.24 0.08 0.14 0.08 0.14 0.01 0.33 0.39 0.33 0.39 XXX

92284 TC A Dark adaptation eye exam ................... 0.00 1.90 1.47 NA NA 0.01 1.91 1.48 NA NA XXX

92285 ............ A Eye photography .................................. 0.20 1.90 1.51 1.90 1.51 0.02 2.12 1.73 2.12 1.73 XXX

65544

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

92285 26 A Eye photography .................................. 0.20 0.09 0.12 0.09 0.12 0.01 0.30 0.33 0.30 0.33 XXX

92285 TC A Eye photography .................................. 0.00 1.81 1.39 NA NA 0.01 1.82 1.40 NA NA XXX

92286 ............ A Internal eye photography ..................... 0.66 2.07 1.89 2.07 1.89 0.03 2.76 2.58 2.76 2.58 XXX

92286 26 A Internal eye photography ..................... 0.66 0.32 0.47 0.32 0.47 0.01 0.99 1.14 0.99 1.14 XXX

92286 TC A Internal eye photography ..................... 0.00 1.75 1.42 NA NA 0.02 1.77 1.44 NA NA XXX

92287 ............ A Internal eye photography ..................... 0.81 1.96 1.88 0.30 0.43 0.02 2.79 2.71 1.13 1.26 XXX

92310 ............ N Contact lens fitting ................................ +1.17 1.08 1.16 0.47 0.70 0.00 2.25 2.33 1.64 1.87 XXX

92311 ............ A Contact lens fitting ................................ 1.08 1.05 1.03 0.40 0.42 0.03 2.16 2.14 1.51 1.53 XXX

92312 ............ A Contact lens fitting ................................ 1.26 1.03 1.09 0.46 0.50 0.03 2.32 2.38 1.75 1.79 XXX

92313 ............ A Contact lens fitting ................................ 0.92 1.06 1.04 0.32 0.36 0.02 2.00 1.98 1.26 1.30 XXX

92314 ............ N Prescription of contact lens .................. +0.69 0.88 0.87 0.28 0.42 0.00 1.57 1.56 0.97 1.11 XXX

92315 ............ A Prescription of contact lens .................. 0.45 0.77 0.76 0.18 0.23 0.01 1.23 1.22 0.64 0.69 XXX

92316 ............ A Prescription of contact lens .................. 0.68 0.85 0.90 0.27 0.33 0.01 1.54 1.59 0.96 1.02 XXX

92317 ............ A Prescription of contact lens .................. 0.45 0.93 0.80 0.19 0.20 0.01 1.39 1.26 0.65 0.66 XXX

92325 ............ A Modification of contact lens .................. 0.00 0.39 0.40 0.39 0.40 0.01 0.40 0.41 0.40 0.41 XXX

92326 ............ A Replacement of contact lens ................ 0.00 1.62 1.64 1.62 1.64 0.05 1.67 1.69 1.67 1.69 XXX

92330 ............ A Fitting of artificial eye ........................... 1.08 1.02 1.07 0.41 0.46 0.04 2.14 2.19 1.53 1.58 XXX

92335 ............ A Fitting of artificial eye ........................... 0.45 0.83 1.16 0.18 0.40 0.01 1.29 1.62 0.64 0.86 XXX

92340 ............ N Fitting of spectacles ............................. +0.37 0.66 0.61 0.15 0.22 0.00 1.03 0.98 0.52 0.59 XXX

92341 ............ N Fitting of spectacles ............................. +0.47 0.69 0.66 0.19 0.28 0.00 1.16 1.13 0.66 0.75 XXX

92342 ............ N Fitting of spectacles ............................. +0.53 0.72 0.70 0.21 0.32 0.00 1.25 1.23 0.74 0.85 XXX

92352 ............ B Special spectacles fitting ...................... +0.37 0.66 0.58 0.15 0.20 0.01 1.04 0.96 0.53 0.58 XXX

92353 ............ B Special spectacles fitting ...................... +0.50 0.71 0.64 0.20 0.26 0.02 1.23 1.16 0.72 0.78 XXX

92354 ............ B Special spectacles fitting ...................... +0.00 8.79 8.88 8.79 8.88 0.08 8.87 8.96 8.87 8.96 XXX

92355 ............ B Special spectacles fitting ...................... +0.00 4.30 4.35 4.30 4.35 0.01 4.31 4.36 4.31 4.36 XXX

92358 ............ B Eye prosthesis service ......................... +0.00 0.96 0.97 0.96 0.97 0.04 1.00 1.01 1.00 1.01 XXX

92370 ............ N Repair & adjust spectacles .................. +0.32 0.50 0.47 0.13 0.19 0.00 0.82 0.79 0.45 0.51 XXX

92371 ............ B Repair & adjust spectacles .................. +0.00 0.61 0.62 0.61 0.62 0.02 0.63 0.64 0.63 0.64 XXX

92390 ............ N Supply of spectacles ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92391 ............ N Supply of contact lenses ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92392 ............ I Supply of low vision aids ...................... +0.00 4.02 4.06 4.02 4.06 0.02 4.04 4.08 4.04 4.08 XXX

92393 ............ I Supply of artificial eye .......................... +0.00 12.46 12.59 12.46 12.59 0.47 12.93 13.06 12.93 13.06 XXX

92395 ............ I Supply of spectacles ............................ +0.00 1.36 1.38 1.36 1.38 0.08 1.44 1.46 1.44 1.46 XXX

92396 ............ I Supply of contact lenses ...................... +0.00 2.29 2.31 2.29 2.31 0.06 2.35 2.37 2.35 2.37 XXX

92499 ............ C Eye service or procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92499 26 C Eye service or procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92499 TC C Eye service or procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92502 ............ A Ear and throat examination .................. 1.51 NA NA 1.33 1.30 0.06 NA NA 2.90 2.87 000

92504 ............ A Ear microscopy examination ................ 0.18 1.04 0.85 0.09 0.10 0.01 1.23 1.04 0.28 0.29 XXX

92506 ............ A Speech/hearing evaluation ................... 0.86 1.47 1.24 0.45 0.41 0.04 2.37 2.14 1.35 1.31 XXX

92507 ............ A Speech/hearing therapy ....................... 0.52 1.34 1.10 0.28 0.26 0.02 1.88 1.64 0.82 0.80 XXX

92508 ............ A Speech/hearing therapy ....................... 0.26 0.97 0.78 0.15 0.14 0.01 1.24 1.05 0.42 0.41 XXX

92510 ............ A Rehab for ear implant .......................... 1.50 1.94 1.83 0.85 0.82 0.06 3.50 3.39 2.41 2.38 XXX

92511 ............ A Nasopharyngoscopy ............................. 0.84 1.28 1.19 0.42 0.43 0.03 2.15 2.06 1.29 1.30 000

92512 ............ A Nasal function studies .......................... 0.55 1.09 0.95 0.20 0.22 0.02 1.66 1.52 0.77 0.79 XXX

92516 ............ A Facial nerve function test ..................... 0.43 0.91 0.79 0.23 0.23 0.02 1.36 1.24 0.68 0.68 XXX

92520 ............ A Laryngeal function studies ................... 0.76 0.56 0.57 0.36 0.34 0.03 1.35 1.36 1.15 1.13 XXX

92525 ............ N Oral function evaluation ....................... +1.50 1.55 1.44 0.60 0.59 0.07 3.12 3.01 2.17 2.16 XXX

92526 ............ A Oral function therapy ............................ 0.55 1.45 1.22 0.25 0.25 0.02 2.02 1.79 0.82 0.82 XXX

92531 ............ B Spontaneous nystagmus study ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92532 ............ B Positional nystagmus study .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92533 ............ B Caloric vestibular test ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92534 ............ B Optokinetic nystagmus ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92541 ............ A Spontaneous nystagmus test ............... 0.40 0.43 0.50 0.43 0.50 0.04 0.87 0.94 0.87 0.94 XXX

92541 26 A Spontaneous nystagmus test ............... 0.40 0.20 0.27 0.20 0.27 0.02 0.62 0.69 0.62 0.69 XXX

92541 TC A Spontaneous nystagmus test ............... 0.00 0.23 0.23 NA NA 0.02 0.25 0.25 NA NA XXX

92542 ............ A Positional nystagmus test .................... 0.33 0.42 0.48 0.42 0.48 0.03 0.78 0.84 0.78 0.84 XXX

92542 26 A Positional nystagmus test .................... 0.33 0.16 0.22 0.16 0.22 0.01 0.50 0.56 0.50 0.56 XXX

92542 TC A Positional nystagmus test .................... 0.00 0.26 0.26 NA NA 0.02 0.28 0.28 NA NA XXX

92543 ............ A Caloric vestibular test ........................... 0.10 0.16 0.18 0.16 0.18 0.02 0.28 0.30 0.28 0.30 XXX

92543 26 A Caloric vestibular test ........................... 0.10 0.05 0.07 0.05 0.07 0.01 0.16 0.18 0.16 0.18 XXX

92543 TC A Caloric vestibular test ........................... 0.00 0.11 0.11 NA NA 0.01 0.12 0.12 NA NA XXX

92544 ............ A Optokinetic nystagmus test .................. 0.26 0.34 0.38 0.34 0.38 0.03 0.63 0.67 0.63 0.67 XXX

92544 26 A Optokinetic nystagmus test .................. 0.26 0.13 0.17 0.13 0.17 0.01 0.40 0.44 0.40 0.44 XXX

92544 TC A Optokinetic nystagmus test .................. 0.00 0.21 0.21 NA NA 0.02 0.23 0.23 NA NA XXX

92545 ............ A Oscillating tracking test ........................ 0.23 0.32 0.35 0.32 0.35 0.03 0.58 0.61 0.58 0.61 XXX

92545 26 A Oscillating tracking test ........................ 0.23 0.11 0.14 0.11 0.14 0.01 0.35 0.38 0.35 0.38 XXX

92545 TC A Oscillating tracking test ........................ 0.00 0.21 0.21 NA NA 0.02 0.23 0.23 NA NA XXX

92546 ............ A Sinusoidal rotational test ...................... 0.29 0.38 0.43 0.38 0.43 0.03 0.70 0.75 0.70 0.75 XXX

92546 26 A Sinusoidal rotational test ...................... 0.29 0.14 0.19 0.14 0.19 0.01 0.44 0.49 0.44 0.49 XXX

92546 TC A Sinusoidal rotational test ...................... 0.00 0.24 0.24 NA NA 0.02 0.26 0.26 NA NA XXX

92547 ............ A Supplemental electrical test ................. 0.00 0.56 0.57 NA NA 0.05 0.61 0.62 NA NA ZZZ

92548 ............ A Posturography ...................................... 0.50 1.72 1.80 1.72 1.80 0.13 2.35 2.43 2.35 2.43 XXX

92548 26 A Posturography ...................................... 0.50 0.26 0.32 0.26 0.32 0.02 0.78 0.84 0.78 0.84 XXX

92548 TC A Posturography ...................................... 0.00 1.46 1.48 NA NA 0.11 1.57 1.59 NA NA XXX

92551 ............ N Pure tone hearing test, air ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92552 ............ A Pure tone audiometry, air ..................... 0.00 0.44 0.45 NA NA 0.03 0.47 0.48 NA NA XXX

92553 ............ A Audiometry, air & bone ........................ 0.00 0.65 0.66 NA NA 0.05 0.70 0.71 NA NA XXX

92555 ............ A Speech threshold audiometry .............. 0.00 0.37 0.38 NA NA 0.03 0.40 0.41 NA NA XXX

92556 ............ A Speech audiometry, complete .............. 0.00 0.57 0.58 NA NA 0.05 0.62 0.63 NA NA XXX

92557 ............ A Comprehensive hearing test ................ 0.00 1.18 1.19 NA NA 0.10 1.28 1.29 NA NA XXX

92559 ............ N Group audiometric testing .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92560 ............ N Bekesy audiometry, screen .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65545

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

92561 ............ A Bekesy audiometry, diagnosis ............. 0.00 0.71 0.72 NA NA 0.05 0.76 0.77 NA NA XXX

92562 ............ A Loudness balance test ......................... 0.00 0.40 0.41 NA NA 0.03 0.43 0.44 NA NA XXX

92563 ............ A Tone decay hearing test ...................... 0.00 0.37 0.38 NA NA 0.03 0.40 0.41 NA NA XXX

92564 ............ A Sisi hearing test .................................... 0.00 0.47 0.48 NA NA 0.04 0.51 0.52 NA NA XXX

92565 ............ A Stenger test, pure tone ........................ 0.00 0.39 0.40 NA NA 0.03 0.42 0.43 NA NA XXX

92567 ............ A Tympanometry ...................................... 0.00 0.52 0.53 NA NA 0.05 0.57 0.58 NA NA XXX

92568 ............ A Acoustic reflex testing .......................... 0.00 0.37 0.38 NA NA 0.03 0.40 0.41 NA NA XXX

92569 ............ A Acoustic reflex decay test .................... 0.00 0.40 0.41 NA NA 0.03 0.43 0.44 NA NA XXX

92571 ............ A Filtered speech hearing test ................. 0.00 0.38 0.39 NA NA 0.03 0.41 0.42 NA NA XXX

92572 ............ A Staggered spondaic word test ............. 0.00 0.09 0.09 NA NA 0.01 0.10 0.10 NA NA XXX

92573 ............ A Lombard test ........................................ 0.00 0.35 0.35 NA NA 0.03 0.38 0.38 NA NA XXX

92575 ............ A Sensorineural acuity test ...................... 0.00 0.30 0.30 NA NA 0.02 0.32 0.32 NA NA XXX

92576 ............ A Synthetic sentence test ........................ 0.00 0.44 0.45 NA NA 0.04 0.48 0.49 NA NA XXX

92577 ............ A Stenger test, speech ............................ 0.00 0.71 0.72 NA NA 0.06 0.77 0.78 NA NA XXX

92579 ............ A Visual audiometry (vra) ........................ 0.00 0.72 0.73 NA NA 0.05 0.77 0.78 NA NA XXX

92582 ............ A Conditioning play audiometry ............... 0.00 0.72 0.73 NA NA 0.05 0.77 0.78 NA NA XXX

92583 ............ A Select picture audiometry ..................... 0.00 0.88 0.89 NA NA 0.07 0.95 0.96 NA NA XXX

92584 ............ A Electrocochleography ........................... 0.00 2.46 2.49 NA NA 0.17 2.63 2.66 NA NA XXX

92585 ............ A Auditor evoke potent, compre .............. 0.50 2.06 2.43 2.06 2.43 0.14 2.70 3.07 2.70 3.07 XXX

92585 26 A Auditor evoke potent, compre .............. 0.50 0.22 0.57 0.22 0.57 0.02 0.74 1.09 0.74 1.09 XXX

92585 TC A Auditor evoke potent, compre .............. 0.00 1.84 1.86 NA NA 0.12 1.96 1.98 NA NA XXX

92586 ............ A Auditor evoke potent, limit .................... 0.00 1.84 1.84 NA NA 0.12 1.96 1.96 NA NA XXX

92587 ............ A Evoked auditory test ............................. 0.13 1.37 1.39 1.37 1.39 0.10 1.60 1.62 1.60 1.62 XXX

92587 26 A Evoked auditory test ............................. 0.13 0.07 0.08 0.07 0.08 0.01 0.21 0.22 0.21 0.22 XXX

92587 TC A Evoked auditory test ............................. 0.00 1.30 1.31 NA NA 0.09 1.39 1.40 NA NA XXX

92588 ............ A Evoked auditory test ............................. 0.36 1.63 1.69 1.63 1.69 0.12 2.11 2.17 2.11 2.17 XXX

92588 26 A Evoked auditory test ............................. 0.36 0.17 0.21 0.17 0.21 0.01 0.54 0.58 0.54 0.58 XXX

92588 TC A Evoked auditory test ............................. 0.00 1.46 1.48 NA NA 0.11 1.57 1.59 NA NA XXX

92589 ............ A Auditory function test(s) ....................... 0.00 0.53 0.54 NA NA 0.05 0.58 0.59 NA NA XXX

92590 ............ N Hearing aid exam, one ear .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92591 ............ N Hearing aid exam, both ears ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92592 ............ N Hearing aid check, one ear .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92593 ............ N Hearing aid check, both ears ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92594 ............ N Electro hearng aid test, one ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92595 ............ N Electro hearng aid tst, both .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92596 ............ A Ear protector evaluation ....................... 0.00 0.59 0.60 NA NA 0.05 0.64 0.65 NA NA XXX

92597 ............ N Oral speech device eval ....................... +1.35 1.49 1.39 0.54 0.68 0.05 2.89 2.79 1.94 2.08 XXX

92598 ............ N Modify oral speech device ................... +0.99 0.76 0.75 0.40 0.48 0.04 1.79 1.78 1.43 1.51 XXX

92599 ............ C ENT procedure/service ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92599 26 C ENT procedure/service ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92599 TC C ENT procedure/service ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92950 ............ A Heart/lung resuscitation cpr ................. 3.80 1.38 1.65 1.17 1.49 0.21 5.39 5.66 5.18 5.50 000

92953 ............ A Temporary external pacing .................. 0.23 NA NA 0.24 0.25 0.01 NA NA 0.48 0.49 000

92960 ............ A Cardioversion electric, ext .................... 2.25 2.19 2.15 0.93 1.21 0.08 4.52 4.48 3.26 3.54 000

92961 ............ A Cardioversion, electric, int .................... 4.60 NA NA 1.96 1.96 0.17 NA NA 6.73 6.73 000

92970 ............ A Cardioassist, internal ............................ 3.52 NA NA 1.06 1.74 0.17 NA NA 4.75 5.43 000

92971 ............ A Cardioassist, external ........................... 1.77 NA NA 0.92 0.99 0.06 NA NA 2.75 2.82 000

92975 ............ A Dissolve clot, heart vessel ................... 7.25 NA NA 3.16 3.92 0.22 NA NA 10.63 11.39 000

92977 ............ A Dissolve clot, heart vessel ................... 0.00 7.99 8.08 7.99 8.08 0.38 8.37 8.46 8.37 8.46 XXX

92978 ............ A Intravasc us, heart add-on ................... 1.80 5.31 5.45 5.31 5.45 0.26 7.37 7.51 7.37 7.51 ZZZ

92978 26 A Intravasc us, heart add-on ................... 1.80 0.78 0.87 0.78 0.87 0.06 2.64 2.73 2.64 2.73 ZZZ

92978 TC A Intravasc us, heart add-on ................... 0.00 4.53 4.58 NA NA 0.20 4.73 4.78 NA NA ZZZ

92979 ............ A Intravasc us, heart add-on ................... 1.44 2.91 3.00 2.91 3.00 0.15 4.50 4.59 4.50 4.59 ZZZ

92979 26 A Intravasc us, heart add-on ................... 1.44 0.63 0.70 0.63 0.70 0.04 2.11 2.18 2.11 2.18 ZZZ

92979 TC A Intravasc us, heart add-on ................... 0.00 2.28 2.30 NA NA 0.11 2.39 2.41 NA NA ZZZ

92980 ............ A Insert intracoronary stent ..................... 14.84 NA NA 6.47 9.28 0.78 NA NA 22.09 24.90 000

92981 ............ A Insert intracoronary stent ..................... 4.17 NA NA 1.81 2.60 0.21 NA NA 6.19 6.98 ZZZ

92982 ............ A Coronary artery dilation ........................ 10.98 NA NA 4.81 6.89 0.57 NA NA 16.36 18.44 000

92984 ............ A Coronary artery dilation ........................ 2.97 NA NA 1.29 1.86 0.16 NA NA 4.42 4.99 ZZZ

92986 ............ A Revision of aortic valve ........................ 21.80 NA NA 11.22 11.68 1.14 NA NA 34.16 34.62 090

92987 ............ A Revision of mitral valve ........................ 22.70 NA NA 11.62 12.03 1.18 NA NA 35.50 35.91 090

92990 ............ A Revision of pulmonary valve ................ 17.34 NA NA 9.38 9.64 0.90 NA NA 27.62 27.88 090

92992 ............ C Revision of heart chamber ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

92993 ............ C Revision of heart chamber ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

92995 ............ A Coronary atherectomy .......................... 12.09 NA NA 5.27 7.56 0.63 NA NA 17.99 20.28 000

92996 ............ A Coronary atherectomy add-on ............. 3.26 NA NA 1.45 2.06 0.17 NA NA 4.88 5.49 ZZZ

92997 ............ A Pul art balloon repr, percut .................. 12.00 NA NA 5.06 7.38 0.63 NA NA 17.69 20.01 000

92998 ............ A Pul art balloon repr, percut .................. 6.00 NA NA 2.45 2.87 0.31 NA NA 8.76 9.18 ZZZ

93000 ............ A Electrocardiogram, complete ................ 0.17 0.52 0.56 NA NA 0.03 0.72 0.76 NA NA XXX

93005 ............ A Electrocardiogram, tracing ................... 0.00 0.45 0.46 NA NA 0.02 0.47 0.48 NA NA XXX

93010 ............ A Electrocardiogram report ...................... 0.17 0.07 0.10 0.07 0.10 0.01 0.25 0.28 0.25 0.28 XXX

93012 ............ A Transmission of ecg ............................. 0.00 2.34 2.37 NA NA 0.15 2.49 2.52 NA NA XXX

93014 ............ A Report on transmitted ecg .................... 0.52 0.20 0.26 0.20 0.26 0.02 0.74 0.80 0.74 0.80 XXX

93015 ............ A Cardiovascular stress test .................... 0.75 1.98 2.12 NA NA 0.11 2.84 2.98 NA NA XXX

93016 ............ A Cardiovascular stress test .................... 0.45 0.19 0.25 0.19 0.25 0.01 0.65 0.71 0.65 0.71 XXX

93017 ............ A Cardiovascular stress test .................... 0.00 1.67 1.69 NA NA 0.09 1.76 1.78 NA NA XXX

93018 ............ A Cardiovascular stress test .................... 0.30 0.12 0.18 0.12 0.18 0.01 0.43 0.49 0.43 0.49 XXX

93024 ............ A Cardiac drug stress test ....................... 1.17 1.60 1.84 1.60 1.84 0.11 2.88 3.12 2.88 3.12 XXX

93024 26 A Cardiac drug stress test ....................... 1.17 0.49 0.72 0.49 0.72 0.04 1.70 1.93 1.70 1.93 XXX

93024 TC A Cardiac drug stress test ....................... 0.00 1.11 1.12 NA NA 0.07 1.18 1.19 NA NA XXX

93040 ............ A Rhythm ECG with report ...................... 0.16 0.19 0.21 NA NA 0.02 0.37 0.39 NA NA XXX

93041 ............ A Rhythm ECG, tracing ........................... 0.00 0.14 0.14 NA NA 0.01 0.15 0.15 NA NA XXX

93042 ............ A Rhythm ECG, report ............................. 0.16 0.05 0.07 0.05 0.07 0.01 0.22 0.24 0.22 0.24 XXX

65546

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

93224 ............ A ECG monitor/report, 24 hrs .................. 0.52 3.61 3.74 NA NA 0.21 4.34 4.47 NA NA XXX

93225 ............ A ECG monitor/record, 24 hrs ................. 0.00 1.23 1.24 NA NA 0.07 1.30 1.31 NA NA XXX

93226 ............ A ECG monitor/report, 24 hrs .................. 0.00 2.17 2.19 NA NA 0.12 2.29 2.31 NA NA XXX

93227 ............ A ECG monitor/review, 24 hrs ................. 0.52 0.21 0.31 0.21 0.31 0.02 0.75 0.85 0.75 0.85 XXX

93230 ............ A ECG monitor/report, 24 hrs .................. 0.52 3.88 4.02 NA NA 0.22 4.62 4.76 NA NA XXX

93231 ............ A Ecg monitor/record, 24 hrs ................... 0.00 1.51 1.53 NA NA 0.09 1.60 1.62 NA NA XXX

93232 ............ A ECG monitor/report, 24 hrs .................. 0.00 2.16 2.18 NA NA 0.11 2.27 2.29 NA NA XXX

93233 ............ A ECG monitor/review, 24 hrs ................. 0.52 0.21 0.31 0.21 0.31 0.02 0.75 0.85 0.75 0.85 XXX

93235 ............ A ECG monitor/report, 24 hrs .................. 0.45 2.78 2.90 NA NA 0.13 3.36 3.48 NA NA XXX

93236 ............ A ECG monitor/report, 24 hrs .................. 0.00 2.60 2.63 NA NA 0.12 2.72 2.75 NA NA XXX

93237 ............ A ECG monitor/review, 24 hrs ................. 0.45 0.18 0.27 0.18 0.27 0.01 0.64 0.73 0.64 0.73 XXX

93268 ............ A ECG record/review ............................... 0.52 3.77 3.87 NA NA 0.24 4.53 4.63 NA NA XXX

93270 ............ A ECG recording ...................................... 0.00 1.23 1.24 NA NA 0.07 1.30 1.31 NA NA XXX

93271 ............ A Ecg/monitoring and analysis ................ 0.00 2.34 2.37 NA NA 0.15 2.49 2.52 NA NA XXX

93272 ............ A Ecg/review, interpret only ..................... 0.52 0.20 0.26 0.20 0.26 0.02 0.74 0.80 0.74 0.80 XXX

93278 ............ A ECG/signal-averaged ........................... 0.25 1.25 1.31 1.25 1.31 0.10 1.60 1.66 1.60 1.66 XXX

93278 26 A ECG/signal-averaged ........................... 0.25 0.11 0.16 0.11 0.16 0.01 0.37 0.42 0.37 0.42 XXX

93278 TC A ECG/signal-averaged ........................... 0.00 1.14 1.15 NA NA 0.09 1.23 1.24 NA NA XXX

93303 ............ A Echo transthoracic ................................ 1.30 4.33 4.52 4.33 4.52 0.23 5.86 6.05 5.86 6.05 XXX

93303 26 A Echo transthoracic ................................ 1.30 0.50 0.65 0.50 0.65 0.04 1.84 1.99 1.84 1.99 XXX

93303 TC A Echo transthoracic ................................ 0.00 3.83 3.87 NA NA 0.19 4.02 4.06 NA NA XXX

93304 ............ A Echo transthoracic ................................ 0.75 2.24 2.37 2.24 2.37 0.13 3.12 3.25 3.12 3.25 XXX

93304 26 A Echo transthoracic ................................ 0.75 0.31 0.42 0.31 0.42 0.02 1.08 1.19 1.08 1.19 XXX

93304 TC A Echo transthoracic ................................ 0.00 1.93 1.95 NA NA 0.11 2.04 2.06 NA NA XXX

93307 ............ A Echo exam of heart .............................. 0.92 4.22 4.44 4.22 4.44 0.22 5.36 5.58 5.36 5.58 XXX

93307 26 A Echo exam of heart .............................. 0.92 0.39 0.57 0.39 0.57 0.03 1.34 1.52 1.34 1.52 XXX

93307 TC A Echo exam of heart .............................. 0.00 3.83 3.87 NA NA 0.19 4.02 4.06 NA NA XXX

93308 ............ A Echo exam of heart .............................. 0.53 2.15 2.27 2.15 2.27 0.13 2.81 2.93 2.81 2.93 XXX

93308 26 A Echo exam of heart .............................. 0.53 0.22 0.32 0.22 0.32 0.02 0.77 0.87 0.77 0.87 XXX

93308 TC A Echo exam of heart .............................. 0.00 1.93 1.95 NA NA 0.11 2.04 2.06 NA NA XXX

93312 ............ A Echo transesophageal .......................... 2.20 4.65 4.84 4.65 4.84 0.32 7.17 7.36 7.17 7.36 XXX

93312 26 A Echo transesophageal .......................... 2.20 0.89 1.04 0.89 1.04 0.08 3.17 3.32 3.17 3.32 XXX

93312 TC A Echo transesophageal .......................... 0.00 3.76 3.80 NA NA 0.24 4.00 4.04 NA NA XXX

93313 ............ A Echo transesophageal .......................... 0.95 4.30 3.41 0.22 0.35 0.05 5.30 4.41 1.22 1.35 XXX

93314 ............ A Echo transesophageal .......................... 1.25 4.28 4.37 4.28 4.37 0.28 5.81 5.90 5.81 5.90 XXX

93314 26 A Echo transesophageal .......................... 1.25 0.52 0.57 0.52 0.57 0.04 1.81 1.86 1.81 1.86 XXX

93314 TC A Echo transesophageal .......................... 0.00 3.76 3.80 NA NA 0.24 4.00 4.04 NA NA XXX

93315 ............ A Echo transesophageal .......................... 2.78 4.86 4.99 4.86 4.99 0.34 7.98 8.11 7.98 8.11 XXX

93315 26 A Echo transesophageal .......................... 2.78 1.10 1.19 1.10 1.19 0.10 3.98 4.07 3.98 4.07 XXX

93315 TC A Echo transesophageal .......................... 0.00 3.76 3.80 NA NA 0.24 4.00 4.04 NA NA XXX

93316 ............ A Echo transesophageal .......................... 0.95 3.09 2.50 0.23 0.36 0.05 4.09 3.50 1.23 1.36 XXX

93317 ............ A Echo transesophageal .......................... 1.83 4.52 4.55 4.52 4.55 0.30 6.65 6.68 6.65 6.68 XXX

93317 26 A Echo transesophageal .......................... 1.83 0.76 0.75 0.76 0.75 0.06 2.65 2.64 2.65 2.64 XXX

93317 TC A Echo transesophageal .......................... 0.00 3.76 3.80 NA NA 0.24 4.00 4.04 NA NA XXX

93318 ............ C Echo transesophageal intraop ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93318 26 C Echo transesophageal intraop ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93318 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 XXX

93320 ............ A Doppler echo exam, heart .................... 0.38 1.86 1.96 1.86 1.96 0.11 2.35 2.45 2.35 2.45 ZZZ

93320 26 A Doppler echo exam, heart .................... 0.38 0.16 0.24 0.16 0.24 0.01 0.55 0.63 0.55 0.63 ZZZ

93320 TC A Doppler echo exam, heart .................... 0.00 1.70 1.72 NA NA 0.10 1.80 1.82 NA NA ZZZ

93321 ............ A Doppler echo exam, heart .................... 0.15 1.16 1.20 1.16 1.20 0.08 1.39 1.43 1.39 1.43 ZZZ

93321 26 A Doppler echo exam, heart .................... 0.15 0.06 0.09 0.06 0.09 0.01 0.22 0.25 0.22 0.25 ZZZ

93321 TC A Doppler echo exam, heart .................... 0.00 1.10 1.11 NA NA 0.07 1.17 1.18 NA NA ZZZ

93325 ............ A Doppler color flow add-on .................... 0.07 2.91 2.94 2.91 2.94 0.18 3.16 3.19 3.16 3.19 ZZZ

93325 26 A Doppler color flow add-on .................... 0.07 0.03 0.03 0.03 0.03 0.01 0.11 0.11 0.11 0.11 ZZZ

93325 TC A Doppler color flow add-on .................... 0.00 2.88 2.91 NA NA 0.17 3.05 3.08 NA NA ZZZ

93350 ............ A Echo transthoracic ................................ 0.78 2.08 2.25 2.08 2.25 0.13 2.99 3.16 2.99 3.16 XXX

93350 26 A Echo transthoracic ................................ 0.78 0.33 0.48 0.33 0.48 0.02 1.13 1.28 1.13 1.28 XXX

93350 TC A Echo transthoracic ................................ 0.00 1.75 1.77 NA NA 0.11 1.86 1.88 NA NA XXX

93501 ............ A Right heart catheterization ................... 3.02 17.59 18.46 17.59 18.46 1.03 21.64 22.51 21.64 22.51 000

93501 26 A Right heart catheterization ................... 3.02 1.27 1.85 1.27 1.85 0.16 4.45 5.03 4.45 5.03 000

93501 TC A Right heart catheterization ................... 0.00 16.32 16.61 NA NA 0.87 17.19 17.48 NA NA 000

93503 ............ A Insert/place heart catheter ................... 2.91 NA NA 0.75 1.21 0.16 NA NA 3.82 4.28 000

93505 ............ A Biopsy of heart lining ............................ 4.38 3.78 4.18 3.78 4.18 0.36 8.52 8.92 8.52 8.92 000

93505 26 A Biopsy of heart lining ............................ 4.38 1.87 2.23 1.87 2.23 0.23 6.48 6.84 6.48 6.84 000

93505 TC A Biopsy of heart lining ............................ 0.00 1.91 1.95 NA NA 0.13 2.04 2.08 NA NA 000

93508 ............ A Cath placement, angiography .............. 4.10 13.94 14.47 13.94 14.47 0.75 18.79 19.32 18.79 19.32 000

93508 26 A Cath placement, angiography .............. 4.10 1.77 2.08 1.77 2.08 0.21 6.08 6.39 6.08 6.39 000

93508 TC A Cath placement, angiography .............. 0.00 12.17 12.39 NA NA 0.54 12.71 12.93 NA NA 000

93510 ............ A Left heart catheterization ...................... 4.33 37.54 38.54 37.54 38.54 2.13 44.00 45.00 44.00 45.00 000

93510 26 A Left heart catheterization ...................... 4.33 1.88 2.24 1.88 2.24 0.22 6.43 6.79 6.43 6.79 000

93510 TC A Left heart catheterization ...................... 0.00 35.66 36.30 NA NA 1.91 37.57 38.21 NA NA 000

93511 ............ A Left heart catheterization ...................... 5.03 36.89 37.69 36.89 37.69 2.11 44.03 44.83 44.03 44.83 000

93511 26 A Left heart catheterization ...................... 5.03 2.18 2.35 2.18 2.35 0.26 7.47 7.64 7.47 7.64 000

93511 TC A Left heart catheterization ...................... 0.00 34.71 35.34 NA NA 1.85 36.56 37.19 NA NA 000

93514 ............ A Left heart catheterization ...................... 7.05 37.49 38.66 37.49 38.66 2.22 46.76 47.93 46.76 47.93 000

93514 26 A Left heart catheterization ...................... 7.05 2.78 3.32 2.78 3.32 0.37 10.20 10.74 10.20 10.74 000

93514 TC A Left heart catheterization ...................... 0.00 34.71 35.34 NA NA 1.85 36.56 37.19 NA NA 000

93524 ............ A Left heart catheterization ...................... 6.95 48.31 49.66 48.31 49.66 2.79 58.05 59.40 58.05 59.40 000

93524 26 A Left heart catheterization ...................... 6.95 2.95 3.48 2.95 3.48 0.36 10.26 10.79 10.26 10.79 000

93524 TC A Left heart catheterization ...................... 0.00 45.36 46.18 NA NA 2.43 47.79 48.61 NA NA 000

93526 ............ A Rt & Lt heart catheters ......................... 5.99 49.20 50.87 49.20 50.87 2.81 58.00 59.67 58.00 59.67 000

93526 26 A Rt & Lt heart catheters ......................... 5.99 2.59 3.42 2.59 3.42 0.31 8.89 9.72 8.89 9.72 000

65547

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

93526 TC A Rt & Lt heart catheters ......................... 0.00 46.61 47.45 NA NA 2.50 49.11 49.95 NA NA 000

93527 ............ A Rt & Lt heart catheters ......................... 7.28 48.50 50.47 48.50 50.47 2.81 58.59 60.56 58.59 60.56 000

93527 26 A Rt & Lt heart catheters ......................... 7.28 3.14 4.29 3.14 4.29 0.38 10.80 11.95 10.80 11.95 000

93527 TC A Rt & Lt heart catheters ......................... 0.00 45.36 46.18 NA NA 2.43 47.79 48.61 NA NA 000

93528 ............ A Rt & Lt heart catheters ......................... 9.00 49.31 50.35 49.31 50.35 2.90 61.21 62.25 61.21 62.25 000

93528 26 A Rt & Lt heart catheters ......................... 9.00 3.95 4.17 3.95 4.17 0.47 13.42 13.64 13.42 13.64 000

93528 TC A Rt & Lt heart catheters ......................... 0.00 45.36 46.18 NA NA 2.43 47.79 48.61 NA NA 000

93529 ............ A Rt, Lt heart catheterization ................... 4.80 47.42 48.52 47.42 48.52 2.68 54.90 56.00 54.90 56.00 000

93529 26 A Rt, Lt heart catheterization ................... 4.80 2.06 2.34 2.06 2.34 0.25 7.11 7.39 7.11 7.39 000

93529 TC A Rt, Lt heart catheterization ................... 0.00 45.36 46.18 NA NA 2.43 47.79 48.61 NA NA 000

93530 ............ A Rt heart cath, congenital ...................... 4.23 17.91 18.78 17.91 18.78 1.11 23.25 24.12 23.25 24.12 000

93530 26 A Rt heart cath, congenital ...................... 4.23 1.59 2.17 1.59 2.17 0.24 6.06 6.64 6.06 6.64 000

93530 TC A Rt heart cath, congenital ...................... 0.00 16.32 16.61 NA NA 0.87 17.19 17.48 NA NA 000

93531 ............ A R & l heart cath, congenital ................. 8.35 49.98 51.46 49.98 51.46 2.96 61.29 62.77 61.29 62.77 000

93531 26 A R & l heart cath, congenital ................. 8.35 3.37 4.01 3.37 4.01 0.46 12.18 12.82 12.18 12.82 000

93531 TC A R & l heart cath, congenital ................. 0.00 46.61 47.45 NA NA 2.50 49.11 49.95 NA NA 000

93532 ............ A R & l heart cath, congenital ................. 10.00 49.37 51.13 49.37 51.13 2.95 62.32 64.08 62.32 64.08 000

93532 26 A R & l heart cath, congenital ................. 10.00 4.01 4.95 4.01 4.95 0.52 14.53 15.47 14.53 15.47 000

93532 TC A R & l heart cath, congenital ................. 0.00 45.36 46.18 NA NA 2.43 47.79 48.61 NA NA 000

93533 ............ A R & l heart cath, congenital ................. 6.70 47.90 48.88 47.90 48.88 2.86 57.46 58.44 57.46 58.44 000

93533 26 A R & l heart cath, congenital ................. 6.70 2.54 2.70 2.54 2.70 0.43 9.67 9.83 9.67 9.83 000

93533 TC A R & l heart cath, congenital ................. 0.00 45.36 46.18 NA NA 2.43 47.79 48.61 NA NA 000

93536 ............ A Insert circulation assi ............................ 4.85 NA NA 2.12 3.04 0.27 NA NA 7.24 8.16 000

93539 ............ A Injection, cardiac cath .......................... 0.40 0.83 0.86 0.17 0.25 0.01 1.24 1.27 0.58 0.66 000

93540 ............ A Injection, cardiac cath .......................... 0.43 0.84 0.87 0.19 0.27 0.01 1.28 1.31 0.63 0.71 000

93541 ............ A Injection for lung angiogram ................. 0.29 NA NA 0.13 0.19 0.01 NA NA 0.43 0.49 000

93542 ............ A Injection for heart x-rays ...................... 0.29 NA NA 0.12 0.18 0.01 NA NA 0.42 0.48 000

93543 ............ A Injection for heart x-rays ...................... 0.29 0.53 0.55 0.13 0.19 0.01 0.83 0.85 0.43 0.49 000

93544 ............ A Injection for aortography ...................... 0.25 0.52 0.55 0.11 0.16 0.01 0.78 0.81 0.37 0.42 000

93545 ............ A Inject for coronary x-rays ..................... 0.40 0.83 0.74 0.17 0.25 0.01 1.24 1.15 0.58 0.66 000

93555 ............ A Imaging, cardiac cath ........................... 0.81 6.40 6.50 6.40 6.50 0.31 7.52 7.62 7.52 7.62 XXX

93555 26 A Imaging, cardiac cath ........................... 0.81 0.35 0.34 0.35 0.34 0.03 1.19 1.18 1.19 1.18 XXX

93555 TC A Imaging, cardiac cath ........................... 0.00 6.05 6.16 NA NA 0.28 6.33 6.44 NA NA XXX

93556 ............ A Imaging, cardiac cath ........................... 0.83 9.91 10.11 9.91 10.11 0.45 11.19 11.39 11.19 11.39 XXX

93556 26 A Imaging, cardiac cath ........................... 0.83 0.36 0.39 0.36 0.39 0.03 1.22 1.25 1.22 1.25 XXX

93556 TC A Imaging, cardiac cath ........................... 0.00 9.55 9.72 NA NA 0.42 9.97 10.14 NA NA XXX

93561 ............ A Cardiac output measurement ............... 0.50 0.69 0.81 0.69 0.81 0.07 1.26 1.38 1.26 1.38 000

93561 26 A Cardiac output measurement ............... 0.50 0.17 0.28 0.17 0.28 0.02 0.69 0.80 0.69 0.80 000

93561 TC A Cardiac output measurement ............... 0.00 0.52 0.53 NA NA 0.05 0.57 0.58 NA NA 000

93562 ............ A Cardiac output measurement ............... 0.16 0.35 0.40 0.35 0.40 0.04 0.55 0.60 0.55 0.60 000

93562 26 A Cardiac output measurement ............... 0.16 0.05 0.09 0.05 0.09 0.01 0.22 0.26 0.22 0.26 000

93562 TC A Cardiac output measurement ............... 0.00 0.30 0.31 NA NA 0.03 0.33 0.34 NA NA 000

93571 ............ A Heart flow reserve measure ................. 1.80 5.29 5.29 5.29 5.29 0.31 7.40 7.40 7.40 7.40 ZZZ

93571 26 A Heart flow reserve measure ................. 1.80 0.76 0.76 0.76 0.76 0.11 2.67 2.67 2.67 2.67 ZZZ

93571 TC A Heart flow reserve measure ................. 0.00 4.53 4.53 NA NA 0.20 4.73 4.73 NA NA ZZZ

93572 ............ A Heart flow reserve measure ................. 1.44 2.88 2.88 2.88 2.88 0.28 4.60 4.60 4.60 4.60 ZZZ

93572 26 A Heart flow reserve measure ................. 1.44 0.60 0.60 0.60 0.60 0.17 2.21 2.21 2.21 2.21 ZZZ

93572 TC A Heart flow reserve measure ................. 0.00 2.28 2.28 NA NA 0.11 2.39 2.39 NA NA ZZZ

93600 ............ A Bundle of His recording ........................ 2.12 2.85 3.28 2.85 3.28 0.22 5.19 5.62 5.19 5.62 000

93600 26 A Bundle of His recording ........................ 2.12 0.91 1.32 0.91 1.32 0.11 3.14 3.55 3.14 3.55 000

93600 TC A Bundle of His recording ........................ 0.00 1.94 1.96 NA NA 0.11 2.05 2.07 NA NA 000

93602 ............ A Intra-atrial recording ............................. 2.12 2.02 2.28 2.02 2.28 0.18 4.32 4.58 4.32 4.58 000

93602 26 A Intra-atrial recording ............................. 2.12 0.92 1.17 0.92 1.17 0.12 3.16 3.41 3.16 3.41 000

93602 TC A Intra-atrial recording ............................. 0.00 1.10 1.11 NA NA 0.06 1.16 1.17 NA NA 000

93603 ............ A Right ventricular recording ................... 2.12 2.59 2.98 2.59 2.98 0.20 4.91 5.30 4.91 5.30 000

93603 26 A Right ventricular recording ................... 2.12 0.92 1.29 0.92 1.29 0.11 3.15 3.52 3.15 3.52 000

93603 TC A Right ventricular recording ................... 0.00 1.67 1.69 NA NA 0.09 1.76 1.78 NA NA 000

93607 ............ A Left ventricular recording ...................... 3.26 2.91 3.17 2.91 3.17 0.26 6.43 6.69 6.43 6.69 000

93607 26 A Left ventricular recording ...................... 3.26 1.43 1.67 1.43 1.67 0.17 4.86 5.10 4.86 5.10 000

93607 TC A Left ventricular recording ...................... 0.00 1.48 1.50 NA NA 0.09 1.57 1.59 NA NA 000

93609 ............ A Mapping of tachycardia ........................ 10.07 7.04 7.03 7.04 7.03 0.66 17.77 17.76 17.77 17.76 000

93609 26 A Mapping of tachycardia ........................ 10.07 4.34 4.30 4.34 4.30 0.52 14.93 14.89 14.93 14.89 000

93609 TC A Mapping of tachycardia ........................ 0.00 2.70 2.73 NA NA 0.14 2.84 2.87 NA NA 000

93610 ............ A Intra-atrial pacing .................................. 3.02 2.64 2.96 2.64 2.96 0.25 5.91 6.23 5.91 6.23 000

93610 26 A Intra-atrial pacing .................................. 3.02 1.29 1.60 1.29 1.60 0.17 4.48 4.79 4.48 4.79 000

93610 TC A Intra-atrial pacing .................................. 0.00 1.35 1.36 NA NA 0.08 1.43 1.44 NA NA 000

93612 ............ A Intraventricular pacing .......................... 3.02 2.90 3.23 2.90 3.23 0.26 6.18 6.51 6.18 6.51 000

93612 26 A Intraventricular pacing .......................... 3.02 1.30 1.61 1.30 1.61 0.17 4.49 4.80 4.49 4.80 000

93612 TC A Intraventricular pacing .......................... 0.00 1.60 1.62 NA NA 0.09 1.69 1.71 NA NA 000

93615 ............ A Esophageal recording .......................... 0.99 0.72 0.72 0.72 0.72 0.05 1.76 1.76 1.76 1.76 000

93615 26 A Esophageal recording .......................... 0.99 0.40 0.40 0.40 0.40 0.03 1.42 1.42 1.42 1.42 000

93615 TC A Esophageal recording .......................... 0.00 0.32 0.32 NA NA 0.02 0.34 0.34 NA NA 000

93616 ............ A Esophageal recording .......................... 1.49 0.82 1.07 0.82 1.07 0.08 2.39 2.64 2.39 2.64 000

93616 26 A Esophageal recording .......................... 1.49 0.50 0.75 0.50 0.75 0.06 2.05 2.30 2.05 2.30 000

93616 TC A Esophageal recording .......................... 0.00 0.32 0.32 NA NA 0.02 0.34 0.34 NA NA 000

93618 ............ A Heart rhythm pacing ............................. 4.26 5.78 6.63 5.78 6.63 0.42 10.46 11.31 10.46 11.31 000

93618 26 A Heart rhythm pacing ............................. 4.26 1.84 2.65 1.84 2.65 0.22 6.32 7.13 6.32 7.13 000

93618 TC A Heart rhythm pacing ............................. 0.00 3.94 3.98 NA NA 0.20 4.14 4.18 NA NA 000

93619 ............ A Electrophysiology evaluation ................ 7.32 10.80 12.28 10.80 12.28 0.77 18.89 20.37 18.89 20.37 000

93619 26 A Electrophysiology evaluation ................ 7.32 3.15 4.55 3.15 4.55 0.38 10.85 12.25 10.85 12.25 000

93619 TC A Electrophysiology evaluation ................ 0.00 7.65 7.73 NA NA 0.39 8.04 8.12 NA NA 000

93620 ............ A Electrophysiology evaluation ................ 11.59 13.91 16.21 13.91 16.21 1.04 26.54 28.84 26.54 28.84 000

93620 26 A Electrophysiology evaluation ................ 11.59 5.01 7.22 5.01 7.22 0.60 17.20 19.41 17.20 19.41 000

65548

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

93620 TC A Electrophysiology evaluation ................ 0.00 8.90 8.99 NA NA 0.44 9.34 9.43 NA NA 000

93621 ............ C Electrophysiology evaluation ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000

93621 26 A Electrophysiology evaluation ................ 12.66 5.47 7.88 5.47 7.88 0.66 18.79 21.20 18.79 21.20 000

93621 TC C Electrophysiology evaluation ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000

93622 ............ C Electrophysiology evaluation ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000

93622 26 A Electrophysiology evaluation ................ 12.74 5.48 7.91 5.48 7.91 0.67 18.89 21.32 18.89 21.32 000

93622 TC C Electrophysiology evaluation ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000

93623 ............ C Stimulation, pacing heart ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

93623 26 A Stimulation, pacing heart ...................... 2.85 1.23 1.68 1.23 1.68 0.15 4.23 4.68 4.23 4.68 ZZZ

93623 TC C Stimulation, pacing heart ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

93624 ............ A Electrophysiologic study ....................... 4.81 4.03 4.35 4.03 4.35 0.36 9.20 9.52 9.20 9.52 000

93624 26 A Electrophysiologic study ....................... 4.81 2.06 2.36 2.06 2.36 0.25 7.12 7.42 7.12 7.42 000

93624 TC A Electrophysiologic study ....................... 0.00 1.97 1.99 NA NA 0.11 2.08 2.10 NA NA 000

93631 ............ A Heart pacing, mapping ......................... 7.60 9.30 10.13 9.30 10.13 1.17 18.07 18.90 18.07 18.90 000

93631 26 A Heart pacing, mapping ......................... 7.60 3.20 3.96 3.20 3.96 0.66 11.46 12.22 11.46 12.22 000

93631 TC A Heart pacing, mapping ......................... 0.00 6.10 6.17 NA NA 0.51 6.61 6.68 NA NA 000

93640 ............ A Evaluation heart device ........................ 3.52 8.59 9.35 8.59 9.35 0.53 12.64 13.40 12.64 13.40 000

93640 26 A Evaluation heart device ........................ 3.52 1.47 2.15 1.47 2.15 0.18 5.17 5.85 5.17 5.85 000

93640 TC A Evaluation heart device ........................ 0.00 7.12 7.20 NA NA 0.35 7.47 7.55 NA NA 000

93641 ............ A Electrophysiology evaluation ................ 5.93 9.68 10.89 9.68 10.89 0.66 16.27 17.48 16.27 17.48 000

93641 26 A Electrophysiology evaluation ................ 5.93 2.56 3.69 2.56 3.69 0.31 8.80 9.93 8.80 9.93 000

93641 TC A Electrophysiology evaluation ................ 0.00 7.12 7.20 NA NA 0.35 7.47 7.55 NA NA 000

93642 ............ A Electrophysiology evaluation ................ 4.89 9.17 10.20 9.17 10.20 0.51 14.57 15.60 14.57 15.60 000

93642 26 A Electrophysiology evaluation ................ 4.89 2.05 3.00 2.05 3.00 0.16 7.10 8.05 7.10 8.05 000

93642 TC A Electrophysiology evaluation ................ 0.00 7.12 7.20 NA NA 0.35 7.47 7.55 NA NA 000

93650 ............ A Ablate heart dysrhythm focus .............. 10.51 NA NA 4.61 6.60 0.55 NA NA 15.67 17.66 000

93651 ............ A Ablate heart dysrhythm focus .............. 16.25 NA NA 7.06 10.13 0.85 NA NA 24.16 27.23 000

93652 ............ A Ablate heart dysrhythm focus .............. 17.68 NA NA 7.66 10.58 0.92 NA NA 26.26 29.18 000

93660 ............ A Tilt table evaluation .............................. 1.89 2.49 2.68 2.49 2.68 0.08 4.46 4.65 4.46 4.65 000

93660 26 A Tilt table evaluation .............................. 1.89 0.82 1.01 0.82 1.01 0.06 2.77 2.96 2.77 2.96 000

93660 TC A Tilt table evaluation .............................. 0.00 1.67 1.67 NA NA 0.02 1.69 1.69 NA NA 000

93662 ............ A Intracardiac ecg (ice) ............................ 2.80 4.98 4.98 4.98 4.98 0.41 8.19 8.19 8.19 8.19 ZZZ

93662 26 A Intracardiac ecg (ice) ............................ 2.80 1.22 1.22 1.22 1.22 0.11 4.13 4.13 4.13 4.13 ZZZ

93662 TC A Intracardiac ecg (ice) ............................ 0.00 3.76 3.76 NA NA 0.30 4.06 4.06 NA NA ZZZ

93668 ............ N Peripheral vascular rehab .................... 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 XXX

93720 ............ A Total body plethysmography ................ 0.17 0.75 0.81 NA NA 0.06 0.98 1.04 NA NA XXX

93721 ............ A Plethysmography tracing ...................... 0.00 0.70 0.71 NA NA 0.05 0.75 0.76 NA NA XXX

93722 ............ A Plethysmography report ....................... 0.17 0.05 0.10 0.05 0.09 0.01 0.23 0.28 0.23 0.27 XXX

93724 ............ A Analyze pacemaker system ................. 4.89 6.08 6.37 6.08 6.37 0.38 11.35 11.64 11.35 11.64 000

93724 26 A Analyze pacemaker system ................. 4.89 2.14 2.39 2.14 2.39 0.18 7.21 7.46 7.21 7.46 000

93724 TC A Analyze pacemaker system ................. 0.00 3.94 3.98 NA NA 0.20 4.14 4.18 NA NA 000

93727 ............ A Analyze ilr system ................................ 0.52 0.22 0.22 0.22 0.22 0.05 0.79 0.79 0.79 0.79 XXX

93731 ............ A Analyze pacemaker system ................. 0.45 0.68 0.73 0.68 0.73 0.05 1.18 1.23 1.18 1.23 XXX

93731 26 A Analyze pacemaker system ................. 0.45 0.19 0.23 0.19 0.23 0.02 0.66 0.70 0.66 0.70 XXX

93731 TC A Analyze pacemaker system ................. 0.00 0.49 0.50 NA NA 0.03 0.52 0.53 NA NA XXX

93732 ............ A Analyze pacemaker system ................. 0.92 0.90 0.93 0.90 0.93 0.06 1.88 1.91 1.88 1.91 XXX

93732 26 A Analyze pacemaker system ................. 0.92 0.39 0.41 0.39 0.41 0.03 1.34 1.36 1.34 1.36 XXX

93732 TC A Analyze pacemaker system ................. 0.00 0.51 0.52 NA NA 0.03 0.54 0.55 NA NA XXX

93733 ............ A Telephone analy, pacemaker ............... 0.17 0.79 0.84 0.79 0.84 0.06 1.02 1.07 1.02 1.07 XXX

93733 26 A Telephone analy, pacemaker ............... 0.17 0.07 0.11 0.07 0.11 0.01 0.25 0.29 0.25 0.29 XXX

93733 TC A Telephone analy, pacemaker ............... 0.00 0.72 0.73 NA NA 0.05 0.77 0.78 NA NA XXX

93734 ............ A Analyze pacemaker system ................. 0.38 0.51 0.56 0.51 0.56 0.03 0.92 0.97 0.92 0.97 XXX

93734 26 A Analyze pacemaker system ................. 0.38 0.16 0.21 0.16 0.21 0.01 0.55 0.60 0.55 0.60 XXX

93734 TC A Analyze pacemaker system ................. 0.00 0.35 0.35 NA NA 0.02 0.37 0.37 NA NA XXX

93735 ............ A Analyze pacemaker system ................. 0.74 0.76 0.81 0.76 0.81 0.06 1.56 1.61 1.56 1.61 XXX

93735 26 A Analyze pacemaker system ................. 0.74 0.32 0.36 0.32 0.36 0.03 1.09 1.13 1.09 1.13 XXX

93735 TC A Analyze pacemaker system ................. 0.00 0.44 0.45 NA NA 0.03 0.47 0.48 NA NA XXX

93736 ............ A Telephone analy, pacemaker ............... 0.15 0.69 0.73 0.69 0.73 0.06 0.90 0.94 0.90 0.94 XXX

93736 26 A Telephone analy, pacemaker ............... 0.15 0.07 0.10 0.07 0.10 0.01 0.23 0.26 0.23 0.26 XXX

93736 TC A Telephone analy, pacemaker ............... 0.00 0.62 0.63 NA NA 0.05 0.67 0.68 NA NA XXX

93737 ............ A Analyze cardio/defibrillator ................... 0.45 0.68 0.72 0.68 0.72 0.04 1.17 1.21 1.17 1.21 XXX

93737 26 A Analyze cardio/defibrillator ................... 0.45 0.19 0.22 0.19 0.22 0.01 0.65 0.68 0.65 0.68 XXX

93737 TC A Analyze cardio/defibrillator ................... 0.00 0.49 0.50 NA NA 0.03 0.52 0.53 NA NA XXX

93738 ............ A Analyze cardio/defibrillator ................... 0.92 0.90 0.92 0.90 0.92 0.06 1.88 1.90 1.88 1.90 XXX

93738 26 A Analyze cardio/defibrillator ................... 0.92 0.39 0.40 0.39 0.40 0.03 1.34 1.35 1.34 1.35 XXX

93738 TC A Analyze cardio/defibrillator ................... 0.00 0.51 0.52 NA NA 0.03 0.54 0.55 NA NA XXX

93740 ............ B Temperature gradient studies .............. +0.16 0.21 0.28 0.21 0.28 0.02 0.39 0.46 0.39 0.46 XXX

93740 26 B Temperature gradient studies .............. +0.16 0.06 0.13 0.06 0.13 0.01 0.23 0.30 0.23 0.30 XXX

93740 TC B Temperature gradient studies .............. +0.00 0.15 0.15 NA NA 0.01 0.16 0.16 NA NA XXX

93741 ............ A Analyze ht pace device sngl ................ 0.80 0.98 0.98 0.98 0.98 0.05 1.83 1.83 1.83 1.83 XXX

93741 26 A Analyze ht pace device sngl ................ 0.80 0.32 0.32 0.32 0.32 0.02 1.14 1.14 1.14 1.14 XXX

93741 TC A Analyze ht pace device sngl ................ 0.00 0.66 0.66 NA NA 0.03 0.69 0.69 NA NA XXX

93742 ............ A Analyze ht pace device sngl ................ 0.91 1.02 1.02 1.02 1.02 0.05 1.98 1.98 1.98 1.98 XXX

93742 26 A Analyze ht pace device sngl ................ 0.91 0.36 0.36 0.36 0.36 0.02 1.29 1.29 1.29 1.29 XXX

93742 TC A Analyze ht pace device sngl ................ 0.00 0.66 0.66 NA NA 0.03 0.69 0.69 NA NA XXX

93743 ............ A Analyze ht pace device dual ................ 1.03 1.14 1.14 1.14 1.14 0.06 2.23 2.23 2.23 2.23 XXX

93743 26 A Analyze ht pace device dual ................ 1.03 0.41 0.41 0.41 0.41 0.03 1.47 1.47 1.47 1.47 XXX

93743 TC A Analyze ht pace device dual ................ 0.00 0.73 0.73 NA NA 0.03 0.76 0.76 NA NA XXX

93744 ............ A Analyze ht pace device dual ................ 1.18 1.13 1.13 1.13 1.13 0.06 2.37 2.37 2.37 2.37 XXX

93744 26 A Analyze ht pace device dual ................ 1.18 0.47 0.47 0.47 0.47 0.03 1.68 1.68 1.68 1.68 XXX

93744 TC A Analyze ht pace device dual ................ 0.00 0.66 0.66 NA NA 0.03 0.69 0.69 NA NA XXX

93760 ............ N Cephalic thermogram ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93762 ............ N Peripheral thermogram ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65549

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

93770 ............ B Measure venous pressure .................... +0.16 0.09 0.12 0.09 0.12 0.02 0.27 0.30 0.27 0.30 XXX

93770 26 B Measure venous pressure .................... +0.16 0.06 0.09 0.06 0.09 0.01 0.23 0.26 0.23 0.26 XXX

93770 TC B Measure venous pressure .................... +0.00 0.03 0.03 NA NA 0.01 0.04 0.04 NA NA XXX

93784 ............ N Ambulatory BP monitoring ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93786 ............ N Ambulatory BP recording ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93788 ............ N Ambulatory BP analysis ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93790 ............ N Review/report BP recording ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93797 ............ A Cardiac rehab ....................................... 0.18 0.40 0.36 0.07 0.08 0.01 0.59 0.55 0.26 0.27 000

93798 ............ A Cardiac rehab/monitor .......................... 0.28 0.47 0.48 0.12 0.16 0.01 0.76 0.77 0.41 0.45 000

93799 ............ C Cardiovascular procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93799 26 C Cardiovascular procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93799 TC C Cardiovascular procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

93875 ............ A Extracranial study ................................. 0.22 1.18 1.24 1.18 1.24 0.10 1.50 1.56 1.50 1.56 XXX

93875 26 A Extracranial study ................................. 0.22 0.08 0.13 0.08 0.13 0.01 0.31 0.36 0.31 0.36 XXX

93875 TC A Extracranial study ................................. 0.00 1.10 1.11 NA NA 0.09 1.19 1.20 NA NA XXX

93880 ............ A Extracranial study ................................. 0.60 3.92 4.01 3.92 4.01 0.33 4.85 4.94 4.85 4.94 XXX

93880 26 A Extracranial study ................................. 0.60 0.22 0.27 0.22 0.27 0.04 0.86 0.91 0.86 0.91 XXX

93880 TC A Extracranial study ................................. 0.00 3.70 3.74 NA NA 0.29 3.99 4.03 NA NA XXX

93882 ............ A Extracranial study ................................. 0.40 2.61 2.67 2.61 2.67 0.22 3.23 3.29 3.23 3.29 XXX

93882 26 A Extracranial study ................................. 0.40 0.15 0.18 0.15 0.18 0.04 0.59 0.62 0.59 0.62 XXX

93882 TC A Extracranial study ................................. 0.00 2.46 2.49 NA NA 0.18 2.64 2.67 NA NA XXX

93886 ............ A Intracranial study .................................. 0.94 4.58 4.64 4.58 4.64 0.37 5.89 5.95 5.89 5.95 XXX

93886 26 A Intracranial study .................................. 0.94 0.39 0.41 0.39 0.41 0.05 1.38 1.40 1.38 1.40 XXX

93886 TC A Intracranial study .................................. 0.00 4.19 4.23 NA NA 0.32 4.51 4.55 NA NA XXX

93888 ............ A Intracranial study .................................. 0.62 3.04 3.09 3.04 3.09 0.26 3.92 3.97 3.92 3.97 XXX

93888 26 A Intracranial study .................................. 0.62 0.24 0.26 0.24 0.26 0.04 0.90 0.92 0.90 0.92 XXX

93888 TC A Intracranial study .................................. 0.00 2.80 2.83 NA NA 0.22 3.02 3.05 NA NA XXX

93922 ............ A Extremity study ..................................... 0.25 1.23 1.29 1.23 1.29 0.13 1.61 1.67 1.61 1.67 XXX

93922 26 A Extremity study ..................................... 0.25 0.09 0.14 0.09 0.14 0.02 0.36 0.41 0.36 0.41 XXX

93922 TC A Extremity study ..................................... 0.00 1.14 1.15 NA NA 0.11 1.25 1.26 NA NA XXX

93923 ............ A Extremity study ..................................... 0.45 2.34 2.45 2.34 2.45 0.22 3.01 3.12 3.01 3.12 XXX

93923 26 A Extremity study ..................................... 0.45 0.17 0.26 0.17 0.26 0.04 0.66 0.75 0.66 0.75 XXX

93923 TC A Extremity study ..................................... 0.00 2.17 2.19 NA NA 0.18 2.35 2.37 NA NA XXX

93924 ............ A Extremity study ..................................... 0.50 2.54 2.67 2.54 2.67 0.26 3.30 3.43 3.30 3.43 XXX

93924 26 A Extremity study ..................................... 0.50 0.19 0.29 0.19 0.29 0.05 0.74 0.84 0.74 0.84 XXX

93924 TC A Extremity study ..................................... 0.00 2.35 2.38 NA NA 0.21 2.56 2.59 NA NA XXX

93925 ............ A Lower extremity study .......................... 0.58 3.93 4.02 3.93 4.02 0.33 4.84 4.93 4.84 4.93 XXX

93925 26 A Lower extremity study .......................... 0.58 0.21 0.26 0.21 0.26 0.04 0.83 0.88 0.83 0.88 XXX

93925 TC A Lower extremity study .......................... 0.00 3.72 3.76 NA NA 0.29 4.01 4.05 NA NA XXX

93926 ............ A Lower extremity study .......................... 0.39 2.62 2.69 2.62 2.69 0.22 3.23 3.30 3.23 3.30 XXX

93926 26 A Lower extremity study .......................... 0.39 0.14 0.18 0.14 0.18 0.03 0.56 0.60 0.56 0.60 XXX

93926 TC A Lower extremity study .......................... 0.00 2.48 2.51 NA NA 0.19 2.67 2.70 NA NA XXX

93930 ............ A Upper extremity study .......................... 0.46 4.12 4.22 4.12 4.22 0.34 4.92 5.02 4.92 5.02 XXX

93930 26 A Upper extremity study .......................... 0.46 0.17 0.23 0.17 0.23 0.03 0.66 0.72 0.66 0.72 XXX

93930 TC A Upper extremity study .......................... 0.00 3.95 3.99 NA NA 0.31 4.26 4.30 NA NA XXX

93931 ............ A Upper extremity study .......................... 0.31 2.73 2.80 2.73 2.80 0.22 3.26 3.33 3.26 3.33 XXX

93931 26 A Upper extremity study .......................... 0.31 0.11 0.15 0.11 0.15 0.02 0.44 0.48 0.44 0.48 XXX

93931 TC A Upper extremity study .......................... 0.00 2.62 2.65 NA NA 0.20 2.82 2.85 NA NA XXX

93965 ............ A Extremity study ..................................... 0.35 1.22 1.30 1.22 1.30 0.12 1.69 1.77 1.69 1.77 XXX

93965 26 A Extremity study ..................................... 0.35 0.13 0.20 0.13 0.20 0.02 0.50 0.57 0.50 0.57 XXX

93965 TC A Extremity study ..................................... 0.00 1.09 1.10 NA NA 0.10 1.19 1.20 NA NA XXX

93970 ............ A Extremity study ..................................... 0.68 4.35 4.44 4.35 4.44 0.38 5.41 5.50 5.41 5.50 XXX

93970 26 A Extremity study ..................................... 0.68 0.25 0.30 0.25 0.30 0.05 0.98 1.03 0.98 1.03 XXX

93970 TC A Extremity study ..................................... 0.00 4.10 4.14 NA NA 0.33 4.43 4.47 NA NA XXX

93971 ............ A Extremity study ..................................... 0.45 2.89 2.95 2.89 2.95 0.25 3.59 3.65 3.59 3.65 XXX

93971 26 A Extremity study ..................................... 0.45 0.16 0.19 0.16 0.19 0.03 0.64 0.67 0.64 0.67 XXX

93971 TC A Extremity study ..................................... 0.00 2.73 2.76 NA NA 0.22 2.95 2.98 NA NA XXX

93975 ............ A Vascular study ...................................... 1.80 5.32 5.32 5.32 5.32 0.47 7.59 7.59 7.59 7.59 XXX

93975 26 A Vascular study ...................................... 1.80 0.65 0.60 0.65 0.60 0.11 2.56 2.51 2.56 2.51 XXX

93975 TC A Vascular study ...................................... 0.00 4.67 4.72 NA NA 0.36 5.03 5.08 NA NA XXX

93976 ............ A Vascular study ...................................... 1.21 3.54 3.54 3.54 3.54 0.31 5.06 5.06 5.06 5.06 XXX

93976 26 A Vascular study ...................................... 1.21 0.43 0.40 0.43 0.40 0.06 1.70 1.67 1.70 1.67 XXX

93976 TC A Vascular study ...................................... 0.00 3.11 3.14 NA NA 0.25 3.36 3.39 NA NA XXX

93978 ............ A Vascular study ...................................... 0.65 4.06 4.15 4.06 4.15 0.36 5.07 5.16 5.07 5.16 XXX

93978 26 A Vascular study ...................................... 0.65 0.24 0.29 0.24 0.29 0.05 0.94 0.99 0.94 0.99 XXX

93978 TC A Vascular study ...................................... 0.00 3.82 3.86 NA NA 0.31 4.13 4.17 NA NA XXX

93979 ............ A Vascular study ...................................... 0.44 2.71 2.77 2.71 2.77 0.24 3.39 3.45 3.39 3.45 XXX

93979 26 A Vascular study ...................................... 0.44 0.16 0.19 0.16 0.19 0.04 0.64 0.67 0.64 0.67 XXX

93979 TC A Vascular study ...................................... 0.00 2.55 2.58 NA NA 0.20 2.75 2.78 NA NA XXX

93980 ............ A Penile vascular study ........................... 1.25 3.92 4.07 3.92 4.07 0.35 5.52 5.67 5.52 5.67 XXX

93980 26 A Penile vascular study ........................... 1.25 0.45 0.56 0.45 0.56 0.07 1.77 1.88 1.77 1.88 XXX

93980 TC A Penile vascular study ........................... 0.00 3.47 3.51 NA NA 0.28 3.75 3.79 NA NA XXX

93981 ............ A Penile vascular study ........................... 0.44 3.36 3.46 3.36 3.46 0.28 4.08 4.18 4.08 4.18 XXX

93981 26 A Penile vascular study ........................... 0.44 0.16 0.23 0.16 0.23 0.02 0.62 0.69 0.62 0.69 XXX

93981 TC A Penile vascular study ........................... 0.00 3.20 3.23 NA NA 0.26 3.46 3.49 NA NA XXX

93990 ............ A Doppler flow testing .............................. 0.25 2.58 2.64 2.58 2.64 0.21 3.04 3.10 3.04 3.10 XXX

93990 26 A Doppler flow testing .............................. 0.25 0.10 0.13 0.10 0.13 0.02 0.37 0.40 0.37 0.40 XXX

93990 TC A Doppler flow testing .............................. 0.00 2.48 2.51 NA NA 0.19 2.67 2.70 NA NA XXX

94010 ............ A Breathing capacity test ......................... 0.17 0.79 0.77 0.79 0.77 0.03 0.99 0.97 0.99 0.97 XXX

94010 26 A Breathing capacity test ......................... 0.17 0.05 0.11 0.05 0.11 0.01 0.23 0.29 0.23 0.29 XXX

94010 TC A Breathing capacity test ......................... 0.00 0.74 0.66 NA NA 0.02 0.76 0.68 NA NA XXX

94014 ............ A Patient recorded spirometry ................. 0.52 0.51 0.51 NA NA 0.03 1.06 1.06 NA NA XXX

94015 ............ A Patient recorded spirometry ................. 0.00 0.34 0.34 NA NA 0.01 0.35 0.35 NA NA XXX

65550

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

94016 ............ A Review patient spirometry .................... 0.52 0.17 0.17 0.17 0.17 0.02 0.71 0.71 0.71 0.71 XXX

94060 ............ A Evaluation of wheezing ........................ 0.31 1.18 1.22 1.18 1.22 0.06 1.55 1.59 1.55 1.59 XXX

94060 26 A Evaluation of wheezing ........................ 0.31 0.10 0.17 0.10 0.17 0.01 0.42 0.49 0.42 0.49 XXX

94060 TC A Evaluation of wheezing ........................ 0.00 1.08 1.05 NA NA 0.05 1.13 1.10 NA NA XXX

94070 ............ A Evaluation of wheezing ........................ 0.60 3.75 3.30 3.75 3.30 0.10 4.45 4.00 4.45 4.00 XXX

94070 26 A Evaluation of wheezing ........................ 0.60 0.18 0.24 0.18 0.24 0.02 0.80 0.86 0.80 0.86 XXX

94070 TC A Evaluation of wheezing ........................ 0.00 3.57 3.06 NA NA 0.08 3.65 3.14 NA NA XXX

94150 ............ B Vital capacity test ................................. +0.07 0.61 0.51 0.61 0.51 0.02 0.70 0.60 0.70 0.60 XXX

94150 26 B Vital capacity test ................................. +0.07 0.03 0.05 0.03 0.05 0.01 0.11 0.13 0.11 0.13 XXX

94150 TC B Vital capacity test ................................. +0.00 0.58 0.46 NA NA 0.01 0.59 0.47 NA NA XXX

94200 ............ A Lung function test (MBC/MVV) ............ 0.11 0.31 0.34 0.31 0.34 0.03 0.45 0.48 0.45 0.48 XXX

94200 26 A Lung function test (MBC/MVV) ............ 0.11 0.03 0.06 0.03 0.06 0.01 0.15 0.18 0.15 0.18 XXX

94200 TC A Lung function test (MBC/MVV) ............ 0.00 0.28 0.28 NA NA 0.02 0.30 0.30 NA NA XXX

94240 ............ A Residual lung capacity ......................... 0.26 1.37 1.27 1.37 1.27 0.05 1.68 1.58 1.68 1.58 XXX

94240 26 A Residual lung capacity ......................... 0.26 0.08 0.12 0.08 0.12 0.01 0.35 0.39 0.35 0.39 XXX

94240 TC A Residual lung capacity ......................... 0.00 1.29 1.15 NA NA 0.04 1.33 1.19 NA NA XXX

94250 ............ A Expired gas collection .......................... 0.11 0.63 0.55 0.63 0.55 0.02 0.76 0.68 0.76 0.68 XXX

94250 26 A Expired gas collection .......................... 0.11 0.03 0.06 0.03 0.06 0.01 0.15 0.18 0.15 0.18 XXX

94250 TC A Expired gas collection .......................... 0.00 0.60 0.49 NA NA 0.01 0.61 0.50 NA NA XXX

94260 ............ A Thoracic gas volume ............................ 0.13 0.39 0.47 0.39 0.47 0.04 0.56 0.64 0.56 0.64 XXX

94260 26 A Thoracic gas volume ............................ 0.13 0.04 0.07 0.04 0.07 0.01 0.18 0.21 0.18 0.21 XXX

94260 TC A Thoracic gas volume ............................ 0.00 0.35 0.40 NA NA 0.03 0.38 0.43 NA NA XXX

94350 ............ A Lung nitrogen washout curve ............... 0.26 1.17 1.08 1.17 1.08 0.04 1.47 1.38 1.47 1.38 XXX

94350 26 A Lung nitrogen washout curve ............... 0.26 0.08 0.12 0.08 0.12 0.01 0.35 0.39 0.35 0.39 XXX

94350 TC A Lung nitrogen washout curve ............... 0.00 1.09 0.96 NA NA 0.03 1.12 0.99 NA NA XXX

94360 ............ A Measure airflow resistance .................. 0.26 0.64 0.78 0.64 0.78 0.06 0.96 1.10 0.96 1.10 XXX

94360 26 A Measure airflow resistance .................. 0.26 0.08 0.11 0.08 0.11 0.01 0.35 0.38 0.35 0.38 XXX

94360 TC A Measure airflow resistance .................. 0.00 0.56 0.67 NA NA 0.05 0.61 0.72 NA NA XXX

94370 ............ A Breath airway closing volume .............. 0.26 2.48 1.97 2.48 1.97 0.03 2.77 2.26 2.77 2.26 XXX

94370 26 A Breath airway closing volume .............. 0.26 0.08 0.10 0.08 0.10 0.01 0.35 0.37 0.35 0.37 XXX

94370 TC A Breath airway closing volume .............. 0.00 2.40 1.87 NA NA 0.02 2.42 1.89 NA NA XXX

94375 ............ A Respiratory flow volume loop ............... 0.31 0.45 0.53 0.45 0.53 0.03 0.79 0.87 0.79 0.87 XXX

94375 26 A Respiratory flow volume loop ............... 0.31 0.09 0.13 0.09 0.13 0.01 0.41 0.45 0.41 0.45 XXX

94375 TC A Respiratory flow volume loop ............... 0.00 0.36 0.40 NA NA 0.02 0.38 0.42 NA NA XXX

94400 ............ A CO2 breathing response curve ............ 0.40 0.84 0.85 0.84 0.85 0.06 1.30 1.31 1.30 1.31 XXX

94400 26 A CO2 breathing response curve ............ 0.40 0.13 0.23 0.13 0.23 0.01 0.54 0.64 0.54 0.64 XXX

94400 TC A CO2 breathing response curve ............ 0.00 0.71 0.62 NA NA 0.05 0.76 0.67 NA NA XXX

94450 ............ A Hypoxia response curve ....................... 0.40 0.81 0.77 0.81 0.77 0.04 1.25 1.21 1.25 1.21 XXX

94450 26 A Hypoxia response curve ....................... 0.40 0.10 0.14 0.10 0.14 0.02 0.52 0.56 0.52 0.56 XXX

94450 TC A Hypoxia response curve ....................... 0.00 0.71 0.63 NA NA 0.02 0.73 0.65 NA NA XXX

94620 ............ A Pulmonary stress test/simple ............... 0.64 2.29 2.28 2.29 2.28 0.10 3.03 3.02 3.03 3.02 XXX

94620 26 A Pulmonary stress test/simple ............... 0.64 0.20 0.34 0.20 0.34 0.02 0.86 1.00 0.86 1.00 XXX

94620 TC A Pulmonary stress test/simple ............... 0.00 2.09 1.94 NA NA 0.08 2.17 2.02 NA NA XXX

94621 ............ A Pulm stress test/complex ..................... 1.42 2.12 2.15 2.12 2.15 0.13 3.67 3.70 3.67 3.70 XXX

94621 26 A Pulm stress test/complex ..................... 1.42 0.44 0.52 0.44 0.52 0.05 1.91 1.99 1.91 1.99 XXX

94621 TC A Pulm stress test/complex ..................... 0.00 1.68 1.63 NA NA 0.08 1.76 1.71 NA NA XXX

94640 ............ A Airway inhalation treatment .................. 0.00 0.67 0.61 0.22 0.27 0.02 0.69 0.63 0.24 0.29 XXX

94642 ............ C Aerosol inhalation treatment ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

94650 ............ A Pressure breathing (IPPB) ................... 0.00 0.64 0.58 0.20 0.25 0.02 0.66 0.60 0.22 0.27 XXX

94651 ............ A Pressure breathing (IPPB) ................... 0.00 0.59 0.54 0.19 0.24 0.02 0.61 0.56 0.21 0.26 XXX

94652 ............ A Pressure breathing (IPPB) ................... 0.00 0.72 0.65 0.22 0.28 0.06 0.78 0.71 0.28 0.34 XXX

94656 ............ A Initial ventilator mgmt ........................... 1.22 NA NA 0.32 0.55 0.06 NA NA 1.60 1.83 XXX

94657 ............ A Continued ventilator mgmt ................... 0.83 NA NA 0.25 0.36 0.03 NA NA 1.11 1.22 XXX

94660 ............ A Pos airway pressure, CPAP ................. 0.76 0.66 0.69 0.23 0.37 0.03 1.45 1.48 1.02 1.16 XXX

94662 ............ A Neg press ventilation, cnp .................... 0.76 NA NA 0.24 0.26 0.02 NA NA 1.02 1.04 XXX

94664 ............ A Aerosol or vapor inhalations ................ 0.00 0.50 0.51 0.16 0.26 0.03 0.53 0.54 0.19 0.29 XXX

94665 ............ A Aerosol or vapor inhalations ................ 0.00 0.51 0.51 0.16 0.25 0.04 0.55 0.55 0.20 0.29 XXX

94667 ............ A Chest wall manipulation ....................... 0.00 0.81 0.76 0.26 0.35 0.04 0.85 0.80 0.30 0.39 XXX

94668 ............ A Chest wall manipulation ....................... 0.00 0.69 0.61 0.22 0.26 0.02 0.71 0.63 0.24 0.28 XXX

94680 ............ A Exhaled air analysis, o2 ....................... 0.26 0.81 0.82 0.81 0.82 0.06 1.13 1.14 1.13 1.14 XXX

94680 26 A Exhaled air analysis, o2 ....................... 0.26 0.09 0.15 0.09 0.15 0.01 0.36 0.42 0.36 0.42 XXX

94680 TC A Exhaled air analysis, o2 ....................... 0.00 0.72 0.67 NA NA 0.05 0.77 0.72 NA NA XXX

94681 ............ A Exhaled air analysis, o2/co2 ................ 0.20 1.71 1.70 1.71 1.70 0.11 2.02 2.01 2.02 2.01 XXX

94681 26 A Exhaled air analysis, o2/co2 ................ 0.20 0.07 0.11 0.07 0.11 0.01 0.28 0.32 0.28 0.32 XXX

94681 TC A Exhaled air analysis, o2/co2 ................ 0.00 1.64 1.59 NA NA 0.10 1.74 1.69 NA NA XXX

94690 ............ A Exhaled air analysis ............................. 0.07 0.56 0.57 0.56 0.57 0.04 0.67 0.68 0.67 0.68 XXX

94690 26 A Exhaled air analysis ............................. 0.07 0.02 0.03 0.02 0.03 0.01 0.10 0.11 0.10 0.11 XXX

94690 TC A Exhaled air analysis ............................. 0.00 0.54 0.54 NA NA 0.03 0.57 0.57 NA NA XXX

94720 ............ A Monoxide diffusing capacity ................. 0.26 1.39 1.32 1.39 1.32 0.06 1.71 1.64 1.71 1.64 XXX

94720 26 A Monoxide diffusing capacity ................. 0.26 0.08 0.12 0.08 0.12 0.01 0.35 0.39 0.35 0.39 XXX

94720 TC A Monoxide diffusing capacity ................. 0.00 1.31 1.20 NA NA 0.05 1.36 1.25 NA NA XXX

94725 ............ A Membrane diffusion capacity ............... 0.26 0.82 1.12 0.82 1.12 0.11 1.19 1.49 1.19 1.49 XXX

94725 26 A Membrane diffusion capacity ............... 0.26 0.08 0.11 0.08 0.11 0.01 0.35 0.38 0.35 0.38 XXX

94725 TC A Membrane diffusion capacity ............... 0.00 0.74 1.01 NA NA 0.10 0.84 1.11 NA NA XXX

94750 ............ A Pulmonary compliance study ............... 0.23 3.58 2.90 3.58 2.90 0.04 3.85 3.17 3.85 3.17 XXX

94750 26 A Pulmonary compliance study ............... 0.23 0.07 0.12 0.07 0.12 0.01 0.31 0.36 0.31 0.36 XXX

94750 TC A Pulmonary compliance study ............... 0.00 3.51 2.78 NA NA 0.03 3.54 2.81 NA NA XXX

94760 ............ T Measure blood oxygen level ................ 0.00 0.09 0.14 NA NA 0.02 0.11 0.16 NA NA XXX

94761 ............ T Measure blood oxygen level ................ 0.00 0.17 0.30 NA NA 0.05 0.22 0.35 NA NA XXX

94762 ............ A Measure blood oxygen level ................ 0.00 0.11 0.38 NA NA 0.08 0.19 0.46 NA NA XXX

94770 ............ A Exhaled carbon dioxide test ................. 0.15 0.76 0.68 0.76 0.68 0.07 0.98 0.90 0.98 0.90 XXX

94770 26 A Exhaled carbon dioxide test ................. 0.15 0.04 0.06 0.04 0.06 0.01 0.20 0.22 0.20 0.22 XXX

94770 TC A Exhaled carbon dioxide test ................. 0.00 0.72 0.62 NA NA 0.06 0.78 0.68 NA NA XXX

65551

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

94772 ............ C Breath recording, infant ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

94772 26 C Breath recording, infant ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

94772 TC C Breath recording, infant ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

94799 ............ C Pulmonary service/procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

94799 26 C Pulmonary service/procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

94799 TC C Pulmonary service/procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95004 ............ A Allergy skin tests .................................. 0.00 0.10 0.10 0.10 0.10 0.01 0.11 0.11 0.11 0.11 XXX

95010 ............ A Sensitivity skin tests ............................. 0.15 0.45 0.37 0.07 0.07 0.01 0.61 0.53 0.23 0.23 XXX

95015 ............ A Sensitivity skin tests ............................. 0.15 0.49 0.40 0.07 0.07 0.01 0.65 0.56 0.23 0.23 XXX

95024 ............ A Allergy skin tests .................................. 0.00 0.14 0.14 0.14 0.14 0.01 0.15 0.15 0.15 0.15 XXX

95027 ............ A Skin end point titration ......................... 0.00 0.14 0.14 NA NA 0.01 0.15 0.15 NA NA XXX

95028 ............ A Allergy skin tests .................................. 0.00 0.23 0.23 NA NA 0.01 0.24 0.24 NA NA XXX

95044 ............ A Allergy patch tests ................................ 0.00 0.20 0.20 0.20 0.20 0.01 0.21 0.21 0.21 0.21 XXX

95052 ............ A Photo patch test ................................... 0.00 0.25 0.25 0.25 0.25 0.01 0.26 0.26 0.26 0.26 XXX

95056 ............ A Photosensitivity tests ............................ 0.00 0.17 0.17 0.17 0.15 0.01 0.18 0.18 0.18 0.16 XXX

95060 ............ A Eye allergy tests ................................... 0.00 0.35 0.35 NA NA 0.02 0.37 0.37 NA NA XXX

95065 ............ A Nose allergy test .................................. 0.00 0.20 0.20 NA NA 0.01 0.21 0.21 NA NA XXX

95070 ............ A Bronchial allergy tests .......................... 0.00 2.27 2.29 NA NA 0.02 2.29 2.31 NA NA XXX

95071 ............ A Bronchial allergy tests .......................... 0.00 2.90 2.93 NA NA 0.02 2.92 2.95 NA NA XXX

95075 ............ A Ingestion challenge test ....................... 0.95 0.89 1.20 0.43 0.59 0.03 1.87 2.18 1.41 1.57 XXX

95078 ............ A Provocative testing ............................... 0.00 0.25 0.25 NA NA 0.02 0.27 0.27 NA NA XXX

95115 ............ A Immunotherapy, one injection .............. 0.00 0.38 0.39 0.38 0.39 0.02 0.40 0.41 0.40 0.41 000

95117 ............ A Immunotherapy injections .................... 0.00 0.50 0.51 0.50 0.51 0.02 0.52 0.53 0.52 0.53 000

95120 ............ I Immunotherapy, one injection .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95125 ............ I Immunotherapy, many antigens ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95130 ............ I Immunotherapy, insect venom ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95131 ............ I Immunotherapy, insect venoms ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95132 ............ I Immunotherapy, insect venoms ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95133 ............ I Immunotherapy, insect venoms ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95134 ............ I Immunotherapy, insect venoms ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95144 ............ A Antigen therapy services ...................... 0.06 0.25 0.22 0.03 0.04 0.01 0.32 0.29 0.10 0.11 000

95145 ............ A Antigen therapy services ...................... 0.06 0.50 0.47 0.03 0.07 0.01 0.57 0.54 0.10 0.14 000

95146 ............ A Antigen therapy services ...................... 0.06 0.60 0.62 0.02 0.10 0.01 0.67 0.69 0.09 0.17 000

95147 ............ A Antigen therapy services ...................... 0.06 0.86 0.89 0.02 0.14 0.01 0.93 0.96 0.09 0.21 000

95148 ............ A Antigen therapy services ...................... 0.06 0.83 0.87 0.03 0.15 0.01 0.90 0.94 0.10 0.22 000

95149 ............ A Antigen therapy services ...................... 0.06 1.03 1.08 0.02 0.17 0.01 1.10 1.15 0.09 0.24 000

95165 ............ A Antigen therapy services ...................... 0.06 0.20 0.18 0.02 0.03 0.01 0.27 0.25 0.09 0.10 000

95170 ............ A Antigen therapy services ...................... 0.06 0.27 0.30 0.02 0.06 0.01 0.34 0.37 0.09 0.13 000

95180 ............ A Rapid desensitization ........................... 2.01 1.71 1.32 0.86 0.67 0.04 3.76 3.37 2.91 2.72 000

95199 ............ C Allergy immunology services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000

95805 ............ A Multiple sleep latency test .................... 1.88 7.66 7.25 7.66 7.25 0.34 9.88 9.47 9.88 9.47 XXX

95805 26 A Multiple sleep latency test .................... 1.88 0.67 0.66 0.67 0.66 0.06 2.61 2.60 2.61 2.60 XXX

95805 TC A Multiple sleep latency test .................... 0.00 6.99 6.59 NA NA 0.28 7.27 6.87 NA NA XXX

95806 ............ A Sleep study, unattended ...................... 1.66 1.73 3.25 1.73 3.08 0.32 3.71 5.23 3.71 5.06 XXX

95806 26 A Sleep study, unattended ...................... 1.66 0.54 1.07 0.54 0.90 0.06 2.26 2.79 2.26 2.62 XXX

95806 TC A Sleep study, unattended ...................... 0.00 1.19 2.18 NA NA 0.26 1.45 2.44 NA NA XXX

95807 ............ A Sleep study, attended .......................... 1.66 10.83 10.34 10.83 10.34 0.40 12.89 12.40 12.89 12.40 XXX

95807 26 A Sleep study, attended .......................... 1.66 0.53 0.90 0.53 0.90 0.05 2.24 2.61 2.24 2.61 XXX

95807 TC A Sleep study, attended .......................... 0.00 10.30 9.44 NA NA 0.35 10.65 9.79 NA NA XXX

95808 ............ A Polysomnography, 1-3 ......................... 2.65 17.52 15.51 17.52 15.51 0.44 20.61 18.60 20.61 18.60 XXX

95808 26 A Polysomnography, 1-3 ......................... 2.65 0.93 1.36 0.93 1.36 0.09 3.67 4.10 3.67 4.10 XXX

95808 TC A Polysomnography, 1-3 ......................... 0.00 16.59 14.15 NA NA 0.35 16.94 14.50 NA NA XXX

95810 ............ A Polysomnography, 4 or more ............... 3.53 15.27 13.83 15.27 13.83 0.47 19.27 17.83 19.27 17.83 XXX

95810 26 A Polysomnography, 4 or more ............... 3.53 1.20 1.57 1.20 1.57 0.12 4.85 5.22 4.85 5.22 XXX

95810 TC A Polysomnography, 4 or more ............... 0.00 14.07 12.26 NA NA 0.35 14.42 12.61 NA NA XXX

95811 ............ A Polysomnography w/cpap .................... 3.80 14.06 13.04 14.06 13.04 0.49 18.35 17.33 18.35 17.33 XXX

95811 26 A Polysomnography w/cpap .................... 3.80 1.28 1.66 1.28 1.66 0.13 5.21 5.59 5.21 5.59 XXX

95811 TC A Polysomnography w/cpap .................... 0.00 12.78 11.38 NA NA 0.36 13.14 11.74 NA NA XXX

95812 ............ A Electroencephalogram (EEG) .............. 1.08 3.39 3.05 3.39 3.05 0.13 4.60 4.26 4.60 4.26 XXX

95812 26 A Electroencephalogram (EEG) .............. 1.08 0.46 0.48 0.46 0.48 0.04 1.58 1.60 1.58 1.60 XXX

95812 TC A Electroencephalogram (EEG) .............. 0.00 2.93 2.57 NA NA 0.09 3.02 2.66 NA NA XXX

95813 ............ A Electroencephalogram (EEG) .............. 1.73 4.59 3.95 4.59 3.95 0.15 6.47 5.83 6.47 5.83 XXX

95813 26 A Electroencephalogram (EEG) .............. 1.73 0.71 0.67 0.71 0.67 0.06 2.50 2.46 2.50 2.46 XXX

95813 TC A Electroencephalogram (EEG) .............. 0.00 3.88 3.28 NA NA 0.09 3.97 3.37 NA NA XXX

95816 ............ A Electroencephalogram (EEG) .............. 1.08 3.15 2.78 3.15 2.78 0.12 4.35 3.98 4.35 3.98 XXX

95816 26 A Electroencephalogram (EEG) .............. 1.08 0.47 0.43 0.47 0.43 0.04 1.59 1.55 1.59 1.55 XXX

95816 TC A Electroencephalogram (EEG) .............. 0.00 2.68 2.35 NA NA 0.08 2.76 2.43 NA NA XXX

95819 ............ A Electroencephalogram (EEG) .............. 1.08 3.63 3.21 3.63 3.21 0.12 4.83 4.41 4.83 4.41 XXX

95819 26 A Electroencephalogram (EEG) .............. 1.08 0.47 0.49 0.47 0.49 0.04 1.59 1.61 1.59 1.61 XXX

95819 TC A Electroencephalogram (EEG) .............. 0.00 3.16 2.72 NA NA 0.08 3.24 2.80 NA NA XXX

95822 ............ A Sleep electroencephalogram ................ 1.08 2.44 2.46 2.44 2.46 0.15 3.67 3.69 3.67 3.69 XXX

95822 26 A Sleep electroencephalogram ................ 1.08 0.47 0.51 0.47 0.51 0.04 1.59 1.63 1.59 1.63 XXX

95822 TC A Sleep electroencephalogram ................ 0.00 1.97 1.95 NA NA 0.11 2.08 2.06 NA NA XXX

95824 ............ A Electroencephalography ....................... 0.74 0.71 0.80 0.71 0.80 0.05 1.50 1.59 1.50 1.59 XXX

95824 26 H Electroencephalography ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

95824 TC H Electroencephalography ....................... 0.00 0.00 0.00 NA NA 0.00 0.00 0.00 NA NA XXX

95827 ............ A Night electroencephalogram ................ 1.08 2.70 2.86 2.70 2.86 0.15 3.93 4.09 3.93 4.09 XXX

95827 26 A Night electroencephalogram ................ 1.08 0.42 0.56 0.42 0.56 0.03 1.53 1.67 1.53 1.67 XXX

95827 TC A Night electroencephalogram ................ 0.00 2.28 2.30 NA NA 0.12 2.40 2.42 NA NA XXX

95829 ............ A Surgery electrocorticogram .................. 6.21 28.41 21.47 28.41 21.47 0.33 34.95 28.01 34.95 28.01 XXX

95829 26 A Surgery electrocorticogram .................. 6.21 2.01 1.63 2.01 1.63 0.31 8.53 8.15 8.53 8.15 XXX

95829 TC A Surgery electrocorticogram .................. 0.00 26.40 19.84 NA NA 0.02 26.42 19.86 NA NA XXX

95830 ............ A Insert electrodes for EEG ..................... 1.70 3.25 2.65 0.75 0.78 0.07 5.02 4.42 2.52 2.55 XXX

65552

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

95831 ............ A Limb muscle testing, manual ............... 0.28 0.47 0.43 0.13 0.14 0.01 0.76 0.72 0.42 0.43 XXX

95832 ............ A Hand muscle testing, manual ............... 0.29 0.43 0.39 0.11 0.12 0.01 0.73 0.69 0.41 0.42 XXX

95833 ............ A Body muscle testing, manual ............... 0.47 0.55 0.52 0.24 0.23 0.01 1.03 1.00 0.72 0.71 XXX

95834 ............ A Body muscle testing, manual ............... 0.60 0.62 0.63 0.29 0.30 0.02 1.24 1.25 0.91 0.92 XXX

95851 ............ A Range of motion measurements .......... 0.16 0.52 0.46 0.08 0.09 0.01 0.69 0.63 0.25 0.26 XXX

95852 ............ A Range of motion measurements .......... 0.11 0.42 0.36 0.05 0.06 0.01 0.54 0.48 0.17 0.18 XXX

95857 ............ A Tensilon test ......................................... 0.53 0.62 0.60 0.24 0.25 0.02 1.17 1.15 0.79 0.80 XXX

95858 ............ A Tensilon test & myogram ..................... 1.56 1.10 1.11 1.10 1.11 0.07 2.73 2.74 2.73 2.74 XXX

95858 26 A Tensilon test & myogram ..................... 1.56 0.71 0.71 0.71 0.71 0.04 2.31 2.31 2.31 2.31 XXX

95858 TC A Tensilon test & myogram ..................... 0.00 0.39 0.40 NA NA 0.03 0.42 0.43 NA NA XXX

95860 ............ A Muscle test, one limb ........................... 0.96 1.12 1.14 1.12 1.14 0.05 2.13 2.15 2.13 2.15 XXX

95860 26 A Muscle test, one limb ........................... 0.96 0.44 0.53 0.44 0.53 0.03 1.43 1.52 1.43 1.52 XXX

95860 TC A Muscle test, one limb ........................... 0.00 0.68 0.61 NA NA 0.02 0.70 0.63 NA NA XXX

95861 ............ A Muscle test, two limbs .......................... 1.54 1.44 1.62 1.44 1.62 0.10 3.08 3.26 3.08 3.26 XXX

95861 26 A Muscle test, two limbs .......................... 1.54 0.71 0.88 0.71 0.88 0.05 2.30 2.47 2.30 2.47 XXX

95861 TC A Muscle test, two limbs .......................... 0.00 0.73 0.74 NA NA 0.05 0.78 0.79 NA NA XXX

95863 ............ A Muscle test, 3 limbs ............................. 1.87 1.77 1.95 1.77 1.95 0.11 3.75 3.93 3.75 3.93 XXX

95863 26 A Muscle test, 3 limbs ............................. 1.87 0.84 1.01 0.84 1.01 0.06 2.77 2.94 2.77 2.94 XXX

95863 TC A Muscle test, 3 limbs ............................. 0.00 0.93 0.94 NA NA 0.05 0.98 0.99 NA NA XXX

95864 ............ A Muscle test, 4 limbs ............................. 1.99 2.68 2.95 2.68 2.95 0.16 4.83 5.10 4.83 5.10 XXX

95864 26 A Muscle test, 4 limbs ............................. 1.99 0.91 1.16 0.91 1.16 0.06 2.96 3.21 2.96 3.21 XXX

95864 TC A Muscle test, 4 limbs ............................. 0.00 1.77 1.79 NA NA 0.10 1.87 1.89 NA NA XXX

95867 ............ A Muscle test, head or neck .................... 0.79 0.94 1.02 0.94 1.02 0.06 1.79 1.87 1.79 1.87 XXX

95867 26 A Muscle test, head or neck .................... 0.79 0.36 0.43 0.36 0.43 0.03 1.18 1.25 1.18 1.25 XXX

95867 TC A Muscle test, head or neck .................... 0.00 0.58 0.59 NA NA 0.03 0.61 0.62 NA NA XXX

95868 ............ A Muscle test, head or neck .................... 1.18 1.22 1.44 1.22 1.44 0.08 2.48 2.70 2.48 2.70 XXX

95868 26 A Muscle test, head or neck .................... 1.18 0.53 0.74 0.53 0.74 0.04 1.75 1.96 1.75 1.96 XXX

95868 TC A Muscle test, head or neck .................... 0.00 0.69 0.70 NA NA 0.04 0.73 0.74 NA NA XXX

95869 ............ A Muscle test, thor paraspinal ................. 0.37 0.38 0.43 0.38 0.43 0.03 0.78 0.83 0.78 0.83 XXX

95869 26 A Muscle test, thor paraspinal ................. 0.37 0.17 0.22 0.17 0.22 0.01 0.55 0.60 0.55 0.60 XXX

95869 TC A Muscle test, thor paraspinal ................. 0.00 0.21 0.21 NA NA 0.02 0.23 0.23 NA NA XXX

95870 ............ A Muscle test, nonparaspinal .................. 0.37 0.37 0.42 0.37 0.42 0.03 0.77 0.82 0.77 0.82 XXX

95870 26 A Muscle test, nonparaspinal .................. 0.37 0.16 0.21 0.16 0.21 0.01 0.54 0.59 0.54 0.59 XXX

95870 TC A Muscle test, nonparaspinal .................. 0.00 0.21 0.21 NA NA 0.02 0.23 0.23 NA NA XXX

95872 ............ A Muscle test, one fiber ........................... 1.50 1.26 1.29 1.26 1.29 0.08 2.84 2.87 2.84 2.87 XXX

95872 26 A Muscle test, one fiber ........................... 1.50 0.66 0.68 0.66 0.68 0.04 2.20 2.22 2.20 2.22 XXX

95872 TC A Muscle test, one fiber ........................... 0.00 0.60 0.61 NA NA 0.04 0.64 0.65 NA NA XXX

95875 ............ A Limb exercise test ................................ 1.34 1.32 1.15 1.32 1.15 0.09 2.75 2.58 2.75 2.58 XXX

95875 26 A Limb exercise test ................................ 1.34 0.56 0.48 0.56 0.48 0.04 1.94 1.86 1.94 1.86 XXX

95875 TC A Limb exercise test ................................ 0.00 0.76 0.67 NA NA 0.05 0.81 0.72 NA NA XXX

95900 ............ A Motor nerve conduction test ................. 0.42 0.70 0.70 0.70 0.70 0.03 1.15 1.15 1.15 1.15 XXX

95900 26 A Motor nerve conduction test ................. 0.42 0.19 0.24 0.19 0.24 0.01 0.62 0.67 0.62 0.67 XXX

95900 TC A Motor nerve conduction test ................. 0.00 0.51 0.46 NA NA 0.02 0.53 0.48 NA NA XXX

95903 ............ A Motor nerve conduction test ................. 0.60 0.52 0.55 0.52 0.55 0.04 1.16 1.19 1.16 1.19 XXX

95903 26 A Motor nerve conduction test ................. 0.60 0.27 0.30 0.27 0.30 0.02 0.89 0.92 0.89 0.92 XXX

95903 TC A Motor nerve conduction test ................. 0.00 0.25 0.25 NA NA 0.02 0.27 0.27 NA NA XXX

95904 ............ A Sense/mixed n conduction tst .............. 0.34 0.62 0.62 0.62 0.62 0.03 0.99 0.99 0.99 0.99 XXX

95904 26 A Sense/mixed n conduction tst .............. 0.34 0.15 0.21 0.15 0.21 0.01 0.50 0.56 0.50 0.56 XXX

95904 TC A Sense/mixed n conduction tst .............. 0.00 0.47 0.41 NA NA 0.02 0.49 0.43 NA NA XXX

95920 ............ A Intraop nerve test add-on ..................... 2.11 2.26 2.42 2.26 2.42 0.20 4.57 4.73 4.57 4.73 ZZZ

95920 26 A Intraop nerve test add-on ..................... 2.11 0.96 1.11 0.96 1.11 0.14 3.21 3.36 3.21 3.36 ZZZ

95920 TC A Intraop nerve test add-on ..................... 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA ZZZ

95921 ............ A Autonomic nerv function test ................ 0.90 0.71 0.72 0.71 0.72 0.05 1.66 1.67 1.66 1.67 XXX

95921 26 A Autonomic nerv function test ................ 0.90 0.34 0.34 0.34 0.34 0.03 1.27 1.27 1.27 1.27 XXX

95921 TC A Autonomic nerv function test ................ 0.00 0.37 0.38 NA NA 0.02 0.39 0.40 NA NA XXX

95922 ............ A Autonomic nerv function test ................ 0.96 0.79 0.79 0.79 0.79 0.05 1.80 1.80 1.80 1.80 XXX

95922 26 A Autonomic nerv function test ................ 0.96 0.42 0.41 0.42 0.41 0.03 1.41 1.40 1.41 1.40 XXX

95922 TC A Autonomic nerv function test ................ 0.00 0.37 0.38 NA NA 0.02 0.39 0.40 NA NA XXX

95923 ............ A Autonomic nerv function test ................ 0.90 2.60 2.14 2.60 2.14 0.05 3.55 3.09 3.55 3.09 XXX

95923 26 A Autonomic nerv function test ................ 0.90 0.39 0.38 0.39 0.38 0.03 1.32 1.31 1.32 1.31 XXX

95923 TC A Autonomic nerv function test ................ 0.00 2.21 1.76 NA NA 0.02 2.23 1.78 NA NA XXX

95925 ............ A Somatosensory testing ......................... 0.54 1.13 1.26 1.13 1.26 0.07 1.74 1.87 1.74 1.87 XXX

95925 26 A Somatosensory testing ......................... 0.54 0.23 0.35 0.23 0.35 0.02 0.79 0.91 0.79 0.91 XXX

95925 TC A Somatosensory testing ......................... 0.00 0.90 0.91 NA NA 0.05 0.95 0.96 NA NA XXX

95926 ............ A Somatosensory testing ......................... 0.54 1.14 1.26 1.14 1.26 0.07 1.75 1.87 1.75 1.87 XXX

95926 26 A Somatosensory testing ......................... 0.54 0.24 0.35 0.24 0.35 0.02 0.80 0.91 0.80 0.91 XXX

95926 TC A Somatosensory testing ......................... 0.00 0.90 0.91 NA NA 0.05 0.95 0.96 NA NA XXX

95927 ............ A Somatosensory testing ......................... 0.54 1.16 1.28 1.16 1.28 0.08 1.78 1.90 1.78 1.90 XXX

95927 26 A Somatosensory testing ......................... 0.54 0.26 0.37 0.26 0.37 0.03 0.83 0.94 0.83 0.94 XXX

95927 TC A Somatosensory testing ......................... 0.00 0.90 0.91 NA NA 0.05 0.95 0.96 NA NA XXX

95930 ............ A Visual evoked potential test ................. 0.35 0.70 0.75 0.70 0.75 0.02 1.07 1.12 1.07 1.12 XXX

95930 26 A Visual evoked potential test ................. 0.35 0.15 0.27 0.15 0.27 0.01 0.51 0.63 0.51 0.63 XXX

95930 TC A Visual evoked potential test ................. 0.00 0.55 0.48 NA NA 0.01 0.56 0.49 NA NA XXX

95933 ............ A Blink reflex test ..................................... 0.59 1.02 1.11 1.02 1.11 0.07 1.68 1.77 1.68 1.77 XXX

95933 26 A Blink reflex test ..................................... 0.59 0.24 0.32 0.24 0.32 0.02 0.85 0.93 0.85 0.93 XXX

95933 TC A Blink reflex test ..................................... 0.00 0.78 0.79 NA NA 0.05 0.83 0.84 NA NA XXX

95934 ............ A H-reflex test .......................................... 0.51 0.44 0.48 0.44 0.48 0.04 0.99 1.03 0.99 1.03 XXX

95934 26 A H-reflex test .......................................... 0.51 0.23 0.27 0.23 0.27 0.02 0.76 0.80 0.76 0.80 XXX

95934 TC A H-reflex test .......................................... 0.00 0.21 0.21 NA NA 0.02 0.23 0.23 NA NA XXX

95936 ............ A H-reflex test .......................................... 0.55 0.46 0.49 0.46 0.49 0.04 1.05 1.08 1.05 1.08 XXX

95936 26 A H-reflex test .......................................... 0.55 0.25 0.28 0.25 0.28 0.02 0.82 0.85 0.82 0.85 XXX

95936 TC A H-reflex test .......................................... 0.00 0.21 0.21 NA NA 0.02 0.23 0.23 NA NA XXX

95937 ............ A Neuromuscular junction test ................. 0.65 0.62 0.67 0.62 0.67 0.04 1.31 1.36 1.31 1.36 XXX

65553

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

95937 26 A Neuromuscular junction test ................. 0.65 0.28 0.33 0.28 0.33 0.02 0.95 1.00 0.95 1.00 XXX

95937 TC A Neuromuscular junction test ................. 0.00 0.34 0.34 NA NA 0.02 0.36 0.36 NA NA XXX

95950 ............ A Ambulatory eeg monitoring .................. 1.51 3.79 4.81 3.79 4.81 0.44 5.74 6.76 5.74 6.76 XXX

95950 26 A Ambulatory eeg monitoring .................. 1.51 0.67 0.83 0.67 0.83 0.08 2.26 2.42 2.26 2.42 XXX

95950 TC A Ambulatory eeg monitoring .................. 0.00 3.12 3.98 NA NA 0.36 3.48 4.34 NA NA XXX

95951 ............ A EEG monitoring/videorecord ................ 6.00 23.52 20.04 23.52 20.04 0.58 30.10 26.62 30.10 26.62 XXX

95951 26 A EEG monitoring/videorecord ................ 6.00 2.61 2.37 2.61 2.37 0.20 8.81 8.57 8.81 8.57 XXX

95951 TC A EEG monitoring/videorecord ................ 0.00 20.91 17.67 NA NA 0.38 21.29 18.05 NA NA XXX

95953 ............ A EEG monitoring/computer .................... 3.08 7.61 7.68 7.61 7.68 0.46 11.15 11.22 11.15 11.22 XXX

95953 26 A EEG monitoring/computer .................... 3.08 1.33 1.33 1.33 1.33 0.10 4.51 4.51 4.51 4.51 XXX

95953 TC A EEG monitoring/computer .................... 0.00 6.28 6.35 NA NA 0.36 6.64 6.71 NA NA XXX

95954 ............ A EEG monitoring/giving drugs ............... 2.45 4.33 3.88 4.33 3.88 0.15 6.93 6.48 6.93 6.48 XXX

95954 26 A EEG monitoring/giving drugs ............... 2.45 1.06 1.30 1.06 1.30 0.10 3.61 3.85 3.61 3.85 XXX

95954 TC A EEG monitoring/giving drugs ............... 0.00 3.27 2.58 NA NA 0.05 3.32 2.63 NA NA XXX

95955 ............ A EEG during surgery .............................. 1.01 2.30 2.51 2.30 2.51 0.19 3.50 3.71 3.50 3.71 XXX

95955 26 A EEG during surgery .............................. 1.01 0.35 0.54 0.35 0.54 0.05 1.41 1.60 1.41 1.60 XXX

95955 TC A EEG during surgery .............................. 0.00 1.95 1.97 NA NA 0.14 2.09 2.11 NA NA XXX

95956 ............ A Eeg monitoring, cable/radio ................. 3.08 31.25 25.48 31.25 25.48 0.47 34.80 29.03 34.80 29.03 XXX

95956 26 A Eeg monitoring, cable/radio ................. 3.08 1.34 1.41 1.34 1.41 0.11 4.53 4.60 4.53 4.60 XXX

95956 TC A Eeg monitoring, cable/radio ................. 0.00 29.91 24.07 NA NA 0.36 30.27 24.43 NA NA XXX

95957 ............ A EEG digital analysis ............................. 1.98 2.56 2.53 2.56 2.53 0.17 4.71 4.68 4.71 4.68 XXX

95957 26 A EEG digital analysis ............................. 1.98 0.87 0.82 0.87 0.82 0.07 2.92 2.87 2.92 2.87 XXX

95957 TC A EEG digital analysis ............................. 0.00 1.69 1.71 NA NA 0.10 1.79 1.81 NA NA XXX

95958 ............ A EEG monitoring/function test ............... 4.25 3.53 3.98 3.53 3.98 0.29 8.07 8.52 8.07 8.52 XXX

95958 26 A EEG monitoring/function test ............... 4.25 1.80 2.23 1.80 2.23 0.18 6.23 6.66 6.23 6.66 XXX

95958 TC A EEG monitoring/function test ............... 0.00 1.73 1.75 NA NA 0.11 1.84 1.86 NA NA XXX

95961 ............ A Electrode stimulation, brain .................. 2.97 2.63 2.70 2.63 2.70 0.24 5.84 5.91 5.84 5.91 XXX

95961 26 A Electrode stimulation, brain .................. 2.97 1.33 1.39 1.33 1.39 0.18 4.48 4.54 4.48 4.54 XXX

95961 TC A Electrode stimulation, brain .................. 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA XXX

95962 ............ A Electrode stim, brain add-on ................ 3.21 2.71 2.76 2.71 2.76 0.23 6.15 6.20 6.15 6.20 ZZZ

95962 26 A Electrode stim, brain add-on ................ 3.21 1.41 1.45 1.41 1.45 0.17 4.79 4.83 4.79 4.83 ZZZ

95962 TC A Electrode stim, brain add-on ................ 0.00 1.30 1.31 NA NA 0.06 1.36 1.37 NA NA ZZZ

95970 ............ A Analyze neurostim, no prog ................. 0.45 0.17 0.17 0.14 0.14 0.03 0.65 0.65 0.62 0.62 XXX

95971 ............ A Analyze neurostim, simple ................... 0.78 0.29 0.29 0.23 0.23 0.06 1.13 1.13 1.07 1.07 XXX

95972 ............ A Analyze neurostim, complex ................ 1.50 0.63 0.63 0.55 0.55 0.17 2.30 2.30 2.22 2.22 XXX

95973 ............ A Analyze neurostim, complex ................ 0.92 0.40 0.40 0.37 0.37 0.07 1.39 1.39 1.36 1.36 ZZZ

95974 ............ A Cranial neurostim, complex .................. 3.00 1.32 1.32 1.32 1.32 0.15 4.47 4.47 4.47 4.47 XXX

95975 ............ A Cranial neurostim, complex .................. 1.70 0.74 0.74 0.73 0.73 0.07 2.51 2.51 2.50 2.50 ZZZ

95999 ............ C Neurological procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

96100 ............ A Psychological testing ............................ 0.00 1.75 1.77 1.75 1.77 0.15 1.90 1.92 1.90 1.92 XXX

96105 ............ A Assessment of aphasia ........................ 0.00 1.75 1.77 1.75 1.77 0.15 1.90 1.92 1.90 1.92 XXX

96110 ............ C Developmental test, lim ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

96111 ............ A Developmental test, extend .................. 0.00 1.75 1.77 1.75 1.77 0.15 1.90 1.92 1.90 1.92 XXX

96115 ............ A Neurobehavior status exam ................. 0.00 1.75 1.77 1.75 1.77 0.15 1.90 1.92 1.90 1.92 XXX

96117 ............ A Neuropsych test battery ....................... 0.00 1.75 1.77 1.75 1.77 0.15 1.90 1.92 1.90 1.92 XXX

96400 ............ A Chemotherapy, sc/im ........................... 0.00 0.13 0.13 0.13 0.13 0.01 0.14 0.14 0.14 0.14 XXX

96405 ............ A Intralesional chemo admin ................... 0.52 1.82 1.47 0.25 0.24 0.02 2.36 2.01 0.79 0.78 000

96406 ............ A Intralesional chemo admin ................... 0.80 2.53 2.05 0.31 0.31 0.02 3.35 2.87 1.13 1.13 000

96408 ............ A Chemotherapy, push technique ........... 0.00 0.96 0.97 0.96 0.97 0.05 1.01 1.02 1.01 1.02 XXX

96410 ............ A Chemotherapy,infusion method ........... 0.00 1.54 1.56 1.54 1.56 0.07 1.61 1.63 1.61 1.63 XXX

96412 ............ A Chemo, infuse method add-on ............. 0.00 1.14 1.15 1.14 1.15 0.06 1.20 1.21 1.20 1.21 ZZZ

96414 ............ A Chemo, infuse method add-on ............. 0.00 1.33 1.34 1.33 1.34 0.07 1.40 1.41 1.40 1.41 XXX

96420 ............ A Chemotherapy, push technique ........... 0.00 1.24 1.25 1.24 1.25 0.07 1.31 1.32 1.31 1.32 XXX

96422 ............ A Chemotherapy,infusion method ........... 0.00 1.22 1.23 1.22 1.23 0.07 1.29 1.30 1.29 1.30 XXX

96423 ............ A Chemo, infuse method add-on ............. 0.00 0.48 0.49 0.48 0.49 0.02 0.50 0.51 0.50 0.51 ZZZ

96425 ............ A Chemotherapy,infusion method ........... 0.00 1.42 1.44 1.42 1.44 0.07 1.49 1.51 1.49 1.51 XXX

96440 ............ A Chemotherapy, intracavitary ................ 2.37 7.97 6.20 1.12 1.06 0.12 10.46 8.69 3.61 3.55 000

96445 ............ A Chemotherapy, intracavitary ................ 2.20 8.33 6.51 1.04 0.91 0.07 10.60 8.78 3.31 3.18 000

96450 ............ A Chemotherapy, into CNS ..................... 1.89 6.73 5.28 0.90 0.79 0.06 8.68 7.23 2.85 2.74 000

96520 ............ A Pump refilling, maintenance ................. 0.00 0.88 0.89 0.88 0.89 0.05 0.93 0.94 0.93 0.94 XXX

96530 ............ A Pump refilling, maintenance ................. 0.00 1.06 1.07 1.06 1.07 0.05 1.11 1.12 1.11 1.12 XXX

96542 ............ A Chemotherapy injection ........................ 1.42 4.02 3.31 0.57 0.58 0.05 5.49 4.78 2.04 2.05 XXX

96545 ............ B Provide chemotherapy agent ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

96549 ............ C Chemotherapy, unspecified .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

96570 ............ A Photodynamic tx, 30 min ...................... 1.10 0.44 0.44 0.44 0.44 0.04 1.58 1.58 1.58 1.58 ZZZ

96571 ............ A Photodynamic tx, addl 15 min .............. 0.55 0.22 0.22 0.22 0.22 0.02 0.79 0.79 0.79 0.79 ZZZ

96900 ............ A Ultraviolet light therapy ......................... 0.00 0.39 0.40 0.39 0.40 0.02 0.41 0.42 0.41 0.42 XXX

96902 ............ B Trichogram ........................................... +0.41 0.25 0.27 0.16 0.20 0.01 0.67 0.69 0.58 0.62 XXX

96910 ............ A Photochemotherapy with UV-B ............ 0.00 0.58 0.59 0.58 0.59 0.03 0.61 0.62 0.61 0.62 XXX

96912 ............ A Photochemotherapy with UV-A ............ 0.00 0.65 0.66 0.65 0.66 0.04 0.69 0.70 0.69 0.70 XXX

96913 ............ A Photochemotherapy, UV-A or B ........... 0.00 1.35 1.36 1.35 1.36 0.08 1.43 1.44 1.43 1.44 XXX

96999 ............ C Dermatological procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97001 ............ A Pt evaluation ......................................... 1.20 0.56 0.52 0.48 0.46 0.10 1.86 1.82 1.78 1.76 XXX

97002 ............ A Pt re-evaluation .................................... 0.60 0.35 0.27 0.26 0.21 0.04 0.99 0.91 0.90 0.85 XXX

97003 ............ A Ot evaluation ........................................ 1.20 0.67 0.60 0.32 0.34 0.05 1.92 1.85 1.57 1.59 XXX

97004 ............ A Ot re-evaluation .................................... 0.60 0.43 0.33 0.13 0.11 0.02 1.05 0.95 0.75 0.73 XXX

97010 ............ B Hot or cold packs therapy .................... +0.06 0.24 0.24 0.01 0.07 0.01 0.31 0.31 0.08 0.14 XXX

97012 ............ A Mechanical traction therapy ................. 0.25 0.27 0.26 0.05 0.09 0.01 0.53 0.52 0.31 0.35 XXX

97014 ............ A Electric stimulation therapy .................. 0.18 0.25 0.24 0.03 0.08 0.01 0.44 0.43 0.22 0.27 XXX

97016 ............ A Vasopneumatic device therapy ............ 0.18 0.25 0.26 0.03 0.09 0.01 0.44 0.45 0.22 0.28 XXX

97018 ............ A Paraffin bath therapy ............................ 0.06 0.22 0.23 0.01 0.07 0.01 0.29 0.30 0.08 0.14 XXX

97020 ............ A Microwave therapy ............................... 0.06 0.23 0.23 0.01 0.06 0.01 0.30 0.30 0.08 0.13 XXX

97022 ............ A Whirlpool therapy ................................. 0.17 0.43 0.38 0.03 0.08 0.01 0.61 0.56 0.21 0.26 XXX

65554

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

97024 ............ A Diathermy treatment ............................. 0.06 0.24 0.24 0.01 0.07 0.01 0.31 0.31 0.08 0.14 XXX

97026 ............ A Infrared therapy .................................... 0.06 0.22 0.22 0.01 0.06 0.01 0.29 0.29 0.08 0.13 XXX

97028 ............ A Ultraviolet therapy ................................ 0.08 0.22 0.22 0.01 0.06 0.01 0.31 0.31 0.10 0.15 XXX

97032 ............ A Electrical stimulation ............................. 0.25 0.28 0.25 0.05 0.08 0.01 0.54 0.51 0.31 0.34 XXX

97033 ............ A Electric current therapy ........................ 0.26 0.31 0.27 0.05 0.08 0.02 0.59 0.55 0.33 0.36 XXX

97034 ............ A Contrast bath therapy ........................... 0.21 0.27 0.23 0.04 0.06 0.01 0.49 0.45 0.26 0.28 XXX

97035 ............ A Ultrasound therapy ............................... 0.21 0.17 0.16 0.04 0.06 0.01 0.39 0.38 0.26 0.28 XXX

97036 ............ A Hydrotherapy ........................................ 0.28 0.36 0.33 0.05 0.10 0.01 0.65 0.62 0.34 0.39 XXX

97039 ............ A Physical therapy treatment ................... 0.20 0.27 0.27 0.04 0.10 0.01 0.48 0.48 0.25 0.31 XXX

97110 ............ A Therapeutic exercises .......................... 0.45 0.19 0.18 0.08 0.10 0.03 0.67 0.66 0.56 0.58 XXX

97112 ............ A Neuromuscular reeducation ................. 0.45 0.30 0.26 0.08 0.10 0.02 0.77 0.73 0.55 0.57 XXX

97113 ............ A Aquatic therapy/exercises .................... 0.44 0.32 0.30 0.08 0.12 0.03 0.79 0.77 0.55 0.59 XXX

97116 ............ A Gait training therapy ............................. 0.40 0.30 0.26 0.07 0.08 0.02 0.72 0.68 0.49 0.50 XXX

97124 ............ A Massage therapy .................................. 0.35 0.28 0.24 0.06 0.08 0.01 0.64 0.60 0.42 0.44 XXX

97139 ............ A Physical medicine procedure ............... 0.21 0.25 0.23 0.04 0.07 0.01 0.47 0.45 0.26 0.29 XXX

97140 ............ A Manual therapy ..................................... 0.43 0.31 0.31 0.08 0.08 0.02 0.76 0.76 0.53 0.53 XXX

97150 ............ A Group therapeutic procedures ............. 0.27 0.27 0.26 0.05 0.09 0.02 0.56 0.55 0.34 0.38 XXX

97504 ............ A Orthotic training .................................... 0.45 0.30 0.26 0.08 0.10 0.03 0.78 0.74 0.56 0.58 XXX

97520 ............ A Prosthetic training ................................. 0.45 0.30 0.27 0.08 0.10 0.02 0.77 0.74 0.55 0.57 XXX

97530 ............ A Therapeutic activities ............................ 0.44 0.18 0.18 0.08 0.11 0.02 0.64 0.64 0.54 0.57 XXX

97532 ............ A Cognitive skills development ................ 0.44 0.23 0.23 0.08 0.08 0.01 0.68 0.68 0.53 0.53 XXX

97533 ............ A Sensory integration .............................. 0.44 0.29 0.29 0.08 0.08 0.01 0.74 0.74 0.53 0.53 XXX

97535 ............ A Self care mngment training .................. 0.45 0.30 0.27 0.08 0.11 0.02 0.77 0.74 0.55 0.58 XXX

97537 ............ A Community/work reintegration .............. 0.45 0.30 0.27 0.08 0.11 0.01 0.76 0.73 0.54 0.57 XXX

97542 ............ A Wheelchair mngment training .............. 0.25 0.26 0.24 0.05 0.08 0.01 0.52 0.50 0.31 0.34 XXX

97545 ............ R Work hardening .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97546 ............ R Work hardening add-on ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

97601 ............ A Wound care selective ........................... 0.50 0.49 0.49 0.09 0.09 0.04 1.03 1.03 0.63 0.63 XXX

97602 ............ B Wound care non-selective .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97703 ............ A Prosthetic checkout .............................. 0.25 0.15 0.16 0.05 0.09 0.02 0.42 0.43 0.32 0.36 XXX

97750 ............ A Physical performance test .................... 0.45 0.24 0.25 0.08 0.13 0.02 0.71 0.72 0.55 0.60 XXX

97770 ............ D Cognitive skills development ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97780 ............ N Acupuncture w/o stimul ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97781 ............ N Acupuncture w/stimul ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97799 ............ C Physical medicine procedure ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97802 ............ N Medical nutrition, indiv, in ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97803 ............ N Med nutrition, indiv, subseq ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97804 ............ N Medical nutrition, group ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

98925 ............ A Osteopathic manipulation ..................... 0.45 0.39 0.36 0.15 0.18 0.01 0.85 0.82 0.61 0.64 000

98926 ............ A Osteopathic manipulation ..................... 0.65 0.45 0.45 0.26 0.30 0.02 1.12 1.12 0.93 0.97 000

98927 ............ A Osteopathic manipulation ..................... 0.87 0.52 0.49 0.31 0.34 0.03 1.42 1.39 1.21 1.24 000

98928 ............ A Osteopathic manipulation ..................... 1.03 0.60 0.57 0.36 0.39 0.03 1.66 1.63 1.42 1.45 000

98929 ............ A Osteopathic manipulation ..................... 1.19 0.66 0.60 0.38 0.39 0.04 1.89 1.83 1.61 1.62 000

98940 ............ A Chiropractic manipulation ..................... 0.45 0.25 0.27 0.13 0.14 0.01 0.71 0.73 0.59 0.60 000

98941 ............ A Chiropractic manipulation ..................... 0.65 0.31 0.31 0.18 0.18 0.02 0.98 0.98 0.85 0.85 000

98942 ............ A Chiropractic manipulation ..................... 0.87 0.37 0.36 0.25 0.23 0.03 1.27 1.26 1.15 1.13 000

98943 ............ N Chiropractic manipulation ..................... +0.40 0.36 0.35 0.16 0.20 0.01 0.77 0.76 0.57 0.61 XXX

99000 ............ B Specimen handling ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99001 ............ B Specimen handling ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99002 ............ B Device handling .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99024 ............ B Postop follow-up visit ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99025 ............ B Initial surgical evaluation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99050 ............ B Medical services after hrs .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99052 ............ B Medical services at night ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99054 ............ B Medical servcs, unusual hrs ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99056 ............ B Non-office medical services ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99058 ............ B Office emergency care ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99070 ............ B Special supplies ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99071 ............ B Patient education materials .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99075 ............ N Medical testimony ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99078 ............ B Group health education ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99080 ............ B Special reports or forms ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99082 ............ C Unusual physician travel ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99090 ............ B Computer data analysis ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99100 ............ B Special anesthesia service ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

99116 ............ B Anesthesia with hypothermia ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

99135 ............ B Special anesthesia procedure .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

99140 ............ B Emergency anesthesia ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

99141 ............ B Sedation, iv/im or inhalant .................... +0.80 2.00 1.73 0.39 0.52 0.04 2.84 2.57 1.23 1.36 XXX

99142 ............ B Sedation, oral/rectal/nasal .................... +0.60 1.17 1.05 0.31 0.40 0.03 1.80 1.68 0.94 1.03 XXX

99170 ............ A Anogenital exam, child ......................... 1.75 1.87 1.87 0.70 0.70 0.07 3.69 3.69 2.52 2.52 000

99172 ............ N Ocular function screen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99173 ............ N Visual acuity screen ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99175 ............ A Induction of vomiting ............................ 0.00 1.38 1.40 1.38 1.40 0.08 1.46 1.48 1.46 1.48 XXX

99183 ............ A Hyperbaric oxygen therapy .................. 2.34 NA NA 0.76 1.02 0.12 NA NA 3.22 3.48 XXX

99185 ............ A Regional hypothermia .......................... 0.00 0.63 0.64 0.63 0.64 0.03 0.66 0.67 0.66 0.67 XXX

99186 ............ A Total body hypothermia ........................ 0.00 1.77 1.79 1.77 1.79 0.37 2.14 2.16 2.14 2.16 XXX

99190 ............ X Special pump services ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99191 ............ X Special pump services ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99192 ............ X Special pump services ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99195 ............ A Phlebotomy ........................................... 0.00 0.44 0.45 0.44 0.45 0.02 0.46 0.47 0.46 0.47 XXX

99199 ............ C Special service/proc/report ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99201 ............ A Office/outpatient visit, new ................... 0.45 0.46 0.46 0.16 0.17 0.02 0.93 0.93 0.63 0.64 XXX

65555

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

99202 ............ A Office/outpatient visit, new ................... 0.88 0.74 0.69 0.33 0.31 0.05 1.67 1.62 1.26 1.24 XXX

99203 ............ A Office/outpatient visit, new ................... 1.34 1.08 0.97 0.50 0.45 0.08 2.50 2.39 1.92 1.87 XXX

99204 ............ A Office/outpatient visit, new ................... 2.00 1.50 1.37 0.74 0.66 0.10 3.60 3.47 2.84 2.76 XXX

99205 ............ A Office/outpatient visit, new ................... 2.67 1.77 1.59 0.97 0.84 0.12 4.56 4.38 3.76 3.63 XXX

99211 ............ A Office/outpatient visit, est ..................... 0.17 0.37 0.34 0.06 0.07 0.01 0.55 0.52 0.24 0.25 XXX

99212 ............ A Office/outpatient visit, est ..................... 0.45 0.51 0.47 0.17 0.17 0.02 0.98 0.94 0.64 0.64 XXX

99213 ............ A Office/outpatient visit, est ..................... 0.67 0.67 0.62 0.24 0.23 0.03 1.37 1.32 0.94 0.93 XXX

99214 ............ A Office/outpatient visit, est ..................... 1.10 1.02 0.92 0.40 0.37 0.04 2.16 2.06 1.54 1.51 XXX

99215 ............ A Office/outpatient visit, est ..................... 1.77 1.32 1.22 0.65 0.59 0.07 3.16 3.06 2.49 2.43 XXX

99217 ............ A Observation care discharge ................. 1.28 NA NA 0.45 0.48 0.05 NA NA 1.78 1.81 XXX

99218 ............ A Observation care .................................. 1.28 NA NA 0.45 0.52 0.05 NA NA 1.78 1.85 XXX

99219 ............ A Observation care .................................. 2.14 NA NA 0.74 0.84 0.08 NA NA 2.96 3.06 XXX

99220 ............ A Observation care .................................. 2.99 NA NA 1.05 1.10 0.11 NA NA 4.15 4.20 XXX

99221 ............ A Initial hospital care ............................... 1.28 NA NA 0.47 0.54 0.05 NA NA 1.80 1.87 XXX

99222 ............ A Initial hospital care ............................... 2.14 NA NA 0.76 0.85 0.08 NA NA 2.98 3.07 XXX

99223 ............ A Initial hospital care ............................... 2.99 NA NA 1.07 1.11 0.10 NA NA 4.16 4.20 XXX

99231 ............ A Subsequent hospital care ..................... 0.64 NA NA 0.24 0.28 0.02 NA NA 0.90 0.94 XXX

99232 ............ A Subsequent hospital care ..................... 1.06 NA NA 0.38 0.41 0.03 NA NA 1.47 1.50 XXX

99233 ............ A Subsequent hospital care ..................... 1.51 NA NA 0.54 0.57 0.05 NA NA 2.10 2.13 XXX

99234 ............ A Observ/hosp same date ....................... 1.95 NA NA 0.70 0.71 0.11 NA NA 2.76 2.77 XXX

99235 ............ A Observ/hosp same date ....................... 2.81 NA NA 0.03 1.03 0.13 NA NA 3.93 4.74 XXX

99236 ............ A Observ/hosp same date ....................... 3.66 NA NA 1.25 1.25 0.17 NA NA 5.08 5.85 XXX

99238 ............ A Hospital discharge day ......................... 1.28 NA NA 0.45 0.48 0.04 NA NA 1.77 1.80 XXX

99239 ............ A Hospital discharge day ......................... 1.75 NA NA 0.62 0.60 0.05 NA NA 2.42 2.40 XXX

99241 ............ A Office consultation ................................ 0.64 0.60 0.62 0.23 0.26 0.04 1.28 1.30 0.91 0.94 XXX

99242 ............ A Office consultation ................................ 1.29 1.00 0.96 0.49 0.47 0.09 2.38 2.34 1.87 1.85 XXX

99243 ............ A Office consultation ................................ 1.72 1.34 1.27 0.67 0.64 0.10 3.16 3.09 2.49 2.46 XXX

99244 ............ A Office consultation ................................ 2.58 1.78 1.67 0.97 0.90 0.13 4.49 4.38 3.68 3.61 XXX

99245 ............ A Office consultation ................................ 3.43 2.24 2.14 1.29 1.20 0.16 5.83 5.73 4.88 4.79 XXX

99251 ............ A Initial inpatient consult .......................... 0.66 NA NA 0.30 0.41 0.04 NA NA 1.00 1.11 XXX

99252 ............ A Initial inpatient consult .......................... 1.32 NA NA 0.57 0.63 0.08 NA NA 1.97 2.03 XXX

99253 ............ A Initial inpatient consult .......................... 1.82 NA NA 0.76 0.83 0.09 NA NA 2.67 2.74 XXX

99254 ............ A Initial inpatient consult .......................... 2.64 NA NA 1.07 1.13 0.11 NA NA 3.82 3.88 XXX

99255 ............ A Initial inpatient consult .......................... 3.65 NA NA 1.44 1.51 0.15 NA NA 5.24 5.31 XXX

99261 ............ A Follow-up inpatient consult ................... 0.42 NA NA 0.21 0.25 0.02 NA NA 0.65 0.69 XXX

99262 ............ A Follow-up inpatient consult ................... 0.85 NA NA 0.37 0.40 0.03 NA NA 1.25 1.28 XXX

99263 ............ A Follow-up inpatient consult ................... 1.27 NA NA 0.52 0.57 0.04 NA NA 1.83 1.88 XXX

99271 ............ A Confirmatory consultation ..................... 0.45 0.64 0.64 0.21 0.24 0.03 1.12 1.12 0.69 0.72 XXX

99272 ............ A Confirmatory consultation ..................... 0.84 0.87 0.85 0.37 0.38 0.06 1.77 1.75 1.27 1.28 XXX

99273 ............ A Confirmatory consultation ..................... 1.19 1.09 1.10 0.51 0.52 0.07 2.35 2.36 1.77 1.78 XXX

99274 ............ A Confirmatory consultation ..................... 1.73 1.41 1.39 0.73 0.71 0.09 3.23 3.21 2.55 2.53 XXX

99275 ............ A Confirmatory consultation ..................... 2.31 1.64 1.70 0.91 1.16 0.10 4.05 4.11 3.32 3.57 XXX

99281 ............ A Emergency dept visit ............................ 0.33 NA NA 0.09 0.14 0.02 NA NA 0.44 0.49 XXX

99282 ............ A Emergency dept visit ............................ 0.55 NA NA 0.15 0.22 0.03 NA NA 0.73 0.80 XXX

99283 ............ A Emergency dept visit ............................ 1.24 NA NA 0.32 0.37 0.08 NA NA 1.64 1.69 XXX

99284 ............ A Emergency dept visit ............................ 1.95 NA NA 0.49 0.56 0.12 NA NA 2.56 2.63 XXX

99285 ............ A Emergency dept visit ............................ 3.06 NA NA 0.74 0.86 0.19 NA NA 3.99 4.11 XXX

99288 ............ B Direct advanced life support ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99291 ............ A Critical care, first hour .......................... 4.00 1.57 1.57 1.32 1.38 0.14 5.71 5.71 5.46 5.52 XXX

99292 ............ A Critical care, addl 30 min ..................... 2.00 0.85 0.81 0.65 0.66 0.07 2.92 2.88 2.72 2.73 ZZZ

99295 ............ A Neonatal critical care ............................ 16.00 NA NA 4.86 5.02 0.70 NA NA 21.56 21.72 XXX

99296 ............ A Neonatal critical care ............................ 8.00 NA NA 2.61 2.63 0.23 NA NA 10.84 10.86 XXX

99297 ............ A Neonatal critical care ............................ 4.00 NA NA 1.32 1.32 0.12 NA NA 5.44 5.44 XXX

99298 ............ A Neonatal critical care ............................ 2.75 NA NA 0.96 0.96 0.10 NA NA 3.81 3.81 XXX

99301 ............ A Nursing facility care .............................. 1.20 NA NA 0.42 0.44 0.04 NA NA 1.66 1.68 XXX

99302 ............ A Nursing facility care .............................. 1.61 NA NA 0.56 0.56 0.05 NA NA 2.22 2.22 XXX

99303 ............ A Nursing facility care .............................. 2.01 NA NA 0.69 0.78 0.06 NA NA 2.76 2.85 XXX

99311 ............ A Nursing fac care, subseq ..................... 0.60 NA NA 0.21 0.25 0.02 NA NA 0.83 0.87 XXX

99312 ............ A Nursing fac care, subseq ..................... 1.00 NA NA 0.34 0.37 0.03 NA NA 1.37 1.40 XXX

99313 ............ A Nursing fac care, subseq ..................... 1.42 NA NA 0.49 0.49 0.04 NA NA 1.95 1.95 XXX

99315 ............ A Nursing fac discharge day ................... 1.13 NA NA 0.39 0.43 0.04 NA NA 1.56 1.60 XXX

99316 ............ A Nursing fac discharge day ................... 1.50 NA NA 0.52 0.53 0.05 NA NA 2.07 2.08 XXX

99321 ............ A Rest home visit, new patient ................ 0.71 0.43 0.42 0.35 0.36 0.02 1.16 1.15 1.08 1.09 XXX

99322 ............ A Rest home visit, new patient ................ 1.01 0.68 0.65 0.45 0.48 0.03 1.72 1.69 1.49 1.52 XXX

99323 ............ A Rest home visit, new patient ................ 1.28 0.93 0.90 0.56 0.62 0.04 2.25 2.22 1.88 1.94 XXX

99331 ............ A Rest home visit, est pat ....................... 0.60 0.47 0.43 0.31 0.31 0.02 1.09 1.05 0.93 0.93 XXX

99332 ............ A Rest home visit, est pat ....................... 0.80 0.59 0.54 0.38 0.38 0.03 1.42 1.37 1.21 1.21 XXX

99333 ............ A Rest home visit, est pat ....................... 1.00 0.72 0.66 0.45 0.46 0.03 1.75 1.69 1.48 1.49 XXX

99341 ............ A Home visit, new patient ........................ 1.01 0.54 0.55 0.48 0.51 0.05 1.60 1.61 1.54 1.57 XXX

99342 ............ A Home visit, new patient ........................ 1.52 0.84 0.79 0.68 0.67 0.05 2.41 2.36 2.25 2.24 XXX

99343 ............ A Home visit, new patient ........................ 2.27 1.30 1.19 1.28 1.17 0.07 3.64 3.53 3.62 3.51 XXX

99344 ............ A Home visit, new patient ........................ 3.03 1.60 1.43 1.30 1.21 0.10 4.73 4.56 4.43 4.34 XXX

99345 ............ A Home visit, new patient ........................ 3.79 1.85 1.62 1.36 1.25 0.12 5.76 5.53 5.27 5.16 XXX

99347 ............ A Home visit, est patient .......................... 0.76 0.47 0.48 0.36 0.39 0.03 1.26 1.27 1.15 1.18 XXX

99348 ............ A Home visit, est patient .......................... 1.26 0.72 0.69 0.53 0.54 0.04 2.02 1.99 1.83 1.84 XXX

99349 ............ A Home visit, est patient .......................... 2.02 1.07 0.97 0.80 0.77 0.06 3.15 3.05 2.88 2.85 XXX

99350 ............ A Home visit, est patient .......................... 3.03 1.48 1.32 1.16 1.08 0.10 4.61 4.45 4.29 4.21 XXX

99354 ............ A Prolonged service, office ...................... 1.77 1.43 1.28 0.63 0.58 0.06 3.26 3.11 2.46 2.41 ZZZ

99355 ............ A Prolonged service, office ...................... 1.77 1.23 1.13 0.62 0.57 0.06 3.06 2.96 2.45 2.40 ZZZ

99356 ............ A Prolonged service, inpatient ................. 1.71 NA NA 0.60 0.68 0.06 NA NA 2.37 2.45 ZZZ

99357 ............ A Prolonged service, inpatient ................. 1.71 NA NA 0.62 0.70 0.06 NA NA 2.39 2.47 ZZZ

99358 ............ B Prolonged serv, w/o contact ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

99359 ............ B Prolonged serv, w/o contact ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

65556

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

99360 ............ X Physician standby services .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99361 ............ B Physician/team conference .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99362 ............ B Physician/team conference .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99371 ............ B Physician phone consultation ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99372 ............ B Physician phone consultation ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99373 ............ B Physician phone consultation ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99374 ............ B Home health care supervision ............. +1.10 1.42 1.20 0.44 0.47 0.04 2.56 2.34 1.58 1.61 XXX

99375 ............ N Home health care supervision ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99377 ............ B Hospice care supervision ..................... +1.10 1.42 1.20 0.44 0.47 0.04 2.56 2.34 1.58 1.61 XXX

99378 ............ N Hospice care supervision ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99379 ............ B Nursing fac care supervision ................ +1.10 1.42 1.20 0.44 0.47 0.03 2.55 2.33 1.57 1.60 XXX

99380 ............ B Nursing fac care supervision ................ +1.73 1.67 1.39 0.69 0.66 0.05 3.45 3.17 2.47 2.44 XXX

99381 ............ N Prev visit, new, infant ........................... +1.19 1.46 1.43 0.48 0.69 0.04 2.69 2.66 1.71 1.92 XXX

99382 ............ N Prev visit, new, age 1-4 ....................... +1.36 1.50 1.51 0.54 0.79 0.04 2.90 2.91 1.94 2.19 XXX

99383 ............ N Prev visit, new, age 5-11 ..................... +1.36 1.44 1.46 0.54 0.79 0.04 2.84 2.86 1.94 2.19 XXX

99384 ............ N Prev visit, new, age 12-17 ................... +1.53 1.52 1.57 0.61 0.89 0.05 3.10 3.15 2.19 2.47 XXX

99385 ............ N Prev visit, new, age 18-39 ................... +1.53 1.52 1.52 0.61 0.84 0.05 3.10 3.10 2.19 2.42 XXX

99386 ............ N Prev visit, new, age 40-64 ................... +1.88 1.71 1.75 0.75 1.03 0.06 3.65 3.69 2.69 2.97 XXX

99387 ............ N Prev visit, new, 65 & over .................... +2.06 1.83 1.88 0.82 1.13 0.06 3.95 4.00 2.94 3.25 XXX

99391 ............ N Prev visit, est, infant ............................. +1.02 0.99 1.03 0.41 0.60 0.03 2.04 2.08 1.46 1.65 XXX

99392 ............ N Prev visit, est, age 1-4 ......................... +1.19 1.06 1.13 0.48 0.69 0.04 2.29 2.36 1.71 1.92 XXX

99393 ............ N Prev visit, est, age 5-11 ....................... +1.19 1.03 1.11 0.48 0.69 0.04 2.26 2.34 1.71 1.92 XXX

99394 ............ N Prev visit, est, age 12-17 ..................... +1.36 1.11 1.22 0.54 0.79 0.04 2.51 2.62 1.94 2.19 XXX

99395 ............ N Prev visit, est, age 18-39 ..................... +1.36 1.14 1.20 0.54 0.75 0.04 2.54 2.60 1.94 2.15 XXX

99396 ............ N Prev visit, est, age 40-64 ..................... +1.53 1.23 1.30 0.61 0.84 0.05 2.81 2.88 2.19 2.42 XXX

99397 ............ N Prev visit, est, 65 & over ...................... +1.71 1.34 1.43 0.68 0.93 0.05 3.10 3.19 2.44 2.69 XXX

99401 ............ N Preventive counseling, indiv ................. +0.48 0.59 0.57 0.19 0.27 0.01 1.08 1.06 0.68 0.76 XXX

99402 ............ N Preventive counseling, indiv ................. +0.98 0.84 0.87 0.39 0.54 0.02 1.84 1.87 1.39 1.54 XXX

99403 ............ N Preventive counseling, indiv ................. +1.46 1.08 1.17 0.58 0.80 0.03 2.57 2.66 2.07 2.29 XXX

99404 ............ N Preventive counseling, indiv ................. +1.95 1.32 1.47 0.78 1.07 0.04 3.31 3.46 2.77 3.06 XXX

99411 ............ N Preventive counseling, group ............... +0.15 0.17 0.17 0.06 0.08 0.01 0.33 0.33 0.22 0.24 XXX

99412 ............ N Preventive counseling, group ............... +0.25 0.24 0.24 0.10 0.14 0.01 0.50 0.50 0.36 0.40 XXX

99420 ............ N Health risk assessment test ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99429 ............ N Unlisted preventive service .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99431 ............ A Initial care, normal newborn ................. 1.17 NA NA 0.36 0.60 0.04 NA NA 1.57 1.81 XXX

99432 ............ A Newborn care, not in hosp ................... 1.26 1.14 1.21 0.33 0.60 0.06 2.46 2.53 1.65 1.92 XXX

99433 ............ A Normal newborn care/hospital ............. 0.62 NA NA 0.20 0.32 0.02 NA NA 0.84 0.96 XXX

99435 ............ A Newborn discharge day hosp .............. 1.50 NA NA 0.57 0.85 0.05 NA NA 2.12 2.40 XXX

99436 ............ A Attendance, birth .................................. 1.50 0.60 0.87 0.46 0.77 0.05 2.15 2.42 2.01 2.32 XXX

99440 ............ A Newborn resuscitation .......................... 2.93 NA NA 0.86 1.47 0.11 NA NA 3.90 4.51 XXX

99450 ............ N Life/disability evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99455 ............ R Disability examination ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99456 ............ R Disability examination ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99499 ............ C Unlisted e&m service ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0021 ............ I Outside state ambulance serv ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0030 ............ D Air ambulance service .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0040 ............ D Helicopter ambulance service .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0050 ............ D Water amb service emergency ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0080 ............ I Noninterest escort in non er ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0090 ............ I Interest escort in non er ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0100 ............ I Nonemergency transport taxi ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0110 ............ I Nonemergency transport bus ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0120 ............ I Noner transport mini-bus ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0130 ............ I Noner transport wheelch van ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0140 ............ I Nonemergency transport air ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0160 ............ I Noner transport case worker ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0170 ............ I Noner transport parking fees ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0180 ............ I Noner transport lodgng recip ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0190 ............ I Noner transport meals recip ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0200 ............ I Noner transport lodgng escrt ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0210 ............ I Noner transport meals escort ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0225 ............ X Neonatal emergency transport ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0300 ............ D Ambulance basic non-emer all ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0302 ............ D Ambulance basic emergeny all ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0304 ............ D Amb adv non-er no serv all .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0306 ............ D Amb adv non-er spec serv all .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0308 ............ D Amb adv er no spec serv all ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0310 ............ D Amb adv er spec serv all ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0320 ............ D Amb basic non-er + supplies ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0322 ............ D Amb basic emerg + supplies ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0324 ............ D Adv non-er serv sep mileage ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0326 ............ D Adv non-er no serv sep mile ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0328 ............ D Adv er no serv sep mileage ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0330 ............ D Adv er spec serv sep mile ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0340 ............ D Amb basic non-er + mileage ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0342 ............ D Ambul basic emer + mileage ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0344 ............ D Amb adv non-er no serv +mile ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0346 ............ D Amb adv non-er serv + mile ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0348 ............ D Adv emer no spec serv + mile ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0350 ............ D Adv emer spec serv + mileage ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0360 ............ D Basic non-er sep mile & supp .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0362 ............ D Basic emer sep mile & supply ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0364 ............ D Adv non-er no serv sep mi&su ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65557

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

A0366 ............ D Adv non-er serv sep mil&supp ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0368 ............ X Adv er no serv sep mile&supp ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0370 ............ D Adv er spec serv sep mi&supp ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0380 ............ D Basic life support mileage .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0382 ............ X Basic support routine suppls ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0384 ............ X Bls defibrillation supplies ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0390 ............ D Advanced life support mileag ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0392 ............ X Als defibrillation supplies ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0394 ............ X Als IV drug therapy supplies ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0396 ............ X Als esophageal intub suppls ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0398 ............ X Als routine disposble suppls ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0420 ............ X Ambulance waiting 1/2 hr ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0422 ............ X Ambulance 02 life sustaining ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0424 ............ X Extra ambulance attendant .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0425 ............ X Ground mileage .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0426 ............ X Als 1 ..................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0427 ............ X ALS1-emergency .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0428 ............ X bls ......................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0429 ............ X BLS-emergency .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0430 ............ X Fixed wing air transport ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0431 ............ X Rotary wing air transport ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0432 ............ X PI volunteer ambulance co .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0433 ............ X als 2 ...................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0434 ............ X Specialty care transport ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0435 ............ X Fixed wing air mileage ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0436 ............ X Rotary wing air mileage ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0888 ............ N Noncovered ambulance mileage .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A0999 ............ X Unlisted ambulance service ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4206 ............ I 1 CC sterile syringe&needle ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4207 ............ I 2 CC sterile syringe&needle ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4208 ............ I 3 CC sterile syringe&needle ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4209 ............ I 5+ CC sterile syringe&needle .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4210 ............ N Nonneedle injection device .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4211 ............ P Supp for self-adm injections ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4212 ............ P Non coring needle or stylet .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4213 ............ I 20+ CC syringe only ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4214 ............ P 30 CC sterile water/saline .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4215 ............ I Sterile needle ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4220 ............ P Infusion pump refill kit .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4221 ............ X Maint drug infus cath per wk ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4222 ............ X Drug infusion pump supplies ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4230 ............ X Infus insulin pump non needl ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4231 ............ X Infusion insulin pump needle ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4232 ............ X Syringe w/needle insulin 3cc ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4244 ............ I Alcohol or peroxide per pint ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4245 ............ I Alcohol wipes per box .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4246 ............ I Betadine/phisohex solution .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4247 ............ I Betadine/iodine swabs/wipes ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4250 ............ N Urine reagent strips/tablets .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4253 ............ P Blood glucose/reagent strips ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4254 ............ X Battery for glucose monitor .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4255 ............ X Glucose monitor platforms ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4256 ............ P Calibrator solution/chips ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4258 ............ P Lancet device each .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4259 ............ P Lancets per box .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4260 ............ N Levonorgestrel implant ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4261 ............ N Cervical cap contraceptive ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4262 ............ B Temporary tear duct plug ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4263 ............ A Permanent tear duct plug ..................... 0.00 0.00 0.26 0.00 0.26 0.00 0.00 0.26 0.00 0.26 XXX

A4265 ............ P Paraffin ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4270 ............ B Disposable endoscope sheath ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4280 ............ X Brst prsths adhsv attchmnt .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4290 ............ X Sacral nerve stim test lead .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4300 ............ A Cath impl vasc access portal ............... 0.00 0.00 0.26 0.00 0.26 0.00 0.00 0.26 0.00 0.26 XXX

A4301 ............ P Implantable access syst perc ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4305 ............ P Drug delivery system >=50 ML ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4306 ............ P Drug delivery system <=5 ML .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4310 ............ P Insert tray w/o bag/cath ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4311 ............ P Catheter w/o bag 2-way latex .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4312 ............ P Cath w/o bag 2-way silicone ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4313 ............ P Catheter w/bag 3-way .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4314 ............ P Cath w/drainage 2-way latex ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4315 ............ P Cath w/drainage 2-way silcne .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4316 ............ P Cath w/drainage 3-way ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4319 ............ X Sterile H2O irrigation solut ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4320 ............ P Irrigation tray ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4321 ............ X Cath therapeutic irrig agent .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4322 ............ P Irrigation syringe ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4323 ............ P Saline irrigation solution ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4324 ............ X Male ext cath w/adh coating ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4325 ............ X Male ext cath w/adh strip ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4326 ............ P Male external catheter .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4327 ............ P Fem urinary collect dev cup ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65558

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

A4328 ............ P Fem urinary collect pouch .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4329 ............ P External catheter start set .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4330 ............ P Stool collection pouch .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4331 ............ X Extension drainage tubing .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4332 ............ X Lubricant for cath insertion ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4333 ............ X Urinary cath anchor device .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4334 ............ X Urinary cath leg strap ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4335 ............ P Incontinence supply .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4338 ............ P Indwelling catheter latex ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4340 ............ P Indwelling catheter special ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4344 ............ P Cath indw foley 2 way silicn ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4346 ............ P Cath indw foley 3 way .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4347 ............ P Male external catheter .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4348 ............ X Male ext cath extended wear ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4351 ............ P Straight tip urine catheter ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4352 ............ P Coude tip urinary catheter .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4353 ............ X Intermittent urinary cath ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4354 ............ P Cath insertion tray w/bag ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4355 ............ P Bladder irrigation tubing ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4356 ............ P Ext ureth clmp or compr dvc ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4357 ............ P Bedside drainage bag .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4358 ............ P Urinary leg bag ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4359 ............ P Urinary suspensory w/o leg b .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4361 ............ P Ostomy face plate ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4362 ............ P Solid skin barrier .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4364 ............ P Liq adhes for facial prosth .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4365 ............ X Adhesive remover wipes ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4367 ............ P Ostomy belt .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4368 ............ X Ostomy filter ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4369 ............ X Skin barrier liquid per oz ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4370 ............ X Skin barrier paste per oz ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4371 ............ X Skin barrier powder per oz ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4372 ............ X Skin barrier solid 4x4 equiv .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4373 ............ X Skin barrier with flange ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4374 ............ X Skin barrier extended wear .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4375 ............ X Drainable plastic pch w fcpl ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4376 ............ X Drainable rubber pch w fcplt ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4377 ............ X Drainable plstic pch w/o fp ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4378 ............ X Drainable rubber pch w/o fp ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4379 ............ X Urinary plastic pouch w fcpl ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4380 ............ X Urinary rubber pouch w fcplt ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4381 ............ X Urinary plastic pouch w/o fp ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4382 ............ X Urinary hvy plstc pch w/o fp ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4383 ............ X Urinary rubber pouch w/o fp ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4384 ............ X Ostomy faceplt/silicone ring ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4385 ............ X Ost skn barrier sld ext wear ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4386 ............ X Ost skn barrier w flng ex wr ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4387 ............ X Ost clsd pouch w att st barr ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4388 ............ X Drainable pch w ex wear barr .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4389 ............ X Drainable pch w st wear barr ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4390 ............ X Drainable pch ex wear convex ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4391 ............ X Urinary pouch w ex wear barr .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4392 ............ X Urinary pouch w st wear barr ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4393 ............ X Urine pch w ex wear bar conv ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4394 ............ X Ostomy pouch liq deodorant ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4395 ............ X Ostomy pouch solid deodorant ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4396 ............ X Peristomal hernia supprt blt ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4397 ............ P Irrigation supply sleeve ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4398 ............ P Ostomy irrigation bag ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4399 ............ P Ostomy irrig cone/cath w brs ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4400 ............ P Ostomy irrigation set ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4402 ............ P Lubricant per ounce ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4404 ............ P Ostomy ring each ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4421 ............ P Ostomy supply misc ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4454 ............ P Tape all types all sizes ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4455 ............ P Adhesive remover per ounce ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4460 ............ P Elastic compression bandage .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4462 ............ X Abdmnl drssng holder/binder ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4464 ............ N Joint support device/garment ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4465 ............ P Non-elastic extremity binder ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4470 ............ P Gravlee jet washer ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4480 ............ P Vabra aspirator ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4481 ............ X Tracheostoma filter ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4483 ............ X Moisture exchanger .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4490 ............ N Above knee surgical stocking .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4495 ............ N Thigh length surg stocking ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4500 ............ N Below knee surgical stocking ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4510 ............ N Full length surg stocking ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4550 ............ A Surgical trays ........................................ 0.00 0.00 0.26 0.00 0.26 0.00 0.00 0.26 0.00 0.26 XXX

A4554 ............ N Disposable underpads .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4556 ............ P Electrodes, pair .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4557 ............ P Lead wires, pair .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4558 ............ P Conductive paste or gel ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65559

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

A4560 ............ D Pessary ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4561 ............ X Pessary rubber, any type ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4562 ............ X Pessary, non rubber,any type .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4565 ............ X Slings .................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4570 ............ X Splint ..................................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4572 ............ X Rib belt ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4575 ............ N Hyperbaric o2 chamber disps .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4580 ............ X Cast supplies (plaster) ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4590 ............ X Special casting material ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4595 ............ X TENS suppl 2 lead per month ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4608 ............ X Transtracheal oxygen cath ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4611 ............ X Heavy duty battery ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4612 ............ X Battery cables ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4613 ............ X Battery charger ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4614 ............ X Hand-held PEFR meter ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4615 ............ X Cannula nasal ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4616 ............ X Tubing (oxygen) per foot ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4617 ............ X Mouth piece .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4618 ............ X Breathing circuits .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4619 ............ X Face tent .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4620 ............ X Variable concentration mask ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4621 ............ X Tracheotomy mask or collar ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4622 ............ X Tracheostomy or larngectomy .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4623 ............ X Tracheostomy inner cannula ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4624 ............ X Tracheal suction tube ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4625 ............ X Trach care kit for new trach ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4626 ............ X Tracheostomy cleaning brush .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4627 ............ N Spacer bag/reservoir ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4628 ............ X Oropharyngeal suction cath ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4629 ............ X Tracheostomy care kit .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4630 ............ X Repl bat t.e.n.s. own by pt ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4631 ............ X Wheelchair battery ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4635 ............ X Underarm crutch pad ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4636 ............ X Handgrip for cane etc ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4637 ............ X Repl tip cane/crutch/walker .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4640 ............ X Alternating pressure pad ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4641 ............ E Diagnostic imaging agent ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4642 ............ E Satumomab pendetide per dose .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4643 ............ E High dose contrast MRI ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4644 ............ E Contrast 100-199 MGs iodine .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4645 ............ E Contrast 200-299 MGs iodine .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4646 ............ E Contrast 300-399 MGs iodine .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4647 ............ B Supp- paramagnetic contr mat ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4649 ............ P Surgical supplies .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4650 ............ X Supp esrd centrifuge ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4655 ............ X Esrd syringe/needle .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4660 ............ X Esrd blood pressure device ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4663 ............ X Esrd blood pressure cuff ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4670 ............ N Auto blood pressure monitor ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4680 ............ X Activated carbon filters ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4690 ............ X Dialyzers ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4700 ............ X Standard dialysate solution .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4705 ............ X Bicarb dialysate solution ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4712 ............ X Sterile water ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4714 ............ X Treated water for dialysis ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4730 ............ X Fistula cannulation set dial ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4735 ............ X Local/topical anesthetics ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4740 ............ X Esrd shunt accessory ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4750 ............ X Arterial or venous tubing ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4755 ............ X Arterial and venous tubing ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4760 ............ X Standard testing solution ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4765 ............ X Dialysate concentrate ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4770 ............ X Blood testing supplies .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4771 ............ X Blood clotting time tube ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4772 ............ X Dextrostick/glucose strips ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4773 ............ X Hemostix ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4774 ............ X Ammonia test paper ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4780 ............ X Esrd sterilizing agent ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4790 ............ X Esrd cleansing agents .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4800 ............ X Heparin/antidote dialysis ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4820 ............ X Supplies hemodialysis kit ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4850 ............ X Rubber tipped hemostats ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4860 ............ X Disposable catheter caps ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4870 ............ X Plumbing/electrical work ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4880 ............ X Water storage tanks ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4890 ............ R Contracts/repair/maintenance .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4900 ............ X Capd supply kit ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4901 ............ X Ccpd supply kit ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4905 ............ X Ipd supply kit ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4910 ............ X Esrd nonmedical supplies .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4912 ............ X Gomco drain bottle ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4913 ............ X Esrd supply ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4914 ............ X Preparation kit ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65560

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

A4918 ............ X Venous pressure clamp ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4919 ............ X Supp dialysis dialyzer holde ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4920 ............ X Harvard pressure clamp ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4921 ............ X Measuring cylinder ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A4927 ............ X Gloves .................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5051 ............ P Pouch clsd w barr attached ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5052 ............ P Clsd ostomy pouch w/o barr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5053 ............ P Clsd ostomy pouch faceplate ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5054 ............ P Clsd ostomy pouch w/flange ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5055 ............ P Stoma cap ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5061 ............ P Pouch drainable w barrier at ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5062 ............ P Drnble ostomy pouch w/o barr ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5063 ............ P Drain ostomy pouch w/flange ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5064 ............ I Drain ostomy pouch w/fceplte .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5065 ............ D Drain ostomy pouch on fcplte .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5071 ............ P Urinary pouch w/barrier ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5072 ............ P Urinary pouch w/o barrier ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5073 ............ P Urinary pouch on barr w/flng ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5074 ............ I Urinary pouch w/faceplate .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5075 ............ I Urinary pouch on faceplate .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5081 ............ P Continent stoma plug ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5082 ............ P Continent stoma catheter ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5093 ............ P Ostomy accessory convex inse ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5102 ............ P Bedside drain btl w/wo tube ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5105 ............ P Urinary suspensory .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5112 ............ P Urinary leg bag ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5113 ............ P Latex leg strap ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5114 ............ P Foam/fabric leg strap ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5119 ............ P Skin barrier wipes box pr 50 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5121 ............ P Solid skin barrier 6x6 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5122 ............ P Solid skin barrier 8x8 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5123 ............ P Skin barrier with flange ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5126 ............ P Disk/foam pad +or- adhesive ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5131 ............ P Appliance cleaner ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5149 ............ D Incontinence/ostomy supply ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5200 ............ X Percutaneous catheter anchor ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5500 ............ X Diab shoe for density insert ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5501 ............ X Diabetic custom molded shoe .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5502 ............ X Diabetic shoe density insert ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5503 ............ X Diabetic shoe w/roller/rockr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5504 ............ X Diabetic shoe with wedge .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5505 ............ X Diab shoe w/metatarsal bar ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5506 ............ X Diabetic shoe w/off set heel ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5507 ............ X Modification diabetic shoe .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A5508 ............ X Diabetic deluxe shoe ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6020 ............ P Collagen wound dressing ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6021 ............ X Collagen dressing <=16 sq in .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6022 ............ X Collagen drsg>6<=48 sq in .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6023 ............ X Collagen dressing >48 sq in ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6024 ............ X Collagen dsg wound filler ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6025 ............ I Silicone gel sheet, each ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6154 ............ P Wound pouch each .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6196 ............ P Alginate dressing <=16 sq in ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6197 ............ P Alginate drsg >16 <=48 sq in ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6198 ............ P alginate dressing > 48 sq in ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6199 ............ P Alginate drsg wound filler ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6200 ............ X Compos drsg <=16 no border .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6201 ............ X Compos drsg >16<=48 no bdr ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6202 ............ X Compos drsg >48 no border ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6203 ............ P Composite drsg <= 16 sq in ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6204 ............ P Composite drsg >16<=48 sq in ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6205 ............ P Composite drsg > 48 sq in ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6206 ............ P Contact layer <= 16 sq in ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6207 ............ P Contact layer >16<= 48 sq in .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6208 ............ P Contact layer > 48 sq in ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6209 ............ P Foam drsg <=16 sq in w/o bdr ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6210 ............ P Foam drg >16<=48 sq in w/o b ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6211 ............ P Foam drg > 48 sq in w/o brdr .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6212 ............ P Foam drg <=16 sq in w/border ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6213 ............ P Foam drg >16<=48 sq in w/bdr ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6214 ............ P Foam drg > 48 sq in w/border ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6215 ............ P Foam dressing wound filler .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6216 ............ P Non-sterile gauze<=16 sq in ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6217 ............ P Non-sterile gauze>16<=48 sq .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6218 ............ P Non-sterile gauze > 48 sq in ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6219 ............ P Gauze <= 16 sq in w/border ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6220 ............ P Gauze >16 <=48 sq in w/bordr ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6221 ............ P Gauze > 48 sq in w/border .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6222 ............ P Gauze <=16 in no w/sal w/o b ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6223 ............ P Gauze >16<=48 no w/sal w/o b ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6224 ............ P Gauze > 48 in no w/sal w/o b .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6228 ............ P Gauze <= 16 sq in water/sal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6229 ............ P Gauze >16<=48 sq in watr/sal ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65561

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

A6230 ............ P Gauze > 48 sq in water/salne .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6231 ............ X Hydrogel dsg<=16 sq in ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6232 ............ X Hydrogel dsg>16<=48 sq in ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6233 ............ X Hydrogel dressing >48 sq in ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6234 ............ P Hydrocolld drg <=16 w/o bdr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6235 ............ P Hydrocolld drg >16<=48 w/o b ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6236 ............ P Hydrocolld drg > 48 in w/o b ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6237 ............ P Hydrocolld drg <=16 in w/bdr ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6238 ............ P Hydrocolld drg >16<=48 w/bdr ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6239 ............ P Hydrocolld drg > 48 in w/bdr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6240 ............ P Hydrocolld drg filler paste .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6241 ............ P Hydrocolloid drg filler dry ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6242 ............ P Hydrogel drg <=16 in w/o bdr .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6243 ............ P Hydrogel drg >16<=48 w/o bdr ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6244 ............ P Hydrogel drg >48 in w/o bdr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6245 ............ P Hydrogel drg <= 16 in w/bdr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6246 ............ P Hydrogel drg >16<=48 in w/b .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6247 ............ P Hydrogel drg > 48 sq in w/b ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6248 ............ P Hydrogel drsg gel filler ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6250 ............ P Skin seal protect moisturizr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6251 ............ P Absorpt drg <=16 sq in w/o b .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6252 ............ P Absorpt drg >16 <=48 w/o bdr ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6253 ............ P Absorpt drg > 48 sq in w/o b ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6254 ............ P Absorpt drg <=16 sq in w/bdr .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6255 ............ P Absorpt drg >16<=48 in w/bdr ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6256 ............ P Absorpt drg > 48 sq in w/bdr ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6257 ............ P Transparent film <= 16 sq in ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6258 ............ P Transparent film >16<=48 in ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6259 ............ P Transparent film > 48 sq in .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6260 ............ P Wound cleanser any type/size ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6261 ............ P Wound filler gel/paste /oz ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6262 ............ P Wound filler dry form / gram ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6263 ............ P Non-sterile elastic gauze/yd ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6264 ............ P Non-sterile no elastic gauze ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6265 ............ P Tape per 18 sq inches ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6266 ............ P Impreg gauze no h20/sal/yard ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6402 ............ P Sterile gauze <= 16 sq in ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6403 ............ P Sterile gauze>16 <= 48 sq in ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6404 ............ P Sterile gauze > 48 sq in ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6405 ............ P Sterile elastic gauze /yd ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A6406 ............ P Sterile non-elastic gauze/yd ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7000 ............ X Disposable canister for pump .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7001 ............ X Nondisposable pump canister .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7002 ............ X Tubing used w suction pump ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7003 ............ X Nebulizer administration set ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7004 ............ X Disposable nebulizer sml vol ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7005 ............ X Nondisposable nebulizer set ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7006 ............ X Filtered nebulizer admin set ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7007 ............ X Lg vol nebulizer disposable .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7008 ............ X Disposable nebulizer prefill .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7009 ............ X Nebulizer reservoir bottle ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7010 ............ X Disposable corrugated tubing .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7011 ............ X Nondispos corrugated tubing ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7012 ............ X Nebulizer water collec devic ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7013 ............ X Disposable compressor filter ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7014 ............ X Compressor nondispos filter ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7015 ............ X Aerosol mask used w nebulize ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7016 ............ X Nebulizer dome & mouthpiece ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7017 ............ X Nebulizer not used w oxygen ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7018 ............ X Water distilled w/nebulizer ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7019 ............ X Saline solution dispenser ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7020 ............ X Sterile H2O or NSS w lgv neb ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7501 ............ X Tracheostoma valve w diaphra ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7502 ............ X Replacement diaphragm/fplate ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7503 ............ X HMES filter holder or cap ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7504 ............ X Tracheostoma HMES filter ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7505 ............ X HMES or trach valve housing .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7506 ............ X HMES/trachvalve adhesivedisk ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7507 ............ X Integrated filter & holder ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7508 ............ X Housing & Integrated Adhesiv ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A7509 ............ X Heat & moisture exchange sys ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9150 ............ E Misc/exper non-prescript dru ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9160 ............ N Podiatrist non-covered servi ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9170 ............ N Chiropractor non-covered ser .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9190 ............ N Misc/expe personal comfort i ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9270 ............ N Non-covered item or service ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9300 ............ N Exercise equipment .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9500 ............ E Technetium TC 99m sestamibi ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9502 ............ X Technetium TC99M tetrofosmin ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9503 ............ E Technetium TC 99m medronate .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9504 ............ X Technetium tc 99m apcitide ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9505 ............ E Thallous chloride TL 201/mci ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9507 ............ X Indium/111 capromab pendetid ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65562

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

A9508 ............ X Iobenguane sulfate I-131 ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9510 ............ X Technetium TC99m Disofenin .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9600 ............ X Strontium-89 chloride ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9605 ............ X Samarium sm153 lexidronamm ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9700 ............ X Echocardiography Contrast .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9900 ............ X Supply/accessory/service ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

A9901 ............ X Delivery/set up/dispensing ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0120 ............ N Periodic oral evaluation ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0140 ............ N Limit oral eval problm focus ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0150 ............ R Comprehensve oral evaluation ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0160 ............ N Extensv oral eval prob focus ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0170 ............ N Re-eval,est pt,problem focus ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0210 ............ I Intraor complete film series .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0220 ............ I Intraoral periapical first f ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0230 ............ I Intraoral periapical ea add ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0240 ............ R Intraoral occlusal film ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0250 ............ R Extraoral first film ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0260 ............ R Extraoral ea additional film ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0270 ............ R Dental bitewing single film ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0272 ............ R Dental bitewings two films .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0274 ............ R Dental bitewings four films ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0277 ............ R Vert bitewings-sev to eight ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0290 ............ I Dental film skull/facial bon ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0310 ............ I Dental saliography ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0320 ............ I Dental tmj arthrogram incl i .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0321 ............ I Dental other tmj films ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0322 ............ I Dental tomographic survey .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0330 ............ I Dental panoramic film .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0340 ............ I Dental cephalometric film ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0350 ............ I Oral/facial images ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0415 ............ N Bacteriologic study ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0425 ............ N Caries susceptibility test ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0460 ............ R Pulp vitality test .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0470 ............ N Diagnostic casts ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0472 ............ R Gross exam, prep & report .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0473 ............ R Micro exam, prep & report ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0474 ............ R Micro w exam of surg margins ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0480 ............ R Cytopath smear prep & report ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D0501 ............ R Histopathologic examinations ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0502 ............ R Other oral pathology procedu .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D0999 ............ R Unspecified diagnostic proce ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D1110 ............ N Dental prophylaxis adult ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1120 ............ N Dental prophylaxis child ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1201 ............ N Topical fluor w prophy child ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1203 ............ N Topical fluor w/o prophy chi ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1204 ............ N Topical fluor w/o prophy adu ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1205 ............ N Topical fluoride w/ prophy a ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1310 ............ N Nutri counsel-control caries .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1320 ............ N Tobacco counseling ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1330 ............ N Oral hygiene instruction ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1351 ............ N Dental sealant per tooth ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D1510 ............ R Space maintainer fxd unilat .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D1515 ............ R Fixed bilat space maintainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D1520 ............ R Remove unilat space maintain ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D1525 ............ R Remove bilat space maintain ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D1550 ............ R Recement space maintainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D2110 ............ N Amalgam one surface primary ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2120 ............ N Amalgam two surfaces primary ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2130 ............ N Amalgam three surfaces prima ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2131 ............ N Amalgam four/more surf prima ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2140 ............ N Amalgam one surface permanen ......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2150 ............ N Amalgam two surfaces permane ......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2160 ............ N Amalgam three surfaces perma ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2161 ............ N Amalgam 4 or > surfaces perm ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2330 ............ N Resin one surface-anterior ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2331 ............ N Resin two surfaces-anterior ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2332 ............ N Resin three surfaces-anterio ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2335 ............ N Resin 4/> surf or w incis an ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2336 ............ N Composite resin crown ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2337 ............ N Compo resin crown ant-perm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2380 ............ N Resin one surf poster primar ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2381 ............ N Resin two surf poster primar ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2382 ............ N Resin three/more surf post p ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2385 ............ N Resin one surf poster perman ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2386 ............ N Resin two surf poster perman .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2387 ............ N Resin three/more surf post p ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2388 ............ N Resin four/more, post perm ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2410 ............ N Dental gold foil one surface ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2420 ............ N Dental gold foil two surface .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2430 ............ N Dental gold foil three surfa ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2510 ............ N Dental inlay metalic 1 surf .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2520 ............ N Dental inlay metallic 2 surf ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2530 ............ N Dental inlay metl 3/more sur ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65563

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

D2542 ............ N Dental onlay metallic 2 surf .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2543 ............ N Dental onlay metallic 3 surf .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2544 ............ N Dental onlay metl 4/more sur ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2610 ............ N Inlay porcelain/ceramic 1 su ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2620 ............ N Inlay porcelain/ceramic 2 su ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2630 ............ N Dental onlay porc 3/more sur ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2642 ............ N Dental onlay porcelin 2 surf ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2643 ............ N Dental onlay porcelin 3 surf ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2644 ............ N Dental onlay porc 4/more sur ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2650 ............ N Inlay composite/resin one su ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2651 ............ N Inlay composite/resin two su ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2652 ............ N Dental inlay resin 3/mre sur ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2662 ............ N Dental onlay resin 2 surface ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2663 ............ N Dental onlay resin 3 surface ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2664 ............ N Dental onlay resin 4/mre sur ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2710 ............ N Crown resin laboratory ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2720 ............ N Crown resin w/ high noble me ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2721 ............ N Crown resin w/ base metal .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2722 ............ N Crown resin w/ noble metal ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2740 ............ N Crown porcelain/ceramic subs ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2750 ............ N Crown porcelain w/ h noble m ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2751 ............ N Crown porcelain fused base m ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2752 ............ N Crown porcelain w/ noble met ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2780 ............ N Crown 3/4 cast hi noble met ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2781 ............ N Crown 3/4 cast base metal .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2782 ............ N Crown 3/4 cast noble metal ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2783 ............ N Crown 3/4 porcelain/ceramic ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2790 ............ N Crown full cast high noble m ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2791 ............ N Crown full cast base metal ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2792 ............ N Crown full cast noble metal .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2799 ............ N Provisional crown ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2910 ............ N Dental recement inlay .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2920 ............ N Dental recement crown ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2930 ............ N Prefab stnlss steel crwn pri .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2931 ............ N Prefab stnlss steel crown pe ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2932 ............ N Prefabricated resin crown .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2933 ............ N Prefab stainless steel crown ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2940 ............ N Dental sedative filling ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2950 ............ N Core build-up incl any pins .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2951 ............ N Tooth pin retention ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2952 ............ N Post and core cast + crown ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2953 ............ N Each addtnl cast post ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2954 ............ N Prefab post/core + crown ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2955 ............ N Post removal ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2957 ............ N Each addtnl prefab post ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2960 ............ N Laminate labial veneer ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2961 ............ N Lab labial veneer resin ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2962 ............ N Lab labial veneer porcelain .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2970 ............ R Temporary- fractured tooth .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D2980 ............ N Crown repair ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D2999 ............ R Dental unspec restorative pr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D3110 ............ N Pulp cap direct ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3120 ............ N Pulp cap indirect ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3220 ............ N Therapeutic pulpotomy ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3221 ............ N Gross pulpal debridement .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3230 ............ N Pulpal therapy anterior prim ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3240 ............ N Pulpal therapy posterior pri .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3310 ............ N Anterior ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3320 ............ N Root canal therapy 2 canals ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3330 ............ N Root canal therapy 3 canals ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3331 ............ N Non-surg tx root canal obs ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3332 ............ N Incomplete endodontic tx ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3333 ............ N Internal root repair ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3346 ............ N Retreat root canal anterior ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3347 ............ N Retreat root canal bicuspid .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3348 ............ N Retreat root canal molar ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3351 ............ N Apexification/recalc initial ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3352 ............ N Apexification/recalc interim ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3353 ............ N Apexification/recalc final ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3410 ............ N Apicoect/perirad surg anter .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3421 ............ N Root surgery bicuspid .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3425 ............ N Root surgery molar ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3426 ............ N Root surgery ea add root ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3430 ............ N Retrograde filling .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3450 ............ N Root amputation ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3460 ............ R Endodontic endosseous implan ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D3470 ............ N Intentional replantation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3910 ............ N Isolation- tooth w rubb dam ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3920 ............ N Tooth splitting ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3950 ............ N Canal prep/fitting of dowel ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D3999 ............ R Endodontic procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4210 ............ I Gingivectomy/plasty per quad .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4211 ............ I Gingivectomy/plasty per toot ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65564

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

D4220 ............ N Gingival curettage per quadr ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4240 ............ N Gingival flap proc w/ planin .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4245 ............ N Apically positioned flap ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4249 ............ N Crown lengthen hard tissue ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4260 ............ R Osseous surgery per quadrant ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4263 ............ R Bone replce graft first site .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4264 ............ R Bone replce graft each add .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4266 ............ N Guided tiss regen resorble ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4267 ............ N Guided tiss regen nonresorb ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4268 ............ R Surgical revision procedure .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4270 ............ R Pedicle soft tissue graft pr ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4271 ............ R Free soft tissue graft proc .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4273 ............ R Subepithelial tissue graft ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4274 ............ N Distal/proximal wedge proc .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4320 ............ N Provision splnt intracoronal .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4321 ............ N Provisional splint extracoro .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4341 ............ N Periodontal scaling & root .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4355 ............ R Full mouth debridement ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4381 ............ R Localized chemo delivery ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D4910 ............ N Periodontal maint procedures .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4920 ............ N Unscheduled dressing change ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D4999 ............ N Unspecified periodontal proc ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5110 ............ N Dentures complete maxillary ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5120 ............ N Dentures complete mandible ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5130 ............ N Dentures immediat maxillary ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5140 ............ N Dentures immediat mandible ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5211 ............ N Dentures maxill part resin .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5212 ............ N Dentures mand part resin .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5213 ............ N Dentures maxill part metal ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5214 ............ N Dentures mandibl part metal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5281 ............ N Removable partial denture ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5410 ............ N Dentures adjust cmplt maxil ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5411 ............ N Dentures adjust cmplt mand ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5421 ............ N Dentures adjust part maxill .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5422 ............ N Dentures adjust part mandbl ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5510 ............ N Dentur repr broken compl bas ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5520 ............ N Replace denture teeth complt .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5610 ............ N Dentures repair resin base ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5620 ............ N Rep part denture cast frame ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5630 ............ N Rep partial denture clasp ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5640 ............ N Replace part denture teeth .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5650 ............ N Add tooth to partial denture ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5660 ............ N Add clasp to partial denture ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5710 ............ N Dentures rebase cmplt maxil ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5711 ............ N Dentures rebase cmplt mand ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5720 ............ N Dentures rebase part maxill ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5721 ............ N Dentures rebase part mandbl .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5730 ............ N Denture reln cmplt maxil ch ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5731 ............ N Denture reln cmplt mand chr ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5740 ............ N Denture reln part maxil chr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5741 ............ N Denture reln part mand chr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5750 ............ N Denture reln cmplt max lab .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5751 ............ N Denture reln cmplt mand lab ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5760 ............ N Denture reln part maxil lab ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5761 ............ N Denture reln part mand lab .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5810 ............ N Denture interm cmplt maxill ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5811 ............ N Denture interm cmplt mandbl ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5820 ............ N Denture interm part maxill .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5821 ............ N Denture interm part mandbl ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5850 ............ N Denture tiss conditn maxill ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5851 ............ N Denture tiss condtin mandbl ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5860 ............ N Overdenture complete .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5861 ............ N Overdenture partial ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5862 ............ N Precision attachment ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5867 ............ N Replacement of precision att ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5875 ............ N Prosthesis modification ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5899 ............ N Removable prosthodontic proc ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5911 ............ R Facial moulage sectional ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5912 ............ R Facial moulage complete ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5913 ............ I Nasal prosthesis ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5914 ............ I Auricular prosthesis .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5915 ............ I Orbital prosthesis ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5916 ............ I Ocular prosthesis ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5919 ............ I Facial prosthesis .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5922 ............ I Nasal septal prosthesis ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5923 ............ I Ocular prosthesis interim ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5924 ............ I Cranial prosthesis ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5925 ............ I Facial augmentation implant ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5926 ............ I Replacement nasal prosthesis ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5927 ............ I Auricular replacement .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5928 ............ I Orbital replacement .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5929 ............ I Facial replacement ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5931 ............ I Surgical obturator ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65565

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

D5932 ............ I Postsurgical obturator .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5933 ............ I Refitting of obturator ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5934 ............ I Mandibular flange prosthesis ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5935 ............ I Mandibular denture prosth ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5936 ............ I Temp obturator prosthesis ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5937 ............ I Trismus appliance ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5951 ............ R Feeding aid ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5952 ............ I Pediatric speech aid ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5953 ............ I Adult speech aid ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5954 ............ I Superimposed prosthesis ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5955 ............ I Palatal lift prosthesis ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5958 ............ I Intraoral con def inter plt ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5959 ............ I Intraoral con def mod palat .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5960 ............ I Modify speech aid prosthesis ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5982 ............ I Surgical stent ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5983 ............ R Radiation applicator .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5984 ............ R Radiation shield .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5985 ............ R Radiation cone locator ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5986 ............ N Fluoride applicator ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5987 ............ R Commissure splint ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D5988 ............ I Surgical splint ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D5999 ............ I Maxillofacial prosthesis ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6010 ............ I Odontics endosteal implant .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6020 ............ I Odontics abutment placement ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6040 ............ I Odontics eposteal implant .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6050 ............ I Odontics transosteal implnt .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6055 ............ I Implant connecting bar ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6056 ............ N Prefabricated abutment ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6057 ............ N Custom abutment ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6058 ............ N Abutment supported crown .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6059 ............ N Abutment supported mtl crown ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6060 ............ N Abutment supported mtl crown ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6061 ............ N Abutment supported mtl crown ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6062 ............ N Abutment supported mtl crown ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6063 ............ N Abutment supported mtl crown ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6064 ............ N Abutment supported mtl crown ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6065 ............ N Implant supported crown ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6066 ............ N Implant supported mtl crown ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6067 ............ N Implant supported mtl crown ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6068 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6069 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6070 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6071 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6072 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6073 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6074 ............ N Abutment supported retainer ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6075 ............ N Implant supported retainer ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6076 ............ N Implant supported retainer ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6077 ............ N Implant supported retainer ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6078 ............ N Implnt/abut suprtd fixd dent .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6079 ............ N Implnt/abut suprtd fixd dent .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6080 ............ I Implant maintenance ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6090 ............ I Repair implant ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6095 ............ I Odontics repr abutment ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6100 ............ I Removal of implant .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6199 ............ I Implant procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6210 ............ N Prosthodont high noble metal .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6211 ............ N Bridge base metal cast ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6212 ............ N Bridge noble metal cast ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6240 ............ N Bridge porcelain high noble ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6241 ............ N Bridge porcelain base metal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6242 ............ N Bridge porcelain nobel metal ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6245 ............ N Bridge porcelain/ceramic ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6250 ............ N Bridge resin w/high noble ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6251 ............ N Bridge resin base metal ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6252 ............ N Bridge resin w/noble metal ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6519 ............ N Inlay/onlay porce/ceramic ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6520 ............ N Dental retainer two surfaces ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6530 ............ N Retainer metallic 3+ surface ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6543 ............ N Dental retainr onlay 3 surf .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6544 ............ N Dental retainr onlay 4/more .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6545 ............ N Dental retainr cast metl ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6548 ............ N Porcelain/ceramic retainer .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6720 ............ N Retain crown resin w hi nble ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6721 ............ N Crown resin w/base metal .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6722 ............ N Crown resin w/noble metal ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6740 ............ N Crown porcelain/ceramic ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6750 ............ N Crown porcelain high noble ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6751 ............ N Crown porcelain base metal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6752 ............ N Crown porcelain noble metal ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6780 ............ N Crown 3/4 high noble metal ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6781 ............ N Crown 3/4 cast based metal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6782 ............ N Crown 3/4 cast noble metal ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65566

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

D6783 ............ N Crown 3/4 porcelain/ceramic ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6790 ............ N Crown full high noble metal ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6791 ............ N Crown full base metal cast ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6792 ............ N Crown full noble metal cast .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6920 ............ R Dental connector bar ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D6930 ............ N Dental recement bridge ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6940 ............ N Stress breaker ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6950 ............ N Precision attachment ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6970 ............ N Post & core plus retainer ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6971 ............ N Cast post bridge retainer ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6972 ............ N Prefab post & core plus reta ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6973 ............ N Core build up for retainer ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6975 ............ N Coping metal ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6976 ............ N Each addtnl cast post ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6977 ............ N Each addtl prefab post ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6980 ............ N Bridge repair ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D6999 ............ N Fixed prosthodontic proc ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7110 ............ R Oral surgery single tooth ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7120 ............ R Each add tooth extraction .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7130 ............ R Tooth root removal ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7210 ............ R Rem imp tooth w mucoper flp .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7220 ............ R Impact tooth remov soft tiss ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7230 ............ R Impact tooth remov part bony .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7240 ............ R Impact tooth remov comp bony ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7241 ............ R Impact tooth rem bony w/comp ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7250 ............ R Tooth root removal ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7260 ............ R Oral antral fistula closure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7270 ............ N Tooth reimplantation ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7272 ............ N Tooth transplantation ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7280 ............ N Exposure impact tooth orthod .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7281 ............ N Exposure tooth aid eruption ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7285 ............ I Biopsy of oral tissue hard .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7286 ............ I Biopsy of oral tissue soft ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7290 ............ N Repositioning of teeth .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7291 ............ R Transseptal fiberotomy ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7310 ............ I Alveoplasty w/ extraction ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7320 ............ I Alveoplasty w/o extraction .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7340 ............ I Vestibuloplasty ridge extens ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7350 ............ I Vestibuloplasty exten graft ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7410 ............ I Rad exc lesion up to 1.25 cm .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7420 ............ I Lesion > 1.25 cm ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7430 ............ I Exc benign tumor to 1.25 cm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7431 ............ I Benign tumor exc > 1.25 cm ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7440 ............ I Malig tumor exc to 1.25 cm ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7441 ............ I Malig tumor > 1.25 cm ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7450 ............ I Rem odontogen cyst to 1.25cm ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7451 ............ I Rem odontogen cyst > 1.25 cm ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7460 ............ I Rem nonodonto cyst to 1.25cm ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7461 ............ I Rem nonodonto cyst > 1.25 cm ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7465 ............ I Lesion destruction ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7471 ............ I Rem exostosis any site ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7480 ............ I Partial ostectomy .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7490 ............ I Mandible resection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7510 ............ I I&d absc intraoral soft tiss .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7520 ............ I I&d abscess extraoral ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7530 ............ I Removal fb skin/areolar tiss ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7540 ............ I Removal of fb reaction ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7550 ............ I Removal of sloughed off bone ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7560 ............ I Maxillary sinusotomy ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7610 ............ I Maxilla open reduct simple .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7620 ............ I Clsd reduct simpl maxilla fx ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7630 ............ I Open red simpl mandible fx ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7640 ............ I Clsd red simpl mandible fx ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7650 ............ I Open red simp malar/zygom fx ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7660 ............ I Clsd red simp malar/zygom fx ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7670 ............ I Closd rductn splint alveolus ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7680 ............ I Reduct simple facial bone fx ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7710 ............ I Maxilla open reduct compound ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7720 ............ I Clsd reduct compd maxilla fx ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7730 ............ I Open reduct compd mandble fx ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7740 ............ I Clsd reduct compd mandble fx ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7750 ............ I Open red comp malar/zygma fx ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7760 ............ I Clsd red comp malar/zygma fx ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7770 ............ I Open reduc compd alveolus fx ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7780 ............ I Reduct compnd facial bone fx ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7810 ............ I Tmj open reduct-dislocation ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7820 ............ I Closed tmp manipulation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7830 ............ I Tmj manipulation under anest .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7840 ............ I Removal of tmj condyle ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7850 ............ I Tmj meniscectomy ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7852 ............ I Tmj repair of joint disc .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7854 ............ I Tmj excisn of joint membrane .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7856 ............ I Tmj cutting of a muscle ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65567

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

D7858 ............ I Tmj reconstruction ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7860 ............ I Tmj cutting into joint ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7865 ............ I Tmj reshaping components .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7870 ............ I Tmj aspiration joint fluid ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7871 ............ N Lysis + lavage w catheters .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7872 ............ I Tmj diagnostic arthroscopy .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7873 ............ I Tmj arthroscopy lysis adhesn .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7874 ............ I Tmj arthroscopy disc reposit ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7875 ............ I Tmj arthroscopy synovectomy ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7876 ............ I Tmj arthroscopy discectomy ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7877 ............ I Tmj arthroscopy debridement .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7880 ............ I Occlusal orthotic appliance .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7899 ............ I Tmj unspecified therapy ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7910 ............ I Dent sutur recent wnd to 5cm .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7911 ............ I Dental suture wound to 5 cm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7912 ............ I Suture complicate wnd > 5 cm ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7920 ............ I Dental skin graft ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7940 ............ R Reshaping bone orthognathic .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D7941 ............ I Bone cutting ramus closed ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7943 ............ I Cutting ramus open w/graft .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7944 ............ I Bone cutting segmented ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7945 ............ I Bone cutting body mandible ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7946 ............ I Reconstruction maxilla total ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7947 ............ I Reconstruct maxilla segment ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7948 ............ I Reconstruct midface no graft ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7949 ............ I Reconstruct midface w/graft ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7950 ............ I Mandible graft ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7955 ............ I Repair maxillofacial defects ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7960 ............ I Frenulectomy/frenulotomy .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7970 ............ I Excision hyperplastic tissue ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7971 ............ I Excision pericoronal gingiva ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7980 ............ I Sialolithotomy ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7981 ............ I Excision of salivary gland ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7982 ............ I Sialodochoplasty .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7983 ............ I Closure of salivary fistula ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7990 ............ I Emergency tracheotomy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7991 ............ I Dental coronoidectomy ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7995 ............ I Synthetic graft facial bones .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7996 ............ I Implant mandible for augment ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7997 ............ N Appliance removal ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D7999 ............ I Oral surgery procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8010 ............ N Limited dental tx primary ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8020 ............ N Limited dental tx transition ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8030 ............ N Limited dental tx adolescent ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8040 ............ N Limited dental tx adult .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8050 ............ N Intercep dental tx primary .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8060 ............ N Intercep dental tx transitn ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8070 ............ N Compre dental tx transition .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8080 ............ N Compre dental tx adolescent ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8090 ............ N Compre dental tx adult ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8210 ............ N Orthodontic rem appliance tx ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8220 ............ N Fixed appliance therapy habt ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8660 ............ N Preorthodontic tx visit ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8670 ............ N Periodic orthodontc tx visit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8680 ............ N Orthodontic retention ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8690 ............ N Orthodontic treatment ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8691 ............ N Repair ortho appliance ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8692 ............ N Replacement retainer ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D8999 ............ N Orthodontic procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9110 ............ R Tx dental pain minor proc .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9210 ............ I Dent anesthesia w/o surgery ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9211 ............ I Regional block anesthesia ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9212 ............ I Trigeminal block anesthesia ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9215 ............ I Local anesthesia .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9220 ............ I General anesthesia .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9221 ............ I General anesthesia ea ad 15m ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9230 ............ R Analgesia .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9241 ............ I Intravenous sedation ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9242 ............ I IV sedation ea ad 30 m ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9248 ............ R Sedation (non-iv) .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9310 ............ I Dental consultation ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9410 ............ I Dental house call .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9420 ............ I Hospital call .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9430 ............ I Office visit during hours ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9440 ............ I Office visit after hours .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9610 ............ I Dent therapeutic drug inject ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9630 ............ R Other drugs/medicaments .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9910 ............ N Dent appl desensitizing med ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9911 ............ N Appl desensitizing resin ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9920 ............ N Behavior management ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9930 ............ R Treatment of complications .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9940 ............ R Dental occlusal guard ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9941 ............ N Fabrication athletic guard ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65568

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

D9950 ............ R Occlusion analysis ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9951 ............ R Limited occlusal adjustment ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9952 ............ R Complete occlusal adjustment ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

D9970 ............ N Enamel microabrasion .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9971 ............ N Odontoplasty 1-2 teeth ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9972 ............ N Extrnl bleaching per arch ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9973 ............ N Extrnl bleaching per tooth .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9974 ............ N Intrnl bleaching per tooth ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

D9999 ............ I Adjunctive procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0001 ............ X Drawing blood for specimen ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0002 ............ A Temporary urinary catheter .................. 0.50 3.00 2.44 0.17 0.32 0.03 3.53 2.97 0.70 0.85 000

G0004 ............ A ECG transm phys review & int ............. 0.52 7.41 7.54 NA NA 0.45 8.38 8.51 NA NA XXX

G0005 ............ A ECG 24 hour recording ........................ 0.00 1.23 1.24 NA NA 0.07 1.30 1.31 NA NA XXX

G0006 ............ A ECG transmission & analysis ............... 0.00 5.97 6.03 NA NA 0.36 6.33 6.39 NA NA XXX

G0007 ............ A ECG phy review & interpret ................. 0.52 0.21 0.27 0.21 0.27 0.02 0.75 0.81 0.75 0.81 XXX

G0008 ............ X Admin influenza virus vac .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0009 ............ X Admin pneumococcal vaccine .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0010 ............ X Admin hepatitis b vaccine .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0015 ............ A Post symptom ECG tracing .................. 0.00 5.97 6.03 NA NA 0.36 6.33 6.39 NA NA XXX

G0016 ............ A Post symptom ECG md review ............ 0.52 0.23 0.28 0.23 0.28 0.02 0.77 0.82 0.77 0.82 XXX

G0025 ............ A Collagen skin test kit ............................ 0.00 0.00 0.26 0.00 0.26 0.00 0.00 0.26 0.00 0.26 XXX

G0026 ............ X Fecal leukocyte examination ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0027 ............ X Semen analysis .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0030 ............ C PET imaging prev PET single .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0030 26 A PET imaging prev PET single .............. 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0030 TC C PET imaging prev PET single .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0031 ............ C PET imaging prev PET multple ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0031 26 A PET imaging prev PET multple ............ 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0031 TC C PET imaging prev PET multple ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0032 ............ C PET follow SPECT 78464 singl ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0032 26 A PET follow SPECT 78464 singl ........... 1.50 0.52 0.52 0.52 0.52 0.05 2.07 2.07 2.07 2.07 XXX

G0032 TC C PET follow SPECT 78464 singl ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0033 ............ C PET follow SPECT 78464 mult ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0033 26 A PET follow SPECT 78464 mult ............ 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0033 TC C PET follow SPECT 78464 mult ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0034 ............ C PET follow SPECT 76865 singl ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0034 26 A PET follow SPECT 76865 singl ........... 1.50 0.52 0.52 0.52 0.52 0.05 2.07 2.07 2.07 2.07 XXX

G0034 TC C PET follow SPECT 76865 singl ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0035 ............ C PET follow SPECT 78465 mult ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0035 26 A PET follow SPECT 78465 mult ............ 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0035 TC C PET follow SPECT 78465 mult ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0036 ............ C PET follow cornry angio sing ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0036 26 A PET follow cornry angio sing ............... 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0036 TC C PET follow cornry angio sing ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0037 ............ C PET follow cornry angio mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0037 26 A PET follow cornry angio mult ............... 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0037 TC C PET follow cornry angio mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0038 ............ C PET follow myocard perf sing .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0038 26 A PET follow myocard perf sing .............. 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0038 TC C PET follow myocard perf sing .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0039 ............ C PET follow myocard perf mult .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0039 26 A PET follow myocard perf mult .............. 1.87 0.70 0.70 0.70 0.70 0.07 2.64 2.64 2.64 2.64 XXX

G0039 TC C PET follow myocard perf mult .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0040 ............ C PET follow stress echo singl ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0040 26 A PET follow stress echo singl ................ 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0040 TC C PET follow stress echo singl ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0041 ............ C PET follow stress echo mult ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0041 26 A PET follow stress echo mult ................ 1.87 0.70 0.70 0.70 0.70 0.05 2.62 2.62 2.62 2.62 XXX

G0041 TC C PET follow stress echo mult ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0042 ............ C PET follow ventriculogm sing ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0042 26 A PET follow ventriculogm sing ............... 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0042 TC C PET follow ventriculogm sing ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0043 ............ C PET follow ventriculogm mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0043 26 A PET follow ventriculogm mult ............... 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0043 TC C PET follow ventriculogm mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0044 ............ C PET following rest ECG singl ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0044 26 A PET following rest ECG singl ............... 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0044 TC C PET following rest ECG singl ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0045 ............ C PET following rest ECG mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0045 26 A PET following rest ECG mult ............... 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0045 TC C PET following rest ECG mult ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0046 ............ C PET follow stress ECG singl ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0046 26 A PET follow stress ECG singl ................ 1.50 0.52 0.52 0.52 0.52 0.04 2.06 2.06 2.06 2.06 XXX

G0046 TC C PET follow stress ECG singl ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0047 ............ C PET follow stress ECG mult ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0047 26 A PET follow stress ECG mult ................ 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0047 TC C PET follow stress ECG mult ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0050 ............ A Residual urine by ultrasound ............... 0.00 0.85 0.86 NA NA 0.04 0.89 0.90 NA NA XXX

G0101 ............ A CA screen;pelvic/breast exam ............. 0.45 0.66 0.57 0.17 0.20 0.01 1.12 1.03 0.63 0.66 XXX

G0102 ............ A Prostate ca screening; dre ................... 0.17 0.37 0.34 0.06 0.07 0.01 0.55 0.52 0.24 0.25 XXX

G0103 ............ X Psa, total screening .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0104 ............ A CA screen;flexi sigmoidscope .............. 0.88 1.75 1.65 0.42 0.46 0.05 2.68 2.58 1.35 1.39 000

G0105 ............ A Colorectal scrn; hi risk ind .................... 3.68 6.60 6.07 1.70 2.38 0.20 10.48 8.95 5.58 6.26 000

65569

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

G0106 ............ A Colon CA screen;barium enema .......... 0.99 2.57 2.63 2.57 2.63 0.15 3.71 3.77 3.71 3.77 XXX

G0106 26 A Colon CA screen;barium enema .......... 0.99 0.35 0.39 0.35 0.39 0.04 1.38 1.42 1.38 1.42 XXX

G0106 TC A Colon CA screen;barium enema .......... 0.00 2.22 2.24 NA NA 0.11 2.33 2.35 NA NA XXX

G0107 ............ X CA screen; fecal blood test .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0108 ............ A Diab manage trn per indiv .................... 0.00 1.64 1.64 NA NA 0.01 1.65 1.65 NA NA XXX

G0109 ............ A Diab manage trn ind/group .................. 0.00 0.96 0.96 NA NA 0.01 0.97 0.97 NA NA XXX

G0110 ............ R Nett pulm-rehab educ; ind .................... 0.90 0.74 0.63 0.36 0.34 0.03 1.67 1.56 1.29 1.27 XXX

G0111 ............ R Nett pulm-rehab educ; group ............... 0.27 0.30 0.28 0.11 0.14 0.01 0.58 0.56 0.39 0.42 XXX

G0112 ............ R Nett;nutrition guid, initial ....................... 1.72 1.44 1.34 0.69 0.78 0.05 3.21 3.11 2.46 2.55 XXX

G0113 ............ R Nett;nutrition guid,subseqnt .................. 1.29 1.11 1.04 0.52 0.60 0.04 2.44 2.37 1.85 1.93 XXX

G0114 ............ R Nett; psychosocial consult .................... 1.20 0.49 0.46 0.48 0.46 0.03 1.72 1.69 1.71 1.69 XXX

G0115 ............ R Nett; psychological testing ................... 1.20 0.67 0.60 0.38 0.38 0.04 1.91 1.84 1.62 1.62 XXX

G0116 ............ R Nett; psychosocial counsel ................... 1.11 1.20 1.00 0.44 0.43 0.04 2.35 2.15 1.59 1.58 XXX

G0120 ............ A Colon ca scrn; barium enema .............. 0.99 2.57 2.63 2.57 2.63 0.15 3.71 3.77 3.71 3.77 XXX

G0120 26 A Colon ca scrn; barium enema .............. 0.99 0.35 0.39 0.35 0.39 0.04 1.38 1.42 1.38 1.42 XXX

G0120 TC A Colon ca scrn; barium enema .............. 0.00 2.22 2.24 NA NA 0.11 2.33 2.35 NA NA XXX

G0121 ............ N Colon ca scrn not hi rsk ind ................. +3.70 6.51 6.00 1.48 2.22 0.14 10.35 9.84 5.32 6.06 XXX

G0122 ............ N Colon ca scrn; barium enema .............. +0.99 2.62 2.66 2.62 2.66 0.15 3.76 3.80 3.76 3.80 XXX

G0122 26 N Colon ca scrn; barium enema .............. +0.99 0.40 0.42 0.40 0.42 0.04 1.43 1.45 1.43 1.45 XXX

G0122 TC N Colon ca scrn; barium enema .............. +0.00 2.22 2.24 NA NA 0.11 2.33 2.35 NA NA XXX

G0123 ............ X Screen cerv/vag thin layer ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0124 ............ A Screen c/v thin layer by MD ................. 0.42 0.18 0.22 0.18 0.22 0.01 0.61 0.65 0.61 0.65 XXX

G0125 ............ A Lung image (PET) ................................ 1.50 56.10 56.11 56.10 56.11 2.00 59.60 59.61 59.60 59.61 XXX

G0125 26 A Lung image (PET) ................................ 1.50 0.52 0.52 0.52 0.52 0.05 2.07 2.07 2.07 2.07 XXX

G0125 TC A Lung image (PET) ................................ 0.00 55.58 55.59 NA NA 1.95 57.53 57.54 NA NA XXX

G0126 ............ A Lung image (PET) staging ................... 1.87 56.28 56.29 56.28 56.29 2.01 60.16 60.17 60.16 60.17 XXX

G0126 26 A Lung image (PET) staging ................... 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0126 TC A Lung image (PET) staging ................... 0.00 55.58 55.59 NA NA 1.95 57.53 57.54 NA NA XXX

G0127 ............ R Trim nail(s) ........................................... 0.11 0.49 0.43 0.04 0.06 0.01 0.61 0.55 0.16 0.18 000

G0128 ............ R CORF skilled nursing service ............... 0.08 0.03 0.03 0.03 0.03 0.01 0.12 0.12 0.12 0.12 XXX

G0130 ............ A Single energy x-ray study .................... 0.22 0.90 0.90 0.90 0.90 0.05 1.17 1.17 1.17 1.17 XXX

G0130 26 A Single energy x-ray study .................... 0.22 0.11 0.11 0.11 0.11 0.01 0.34 0.34 0.34 0.34 XXX

G0130 TC A Single energy x-ray study .................... 0.00 0.79 0.79 NA NA 0.04 0.83 0.83 NA NA XXX

G0131 ............ A CT scan, bone density study ............... 0.25 3.18 3.18 3.18 3.18 0.14 3.57 3.57 3.57 3.57 XXX

G0131 26 A CT scan, bone density study ............... 0.25 0.13 0.13 0.13 0.13 0.01 0.39 0.39 0.39 0.39 XXX

G0131 TC A CT scan, bone density study ............... 0.00 3.05 3.05 NA NA 0.13 3.18 3.18 NA NA XXX

G0132 ............ A CT scan, bone density study ............... 0.22 0.90 0.90 0.90 0.90 0.05 1.17 1.17 1.17 1.17 XXX

G0132 26 A CT scan, bone density study ............... 0.22 0.11 0.11 0.11 0.11 0.01 0.34 0.34 0.34 0.34 XXX

G0132 TC A CT scan, bone density study ............... 0.00 0.79 0.79 NA NA 0.04 0.83 0.83 NA NA XXX

G0141 ............ A Scr c/v cyto,autosys and md ................ 0.42 0.18 0.22 0.18 0.22 0.01 0.61 0.65 0.61 0.65 XXX

G0143 ............ X Scr c/v cyto,thinlayer,rescr ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0144 ............ X Scr c/v cyto,thinlayer,rescr ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0145 ............ X Scr c/v cyto,thinlayer,rescr ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0147 ............ X Scr c/v cyto, automated sys ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0148 ............ X Scr c/v cyto, autosys, rescr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0159 ............ D Perc declot dialysis graft ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0160 ............ D Cryo. ablation, prostate ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090

G0161 ............ D Echo guide for cryo probes .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0161 26 D Echo guide for cryo probes .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0161 TC D Echo guide for cryo probes .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0163 ............ A Pet for rec of colorectal ca ................... 1.50 56.15 56.15 56.15 56.15 2.00 59.65 59.65 59.65 59.65 XXX

G0163 26 A Pet for rec of colorectal ca ................... 1.50 0.57 0.57 0.57 0.57 0.05 2.12 2.12 2.12 2.12 XXX

G0163 TC A Pet for rec of colorectal ca ................... 0.00 55.58 55.58 NA NA 1.95 57.53 57.53 NA NA XXX

G0164 ............ A Pet for lymphoma staging .................... 1.87 56.28 56.28 56.28 56.28 2.01 60.16 60.16 60.16 60.16 XXX

G0164 26 A Pet for lymphoma staging .................... 1.87 0.70 0.70 0.70 0.70 0.06 2.63 2.63 2.63 2.63 XXX

G0164 TC A Pet for lymphoma staging .................... 0.00 55.58 55.58 NA NA 1.95 57.53 57.53 NA NA XXX

G0165 ............ A Pet,rec of melanoma/met ca ................ 1.50 56.17 56.17 56.17 56.17 2.00 59.67 59.67 59.67 59.67 XXX

G0165 26 A Pet,rec of melanoma/met ca ................ 1.50 0.59 0.59 0.59 0.59 0.05 2.14 2.14 2.14 2.14 XXX

G0165 TC A Pet,rec of melanoma/met ca ................ 0.00 55.58 55.58 NA NA 1.95 57.53 57.53 NA NA XXX

G0166 ............ A Extrnl counterpulse, per tx ................... 0.07 3.68 3.68 0.03 0.03 0.01 3.76 3.76 0.11 0.11 XXX

G0167 ............ C Hyperbaric oz tx;no md reqrd .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0168 ............ A Wound closure by adhesive ................. 0.45 1.79 1.79 0.25 0.25 0.01 2.25 2.25 0.71 0.71 000

G0169 ............ D Removal tissue; no anesthsia .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0170 ............ D Skin biograft ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 010

G0171 ............ D Skin biograft add-on ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

G0173 ............ X Stereo radoisurgery,complete .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0174 ............ X Intensitymodulatedradiation .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0175 ............ X OPPS Service,sched team conf ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0176 ............ X OPPS/PHP;activity therapy .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0177 ............ X OPPS/PHP; train & educ serv ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0178 ............ X Intensitymodulatedradiation .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0179 ............ A Intensitymodulatedradiation .................. 0.45 1.09 1.09 0.18 0.18 0.06 1.60 1.60 0.69 0.69 XXX

G0180 ............ A MD certification HHA patient ................ 0.67 1.18 1.18 0.27 0.27 0.06 1.91 1.91 1.00 1.00 XXX

G0181 ............ A Home health care supervision ............. 1.73 1.40 1.40 0.63 0.63 0.06 3.19 3.19 2.42 2.42 XXX

G0182 ............ A Hospice care supervision ..................... 1.73 1.73 1.73 0.60 0.60 0.06 3.52 3.52 2.39 2.39 XXX

G0183 ............ X Ocular photodynamic therapy .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0184 ............ A Ocular photocoagulation ...................... 0.47 0.23 0.23 0.23 0.23 0.50 1.20 1.20 1.20 1.20 ZZZ

G0185 ............ C Transpuppillary thermotx ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

G0186 ............ C Dstry eye lesn,fdr vssl tech .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

G0187 ............ C Dstry mclr drusen,photocoag ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

G0188 ............ C Xray lwr extrmty-full lngth ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0188 26 C Xray lwr extrmty-full lngth ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0188 TC C Xray lwr extrmty-full lngth ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65570

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

G0190 ............ X MD recertification HHA patient ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0191 ............ X Immunization admin,each add ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0192 ............ N Immunization oral/intranasal ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0193 ............ C Endoscopicstudyswallowfunctn ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0194 ............ C Sensorytestingendoscopicstud ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0195 ............ C Clinicalevalswallowingfunct .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0196 ............ C Evalofswallowingwithradioopa .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0197 ............ A Evalofptforprescipspeechdevi ............... 1.35 1.91 1.91 0.77 0.77 0.04 3.30 3.30 2.16 2.16 XXX

G0198 ............ A Patientadapation&trainforspe ............... 0.99 1.05 1.05 0.57 0.57 0.03 2.07 2.07 1.59 1.59 XXX

G0199 ............ A Reevaluationofpatientusespec ............. 1.01 1.72 1.72 0.58 0.58 0.03 2.76 2.76 1.62 1.62 XXX

G0200 ............ A Evalofpatientprescipofvoicep ................ 1.35 1.91 1.91 0.77 0.77 0.04 3.30 3.30 2.16 2.16 XXX

G0201 ............ A Modifortraininginusevoicepro ................ 0.99 1.05 1.05 0.57 0.57 0.03 2.07 2.07 1.59 1.59 XXX

G9001 ............ X MCCD, initial rate ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9002 ............ X MCCD,maintenance rate ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9003 ............ X MCCD, risk adj hi, initial ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9004 ............ X MCCD, risk adj lo, initial ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9005 ............ X MCCD, risk adj, maintenance .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9006 ............ X MCCD, Home monitoring ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9007 ............ X MCCD, sch team conf .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9008 ............ X Mccd,phys coor-care ovrsght ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G9016 ............ N Demo-smoking cessation coun ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0001 ............ I Alcohol and/or drug assess .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0002 ............ I Alcohol and/or drug screenin ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0003 ............ I Alcohol and/or drug screenin ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0004 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0005 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0006 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0007 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0008 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0009 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0010 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0011 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0012 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0013 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0014 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0015 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0016 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0017 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0018 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0019 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0020 ............ I Alcohol and/or drug services ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0021 ............ I Alcohol and/or drug training ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0022 ............ I Alcohol and/or drug interven ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0023 ............ I Alcohol and/or drug outreach ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0024 ............ I Alcohol and/or drug preventi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0025 ............ I Alcohol and/or drug preventi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0026 ............ I Alcohol and/or drug preventi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0027 ............ I Alcohol and/or drug preventi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0028 ............ I Alcohol and/or drug preventi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0029 ............ I Alcohol and/or drug preventi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

H0030 ............ I Alcohol and/or drug hotline .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0120 ............ E Tetracyclin injection .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0130 ............ E Abciximab injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0150 ............ E Injection adenosine 6 MG .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0151 ............ E Adenosine injection .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0170 ............ E Adrenalin epinephrin inject ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0190 ............ E Inj biperiden lactate/5 mg ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0200 ............ E Alatrofloxacin mesylate ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0205 ............ E Alglucerase injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0207 ............ E Amifostine ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0210 ............ E Methyldopate hcl injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0256 ............ E Alpha 1 proteinase inhibitor ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0270 ............ E Alprostadil for injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0275 ............ E Alprostadil urethral suppos ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0280 ............ E Aminophyllin 250 MG inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0282 ............ E Amiodarone HCl ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0285 ............ E Amphotericin B ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0286 ............ E Amphotericin B lipid complex ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0290 ............ E Ampicillin 500 MG inj ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0295 ............ E Ampicillin sodium per 1.5 gm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0300 ............ E Amobarbital 125 MG inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0330 ............ E Succinycholine chloride inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0340 ............ E Nandrolon phenpropionate inj .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0350 ............ E Injection anistreplase 30 u ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0360 ............ E Hydralazine hcl injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0380 ............ E Inj metaraminol bitartrate ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0390 ............ E Chloroquine injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0395 ............ E Arbutamine HCl injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0400 ............ E Inj trimethaphan camsylate .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0456 ............ E Azithromycin ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0460 ............ E Atropine sulfate injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0470 ............ E Dimecaprol injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0475 ............ E Baclofen 10 MG injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65571

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

J0476 ............ E Baclofen intrathecal trial ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0500 ............ E Dicyclomine injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0510 ............ E Benzquinamide injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0515 ............ E Inj benztropine mesylate ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0520 ............ E Bethanechol chloride inject .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0530 ............ E Penicillin g benzathine inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0540 ............ E Penicillin g benzathine inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0550 ............ E Penicillin g benzathine inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0560 ............ E Penicillin g benzathine inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0570 ............ E Penicillin g benzathine inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0580 ............ E Penicillin g benzathine inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0585 ............ E Botulinum toxin a per unit .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0590 ............ E Ethylnorepinephrine hcl inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0600 ............ E Edetate calcium disodium inj ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0610 ............ E Calcium gluconate injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0620 ............ E Calcium glycer & lact/10 ML ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0630 ............ E Calcitonin salmon injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0635 ............ E Calcitriol injection ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0640 ............ E Leucovorin calcium injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0670 ............ E Inj mepivacaine HCL/10 ml .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0690 ............ E Cefazolin sodium injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0694 ............ E Cefoxitin sodium injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0695 ............ E Cefonocid sodium injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0696 ............ E Ceftriaxone sodium injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0697 ............ E Sterile cefuroxime injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0698 ............ E Cefotaxime sodium injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0702 ............ E Betamethasone acet&sod phosp ......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0704 ............ E Betamethasone sod phosp/4 MG ........ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0710 ............ E Cephapirin sodium injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0713 ............ E Inj ceftazidime per 500 mg ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0715 ............ E Ceftizoxime sodium / 500 MG .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0720 ............ E Chloramphenicol sodium injec ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0725 ............ E Chorionic gonadotropin/1000u ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0730 ............ E Chlorpheniramin maleate inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0735 ............ E Clonidine hydrochloride ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0740 ............ E Cidofovir injection ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0743 ............ E Cilastatin sodium injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0745 ............ E Inj codeine phosphate /30 MG ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0760 ............ E Colchicine injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0770 ............ E Colistimethate sodium inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0780 ............ E Prochlorperazine injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0800 ............ E Corticotropin injection ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0810 ............ E Cortisone injection ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0835 ............ E Inj cosyntropin per 0.25 MG ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0850 ............ E Cytomegalovirus imm IV /vial ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0895 ............ E Deferoxamine mesylate inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0900 ............ E Testosterone enanthate inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0945 ............ E Brompheniramine maleate inj .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J0970 ............ E Estradiol valerate injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1000 ............ E Depo-estradiol cypionate inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1020 ............ E Methylprednisolone 20 MG inj ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1030 ............ E Methylprednisolone 40 MG inj ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1040 ............ E Methylprednisolone 80 MG inj ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1050 ............ E Medroxyprogesterone inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1055 ............ N Medrxyprogester acetate inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1060 ............ E Testosterone cypionate 1 ML ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1070 ............ E Testosterone cypionat 100 MG ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1080 ............ E Testosterone cypionat 200 MG ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1090 ............ E Testosterone cypionate 50 MG ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1095 ............ E Inj dexamethasone acetate .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1100 ............ E Dexamethasone sodium phos .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1110 ............ E Inj dihydroergotamine mesylt ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1120 ............ E Acetazolamid sodium injectio ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1160 ............ E Digoxin injection ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1165 ............ E Phenytoin sodium injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1170 ............ E Hydromorphone injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1180 ............ E Dyphylline injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1190 ............ E Dexrazoxane HCl injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1200 ............ E Diphenhydramine hcl injectio ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1205 ............ E Chlorothiazide sodium inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1212 ............ E Dimethyl sulfoxide 50% 50 ML ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1230 ............ E Methadone injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1240 ............ E Dimenhydrinate injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1245 ............ E Dipyridamole injection .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1250 ............ E Inj dobutamine HCL/250 mg ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1260 ............ E Dolasetron mesylate ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1320 ............ E Amitriptyline injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1325 ............ E Epoprostenol injection .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1327 ............ E Eptifibatide injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1330 ............ E Ergonovine maleate injection ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1362 ............ E Erythromycin glucep / 250 MG ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1364 ............ E Erythro lactobionate /500 MG .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1380 ............ E Estradiol valerate 10 MG inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65572

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

J1390 ............ E Estradiol valerate 20 MG inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1410 ............ E Inj estrogen conjugate 25 MG .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1435 ............ E Injection estrone per 1 MG .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1436 ............ E Etidronate disodium inj ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1438 ............ E Etanercept injection .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1440 ............ E Filgrastim 300 mcg injeciton ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1441 ............ E Filgrastim 480 mcg injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1450 ............ E Fluconazole .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1452 ............ E Intraocular Fomivirsen na ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1455 ............ E Foscarnet sodium injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1460 ............ E Gamma globulin 1 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1470 ............ E Gamma globulin 2 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1480 ............ E Gamma globulin 3 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1490 ............ E Gamma globulin 4 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1500 ............ E Gamma globulin 5 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1510 ............ E Gamma globulin 6 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1520 ............ E Gamma globulin 7 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1530 ............ E Gamma globulin 8 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1540 ............ E Gamma globulin 9 CC inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1550 ............ E Gamma globulin 10 CC inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1560 ............ E Gamma globulin > 10 CC inj ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1561 ............ E Immune globulin 500 mg ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1562 ............ D Immune globulin 5 gms ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1563 ............ E IV immune globulin ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1565 ............ E RSV-ivig ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1570 ............ E Ganciclovir sodium injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1580 ............ E Garamycin gentamicin inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1600 ............ E Gold sodium thiomaleate inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1610 ............ E Glucagon hydrochloride/1 MG ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1620 ............ E Gonadorelin hydroch/ 100 mcg ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1626 ............ E Granisetron HCl injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1630 ............ E Haloperidol injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1631 ............ E Haloperidol decanoate inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1642 ............ E Inj heparin sodium per 10 u ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1644 ............ E Inj heparin sodium per 1000u .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1645 ............ E Dalteparin sodium ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1650 ............ E Inj enoxaparin sodium .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1670 ............ E Tetanus immune globulin inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1690 ............ E Prednisolone tebutate inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1700 ............ E Hydrocortisone acetate inj .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1710 ............ E Hydrocortisone sodium ph inj ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1720 ............ E Hydrocortisone sodium succ i .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1730 ............ E Diazoxide injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1739 ............ E Hydroxyprogesterone cap 125 ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1741 ............ E Hydroxyprogesterone cap 250 ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1742 ............ E Ibutilide fumarate injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1745 ............ E Infliximab injection ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1750 ............ E Iron dextran .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1785 ............ E Injection imiglucerase /unit ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1790 ............ E Droperidol injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1800 ............ E Propranolol injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1810 ............ E Droperidol/fentanyl inj ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1820 ............ E Insulin injection ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1825 ............ E Interferon beta-1a ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1830 ............ E Interferon beta-1b / .25 MG ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1840 ............ E Kanamycin sulfate 500 MG inj ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1850 ............ E Kanamycin sulfate 75 MG inj ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1885 ............ E Ketorolac tromethamine inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1890 ............ E Cephalothin sodium injection ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1910 ............ E Kutapressin injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1930 ............ E Propiomazine injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1940 ............ E Furosemide injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1950 ............ E Leuprolide acetate /3.75 MG ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1955 ............ E Inj levocarnitine per 1 gm ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1956 ............ E Levofloxacin injection ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1960 ............ E Levorphanol tartrate inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1970 ............ E Methotrimeprazine injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1980 ............ E Hyoscyamine sulfate inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J1990 ............ E Chlordiazepoxide injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2000 ............ E Lidocaine injection ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2010 ............ E Lincomycin injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2060 ............ E Lorazepam injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2150 ............ E Mannitol injection .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2175 ............ E Meperidine hydrochl /100 MG .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2180 ............ E Meperidine/promethazine inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2210 ............ E Methylergonovin maleate inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2240 ............ E Metocurine iodide injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2250 ............ E Inj midazolam hydrochloride ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2260 ............ E Inj milrinone lactate / 5 ML ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2270 ............ E Morphine sulfate injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2271 ............ E Morphine so4 injection 100mg ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2275 ............ E Morphine sulfate injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2300 ............ E Inj nalbuphine hydrochloride ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65573

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

J2310 ............ E Inj naloxone hydrochloride ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2320 ............ E Nandrolone decanoate 50 MG ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2321 ............ E Nandrolone decanoate 100 MG ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2322 ............ E Nandrolone decanoate 200 MG ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2330 ............ E Thiothixene injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2350 ............ E Niacinamide/niacin injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2352 ............ E Octreotide acetate injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2355 ............ E Oprelvekin injection .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2360 ............ E Orphenadrine injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2370 ............ E Phenylephrine hcl injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2400 ............ E Chloroprocaine hcl injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2405 ............ E Ondansetron hcl injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2410 ............ E Oxymorphone hcl injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2430 ............ E Pamidronate disodium /30 MG ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2440 ............ E Papaverin hcl injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2460 ............ E Oxytetracycline injection ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2480 ............ E Hydrochlorides of opium inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2500 ............ E Paricalcitol ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2510 ............ E Penicillin g procaine inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2512 ............ E Inj pentagastrin per 2 ML ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2515 ............ E Pentobarbital sodium inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2540 ............ E Penicillin g potassium inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2543 ............ E Piperacillin/tazobactam ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2545 ............ E Pentamidine isethionte/300mg ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2550 ............ E Promethazine hcl injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2560 ............ E Phenobarbital sodium inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2590 ............ E Oxytocin injection ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2597 ............ E Inj desmopressin acetate ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2640 ............ E Prednisolone sodium ph inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2650 ............ E Prednisolone acetate inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2670 ............ E Totazoline hcl injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2675 ............ E Inj progesterone per 50 MG ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2680 ............ E Fluphenazine decanoate 25 MG .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2690 ............ E Procainamide hcl injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2700 ............ E Oxacillin sodium injeciton ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2710 ............ E Neostigmine methylslfte inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2720 ............ E Inj protamine sulfate/10 MG ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2725 ............ E Inj protirelin per 250 mcg ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2730 ............ E Pralidoxime chloride inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2760 ............ E Phentolaine mesylate inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2765 ............ E Metoclopramide hcl injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2770 ............ E Quinupristin/dalfopristin ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2780 ............ E Ranitidine hydrochloride inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2790 ............ E Rho d immune globulin inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2792 ............ E Rho(D) immune globulin h, sd ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2795 ............ E Ropivacaine HCl injection .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2800 ............ E Methocarbamol injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2810 ............ E Inj theophylline per 40 MG ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2820 ............ E Sargramostim injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2860 ............ E Secobarbital sodium inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2910 ............ E Aurothioglucose injeciton ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2912 ............ E Sodium chloride injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2915 ............ E NA Ferric Gluconate Complex ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2920 ............ E Methylprednisolone injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2930 ............ E Methylprednisolone injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2950 ............ E Promazine hcl injeciton ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2970 ............ E Methicillin sodium injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2993 ............ E Reteplase injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2994 ............ D Reteplase double bolus ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2995 ............ E Inj streptokinase /250000 IU ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2996 ............ D Alteplase recombinant inj ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J2997 ............ E Alteplase recombinant .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3000 ............ E Streptomycin injection .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3010 ............ E Fentanyl citrate injeciton ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3030 ............ E Sumatriptan succinate / 6 MG ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3070 ............ E Pentazocine hcl injeciton ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3080 ............ E Chlorprothixene injection ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3105 ............ E Terbutaline sulfate inj ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3120 ............ E Testosterone enanthate inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3130 ............ E Testosterone enanthate inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3140 ............ E Testosterone suspension inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3150 ............ E Testosteron propionate inj .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3230 ............ E Chlorpromazine hcl injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3240 ............ E Thyrotropin injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3245 ............ E Tirofiban hydrochloride ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3250 ............ E Trimethobenzamide hcl inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3260 ............ E Tobramycin sulfate injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3265 ............ E Injection torsemide 10 mg/ml ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3270 ............ E Imipramine hcl injection ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3280 ............ E Thiethylperazine maleate inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3301 ............ E Triamcinolone acetonide inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3302 ............ E Triamcinolone diacetate inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3303 ............ E Triamcinolone hexacetonl inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65574

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

J3305 ............ E Inj trimetrexate glucoronate .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3310 ............ E Perphenazine injeciton ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3320 ............ E Spectinomycn di-hcl inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3350 ............ E Urea injection ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3360 ............ E Diazepam injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3364 ............ E Urokinase 5000 IU injection ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3365 ............ E Urokinase 250,000 IU inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3370 ............ R Vancomycin hcl injeciton ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3390 ............ E Methoxamine injection .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3400 ............ E Triflupromazine hcl inj .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3410 ............ E Hydroxyzine hcl injeciton ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3420 ............ E Vitamin b12 injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3430 ............ E Vitamin k phytonadione inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3450 ............ E Mephentermine sulfate inj .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3470 ............ E Hyaluronidase injection ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3475 ............ E Inj magnesium sulfate .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3480 ............ E Inj potassium chloride .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3485 ............ E Zidovudine ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3490 ............ E Drugs unclassified injection .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3520 ............ N Edetate disodium per 150 mg .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3530 ............ E Nasal vaccine inhalation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3535 ............ N Metered dose inhaler drug ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J3570 ............ N Laetrile amygdalin vit B17 .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7030 ............ E Normal saline solution infus ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7040 ............ E Normal saline solution infus ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7042 ............ E 5% dextrose/normal saline ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7050 ............ E Normal saline solution infus ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7051 ............ E Sterile saline/water ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7060 ............ E 5% dextrose/water ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7070 ............ E D5w infusion ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7100 ............ E Dextran 40 infusion .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7110 ............ E Dextran 75 infusion .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7120 ............ E Ringers lactate infusion ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7130 ............ E Hypertonic saline solution .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7190 ............ X Factor viii .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7191 ............ X Factor VIII (porcine) ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7192 ............ X Factor viii recombinant ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7194 ............ X Factor ix complex ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7197 ............ X Antithrombin iii injection ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7198 ............ E Anti-inhibitor .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7199 ............ E Hemophilia clot factor noc .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7300 ............ N Intraut copper contraceptive ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7310 ............ E Ganciclovir long act implant ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7315 ............ E Sodium hyaluronate injection ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7320 ............ E Hylan G-F 20 injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7330 ............ E Cultured chondrocytes implnt ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7500 ............ X Azathioprine oral 50mg ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7501 ............ X Azathioprine parenteral ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7502 ............ E Cyclosporine oral 100 mg .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7504 ............ X Lymphocyte immune globulin ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7505 ............ X Monoclonal antibodies .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7506 ............ X Prednisone oral .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7507 ............ E Tacrolimus oral per 1 MG .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7508 ............ E Tacrolimus oral per 5 MG .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7509 ............ X Methylprednisolone oral ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7510 ............ X Prednisolone oral per 5 mg .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7513 ............ E Daclizumab, parenteral ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7515 ............ E Cyclosporine oral 25 mg ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7516 ............ E Cyclosporin parenteral 250mg ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7517 ............ E Mycophenolate mofetil oral .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7520 ............ E Sirolimus, oral ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7525 ............ E Tacrolimus injection .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7599 ............ X Immunosuppressive drug noc .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7608 ............ E Acetylcysteine inh sol u d .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7610 ............ D Acetylcysteine 10% injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7615 ............ D Acetylcysteine 20% injection ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7618 ............ E Albuterol inh sol con ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7619 ............ E Albuterol inh sol u d ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7620 ............ D Albuterol sulfate .083%/ml ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7625 ............ D Albuterol sulfate .5% inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7627 ............ D Bitolterolmesylate inhal sol ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7628 ............ E Bitolterol mes inhal sol con .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7629 ............ E Bitolterol mes inh sol u d ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7630 ............ D Cromolyn sodium injeciton ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7631 ............ E Cromolyn sodium inh sol u d ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7635 ............ E Atropine inhal sol con ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7636 ............ E Atropine inhal sol unit dose .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7637 ............ E Dexamethasone inhal sol con .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7638 ............ E Dexamethasone inhal sol u d .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7639 ............ E Dornase alpha inhal sol u d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7640 ............ D Epinephrine injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7642 ............ E Glycopyrrolate inhal sol con ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7643 ............ E Glycopyrrolate inhal sol u d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65575

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

J7644 ............ E Ipratropium brom inh sol u d ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7645 ............ D Ipratropium bromide .02%/ml ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7648 ............ E Isoetharine hcl inh sol con ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7649 ............ E Isoetharine hcl inh sol u d .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7650 ............ D Isoetharine hcl .1% inj .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7651 ............ D Isoetharine hcl .125% inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7652 ............ D Isoetharine hcl .167% inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7653 ............ D Isoetharine hcl .2%/ inj ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7654 ............ D Isoetharine hcl .25% inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7655 ............ D Isoetharine hcl 1% inj ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7658 ............ E Isoproterenolhcl inh sol con ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7659 ............ E Isoproterenol hcl inh sol ud .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7660 ............ D Isoproterenol hcl .5% inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7665 ............ D Isoproterenol hcl 1% inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7668 ............ E Metaproterenol inh sol con ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7669 ............ E Metaproterenol inh sol u d ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7670 ............ D Metaproterenol sulfate .4% .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7672 ............ D Metaproterenol sulfate .6% .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7675 ............ D Metaproterenol sulfate 5% ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7680 ............ E Terbutaline so4 inh sol con .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7681 ............ E Terbutaline so4 inh sol u d .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7682 ............ E Tobramycin inhalation sol .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7683 ............ E Triamcinolone inh sol con .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7684 ............ E Triamcinolone inh sol u d ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7699 ............ E Inhalation solution for DME .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J7799 ............ E Non-inhalation drug for DME ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8499 ............ N Oral prescrip drug non chemo ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8510 ............ E Oral busulfan ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8520 ............ E Capecitabine, oral, 150 mg .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8521 ............ E Capecitabine, oral, 500 mg .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8530 ............ E Cyclophosphamide oral 25 MG ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8560 ............ E Etoposide oral 50 MG .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8600 ............ E Melphalan oral 2 MG ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8610 ............ E Methotrexate oral 2.5 MG .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8700 ............ E Temozolmide ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J8999 ............ E Oral prescription drug chemo ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9000 ............ E Doxorubic hcl 10 MG vl chemo ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9001 ............ E Doxorubicin hcl liposome inj ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9015 ............ E Aldesleukin/single use vial ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9020 ............ E Asparaginase injection ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9031 ............ E Bcg live intravesical vac ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9040 ............ E Bleomycin sulfate injection ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9045 ............ E Carboplatin injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9050 ............ E Carmus bischl nitro inj .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9060 ............ E Cisplatin 10 MG injeciton ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9062 ............ E Cisplatin 50 MG injeciton ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9065 ............ E Inj cladribine per 1 MG ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9070 ............ E Cyclophosphamide 100 MG inj ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9080 ............ E Cyclophosphamide 200 MG inj ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9090 ............ E Cyclophosphamide 500 MG inj ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9091 ............ E Cyclophosphamide 1.0 grm inj ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9092 ............ E Cyclophosphamide 2.0 grm inj ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9093 ............ E Cyclophosphamide lyophilized ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9094 ............ E Cyclophosphamide lyophilized ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9095 ............ E Cyclophosphamide lyophilized ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9096 ............ E Cyclophosphamide lyophilized ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9097 ............ E Cyclophosphamide lyophilized ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9100 ............ E Cytarabine hcl 100 MG inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9110 ............ E Cytarabine hcl 500 MG inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9120 ............ E Dactinomycin actinomycin d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9130 ............ E Dacarbazine 10 MG inj ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9140 ............ E Dacarbazine 200 MG inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9150 ............ E Daunorubicin ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9151 ............ E Daunorubicin citrate liposom ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9160 ............ E Denileukin diftitox, 300 mcg ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9165 ............ E Diethylstilbestrol injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9170 ............ E Docetaxel .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9180 ............ E Epirubicin HCl injection ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9181 ............ E Etoposide 10 MG inj ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9182 ............ E Etoposide 100 MG inj ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9185 ............ E Fludarabine phosphate inj .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9190 ............ E Fluorouracil injection ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9200 ............ E Floxuridine injection .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9201 ............ E Gemcitabine HCl .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9202 ............ E Goserelin acetate implant .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9206 ............ E Irinotecan injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9208 ............ E Ifosfomide injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9209 ............ E Mesna injection .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9211 ............ E Idarubicin hcl injeciton .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9212 ............ E Interferon alfacon-1 .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9213 ............ E Interferon alfa-2a inj ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9214 ............ E Interferon alfa-2b inj ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9215 ............ E Interferon alfa-n3 inj ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65576

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

J9216 ............ E Interferon gamma 1-b inj ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9217 ............ E Leuprolide acetate suspnsion .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9218 ............ E Leuprolide acetate injeciton ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9219 ............ E Leuprolide acetate implant ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9230 ............ E Mechlorethamine hcl inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9245 ............ E Inj melphalan hydrochl 50 MG ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9250 ............ E Methotrexate sodium inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9260 ............ E Methotrexate sodium inj ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9265 ............ E Paclitaxel injection ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9266 ............ E Pegaspargase/singl dose vial .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9268 ............ E Pentostatin injection ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9270 ............ E Plicamycin (mithramycin) inj ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9280 ............ E Mitomycin 5 MG inj .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9290 ............ E Mitomycin 20 MG inj ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9291 ............ E Mitomycin 40 MG inj ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9293 ............ E Mitoxantrone hydrochl / 5 MG .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9310 ............ E Rituximab cancer treatment ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9320 ............ E Streptozocin injection ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9340 ............ E Thiotepa injection ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9350 ............ E Topotecan ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9355 ............ E Trastuzumab ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9357 ............ E Valrubicin, 200 mg ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9360 ............ E Vinblastine sulfate inj ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9370 ............ E Vincristine sulfate 1 MG inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9375 ............ E Vincristine sulfate 2 MG inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9380 ............ E Vincristine sulfate 5 MG inj .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9390 ............ E Vinorelbine tartrate/10 mg .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9600 ............ E Porfimer sodium ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

J9999 ............ E Chemotherapy drug .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

M0064 ............ A Visit for drug monitoring ....................... 0.37 0.26 0.25 0.12 0.14 0.01 0.64 0.63 0.50 0.52 XXX

M0075 ............ N Cellular therapy .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

M0076 ............ N Prolotherapy ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

M0100 ............ N Intragastric hypothermia ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

M0300 ............ N IV chelationtherapy ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

M0301 ............ N Fabric wrapping of aneurysm ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

M0302 ............ A Assessment of cardiac output .............. 0.17 0.88 0.88 0.88 0.88 0.02 1.07 1.07 1.07 1.07 XXX

M0302 26 A Assessment of cardiac output .............. 0.17 0.08 0.08 0.08 0.08 0.01 0.26 0.26 0.26 0.26 XXX

M0302 TC A Assessment of cardiac output .............. 0.00 0.80 0.80 NA NA 0.01 0.81 0.81 NA NA XXX

P2028 ............ X Cephalin floculation test ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P2029 ............ X Congo red blood test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P2031 ............ N Hair analysis ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P2033 ............ X Blood thymol turbidity ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P2038 ............ X Blood mucoprotein ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P3000 ............ X Screen pap by tech w md supv ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P3001 ............ A Screening pap smear by phys ............. 0.42 0.18 0.22 0.18 0.22 0.01 0.61 0.65 0.61 0.65 XXX

P7001 ............ I Culture bacterial urine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9010 ............ E Whole blood for transfusion ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9011 ............ E Blood split unit ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9012 ............ E Cryoprecipitate each unit ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9013 ............ D Unit/s blood fibrinogen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9016 ............ E RBC leukocytes reduced ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9017 ............ E One donor fresh frozn plasma ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9018 ............ D Plasma protein fract, unit ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9019 ............ E Platelets, each unit ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9020 ............ E Plaelet rich plasma unit ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9021 ............ E Red blood cells unit .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9022 ............ E Washed red blood cells unit ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9023 ............ X Frozen plasma, pooled, sd ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9031 ............ X Platelets leukocytes reduced ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9032 ............ X Platelets, irradiated ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9033 ............ X Platelets leukoreduced irrad ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9034 ............ X Platelets, pheresis ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9035 ............ X Platelet pheres leukoreduced ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9036 ............ X Platelet pheresis irradiated ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9037 ............ X Plate pheres leukoredu irrad ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9038 ............ X RBC irradiated ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9039 ............ X RBC deglycerolized .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9040 ............ X RBC leukoreduced irradiated ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9041 ............ X Albumin(human), 5% ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9042 ............ X Albumin (human), 25% ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9043 ............ X Plasma protein fraction ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9044 ............ X Cryoprecipitatereducedplasma ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9603 ............ X One-way allow prorated miles .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9604 ............ X One-way allow prorated trip ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9612 ............ X Catheterize for urine spec .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

P9615 ............ X Urine specimen collect mult ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0034 ............ D Admin of influenza vaccine .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0035 ............ A Cardiokymography ............................... 0.17 0.45 0.48 0.45 0.48 0.03 0.65 0.68 0.65 0.68 XXX

Q0035 26 A Cardiokymography ............................... 0.17 0.07 0.09 0.07 0.09 0.01 0.25 0.27 0.25 0.27 XXX

Q0035 TC A Cardiokymography ............................... 0.00 0.38 0.39 NA NA 0.02 0.40 0.41 NA NA XXX

Q0091 ............ A Obtaining screen pap smear ................ 0.37 0.72 0.62 0.14 0.18 0.01 1.10 1.00 0.52 0.56 XXX

Q0092 ............ A Set up port xray equipment .................. 0.00 0.32 0.32 NA NA 0.01 0.33 0.33 NA NA XXX

Q0111 ............ X Wet mounts/ w preparations ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65577

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

Q0112 ............ X Potassium hydroxide preps .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0113 ............ X Pinworm examinations ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0114 ............ X Fern test ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0115 ............ X Post-coital mucous exam ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0136 ............ X Non esrd epoetin alpha inj ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0144 ............ N Azithromycin dihydrate, oral ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0156 ............ D Human albumin 5% .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0157 ............ D Human albumin 25% ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0160 ............ X Factor IX non-recombinant ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0161 ............ X Factor IX recombinant .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0163 ............ X Diphenhydramine HCl 50mg ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0164 ............ X Prochlorperazine maleate 5mg ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0165 ............ X Prochlorperazine maleate10mg ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0166 ............ X Granisetron HCl 1 mg oral ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0167 ............ X Dronabinol 2.5mg oral .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0168 ............ X Dronabinol 5mg oral ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0169 ............ X Promethazine HCl 12.5mg oral ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0170 ............ X Promethazine HCl 25 mg oral .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0171 ............ X Chlorpromazine HCl 10mg oral ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0172 ............ X Chlorpromazine HCl 25mg oral ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0173 ............ X Trimethobenzamide HCl 250mg .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0174 ............ X Thiethylperazine maleate10mg ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0175 ............ X Perphenazine 4mg oral ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0176 ............ X Perphenazine 8mg oral ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0177 ............ X Hydroxyzine pamoate 25mg ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0178 ............ X Hydroxyzine pamoate 50mg ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0179 ............ X Ondansetron HCl 8mg oral .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0180 ............ X Dolasetron mesylate oral ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0181 ............ X Unspecified oral anti-emetic ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0183 ............ X Nonmetabolic active tissue .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0184 ............ X Metabolically active tissue .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0185 ............ X Metabolic active D/E tissue .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0186 ............ D Paramedic intercept, rural .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q0187 ............ E Factor viia recombinant ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q1001 ............ X Ntiol category 1 .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q1002 ............ X Ntiol category 2 .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q1003 ............ X Ntiol category 3 .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q1004 ............ X Ntiol category 4 .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q1005 ............ X Ntiol category 5 .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2001 ............ N Oral cabergoline 0.5 mg ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2002 ............ E Elliotts b solution per ml ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2003 ............ E Aprotinin, 10,000 kiu ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2004 ............ E Bladder calculi irrig sol ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2005 ............ E Corticorelin ovine triflutat ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2006 ............ E Digoxin immune fab (ovine) ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2007 ............ E Ethanolamine oleate 100 mg ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2008 ............ E Fomepizole, 1.5 mg .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2009 ............ E Fosphenytoin, 50 mg ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2010 ............ E Glatiramer acetate, per dose ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2011 ............ E Hemin, per 1 mg .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2012 ............ E Pegademase bovine, 25 iu .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2013 ............ E Pentastarch 10% solution .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2014 ............ E Sermorelin acetate, 0.5 mg .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2015 ............ E Somatrem, 5 mg ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2016 ............ E Somatropin, 1 mg ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2017 ............ E Teniposide, 50 mg ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2018 ............ E Urofollitropin, 75 iu ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2019 ............ E Basiliximab ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2020 ............ E Histrelin acetate .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2021 ............ E Lepirudin ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q2022 ............ E VonWillebrandFactrCmplxperIU ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3001 ............ E Brachytherapy Radioelements ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3002 ............ E Gallium ga 67 ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3003 ............ E Technetium tc99m bicisate .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3004 ............ E Xenon xe 133 ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3005 ............ E Technetium tc99m mertiatide ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3006 ............ E Technetium tc99m glucepatate ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3007 ............ E Sodium phosphate p32 ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3008 ............ E Indium 111-in pentetreotide ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3009 ............ E Technetium tc99m oxidronate .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3010 ............ E Technetium tc99mlabeledrbcs ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3011 ............ E Chromic phosphate p32 ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q3012 ............ E Cyanocobalamin cobalt co57 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9920 ............ E Epoetin with hct <= 20 ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9921 ............ E Epoetin with hct = 21 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9922 ............ E Epoetin with hct = 22 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9923 ............ E Epoetin with hct = 23 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9924 ............ E Epoetin with hct = 24 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9925 ............ E Epoetin with hct = 25 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9926 ............ E Epoetin with hct = 26 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9927 ............ E Epoetin with hct = 27 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9928 ............ E Epoetin with hct = 28 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9929 ............ E Epoetin with hct = 29 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65578

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

Q9930 ............ E Epoetin with hct = 30 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9931 ............ E Epoetin with hct = 31 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9932 ............ E Epoetin with hct = 32 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9933 ............ E Epoetin with hct = 33 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9934 ............ E Epoetin with hct = 34 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9935 ............ E Epoetin with hct = 35 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9936 ............ E Epoetin with hct = 36 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9937 ............ E Epoetin with hct = 37 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9938 ............ E Epoetin with hct = 38 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9939 ............ E Epoetin with hct = 39 ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

Q9940 ............ E Epoetin with hct >= 40 ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

R0070 ............ C Transport portable x-ray ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

R0075 ............ C Transport port x-ray multipl .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

R0076 ............ B Transport portable EKG ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0009 ............ I Injection, butorphanol tartr ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0010 ............ D Injection, somatrem, 5 mg .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0011 ............ D Injection, somatropin, 5 mg .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0012 ............ I Butorphanol tartrate, nasal ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0014 ............ I Tacrine hydrochloride, 10 mg .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0016 ............ I Injection, amikacin sulfate .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0017 ............ I Injection, aminocaproic acid ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0020 ............ I Injection, bupivicaine hydro .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0021 ............ I Injection, cefoperazone sod ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0023 ............ I Injection, cimetidine hydroc .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0024 ............ I Injection, ciprofloxacin .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0028 ............ I Injection, famotidine, 20 mg ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0029 ............ I Injection, fluconazole ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0030 ............ I Injection, metronidazole ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0032 ............ I Injection, nafcillin sodium ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0034 ............ I Injection, ofloxacin, 400 mg ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0039 ............ I Injection, sulfamethoxazole .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0040 ............ I Injection, ticarcillin disod ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0071 ............ I Injection, acyclovir sodium ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0072 ............ I Injection, amikacin sulfate .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0073 ............ I Injection, aztreonam, 500 mg ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0074 ............ I Injection, cefotetan disodiu ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0077 ............ I Injection, clindamycin phosp ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0078 ............ I Injection, fosphenytoin sodi .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0080 ............ I Injection, pentamidine iseth .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0081 ............ I Injection, piperacillin sodi ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0085 ............ I injection, gatifloxacin ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0086 ............ I Injection, verteporfin, 15mg .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0090 ............ I Sildenafil citrate, 25 mg ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0096 ............ I Injection, itraconazole, 200 .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0097 ............ D Injection, ibutilide fumarat .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0098 ............ D Injection, sodium ferric glu ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0156 ............ I Exemestane, 25 mg ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0157 ............ I Becaplermin gel 1%, 0.5 gm ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0220 ............ I Medical conference by physic .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0221 ............ I Medical conference, 60 min ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0601 ............ I Screening proctoscopy ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0605 ............ I Digital rectal examination, .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0610 ............ I Annual gynecological examina ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0612 ............ I Annual gynecological examina ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0620 ............ I Routine ophthalmological exa .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0621 ............ I Routine ophthalmological exa .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0630 ............ I Removal of sutures .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0800 ............ I Laser in situ keratomileusis .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0810 ............ I Photorefractive keratectomy ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0820 ............ I Computerized corneal topogra ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S0830 ............ I Ultrasound pachymetry ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S1015 ............ I IV tubing extension set ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S1016 ............ I Non-pvc intravenous administ .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2050 ............ D Donor enterectomy, with prep .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2052 ............ I Transplantation of small int .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2053 ............ I Transplantation of small int .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2054 ............ I Transplantation of multivisc .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2055 ............ I Harvesting of donor multivis ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2060 ............ I Lobar lung transplantation .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2061 ............ I Donor lobectomy (lung) ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2102 ............ I Islet cell tissue transplant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2103 ............ I Adrenal tissue transplant ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2109 ............ D Autologous chondrocyte trans .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2120 ............ I Low density lipoprotein(LDL) ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2140 ............ I Cord blood harvesting .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2142 ............ I Cord blood-derived stem-cell ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2180 ............ I Donor leukocyte infusion ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2190 ............ D Subcutaneous implantation of .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2202 ............ I Echosclerotherapy ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2204 ............ D Transmyocardial laser revasc .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2205 ............ I Minimally invasive direct co ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2206 ............ I Minimally invasive direct co ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2207 ............ I Minimally invasive direct co ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65579

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

S2208 ............ I Minimally invasive direct co ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2209 ............ I Minimally invasive direct co ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2210 ............ I Cryosurgical ablation (in si ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2220 ............ I Thrombectomy, coronary ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2300 ............ I Arthroscopy, shoulder, surgi ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2340 ............ I Chemodenervation of abductor ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2350 ............ I Diskectomy, anterior, with d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2351 ............ I Diskectomy, anterior, with d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2370 ............ I Intradiscal electrothermal ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S2371 ............ I Each additional interspace ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3620 ............ X Newborn metabolic screening .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3645 ............ I HIV-1 antibody testing of or ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3650 ............ I Saliva test, hormone level; ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3652 ............ I Saliva test, hormone level; ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3700 ............ I Bladder tumor-associated .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3708 ............ I Gastrointestinal fat absorpt .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3902 ............ I Ballistocardiogram ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3904 ............ I Masters two step .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S3906 ............ I Transfusion, direct, blood ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5000 ............ I Prescription drug, generic .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5001 ............ I Prescription drug,brand name .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5002 ............ I Fat emulsion 10% in 250 ml ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5003 ............ I Fat emulsion 20% in 250 ml ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5010 ............ I 5% dextrose and 45% saline ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5011 ............ I 5% dextrose in lactated ring ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5012 ............ I 5% dextrose with potassium ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5013 ............ I 5% dextrose/45%saline,1000ml ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5014 ............ I 5% dextrose/45%saline,1500ml ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5016 ............ I Antibiotic admin supplies w/ ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5017 ............ I Antibiotic adminsupplies w/o ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5018 ............ I Pain therapy admin supplies ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5019 ............ I Chemotherapy admin supplies ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5020 ............ I Chemotherapy admin supplies ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5021 ............ I Hydration therapy admin supp ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5022 ............ I Growth hormone therapy ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5025 ............ I Infusion pump rental,perdiem ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S5503 ............ I Maintenance of implanted vas ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8001 ............ I Radiofrequency stimulation .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8035 ............ I Magnetic source imaging ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8040 ............ I Topographic brain mapping ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8048 ............ D Isolated limb perfusion ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8049 ............ I Intraoperative radiation the .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8060 ............ D Supply of contrast material .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8080 ............ I Scintimammography ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8085 ............ I Fluorine-18 fluorodeoxygluco ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8092 ............ I Electron beam computed tomog .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8095 ............ I Wig (for medically-induced h ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8096 ............ I Portable peak flow meter ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8105 ............ I Oximeter for measuring blood .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8110 ............ I Peak expiratory flow rate (p ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8200 ............ I Chest compression vest ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8205 ............ I Chest compression system gen ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8210 ............ I Mucus trap ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8260 ............ I Oral orthotic for treatment .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8300 ............ D Sacral nerve stimulation tes ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8400 ............ I Incontinence pants, each ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8402 ............ I Diapers, each ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8405 ............ I Incontinence liners, each ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8950 ............ I Complex lymphedema therapy, ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S8999 ............ I Resuscitation bag ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9001 ............ I Home uterine monitor with or ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9007 ............ I Ultrafiltration monitor ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9015 ............ I Automated EEG monitoring ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9022 ............ I Digital subtraction angiogra .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9023 ............ I Xenon regional cerebral bloo ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9024 ............ I Paranasal sinus ultrasound .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9025 ............ I Omnicardiogram/cardiointegra ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9033 ............ D Gait analysis ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9035 ............ I Medical equipment or supplie .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9055 ............ I Procuren or other growth fac ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9056 ............ I Coma stimulation per diem .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9061 ............ I Medical supplies and equipme ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9075 ............ I Smoking cessation treatment ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9085 ............ I Meniscal allograft transplan ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9088 ............ I Services provided in urgent ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9090 ............ I Vertebral axial decompressio ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9122 ............ I Home health aide or certifie ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9123 ............ I Nursing care, in the home; b ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9124 ............ I Nursing care, in the home; b ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9125 ............ I Respite care, in the home, p ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9126 ............ I Hospice care, in the home, p ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9127 ............ I Social work visit, in the ho ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9128 ............ I Speech therapy, in the home, .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65580

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

S9129 ............ I Occupational therapy, in the ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9140 ............ I Diabetic Management Program, .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9141 ............ I Diabetic Management Program, .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9200 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9210 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9220 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9225 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9230 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9300 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9308 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9310 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9395 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9420 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9423 ............ I Nursing services, patient as ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9425 ............ I Nursing services and all nec ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9435 ............ I Medical foods for inborn err ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9455 ............ I Diabetic Management Program, .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9460 ............ I Diabetic Management Program, .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9465 ............ I Diabetic Management Program, .......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9470 ............ I Nutritional counseling, diet ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9472 ............ I Cardiac rehabilitation progr .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9473 ............ I Pulmonary rehabilitation pro ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9474 ............ I Enterostomal therapy by a re ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9475 ............ I Ambulatory setting substance .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9480 ............ I Intensive outpatient psychia ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9485 ............ I Crisis intervention mental h .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9524 ............ I Nursing services related to .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9526 ............ I Skilled nursing visits for ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9527 ............ I Insertion of a peripherally ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9528 ............ I Insertion of midline central ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9533 ............ I Pain management, intravenous ........... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9535 ............ I Administration of hematopoie ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9539 ............ I Administration of antibiotic ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9543 ............ I Administration of medication ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9545 ............ I Administration of immune glo ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9550 ............ I Home IV therapy, hydration ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9555 ............ I Additional home infusion ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9990 ............ I Services provided as part of ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9991 ............ I Services provided as part of ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9992 ............ I Transportation costs to and ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9994 ............ I Lodging costs (e.g. hotel ch ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9996 ............ I Meals for clinical trial par ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

S9999 ............ I Sales tax ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2020 ............ X Vision svcs frames purchases ............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2025 ............ N Eyeglasses delux frames ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2100 ............ X Lens spher single plano 4.00 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2101 ............ X Single visn sphere 4.12-7.00 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2102 ............ X Singl visn sphere 7.12-20.00 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2103 ............ X Spherocylindr 4.00d/12-2.00d .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2104 ............ X Spherocylindr 4.00d/2.12-4d ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2105 ............ X Spherocylinder 4.00d/4.25-6d .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2106 ............ X Spherocylinder 4.00d/>6.00d ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2107 ............ X Spherocylinder 4.25d/12-2d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2108 ............ X Spherocylinder 4.25d/2.12-4d .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2109 ............ X Spherocylinder 4.25d/4.25-6d .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2110 ............ X Spherocylinder 4.25d/over 6d .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2111 ............ X Spherocylindr 7.25d/.25-2.25 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2112 ............ X Spherocylindr 7.25d/2.25-4d ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2113 ............ X Spherocylindr 7.25d/4.25-6d ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2114 ............ X Spherocylinder over 12.00d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2115 ............ X Lens lenticular bifocal ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2116 ............ X Nonaspheric lens bifocal ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2117 ............ X Aspheric lens bifocal ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2118 ............ X Lens aniseikonic single ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2199 ............ X Lens single vision not oth c ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2200 ............ X Lens spher bifoc plano 4.00d ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2201 ............ X Lens sphere bifocal 4.12-7.0 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2202 ............ X Lens sphere bifocal 7.12-20. ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2203 ............ X Lens sphcyl bifocal 4.00d/.1 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2204 ............ X Lens sphcy bifocal 4.00d/2.1 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2205 ............ X Lens sphcy bifocal 4.00d/4.2 ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2206 ............ X Lens sphcy bifocal 4.00d/ove ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2207 ............ X Lens sphcy bifocal 4.25-7d/. ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2208 ............ X Lens sphcy bifocal 4.25-7/2. ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2209 ............ X Lens sphcy bifocal 4.25-7/4. ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2210 ............ X Lens sphcy bifocal 4.25-7/ov ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2211 ............ X Lens sphcy bifo 7.25-12/.25- ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2212 ............ X Lens sphcyl bifo 7.25-12/2.2 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2213 ............ X Lens sphcyl bifo 7.25-12/4.2 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2214 ............ X Lens sphcyl bifocal over 12. ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2215 ............ X Lens lenticular bifocal ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2216 ............ X Lens lenticular nonaspheric ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2217 ............ X Lens lenticular aspheric bif .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65581

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

V2218 ............ X Lens aniseikonic bifocal ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2219 ............ X Lens bifocal seg width over ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2220 ............ X Lens bifocal add over 3.25d ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2299 ............ X Lens bifocal speciality .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2300 ............ X Lens sphere trifocal 4.00d .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2301 ............ X Lens sphere trifocal 4.12-7. ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2302 ............ X Lens sphere trifocal 7.12-20 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2303 ............ X Lens sphcy trifocal 4.0/.12- .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2304 ............ X Lens sphcy trifocal 4.0/2.25 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2305 ............ X Lens sphcy trifocal 4.0/4.25 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2306 ............ X Lens sphcyl trifocal 4.00/>6 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2307 ............ X Lens sphcy trifocal 4.25-7/. .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2308 ............ X Lens sphc trifocal 4.25-7/2. .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2309 ............ X Lens sphc trifocal 4.25-7/4. .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2310 ............ X Lens sphc trifocal 4.25-7/>6 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2311 ............ X Lens sphc trifo 7.25-12/.25- ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2312 ............ X Lens sphc trifo 7.25-12/2.25 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2313 ............ X Lens sphc trifo 7.25-12/4.25 ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2314 ............ X Lens sphcyl trifocal over 12 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2315 ............ X Lens lenticular trifocal .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2316 ............ X Lens lenticular nonaspheric ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2317 ............ X Lens lenticular aspheric tri ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2318 ............ X Lens aniseikonic trifocal ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2319 ............ X Lens trifocal seg width > 28 ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2320 ............ X Lens trifocal add over 3.25d ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2399 ............ X Lens trifocal speciality .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2410 ............ X Lens variab asphericity sing ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2430 ............ X Lens variable asphericity bi .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2499 ............ X Variable asphericity lens ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2500 ............ X Contact lens pmma spherical ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2501 ............ X Cntct lens pmma-toric/prism ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2502 ............ X Contact lens pmma bifocal ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2503 ............ X Cntct lens pmma color vision ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2510 ............ X Cntct gas permeable sphericl .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2511 ............ X Cntct toric prism ballast ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2512 ............ X Cntct lens gas permbl bifocl ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2513 ............ X Contact lens extended wear ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2520 ............ P Contact lens hydrophilic ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2521 ............ X Cntct lens hydrophilic toric ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2522 ............ X Cntct lens hydrophil bifocl .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2523 ............ X Cntct lens hydrophil extend .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2530 ............ X Contact lens gas impermeable ............ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2531 ............ X Contact lens gas permeable ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2599 ............ X Contact lens/es other type ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2600 ............ X Hand held low vision aids .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2610 ............ X Single lens spectacle mount ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2615 ............ X Telescop/othr compound lens .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2623 ............ X Plastic eye prosth custom .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2624 ............ X Polishing artifical eye ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2625 ............ X Enlargemnt of eye prosthesis .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2626 ............ X Reduction of eye prosthesis ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2627 ............ X Scleral cover shell ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2628 ............ X Fabrication & fitting .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2629 ............ X Prosthetic eye other type ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2630 ............ X Anter chamber intraocul lens ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2631 ............ X Iris support intraoclr lens ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2632 ............ X Post chmbr intraocular lens ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2700 ............ X Balance lens ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2710 ............ X Glass/plastic slab off prism .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2715 ............ X Prism lens/es ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2718 ............ X Fresnell prism press-on lens ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2730 ............ X Special base curve ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2740 ............ X Rose tint plastic .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2741 ............ X Non-rose tint plastic ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2742 ............ X Rose tint glass ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2743 ............ X Non-rose tint glass ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2744 ............ X Tint photochromatic lens/es ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2750 ............ X Anti-reflective coating ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2755 ............ X UV lens/es ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2760 ............ X Scratch resistant coating ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2770 ............ X Occluder lens/es ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2780 ............ X Oversize lens/es ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2781 ............ X Progressive lens per lens ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2785 ............ X Corneal tissue processing .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2790 ............ X Amniotic membrane ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V2799 ............ X Miscellaneous vision service ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5008 ............ N Hearing screening ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5010 ............ N Assessment for hearing aid ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5011 ............ N Hearing aid fitting/checking .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5014 ............ N Hearing aid repair/modifying ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5020 ............ N Conformity evaluation ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5030 ............ N Body-worn hearing aid air .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5040 ............ N Body-worn hearing aid bone ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65582

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM B.—RELATIVE VALUE UNITS (RVU’S) AND RELATED INFORMATION—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

V5050 ............ N Hearing aid monaural in ear ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5060 ............ N Behind ear hearing aid ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5070 ............ N Glasses air conduction ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5080 ............ N Glasses bone conduction ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5090 ............ N Hearing aid dispensing fee .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5100 ............ N Body-worn bilat hearing aid ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5110 ............ N Hearing aid dispensing fee .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5120 ............ N Body-worn binaur hearing aid .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5130 ............ N In ear binaural hearing aid ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5140 ............ N Behind ear binaur hearing ai ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5150 ............ N Glasses binaural hearing aid ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5160 ............ N Dispensing fee binaural ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5170 ............ N Within ear cros hearing aid .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5180 ............ N Behind ear cros hearing aid ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5190 ............ N Glasses cros hearing aid ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5200 ............ N Cros hearing aid dispens fee ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5210 ............ N In ear bicros hearing aid ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5220 ............ N Behind ear bicros hearing ai ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5230 ............ N Glasses bicros hearing aid ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5240 ............ N Dispensing fee bicros ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5299 ............ R Hearing service .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5336 ............ N Repair communication device .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5362 ............ R Speech screening ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5363 ............ R Language screening ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

V5364 ............ R Dysphagia screening ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

ADDENDUM C.—CODES WITH INTERIM RVUS

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

11980 ............ A Implant hormone pellet(s) .................... 1.48 1.14 1.14 0.63 0.63 0.10 2.72 2.72 2.21 2.21 000

15342 ............ A Cultured skin graft, 25 cm .................... 1.00 2.20 2.20 0.78 0.78 0.39 3.59 3.59 2.17 2.17 010

15343 ............ A Culture skn graft addl 25 cm ................ 0.25 0.28 0.28 0.10 0.10 0.09 0.62 0.62 0.44 0.44 ZZZ

16035 ............ A Incision of burn scab, initi .................... 3.75 NA NA 1.59 1.70 0.36 NA NA 5.70 5.81 090

16036 ............ A Incise burn scab, addl incis .................. 1.50 NA NA 0.64 0.64 0.18 NA NA 2.32 2.32 ZZZ

19100 ............ A Bx breast percut w/o image ................. 1.27 3.33 2.67 0.46 0.43 0.10 4.70 4.04 1.83 1.80 000

19101 ............ A Biopsy of breast, open ......................... 3.18 9.82 8.00 2.97 2.86 0.20 13.20 11.38 6.35 6.24 010

19102 ............ A Bx breast percut w/image .................... 2.00 4.58 4.58 0.73 0.73 0.08 6.66 6.66 2.81 2.81 000

19103 ............ A Bx breast percut w/device .................... 2.37 10.83 10.83 0.86 0.86 0.08 13.28 13.28 3.31 3.31 000

19120 ............ A Removal of breast lesion ..................... 5.56 4.41 4.10 3.62 3.50 0.56 10.53 10.22 9.74 9.62 090

19125 ............ A Excision, breast lesion ......................... 6.06 5.04 4.57 3.78 3.62 0.61 11.71 11.24 10.45 10.29 090

19126 ............ A Excision, addl breast lesion ................. 2.93 NA NA 1.11 1.23 0.30 NA NA 4.34 4.46 ZZZ

19295 ............ A Place breast clip, percut ....................... 0.00 2.61 2.61 0.94 0.94 0.01 2.62 2.62 0.95 0.95 ZZZ

20979 ............ A Us bone stimulation .............................. 0.62 0.57 0.57 0.25 0.25 0.04 1.23 1.23 0.91 0.91 000

21199 ............ A Reconstr lwr jaw w/advance ................ 16.00 NA NA 10.53 10.53 1.00 NA NA 27.53 27.53 090

22520 ............ A Percut vertebroplasty thor .................... 8.91 NA NA 3.95 3.95 0.89 NA NA 13.75 13.75 010

22521 ............ A Percut vertebroplasty lumb .................. 8.34 NA NA 3.72 3.72 0.84 NA NA 12.90 12.90 010

22522 ............ A Percut vertebroplasty addl ................... 3.00 NA NA 1.20 1.20 0.30 NA NA 4.50 4.50 ZZZ

30465 ............ A Repair nasal stenosis ........................... 11.64 NA NA 9.12 9.12 0.82 NA NA 21.58 21.58 090

33140 ............ A Heart revascularize (tmr) ...................... 20.00 NA NA 12.79 12.79 2.27 NA NA 35.06 35.06 090

33141 ............ A Heart tmr w/other procedure ................ 4.84 NA NA 1.97 1.97 0.60 NA NA 7.41 7.41 ZZZ

33533 ............ A CABG, arterial, single ........................... 25.83 NA NA 19.44 22.29 3.24 NA NA 48.51 51.36 090

33534 ............ A CABG, arterial, two .............................. 28.82 NA NA 20.12 23.69 3.63 NA NA 52.57 56.14 090

33535 ............ A CABG, arterial, three ............................ 31.81 NA NA 21.05 25.28 3.97 NA NA 56.83 61.06 090

33536 ............ A Cabg, arterial, four or more .................. 34.79 NA NA 18.16 24.00 3.29 NA NA 56.24 62.08 090

34800 ............ A Endovasc abdo repair w/tube .............. 20.75 NA NA 9.72 9.72 1.49 NA NA 31.96 31.96 090

34802 ............ A Endovasc abdo repr w/device .............. 23.00 NA NA 10.62 10.62 1.65 NA NA 35.27 35.27 090

34804 ............ A Endovasc abdo repr w/device .............. 23.00 NA NA 10.62 10.62 1.65 NA NA 35.27 35.27 090

34808 ............ A Endovasc abdo occlud device ............. 4.13 NA NA 1.65 1.65 0.29 NA NA 6.07 6.07 ZZZ

34812 ............ A Xpose for endoprosth, aortic ................ 6.75 NA NA 2.70 2.70 0.49 NA NA 9.94 9.94 000

34813 ............ A Xpose for endoprosth, femorl ............... 4.80 NA NA 1.92 1.92 0.34 NA NA 7.06 7.06 ZZZ

34820 ............ A Xpose for endoprosth, iliac .................. 9.75 NA NA 3.90 3.90 0.70 NA NA 14.35 14.35 000

34825 ............ A Endovasc extend prosth, init ................ 12.00 NA NA 6.23 6.23 0.86 NA NA 19.09 19.09 090

34826 ............ A Endovasc exten prosth, addl ................ 4.13 NA NA 1.65 1.65 0.29 NA NA 6.07 6.07 ZZZ

34830 ............ A Open aortic tube prosth repr ................ 32.59 NA NA 14.81 14.81 2.34 NA NA 49.74 49.74 090

34831 ............ A Open aortoiliac prosth repr .................. 35.34 NA NA 15.90 15.90 2.53 NA NA 53.77 53.77 090

34832 ............ A Open aortofemor prosth repr ............... 35.34 NA NA 15.90 15.90 2.53 NA NA 53.77 53.77 090

35600 ............ A Harvest artery for cabg ........................ 4.95 NA NA 1.98 1.98 0.54 NA NA 7.47 7.47 ZZZ

36540 ............ B Collect blood venous device ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

36831 ............ A Av fistula excision, open ...................... 8.00 2.95 2.95 2.95 2.95 0.79 11.74 11.74 11.74 11.74 090

36832 ............ A Av fistula revision, open ....................... 10.50 NA NA 5.90 6.35 1.13 NA NA 17.53 17.98 090

36870 ............ A Av fistula revision, open ....................... 5.16 30.67 30.67 2.51 2.51 0.40 36.23 36.23 8.07 8.07 090

65583

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM C.—CODES WITH INTERIM RVUS—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

38500 ............ A Biopsy/removal, lymph nodes .............. 2.88 2.64 2.41 2.30 2.16 0.28 5.80 5.57 5.46 5.32 010

38530 ............ A Biopsy/removal, lymph nodes .............. 6.13 NA NA 5.36 4.88 0.63 NA NA 12.12 11.64 090

43231 ............ A Esoph endoscopy w/us exam .............. 4.09 NA NA 1.84 1.84 0.24 NA NA 6.17 6.17 000

43232 ............ A Esoph endoscopy w/us fn bx ............... 4.71 NA NA 2.18 2.18 0.28 NA NA 7.17 7.17 000

43240 ............ A Esoph endoscope w/drain cyst ............ 7.39 NA NA 3.05 3.05 0.45 NA NA 10.89 10.89 000

43241 ............ A Upper GI endoscopy with tube ............ 2.59 NA NA 1.22 1.69 0.14 NA NA 3.95 4.42 000

43242 ............ A Uppr gi endoscopy w/us fn bx ............. 5.51 1.98 1.98 1.98 1.98 0.34 7.83 7.83 7.83 7.83 000

43256 ............ A Uppr gi endoscopy w stent .................. 4.35 1.56 1.56 1.56 1.56 0.26 6.17 6.17 6.17 6.17 000

43752 ............ B Nasal/orogastric w/stent ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44132 ............ N Enterectomy, cadaver donor ................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44133 ............ N Enterectomy, live donor ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44135 ............ N Intestine transplnt, cadaver .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44136 ............ N Intestine transplant, live ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

44360 ............ A Small bowel endoscopy ....................... 2.59 NA NA 1.31 1.85 0.14 NA NA 4.04 4.58 000

44361 ............ A Small bowel endoscopy/biopsy ............ 2.87 NA NA 1.41 2.02 0.15 NA NA 4.43 5.04 000

44363 ............ A Small bowel endoscopy ....................... 3.50 NA NA 1.60 2.01 0.19 NA NA 5.29 5.70 000

44364 ............ A Small bowel endoscopy ....................... 3.74 NA NA 1.73 2.56 0.21 NA NA 5.68 6.51 000

44365 ............ A Small bowel endoscopy ....................... 3.31 NA NA 1.58 2.30 0.18 NA NA 5.07 5.79 000

44366 ............ A Small bowel endoscopy ....................... 4.41 NA NA 1.96 2.96 0.22 NA NA 6.59 7.59 000

44369 ............ A Small bowel endoscopy ....................... 4.52 NA NA 1.95 2.98 0.23 NA NA 6.70 7.73 000

44370 ............ A Small bowel endoscopy/stent ............... 4.33 1.56 1.56 1.56 1.56 0.26 6.15 6.15 6.15 6.15 000

44372 ............ A Small bowel endoscopy ....................... 4.41 NA NA 1.99 2.98 0.27 NA NA 6.67 7.66 000

44373 ............ A Small bowel endoscopy ....................... 3.50 NA NA 1.70 2.45 0.19 NA NA 5.39 6.14 000

44376 ............ A Small bowel endoscopy ....................... 5.26 NA NA 2.28 2.81 0.29 NA NA 7.83 8.36 000

44377 ............ A Small bowel endoscopy/biopsy ............ 5.53 NA NA 2.38 2.94 0.28 NA NA 8.19 8.75 000

44378 ............ A Small bowel endoscopy ....................... 7.13 NA NA 2.95 3.64 0.37 NA NA 10.45 11.14 000

44379 ............ A S bowel endoscope w/stent ................. 7.07 2.52 2.52 2.52 2.52 0.45 10.04 10.04 10.04 10.04 000

44380 ............ A Small bowel endoscopy ....................... 1.05 NA NA 0.74 1.01 0.08 NA NA 1.87 2.14 000

44382 ............ A Small bowel endoscopy ....................... 1.27 NA NA 0.82 1.16 0.09 NA NA 2.18 2.52 000

44383 ............ A Ileoscopy w/stent .................................. 2.41 0.87 0.87 0.87 0.87 0.15 3.43 3.43 3.43 3.43 000

44388 ............ A Colon endoscopy .................................. 2.50 5.48 5.09 1.26 1.79 0.18 8.16 7.77 3.94 4.47 000

44389 ............ A Colonoscopy with biopsy ...................... 2.77 5.92 5.53 1.37 1.96 0.18 8.87 8.48 4.32 4.91 000

44390 ............ A Colonoscopy for foreign body .............. 3.39 6.56 5.63 1.59 1.91 0.22 10.17 9.24 5.20 5.52 000

44391 ............ A Colonoscopy for bleeding ..................... 3.82 5.60 5.63 1.55 2.45 0.23 9.65 9.68 5.60 6.50 000

44392 ............ A Colonoscopy & polypectomy ................ 3.38 6.12 5.99 1.59 2.33 0.23 9.73 9.60 5.20 5.94 000

44393 ............ A Colonoscopy, lesion removal ............... 4.28 6.79 6.56 1.92 2.88 0.27 11.34 11.11 6.47 7.43 000

44394 ............ A Colonoscopy w/snare ........................... 3.92 6.54 6.31 1.79 2.67 0.26 10.72 10.49 5.97 6.85 000

44397 ............ A Colonoscopy w stent ............................ 4.23 NA NA 1.90 1.90 0.30 NA NA 6.43 6.43 000

44500 ............ A Intro, gastrointestinal tube .................... 0.49 NA NA 0.35 0.36 0.02 NA NA 0.86 0.87 000

45300 ............ A Proctosigmoidoscopy dx ...................... 0.38 1.24 1.08 0.23 0.25 0.05 1.67 1.51 0.66 0.68 000

45303 ............ A Proctosigmoidoscopy dilate .................. 0.44 1.41 1.23 0.26 0.28 0.06 1.91 1.73 0.76 0.78 000

45305 ............ A Protosigmoidoscopy w/bx ..................... 0.56 1.34 1.23 0.30 0.34 0.09 1.99 1.88 0.95 0.99 000

45307 ............ A Protosigmoidoscopy fb ......................... 0.94 2.26 2.04 0.44 0.68 0.15 3.35 3.13 1.53 1.77 000

45308 ............ A Protosigmoidoscopy removal ............... 0.83 1.49 1.43 0.40 0.46 0.13 2.45 2.39 1.36 1.42 000

45309 ............ A Protosigmoidoscopy removal ............... 1.11 2.07 1.86 0.50 0.53 0.17 3.35 3.14 1.78 1.81 000

45315 ............ A Protosigmoidoscopy removal ............... 1.40 2.32 2.06 0.62 0.79 0.20 3.92 3.66 2.22 2.39 000

45317 ............ A Protosigmoidoscopy bleed ................... 1.50 1.76 1.66 0.65 0.83 0.20 3.46 3.36 2.35 2.53 000

45320 ............ A Protosigmoidoscopy ablate .................. 1.58 1.71 1.79 0.68 1.02 0.20 3.49 3.57 2.46 2.80 000

45321 ............ A Protosigmoidoscopy volvul ................... 1.17 NA NA 0.53 0.80 0.17 NA NA 1.87 2.14 000

45327 ............ A Proctosigmoidoscopy w/stent ............... 1.46 NA NA 0.83 0.83 0.12 NA NA 2.41 2.41 000

45330 ............ A Diagnostic sigmoidoscopy .................... 0.88 1.75 1.65 0.42 0.46 0.05 2.68 2.58 1.35 1.39 000

45331 ............ A Sigmoidoscopy and biopsy .................. 1.15 1.98 1.92 0.52 0.77 0.07 3.20 3.14 1.74 1.99 000

45332 ............ A Sigmoidoscopy w/fb removal ............... 1.79 3.54 3.13 0.75 1.04 0.11 5.44 5.03 2.65 2.94 000

45333 ............ A Sigmoidoscopy & polypectomy ............ 1.79 3.14 2.96 0.75 1.15 0.12 5.05 4.87 2.66 3.06 000

45334 ............ A Sigmoidoscopy for bleeding ................. 2.73 NA NA 1.09 1.55 0.16 NA NA 3.98 4.44 000

45337 ............ A Sigmoidoscopy & decompress ............. 2.15 NA NA 0.89 1.37 0.15 NA NA 3.19 3.67 000

45338 ............ A Sigmoidoscpy w/tumr remove .............. 2.34 3.67 3.36 0.95 1.32 0.15 6.16 5.85 3.44 3.81 000

45339 ............ A Sigmoidoscopy w/ablate tumr .............. 2.86 2.85 3.02 1.14 1.74 0.17 5.88 6.05 4.17 4.77 000

45341 ............ A Sigmoidoscopy w/ultrasound ................ 3.46 NA NA 1.66 1.66 0.24 NA NA 5.36 5.36 000

45342 ............ A Sigmoidoscopy w/us guide bx .............. 4.08 NA NA 1.81 1.81 0.29 NA NA 6.18 6.18 000

45345 ............ A Sigmodoscopy w/stent ......................... 2.66 NA NA 1.30 1.30 0.18 NA NA 4.14 4.14 000

45378 ............ A Diagnostic colonoscopy ........................ 3.68 6.60 6.07 1.70 2.38 0.20 10.48 9.95 5.58 6.26 000

45379 ............ A Colonoscopy w/fb removal ................... 4.69 7.33 6.94 2.05 2.95 0.25 12.27 11.88 6.99 7.89 000

45380 ............ A Colonoscopy and biopsy ...................... 3.98 6.78 6.39 1.81 2.56 0.21 10.97 10.58 6.00 6.75 000

45382 ............ A Colonoscopy/control bleeding .............. 5.69 7.95 7.56 2.23 3.27 0.27 13.91 13.52 8.19 9.23 000

45383 ............ A Lesion removal colonoscopy ................ 5.83 7.82 7.47 2.48 3.47 0.32 13.97 13.62 8.63 9.62 000

45384 ............ A Lesion remove colonoscopy ................. 4.67 7.41 6.96 2.06 2.95 0.24 12.32 11.87 6.97 7.86 000

45385 ............ A Lesion removal colonoscopy ................ 5.27 7.57 7.48 2.28 3.30 0.28 13.12 13.03 7.83 8.85 000

45387 ............ A Colonoscopy w/stent ............................ 5.62 NA NA 2.41 2.41 0.36 NA NA 8.39 8.39 000

47379 ............ C Laparoscope procedure, liver ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

50545 ............ A Laparo radical nephrectomy ................. 24.00 NA NA 9.41 9.41 1.81 NA NA 35.22 35.22 090

50546 ............ A Laparoscopic nephrectomy .................. 20.48 NA NA 8.31 8.31 1.37 NA NA 30.16 30.16 090

50548 ............ A Laparo remove k/ureter ........................ 24.40 NA NA 9.44 9.44 1.49 NA NA 35.33 35.33 090

50947 ............ A Laparo new ureter/bladder ................... 24.50 NA NA 11.62 11.62 1.84 NA NA 37.96 37.96 090

50948 ............ A Laparo new ureter/bladder ................... 22.50 NA NA 10.51 10.51 1.70 NA NA 34.71 34.71 090

50949 ............ C Laparoscope proc, ureter ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY

52341 ............ A Cysto w/ureter stricture tx .................... 6.00 NA NA 2.40 2.40 0.34 NA NA 8.74 8.74 000

52342 ............ A Cysto w/up stricture tx .......................... 6.50 NA NA 2.60 2.60 0.36 NA NA 9.46 9.46 000

52343 ............ A Cysto w/renal stricture tx ...................... 7.20 NA NA 2.88 2.88 0.40 NA NA 10.48 10.48 000

52344 ............ A Cysto/uretero, stone remove ................ 7.70 NA NA 3.08 3.08 0.42 NA NA 11.20 11.20 000

52345 ............ A Cysto/uretero w/up stricture ................. 8.20 NA NA 3.28 3.28 0.46 NA NA 11.94 11.94 000

52346 ............ A Cystouretero w/renal strict ................... 9.23 NA NA 3.69 3.69 0.51 NA NA 13.43 13.43 000

52351 ............ A Cystouretro & or pyeloscope ................ 5.86 NA NA 1.96 2.74 0.32 NA NA 8.14 8.92 000

65584

——————————

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM C.—CODES WITH INTERIM RVUS—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

52352 ............ A Cystouretro w/stone remove ................ 6.88 NA NA 2.30 3.78 0.38 NA NA 9.56 11.04 000

52353 ............ A Cystouretero w/lithotripsy ..................... 7.97 NA NA 2.66 4.38 0.44 NA NA 11.07 12.79 000

52354 ............ A Cystouretero w/biopsy .......................... 7.34 NA NA 2.45 3.44 0.41 NA NA 10.20 11.19 000

52355 ............ A Cystouretero w/excise tumor ................ 8.82 NA NA 2.95 3.82 0.50 NA NA 12.27 13.14 000

52400 ............ A Cystouretero w/congen repr ................. 9.68 NA NA 5.36 5.42 0.53 NA NA 15.57 15.63 090

54512 ............ A Excise lesion testis ............................... 8.58 NA NA 4.86 4.86 0.51 NA NA 13.95 13.95 090

54522 ............ A Orchiectomy, partial ............................. 9.50 NA NA 5.79 5.79 0.57 NA NA 15.86 15.86 090

55873 ............ A Cryoablate prostate .............................. 17.80 NA NA 10.16 10.16 1.01 NA NA 28.97 28.97 090

57022 ............ A I &d vaginal hematoma, ob .................. 2.56 NA NA 1.60 1.60 0.14 NA NA 4.30 4.30 010

57023 ............ A I &d vag hematoma, trauma ................ 2.56 NA NA 1.60 1.60 0.14 NA NA 4.30 4.30 010

57287 ............ A Revise/remove sling repair ................... 10.71 NA NA 7.02 7.02 0.64 NA NA 18.37 18.37 090

58353 ............ A Endometr ablate, thermal ..................... 3.56 NA NA 2.16 2.16 0.19 NA NA 5.91 5.91 010

61697 ............ A Brain aneurysm repr, complx ............... 50.52 NA NA 27.76 27.76 9.57 NA NA 87.85 87.85 090

61698 ............ A Brain aneurysm repr, complx ............... 48.41 NA NA 26.87 26.87 9.28 NA NA 84.56 84.56 090

61700 ............ A Brain aneurysm repr , simple ............... 50.52 NA NA 27.76 29.42 10.18 NA NA 88.46 90.12 090

61702 ............ A Inner skull vessel surgery .................... 48.41 NA NA 26.87 30.01 9.75 NA NA 85.03 88.17 090

62252 ............ A Csf shunt reprogram ............................ 0.74 1.40 1.40 1.40 1.40 0.04 2.18 2.18 2.18 2.18 XXX

63040 ............ A Laminotomy, single cervical ................. 18.81 NA NA 12.98 15.35 3.36 NA NA 35.15 37.52 090

63042 ............ A Laminotomy, single lumbar .................. 17.47 NA NA 12.60 14.67 3.11 NA NA 33.18 35.25 090

63043 ............ B Laminotomy, addl cervical .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

63044 ............ B Laminotomy, addl lumbar ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ

64612 ............ A Destroy nerve, face muscle ................. 1.96 2.95 2.61 1.65 1.44 0.09 5.00 4.66 3.70 3.49 010

64613 ............ A Destroy nerve, spine muscle ................ 1.96 1.61 1.60 1.37 1.23 0.10 3.67 3.66 3.43 3.29 010

64614 ............ A Destroy nerve, extrem musc ................ 2.20 3.37 3.37 0.81 0.81 0.16 5.73 5.73 3.17 3.17 010

66982 ............ A Cataract surgery, complex ................... 13.50 NA NA 9.09 9.09 0.55 NA NA 23.14 23.14 090

66984 ............ A Cataract surg w/iol, i stage .................. 10.23 NA NA 7.60 8.77 0.41 NA NA 18.24 19.41 090

67221 ............ A Ocular photodynamic ther .................... 4.01 4.40 4.40 2.00 2.00 0.50 8.91 8.91 6.51 6.51 000

69714 ............ A Implant temple bone w/stimul .............. 14.00 NA NA 8.71 8.71 0.97 NA NA 23.68 23.68 090

69715 ............ A Temple bne implnt w/stimulat .............. 18.25 NA NA 10.49 10.49 1.25 NA NA 29.99 29.99 090

69717 ............ A Temple bone implant revision .............. 14.98 NA NA 8.37 8.37 1.04 NA NA 24.39 24.39 090

69718 ............ A Revise temple bone implant ................. 18.50 NA NA 10.58 10.58 1.27 NA NA 30.35 30.35 090

70496 ............ A Ct angiography, head ........................... 1.75 7.71 7.71 7.71 7.71 0.54 10.00 10.00 10.00 10.00 XXX

70498 ............ A Ct angiography, neck ........................... 1.75 7.71 7.71 7.71 7.71 0.54 10.00 10.00 10.00 10.00 XXX

70540 ............ A Mri orbit/face/neck w/o dye .................. 0.98 11.48 11.69 11.48 11.69 0.36 12.82 13.03 12.82 13.03 XXX

70542 ............ A Mri orbit/face/neck w/dye ..................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

70543 ............ A Mri orbt/fac/nck w/o&w dye .................. 1.56 25.27 25.27 25.27 25.27 0.78 27.61 27.61 27.61 27.61 XXX

70544 ............ A Mr angiography head w/o dye ............. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70545 ............ A Mr angiography head w/dye ................. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70546 ............ A Mr angiograph head w/o&w dye .......... 1.80 22.89 22.89 22.89 22.89 0.56 25.25 25.25 25.25 25.25 XXX

70547 ............ A Mr angiography neck w/o dye .............. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70548 ............ A Mr angiography neck w/dye ................. 1.20 11.56 11.56 11.56 11.56 0.56 13.32 13.32 13.32 13.32 XXX

70549 ............ A Mr angiograph neck w/o&w dye ........... 1.80 22.89 22.89 22.89 22.89 0.56 25.25 25.25 25.25 25.25 XXX

71275 ............ A Ct angiography, chest .......................... 1.20 9.26 9.26 9.26 9.26 0.37 10.83 10.83 10.83 10.83 XXX

71550 ............ A Mri chest w/o dye ................................. 1.10 11.52 11.74 11.52 11.74 0.41 13.03 13.25 13.03 13.25 XXX

71551 ............ A Mri chest w/dye .................................... 1.30 13.80 13.80 13.80 13.80 0.48 15.58 15.58 15.58 15.58 XXX

71552 ............ A Mri chest w/o&w dye ............................ 1.70 25.31 25.31 25.31 25.31 0.63 27.64 27.64 27.64 27.64 XXX

72191 ............ A Ct angiograph pelv w/o&w dye ............ 1.20 8.91 8.91 8.91 8.91 0.37 10.48 10.48 10.48 10.48 XXX

72195 ............ A Mri pelvis w/o dye ................................ 1.10 11.52 11.52 11.52 11.52 0.41 13.03 13.03 13.03 13.03 XXX

72196 ............ A Mri pelvis w/dye .................................... 1.30 13.80 13.44 13.80 13.44 0.48 15.58 15.22 15.58 15.22 XXX

72197 ............ A Mri pelvis w/o & w dye ......................... 1.70 25.31 25.31 25.31 25.31 0.85 27.86 27.86 27.86 27.86 XXX

73206 ............ A Ct angio upr extrm w/o&w dye ............. 1.20 7.85 7.85 7.85 7.85 0.37 9.42 9.42 9.42 9.42 XXX

73218 ............ A Mri upper extremity w/o dye ................. 0.98 11.48 11.48 11.48 11.48 0.36 12.82 12.82 12.82 12.82 XXX

73219 ............ A Mri upper extremity w/dye .................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73220 ............ A Mri uppr extremity w/o&w dye .............. 1.56 25.27 22.03 25.27 22.03 0.78 27.61 24.37 27.61 24.37 XXX

73221 ............ A Mri joint upr extrem w/o dye ................ 0.98 11.48 11.63 11.48 11.63 0.36 12.82 12.97 12.82 12.97 XXX

73222 ............ A Mri joint upr extrem w/ dye .................. 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73223 ............ A Mri joint upr extr w/o&w dye ................ 1.56 25.27 25.27 25.27 25.27 0.78 27.61 27.61 27.61 27.61 XXX

73706 ............ A Ct angio lwr extr w/o&w dye ................ 1.20 7.85 7.85 7.85 7.85 0.37 9.42 9.42 9.42 9.42 XXX

73718 ............ A Mri lower extremity w/o dye ................. 0.98 11.48 11.48 11.48 11.48 0.36 12.82 12.82 12.82 12.82 XXX

73719 ............ A Mri lower extremity w/dye .................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73720 ............ A Mri lwr extremity w/o&w dye ................ 1.56 25.26 22.02 25.26 22.02 0.78 27.60 24.36 27.60 24.36 XXX

73721 ............ A Mri joint of lwr extre w/o d .................... 0.98 11.48 11.63 11.48 11.63 0.36 12.82 12.97 12.82 12.97 XXX

73722 ............ A Mri joint of lwr extr w/dye ..................... 1.17 13.76 13.76 13.76 13.76 0.43 15.36 15.36 15.36 15.36 XXX

73723 ............ A Mri joint lwr extr w/o&w dye ................. 1.56 25.27 25.27 25.27 25.27 0.78 27.61 27.61 27.61 27.61 XXX

74175 ............ A Ct angio abdom w/o&w dye ................. 1.20 8.91 8.91 8.91 8.91 0.37 10.48 10.48 10.48 10.48 XXX

74181 ............ A Mri abdomen w/o dye ........................... 1.10 11.52 11.74 11.52 11.74 0.41 13.03 13.25 13.03 13.25 XXX

74182 ............ A Mri abdomen w/dye .............................. 1.30 13.80 13.80 13.80 13.80 0.48 15.58 15.58 15.58 15.58 XXX

74183 ............ A Mri abdomen w/o&w dye ...................... 1.70 25.31 25.31 25.31 25.31 0.85 27.86 27.86 27.86 27.86 XXX

75635 ............ A Ct angio abdominal arteries ................. 1.89 9.19 9.19 9.19 9.19 0.37 11.45 11.45 11.45 11.45 XXX

75952 ............ A Endovasc repair abdom aorta .............. 4.00 1.60 1.60 1.60 1.60 0.68 6.28 6.28 6.28 6.28 XXX

75953 ............ A Abdom aneurysm endovas rpr ............. 1.36 0.54 0.54 0.54 0.54 0.68 2.58 2.58 2.58 2.58 XXX

76012 ............ A Percut vertebroplasty fluor ................... 1.31 0.49 0.49 0.49 0.49 1.10 2.90 2.90 2.90 2.90 XXX

76013 ............ A Percut vertebroplasty, ct ...................... 1.38 0.52 0.52 0.52 0.52 0.48 2.38 2.38 2.38 2.38 XXX

76393 ............ A Mr guidance for needle place .............. 1.50 11.66 11.66 11.66 11.66 0.52 13.68 13.68 13.68 13.68 XXX

76818 ............ A Fetl biophys profil w/stress ................... 0.86 1.93 1.96 1.93 1.96 0.12 2.91 2.94 2.91 2.94 XXX

76819 ............ A Fetl biophys profil w/o strs ................... 0.63 1.84 1.84 1.84 1.84 0.11 2.58 2.58 2.58 2.58 XXX

76975 ............ A GI endoscopic ultrasound .................... 0.81 1.80 1.84 1.80 1.84 0.11 2.72 2.76 2.72 2.76 XXX

77520 ............ C Proton trmt, simple w/o comp .............. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77522 ............ C Proton trmt, simple w/comp ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77523 ............ C Proton trmt, intermediate ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

77525 ............ C Proton treatment, complex ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

90940 ............ X Hemodialysis access study .................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

91132 ............ C Electrogastrography ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

65585

ADDENDUM C.—CODES WITH INTERIM RVUS—Continued

CPT1/

HCPCS2 MOD Status Description

Physician

Work

RVUs3

Fully Implemented NonFacility

PE

RVUs

Year

2001

Transitional

Non-Facility PE

RVUs

Fully Implemented Facility PE

RVUs

Year

2001

Transitional

Facility

PE

RVUs

MalPractice

RVUs

Fully Implemented NonFacility

Total

Year

2001

Transitional

Non-Facility

Total

Fully Implemented Facility Total

Year

2001

Transitional

Facility

Total

Global

91133 ............ C Electrogastrography w/test ................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

92585 ............ A Auditor evoke potent, compre .............. 0.50 2.06 2.43 2.06 2.43 0.14 2.70 3.07 2.70 3.07 XXX

92586 ............ A Auditor evoke potent, limit .................... 0.00 1.84 1.84 NA NA 0.12 1.96 1.96 NA NA XXX

93662 ............ A Intracardiac ecg (ice) ............................ 2.80 4.98 4.98 4.98 4.98 0.41 8.19 8.19 8.19 8.19 ZZZ

93668 ............ N Peripheral vascular rehab .................... 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 XXX

96570 ............ A Photodynamic tx, 30 min ...................... 1.10 0.44 0.44 0.44 0.44 0.04 1.58 1.58 1.58 1.58 ZZZ

96571 ............ A Photodynamic tx, addl 15 min .............. 0.55 0.22 0.22 0.22 0.22 0.02 0.79 0.79 0.79 0.79 ZZZ

97532 ............ A Cognitive skills development ................ 0.44 0.23 0.23 0.08 0.08 0.01 0.68 0.68 0.53 0.53 XXX

97533 ............ A Sensory integration .............................. 0.44 0.29 0.29 0.08 0.08 0.01 0.74 0.74 0.53 0.53 XXX

97601 ............ A Wound care selective ........................... 0.50 0.49 0.49 0.09 0.09 0.04 1.03 1.03 0.63 0.63 XXX

97602 ............ B Wound care non-selective .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97802 ............ N Medical nutrition, indiv, in ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97803 ............ N Med nutrition, indiv, subseq ................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

97804 ............ N Medical nutrition, group ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99172 ............ N Ocular function screen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

99234 ............ A Observ/hosp same date ....................... 1.95 NA NA 0.70 0.71 0.11 NA NA 2.76 2.77 XXX

99235 ............ A Observ/hosp same date ....................... 2.81 NA NA 0.99 1.03 0.13 NA NA 3.93 3.97 XXX

99236 ............ A Observ/hosp same date ....................... 3.66 NA NA 1.25 1.25 0.17 NA NA 5.08 5.08 XXX

99291 ............ A Critical care, first hour .......................... 4.00 1.57 1.57 1.32 1.38 0.14 5.71 5.71 5.46 5.52 XXX

99292 ............ A Critical care, addl 30 min ..................... 2.00 0.85 0.81 0.65 0.66 0.07 2.92 2.88 2.72 2.73 ZZZ

G0179 ............ A MD recertification HHA patient ............. 0.45 1.09 1.09 0.18 0.18 0.06 1.60 1.60 0.69 0.69 XXX

G0180 ............ A MD certification HHA patient ................ 0.67 1.18 1.18 0.27 0.27 0.06 1.91 1.91 1.00 1.00 XXX

G0181 ............ A Home health care supervision ............. 1.73 1.40 1.40 0.63 0.63 0.06 3.19 3.19 2.42 2.42 XXX

G0182 ............ A Hospice care supervision ..................... 1.73 1.73 1.73 0.60 0.60 0.06 3.52 3.52 2.39 2.39 XXX

G0184 ............ A Ocular photocoagulation ...................... 0.47 0.23 0.23 0.23 0.23 0.50 1.20 1.20 1.20 1.20 ZZZ

G0193 ............ C Endoscopic study swallow functn ........ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0194 ............ C Sensory testing endoscopic stud ......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0195 ............ C Clinical eval swallowing funct ............... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0196 ............ C Eval of swallowing with radioopa ......... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX

G0197 ............ A Eval of pt for prescip speech devi ....... 1.35 1.91 1.91 0.77 0.77 0.04 3.30 3.30 2.16 2.16 XXX

G0198 ............ A Patient adapation & train for spe ......... 0.99 1.05 1.05 0.57 0.57 0.03 2.07 2.07 1.59 1.59 XXX

G0199 ............ A Reevaluation of patient use spec ......... 1.01 1.72 1.72 0.58 0.58 0.03 2.76 2.76 1.62 1.62 XXX

G0200 ............ A Eval of patient prescip of voice p ......... 1.35 1.91 1.91 0.77 0.77 0.04 3.30 3.30 2.16 2.16 XXX

G0201 ............ A Modi for training in use voice pro ........ 0.99 1.05 1.05 0.57 0.57 0.03 2.07 2.07 1.59 1.59 XXX

M0302 ............ A Assessment of cardiac output .............. 0.17 0.88 0.88 0.88 0.88 0.02 1.07 1.07 1.07 1.07 XXX

1 CPT codes and descriptions only are copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved.

3+ Indicates RVUs are not used for Medicare payment.

4PE RVUs = Practice Expense Relative Value Units.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM D.—2002 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY

Carrier No. Locality

No. Locality name Work Practiceexpense Malpractice

00510 ....... 00 ALABAMA .................................................................................................. 0.978 0.870 0.807

00831 ....... 01 ALASKA ..................................................................................................... 1.064 1.172 1.223

00832 ....... 00 ARIZONA ................................................................................................... 0.994 0.978 1.111

00520 ....... 13 ARKANSAS ............................................................................................... 0.953 0.847 0.340

02050 ....... 26 ANAHEIM/SANTA ANA, CA ...................................................................... 1.037 1.184 0.955

02050 ....... 18 LOS ANGELES, CA .................................................................................. 1.056 1.139 0.955

31140 ....... 03 MARIN/NAPA/SOLANO, CA ..................................................................... 1.015 1.248 0.687

31140 ....... 07 OAKLAND/BERKELEY, CA ....................................................................... 1.041 1.235 0.687

31140 ....... 05 SAN FRANCISCO, CA .............................................................................. 1.068 1.458 0.687

31140 ....... 06 SAN MATEO, CA ...................................................................................... 1.048 1.432 0.687

31140 ....... 09 SANTA CLARA, CA ................................................................................... 1.063 1.380 0.639

02050 ....... 17 VENTURA, CA ........................................................................................... 1.028 1.125 0.783

02050 ....... 99 REST OF CALIFORNIA* ........................................................................... 1.007 1.034 0.748

31140 ....... 99 REST OF CALIFORNIA* ........................................................................... 1.007 1.034 0.748

00824 ....... 01 COLORADO .............................................................................................. 0.985 0.992 0.840

10230 ....... 00 CONNECTICUT ......................................................................................... 1.050 1.156 0.966

00902 ....... 01 DELAWARE ............................................................................................... 1.019 1.035 0.712

00903 ....... 01 DC + MD/VA SUBURBS ........................................................................... 1.050 1.166 0.909

00590 ....... 03 FORT LAUDERDALE, FL .......................................................................... 0.996 1.018 1.877

00590 ....... 04 MIAMI, FL .................................................................................................. 1.015 1.052 2.528

00590 ....... 99 REST OF FLORIDA .................................................................................. 0.975 0.946 1.265

00511 ....... 01 ATLANTA, GA ........................................................................................... 1.006 1.059 0.935

00511 ....... 99 REST OF GEORGIA ................................................................................. 0.970 0.892 0.935

00833 ....... 01 HAWAII/GUAM .......................................................................................... 0.997 1.124 0.834

05130 ....... 00 IDAHO ........................................................................................................ 0.960 0.881 0.497

00952 ....... 16 CHICAGO, IL ............................................................................................. 1.028 1.092 1.797

00952 ....... 12 EAST ST. LOUIS, IL .................................................................................. 0.988 0.924 1.691

00952 ....... 15 SUBURBAN CHICAGO, IL ........................................................................ 1.006 1.071 1.645

00952 ....... 99 REST OF ILLINOIS ................................................................................... 0.964 0.889 1.157

00630 ....... 00 INDIANA .................................................................................................... 0.981 0.922 0.481

00826 ....... 00 IOWA ......................................................................................................... 0.959 0.876 0.596

65586 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM D.—2002 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY—Continued

Carrier No. Locality

No. Locality name Work Practiceexpense Malpractice

00650 ....... 00 KANSAS* ................................................................................................... 0.963 0.895 0.756

00740 ....... 04 KANSAS* ................................................................................................... 0.963 0.895 0.756

00660 ....... 00 KENTUCKY ............................................................................................... 0.970 0.866 0.877

00528 ....... 01 NEW ORLEANS, LA .................................................................................. 0.998 0.945 1.283

00528 ....... 99 REST OF LOUISIANA ............................................................................... 0.968 0.870 1.073

31142 ....... 03 SOUTHERN MAINE .................................................................................. 0.979 0.999 0.666

31142 ....... 99 REST OF MAINE ....................................................................................... 0.961 0.910 0.666

00901 ....... 01 BALTIMORE/SURR. CNTYS, MD ............................................................. 1.021 1.038 0.916

00901 ....... 99 REST OF MARYLAND .............................................................................. 0.984 0.972 0.774

31143 ....... 01 METROPOLITAN BOSTON ...................................................................... 1.041 1.239 0.784

31143 ....... 99 REST OF MASSACHUSETTS .................................................................. 1.010 1.129 0.784

00953 ....... 01 DETROIT, MI ............................................................................................. 1.043 1.038 2.738

00953 ....... 99 REST OF MICHIGAN ................................................................................ 0.997 0.938 1.571

10240 ....... 00 MINNESOTA .............................................................................................. 0.990 0.974 0.452

10250 ....... 00 MISSISSIPPI .............................................................................................. 0.957 0.837 0.779

00740 ....... 02 METROPOLITAN KANSAS CITY, MO ..................................................... 0.988 0.967 0.846

00523 ....... 01 METROPOLITAN ST. LOUIS, MO ............................................................ 0.994 0.938 0.846

00740 ....... 99 REST OF MISSOURI* ............................................................................... 0.946 0.825 0.793

00523 ....... 99 REST OF MISSOURI* ............................................................................... 0.946 0.825 0.793

00751 ....... 01 MONTANA ................................................................................................. 0.950 0.876 0.727

00655 ....... 00 NEBRASKA ............................................................................................... 0.948 0.877 0.430

00834 ....... 00 NEVADA .................................................................................................... 1.005 1.039 1.209

31144 ....... 40 NEW HAMPSHIRE .................................................................................... 0.986 1.030 0.825

00805 ....... 01 NORTHERN NJ ......................................................................................... 1.058 1.193 0.860

00805 ....... 99 REST OF NEW JERSEY .......................................................................... 1.029 1.110 0.860

00521 ....... 05 NEW MEXICO ........................................................................................... 0.973 0.900 0.902

00803 ....... 01 MANHATTAN, NY ..................................................................................... 1.094 1.351 1.668

00803 ....... 02 NYC SUBURBS/LONG I., NY ................................................................... 1.068 1.251 1.952

00803 ....... 03 POUGHKPSIE/N NYC SUBURBS, NY ..................................................... 1.011 1.075 1.275

14330 ....... 04 QUEENS, NY ............................................................................................. 1.058 1.228 1.871

00801 ....... 99 REST OF NEW YORK .............................................................................. 0.998 0.944 0.764

05535 ....... 00 NORTH CAROLINA ................................................................................... 0.970 0.931 0.595

00820 ....... 01 NORTH DAKOTA ...................................................................................... 0.950 0.880 0.657

16360 ....... 00 OHIO .......................................................................................................... 0.988 0.944 0.957

00522 ....... 00 OKLAHOMA ............................................................................................... 0.968 0.876 0.444

00835 ....... 01 PORTLAND, OR ........................................................................................ 0.996 1.049 0.436

00835 ....... 99 REST OF OREGON .................................................................................. 0.961 0.933 0.436

00865 ....... 01 METROPOLITAN PHILADELPHIA, PA ..................................................... 1.023 1.092 1.413

00865 ....... 99 REST OF PENNSYLVANIA ...................................................................... 0.989 0.929 0.774

00973 ....... 20 PUERTO RICO .......................................................................................... 0.881 0.712 0.275

00870 ....... 01 RHODE ISLAND ........................................................................................ 1.017 1.065 0.883

00880 ....... 01 SOUTH CAROLINA ................................................................................... 0.974 0.904 0.279

00820 ....... 02 SOUTH DAKOTA ...................................................................................... 0.935 0.878 0.406

05440 ....... 35 TENNESSEE ............................................................................................. 0.975 0.900 0.592

00900 ....... 31 AUSTIN, TX ............................................................................................... 0.986 0.996 0.859

00900 ....... 20 BEAUMONT, TX ........................................................................................ 0.992 0.890 1.338

00900 ....... 09 BRAZORIA, TX .......................................................................................... 0.992 0.978 1.338

00900 ....... 11 DALLAS, TX .............................................................................................. 1.010 1.065 0.931

00900 ....... 28 FORT WORTH, TX .................................................................................... 0.987 0.981 0.931

00900 ....... 15 GALVESTON, TX ...................................................................................... 0.988 0.969 1.338

00900 ....... 18 HOUSTON, TX .......................................................................................... 1.020 1.007 1.336

00900 ....... 99 REST OF TEXAS ...................................................................................... 0.966 0.880 0.956

00910 ....... 09 UTAH ......................................................................................................... 0.976 0.941 0.644

31145 ....... 50 VERMONT ................................................................................................. 0.973 0.986 0.539

00973 ....... 50 VIRGIN ISLANDS ...................................................................................... 0.965 1.023 1.002

10490 ....... 00 VIRGINIA ................................................................................................... 0.984 0.938 0.500

00836 ....... 02 SEATTLE (KING CNTY), WA .................................................................... 1.005 1.100 0.788

00836 ....... 99 REST OF WASHINGTON ......................................................................... 0.981 0.972 0.788

16510 ....... 16 WEST VIRGINIA ........................................................................................ 0.963 0.850 1.378

00951 ....... 00 WISCONSIN .............................................................................................. 0.981 0.929 0.939

00825 ....... 21 WYOMING ................................................................................................. 0.967 0.895 1.005

* Payment locality is serviced by two carriers.

Note: Work GPCI is the 1/4 work GPCI required by Section 1848(e)(1)(A)(iii) of the Social Security Act. GPCIs rescaled by the following factors for budget netrality: Work = 0.99699; Practice Expense = 0.99235; Malpractice Expense = 1.00215.

ADDENDUM E.—2001 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY

Carrier No. Locality

No. Locality name Work Practiceexpense Malpractice

00510 ....... 00 ALABAMA .................................................................................................. 0.978 0.871 0.841

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65587

ADDENDUM E.—2001 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY—Continued

Carrier No. Locality

No. Locality name Work Practiceexpense Malpractice

00831 ....... 01 ALASKA ..................................................................................................... 1.063 1.172 1.378

00832 ....... 00 ARIZONA ................................................................................................... 0.994 0.975 1.150

00520 ....... 13 ARKANSAS ............................................................................................... 0.953 0.851 0.371

02050 ....... 26 ANAHEIM/SANTA ANA, CA ...................................................................... 1.036 1.187 0.901

02050 ....... 18 LOS ANGELES, CA .................................................................................. 1.055 1.169 0.901

31140 ....... 03 MARIN/NAPA/SOLANO, CA ..................................................................... 1.014 1.205 0.677

31140 ....... 07 OAKLAND/BERKELEY, CA ....................................................................... 1.040 1.216 0.677

31140 ....... 05 SAN FRANCISCO, CA .............................................................................. 1.067 1.378 0.677

31140 ....... 06 SAN MATEO, CA ...................................................................................... 1.047 1.353 0.677

31140 ....... 09 SANTA CLARA, CA ................................................................................... 1.062 1.321 0.653

02050 ....... 17 VENTURA, CA ........................................................................................... 1.027 1.128 0.750

02050 ....... 99 REST OF CALIFORNIA* ........................................................................... 1.007 1.039 0.723

31140 ....... 99 REST OF CALIFORNIA* ........................................................................... 1.007 1.039 0.723

00824 ....... 01 COLORADO .............................................................................................. 0.986 0.981 0.817

10230 ....... 00 CONNECTICUT ......................................................................................... 1.049 1.164 1.009

00902 ....... 01 DELAWARE ............................................................................................... 1.019 1.032 0.786

00903 ....... 01 DC + MD/VA SUBURBS ........................................................................... 1.050 1.164 0.970

00590 ....... 03 FORT LAUDERDALE, FL .......................................................................... 0.996 1.022 1.830

00590 ....... 04 MIAMI, FL .................................................................................................. 1.015 1.064 2.439

00590 ....... 99 REST OF FLORIDA .................................................................................. 0.975 0.947 1.296

00511 ....... 01 ATLANTA, GA ........................................................................................... 1.006 1.046 0.943

00511 ....... 99 REST OF GEORGIA ................................................................................. 0.970 0.896 0.943

00833 ....... 01 HAWAII/GUAM .......................................................................................... 0.997 1.154 0.894

05130 ....... 00 IDAHO ........................................................................................................ 0.960 0.887 0.532

00952 ....... 16 CHICAGO, IL ............................................................................................. 1.027 1.090 1.745

00952 ....... 12 EAST ST. LOUIS, IL .................................................................................. 0.988 0.927 1.589

00952 ....... 15 SUBURBAN CHICAGO, IL ........................................................................ 1.006 1.069 1.505

00952 ....... 99 REST OF ILLINOIS ................................................................................... 0.964 0.888 1.074

00630 ....... 00 INDIANA .................................................................................................... 0.981 0.919 0.445

00826 ....... 00 IOWA ......................................................................................................... 0.959 0.879 0.622

00650 ....... 00 KANSAS* ................................................................................................... 0.963 0.897 0.823

00740 ....... 04 KANSAS* ................................................................................................... 0.963 0.897 0.823

00660 ....... 00 KENTUCKY ............................................................................................... 0.970 0.870 0.842

00528 ....... 01 NEW ORLEANS, LA .................................................................................. 0.998 0.947 1.218

00528 ....... 99 REST OF LOUISIANA ............................................................................... 0.969 0.876 1.052

31142 ....... 03 SOUTHERN MAINE .................................................................................. 0.979 1.015 0.687

31142 ....... 99 REST OF MAINE ....................................................................................... 0.961 0.917 0.687

00901 ....... 01 BALTIMORE/SURR. CNTYS, MD ............................................................. 1.020 1.038 1.007

00901 ....... 99 REST OF MARYLAND .............................................................................. 0.985 0.979 0.820

31143 ....... 01 METROPOLITAN BOSTON ...................................................................... 1.040 1.218 0.748

31143 ....... 99 REST OF MASSACHUSETTS .................................................................. 1.010 1.111 0.748

00953 ....... 01 DETROIT, MI ............................................................................................. 1.042 1.030 2.903

00953 ....... 99 REST OF MICHIGAN ................................................................................ 0.996 0.938 1.700

10240 ....... 00 MINNESOTA .............................................................................................. 0.990 0.971 0.479

10250 ....... 00 MISSISSIPPI .............................................................................................. 0.957 0.841 0.750

00740 ....... 02 METROPOLITAN KANSAS CITY, MO ..................................................... 0.988 0.958 1.021

00523 ....... 01 METROPOLITAN ST. LOUIS, MO ............................................................ 0.994 0.940 1.022

00740 ....... 99 REST OF MISSOURI* ............................................................................... 0.946 0.826 0.979

00523 ....... 99 REST OF MISSOURI* ............................................................................... 0.946 0.826 0.979

00751 ....... 01 MONTANA ................................................................................................. 0.951 0.877 0.729

00655 ....... 00 NEBRASKA ............................................................................................... 0.949 0.875 0.436

00834 ....... 00 NEVADA .................................................................................................... 1.005 1.035 1.103

31144 ....... 40 NEW HAMPSHIRE .................................................................................... 0.987 1.032 0.919

00805 ....... 01 NORTHERN NJ ......................................................................................... 1.057 1.192 0.827

00805 ....... 99 REST OF NEW JERSEY .......................................................................... 1.028 1.102 0.827

00521 ....... 05 NEW MEXICO ........................................................................................... 0.973 0.905 0.809

00803 ....... 01 MANHATTAN, NY ..................................................................................... 1.093 1.352 1.661

00803 ....... 02 NYC SUBURBS/LONG I., NY ................................................................... 1.067 1.242 1.942

00803 ....... 03 POUGHKPSIE/N NYC SUBURBS, NY ..................................................... 1.010 1.079 1.300

14330 ....... 04 QUEENS, NY ............................................................................................. 1.057 1.231 1.855

00801 ....... 99 REST OF NEW YORK .............................................................................. 0.998 0.951 0.778

05535 ....... 00 NORTH CAROLINA ................................................................................... 0.970 0.927 0.546

00820 ....... 01 NORTH DAKOTA ...................................................................................... 0.950 0.879 0.657

16360 ....... 00 OHIO .......................................................................................................... 0.989 0.941 1.016

00522 ....... 00 OKLAHOMA ............................................................................................... 0.969 0.879 0.447

00835 ....... 01 PORTLAND, OR ........................................................................................ 0.996 1.035 0.511

00835 ....... 99 REST OF OREGON .................................................................................. 0.961 0.935 0.511

00865 ....... 01 METROPOLITAN PHILADELPHIA, PA ..................................................... 1.023 1.090 1.310

00865 ....... 99 REST OF PENNSYLVANIA ...................................................................... 0.989 0.930 0.705

00973 ....... 20 PUERTO RICO .......................................................................................... 0.882 0.720 0.317

00870 ....... 01 RHODE ISLAND ........................................................................................ 1.017 1.067 1.036

65588 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

ADDENDUM E.—2001 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY—Continued

Carrier No. Locality

No. Locality name Work Practiceexpense Malpractice

00880 ....... 01 SOUTH CAROLINA ................................................................................... 0.975 0.905 0.279

00820 ....... 02 SOUTH DAKOTA ...................................................................................... 0.935 0.876 0.420

05440 ....... 35 TENNESSEE ............................................................................................. 0.975 0.900 0.572

00900 ....... 31 AUSTIN, TX ............................................................................................... 0.986 0.998 0.854

00900 ....... 20 BEAUMONT, TX ........................................................................................ 0.992 0.895 1.362

00900 ....... 09 BRAZORIA, TX .......................................................................................... 0.992 0.978 1.362

00900 ....... 11 DALLAS, TX .............................................................................................. 1.010 1.040 0.930

00900 ....... 28 FORT WORTH, TX .................................................................................... 0.987 0.976 0.930

00900 ....... 15 GALVESTON, TX ...................................................................................... 0.988 0.969 1.362

00900 ....... 18 HOUSTON, TX .......................................................................................... 1.020 1.007 1.377

00900 ....... 99 REST OF TEXAS ...................................................................................... 0.966 0.884 0.914

00910 ....... 09 UTAH ......................................................................................................... 0.977 0.925 0.619

31145 ....... 50 VERMONT ................................................................................................. 0.973 0.985 0.544

00973 ....... 50 VIRGIN ISLANDS ...................................................................................... 0.965 1.029 1.017

10490 ....... 00 VIRGINIA ................................................................................................... 0.985 0.939 0.529

00836 ....... 02 SEATTLE (KING CNTY), WA .................................................................... 1.005 1.090 0.765

00836 ....... 99 REST OF WASHINGTON ......................................................................... 0.982 0.974 0.765

16510 ....... 16 WEST VIRGINIA ........................................................................................ 0.963 0.852 1.242

00951 ....... 00 WISCONSIN .............................................................................................. 0.981 0.931 0.890

00825 ....... 21 WYOMING ................................................................................................. 0.967 0.895 0.855

*Payment locality is serviced by two carriers.

Note: Work GPCI is the 1⁄4 work GPCI required by Section 1848(e)(1)(A)(iii) of the Social Security Act. GPCIs rescaled by the following factors

for budget neutrality: Work = 0.99699; Practice Expense = 0.99235; Malpractice Expense = 1.00215.

ADDENDUM F.—PROPOSED 2002 VERSUS 1999 GEOGRAPHIC ADJUSTMENT FACTORS (GAF)

[In Descending Order of Difference]

Locality 1999

GAF

2002

GAF Difference Percentdifference

SAN MATEO, CA ............................................................................................................ 1.122 1.199 0.077 6.89

SAN FRANCISCO, CA .................................................................................................... 1.143 1.221 0.078 6.84

SANTA CLARA, CA ......................................................................................................... 1.125 1.184 0.059 5.28

MARIN/NAPA/SOLANO, CA ........................................................................................... 1.058 1.104 0.046 4.33

METROPOLITAN BOSTON ............................................................................................ 1.088 1.117 0.029 2.64

OAKLAND/BERKELEY, CA ............................................................................................. 1.086 1.113 0.027 2.46

REST OF MASSACHUSETTS ........................................................................................ 1.030 1.053 0.023 2.24

DALLAS, TX .................................................................................................................... 1.009 1.031 0.022 2.19

UTAH ............................................................................................................................... 0.931 0.951 0.020 2.10

SEATTLE (KING CNTY), WA .......................................................................................... 1.023 1.038 0.015 1.48

INDIANA .......................................................................................................................... 0.927 0.941 0.014 1.46

NORTH CAROLINA ......................................................................................................... 0.928 0.942 0.014 1.46

WYOMING ....................................................................................................................... 0.925 0.938 0.013 1.36

PORTLAND, OR .............................................................................................................. 0.987 1.000 0.013 1.35

REST OF NEW JERSEY ................................................................................................ 1.044 1.058 0.014 1.34

COLORADO .................................................................................................................... 0.971 0.983 0.012 1.27

ATLANTA, GA ................................................................................................................. 1.015 1.026 0.011 1.10

SOUTH CAROLINA ......................................................................................................... 0.913 0.923 0.010 1.06

NEVADA .......................................................................................................................... 1.016 1.026 0.010 1.00

SOUTH DAKOTA ............................................................................................................ 0.886 0.895 0.009 0.99

MINNESOTA .................................................................................................................... 0.957 0.966 0.009 0.99

REST OF PENNSYLVANIA ............................................................................................ 0.948 0.956 0.008 0.89

NORTHERN NJ ............................................................................................................... 1.099 1.109 0.010 0.89

VERMONT ....................................................................................................................... 0.957 0.965 0.008 0.88

NEBRASKA ..................................................................................................................... 0.894 0.902 0.008 0.87

TENNESSEE ................................................................................................................... 0.924 0.932 0.008 0.82

VENTURA, CA ................................................................................................................. 1.055 1.062 0.007 0.66

NORTH DAKOTA ............................................................................................................ 0.906 0.912 0.006 0.63

ANAHEIM/SANTA ANA, CA ............................................................................................ 1.090 1.097 0.007 0.63

REST OF ILLINOIS ......................................................................................................... 0.933 0.939 0.006 0.60

SUBURBAN CHICAGO, IL .............................................................................................. 1.048 1.054 0.006 0.57

METROPOLITAN PHILADELPHIA, PA ........................................................................... 1.059 1.065 0.006 0.56

FORT WORTH, TX .......................................................................................................... 0.978 0.983 0.005 0.55

OKLAHOMA ..................................................................................................................... 0.908 0.913 0.005 0.52

NEW MEXICO ................................................................................................................. 0.935 0.940 0.005 0.49

WEST VIRGINIA .............................................................................................................. 0.925 0.929 0.004 0.39

VIRGINIA ......................................................................................................................... 0.946 0.950 0.004 0.37

REST OF WASHINGTON ............................................................................................... 0.968 0.971 0.003 0.35

REST OF CALIFORNIA .................................................................................................. 1.007 1.010 0.003 0.32

ARKANSAS ..................................................................................................................... 0.886 0.889 0.003 0.32

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65589

ADDENDUM F.—PROPOSED 2002 VERSUS 1999 GEOGRAPHIC ADJUSTMENT FACTORS (GAF)—Continued

[In Descending Order of Difference]

Locality 1999

GAF

2002

GAF Difference Percentdifference

WISCONSIN .................................................................................................................... 0.955 0.957 0.002 0.26

MONTANA ....................................................................................................................... 0.910 0.912 0.002 0.19

AUSTIN, TX ..................................................................................................................... 0.985 0.986 0.001 0.14

DELAWARE ..................................................................................................................... 1.015 1.016 0.001 0.12

MISSISSIPPI .................................................................................................................... 0.900 0.901 0.001 0.08

IOWA ............................................................................................................................... 0.912 0.913 0.001 0.08

KENTUCKY ..................................................................................................................... 0.923 0.924 0.001 0.07

REST OF TEXAS ............................................................................................................ 0.929 0.930 0.001 0.07

DC + MD/VA SUBURBS ................................................................................................. 1.095 1.095 ¥0.000 ¥0.02

IDAHO .............................................................................................................................. 0.913 0.912 ¥0.001 ¥0.14

REST OF OREGON ........................................................................................................ 0.934 0.933 ¥0.001 ¥0.15

NEW ORLEANS, LA ........................................................................................................ 0.986 0.984 ¥0.002 ¥0.17

ARIZONA ......................................................................................................................... 0.994 0.991 ¥0.003 ¥0.27

NYC SUBURBS/LONG I., NY ......................................................................................... 1.177 1.173 ¥0.004 ¥0.30

ALABAMA ........................................................................................................................ 0.930 0.927 ¥0.003 ¥0.36

REST OF MAINE ............................................................................................................. 0.934 0.931 ¥0.003 ¥0.36

CHICAGO, IL ................................................................................................................... 1.084 1.080 ¥0.004 ¥0.38

OHIO ................................................................................................................................ 0.973 0.968 ¥0.005 ¥0.47

MANHATTAN, NY ........................................................................................................... 1.227 1.221 ¥0.006 ¥0.47

REST OF GEORGIA ....................................................................................................... 0.940 0.936 ¥0.004 ¥0.47

PUERTO RICO ................................................................................................................ 0.794 0.790 ¥0.004 ¥0.47

BALTIMORE/SURR. CNTYS, MD ................................................................................... 1.031 1.025 ¥0.006 ¥0.57

VIRGIN ISLANDS ............................................................................................................ 0.997 0.991 ¥0.006 ¥0.57

EAST ST. LOUIS, IL ........................................................................................................ 0.989 0.983 ¥0.006 ¥0.57

REST OF NEW YORK .................................................................................................... 0.973 0.967 ¥0.006 ¥0.57

KANSAS .......................................................................................................................... 0.933 0.928 ¥0.005 ¥0.58

CONNECTICUT ............................................................................................................... 1.100 1.093 ¥0.007 ¥0.65

REST OF LOUISIANA ..................................................................................................... 0.936 0.930 ¥0.006 ¥0.68

BRAZORIA, TX ................................................................................................................ 1.005 0.997 ¥0.008 ¥0.77

METROPOLITAN KANSAS CITY, MO ........................................................................... 0.982 0.974 ¥0.008 ¥0.77

REST OF MARYLAND .................................................................................................... 0.980 0.972 ¥0.008 ¥0.77

HOUSTON, TX ................................................................................................................ 1.034 1.025 ¥0.009 ¥0.86

NEW HAMPSHIRE .......................................................................................................... 1.008 0.999 ¥0.009 ¥0.86

GALVESTON, TX ............................................................................................................ 1.000 0.991 ¥0.009 ¥0.87

REST OF FLORIDA ........................................................................................................ 0.981 0.972 ¥0.009 ¥0.88

POUGHKPSIE/N NYC SUBURBS, NY ........................................................................... 1.056 1.046 ¥0.010 ¥0.94

SOUTHERN MAINE ........................................................................................................ 0.987 0.977 ¥0.010 ¥0.97

QUEENS, NY ................................................................................................................... 1.167 1.156 ¥0.011 ¥0.98

FORT LAUDERDALE, FL ................................................................................................ 1.046 1.033 ¥0.013 ¥1.23

RHODE ISLAND .............................................................................................................. 1.047 1.033 ¥0.014 ¥1.33

BEAUMONT, TX .............................................................................................................. 0.973 0.959 ¥0.014 ¥1.39

ALASKA ........................................................................................................................... 1.131 1.115 ¥0.016 ¥1.44

LOS ANGELES, CA ........................................................................................................ 1.104 1.088 ¥0.016 ¥1.46

METROPOLITAN ST. LOUIS, MO .................................................................................. 0.983 0.965 ¥0.018 ¥1.79

REST OF MISSOURI ...................................................................................................... 0.908 0.890 ¥0.018 ¥2.00

REST OF MICHIGAN ...................................................................................................... 1.013 0.990 ¥0.023 ¥2.24

MIAMI, FL ........................................................................................................................ 1.105 1.079 ¥0.026 ¥2.36

HAWAII/GUAM ................................................................................................................ 1.072 1.046 ¥0.026 ¥2.42

DETROIT, MI ................................................................................................................... 1.131 1.095 ¥0.036 ¥3.20

Addendum G—Technical Addendum

To The April 1999 Report On The

Development Of Resource Based

Malpractice Relative Value Units

Prepared By KPMG

Table of Contents

Executive Summary

E.1. Changes in This Update of the Resource

Based Malpractice Relative Value Units

E.2. Impact by Physician Specialty

E.3. Impact by Class of Procedure

Background

B.1. Background of the Malpractice RVU

B.2. Malpractice Insurance Premium Rate

Survey

Methodology

M.1. Overview

M.2. Mapping of Medicare Specialties to ISO

Codes

M.3. Calculating the National Average

Specialist Premiums

M.4. Specialist Risk Factors

Surgical Codes vs. Non Surgical codes

Obstetrical Codes

Obstetrics/Gynecology Risk Factors

Spinal Surgeries

Invasive Cardiology Procedures

Risk Factor Assignment Algorithm

M.5. Physician Profile Dataset

M.6. Calculating Average Risk Factors by

Procedure

M.7. Codes Whose RBMRVUS were not

Assigned Using the Risk Factor

Algorithms

M.8. Budget Neutrality Adjustment

M.9. Numerical Example

Executive Summary

E.1. Changes in This Update of the

Resource Based Malpractice Relative

Value Units

This addendum to the original April

1999 Report on Resource Based

Malpractice Relative Value Units

(RBMRVUs) describes the first update to

the RBMRVUs. The Original Report

converted the Malpractice Relative

65590 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

Value Units (RVUs) to a resource basis

from a charge basis and was the source

of the 2000 Malpractice RVUs. The

conversion was accomplished by

deriving physician specialty surgical

and non-surgical risk factors from

Malpractice premium and rating data.

These risk factors were than used to

calculate RBMRVUs by procedure based

on the composition of physician

specialties performing the procedure.

The changes included in this update

are as follows:

• 1996–98 Malpractice Premium Data

replaces 1993–95 Malpractice Premium

Data.

• Where premium data was not

available, KPMG consulted the rating

manuals of 5 physician malpractice

insurers as opposed to using just St.

Paul’s manual.

• In the Original Report,

Neurosurgeons had separate risk factors

for surgical and non-surgical

procedures. This has been changed so

that the same surgical risk factor is used

for all procedures performed by

Neurosurgeons.

• The risk factor used for most

surgical procedures performed by

Neurologists and Cardiologists is now

the factor for minor surgery. In the

original report, the factor for major

surgery was used. Pursuant to our

conversation, the change was made

because the surgical procedures

performed by Neurologists and

Cardiologists are less intensive than

those performed by their surgical

counterparts This change was made for

all procedures except invasive

Cardiology procedures, which are

discussed in the following item.

• Risk factors for invasive Cardiology

procedures, including Cardiac

Catheterizations and Angioplasties,

were established separately from risk

factors for other procedures, and were

based on data from the new malpractice

survey for Cardiologists performing

these procedures. These invasive

Cardiology procedures have the

following Current Procedural

Terminology (CPT) Codes: 92980–

92998, 93501–93536, 93600–93614,

93617–93641 and 93643–93652.

• 1999 Physician Utilization data

provided by HCFA mapped to 2000 CPT

codes was used as the basis for the

distribution of physician specialty by

procedure. The first report used 1997

utilization data mapped to 1999 CPT

codes.

This addendum includes an analysis

of the impact of the new risk factors and

a numerical example illustrating the

calculation of the CPT level RBMRVUs.

This addendum has been organized

according to the structure of the initial

Resource Based Malpractice RVU report.

Only those sections with changes have

been updated.

E.2. Impact by Physician Specialty

The exhibit on pages 6–7 illustrates

the impact that this update has on the

various physician specialties. All figures

are expressed as a percentage of total

RVUs, including the impact

percentages. Anesthesiologists and

Pathologists derive only a small portion

of their income from procedures which

have explicit Malpractice Relative Value

Units. The impact to Anesthesiologists

and Pathologists as presented in this

exhibit shows the change in the portion

of their income attributable only to

those codes having explicit Malpractice

Relative Value Units. Total RVUs are

calculated using the 2000 physician fee

schedule. Other changes will take place

in 2001 that may change these

percentages as a percentage of total

RVUs. In particular, an additional year

of phasing in the Resource Based

Practice Expense RVUs may have a

significant impact on the Malpractice

RVUs as a percentage of total RVUs by

specialty. It is the intention of this

exhibit to show only the isolated impact

of the RBMRVU change. For this reason,

other changes made in the 2001 RBRVS

have not been included.

This update produces more modest

changes than were originally made by

converting the Malpractice RVUs from a

charge basis to a resource basis. The

biggest gains are for Orthopedic

Surgeons (+1.1%) and Hand Surgeons

(+0.7%). These changes occur for the

following reasons:

• Orthopedic Surgeons: The 1993–95

Malpractice Survey only tracked

Orthopedic Surgeons that perform

spinal surgeries. In the Original Report,

a reduction was made in the Orthopedic

Surgical Risk Factor to reflect the

possibility that the premium data in the

survey might be artificially high for

other Orthopedic Surgeons. The 1996–

98 Malpractice Premium Survey

provided additional data on this subject.

When Malpractice Insurers differentiate

between Orthopedic Surgeons that do

and don’t perform spinal surgery the

differences can be substantial; however,

the survey indicated that this practice is

not as widespread as originally

anticipated. For this reason, the average

1996–98 premium data was used as the

basis for the Orthopedic Surgeons’ risk

factor in this update.

• Hand Surgeons: Orthopedic

Surgeons also perform many of the

surgical procedures that Hand Surgeons

perform; resulting in a carry over effect

to the Hand Surgeon specialty.

The biggest reductions are for

Anesthesiologists (¥1.3%),

Nephrologists (¥0.9%), and

Cardiologists (¥0.7%). Explanation of

these losses are as follows:

• Anesthesiologists: Based on the

1996–98 Malpractice Survey,

Anesthesiologists’ premiums are

decreasing at the fastest rate (3.75% per

year). Because Anesthesiologists receive

very little of their Medicare fees from

the Malpractice RVUs in this update,

this change impacts them less than the

¥1.3% change would imply.

• Nephrologists: Nephrologists are

not tracked in the survey; their risk

factor was based on the St. Paul’s

underwriting manual in the original

RBMRVU report. This update uses five

separate underwriting manuals

(although only four had risk factors for

Nephrologists). St. Paul’s assigns

Nephrologists the highest risk factor of

the four, and was the only insurer to

have separate factors for surgical and

non-surgical.

• Cardiologists: Cardiologists have

been impacted by the reduction in the

risk factor for invasive Cardiology

procedures. Our new RBMRVUs for

these procedures used risk factors

appropriate for Cardiologists performing

these procedures.

IMPACT ANALYSIS BY MEDICARE SPECIALTY CODE

[All Figures Expressed as a Percentage of Total RVUs]

Spclty

code Medicare description

Resource-based

RBMRVUs by year Impact from

2000 to

2001* 2000 2001

01 ............. General practice ................................................................................................................ 2.6% 2.7% +0.1%

02 ............. General surgery ................................................................................................................. 4.5% 4.5% +0.1%

03 ............. Allergy/Immunology ........................................................................................................... 3.9% 4.0% +0.1%

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65591

IMPACT ANALYSIS BY MEDICARE SPECIALTY CODE—Continued

[All Figures Expressed as a Percentage of Total RVUs]

Spclty

code Medicare description

Resource-based

RBMRVUs by year Impact from

2000 to

2001* 2000 2001

04 ............. Otolaryngology ................................................................................................................... 3.3% 3.4% +0.1%

05 ............. Anesthesiology .................................................................................................................. 4.9% 3.6% ¥1.3%

06 ............. Cardiology .......................................................................................................................... 3.6% 2.9% ¥0.7

07 ............. Dermatology ...................................................................................................................... 2.4% 2.5% +0.1%

08 ............. Family practice .................................................................................................................. 2.3% 2.5% +0.2%

10 ............. Gastroenterology ............................................................................................................... 2.9% 2.7% ¥0.2%

11 ............. Internal medicine ............................................................................................................... 2.5% 2.5% +0.0%

12 ............. Osteopathic manipulative therapy ..................................................................................... 2.5% 2.6% +0.1%

13 ............. Neurology .......................................................................................................................... 2.7% 2.8% +0.0%

14 ............. Neurosurgery ..................................................................................................................... 6.4% 7.0% +0.6%

16 ............. Obstetrics/Gynecology ....................................................................................................... 3.1% 3.6% +0.5%

18 ............. Ophthalmology ................................................................................................................... 2.0% 1.9% ¥0.1%

19 ............. Oral surgery (dentists only) ............................................................................................... 3.1% 3.3% +0.2%

20 ............. Orthopedic surgery ............................................................................................................ 4.0% 5.1% +1.1%

22 ............. Pathology ........................................................................................................................... 1.9% 2.5% +0.6%

24 ............. Plastic and reconstructive surgery .................................................................................... 3.7% 3.9% +0.2%

25 ............. Physical medicine and rehab ............................................................................................ 2.6% 2.5% ¥0.1%

26 ............. Psychiatry .......................................................................................................................... 2.0% 1.9% ¥0.1%

28 ............. Colorectal surgery (formerly proctology) ........................................................................... 4.0% 3.7% ¥0.2%

29 ............. Pulmonary disease ............................................................................................................ 2.6% 2.6% +0.1%

30 ............. Diagnostic radiology .......................................................................................................... 3.4% 3.6% +0.2%

33 ............. Thoracic surgery ................................................................................................................ 5.4% 5.3% ¥0.1%

34 ............. Urology .............................................................................................................................. 2.8% 3.0% +0.2%

35 ............. Chiropractic ........................................................................................................................ 1.8% 1.8% 0.0%

36 ............. Nuclear medicine ............................................................................................................... 3.4% 3.4% +0.0%

37 ............. Pediatric medicine ............................................................................................................. 2.9% 2.9% +0.0%

38 ............. Geriataric medicine ............................................................................................................ 2.4% 2.4% +0.1%

39 ............. Nephrology ........................................................................................................................ 3.2% 2.2% ¥0.9%

40 ............. Hand surgery ..................................................................................................................... 3.6% 4.3% +0.7%

41 ............. Optometrist ........................................................................................................................ 1.8% 1.6% ¥0.2%

44 ............. Infectious disease .............................................................................................................. 2.6% 2.6% +0.0%

46 ............. Endocrinology .................................................................................................................... 2.4% 2.5% +0.1%

48 ............. Podiatry .............................................................................................................................. 3.1% 3.0% ¥0.1%

62 ............. Psychologist ....................................................................................................................... 6.3% 6.2% ¥0.1%

64 ............. Audiologist ......................................................................................................................... 7.1% 7.1% +0.0%

65 ............. Physical therapist .............................................................................................................. 2.9% 2.6% ¥0.3%

66 ............. Rheumatology .................................................................................................................... 2.4% 2.7% +0.3%

67 ............. Occupational therapist ....................................................................................................... 3.0% 2.7% ¥0.3%

68 ............. Clinical psychologist .......................................................................................................... 2.5% 2.2% ¥0.3%

69 ............. Clinical lab ......................................................................................................................... 2.4% 2.8% +0.4%

70 ............. Multispecialty clinic or group practice ............................................................................... 3.1% 3.1% 0.0%

76 ............. Peripheral vascular disease .............................................................................................. 4.7% 4.7% +0.0%

77 ............. Vascular surgery ................................................................................................................ 5.3% 5.2% 0.0%

78 ............. Cardiac surgery ................................................................................................................. 5.6% 5.4% ¥0.1%

79 ............. Addiction medicine ............................................................................................................ 2.2% 2.2% 0.0%

81 ............. Critical care ........................................................................................................................ 2.8% 2.8% ¥0.1%

82 ............. Hematology ........................................................................................................................ 2.7% 2.7% +0.1%

83 ............. Hematology/oncology ........................................................................................................ 2.8% 2.9% +0.1%

84 ............. Preventive medicine .......................................................................................................... 2.6% 2.6% +0.0%

85 ............. Maxillofacial Surgery ......................................................................................................... 3.4% 3.6% +0.2%

86 ............. Neuropsychiatry ................................................................................................................. 2.3% 2.3% ¥0.1%

90 ............. Medical oncology ............................................................................................................... 2.9% 3.0% +0.1%

91 ............. Surgical oncology .............................................................................................................. 4.0% 4.3% +0.3%

92 ............. Radiation oncology ............................................................................................................ 3.3% 3.5% +0.3%

93 ............. Emergency Medicine ......................................................................................................... 4.3% 4.2% ¥0.1%

94 ............. Interventional Radiology .................................................................................................... 3.3% 3.4% +0.1%

95 ............. Independent physiological lab ........................................................................................... 5.0% 5.0% 0.0%

97 ............. Physician assistant ............................................................................................................ 2.2% 2.3% +0.1%

98 ............. Gynecologist/oncologist ..................................................................................................... 3.5% 4.0% +0.6%

Total ................................................................................................................................... 3.0% 3.0% +0.0

* Rounding may create the appearance of arithmetic errors.

E.3. Impact by Class of Procedure

The exhibit on pages 9–11 shows the

impact that the proposed update to the

RBMRVUs will have on different types

of procedures. All figures are again

expressed as a percentage of total RVUs

including the impact percentages. The

largest increases are for Maternity

(+2.0%), Musculoskeletal surgeries

65592 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

(+1.4%) and Female Genital surgeries

(+1.2%). (Cytogenic Studies also

increase +1.3%; however, utilization is

very small and there is only one CPT

code in this range 88230–88299 that

uses RVUs: 88291). Following is an

explanation of these gains:

• Musculoskeletal Surgeries: These

surgeries tend to be performed by

Orthopedic Surgeons. Since Orthopedic

Surgeons’ risk factors increased, the

Malpractice RVUs for these codes have

also increased.

• Maternity: RVUs for maternity

procedures are linked to the risk factor

selected for Obstetrics. This is not a

specialty tracked in the physician

malpractice survey—the risk factor was

assigned by reviewing rating manuals.

The five malpractice insurers’ manuals

showed an increased risk factor was

needed for Obstetrics.

• Female Genital Surgeries: Similar to

Obstetrics, the five malpractice insurers’

manuals showed that an increase was

needed in the surgical risk factor for

Gynecologists.

The largest decreases were for

Dialysis (¥1.6%) and Medical

Cardiovascular procedures (¥1.4%).

Following is an explanation of these

reductions:

• Dialysis: The RVUs decreased

because of the decrease in risk factor for

Nephrologists.

• Medical Cardiovascular: These

procedures include the invasive

Cardiology procedures mentioned in the

previous section for Cardiologists. The

risk factor for Cardiologists was

reduced, and the resulting RVUs for

these procedures are more reflective of

actual insurer practice.

IMPACT ANALYSIS BY PROCEDURE TYPE

[All Figures Expressed as a Percentage of Total RVUs]

Type

Resource-based

RBMRVUs by year

Impact by

year

2000 2001 2000 to

2001*

Surgical:

Auditory System ............................................................................................................................... 3.2% 3.2% +0.0%

Cardiovascular System ..................................................................................................................... 5.7% 5.3% ¥0.4%

Digestive System .............................................................................................................................. 4.3% 4.1% ¥0.3%

Endocrine System ............................................................................................................................ 5.2% 5.4% +0.1%

Eye and Ocular Adnexa ................................................................................................................... 2.0% 2.1% +0.0%

Female Genital System .................................................................................................................... 4.3% 5.5% +1.2%

Hemic and Lymphatic Systems ........................................................................................................ 4.9% 5.2% +0.3%

Integumentary System ...................................................................................................................... 3.4% 3.3% 0.0%

Male Genital System ........................................................................................................................ 3.1% 3.3% +0.2%

Maternity Care and Delivery ............................................................................................................. 8.1% 10.1% +2.0%

Mediastinum and Diaphragm ........................................................................................................... 5.5% 5.4% 0.0%

Muskuloskeletal System ................................................................................................................... 4.6% 6.0% +1.4%

Nervous System ............................................................................................................................... 7.2% 6.8% ¥0.5%

Operating Microscope ...................................................................................................................... 10.8% 9.8% ¥0.9%

Respiratory System .......................................................................................................................... 4.0% 4.0% 0.0%

Urinary System ................................................................................................................................. 3.1% 3.3% +0.2%

Subtotal ......................................................................................................................................... 4.1% 4.2% +0.1%

E&M:

Care Plan Oversight Services .......................................................................................................... 2.2% 2.2% 0.0%

Consultations .................................................................................................................................... 2.8% 3.0% +0.2%

Critical Care Services ....................................................................................................................... 2.8% 2.8% 0.0%

Domiciliary, Rest Home or Custodial Care ...................................................................................... 2.2% 2.1% 0.0%

Emergency Department Services ..................................................................................................... 4.5% 4.3% ¥0.1%

Home Services ................................................................................................................................. 2.3% 2.3% +0.0%

Hospital Inpatient Services ............................................................................................................... 2.4% 2.4% 0.0%

Hospital Observation ........................................................................................................................ 2.6% 2.6% 0.0%

Neonatal Intensive Care ................................................................................................................... 2.6% 3.0% +0.3%

Newborn Care .................................................................................................................................. 1.9% 2.0% +0.1%

Nursing Facility Services .................................................................................................................. 2.3% 2.2% 0.0%

Office or Other Outpatient ................................................................................................................ 1.9% 2.3% +0.3%

Prolonged Services .......................................................................................................................... 2.2% 2.2% 0.0%

Subtotal ......................................................................................................................................... 2.4% 2.5% +0.2%

Medicine:

Allergy and Clinical Immunology ...................................................................................................... 4.7% 4.7% 0.0%

Biofeedback ...................................................................................................................................... 2.0% 1.8% ¥0.2%

Cardiovascular .................................................................................................................................. 4.4% 3.0% ¥1.4%

Central Nervous System Tests ........................................................................................................ 7.7% 7.7% 0.0%

Chemotherapy .................................................................................................................................. 4.6% 4.6% +0.0%

Chiropractic Manipulative Therapy ................................................................................................... 1.8% 1.8% 0.0%

Dialysis ............................................................................................................................................. 3.6% 2.0% ¥1.6%

Gastroenterology .............................................................................................................................. 3.3% 3.3% 0.0%

Neurology and Neuromuscular Procedures ..................................................................................... 3.0% 2.9% ¥0.2%

Non-Invasive Vascular Diagnostic Studies ...................................................................................... 6.2% 6.2% 0.0%

Opthalmology .................................................................................................................................... 1.7% 1.4% ¥0.3%

Osteopathic Manipulative Therapy ................................................................................................... 2.1% 1.9% ¥0.3%

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65593

IMPACT ANALYSIS BY PROCEDURE TYPE—Continued

[All Figures Expressed as a Percentage of Total RVUs]

Type

Resource-based

RBMRVUs by year

Impact by

year

2000 2001 2000 to

2001*

Physical Medicine and Rehabilitation ............................................................................................... 2.8% 2.6% ¥0.3%

Subtotal ......................................................................................................................................... 3.4% 2.7% ¥0.7%

Pathology & Lab:

Chemistry .......................................................................................................................................... 1.7% 1.7% 0.0%

Consultations (Clinical Pathology) .................................................................................................... 1.8% 1.9% +0.1%

Cytogenic Studies ............................................................................................................................. 1.3% 2.6% +1.3%

Cytopathology ................................................................................................................................... 2.1% 2.7% +0.6%

Hematology & Coagulation ............................................................................................................... 1.5% 1.6% +0.1%

Immunology ...................................................................................................................................... 3.4% 3.5% +0.1%

Microbiology ...................................................................................................................................... 1.8% 1.8% 0.0%

Other ................................................................................................................................................. 1.8% 1.8% 0.0%

Surgical pathology ............................................................................................................................ 2.0% 2.6% +0.6%

Subtotal ......................................................................................................................................... 2.0% 2.6% 0.5%

Radiology

Diagnostic Imaging ........................................................................................................................... 3.6% 3.8% +0.2%

Diagnostic Ultrasound ...................................................................................................................... 3.5% 3.6% +0.1%

Nuclear Medicine .............................................................................................................................. 3.6% 3.6% +0.1%

Radiation Oncology .......................................................................................................................... 3.3% 3.6% +0.3%

Subtotal ......................................................................................................................................... 3.5% 3.7% +0.2%

* Rounding may create the appearance of arithmetic errors.

Background

B.1. Background of the Malpractice RVU

Please see the April 1999 report on

RBMRVUs for a complete description of

the charge based Malpractice RVUs.

B.2. Malpractice Insurance Premium

Rate Survey

The original development of Resource

Based Malpractice RVUs relied upon

malpractice insurance premiums for the

1993–95 period. As part of the update

to the Malpractice Geographic Practice

Cost Indices (GPCI) scheduled to be

implemented in the 2001 fee schedule,

KPMG collected physician malpractice

insurance data for the 1996–98 period.

One of the purposes of this addendum

is to establish new specialist risk factors

derived from the information collected

in the most recent survey.

In order to collect the necessary

premium data, 52 Departments of

Insurance (DOI) from all fifty states,

Washington D.C. and Puerto Rico were

contacted and sent questionnaires. Each

Department of Insurance was requested

to supply:

• 1996–98 Premium Rates for the top

Physician Malpractice Insurers doing

business in the state. These premium

rates had to conform to a very specific

benefit plan. Annual premiums were

collected and/or adjusted to the

following specifications: $1 million

limit on individual claims/ $3 million

limit on aggregate claims, mature

‘‘claims-made’’ coverage (see Section

4.2.2. of the Third Update of the GPCI

for a detailed discussion of ‘‘claimsmade’’).

• Name and number of contacts at the

DOI and Insurance Carriers.

• Definitions of the geographic rating

areas used in the state.

• Definitions of Risk Classifications.

For the majority of states, copies of

rate filings were obtained. A few states

summarized this information by

specialty across insurer. Some states did

not have filings or could not comply

with the survey in a timely manner. For

these states, malpractice insurers were

contacted directly.

Some states have Joint Underwriting

Associations (JUAs) and Patient

Compensation Funds (PCFs) that impact

physician malpractice costs. The South

Carolina JUA was included because it

has the majority market share. All other

JUAs were excluded. PCFs were

included only when participation was

mandatory, with one exception. In

South Carolina, the PCF was included

even though it is not mandatory because

the majority of South Carolina

physicians that participate in the JUA

also participate in the PCF.

Since PCFs often provide unlimited

coverage, states with mandatory PCFs

may have a cost level that is higher than

the $1 million/$3 million limits

mentioned previously. For those states,

no actuarial adjustment was made to

reduce the premium level to a $1

million/$3 million policy. This was

considered appropriate since the

intention of the survey was to track

actual physician costs as closely as

possible.

Overall KPMG collected physician

malpractice insurance premium data on

a total of 46 companies across all 50

states, Puerto Rico, and Washington,

D.C. Insurance companies that operated

in more than one state are counted once

in this total. In 38 states KPMG

collected data from at least two

companies. In the remainder of the

states, KPMG received information from

one company. In each of these states,

the sole insurer had a medical

malpractice market share of 49% or

more (medical malpractice insurance

includes physician and hospital

malpractice insurance). On average, data

was collected from insurance companies

with a 56% medical malpractice market

share.

There is reason to believe that the

actual captured physician malpractice

insurance market share is larger than

stated here. This is due to the fact that

market share statistics included hospital

malpractice insurance, but companies

that primarily deal in hospital

65594 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

malpractice have been largely excluded.

The most credible and consistently

available source of medical malpractice

insurance premium data comes from

National Association of Insurance

Commissioners (NAIC) annual

statement blanks. Unfortunately, the

annual statement line for medical

malpractice includes both hospital and

physician malpractice insurance.

Departments of Insurance provided

input regarding significant physician

malpractice insurance carriers.

The Office of Management and Budget

(OMB) approved physician malpractice

survey was primarily designed to

update the GPCI not the Malpractice

RVU. The needs of the two updates are

not the same. While the GPCI focuses on

regional cost differences, the ideal

Malpractice RVU survey would provide

more detail on premium variations by

specialty. In accordance with the OMB

approved survey, malpractice data was

collected for twenty physician

specialties. (There are over 90 HCFA

specialty codes.) Since the amount of

time it takes to perform the survey is a

critical component of OMB approval,

the number of specialties tracked in the

survey has not been changed. In order

to supplement the premium survey, five

rating manuals were used from among

the largest malpractice insurers in order

to derive risk factors for specialties not

tracked in the survey. Even for the

twenty specialties tracked in the survey,

it was necessary to supplement the

premium data with risk factors from the

selected five insurers. Since the survey

specified the level of surgical

involvement for a specialty, it was not

possible to get a surgical and nonsurgical risk factor from the same

premium data.

Typically malpractice insurers subdivide each specialty into three separate

levels of surgical involvement:

1. Major Surgery

2. Minor Surgery (typically assisting the

surgeon or performing very minor

surgeries)

3. No Surgery

The surgical risk factors are derived

from the highest level of surgical

involvement listed for the specialty in

the insurers rating manual, typically the

‘‘major surgery’’ category. The nonsurgical factors are derived from the

lowest level of surgical involvement

listed, typically the ‘‘no surgery’’

factors. For those surveyed specialties

that had minor surgical involvement,

the premium data was used as a

reasonability check with the selected

surgical and non-surgical risk factors.

The minor surgery premium risk factor

should fall between the surgical and

non-surgical factors and should also be

in line with the minor surgery risk

factor of the median or most

representative rating manual.

For Cardiologists and Neurologists,

the minor surgery premium average was

also used to set the surgical risk factors.

This is due to the fact that the surgical

procedures that these specialties

perform tend to fit the minor surgery

category.

One American Medical Association

(AMA) suggestion regarding the first

calculation of the RBMRVUs was their

desire that surgical specialties always be

granted their surgical risk factor even for

the non-surgical procedures that they

perform. This change has been

incorporated in this update of the risk

factors for specialties defined as

surgeons. The two specialties impacted

by this change are Neurosurgeons and

Surgical Oncologists.

In the first RBMRVU calculation,

Neurologists and Neurosurgeons shared

surgical and non-surgical risk factors.

This was not inconsistent with the St.

Paul’s rating manual. Neurosurgeons

received higher Malpractice RVU

compensation because they performed

more surgical procedures. However, the

surgical risk factor for Neurosurgeons is

now used to calculate the malpractice

RVUs for all procedures they perform—

surgical and non-surgical. As noted

above, Neurologists receive the minor

surgery risk factor for the surgical

procedures they perform.

In the original report, Surgical

Oncologists were mapped to the Avg.

Physician risk factors with separate

surgical and non-surgical risk factors. In

this update, Surgical Oncologists are

given the General Surgeons’ risk factors

which are the same for surgical and

non-surgical procedures.

The following table (A–1) shows how

the premium data was used for each of

the twenty tracked physician specialties

(note that any risk factor that is not

calculated using premium data from the

survey was derived from the rating

manual risk factors):

TABLE A–1.—USES OF THE PHYSICIAN MALPRACTICE PREMIUM DATA COLLECTED IN THE SURVEY

Specialty Surgery Used for

surgical RF?

Used for

non-surgical

RF?

Used for

reasonability

check?

Ophthalmology ....................................................................................................... Major ............ Yes ............... No ................ Yes.

General Surgery ..................................................................................................... Major ............ Yes ............... Yes ............... Yes.

Thoracic Surgery .................................................................................................... Major ............ Yes ............... Yes ............... Yes.

Urology Surgery ..................................................................................................... Major ............ Yes ............... Yes ............... Yes.

Anesthesiology ....................................................................................................... Major ............ Yes ............... Yes ............... Yes.

Neurosurgery ......................................................................................................... Major ............ Yes ............... Yes ............... Yes.

Orthopedic Surgery ................................................................................................ Major ............ Yes ............... Yes ............... Yes.

Plastic Surgery ....................................................................................................... Major ............ Yes ............... Yes ............... Yes.

Otorhinolaryngology ............................................................................................... Major ............ Yes ............... No ................ Yes.

Gynecology ............................................................................................................ None ............ No ................ Yes ............... Yes.

Psychiatry ............................................................................................................... None ............ No ................ Yes ............... Yes.

Pulmonary Disease ................................................................................................ None ............ Yes ............... Yes ............... Yes.

Gastroenterology .................................................................................................... Minor ............ No ................ No ................ Yes.

Radiology ............................................................................................................... Minor ............ Yes ............... Yes ............... Yes.

Cardiovascular Disease ......................................................................................... Minor ............ Yes ............... No ................ Yes.

Dermatology ........................................................................................................... Minor ............ No ................ No ................ Yes.

Internal Medicine .................................................................................................... Minor ............ No ................ No ................ Yes.

Neurology ............................................................................................................... Minor ............ Yes ............... No ................ Yes.

Pathology ............................................................................................................... Minor ............ Yes ............... Yes ............... Yes.

General/Family Practice ......................................................................................... Minor ............ No ................ No ................ Yes.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65595

Methodology

M.1. Overview

Please see the Final Report on the

Resource Based Malpractice RVUs for a

complete overview of the methodology.

This update only describes changes to

the original methodology. The following

changes are being implemented in this

update:

• 1996–98 Malpractice Premium Data

is used in place of 1993–95 Premium

Data.

• Physician premium data from the

survey is used to calculate risk factors

according to Table A–1 of this update.

• The premium weighted average risk

factors of five selected Malpractice

Insurers are used. They are Continental

Casualty Company (CNA), St. Paul Fire

and Marine Insurance Company (St.

Paul), Medical Liability Mutual

Insurance Company (MLMIC), Medical

Protective Company (Medical

Protective), and Doctors Company.

These five insurers are among the

largest malpractice insurers. This is the

methodology used for all specialties that

are not based on malpractice premium

data.

M.2. Mapping of Medicare Specialties to

ISO Codes

Please see the April 1999 Report on

RBMRVUs for a complete discussion of

malpractice insurer’s ISO codes and

how they are translated into Medicare

Physician Specialty Codes.

M.3. Calculating the National Average

Specialist Premiums

Please see section M.3. of the Final

Report on the Resource Based

Malpractice RVUs for a complete

discussion of methodology. One of the

adjustments described in that report

‘‘normalizes’’ the premium data in the

survey for the geographic spread of

specialties. A geographic bias is

measured by calculating the average

Malpractice GPCI that a specialty

receives. Variations can be noticeable.

For example, it was found that

Psychiatrists have a Malpractice GPCI

that is 5.6% above the average while

General/Family Practitioners are 6.2%

below the average. Not to adjust for this

phenomenon would effectively create a

‘‘double count’’ of the geographic

concentration of a given specialty.

Specialties more highly concentrated in

high malpractice cost areas would

receive higher RVUs because their

premiums would be higher, in part due

to their geographic concentration in

higher cost areas. At the same time they

would receive a higher Malpractice

GPCI for the identical reason. For

specialties more highly concentrated in

lower malpractice cost areas, the

opposite would be true. They would be

effectively ‘‘double penalized’’ for their

concentration in low malpractice cost

areas. By dividing each specialty’s

premium by its average Malpractice

GPCI, risk factors developed from these

new adjusted premiums more accurately

reflect the relative cost differences of

each specialty as opposed to the

geographic dispersion of the specialty.

This normalization calculation has

been updated for the risk factors used in

this update. A 1998 RVU distribution

was used in place of the 1997 RVU

distribution used in the original report.

The 2002–3 Malpractice GPCI was used

as the basis for the normalization. The

2001 ‘‘phase-in’’ Malpractice GPCI was

considered, but the 2002–2003

Malpractice GPCI was utilized since it

will be in place longer than the 2001

Malpractice GPCI and it is unlikely that

Malpractice RVUs will be updated in

the interim (beyond updates for new

CPT codes).

In Table A–2, the average malpractice

premiums tracked in the survey are

shown along with their average 2002–3

Malpractice GPCI and the adjusted

premium used for risk factors. Note that

Psychiatry has been normalized to a

1.31 risk factor to be consistent with the

average non-surgical factor developed

from the five malpractice insurers’ rate

manuals (see Table A–3) for Psychiatry.

This makes it easier to perform an

‘‘apples to apples’’ comparison of the

risk factors developed from premium

data versus the comparable rating

manual risk factors.

M.4. Specialist Risk Factors

Surgical Codes vs. Non Surgical Codes

Consistent with the development of

the original RBMRVUs, separate surgical

and non-surgical risk factors continue to

be used. For the purposes of calculating

RBMRVUs surgeries are defined as CPT

codes falling in the range of 10000

through 69999, and codes 92980–92998,

93501–93536, 93600–93614, 93617–

93641 and 93643–93652.

Obstetrical Codes

Medicare specialty codes do not

distinguish between Obstetricians and

Gynecologists. However, malpractice

premiums can be quite different for

these specialties. Because the majority

of Medicare OB/GYN services will be

Gynecological, a Gynecology risk factor

was used for all OB/GYN procedures,

except those that are clearly Obstetrical,

such as maternity codes (59000–59899).

These codes were assigned a risk factor

that is consistent with a risk factor for

an Obstetrician who performs surgery in

the Original Report. This practice is

continued in this addendum. The

obstetrical risk factor has been updated.

Obstetrics/Gynecology Risk Factors

Obstetricians and Gynecologists have

raised the concern about their average

malpractice premium and their

corresponding Malpractice RVUs. The

survey tracked the Malpractice premium

for a Gynecologist who does not perform

surgery. We recognize that

approximately 40% of Work RVUs paid

to Gynecologists under the Medicare

program are for surgical procedures. We

also recognize that Obstetricians have

virtually no utilization under the

Medicare program and that they will

pay much more for Malpractice

Insurance than the typical Gynecologist.

These issues have been addressed in

the risk factor methodology. First,

Gynecologists receive a risk factor

consistent with their Malpractice

Survey Premium only for non-surgical

procedures. For their surgical

procedures they receive a risk factor that

is 3.26 times (6.17 vs. 1.89) that which

would be granted if we only used their

Survey Premium. Second, Obstetricians

have been handled by making an

explicit adjustment to the maternity

codes in order to reflect their higher

malpractice costs. These codes are

granted a risk factor of 10.83 (based on

the rate manuals) which is 76% higher

than the Gynecologists’ Surgical risk

factor and 461% higher than the

Gynecologists’ Non Surgical risk factor.

Spinal Surgeries

If the risk factor calculated for a

Spinal Surgery procedure (CPTs 22100–

22899) falls below the risk factor for an

Orthopedic Surgeon performing Spinal

Surgery (8.64), then the risk factor for an

Orthopedic Surgeon performing spinal

surgery is used.

Invasive Cardiology Procedures

The following codes receive the

greater of their actual average risk factor

or the risk factor for invasive Cardiology

(3.16): 92980–92998, 93501–93536,

93600–93614, 93617–93641 and 93643–

93652.

Risk Factor Assignment Algorithm

The Risk Factor Assignment

Algorithm from the original report is

presented in this section. Changes are

indicated in bold:

Having discussed the background and

issues surrounding the physician risk

factors, the actual mechanics of the

algorithm used to assign risk factors will

now be described. The assignment

algorithm was as follows:

65596 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

1. The lowest normalized malpractice

premium specialty was determined to

be Psychiatry. This specialty was

assigned a risk factor value of ‘‘1.31’’.

This factor was selected to be consistent

with the risk factor developed for nonsurgical Psychiatry developed from

rating manuals.

2. If the specialty’s normalized

average malpractice premium is the

basis for the risk factor (as defined in

Table A–1), the Risk Factor was

calculated as follows:

SPEC NORMAL PRE NORMAL PRE

PREM AVG MGPCI

RF

SPEC

= ( ) ×

=

M M 

NORMAL PREM

SPEC PSYCHIATRIST

SPEC SPEC

/ ..

/

131

For example, Ophthalmologists’ had a

96–98 average premium of $11,209.

Their average MGPCI was 0.98915.

Dividing $11,209 by .98915 yields

$11,332 as the normalized average

premium. Dividing this result by the

adjusted Psychiatrists’ premium

($11,332/$6,263) gives an answer of

1.81. This 1.81 is then multiplied by

1.31 to give the final risk factor of 2.37.

3. If the risk factor was not being set

with malpractice premium data, five

rating manuals from among the largest

malpractice insurers were consulted and

an average risk factor (RF) was

developed based on the market share

weighted average. Using Psychiatry,

non-surgical as an example: C.N.A.

Weighting × C.N.A. RF + St. Paul

Weighting × St. Paul RF + M.L.M.I.C.

Weighting × M.L.M.I.C. RF + Medical

Protective Weighting × Medical

Protective Risk Factor + Doctors

Weighting × Doctors Risk Factor =

25.955% × 1.50 + 25.547% × 1.00 +

20.923% × 1.00 + 14.637% × 1.33

+ 12.938% × 2.00 = Note that

Weightings are developed by

calculating the Insurers’ annual

earned premium as a percent of the

total for all five insurers.

M.5. Physician Profile Dataset

The April 1999 report on the

RBMRVU describes this dataset. For this

update, we used 1999 utilization data

cross walked to 2000 CPT codes. HCFA

performed this cross walk before giving

the utilization data to KPMG. The most

critical task performed on this data by

KPMG was the application of the

Modifiers to the underlying utilization

data. KPMG made the conversions to the

Allowed Services counts outlined in the

table on the next page. The adjustments

in the table are consistent with the

modifier adjustments that HCFA

specifies for processing physician

claims.

Modifier Description Code type Handling/value of code

51 ............. Multiple Procedures .................................. Rule applies .............................................. 50%.

Endoscopic Procedure * ............................ 100%; summary data only. Since claims

history could not be taken into account

endoscopies are counted 100%.

Modifier does not apply ............................. 100%.

No payment adjustment ............................ 100%.

54 ............. Surgical Only ............................................. Surgery code ............................................. Intraoperative % applied.

Non surgery code ...................................... 0%.

55 ............. Post Operative Only .................................. Surgery code ............................................. Post Op % applied.

Non surgery code ...................................... 0%.

56 ............. Pre Operative Only ................................... Surgery code ............................................. Pre Op % applied.

Non surgery code ...................................... 0%.

62 ............. Co Surgeons ............................................. Co Surgeons not permitted ....................... 0%.

Co Surgeons permitted with or without

documentation.

62.5%.

Does not apply .......................................... 0%.

80 ............. Asst. Surgeon ............................................ Don’t pay or does not apply ...................... 0%.

Asst Surgeon permitted with or without

documentation.

16%.

26 ............. Prof. Only .................................................. .................................................................... 100%.

TC ............. Technical Only .......................................... .................................................................... Malpractice RVUs are unchanged.

53 ............. Terminated endoscopy .............................. .................................................................... 100%.

* This is more likely to distort the impact analysis rather than the average risk factor. Endoscopies will be over-weighted in the impact analysis.

M.6. Calculating Average Risk Factors

by Procedure

Please see the April 1999 report for a

complete description of the calculation.

The formula for calculating the risk

factors is stated below:

SPEC Allergist

SPEC

=

( ) × = ∑

/Immunologist through Vascular Surgeon

SERVICES RF

SERVICES Avg. RF PROC/MOD, SPEC

PROC/MOD

PROC/MOD

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65597

Where:

SERVICESPROC/MOD, SPEC = Number of

procedures performed in 1999 by

specialty for specific procedure

code

RFSPEC= Risk factor for specialty

calculated in M.4.

SERVICESPROC/MOD = Number of

procedures performed in 1999 for

specific procedure code

Avg. RFPROC/MOD = The average risk

factor for the particular

combination of procedure and

modifier code.

M.7. Codes Whose RBMRVUs were not

Assigned Using the Risk Factor

Algorithms

Please see table A–5 for the

assignments made for codes with

insufficient utilization data.

M.8. Budget Neutrality Adjustment

Please see the April 1999 report for a

complete discussion. The new budget

neutrality adjustment is .0171569. Note

that this adjustment is applied before

inclusion of the technical codes which

are left unchanged.

The formula for budget neutrality and

the final calculation of RBMRVUs is

given below:

2000 Aggregate MP RVUs

SERVICES RAW RBMRVU

PROC = 00000 to 99999

( ) PROC/MOD PROC/MOD × =

∑ BN Adj.

This budget neutrality adjustment is

multiplied by the Unadjusted

RBMRVUs to get the final RBMRVUs.

RBMRVUPROC MOD / = × Raw RBMRVU BN Adj. PROC/MOD

Where:

SERVICESPROC/MOD = Number of

procedures performed in 1999 for

specific procedure code

Raw RBMRVUPROC/MOD = The resourcebased RVU allocation for the riskfactor method prior to adjustment

for budget neutrality

2000 Aggregate MP RVUs = 2000

aggregate malpractice RVUs

projected from the 1999 utilization

data and 2000 malpractice RVUs

BN Adj = 2001 budget neutrality

adjustment, forces RBMRVUs to be

budget neutral to the 1999

experience

RBMRVUPROC/MOD = RBMRVU after

applying 2001 budget neutrality

adjustment

M.9. Numerical Example

The development of risk factors has

been demonstrated in a previous

section. This numerical example will

focus on applying those risk factors to

the Procedure Code Malpractice

Relative Value Units.

This example will look at the

calculation of the Resource Based

Malpractice RVU for code 99213–Office/

Outpatient Visit, Established Patient,

and is shown on the next page. We start

with raw physician specialty utilization

databased on 1999 utilization and

mapped to 2000 codes by the Health

Care Financing Administration. In the

exhibit, Column B shows the

distribution of services by specialty.

Column B is labeled ‘‘Adjusted Allowed

Services’’ because certain modifier rules

have been applied to the counts.

NUMERICAL EXAMPLE FOR CPT CODE 99213 CALCULATION OF THE AVERAGE RISK FACTOR

Code Description

A

Risk

factor

B

Adjusted

allowed

svcs

C

Percent of

total

D

Product

A X B

1 ............. General practice ........................................................................................ 1.73 4,507,361 5.18 7,797,735

2 ............. General surgery ......................................................................................... 6.14 1,516,808 1.74 9,313,201

3 ............. Allergy/Immunology ................................................................................... 1.05 306,558 0.35 321,886

4 ............. Otolaryngology ........................................................................................... 2.31 1,484,673 1.70 3,429,595

5 ............. Anesthesiology ........................................................................................... 3.28 289,300 0.33 948,904

6 ............. Cardiology .................................................................................................. 1.81 5,711,251 6.56 10,337,364

7 ............. Dermatology ............................................................................................... 1.12 1,904,507 2.19 2,133,048

8 ............. Family practice ........................................................................................... 1.73 18,552,260 21.30 32,095,410

10 ............. Gastroenterology ....................................................................................... 1.95 1,564,620 1.80 3,051,009

11 ............. Internal medicine ....................................................................................... 1.89 25,202,921 28.94 47,633,521

12 ............. Osteopathic manipulative therapy ............................................................. 2.19 86,452 0.10 189,330

13 ............. Neurology ................................................................................................... 1.96 1,102,524 1.27 2,160,947

14 ............. Neurosurgery ............................................................................................. 12.64 187,609 0.22 2,371,378

16 ............. Obstetrics/Gynecology ............................................................................... 1.89 822,589 0.94 1,554,693

18 ............. Ophthalmology ........................................................................................... 1.18 3,171,237 3.64 3,742,060

19 ............. Oral surgery (dentists only) ....................................................................... 2.19 9,070 0.01 19,863

20 ............. Orthopedic surgery .................................................................................... 8.53 2,643,730 3.04 22,551,017

22 ............. Pathology ................................................................................................... 2.07 25,423 0.03 52,626

24 ............. Plastic and reconstructive surgery ............................................................ 6.57 114,446 0.13 751,910

25 ............. Physical medicine and rehab .................................................................... 1.07 340,226 0.39 364,042

26 ............. Psychiatry .................................................................................................. 1.31 91,260 0.10 119,551

28 ............. Colorectal surgery (formerly proctolog) ..................................................... 3.81 52,161 0.06 198,733

29 ............. Pulmonary disease .................................................................................... 1.94 1,785,484 2.05 3,463,839

65598 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

NUMERICAL EXAMPLE FOR CPT CODE 99213 CALCULATION OF THE AVERAGE RISK FACTOR—Continued

Code Description

A

Risk

factor

B

Adjusted

allowed

svcs

C

Percent of

total

D

Product

A X B

30 ............. Diagnostic radiology .................................................................................. 2.60 71,349 0.08 185,507

33 ............. Thoracic surgery ........................................................................................ 8.14 90,142 0.10 733,756

34 ............. Urology ....................................................................................................... 3.58 3,013,435 3.46 10,788,097

36 ............. Nuclear medicine ....................................................................................... 1.38 10,151 0.01 14,008

37 ............. Pediatric medicine ..................................................................................... 1.75 128,072 0.15 224,126

38 ............. Geriataric medicine .................................................................................... 1.16 242,737 0.28 281,575

39 ............. Nephrology ................................................................................................. 1.57 661,649 0.76 1,038,789

40 ............. Hand surgery ............................................................................................. 5.75 32,714 0.04 188,106

41 ............. Optometrist ................................................................................................ 2.19 629,614 0.72 1,378,855

44 ............. Infectious disease ...................................................................................... 1.57 242,070 0.28 380,050

46 ............. Endocrinology ............................................................................................ 1.57 689,586 0.79 1,082,650

48 ............. Podiatry ...................................................................................................... 2.19 1,392,115 1.60 3,048,732

65 ............. Physical therapist ....................................................................................... 1.07 18 0.00 19

66 ............. Rheumatology ............................................................................................ 1.68 1,248,991 1.43 2,098,305

67 ............. Occupational therapist ............................................................................... 1.08 4 0.00 4

68 ............. Clinical psychologist .................................................................................. 1.31 10 0.00 13

69 ............. Clinical lab ................................................................................................. 2.07 95 0.00 197

70 ............. Multispecialty clinic or group practice ........................................................ 2.19 3,515,620 4.04 7,699,208

76 ............. Peripheral vascular disease ...................................................................... 2.19 15,471 0.02 33,881

77 ............. Vascular surgery ........................................................................................ 7.41 157,071 0.18 1,163,896

78 ............. Cardiac surgery ......................................................................................... 7.93 15,718 0.02 124,644

79 ............. Addiction medicine ..................................................................................... 1.31 9,586 0.01 12,558

81 ............. Critical care ................................................................................................ 2.19 57,499 0.07 125,923

82 ............. Hematology ................................................................................................ 1.62 70,854 0.08 114,783

83 ............. Hematology/oncology ................................................................................ 1.62 1,531,160 1.76 2,480,479

84 ............. Preventive medicine .................................................................................. 1.29 7,780 0.01 10,036

85 ............. Maxillofacial surgery .................................................................................. 6.57 4,718 0.01 30,997

86 ............. Neuropsychiatry ......................................................................................... 1.31 2,358 0.00 3,089

90 ............. Medical oncology ....................................................................................... 1.85 592,350 0.68 1,095,848

91 ............. Surgical oncology ...................................................................................... 6.14 30,958 0.04 190,082

92 ............. Radiation oncology .................................................................................... 2.40 186,255 0.21 447,012

93 ............. Emergency medicine ................................................................................. 4.30 294,726 0.34 1,267,322

94 ............. Interventional Radiology ............................................................................ 2.68 1,908 0.00 5,113

95 ............. Independent physiological lab ................................................................... 2.07 3 0.00 6

98 ............. Gynecologist/oncologist ............................................................................. 1.93 30,429 0.03 58,728

SUBTOTAL FOR RISK FCTR CALCULATION ........................................ 2.21 86,449,686 99.26 190,908,055

OTHER ................................................................................................... 645,885 0.74 N/A

TOTAL ....................................................................................................... .................... 87,095,571 100.00 ....................

Avg RF for Sum of Col this Procedure = Sum of Column D

umn B

= 190,908,055

 86,449,686 = 2 21 .

Notice that 0.74% of the services are

performed by specialties that have not

had risk factors developed for them

(‘‘OTHER’’). For this 99213 code, this is

largely comprised of Physician

Assistants and Nurse Practitioners.

The next step is to determine the

average risk factor. Column D shows the

product of each specialties’ risk factor

multiplied by the number of Allowed

Services for that specialty. If we add up

each specialties’ product and divide by

the total number of allowed services, we

have calculated the average risk factor

for the code. For code 99213 this is

(190,908,055) / (86,449,686) = 2.21. Note

that this is just an application of the

following formula shown in Section M6:

SPEC Allergist

SPEC

=

( ) × = ∑

/Immunologist through Vascular Surgeon

SERVICES RF

SERVICES Avg. RF PROC/MOD, SPEC

PROC/MOD

PROC/MOD

Next we need to multiply the average

risk factor for the code by the Work

RVUs for the code. For code 99213 this

is: 2.21 * 0.67 = 1.48. Finally the budget

neutrality adjustment of .0171569 is

applied to 1.48. The result is .0171569

* 1.48 = .03 Malpractice RVUs.

Attachments

Table A–2: Average Premiums, MGPCI,

and Resulting Risk Factors by

Specialty

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65599

Table A–3: Weighted Average Risk

Factors Developed from Five Rating

Manuals

Table A–4: Selected Risk Factors by

HCFA Specialty

Table A–5: Cross Walk Assumptions 1

TABLE A–2.—AVERAGE PREMIUMS, MGPCI AND RESULTING RISK FACTORS BY SPECIALTY

ISO Specialty 1996 avg 1997 avg 1998 avg 93–95 96–98 Annual

trend

Avg

MGPCI

Normalized

96–98*** Risk fctr***

80114 .... Opthalmology ........................... $11,304 $11,377 $10,945 $10,960 $11,209 0.75% 0.989% $11,332 2.37

80143 .... General surgery ....................... 27,667 28,116 27,694 27,020 27,825 0.98% 0.948 29,367 6.14

80144 .... Thoracic surgery ...................... 39,056 39,020 38,359 38,789 38,812 0.02% 0.997 38,919 8.14

80145 .... Urology ..................................... 16,799 17,163 16,911 15,817 16,958 2.35% 0.991 17,116 3.58

80151 .... Anesthesiology ......................... 15,708 15,468 14,904 17,231 15,360 ¥3.75% 0.980 15,678 3.28

80152 .... Neurosurgery ........................... 58,104 58,263 56,735 54,610 57,701 1.85% 0.954 60,455 12.64

80154 .... Orthopedic surgery .................. 39,182 38,882 37,688 38,877 38,584 ¥0.25% 0.946 40,774 8.53

80156 .... Plastic surgery ......................... 31,670 31,708 31,062 30,599 31,480 0.95% 1.002 31,415 6.57

80159 .... Otolaryngology ......................... 20,603 19,845 19,521 19,748 19,990 0.41% 0.989 20,212 4.23

80244 .... Gynecology .............................. 8,445 8,690 8,790 *n/a 8,642 *n/a 0.957 9,033 1.89

80249 .... Psychiatry** .............................. 6,645 6,533 6,664 7,240 6,614 ¥2.96% 1.056 6,263 1.31

80269 .... Pulmonary disease .................. 9,352 9,553 9,620 8,594 9,508 3.42% 1.025 9,278 1.94

80274 .... Gastroenterology ..................... 11,691 11,890 11,655 11,008 11,745 2.18% 1.008 11,648 2.44

80280 .... Diagnostic radiology ................ 12,099 12,651 12,365 10,783 12,372 4.68% 0.994 12,442 2.60

80281 .... Cardiology ................................ 13,265 13,367 12,980 12,465 13,204 1.94% 1.013 13,037 2.73

80282 .... Dermatology ............................. 10,690 10,856 10,394 10,946 10,650 ¥0.91% 1.037 10,272 2.15

80284 .... Internal medicine ..................... 11,770 11,941 11,798 11,491 11,836 0.99% 1.019 11,611 2.43

80288 .... Neurology ................................. 14,000 13,758 13,421 12,396 13,726 3.45% 1.029 13,335 2.79

80292 .... Pathology ................................. 9,633 9,690 9,439 8,913 9,587 2.46% 0.969 9,895 2.07

80423 .... General practice ...................... 11,181 11,354 11,167 10,465 11,234 2.39% 0.938 11,977 2.51

* Data not available.

** Psychiatry is set to 1.31 to be consistent with risk factor taken from rating manuals (see Table A–3).

*** Actual precision on premium and GPCIs is greater than shown. May not be able to reproduce results exactly due to rounding.

TABLE A–3.—WEIGHTED AVERAGE RISK FACTORS DEVELOPED FROM FIVE RATING MANUALS

[Calculation of Weighted Average Risk Factors]

Code Description

Weights-->

Weighted Avg. Risk Factors

25.955%

C.N.A.

25.547%

St. Paul

20.923% Insurers MLMIC14.637%

Med. Prof.

12.938%

Doctors

Non Surg Surg Non Surg Surg Non Surg Surg Non Surg Surg Non Surg Surg Non Surg Surg

01 ......... General practice ......................... 1.73 4.43 1.67 6.17 1.23 2.93 2.24 5.09 1.57 2.60 2.18 4.89

02 ......... General surgery ......................... 6.24 6.24 6.17 6.17 4.64 4.64 8.04 8.04 5.38 5.38 7.63 7.63

03 ......... Allergy/Immunology .................... 1.05 1.29 1.00 1.00 1.00 1.00 1.00 1.00 1.00 2.60 1.40 1.40

04 ......... Otolaryngology ........................... 2.31 3.92 1.00 3.58 1.23 2.93 3.59 5.09 1.33 2.60 6.12 6.12

05 ......... Anesthesiology ........................... 3.11 3.11 3.58 3.58 2.43 2.43 3.14 3.14 3.36 3.36 3.15 3.15

06 ......... Cardiology .................................. 1.81 2.85 1.50 3.58 1.23 1.79 2.91 2.91 1.33 2.60 2.37 3.62

Cardiac Catheterization .............. 3.16 3.16 3.58 3.58 2.36 2.36 3.20 3.20 3.36 3.36 3.62 3.62

07 ......... Dermatology ............................... 1.12 2.41 1.00 1.50 1.00 4.64 1.00 1.00 1.00 2.60 1.93 1.93

08 ......... Family practice ........................... 1.73 4.43 1.67 6.17 1.23 2.93 2.24 5.09 1.57 2.60 2.18 4.89

10 ......... Gastroenterology ........................ 1.95 2.78 1.50 3.58 1.23 2.36 2.91 2.91 1.57 1.57 3.13 3.13

11 ......... Internal medicine ........................ 1.89 2.53 1.67 3.58 1.23 1.79 2.91 2.91 1.57 1.57 2.37 2.37

13 ......... Neurology ................................... 1.96 2.11 1.67 1.67 1.23 1.79 2.39 2.39 1.57 1.47 3.75 3.75

14 ......... Neurosurgery .............................. 12.67 12.67 10.00 10.00 9.42 9.42 20.96 20.96 10.63 10.63 13.31 13.31

16 ......... Gynecology ................................ 1.93 6.17 1.50 6.17 1.23 4.64 3.59 9.01 1.33 5.38 2.18 5.48

Obstetrics ................................... n/a 10.83 n/a 10.00 n/a 7.15 n/a 15.53 n/a 10.63 n/a 12.41

18 ......... Ophthalmology ........................... 1.18 2.36 1.00 1.50 1.23 1.79 1.00 3.20 1.33 2.60 1.55 3.60

20 ......... Orthopedic surgery wo Spinal .... 8.45 8.45 8.17 8.17 6.01 6.01 12.18 12.18 7.97 7.97 8.36 8.36

Orthopedic surgery with Spinal .. 8.64 8.64 8.17 8.17 6.01 6.01 12.18 12.18 9.30 9.30 8.36 8.36

22 ......... Pathology ................................... 1.57 1.77 1.50 1.50 1.00 1.79 1.81 1.81 1.57 1.57 2.43 2.43

24 ......... Plastic Surgery ........................... 7.19 7.19 8.17 8.17 4.64 4.64 9.01 9.01 7.97 7.97 6.42 6.42

25 ......... Physical Med & Rehab .............. 1.07 1.07 1.00 1.00 1.23 1.23 1.00 1.00 n/a n/a 1.00 1.00

26 ......... Psychiatry ................................... 1.31 1.49 1.50 1.50 1.00 1.00 1.00 1.00 1.33 2.60 2.00 2.00

28 ......... Colorectal surgery ...................... 3.81 3.81 3.58 3.58 2.36 2.36 5.09 5.09 n/a n/a 5.02 5.02

29 ......... Pulmonary disease ..................... 1.82 1.82 1.00 1.00 1.23 1.23 2.91 2.91 1.57 1.57 3.13 3.13

30 ......... Diagnostic radiology ................... 2.28 2.58 1.67 1.67 1.23 1.79 4.24 4.24 1.57 2.60 3.26 3.26

33 ......... Thoracic surgery ........................ 7.20 7.20 6.17 6.17 6.01 6.01 8.04 8.04 9.30 9.30 7.91 7.91

34 ......... Urology ....................................... 3.59 3.59 3.58 3.58 2.36 2.36 5.09 5.09 2.60 2.60 4.71 4.71

36 ......... Nuclear medicine ....................... 1.38 1.61 1.50 1.50 1.23 1.23 n/a n/a 1.33 2.60 1.47 1.47

37 ......... Pediatric medicine ...................... 1.75 4.92 1.67 6.17 1.23 4.64 n/a n/a n/a n/a 2.97 2.97

38 ......... Geriataric medicine .................... 1.16 2.08 1.00 1.50 1.23 2.36 n/a n/a 1.33 2.60 n/a n/a

39 ......... Nephrology ................................. 1.57 1.94 1.50 1.50 1.23 2.36 n/a n/a 1.57 1.57 2.37 2.37

40 ......... Hand surgery .............................. 5.75 5.75 6.17 6.17 4.64 4.64 n/a n/a 5.38 5.38 7.54 7.54

44 ......... Infectious disease ...................... 1.57 1.75 1.50 1.50 1.23 1.79 n/a n/a 1.57 1.57 2.37 2.37

46 ......... Endocrinology ............................. 1.57 1.94 1.50 1.50 1.23 2.36 n/a n/a 1.57 1.57 2.37 2.37

66 ......... Rheumatology ............................ 1.68 2.01 1.00 1.00 1.23 1.79 2.91 2.91 1.33 2.60 2.37 2.37

67 ......... Occupational therapist ............... 1.08 1.08 1.00 1.00 1.23 1.23 1.00 1.00 n/a n/a n/a n/a

77 ......... Vascular surgery ........................ 7.41 7.41 6.17 6.17 6.01 6.01 9.01 9.01 9.30 9.30 7.91 7.91

78 ......... Cardiac surgery .......................... 7.93 7.93 8.17 8.17 6.01 6.01 9.01 9.01 9.30 9.30 7.91 7.91

82 ......... Hematology ................................ 1.62 1.76 1.50 1.50 1.23 1.79 1.81 1.81 1.57 1.57 2.37 2.37

83 ......... Hematology/oncology ................. 1.62 1.76 1.50 1.50 1.23 1.79 1.81 1.81 1.57 1.57 2.37 2.37

84 ......... Preventive medicine ................... 1.29 4.43 1.00 6.17 1.23 2.93 1.00 5.09 1.57 2.60 2.18 4.89

90 ......... Medical oncology ....................... 1.85 1.85 1.50 1.50 1.23 1.23 2.91 2.91 1.57 1.57 2.37 2.37

92 ......... Radiation oncology ..................... 2.40 2.40 1.50 1.50 2.36 2.36 2.91 2.91 2.60 2.60 3.26 3.26

93 ......... Emergency medicine .................. 4.30 4.96 6.17 6.17 2.93 4.64 3.25 3.25 3.36 4.82 6.06 6.06

94 ......... Interventional Radiology ............. 2.68 2.68 1.50 1.50 2.36 2.36 4.24 4.24 2.60 2.60 3.26 3.26

98 ......... Gynecologist/oncologist ............. 1.93 6.17 1.50 6.17 1.23 4.64 3.59 9.01 1.33 5.38 2.18 5.48

65600 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

TABLE A–4.—MEDICARE SPECIALTIES AND RISK FACTOR ASSIGNMENT

Code Medical description

Non surgical risk

factor

Surgical

risk factor Notes

01 ............. General practice ........................................................ 1.73 4.43 Rating Manuals used.

02 ............. General surgery ......................................................... 6.14 6.14 Premium data used.

03 ............. Allergy/Immunology ................................................... 1.05 1.29 Rating Manuals used.

04 ............. Otolaryngology .......................................................... 2.31 4.23 Surg RF from survey, Non-Surg RF from manuals.

05 ............. Anesthesiology .......................................................... 3.28 3.28 Premium data used.

06 ............. Cardiology ................................................................. 1.81 2.73 Surg RF from survey, Non-Surg RF from manuals.

07 ............. Dermatology .............................................................. 1.12 2.41 Rating Manuals used.

08 ............. Family practice .......................................................... 1.73 4.43 Rating Manuals used.

10 ............. Gastroenterology ....................................................... 1.95 2.78 Rating Manuals used.

11 ............. Internal medicine ....................................................... 1.89 2.53 Rating Manuals used.

12 ............. Osteopathic manipulative therapy ............................. 2.19 3.75 Cross walked to All Physician Average Risk Factors.

13 ............. Neurology .................................................................. 1.96 2.79 Surg RF from survey, Non-Surg RF from manuals.

14 ............. Neurosurgery ............................................................. 12.64 12.64 Premium data used.

16 ............. Obstetrics/Gynecology .............................................. 1.89 6.17 Surg RF from manuals, Non-Surg RF from survey.

18 ............. Ophthalmology .......................................................... 1.18 2.37 Surg RF from survey, Non-Surg RF from Manuals.

19 ............. Oral surgery (dentists only) ....................................... 2.19 3.75 Cross walked to All Physician Average Risk Factors.

20 ............. Orthopedic surgery .................................................... 8.53 8.53 Premium data used.

22 ............. Pathology ................................................................... 2.07 2.07 Premium data used.

24 ............. Plastic and reconstructive surgery ............................ 6.57 6.57 Premium data used.

25 ............. Physical medicine and rehab .................................... 1.07 1.07 Rating Manuals used.

26 ............. Psychiatry .................................................................. 1.31 1.49 Surg RF from manuals, Non-Surg RF from survey.

28 ............. Colorectal surgery (formerly proctology) ................... 3.81 3.81 Rating Manuals used.

29 ............. Pulmonary disease .................................................... 1.94 1.94 Premium data used.

30 ............. Diagnostic radiology .................................................. 2.60 2.60 Premium data used.

33 ............. Thoracic surgery ........................................................ 8.14 8.14 Premium data used.

34 ............. Urology ...................................................................... 3.58 3.58 Premium data used.

35 ............. Chiropractic ............................................................... 1.89 2.53 Cross walked to Internal Medicine Risk Factor.

36 ............. Nuclear medicine ....................................................... 1.38 1.61 Rating Manuals used.

37 ............. Pediatric medicine ..................................................... 1.75 4.92 Rating Manuals used.

38 ............. Geriataric medicine ................................................... 1.16 2.08 Rating Manuals used.

39 ............. Nephrology ................................................................ 1.57 1.94 Rating Manuals used.

40 ............. Hand surgery ............................................................. 5.75 5.75 Rating Manuals used.

41 ............. Optometrist ................................................................ 2.19 3.75 Cross walked to All Physician Average Risk Factors.

44 ............. Infectious disease ...................................................... 1.57 1.75 Rating Manuals used.

46 ............. Endocrinology ............................................................ 1.57 1.94 Rating Manuals used.

48 ............. Podiatry ..................................................................... 2.19 3.75 Cross walked to All Physician Average Risk Factors.

62 ............. Psychologist .............................................................. 1.31 1.49 Cross walked to Psychiatrists’ Risk Factors.

65 ............. Physical Therapist ..................................................... 1.07 1.07 Cross walked to Physical Med. & Rehab Risk Factors.

66 ............. Rheumatology ........................................................... 1.68 2.01 Rating Manuals used.

67 ............. Occupational therapist (independently practicing) .... 1.08 1.08 Rating Manuals used.

68 ............. Clinical psychologist .................................................. 1.31 1.49 Cross walked to Psychiatrists’ Risk Factors.

69 ............. Clinical lab ................................................................. 2.07 2.07 Cross walked to Pathologists’ Risk Factors.

70 ............. Multispecialty clinic or group practice ....................... 2.19 3.75 Cross walked to All Physician Average Risk Factors.

76 ............. Peripheral vascular disease ...................................... 2.19 3.75 Cross walked to All Physician Average Risk Factors.

77 ............. Vascular surgery ....................................................... 7.41 7.41 Rating Manuals used.

78 ............. Cardiac surgery ......................................................... 7.93 7.93 Rating Manuals used.

79 ............. Addiction medicine .................................................... 1.31 1.49 Cross walked to Psychiatrists’ Risk Factors.

81 ............. Critical care ............................................................... 2.19 3.75 Cross walked to All Physician Average Risk Factors.

82 ............. Hematology ............................................................... 1.62 1.76 Rating Manuals used.

83 ............. Hematology/oncology ................................................ 1.62 1.76 Rating Manuals used.

84 ............. Preventive medicine .................................................. 1.29 4.43 Rating Manuals used.

85 ............. Maxillofacial surgery .................................................. 6.57 6.57 Cross walked to Plastic Surgeons’ Risk Factors.

86 ............. Neuropsychiatry ......................................................... 1.31 1.49 Cross walked to Psychiatrists’ Risk Factors.

90 ............. Medical oncology ....................................................... 1.85 1.85 Rating Manuals used.

91 ............. Surgical Oncology ..................................................... 6.14 6.14 Cross walked to General Surgeons’ Risk Factors.

92 ............. Radiation oncology .................................................... 2.40 2.40 Rating Manuals used.

93 ............. Emergency medicine ................................................. 4.30 4.96 Rating Manuals used.

94 ............. Interventional Radiology ............................................ 2.68 2.68 Rating Manuals used.

95 ............. Independent physiological lab ................................... 2.07 2.07 Cross walked to Pathologists’ Risk Factors.

98 ............. Gynecologist/oncologist ............................................. 1.93 6.17 Rating Manuals used.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65601

EXHIBIT A–5.—CROSS WALK ASSUMPTIONS

HCPCS MOD Description Status

Cross walk assumption

HCPCS MOD Description

11975 ....... ............. Insert contraceptive cap ........................... N 11976 ...... ............. Removal of contraceptive cap.

11977 ....... ............. Removal/reinsert contra cap .................... N 11976 ...... ............. Removal of contraceptive cap.

11980 ....... ............. Implant hormone pellet(s) ........................ A XXXXX ..... ............. AVG SURGICAL.

13300 ....... ............. Repair of wound or lesion ........................ D 13102 ...... ............. Repair wound/lesion add-on.

15580 ....... ............. Attach skin pedicle graft ........................... D 15574 ...... ............. Form skin pedicle flap.

15625 ....... ............. Skin graft .................................................. D 15350 ...... ............. Skin homograft.

15775 ....... ............. Hair transplant punch grafts ..................... R 15776 ...... ............. Hair transplant punch grafts.

15850 ....... ............. Removal of sutures .................................. B 15851 ...... ............. Removal of sutures.

20979 ....... ............. Us bone stimulation .................................. N XXXXX ..... ............. Interventional Radiology.

21077 ....... ............. Prepare face/oral prosthesis .................... A 21076 ...... ............. Prepare face/oral prosthesis.

21083 ....... ............. Prepare face/oral prosthesis .................... A 21076 ...... ............. Prepare face/oral prosthesis.

21127 ....... ............. Augmentation, lower jaw bone ................. A 21125 ...... ............. Augmentation, lower jaw bone.

21155 ....... ............. Reconstruct midface, lefort ...................... A 21154 ...... ............. Reconstruct midface, lefort.

21159 ....... ............. Reconstruct midface, lefort ...................... A 21154 ...... ............. Reconstruct midface, lefort.

21263 ....... ............. Revise eye sockets .................................. A 21260 ...... ............. Revise eye sockets.

24931 ....... ............. Amputate upper arm & implant ................ A 24900 ...... ............. Amputation of upper arm.

25455 ....... ............. Revision of wrist joint ............................... A 25450 ...... ............. Revision of wrist joint.

26504 ....... ............. Hand tendon reconstruction ..................... A 26500 ...... ............. Hand tendon reconstruction.

26551 ....... ............. Great toe-hand transfer ............................ A XXXXX ..... ............. Orthopedic Surgeon.

26554 ....... ............. Double transfer, toe-hand ........................ A XXXXX ..... ............. Orthopedic Surgeon.

26556 ....... ............. Toe joint transfer ...................................... A XXXXX ..... ............. Orthopedic Surgeon.

27734 ....... ............. Repair lower leg epiphyses ...................... A 27730 ...... ............. Repair of tibia epiphysis.

32001 ....... ............. Total lung lavage ...................................... D 32997 ...... ............. Total lung lavage.

33242 ....... ............. Repair pulse generator/leads ................... D 33218 ...... ............. Revise eltrd pacing-defib.

33247 ....... ............. Insert/replace leads .................................. D 33216 ...... ............. Revise eltrd pacing-defib.

33506 ....... ............. Repair artery, translocation ...................... A 33502 ...... ............. Coronary artery correction.

33688 ....... ............. Repair heart septum defect ...................... A 33684 ...... ............. Repair heart septum defect.

33710 ....... ............. Repair of heart defects ............................. A 33702 ...... ............. Repair of heart defects.

33771 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33774 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33775 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33776 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33777 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33778 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33781 ....... ............. Repair great vessels defect ..................... A 33770 ...... ............. Repair great vessels defect.

33918 ....... ............. Repair pulmonary atresia ......................... A 33917 ...... ............. Repair pulmonary atresia.

33968 ....... ............. Remove aortic assist device .................... A 33971 ...... ............. Aortic circulation assist.

36550 ....... ............. Declot vascular device ............................. A 36533 ...... ............. Insertion of access device.

42210 ....... ............. Reconstruct cleft palate ............................ A 42205 ...... ............. Reconstruct cleft palate.

42227 ....... ............. Lengthening of palate ............................... A 42226 ...... ............. Lengthening of palate.

42509 ....... ............. Parotid duct diversion ............................... A 42507 ...... ............. Parotid duct diversion.

42835 ....... ............. Removal of adenoids ............................... A 42830 ...... ............. Removal of adenoids.

46742 ....... ............. Repair of imperforated anus .................... A 46753 ...... ............. Reconstruction of anus.

46746 ....... ............. Repair of cloacal anomaly ........................ A 46744 ...... ............. Repair of cloacal anomaly.

46748 ....... ............. Repair of cloacal anomaly ........................ A 46744 ...... ............. Repair of cloacal anomaly.

46751 ....... ............. Repair of anal sphincter ........................... A 46753 ...... ............. Reconstruction of anus.

47136 ....... ............. Transplantation of liver ............................. R 47130 ...... ............. Partial removal of liver.

49611 ....... ............. Repair umbilical lesion ............................. A 49610 ...... ............. Repair umbilical lesion.

50526 ....... ............. Repair renal-abdomen fistula ................... A 50525 ...... ............. Repair renal-abdomen fistula.

54316 ....... ............. Reconstruction of urethra ......................... A 54322 ...... ............. Reconstruction of urethra.

54901 ....... ............. Fusion of spermatic ducts ........................ A 54900 ...... ............. Fusion of spermatic ducts.

56300 ....... ............. Laparoscopy; diagnostic ........................... D 49320 ...... ............. Diag laparo separate proc.

56301 ....... ............. Laparoscopy; tubal cautery ...................... D 58670 ...... ............. Laparoscopy, tubal cautery.

56302 ....... ............. Laparoscopy; tubal block ......................... D 58671 ...... ............. Laparoscopy, tubal block.

56303 ....... ............. Laparoscopy; excise lesions .................... D 58662 ...... ............. Laparoscopy, excise lesions.

56304 ....... ............. Laparoscopy; lysis .................................... D 58660 ...... ............. Laparoscopy, lysis.

56305 ....... ............. Laparoscopy; biopsy ................................ D 49321 ...... ............. Laparoscopy, biopsy.

56306 ....... ............. Laparoscopy; aspiration ........................... D 49322 ...... ............. Laparoscopy, aspiration.

56307 ....... ............. Laparoscopy; remove adnexa .................. D 58661 ...... ............. Laparoscopy, remove adnexa.

56308 ....... ............. Laparoscopy; hysterectomy ..................... D 58550 ...... ............. Laparo-asst vag hysterectomy.

56309 ....... ............. Laparoscopy; remove myoma .................. D 58551 ...... ............. Laparoscopy, remove myoma.

56310 ....... ............. Laparoscopic enterolysis .......................... D 44200 ...... ............. Laparoscopy, enterolysis.

56311 ....... ............. Laparoscopic lymph node biop ................ D 38570 ...... ............. Laparoscopy, lymph node biop.

56312 ....... ............. Laparoscopic lymphadenectomy .............. D 38571 ...... ............. Laparoscopy, lymphadenectomy.

56313 ....... ............. Laparoscopic lymphadenectomy .............. D 38572 ...... ............. Laparoscopy, lymphadenectomy.

56314 ....... ............. Lapar; drain lymphocele ........................... D 49323 ...... ............. Laparo drain lymphocele.

56315 ....... ............. Laparoscopic appendectomy ................... D 44970 ...... ............. Laparoscopy, appendectomy.

56316 ....... ............. Laparoscopic hernia repair ....................... D 49650 ...... ............. Laparo hernia repair initial.

56317 ....... ............. Laparoscopic hernia repair ....................... D 49651 ...... ............. Laparo hernia repair recur.

56318 ....... ............. Laparoscopic orchiectomy ........................ D 54690 ...... ............. Laparoscopy, surgical; orchiectomy.

65602 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations

EXHIBIT A–5.—CROSS WALK ASSUMPTIONS—Continued

HCPCS MOD Description Status

Cross walk assumption

HCPCS MOD Description

56320 ....... ............. Laparoscopy, spermatic veins .................. D 55550 ...... ............. Laparo ligate spermatic vein.

56322 ....... ............. Laparoscopy, vagus nerves ..................... D 43651 ...... ............. Laparoscopy, vagus nerve.

56323 ....... ............. Laparoscopy, vagus nerves ..................... D 43652 ...... ............. Laparoscopy, vagus nerve.

56324 ....... ............. Laparoscopy, cholecystoenter .................. D 47570 ...... ............. Laparo cholecystoenterostomy.

56340 ....... ............. Laparoscopic cholecystectomy ................ D 47562 ...... ............. Laparoscopic cholecystectomy.

56341 ....... ............. Laparoscopic cholecystectomy ................ D 47563 ...... ............. Laparo cholecystectomy/graph.

56342 ....... ............. Laparoscopic cholecystectomy ................ D 47564 ...... ............. Laparo cholecystectomy/explr.

56343 ....... ............. Laparoscopic salpingostomy .................... D 58673 ...... ............. Laparoscopy, salpingostomy.

56344 ....... ............. Laparoscopic fimbrioplasty ....................... D 58672 ...... ............. Laparoscopy, fimbrioplasty.

56346 ....... ............. Laparoscopic gastrostomy ....................... D 43653 ...... ............. Laparoscopy, gastrostomy.

56348 ....... ............. Laparo; resect intestine ............................ D 44202 ...... ............. Laparo, resect intestine.

56349 ....... ............. Laparoscopy; fundoplasty ........................ D 43280 ...... ............. Laparoscopy, fundoplasty.

56350 ....... ............. Hysteroscopy; diagnostic ......................... D 58555 ...... ............. Hysteroscopy, dx, sep proc.

56351 ....... ............. Hysteroscopy; biopsy ............................... D 58558 ...... ............. Hysteroscopy, biopsy.

56352 ....... ............. Hysteroscopy; lysis ................................... D 58559 ...... ............. Hysteroscopy, lysis.

56353 ....... ............. Hysteroscopy; resect septum ................... D 58560 ...... ............. Hysteroscopy, resect septum.

56354 ....... ............. Hysteroscopy; remove myoma ................. D 58561 ...... ............. Hysteroscopy, remove myoma.

56355 ....... ............. Hysteroscopy; remove impact .................. D 58562 ...... ............. Hysteroscopy, remove fb.

56356 ....... ............. Hysteroscopy; ablation ............................. D 58563 ...... ............. Hysteroscopy, ablation.

56362 ....... ............. Laparoscopy w/cholangio ......................... D 47560 ...... ............. Laparoscopy w/cholangio.

56363 ....... ............. Laparoscopy w/biopsy .............................. D 47561 ...... ............. Laparo w/cholangio/biopsy.

58300 ....... ............. Insert intrauterine device .......................... N 58301 ...... ............. Remove intrauterine device.

58970 ....... ............. Retrieval of oocyte ................................... A XXXXX ..... ............. Gynecologist.

58976 ....... ............. Transfer of embryo ................................... A XXXXX ..... ............. Gynecologist.

61544 ....... ............. Remove & treat brain lesion .................... A 61533 ...... ............. Implant brain electrodes.

61609 ....... ............. Transect artery, sinus ............................... A XXXXX ..... ............. Neurosurgeon.

61611 ....... ............. Transect artery, sinus ............................... A XXXXX ..... ............. Neurosurgeon.

61855 ....... ............. Implant neuroelectrodes ........................... D 61862 ...... ............. Implant neurostimul, subcort.

61865 ....... ............. Implant neuroelectrodes ........................... D 61862 ...... ............. Implant neurostimul, subcort.

61885 ....... ............. Implant neurostim one array .................... A XXXXX ..... ............. Neurosurgeon.

62115 ....... ............. Reduction of skull defect .......................... A XXXXX ..... ............. Neurosurgeon.

62274 ....... ............. Inject spinal anesthetic ............................. D 62310 ...... ............. Inject spine c/t.

62275 ....... ............. Inject spinal anesthetic ............................. D 62310 ...... ............. Inject spine c/t.

62276 ....... ............. Inject spinal anesthetic ............................. D 62318 ...... ............. Inject spine w/cath, c/t.

62277 ....... ............. Inject spinal anesthetic ............................. D 62318 ...... ............. Inject spine w/cath, c/t.

62278 ....... ............. Inject spinal anesthetic ............................. D 62311 ...... ............. Inject spine l/s (cd).

62279 ....... ............. Inject spinal anesthetic ............................. D 62319 ...... ............. Inject spine w/cath l/s (cd).

62288 ....... ............. Injection into spinal canal ......................... D 62310 ...... ............. Inject spine c/t.

62289 ....... ............. Injection into spinal canal ......................... D 62311 ...... ............. Inject spine l/s (cd).

62298 ....... ............. Injection into spinal canal ......................... D 62310 ...... ............. Inject spine c/t.

63196 ....... ............. Incise spinal column & cord ..................... A 63197 ...... ............. Incise spinal column & cord.

63198 ....... ............. Incise spinal column & cord ..................... A 63197 ...... ............. Incise spinal column & cord.

63199 ....... ............. Incise spinal column & cord ..................... A 63197 ...... ............. Incise spinal column & cord.

64440 ....... ............. Injection for nerve block ........................... D 64479 ...... ............. Inj foramen epidural c/t.

64441 ....... ............. Injection for nerve block ........................... D 64480 ...... ............. Inj foramen epidural add-on.

64442 ....... ............. Injection for nerve block ........................... D 64475 ...... ............. Inj paravertebral l/s.

64443 ....... ............. Inject, nerve block add-on ........................ D 64476 ...... ............. Inj paravertebral l/s add-on.

64862 ....... ............. Repair of low back nerves ....................... A 64861 ...... ............. Repair of arm nerves.

64870 ....... ............. Fusion of facial/other nerve ...................... A 64866 ...... ............. Fusion of facial/other nerve.

64876 ....... ............. Repair nerve/shorten bone ....................... A 64874 ...... ............. Repair & revise nerve add-on.

77419 ....... ............. Weekly radiation therapy .......................... D 77427 ...... ............. Radiation tx management, x5.

77420 ....... ............. Weekly radiation therapy .......................... D 77427 ...... ............. Radiation tx management, x5.

77425 ....... ............. Weekly radiation therapy .......................... D 77427 ...... ............. Radiation tx management, x5.

77430 ....... ............. Weekly radiation therapy .......................... D 77427 ...... ............. Radiation tx management, x5.

78351 ....... ............. Bone mineral, dual photon ....................... N 78350 ...... ............. Bone mineral, single photon.

89136 ....... ............. Sample stomach contents ........................ A 89135 ...... ............. Sample stomach contents.

90875 ....... ............. Psychophysiological therapy .................... N XXXXX ..... ............. PSYCHIATRY.

90876 ....... ............. Psychophysiological therapy .................... N XXXXX ..... ............. PSYCHIATRY.

90885 ....... ............. Psy evaluation of records ......................... B XXXXX ..... ............. PSYCHIATRY.

90887 ....... ............. Consultation with family ........................... B XXXXX ..... ............. PSYCHIATRY.

92015 ....... ............. Refraction ................................................. N XXXXX ..... ............. OPTHALMOLOGY.

92352 ....... ............. Special spectacles fitting .......................... B XXXXX ..... ............. OPTOMETRIST.

92353 ....... ............. Special spectacles fitting .......................... B XXXXX ..... ............. OPTOMETRIST.

92354 ....... ............. Special spectacles fitting .......................... B XXXXX ..... ............. OPTOMETRIST.

92355 ....... ............. Special spectacles fitting .......................... B XXXXX ..... ............. OPTOMETRIST.

92358 ....... ............. Eye prosthesis service ............................. B XXXXX ..... ............. OPTHALMOLOGY.

92371 ....... ............. Repair & adjust spectacles ...................... B XXXXX ..... ............. OPTOMETRIST.

92392 ....... ............. Supply of low vision aids .......................... I XXXXX ..... ............. OPTOMETRIST.

92393 ....... ............. Supply of artificial eye .............................. I XXXXX ..... ............. OPTHALMOLOGY.

92395 ....... ............. Supply of spectacles ................................ I XXXXX ..... ............. OPTOMETRIST.

Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations 65603

EXHIBIT A–5.—CROSS WALK ASSUMPTIONS—Continued

HCPCS MOD Description Status

Cross walk assumption

HCPCS MOD Description

92396 ....... ............. Supply of contact lenses .......................... I XXXXX ..... ............. OPTOMETRIST.

96570 ....... ............. Photodynamic tx, 30 min .......................... A XXXXX ..... ............. SURGICAL ONCOLOGY.

96571 ....... ............. Photodynamic tx, addl 15 min .................. A XXXXX ..... ............. SURGICAL ONCOLOGY.

96902 ....... ............. Trichogram ............................................... B XXXXX ..... ............. DERMATOLOGY.

97010 ....... ............. Hot or cold packs therapy ........................ B XXXXX ..... ............. PHYSICAL MEDICINE.

98943 ....... ............. Chiropractic manipulation ......................... N 98942 ...... ............. Chiropractic manipulation.

99141 ....... ............. Sedation, iv/im or inhalant ........................ B XXXXX ..... ............. ANESTHESIOLOGIST.

99142 ....... ............. Sedation, oral/rectal/nasal ........................ B XXXXX ..... ............. ANESTHESIOLOGIST.

99170 ....... ............. Anogenital exam, child ............................. A XXXXX ..... ............. AVG NON SURGICAL.

99374 ....... ............. Home health care supervision ................. B 99375 ...... ............. Home health care supervision.

99377 ....... ............. Hospice care supervision ......................... B 99378 ...... ............. Hospice care supervision.

99379 ....... ............. Nursing fac care supervision .................... B 99313 ...... ............. Nursing fac care, subseq.

99380 ....... ............. Nursing fac care supervision .................... B 99313 ...... ............. Nursing fac care, subseq.

99381 ....... ............. Prev visit, new, infant ............................... N XXXXX ..... ............. PEDIATRICIAN.

99382 ....... ............. Prev visit, new, age 1-4 ........................... N XXXXX ..... ............. PEDIATRICIAN.

99383 ....... ............. Prev visit, new, age 5-11 ......................... N XXXXX ..... ............. PEDIATRICIAN.

99384 ....... ............. Prev visit, new, age 12-17 ....................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99385 ....... ............. Prev visit, new, age 18-39 ....................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99386 ....... ............. Prev visit, new, age 40-64 ....................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99387 ....... ............. Prev visit, new, 65 & over ........................ N XXXXX ..... ............. FAMILY PRACTITIONER.

99391 ....... ............. Prev visit, est, infant ................................. N XXXXX ..... ............. PEDIATRICIAN.

99392 ....... ............. Prev visit, est, age 1-4 ............................. N XXXXX ..... ............. PEDIATRICIAN.

99393 ....... ............. Prev visit, est, age 5-11 ........................... N XXXXX ..... ............. PEDIATRICIAN.

99394 ....... ............. Prev visit, est, age 12-17 ......................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99395 ....... ............. Prev visit, est, age 18-39 ......................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99396 ....... ............. Prev visit, est, age 40-64 ......................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99397 ....... ............. Prev visit, est, 65 & over .......................... N XXXXX ..... ............. FAMILY PRACTITIONER.

99401 ....... ............. Preventive counseling, indiv ..................... N XXXXX ..... ............. PSYCHIATRIST.

99402 ....... ............. Preventive counseling, indiv ..................... N XXXXX ..... ............. PSYCHIATRIST.

99403 ....... ............. Preventive counseling, indiv ..................... N XXXXX ..... ............. PSYCHIATRIST.

99404 ....... ............. Preventive counseling, indiv ..................... N XXXXX ..... ............. PSYCHIATRIST.

99411 ....... ............. Preventive counseling, group ................... N XXXXX ..... ............. PSYCHIATRIST.

99412 ....... ............. Preventive counseling, group ................... N XXXXX ..... ............. PSYCHIATRIST.

G0102 ...... ............. Prostate ca screening; dre ....................... A XXXXX ..... ............. UROLOGIST.

G0114 ...... ............. Nett; psychosocial consult ........................ R XXXXX ..... ............. PSYCHIATRIST.

G0121 ...... ............. Colon ca scrn not hi rsk ind ..................... N XXXXX ..... ............. AVG NON SURGICAL.

G0128 ...... ............. CORF skilled nursing service ................... R XXXXX ..... ............. NURSE PRACTITIONER.

G0166 ...... ............. Extrnl counterpulse, per tx ....................... A XXXXX ..... ............. NURSE PRACTITIONER.

G0167 ...... ............. Hyperbaric oz tx;no md reqrd .................. A XXXXX ..... ............. NURSE PRACTITIONER.

G0168 ...... ............. Wound closure by adhesive ..................... A XXXXX ..... ............. NURSE PRACTITIONER.

G0169 ...... ............. Removal tissue; no anesthsia .................. A XXXXX ..... ............. AVG SURGICAL.

G0170 ...... ............. Skin biograft ............................................. A 15350 ...... ............. Skin homograft.

G0171 ...... ............. Skin biograft add-on ................................. A 15350 ...... ............. Skin homograft.

Q0068 ...... ............. Extracorpeal plasmapheresis ................... D XXXXX ..... ............. AVG NON SURGICAL.

[FR Doc. 00–27833 Filed 10–31–00; 8:45 am]

BILLING CODE 4210–01–P