DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Medicare & Medicaid Services 

42 CFR Part 414 

CMS-1582-PN 

RIN 0938-AQ87 

Medicare Program; Five-Year Review of Work Relative Value Units Under the Physician 

Fee Schedule 

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

ACTION: Proposed notice. 

SUMMARY: This proposed notice sets forth proposed revisions to work relative value units 

(RVUs) and corresponding changes to the practice expense and malpractice RVUs affecting 

payment for physicians' services. The statute requires that we review RVUs no less often than 

every 5 years. This is our Fourth Five-Year Review of Work RVUs since we implemented the 

physician fee schedule (PFS) on January 1, 1992. These revisions to work RVUs are proposed to 

be effective for services furnished beginning January 1, 2012. These revisions reflect changes in 

medical practice and coding that affect the relative amount of physician work required to 

perform each service as required by the statute. The Fourth Five-Year Review of Work includes 

services that were submitted through public comment and by the Medicare contractor medical 

directors (CMDs), as well as a number of potentially misvalued codes identified by CMS (that is, 

Harvard valued codes and codes with Site-of-Service anomalies). 

DATE: To be assured consideration, comments must be received at one of the addresses 

provided below, no later than 5 p.m. on July 25, 2011.

ADDRESSES: In commenting, please refer to file code CMS-1582-PN. Because of staff and 
CMS-1582-PN 2

resource limitations, we cannot accept comments by facsimile (FAX) transmission. 

 You may submit comments in one of four ways (please choose only one of the ways 

listed) 

1. Electronically. You may submit electronic comments on this regulation to 

http://www.regulations.gov. Follow the "Submit a comment" instructions. 

 2. By regular mail. You may mail written comments to the following address ONLY: 

 Centers for Medicare & Medicaid Services, 

Department of Health and Human Services, 

Attention: CMS-1582-PN, 

P.O. Box 8013, 

Baltimore, MD 21244-8013. 

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

comment period. 

3. By express or overnight mail. You may send written comments to the following 

address ONLY: 

 Centers for Medicare & Medicaid Services, 

 Department of Health and Human Services, 

 Attention: CMS-1582-PN, 

 Mail Stop C4-26-05, 

 7500 Security Boulevard, 

Baltimore, MD 21244-1850. 

4. By hand or courier. If you prefer, you may deliver (by hand or courier) your 
CMS-1582-PN 3

written comments before the close of the comment period to either of the following addresses: 

a. For delivery in Washington, DC-- 

 Centers for Medicare & Medicaid Services, 

Department of Health and Human Services, 

Room 445-G, Hubert H. Humphrey Building, 

 200 Independence Avenue, SW., 

 Washington, DC 20201 

(Because access to the interior of the Hubert H. Humphrey Building is not readily 

available to persons without Federal government identification, commenters are encouraged to 

leave their comments in the CMS drop slots located in the main lobby of the building. A stampin clock is available for persons wishing to retain a proof of filing by stamping in and retaining 

an extra copy of the comments being filed.) 

b. For delivery in Baltimore, MD-- 

 Centers for Medicare & Medicaid Services, 

Department of Health and Human Services, 

7500 Security Boulevard, 

Baltimore, MD 21244-1850. 

If you intend to deliver your comments to the Baltimore address, please call telephone 

number (410) 786-9994 in advance to schedule your arrival with one of our staff members. 

 Comments mailed to the addresses indicated as appropriate for hand or courier delivery 

may be delayed and received after the comment period. 

For information on viewing public comments, see the beginning of the 
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"SUPPLEMENTARY INFORMATION" section. 

FOR FURTHER INFORMATION CONTACT: 

Erin Smith, (410) 786–4497, for issues related to physician payment and for all other issues not 

identified below. 

Elizabeth Truong, (410) 786-6005, or Sara Vitolo, (410) 786-5714, for issues related to work 

RVUs. 

Ryan Howe, (410) 786-3355, for issues related to PE RVUs. 

SUPPLEMENTARY INFORMATION: 

Inspection of Public Comments: All comments received before the close of the comment period 

are available for viewing by the public, including any personally identifiable or confidential 

business information that is included in a comment. We post all comments received before the 

close of the comment period on the following Web site as soon as possible after they have been 

received: http://regulations.gov. Follow the search instructions on that Web site to view public 

comments. 

 Comments received timely will be also available for public inspection as they are 

received, generally beginning approximately 3 weeks after publication of a document, at the 

headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, 

Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To 

schedule an appointment to view public comments, phone 1-800-743-3951. 
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Table of Contents 

I. Background 

 A. History 

B. Physician Fee Schedule Rulemaking 

C. The Five-Year Review Process 

1. Identification of CPT Codes for Review 

2. Background on American Medical Association/Specialty Society Relative Value Update 

Committee (AMA RUC) Recommendations AMA RUC 

3. Five-Year Review of Work Process 

II. CMS Review of Five-Year Review Codes 

A. CMS Analytical Approach 

B. Summary of Proposed Work RVUs for Five-Year Review Codes 

C. Code-Specific Discussions of Proposed Alternative Work RVUs 

1. Drainage of Hematoma 

2. Wound Repair 

3. Skin Grafts 

4. Destruction of Skin Lesions 

5. Partial Mastectomy 

6. Percutaneous Vertebroplasty/Kyphoplasty 

7. Closed Treatment of Distal Radial Fracture 

8. Orthopaedic Surgery – Thigh/Knee 

9. Treatment of Ankle Fracture 
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10. Orthopaedic Surgery/Podiatry 

11. Application of Cast and Strapping 

12. Cardiothoracic Surgery 

13. Vascular Surgery 

14. Excise Parotid Gland/Lesion 

15. Endoscopic Cholangiopancreatography 

16. Sigmoidoscopy 

17. Laparoscopic Cholecystectomy 

18. Hernia Repair 

19. Laparoscopic Hernia Repair 

20. Urologic Procedures 

21. Removal of Thyroid/Parathyroid 

22. Implant Neuroelectrodes 

23. Injection of Anesthetic Agent 

24. Gastric Emptying Study 

25. Nasopharyngoscopy 

26. Cardiopulmonary Resuscitation 

27. Osteopathic Manipulative Treatment 

28. Observation Care 

D. HCPAC-Recommended Work RVUs--Excision of Nail 

E. CPT Codes Identified through the Five-Year Review Process, but not Reviewed by CMS 

1. CPT Codes Referred to CPT Editorial Board 
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2. CPT Codes Withdrawn from the Five-Year Review 

3. CPT Codes that are Interim Final for CY 2011 

4. CPT Codes for Preventive Medicine Services 

F. Resource-Based Practice Expense RVUs 

1. Overview 

2. Practice Expense Methodology 

a. Direct Practice Expense 

b. Indirect Practice Expense per Hour Data 

c. Allocation of Practice Expense to Services 

d. Facility and Nonfacility Costs 

e. Services With Technical Components and Professional Components 

f. Practice Expense RVU Methodology 

3. Practice Expense RVUs for Codes Included in the Five-Year Review 

a. Changes to Direct Practice Expense Inputs 

(1). Changes in Intra-service Physician Time in the Nonfacility Setting 

(2). Changes in Hospital Discharge Management Services in the Facility Setting 

(3). Changes in the Number or Level of Postoperative Office Visits in the Global Period 

b. Changes in Components of the Indirect Practice Expense Methodology 

(1.) Work RVUs, Direct PE RVUs, and Clinical Labor PE RVUs. 

(2.) Physician Time 

G. Malpractice RVUs 

III. Budget Neutrality 
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IV. Collection of Information Requirements 

V. Regulatory Impact Analysis 

A. Overall Impact 

B. Anticipated Effects: Impact on Beneficiaries 

C. Alternatives Considered 

D. Accounting Statement and Table 

E. Conclusion 

Addendum A: Explanation and Use of Addendum B 

Addendum B: Relative Value Units and Related Information 

Addendum C: Codes With Work RVUs Subject to Comment 

In addition, because of the many organizations and terms to which we refer by acronym 

in this proposed notice, we are listing these acronyms and their corresponding terms in 

alphabetical order below: 

AAD American Academy of Dermatology 

AAN American Academy of Neurology 

AANEM American Association of Neuromuscular and Electrodiagnostic Medicine 

AAFP American Academy of Family Physicians 

AAGP American Association for Geriatric Psychiatry 

AAHCP American Academy of Home Care Physicians 

AANS American Association of Neurological Surgeons 

AAO American Academy of Ophthalmology 

AAO-HNS American Academy of Otolaryngology—Head and Neck Surgery 

AAOA American Academy of Otolaryngic Allergy 

AAOS American Academy of Orthopaedic Surgeons 

AAP American Academy of Pediatrics 
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AAPM American Academy of Pain Medicine 

AAPMR American Academy of Physical Medicine and Rehabilitation 

AATS American Association for Thoracic Surgery 

ACC American College of Cardiology 

ACG American College of Gastroenterology 

ACNS American Clinical Neurophysiology Society 

ACOG American College of Obstetricians and Gynecologists 

ACR American College of Radiology 

ACS American College of Surgeons 

AFROC Association of Freestanding Radiation Oncology Centers 

AGA American Gastroenterological Association 

AGS American Geriatric Society 

AK Actinic keratoses 

AMA American Medical Association 

AMDA American Medical Directors Association 

AOA American Optometric Association 

ASA American Society of Anesthesiologists 

ASC Ambulatory surgical center 

ASCRS American Society of Colon and Rectal Surgeons 

ASGE American Society of Gastrointestinal Endoscopy 

ASHA American Speech-Language-Hearing Association 

ASPS American Society of Plastic Surgeons 

ASSH American Society for Surgery of the Hand 

ASTRO American Society for Therapeutic Radiology and Oncology 

AUA American Urological Association 

BBA 97 Balanced Budget Act of 1997 (Pub. L. 105-33) 

BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget 

Refinement Act of 1999 (Pub. L. 106-113) 

BNF Budget neutrality factor 
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CAPU Coalition for the Advancement of Prosthetic Urology 

CF Conversion factor 

CNS Congress of Neurological Surgeons 

CPEP Clinical Practice Expert Panels 

CPT Current Procedural Terminology 

CY Calendar year 

DRG Diagnosis-Related Group 

E/M Evaluation and management 

FR Federal Register

HCPAC Health Care Professionals Advisory Committee 

HCPCS Healthcare Common Procedure Coding System 

HHS Health and Human Services 

ICU Intensive care unit 

IDTF Independent diagnostic testing facility 

IWPUT Intra-service work per unit of time 

JCAAI Joint Council of Allergy, Asthma, and Immunology 

MMA Medicare Prescription Drug, Improvement, and Modernization Act of 2003 

(Pub. L. 108-173) 

MMSV Minimum multi-specialty visit 

MPC [the RUC’s] Multi-Specialty Points of Comparison 

NCQDIS National Coalition of Quality Diagnostic Imaging Services 

NPWP Non-physician work pool 

NSQIP National Surgical Quality Improvement Program 

PC Professional component 

PE Practice Expense 

PE/HR Practice expense per hour 

PEAC Practice Expense Advisory Committee 

PERC Practice Expense Review Committee 

PFS Physician fee schedule 
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RFA Regulatory Flexibility Act 

RIA Regulatory impact analysis 

RN Registered nurse 

RUC [AMA's Specialty Society] Relative [Value] Update Committee 

RVU Relative value unit 

SMS [AMA’s] Socioeconomic Monitoring System 

SNF Skilled nursing facility 

STS Society of Thoracic Surgeons 

SVS Society for Vascular Surgery 

TC Technical component 

VA [Department of] Veteran Affairs 

CPT (Current Procedural Terminology) Copyright Notice 

 Throughout this proposed rule, we use CPT codes and descriptions to refer to a variety of 

services. We note that CPT codes and descriptions are copyright 2010 American Medical 

Association. All Rights Reserved. CPT is a registered trademark of the American Medical 

Association (AMA). Applicable FARS/DFARS apply. 

I. Background 

A. 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." Section 1848 of the Act 

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. 
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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 (PE), and 

malpractice expense. In order to establish physician work, PE, and malpractice expense RVUs, 

section 1848(c)(2)(K)(iii) of the Act (as added by section 3134 of the Patient Protection and 

Affordable Care Act (Pub. L. 111-148) (hereinafter the "Affordable Care Act") also specifies that 

the Secretary may use existing processes to receive recommendations on the review and 

appropriate adjustment of potentially misvalued services. Section 1848(c)(2)(B)(i) of the Act 

requires that we review RVUs no less often than every 5 years. 

 The statute also specifies a budget neutrality requirement. Specifically, section 

1848(c)(2)(B)(ii)(II) of the Act requires that increases or decreases in RVUs may not cause the 

amount of expenditures under Part B for the year to differ more than $20 million from what it 

would have been in the absence of these changes. If this threshold is exceeded, we are required 

to make adjustments to preserve budget neutrality. 

B. Physician Fee Schedule Rulemaking

 On an annual basis, we publish regulations relating to updates to the RVUs and revisions 

to the payment policies under the PFS. Most recently, in the calendar year (CY) 2011 PFS final 

rule with comment period that was published in the Federal Register on November 29, 2010 

(75 FR 73170) (hereinafter referred to as the CY 2011 PFS final rule with comment period), we 

finalized most of the CY 2010 interim physician work, PE, and malpractice RVUs; issued new 

interim work, PE, and malpractice RVUs for new and revised codes for CY 2011; and finalized 

several other payment policies related to the PFS. In the January 11, 2011 Federal Register 
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(76 FR 1670), we published a correction notice that identified and corrected a number of 

technical and typographical errors in the CY 2011 PFS final rule with comment period. The 

provisions of the correction notice were effective January 1, 2010. 

As noted previously, section 1848(c)(2)(B)(i) of the Act requires that we review RVUs 

no less often than every 5 years. We implemented the PFS effective for services furnished 

beginning January 1, 1992. The First Five-Year Review of Work was initiated in 

December 1994, and was effective for services furnished beginning January 1, 1997. The 

Second Five-Year Review of Work was initiated in November 1999, and was effective for 

services furnished beginning January 1, 2002. The Third Five-Year Review of Work was 

initiated in November 2004, and was effective for services furnished beginning January 1, 2007. 

The Fourth Five-Year Review of Work, the subject of this proposed notice, was initiated in 

November 2009 and will be effective for services furnished beginning January 1, 2012. 

This proposed notice describes the Fourth Five-Year Review of Work and sets forth 

proposed revisions to work RVUs resulting from the latest Review. This proposed notice also 

sets forth corresponding proposed changes to PE and malpractice RVUs affecting payment for 

physicians' services. Proposed revisions of physician work RVUs in this proposed notice and 

corresponding proposed changes to the PE and malpractice RVUs are subject to a 60-day public 

comment period. We will review public comments, make adjustments to our proposals in 

response to comments, as appropriate, and include final values in the CY 2012 PFS final rule 

with comment period, effective for services furnished beginning January 1, 2012. 

We note that with each PFS rule, we provide a summary table ("Addendum B") of 

physician work, PE, and malpractice RVUs by HCPCS code for all services under the PFS. For 
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this proposed notice, to create Addendum B, we retained the current CY 2011 RVUs for most 

codes and displayed new RVUs for only those codes involved in the Fourth Five-Year Review of 

Work. PE RVUs for these Five-Year Review codes were calculated using CY 2009 Medicare 

PFS utilization data in order to maintain consistency with the current CY 2011 RVUs displayed 

for all other services. 

We note that the Addendum B that will appear in the upcoming CY 2012 PFS proposed 

rule, where the annual updates to the RVUs and revisions to the payment policies under the PFS 

are customarily proposed, will include PE RVUs recalculated using the most recently available 

Medicare PFS utilization data and reflect other changes that would result from proposed 

revisions to PFS payment policies for CY 2012 that also would be effective beginning 

January 1, 2012. 

C. The Five-Year Review Process

1. Identification of CPT Codes for Review 

We initiated the Fourth Five-Year Review of Work by soliciting public comments in the 

CY 2010 PFS final rule with comment period that was published in the Federal Register on 

November 25, 2009 (74 FR 61738 and 61941) on potentially misvalued codes for all services. In 

response to our solicitation of potentially misvalued codes, we received comments from 

approximately 16 specialty groups, organizations, and individuals involving 113 Current 

Procedural Terminology (CPT) codes. Ten additional codes were submitted by the Medicare 

contractor medical directors (CMDs). Furthermore, CMS identified 96 services that we believed 

should be reviewed as part of the Fourth Five-Year Review of Work. These services fall within 

the two categories described in the CY 2010 PFS final rule with comment period: 1) codes that 
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were not previously reviewed by the AMA RUC, specifically, Harvard-valued codes with an 

annual utilization of > 30,000 services, and 2) codes that are valued as being performed in the 

inpatient setting, but that are now performed predominantly on an outpatient basis (codes with 

Site-of-Service anomalies). For Site-of-Service anomaly codes, we also applied additional 

selection criteria. Specifically, the codes we selected for the Fourth Five-Year Review of Work 

contained at least one inpatient hospital visit in their value and the most recently available 

Medicare PFS claims data at that time showed annual allowed charges of greater than $1 million. 

The following tables list the codes identified for the Fourth Five-Year Review of Work. 

TABLE 1: HARVARD-VALUED CODES WITH ANNUAL 

UTILIZATION > 30,000 SERVICES 

CPT 

Code Mod Status Indicator Short Descriptor CY 2010 

Work RVU 

10140 A Drainage of hematoma/fluid 1.58

10160 A Puncture drainage of lesion 1.25

11732 A Remove nail plate, add-on 0.57

11765 A Excision of nail fold, toe 0.74

11901 A Added skin lesions injection 0.80

12011 A Repair superficial wound(s) 1.81

12013 A Repair superficial wound(s) 2.04

12031 A Intmd wnd repair s/tr/ext 2.20

12051 A Intmd wnd repair face/mm 2.52

13101 A Repair of wound or lesion 3.96

15260 A Skin full graft een & lips 11.64

17250 A Chemical cautery, tissue 0.50

17271 A Destruction of skin lesions 1.54

17272 A Destruction of skin lesions 1.82

17280 A Destruction of skin lesions 1.22

25600 A Treat fracture radius/ulna 2.78

28285 A Repair of hammertoe 4.76

29125 A Apply forearm splint 0.59

29405 A Apply short leg cast 0.86

29515 A Application lower leg splint 0.73

29550 A Strapping of toes 0.47

29826 A Shoulder arthroscopy/surgery 9.16
CMS-1582-PN 16

CPT 

Code Mod Status Indicator Short Descriptor CY 2010 Work RVU 

29880 A Knee arthroscopy/surgery 9.45

29881 A Knee arthroscopy/surgery 8.71

32405 A Biopsy, lung or mediastinum 1.93

36010 A Place catheter in vein 2.43

36200 A Place catheter in aorta 3.02

36215 A Place catheter in artery 4.67

36216 A Place catheter in artery 5.27

36246 A Place catheter in artery 5.27

36247 A Place catheter in artery 6.29

36471 A Injection therapy of veins 1.65

36600 A Withdrawal of arterial blood 0.32

37620 A Revision of major vein 11.57

43262 A Endo cholangiopancreatograph 7.38

45331 A Sigmoidoscopy and biopsy 1.15

47000 A Needle biopsy of liver 1.90

47563* A Laparo cholecystectomy/graph 12.11

51705 A Change of bladder tube 1.05

52005 A Cystoscopy & ureter catheter 2.37

52310 A Cystoscopy and treatment 2.81

62284 A Injection for myelogram 1.54

64405 A N block inj, occipital 1.32

67810 A Biopsy of eyelid 1.48

69220 A Clean out mastoid cavity 0.83

78264 26 A Gastric emptying study 0.78

92070 A Fitting of contact lens 0.70

92120 A Tonography & eye evaluation 0.81

92511 A Nasopharyngoscopy 0.84

92950 A Heart/lung resuscitation cpr 3.79

93321 26 A Doppler echo exam, heart 0.15

98925 A Osteopathic manipulation 0.45

98928 A Osteopathic manipulation 1.03

98929 A Osteopathic manipulation 1.19

99218 A Observation care 1.28

99219 A Observation care 2.14

99220 A Observation care 2.99

 *CPT code 47563 is also identified on the Site-of-Service anomaly list. 
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TABLE 2: CODES SUBMITTED BY CONTRACTOR MEDICAL DIRECTORS 

CPT 

Code Mod Status Indicator Short Descriptor CY 2010 Work RVU 

11040 A Debride skin, partial 0.50

11041 A Debride skin, full 0.60

11042 A Debride skin/tissue 0.80

11043 A Debride tissue/muscle 3.14

11044 A Debride tissue/muscle/bone 4.26

88305 26 A Tissue exam by pathologist 0.75

88307 26 A Tissue exam by pathologist 1.59

88309 26 A Tissue exam by pathologist 2.8

95920 26 A Intraop nerve test add-on 2.11

94660 A Pos airway pressure, CPAP 0.76

TABLE 3: CODES SUBMITTED BY COMMENTERS ON CY 2010 PFS FINAL RULE 

CPT 

Code 

Status 

Indicator Short Descriptor CY 2010 Work RVU 

21365 A Treat cheek bone fracture 16.77 

21470 A Treat lower jaw fracture 17.54 

32851 A Lung transplant, single 41.61 

32852 A Lung transplant with bypass 45.48 

32853 A Lung transplant, double 50.78 

32854 A Lung transplant with bypass 54.74 

33030 A Partial removal of heart sac 22.39 

33031 A Partial removal of heart sac 25.38 

33315 A Exploratory heart surgery 26.17 

33412 A Replacement of aortic valve 43.94 

33468 A Revision of tricuspid valve 32.94 

33645 A Revision of heart veins 28.10 

33647 A Repair heart septum defects 29.53 

33692 A Repair of heart defects 31.54 

33710 A Repair of heart defects 30.41 

33875 A Thoracic aortic graft 35.78 

33910 A Remove lung artery emboli 29.71 

33916 A Surgery of great vessel 28.42 

33935 R Transplantation, heart/lung 62.01 

33975 A Implant ventricular device 20.97 

33976 A Implant ventricular device 22.97 

33977 A Remove ventricular device 20.28 
CMS-1582-PN 18

CPT 

Code 

Status 

Indicator Short Descriptor CY 2010 Work RVU 

33978 A Remove ventricular device 22.72 

33979 A Insert intracorporeal device 45.93 

33980 A Remove intracorporeal device 65.20 

33981 C Replace vad pump ext 0.00 

33982 C Replace vad intra w/o bp 0.00 

33983 C Replace vad intra w/bp 0.00 

35188 A Repair blood vessel lesion 15.16 

35612 A Artery bypass graft 16.82 

35800 A Explore neck vessels 8.07 

35840 A Explore abdominal vessels 10.96 

35860 A Explore limb vessels 6.80 

36470 A Injection therapy of vein 1.10 

36471* A Injection therapy of veins 1.65 

37140 A Revision of circulation 25.23 

37145 A Revision of circulation 26.24 

37160 A Revision of circulation 23.24 

37180 A Revision of circulation 26.24 

37181 A Splice spleen/kidney veins 28.37 

42426 A Excise parotid gland/lesion 22.66 

43425 A Repair esophagus opening 25.04 

90801 A Psy dx interview 2.80 

90802 A Intac psy dx interview 3.01 

90804 A Psytx, office, 20-30 min 1.21 

90805 A Psytx, off, 20-30 min w/e&m 1.37 

90806 A Psytx, off, 45-50 min 1.86 

90807 A Psytx, off, 45-50 min w/e&m 2.02 

90808 A Psytx, office, 75-80 min 2.79 

90809 A Psytx, off, 75-80, w/e&m 2.95 

90810 A Intac psytx, off, 20-30 min 1.32 

90811 A Intac psytx, 20-30, w/e&m 1.48 

90812 A Intac psytx, off, 45-50 min 1.97 

90813 A Intac psytx, 45-50 min w/e&m 2.13 

90814 A Intac psytx, off, 75-80 min 2.90 

90815 A Intac psytx, 75-80 w/e&m 3.06 

90816 A Psytx, hosp, 20-30 min 1.25 

90817 A Psytx, hosp, 20-30 min w/e&m 1.41 

90818 A Psytx, hosp, 45-50 min 1.89 

90819 A Psytx, hosp, 45-50 min 2.05 

90821 A Psytx, hosp, 75-80 min 2.83 

90822 A Psytx, hosp, 75-80 min w/e&m 2.99 
CMS-1582-PN 19

CPT 

Code 

Status 

Indicator Short Descriptor CY 2010 Work RVU 

90823 A Intac psytx, hosp, 20-30 min 1.36 

90824 A Intac psytx, hsp 20-30 w/e&m 1.52 

90826 A Intac psytx, hosp, 45-50 min 2.01 

90827 A Intac psytx, hsp 45-50 w/e&m 2.16 

90828 A Intac psytx, hosp, 75-80 min 2.94 

90829 A Intac psytx, hsp 75-80 w/e&m 3.10 

90845 A Psychoanalysis 1.79 

90846 R Family psytx w/o patient 1.83 

90847 R Family psytx w/patient 2.21 

90849 R Multiple family group psytx 0.59 

90853 A Group psychotherapy 0.59 

90857 A Intac group psytx 0.63 

90862 A Medication management 0.95 

90870 A Electroconvulsive therapy 1.88 

90875 N Psychophysiological therapy 1.20 

90876 N Psychophysiological therapy 1.90 

90880 A Hypnotherapy 2.19 

99026 N In-hospital on call service 0.00 

99027 N Out-of-hosp on call service 0.00 

99218* A Observation care 1.28 

99219* A Observation care 2.14 

99220* A Observation care 2.99 

99288 B Direct advanced life support 0.00 

99315 A Nursing fac discharge day 1.13 

99316 A Nursing fac discharge day 1.50 

99341 A Home visit, new patient 1.01 

99342 A Home visit, new patient 1.52 

99343 A Home visit, new patient 2.53 

99344 A Home visit, new patient 3.38 

99345 A Home visit, new patient 4.09 

99347 A Home visit, est patient 1.00 

99348 A Home visit, est patient 1.56 

99349 A Home visit, est patient 2.33 

99350 A Home visit, est patient 3.28 

99381 N Init pm e/m, new pat, inf 1.19 

99382 N Init pm e/m, new pat 1-4 yrs 1.36 

99383 N Prev visit, new, age 5-11 1.36 

99384 N Prev visit, new, age 12-17 1.53 

99385 N Prev visit, new, age 18-39 1.53 

99386 N Prev visit, new, age 40-64 1.88 
CMS-1582-PN 20

CPT 

Code 

Status 

Indicator Short Descriptor CY 2010 Work RVU 

99387 N Init pm e/m, new pat 65+ yrs 2.06 

99391 N Per pm reeval, est pat, inf 1.02 

99392 N Prev visit, est, age 1-4 1.19 

99393 N Prev visit, est, age 5-11 1.19 

99394 N Prev visit, est, age 12-17 1.36 

99395 N Prev visit, est, age 18-39 1.36 

99396 N Prev visit, est, age 40-64 1.53 

99397 N Per pm reeval est pat 65+ yr 1.71 

99460 A Init nb em per day, hosp 1.17 

99462 A Sbsq nb em per day, hosp 0.62 

99463 A Same day nb discharge 1.50 

*CPT code 36471, 99218, 99219, and 99220 are also identified on the Harvard-valued codes with annual 

utilization > 30,000 services list. 

TABLE 4: CODES WITH SITE-OF-SERVICE ANOMALIES 

CPT Code Mod Status 

Indicator Short Descriptor 

CY 2010

Work 

RVU 

15120 A Skn splt a-grft fac/nck/hf/g 11.16

15240 A Skin full grft face/genit/hf 10.41

15365 A Apply cult derm sub f/n/hf/g 4.30

15732 A Muscle-skin graft, head/neck 19.90

15740 A Island pedicle flap graft 11.80

19302 A P-mastectomy w/ln removal 13.99

22521 A Percut vertebroplasty lumb 8.65

22523 A Percut kyphoplasty, thor 9.26

27385 A Repair of thigh muscle 8.11

27530 A Treat knee fracture 4.09

27792 A Treatment of ankle fracture 9.71

28002 A Treatment of foot infection 5.93

28122 A Partial removal of foot bone 7.72

28715 A Fusion of foot bones 14.60

28820 A Amputation of toe 5.00

28825 A Partial amputation of toe 6.01

33411 A Replacement of aortic valve 62.07

36819 A Av fuse, uppr arm, basilic 14.47

36821 A Av fusion direct any site 12.11

42415 A Excise parotid gland/lesion 18.12
CMS-1582-PN 21

CPT Code Mod Status 

Indicator Short Descriptor 

CY 2010

Work 

RVU 

47563* A Laparo cholecystectomy/graph 12.11

49421 A Insert abdom drain, perm 5.90

49507 A Prp i/hern init block >5 yr 10.05

49587 A Rpr umbil hern, block > 5 yr 8.04

49652 A Lap vent/abd hernia repair 12.88

49653 A Lap vent/abd hern proc comp 16.21

49654 A Lap inc hernia repair 15.03

49655 A Lap inc hern repair comp 18.11

52630 A Remove prostate regrowth 7.73

52649 A Prostate laser enucleation 17.29

53440 A Male sling procedure 15.54

57288 A Repair bladder defect 12.13

60220 A Partial removal of thyroid 12.37

60240 A Removal of thyroid 16.22

60500 A Explore parathyroid glands 16.78

61885 A Insrt/redo neurostim 1 array 7.57

63655 A Implant neuroelectrodes 11.56

64626 A Destr paravertebrl nerve c/t 3.92

77427 A Radiation tx management, x5 3.70

*CPT code 47563 is also identified on the Harvard-valued codes with annual utilization > 30,000 services 

list. 

2. Background on American Medical Association Specialty Society Relative Value Update 

Committee (AMA RUC) Recommendations 

Section 1848(c)(2)(K)(iii) of the Act (as added by section 3134 of the Affordable Care 

Act) specifies that the Secretary may use existing processes to receive recommendations on the 

review and appropriate adjustment of potentially misvalued services. In accordance with section 

1848(c)(2)(K)(iii) of the Act, we develop and propose appropriate adjustments to the RVUs, 

taking into account the recommendations provided by the AMA RUC, the Medicare Payment 

Advisory Commission (MedPAC), and others. To respond to concerns expressed by MedPAC, 

the Congress, and other stakeholders regarding the accuracy of values for services under the PFS, 
CMS-1582-PN 22

the AMA RUC has used an annual process to systematically identify, review, and provide CMS 

with recommendations for revised work values for many existing potentially misvalued services. 

In addition to providing recommendations to CMS for work RVUs, the AMA RUC also reviews 

direct PE (clinical labor, medical supplies, and medical equipment) for individual services and 

examines the many broad methodological issues relating to the development of PE RVUs. 

For many years, the AMA RUC has provided CMS with recommendations on the 

appropriate relative values for PFS services. The AMA RUC’s recommendations on physician 

work RVUs have resulted in significant refinements in physician work RVUs over the years. In 

recent years CMS and the AMA RUC have taken increasingly significant steps to address 

potentially misvalued codes. As MedPAC noted in its March 2009 Report to Congress, in the 

intervening years since MedPAC made the initial recommendations, "CMS and the AMA RUC 

have taken several steps to improve the review process." In addition to the Five-Year Reviews 

of Work, over the past several years CMS and the AMA RUC have identified and reviewed a 

number of potentially misvalued codes on an annual basis based on various identification screens 

for codes at risk for being misvalued, such as codes with high growth rates, codes that are 

frequently billed together in one encounter, and codes that are valued as inpatient services but 

that are now predominantly performed as outpatient services. This annual review of work RVUs 

and direct PE inputs for potentially misvalued codes was further bolstered by the Affordable 

Care Act mandate to examine potentially misvalued codes, with an emphasis on the following 

categories specified in section 1848(c)(2)(K)(ii) (as added by section 3134 of the Affordable 

Care Act): 

• Codes and families of codes for which there has been the fastest growth. 
CMS-1582-PN 23

• Codes or families of codes that have experienced substantial changes in practice 

expenses. 

• Codes that are recently established for new technologies or services. 

• Multiple codes that are frequently billed in conjunction with furnishing a single 

service. 

• Codes with low relative values, particularly those that are often billed multiple times 

for a single treatment. 

• Codes which have not been subject to review since the implementation of the RBRVS 

(the 'Harvard valued codes'). 

• Other codes determined to be appropriate by the Secretary. (For example, codes for 

which there have been shifts in the Site-of-Service (Site-of-Service anomalies), as well as codes 

that qualify as "23-hour stay" outpatient services.) 

As a result of the annual potentially misvalued code review, CMS has reviewed over 700 

codes for work and PE RVU changes outside of the comprehensive Five-Year Review process 

over the past several years and adopted appropriate work RVUs and direct PE inputs for these 

services in the context of contemporary medical practice. 

This Fourth Five-Year Review of Work advances the progress of our initiative to 

examine potentially misvalued codes by identifying and reviewing additional codes for CY 2012 

in several of the categories specified in the Affordable Care Act, including a number of 

Harvard-valued codes. As noted previously, we typically discuss the potentially misvalued 

codes initiative in the annual PFS proposed and final rules (for CY 2011, at 75 FR 40065 through 

40082 and 75 FR 73215 through 73216, respectively). For example, we provided a detailed 
CMS-1582-PN 24

discussion of the prior reviews of potentially misvalued codes in the CY 2011 PFS final rule with 

comment period (75 FR 73215 through73216). Furthermore, in addition to the proposals in this 

Five-Year Review of Work proposed notice, we plan to continue our work examining potentially 

misvalued codes for CY 2012 in the areas specified by the Affordable Care Act and others 

identified by the Secretary, consistent with the new legislative mandate on this issue. We will 

provide a comprehensive update regarding our progress to date in evaluating and revising the 

values for potentially misvalued codes, and discuss our priorities and future plans to ensure the 

accuracy of the relative values for all services paid under the PFS in the forthcoming CY 2012 

PFS proposed rule. 

We greatly appreciate the considerable sustained efforts made by all members and staff of the 

AMA RUC to date, and we look forward to continuing our collaborative work with the AMA 

RUC toward our mutual goal of ensuring that CPT codes are appropriately valued under the PFS. 

For codes used primarily by nonphysician practitioners, the Health Care Professionals 

Advisory Committee (HCPAC), a deliberative body of nonphysician practitioners that also 

convenes during the AMA RUC meeting, submits recommendations directly to CMS. The 

HCPAC represents physician assistants, chiropractors, nurses, occupational therapists, 

optometrists, physical therapists, podiatrists, psychologists, audiologists, speech pathologists, 

social workers, and registered dieticians. We greatly appreciate the efforts of the HCPAC as 

well. 

3. AMA RUC Five-Year Review of Work Process 

After compiling the list of potentially misvalued codes to be reviewed in the Fourth 

Five-Year Review of Work (Tables 1 through 4), we submitted the list to the AMA RUC. 
CMS-1582-PN 25

According to the AMA RUC’s Five-Year Review timetable, upon receipt of the list of 

codes from CMS, the AMA RUC sent Level of Interest (LOI) forms to all specialty societies and 

the HCPAC so that the Five-Year Review codes could be reviewed initially by the appropriate 

specialty societies. To prepare for presentations of the codes to the AMA RUC, most specialty 

societies compiled data using a standard survey instrument whereby respondents compared the 

surveyed service with similar "reference" services for which there generally are well-established 

work values. Respondents were asked to estimate: the work RVU for the survey code; the time 

to perform the"pre-","intra-", and"post-" service activities; and the technical skill, risk, and 

judgment involved with performing the service. Post-service activities were broken down into 

hospital and office visits and were assigned an appropriate evaluation and management (E/M) 

code by the respondents for the typical service. Each specialty society was responsible for 

selecting the physician sample size to be surveyed. In general, a minimum of 30 responses was 

required by the AMA RUC for the survey to be considered adequate. It is our understanding that 

the AMA RUC is currently reviewing its survey methodologies in order to improve the survey 

instrument’s ability to provide valid and reliable data. 

As part of the AMA RUC’s process, the specialty societies also provided the AMA RUC 

with a work RVU recommendation for each code under review. The AMA RUC met to hear the 

presentations from the specialty societies for each code, deliberate as a group, and vote on the 

work RVU, physician times, PE direct inputs (if applicable), and other aspects pertaining to the 

valuation of a code. The AMA RUC then sent its recommendations to CMS. As we have stated 

previously in conducting Five-Year Reviews, we retain the responsibility for analyzing any 

comments and recommendations received from the AMA RUC, developing the proposed notice, 
CMS-1582-PN 26

evaluating the comments on the proposed notice, and deciding whether and how to revise the 

work RVUs for any given service. 

II. CMS Review of Five-Year Review Codes 

A. CMS Analytical Approach

We conducted a clinical review of each code and reviewed the AMA RUC 

recommendations for work RVU, time to perform the "pre-","intra-", and "post-" service 

activities, as well as other components of the service which contribute to the value. Our clinical 

review generally includes, but is not limited to, a review of information provided by the AMA 

RUC, medical literature, public comments, and comparative databases, as well as a comparison 

with other codes within the Medicare PFS, consultation with other physicians and healthcare care 

professionals within CMS and the Federal Government, and the clinical experience of the 

physicians on the clinical team. We also assessed the methodology and data used to develop the 

recommendations and the rationale for the recommendations. As we noted in the CY 2011 PFS 

final rule with comment period (75 FR 73328 through 73329), the AMA RUC uses a variety of 

methodologies and approaches to assign work RVUs, including building block, survey data, 

crosswalk to key reference or similar codes, and magnitude estimation. The resource-based 

relative value system (RBRVS) has incorporated into it cross-specialty and cross-organ system 

relativity. This RBRVS requires assessment of relative value and takes into account the clinical 

intensity and time required to perform a service. In selecting which methodological approach 

will best determine the appropriate value for a service we consider the current physician work 

and time values, AMA RUC recommended physician work and time values, and specialty 

society physician work and time values, as well as the intensity of the service, all relative to 
CMS-1582-PN 27

other services. In general, if we had concerns regarding the AMA RUC’s application of a 

particular methodology for a code, we assessed whether the recommended work RVUs were 

appropriate by using alternative methodologies. For a full discussion of our views and concerns 

regarding the various methodologies, we refer readers to the CY 2011 PFS final rule with 

comment period (75 FR 73328 through 73329). During our clinical review to assess the 

appropriate values for the codes included in the Fourth Five-Year Review, several recurring 

scenarios emerged. We developed systematic approaches to address two particular areas of 

concern. 

The first area of concern pertains to codes with Site-of-Service anomalies. These are 

codes that were originally valued as inpatient services but current Medicare PFS claims data 

show they are furnished predominantly as outpatient services. We noted that for nearly all of the 

codes with Site-of-Service anomalies, the accompanying survey data suggest they are "23 hour 

stay" outpatient services. We discussed in the CY 2011 PFS final rule with comment period 

(75 FR 73226 through 73227) the "23 hour stay service," which is a term of art describing 

services that typically have lengthy hospital outpatient recovery periods. For these 23 hour stay 

services, the typical patient is commonly at the hospital for less than 24 hours, but often stays 

overnight at the hospital. For example, if the patient arrives at the hospital at 6 AM for a 

scheduled surgical procedure that typically has a lengthy hospital outpatient recovery period, the 

patient may recover during the day and be ready to be discharged late in the evening without 

having to stay overnight at the hospital. More commonly, however, if the patient arrives at the 

hospital at noon for a surgical procedure that typically has a lengthy hospital outpatient recovery 

period, the patient may stay at the hospital overnight to recover and be discharged the following 
CMS-1582-PN 28

morning. On occasion, the patient may recover at the hospital for longer than a single night, 

either because the patient requires an even longer recovery period or the surgery was performed 

outside of usual business hours. For example, if the patient arrives at the hospital at 11 p.m. and 

requires an unscheduled surgical procedure that typically has a lengthy hospital outpatient 

recovery period, the patient may stay at the hospital overnight in preparation for surgery, have 

the surgical procedure performed, and then stay through another night recovering at the hospital 

before being discharged. In all these cases, unless a treating physician has written an order to 

admit the patient as an inpatient, the patient is considered for Medicare purposes to be a hospital 

outpatient, not an inpatient, and our claims data support that the typical 23 hour stay service is 

billed as an outpatient service. 

We believe that the values of the codes that fall into the 23 hour stay category, that is, 

services that typically have lengthy hospital outpatient recovery periods, should not reflect work 

that is typically associated with an inpatient service. For example, inpatient E/M visit codes such 

as CPT codes 99231 (Level 1 subsequent hospital care, per day); 99232 (Level 2 subsequent 

hospital care, per day); and 99233 (Level 3 subsequent hospital care, per day), should not be 

included at their full RVU value in the valuation of these services that typically have lengthy 

hospital outpatient recovery periods. However, as we stated in the CY 2011 PFS final rule with 

comment period (75 FR 73226 through 73227), we find it is plausible that while the patient 

receiving the outpatient 23 hour stay service remains a hospital outpatient, the patient would 

typically be cared for by a physician during that lengthy recovery period at the hospital. While 

we do not believe that post-procedure hospital visits would be at the inpatient level since the 

typical case is an outpatient who would be ready to be discharged from the hospital in 23 hours 
CMS-1582-PN 29

or less, we believe it is generally appropriate to include the intra-service time of the inpatient 

hospital visit in the immediate post-service time of the 23 hour stay code under review. In 

addition, we indicated that we believe it is appropriate to include a half day, rather than a full 

day, of a discharge day management service. While some commenters advocated for a deferral 

on the issue of valuing 23 hour stay services, we note that a number of commenters supported 

CMS' approach. Consequently, we finalized this policy in the CY 2011 PFS final rule with 

comment period (75 FR 73226 through 73227) and encouraged the AMA RUC to apply this 

methodology in developing the recommendations it provides to us for valuing 23 hour stay 

codes, in order to ensure the consistent and appropriate valuation of the physician work for these 

services. 

The AMA RUC reviewed a number of Site-of-Service anomaly codes during its February 

2011 meeting, many of which are Site-of-Service anomaly codes that have been valued on an 

interim basis since CY 2009. These Site-of-Service anomaly codes typically have a lengthy 

hospital outpatient recovery period and thus would be subject to the policy previously described 

for valuing the post-procedure physician care. CMS had requested that the AMA RUC re-review 

them due to concerns over the methodology the AMA RUC used originally in valuing these 

codes (74 FR 61777 and 75 FR 73221). Contrary to the 23 hour stay policy we finalized in the 

CY 2011 PFS final rule with comment period (75 FR 73226 through 73227), as described above, 

in the AMA RUC’s review of Site-of-Service anomaly codes for CY 2012 as part of this FiveYear Review, the AMA RUC often recommended replacing the hospital inpatient post-operative 

visit blocks in the current work values with blocks for subsequent observation care services, 

specifically CPT codes 99224 (Level 1 subsequent observation care, per day) and 99225 (Level 2 
CMS-1582-PN 30

subsequent observation care, per day), which recently became effective under the PFS beginning 

in CY 2011. The AMA RUC stated in its summary recommendations to CMS, "Adjustments to 

the allocation of post-operative visits are used as proxies and do not constitute changes to the 

physician work relative value of the service which was determined by magnitude estimation and 

physician specialty survey data during the last RUC review." However, we note that the AMA 

RUC generally recommended maintaining the current interim value of the CY 2009 

Site-of-Service anomaly codes while replacing the inpatient hospital visit code blocks with 

subsequent observation care code blocks. 

We continue to be concerned over the AMA RUC’s approach to valuing the physician 

work for these Site-of-Service anomaly codes. We believe the appropriate methodology entails 

accounting for the removal of the inpatient visit blocks in the work value for the Site-of-Service 

anomaly code since these services are no longer typically furnished in the inpatient setting. We 

do not believe it is appropriate to simply exchange the inpatient post-operative visits in the 

original value with subsequent observation care visits (which are appropriately reported in cases 

of nonsurgical hospital outpatient stays spanning 3 calendar days or longer), and maintain the 

current work RVUs. Furthermore, instead of the half discharge day management service 

included in past recommendations (CPT code 99238 (Hospital discharge day management; 30 

minutes or less)), the AMA RUC generally recommended including a full observation care 

discharge day management service (CPT code 99217 (Observation care discharge day 

management (this code is to be utilized by the physician to report all services provided to a 

patient on discharge from “observation status” if the discharge is on other than the initial date of 

“observation status.”))) However, the AMA RUC indicated it is currently assessing this code to 
CMS-1582-PN 31

revise the physician times. We do not believe it is appropriate to substitute a full day of CPT 

code 99217 for the half day of CPT code 99238 that would be included in the work value for a 

Site-of-Service anomaly code according to CMS’ established policy, especially given the AMA 

RUC’s ongoing review of CPT code 99217. 

Accordingly, where the data suggested a Site-of-Service anomaly code (more than 

50 percent of the most recent Medicare utilization is outpatient – based on PFS data from the 

fourth quarter of CY 2009 and the first three quarters of CY 2010 to represent the most recent 

full 12 months of claims data available) resembles a 23 hour stay outpatient service and the 

AMA RUC’s recommended value from the Five-Year Review continued to include inpatient 

visits (or subsequent observation care codes) in the post-operative period, we applied the policy 

described above. That is, we consistently removed any post-procedure inpatient visits or 

subsequent observation care services included in the AMA RUC-recommended values for these 

codes and adjusted physician times accordingly. We also consistently included the value of a 

half day of a discharge management service. 

An additional concern that arose in our clinical review of the codes relates to codes that 

are typically billed with an E/M service on the same day. The AMA RUC noted for a number of 

codes that the service was typically billed with an additional E/M service on the same day; 

however, it appears the AMA RUC did not consistently account for this overlap in formulating 

its time recommendations, an issue discussed on a CPT code-specific basis below. In cases 

where a service is typically furnished with an E/M service on the same day, we believe it is 

understood that there may be overlap between the two services in some of the activities 

conducted during the pre- and post-service times of the procedure code, and that these 
CMS-1582-PN 32

overlapping activities should not be counted twice. Accordingly, in cases where the most 

recently available Medicare PFS claims data show the code is typically (greater than 50 percent 

of the time – based on PFS data from CY 2009) billed with an E/M visit on the same day, and 

where we believe that the AMA RUC did not adequately account for overlapping activities in the 

recommended value for the code, we systematically adjusted the physician times for the code to 

account for the overlap. After clinical review of the pre- and post-service work, we believe that 

at least 1/3 of the physician time in both the pre-service evaluation and post-service period is 

duplicative of the E/M visit in this circumstance. Therefore, we adjusted the pre-service 

evaluation portion of the pre-service time to 2/3 of the AMA RUC-recommended time. 

Similarly, we also adjusted the post-service time to 2/3 of the AMA RUC-recommended time. 

As noted in the CY 2011 proposed rule (75 FR 73328), in reviewing the AMA RUC 

recommendations for valuing the work of new, revised, and potentially misvalued services, we 

expend significant effort in evaluating whether the recommended values reflect the work 

elements, such as time, mental effort, and professional judgment, technical skill and physical 

effort, and stress due to risk, involved with furnishing the service. Subjecting each of the codes 

to a clinical review, we examined the pre-, post-, and intra-service components of the work. In 

cases where we disagreed with the AMA RUC’s recommended work RVU, we proposed 

alternative values based on comparisons with other established reference codes with clinical 

similarity or analogous physician times, or the 25th percentile or low value as indicated in the 

physician survey, or, where applicable, employed the building block approach. 

Over the last several years our rate of acceptance of the AMA RUC recommendations has 

been higher. However, in response to concerns expressed by MedPAC, and other stakeholders 
CMS-1582-PN 33

regarding the accurate valuation of services under the PFS, we have intensified our scrutiny of 

the work valuations of new, revised, and potentially misvalued codes. We note that most 

recently, section 3134 of the Affordable Care Act added a new requirement, which specifies that 

the Secretary shall establish a formal process to validate RVUs under the PFS. The validation 

process may include validation of work elements (such as time, mental effort and professional 

judgment, technical skill and physical effort, and stress due to risk) involved with furnishing a 

service and may include validation of the pre-, post-, and intra-service components of work. 

Furthermore, the Secretary is directed to validate a sampling of the work RVUs of codes 

identified through any of the seven categories of potentially misvalued codes specified by section 

1848(c)(2)(K)(ii) of the Act (as added by section 3134 of the Affordable Care Act). While we 

are currently in the planning stage of developing a formal validation process, we have 

incorporated, where appropriate, the validation principles specified in the law in this Five-Year 

Review process. 

B. Summary of Proposed Work RVUs for Five-Year Review Codes

As stated previously, we sent the AMA RUC an initial list of 219 codes for review. We 

have encouraged the AMA RUC to review codes on a "family" basis rather than in isolation in 

order to ensure that appropriate relativity in the system is retained. Consequently, the AMA 

RUC included additional codes for review, resulting in a total of 290 codes for the Fourth 

Five-Year Review of Work. Of those 290 codes, 53 were subsequently sent to the CPT Editorial 

Panel to consider coding changes, 14 were not reviewed by the AMA RUC (and subsequently 

not reviewed by CMS) because the specialty society that had originally requested the review in 

its public comments on the CY 2010 PFS final rule with comment period elected to withdraw the 
CMS-1582-PN 34

codes, 36 were not reviewed by the AMA RUC because their values were set as interim final in 

the CY 2011 PFS final rule with comment period, and 14 were not reviewed by CMS because 

they were noncovered services under Medicare. Therefore, the AMA RUC reviewed 173 of the 

290 codes initially identified for this Fourth Five-Year Review of Work, and provided the 

recommendations to CMS that are addressed below in this proposed notice. A list of the 

remaining codes that were identified for possible review through the Five-Year Review process 

but not reviewed can be found in section II.E. of this proposed notice. Upon clinical review, we 

are proposing to accept 89 out of 173 (51 percent) of the AMA RUC recommendations for work 

RVUs. In some cases, we also refined physician times for codes as deemed appropriate to 

correspond with the proposed work RVUs. CMS’ decisions are summarized in Table 6. 

In addition, the HCPAC submitted for CMS review its recommendations to modify work 

RVUs for five CPT codes under the Fourth Five-Year Review of Work. Of those five CPT 

codes, three were not reviewed by CMS because the codes were withdrawn by the relevant 

specialty society due to a low survey response rate. We did not accept the HCPAC 

recommendations for the two remaining CPT codes, as detailed in section II.D.1 of this proposed 

notice. 

TABLE 5: AMA RUC AND HCPAC RECOMMENDATIONS, AND PROPOSED 

WORK RVUS FOR THE FOURTH FIVE-YEAR REVIEW OF THE RBRVS 

CPT 

Code Short Descriptor 

CY 

2011 

Work 

RVU 

AMA 

RUC/HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

10140 Drainage of hematoma/fluid 1.58 1.58 1.58 Agree x 

10160 Puncture drainage of lesion 1.25 1.25 1.25 Agree 

11732 Remove nail plate, add-on 0.57 0.48 0.44 Disagree x 

11765 Excision of nail fold, toe 0.74 1.48 1.22 Disagree x 

12031 Intmd wnd repair s/tr/ext 2.20 2.00 2.00 Agree 

12032 Intmd wnd repair s/tr/ext 2.52 2.52 2.52 Agree 
CMS-1582-PN 35

CPT 

Code Short Descriptor 

CY 

2011 

Work 

RVU 

AMA 

RUC/HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

12034 Intmd wnd repair s/tr/ext 2.97 2.97 2.97 Agree 

12035 Intmd wnd repair s/tr/ext 3.47 3.60 3.50 Disagree 

12036 Intmd wnd repair s/tr/ext 4.09 4.50 4.23 Disagree x 

12037 Intmd wnd repair s/tr/ext 4.71 5.25 5.00 Disagree 

12041 Intmd wnd repair n-hf/genit 2.42 2.10 2.10 Agree 

12042 Intmd wnd repair n-hg/genit 2.79 2.79 2.79 Agree 

12044 Intmd wnd repair n-hg/genit 3.19 3.19 3.19 Agree 

12045 Intmd wnd repair n-hg/genit 3.68 3.90 3.75 Disagree 

12046 Intmd wnd repair n-hg/genit 4.29 4.60 4.30 Disagree x 

12047 Intmd wnd repair n-hg/genit 4.69 5.50 4.95 Disagree x 

12051 Intmd wnd repair face/mm 2.52 2.33 2.33 Agree 

12052 Intmd wnd repair face/mm 2.87 2.87 2.87 Agree 

12053 Intmd wnd repair face/mm 3.17 3.17 3.17 Agree 

12054 Intmd wnd repair, face/mm 3.50 3.50 3.50 Agree 

12055 Intmd wnd repair face/mm 4.47 4.65 4.50 Disagree x 

12056 Intmd wnd repair face/mm 5.28 5.50 5.30 Disagree x 

12057 Intmd wnd repair face/mm 6.00 6.28 6.00 Disagree x 

13100 Repair of wound or lesion 3.17 3.17 3.17 Agree x 

13101 Repair of wound or lesion 3.96 3.96 3.96 Agree x 

15120 Skn splt a-grft fac/nck/hf/g 11.16 10.15 10.15 Agree 

15121 Skn splt a-grft f/n/hf/g add 2.67 2.00 2.00 Agree 

15260 Skin full graft een & lips 11.64 11.64 11.64 Agree 

15732 Muscle-skin graft, head/neck 19.90 19.83 16.38 Disagree x 

17250 Chemical cautery, tissue 0.50 0.50 0.50 Agree 

17260 Destruction of skin lesions 0.96 0.96 0.96 Agree 

17261 Destruction of skin lesions 1.22 1.22 1.22 Agree 

17262 Destruction of skin lesions 1.63 1.63 1.63 Agree 

17263 Destruction of skin lesions 1.84 1.84 1.84 Agree 

17264 Destruction of skin lesions 1.99 1.99 1.99 Agree 

17266 Destruction of skin lesions 2.39 2.39 2.39 Agree 

17270 Destruction of skin lesions 1.37 1.37 1.37 Agree x 

17271 Destruction of skin lesions 1.54 1.54 1.54 Agree x 

17272 Destruction of skin lesions 1.82 1.82 1.82 Agree 

17273 Destruction of skin lesions 2.10 2.10 2.10 Agree 

17274 Destruction of skin lesions 2.64 2.64 2.64 Agree x 

17276 Destruction of skin lesions 3.25 3.25 3.25 Agree 

17280 Destruction of skin lesions 1.22 1.22 1.22 Agree 

17281 Destruction of skin lesions 1.77 1.77 1.77 Agree 

17282 Destruction of skin lesions 2.09 2.09 2.09 Agree 

17283 Destruction of skin lesions 2.69 2.69 2.69 Agree 

17284 Destruction of skin lesions 3.26 3.20 3.20 Agree 
CMS-1582-PN 36

CPT 

Code Short Descriptor 

CY 

2011 

Work 

RVU 

AMA 

RUC/HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

17286 Destruction of skin lesions 4.48 4.48 4.48 Agree 

19302 P-mastectomy w/ln removal 13.99 13.99 13.87 Disagree 

22520 Percut vertebroplasty thor 9.22 9.22 9.22 Agree 

22521 Percut vertebroplasty lumb 8.65 8.65 8.01 Disagree 

22522 Percut vertebroplasty addl 4.30 4.30 4.30 Agree 

22523 Percut kyphoplasty, thor 9.26 9.26 8.62 Disagree 

22524 Percut kyphoplasty, lumbar 8.86 8.86 8.22 Disagree 

22525 Percut kyphoplasty, add-on 4.47 4.47 4.47 Agree 

25600 Treat fracture radius/ulna 2.78 2.78 2.64 Disagree x 

25605 Treat fracture radius/ulna 7.25 6.50 6.00 Disagree x 

27385 Repair of thigh muscle 8.11 8.11 6.93 Disagree x 

27530 Treat knee fracture 4.09 2.81 2.65 Disagree x 

27792 Treatment of ankle fracture 9.71 9.71 8.75 Disagree x 

28002 Treatment of foot infection 5.93 5.34 4.00 Disagree 

28003 Treatment of foot infection 9.06 9.06 9.06 Agree 

28120 Part removal of ankle/heel 8.27 8.27 7.31 Disagree x 

28122 Partial removal of foot bone 7.72 7.72 6.76 Disagree x 

28285 Repair of hammertoe 4.76 5.62 4.76 Disagree 

28715 Fusion of foot bones 14.60 14.60 13.42 Disagree x 

28820 Amputation of toe 5.00 7.00 5.82 Disagree x 

28825 Partial amputation of toe 6.01 6.01 5.37 Disagree x 

29125 Apply forearm splint 0.59 0.59 0.50 Disagree x 

29126 Apply forearm splint 0.77 0.77 0.68 Disagree x 

29405 Apply short leg cast 0.86 0.80 0.80 Agree 

29425 Apply short leg cast 1.01 0.80 0.80 Agree 

29515 Application lower leg splint 0.73 0.73 0.73 Agree x 

32405 Biopsy, lung or mediastinum 1.93 1.93 1.93 Agree 

32851 Lung transplant, single 41.61 63.00 59.64 Disagree 

32852 Lung transplant with bypass 45.48 74.37 65.50 Disagree 

32853 Lung transplant, double 50.78 90.00 84.48 Disagree 

32854 Lung transplant with bypass 54.74 95.00 90.00 Disagree 

33030 Partial removal of heart sac 22.39 39.50 36.00 Disagree 

33031 Partial removal of heart sac 25.38 45.00 45.00 Agree 

33120 Removal of heart lesion 27.45 42.88 38.45 Disagree 

33315 Exploratory heart surgery 26.17 35.00 35.00 Agree 

33411 Replacement of aortic valve 62.07 62.07 62.07 Agree 

33412 Replacement of aortic valve 43.94 60.00 59.00 Disagree 

33468 Revision of tricuspid valve 32.94 50.00 45.13 Disagree 

33645 Revision of heart veins 28.10 33.00 31.30 Disagree 

33647 Repair heart septum defects 29.53 35.00 33.00 Disagree 

33692 Repair of heart defects 31.54 38.75 36.15 Disagree 
CMS-1582-PN 37

CPT 

Code Short Descriptor 

CY 

2011 

Work 

RVU 

AMA 

RUC/HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

33710 Repair of heart defects 30.41 43.00 37.50 Disagree 

33875 Thoracic aortic graft 35.78 56.83 50.72 Disagree 

33910 Remove lung artery emboli 29.71 52.33 48.21 Disagree 

33916 Surgery of great vessel 28.42 78.00 78.00 Agree 

33935 Transplantation, heart/lung 62.01 100.00 91.78 Disagree 

33975 Implant ventricular device 20.97 25.00 25.00 Agree 

33976 Implant ventricular device 22.97 30.75 30.75 Agree 

33977 Remove ventricular device 20.28 20.86 20.86 Agree 

33978 Remove ventricular device 22.72 25.00 25.00 Agree 

33979 Insert intracorporeal device 45.93 37.50 37.50 Agree 

33980 Remove intracorporeal device 65.20 40.00 33.50 Disagree 

33981 Replace vad pump ext 0.00 16.11 16.11 Agree 

33982 Replace vad intra w/o bp 0.00 37.86 37.86 Agree 

33983 Replace vad intra w/bp 0.00 44.54 44.54 Agree 

35188 Repair blood vessel lesion 15.16 18.50 18.00 Disagree 

35612 Artery bypass graft 16.82 22.00 20.35 Disagree 

35800 Explore neck vessels 8.07 13.89 12.00 Disagree 

35840 Explore abdominal vessels 10.96 21.19 20.75 Disagree 

35860 Explore limb vessels 6.80 16.89 15.25 Disagree 

36200 Place catheter in aorta 3.02 3.02 3.02 Agree 

36246 Place catheter in artery 5.27 5.27 5.27 Agree 

36247 Place catheter in artery 6.29 7.00 6.29 Disagree 

36470 Injection therapy of vein 1.10 1.10 1.10 Agree 

36471 Injection therapy of veins 1.65 1.65 1.65 Agree 

36600 Withdrawal of arterial blood 0.32 0.32 0.32 Agree x 

36819 Av fuse, uppr arm, basilic 14.47 14.47 13.29 Disagree x 

36821 Av fusion direct any site 12.11 12.11 12.11 Agree 

36825 Artery-vein autograft 15.13 15.13 14.17 Disagree x 

37140 Revision of circulation 25.23 40.00 40.00 Agree 

37145 Revision of circulation 26.24 37.00 37.00 Agree 

37160 Revision of circulation 23.24 38.00 38.00 Agree 

37180 Revision of circulation 26.24 36.50 36.50 Agree 

37181 Splice spleen/kidney veins 28.37 40.00 40.00 Agree 

42415 Excise parotid gland/lesion 18.12 18.12 17.16 Disagree x 

42420 Excise parotid gland/lesion 21.00 21.00 19.53 Disagree x 

43262 Endo cholangiopancreatograph 7.38 7.38 7.38 Agree x 

43415 Repair esophagus wound 28.91 44.88 44.88 Agree 

45331 Sigmoidoscopy and biopsy 1.15 1.15 1.15 Agree x 

47563 Laparo cholecystectomy/graph 12.11 12.11 11.47 Disagree x 

47564 Laparo cholecystectomy/explr 14.24 20.00 18.00 Disagree 

49507 Prp i/hern init block >5 yr 10.05 10.05 9.09 Disagree x 
CMS-1582-PN 38

CPT 

Code Short Descriptor 

CY 

2011 

Work 

RVU 

AMA 

RUC/HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

49521 Rerepair ing hernia, blocked 12.44 12.44 11.48 Disagree x 

49587 Rpr umbil hern, block > 5 yr 8.04 8.04 7.08 Disagree x 

49652 Lap vent/abd hernia repair 12.88 12.88 11.92 Disagree x 

49653 Lap vent/abd hern proc comp 16.21 16.21 14.94 Disagree x 

49654 Lap inc hernia repair 15.03 15.03 13.76 Disagree x 

49655 Lap inc hern repair comp 18.11 18.11 16.84 Disagree x 

51705 Change of bladder tube 1.05 0.90 0.90 Agree 

51710 Change of bladder tube 1.52 1.35 1.35 Agree x 

52005 Cystoscopy & ureter catheter 2.37 2.37 2.37 Agree 

52007 Cystoscopy and biopsy 3.02 3.02 3.02 Agree 

52310 Cystoscopy and treatment 2.81 2.81 2.81 Agree 

52315 Cystoscopy and treatment 5.20 5.20 5.20 Agree 

52630 Remove prostate regrowth 7.73 7.73 6.55 Disagree x 

52640 Relieve bladder contracture 4.79 4.79 4.79 Agree 

52649 Prostate laser enucleation 17.29 15.20 14.56 Disagree x 

53440 Male sling procedure 15.54 14.00 13.36 Disagree x 

57287 Revise/remove sling repair 11.15 11.15 11.15 Agree 

57288 Repair bladder defect 12.13 12.13 12.13 Agree 

60220 Partial removal of thyroid 12.37 12.37 11.19 Disagree x 

60240 Removal of thyroid 16.22 16.22 15.04 Disagree x 

60500 Explore parathyroid glands 16.78 16.78 15.60 Disagree x 

62284 Injection for myelogram 1.54 1.54 1.54 Agree 

63655 Implant neuroelectrodes 11.56 11.56 10.92 Disagree x 

64405 N block inj, occipital 1.32 1.00 0.94 Disagree 

69220 Clean out mastoid cavity 0.83 0.83 0.83 Agree 

78264 Gastric emptying study 0.78 0.95 0.80 Disagree x 

92511 Nasopharyngoscopy 0.84 0.61 0.61 Agree x 

92950 Heart/lung resuscitation cpr 3.79 4.50 4.00 Disagree x 

93321 Doppler echo exam, heart 0.15 0.15 0.15 Agree 

94660 Pos airway pressure, cpap 0.76 0.76 0.76 Agree 

98925 Osteopathic manipulation 0.45 0.50 0.46 Disagree x 

98926 Osteopathic manipulation 0.65 0.75 0.71 Disagree x 

98927 Osteopathic manipulation 0.87 1.00 0.96 Disagree x 

98928 Osteopathic manipulation 1.03 1.25 1.21 Disagree x 

98929 Osteopathic manipulation 1.19 1.50 1.46 Disagree x 

99218 Observation care 1.28 1.92 1.28 Disagree x 

99219 Observation care 2.14 2.60 2.14 Disagree x 

99220 Observation care 2.99 3.56 2.99 Disagree x 

99234 Observ/hosp same date 2.56 2.56 1.92 Disagree x 

99235 Observ/hosp same date 3.41 3.24 2.78 Disagree x 

99236 Observ/hosp same date 4.26 4.20 3.63 Disagree x 
CMS-1582-PN 39

CPT 

Code Short Descriptor 

CY 

2011 

Work 

RVU 

AMA 

RUC/HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

99315 Nursing fac discharge day 1.13 1.28 1.28 Agree 

99316 Nursing fac discharge day 1.50 1.90 1.90 Agree 

99460 Init nb em per day, hosp 1.17 1.92 1.92 Agree 

99462 Sbsq nb em per day, hosp 0.62 0.84 0.84 Agree 

99463 Same day nb discharge 1.50 2.13 2.13 Agree 
CMS-1582-PN 40

TABLE 6: FIVE-YEAR REVIEW CODES WITH CMS PROPOSED REFINEMENTS TO THE AMA RUC R

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

10140 Drainage of hematoma/fluid Current 1.58 7.0 0.0 0.0 16.0 7.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 010140 Drainage of hematoma/fluid RUC Rec 1.58 17.0 3.0 5.0 15.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 010140 Drainage of hematoma/fluid CMS Rec 1.58 7.0 3.0 5.0 15.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 011732 Remove nail plate add-on Current 0.57 0.0 0.0 0.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 011732 Remove nail plate add-on RUC Rec 0.48 0.0 1.0 1.0 10.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 011732 Remove nail plate add-on CMS Rec 0.44 0.0 1.0 1.0 10.0 1.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 011765 Excision of nail fold toe Current 0.74 7.0 0.0 0.0 24.0 7.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 011765 Excision of nail fold toe RUC Rec 1.48 17.0 1.0 5.0 15.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 011765 Excision of nail fold toe CMS Rec 1.22 11.0 1.0 5.0 15.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012036 Intmd wnd repair s/tr/ext Current 4.09 12.0 0.0 0.0 84.0 11.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012036 Intmd wnd repair s/tr/ext RUC Rec 4.50 13.0 3.0 5.0 75.0 12.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012036 Intmd wnd repair s/tr/ext CMS Rec 4.23 13.0 3.0 5.0 70.0 12.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012046 Intmd wnd repair n-hg/genit Current 4.29 12.0 0.0 0.0 90.0 11.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012046 Intmd wnd repair n-hg/genit RUC Rec 4.60 13.0 3.0 5.0 80.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012046 Intmd wnd repair n-hg/genit CMS Rec 4.30 9.0 3.0 5.0 80.0 9.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012047 Intmd wnd repair n-hg/genit Current 4.69 13.0 0.0 0.0 111.0 12.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012047 Intmd wnd repair n-hg/genit RUC Rec 5.50 13.0 3.0 5.0 100.0 15.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012047 Intmd wnd repair n-hg/genit CMS Rec 4.95 9.0 3.0 5.0 100.0 10.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012055 Intmd wnd repair face/mm Current 4.47 13.0 0.0 0.0 89.0 12.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012055 Intmd wnd repair face/mm RUC Rec 4.65 13.0 3.0 5.0 70.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012055 Intmd wnd repair face/mm CMS Rec 4.50 13.0 3.0 5.0 60.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012056 Intmd wnd repair face/mm Current 5.28 14.0 0.0 0.0 106.0 12.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012056 Intmd wnd repair face/mm RUC Rec 5.50 13.0 3.0 5.0 85.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012056 Intmd wnd repair face/mm CMS Rec 5.30 13.0 3.0 5.0 70.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 012057 Intmd wnd repair face/mm Current 6.00 15.0 0.0 0.0 131.0 13.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 012057 Intmd wnd repair face/mm RUC Rec 6.28 13.0 3.0 5.0 100.0 15.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 0
CMS-1582-PN 41

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

12057 Intmd wnd repair face/mm CMS Rec 6.00 13.0 3.0 5.0 90.0 15.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 013100 Repair of wound or lesion Current 3.17 21.0 0.0 0.0 33.0 21.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 013100 Repair of wound or lesion RUC Rec 3.17 17.0 1.0 5.0 35.0 16.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 013100 Repair of wound or lesion CMS Rec 3.17 21.0 0.0 0.0 33.0 21.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 013101 Repair of wound or lesion Current 3.96 21.0 0.0 0.0 53.0 21.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 013101 Repair of wound or lesion RUC Rec 3.96 17.0 1.0 5.0 56.0 18.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 013101 Repair of wound or lesion CMS Rec 3.96 21.0 0.0 0.0 53.0 21.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 015732 Muscle-skin graft, head/neck Current 19.90 60.0 0.0 0.0 150.0 30.0 0.0 0.0 4.0 1.0 0.0 1.0 0.0 0.0 015732 Muscle-skin graft, head/neck RUC Rec 19.83 40.0 12.0 20.0 150.0 30.0 0.0 0.0 1.0 1.0 1.0 1.0 0.0 0.0 015732 Muscle-skin graft, head/neck CMS Rec 16.38 40.0 12.0 20.0 150.0 60.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 017270 Destruction of skin lesions Current 1.37 4.0 0.0 0.0 15.0 4.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017270 Destruction of skin lesions RUC Rec 1.37 7.0 0.0 2.0 15.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017270 Destruction of skin lesions CMS Rec 1.37 7.0 0.0 2.0 16.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017271 Destruction of skin lesions Current 1.54 6.0 0.0 0.0 18.0 6.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017271 Destruction of skin lesions RUC Rec 1.54 7.0 0.0 2.0 19.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017271 Destruction of skin lesions CMS Rec 1.54 7.0 0.0 2.0 18.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017274 Destruction of skin lesions Current 2.64 8.0 0.0 0.0 32.0 8.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017274 Destruction of skin lesions RUC Rec 2.64 7.0 0.0 2.0 32.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 017274 Destruction of skin lesions CMS Rec 2.64 7.0 0.0 2.0 33.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 025600 Treat fracture radius/ulna Current 2.78 13.0 0.0 0.0 25.0 12.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 025600 Treat fracture radius/ulna RUC Rec 2.78 7.0 0.0 0.0 15.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 025600 Treat fracture radius/ulna CMS Rec 2.64 5.0 0.0 0.0 15.0 7.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 025605 Treat fracture radius/ulna Current 7.25 22.0 0.0 15.0 35.0 23.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 025605 Treat fracture radius/ulna RUC Rec 6.50 14.0 1.0 5.0 30.0 20.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 025605 Treat fracture radius/ulna CMS Rec 6.00 14.0 1.0 5.0 30.0 13.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 027385 Repair of thigh muscle Current 8.11 22.0 0.0 25.0 66.0 19.0 0.0 0.0 1.5 0.0 0.0 1.0 0.0 0.0 027385 Repair of thigh muscle RUC Rec 8.11 33.0 9.0 15.0 60.0 20.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 027385 Repair of thigh muscle CMS Rec 6.93 33.0 9.0 15.0 60.0 30.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 0
CMS-1582-PN 42

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

27530 Treat knee fracture Current 4.09 17.0 0.0 15.0 33.0 8.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 027530 Treat knee fracture RUC Rec 2.81 7.0 2.0 0.0 15.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 027530 Treat knee fracture CMS Rec 2.65 5.0 0.0 0.0 15.0 7.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 027792 Treatment of ankle fracture Current 9.71 40.0 10.0 15.0 60.0 20.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 027792 Treatment of ankle fracture RUC Rec 9.71 33.0 10.0 15.0 60.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 027792 Treatment of ankle fracture CMS Rec 8.75 33.0 10.0 15.0 60.0 30.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 028120 Part removal of ankle/heel Current 8.27 33.0 10.0 15.0 50.0 20.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 028120 Part removal of ankle/heel RUC Rec 8.27 33.0 10.0 15.0 50.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 028120 Part removal of ankle/heel CMS Rec 7.31 33.0 10.0 15.0 50.0 30.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 028122 Partial removal of foot bone Current 7.72 33.0 10.0 15.0 50.0 20.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 028122 Partial removal of foot bone RUC Rec 7.72 33.0 10.0 15.0 45.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 028122 Partial removal of foot bone CMS Rec 6.76 33.0 10.0 15.0 45.0 30.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 028715 Fusion of foot bones Current 14.60 60.0 0.0 0.0 130.0 30.0 0.0 0.0 2.0 0.0 0.0 1.0 0.0 0.0 028715 Fusion of foot bones RUC Rec 14.60 40.0 3.0 15.0 125.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 028715 Fusion of foot bones CMS Rec 13.42 40.0 3.0 15.0 125.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 028820 Amputation of toe Current 5.00 22.0 0.0 25.0 42.0 16.0 0.0 0.0 3.5 0.0 0.0 1.0 0.0 0.0 028820 Amputation of toe RUC Rec 7.00 33.0 10.0 15.0 30.0 20.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 028820 Amputation of toe CMS Rec 5.82 33.0 10.0 15.0 30.0 30.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 028825 Partial amputation of toe Current 6.01 33.0 10.0 15.0 30.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 028825 Partial amputation of toe RUC Rec 6.01 33.0 10.0 15.0 30.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 028825 Partial amputation of toe CMS Rec 5.37 33.0 10.0 15.0 30.0 20.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 029125 Apply forearm splint Current 0.59 6.0 0.0 0.0 21.0 7.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029125 Apply forearm splint RUC Rec 0.59 7.0 0.0 0.0 15.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029125 Apply forearm splint CMS Rec 0.50 5.0 0.0 0.0 15.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029126 Apply forearm splint Current 0.77 8.0 0.0 0.0 25.0 8.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029126 Apply forearm splint RUC Rec 0.77 7.0 0.0 0.0 30.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029126 Apply forearm splint CMS Rec 0.68 5.0 0.0 0.0 30.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029515 Application lower leg splint Current 0.73 9.0 0.0 0.0 22.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0
CMS-1582-PN 43

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

29515 Application lower leg splint RUC Rec 0.73 7.0 0.0 0.0 15.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 029515 Application lower leg splint CMS Rec 0.73 5.0 0.0 0.0 15.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 033980 Remove intracorporeal device Current 65.20 178.0 0.0 0.0 360.0 80.0 4.0 3.0 2.0 9.0 2.0 0.0 1.0 0.0 033980 Remove intracorporeal device RUC Rec 40.00 60.0 15.0 20.0 300.0 90.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 033980 Remove intracorporeal device CMS Rec 33.50 60.0 15.0 20.0 300.0 90.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036247 Place catheter in artery Current 6.29 0.0 0.0 0.0 86.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036247 Place catheter in artery RUC Rec 7.00 33.0 3.0 5.0 60.0 30.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036247 Place catheter in artery CMS Rec 6.29 33.0 3.0 5.0 60.0 30.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036600 Withdrawal of arterial blood Current 0.32 0.0 0.0 0.0 8.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036600 Withdrawal of arterial blood RUC Rec 0.32 5.0 0.0 0.0 10.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036600 Withdrawal of arterial blood CMS Rec 0.32 3.0 0.0 0.0 10.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 036819 Av fuse uppr arm basilic Current 14.47 55.0 0.0 0.0 120.0 15.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 036819 Av fuse uppr arm basilic RUC Rec 14.47 40.0 5.0 20.0 130.0 25.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 036819 Av fuse uppr arm basilic CMS Rec 13.29 40.0 5.0 20.0 130.0 35.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 036825 Artery-vein autograft Current 15.13 40.0 10.0 20.0 120.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 036825 Artery-vein autograft RUC Rec 15.13 40.0 10.0 20.0 120.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 036825 Artery-vein autograft CMS Rec 14.17 40.0 10.0 20.0 120.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 042415 Excise parotid gland/lesion Current 18.12 40.0 12.0 20.0 150.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 042415 Excise parotid gland/lesion RUC Rec 18.12 40.0 12.0 20.0 150.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 042415 Excise parotid gland/lesion CMS Rec 17.16 40.0 12.0 20.0 150.0 30.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 042420 Excise parotid gland/lesion Current 21.00 40.0 12.0 20.0 180.0 20.0 0.0 0.0 1.0 1.0 0.0 1.0 0.0 0.0 042420 Excise parotid gland/lesion RUC Rec 21.00 40.0 12.0 20.0 180.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 142420 Excise parotid gland/lesion CMS Rec 19.53 40.0 12.0 20.0 180.0 50.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 043262 Endo cholangiopancreatograph Current 7.38 25.0 0.0 25.0 75.0 28.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 043262 Endo cholangiopancreatograph RUC Rec 7.38 15.0 5.0 5.0 45.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 043262 Endo cholangiopancreatograph CMS Rec 7.38 25.0 0.0 25.0 75.0 28.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 045331 Sigmoidoscopy and biopsy Current 1.15 7.0 0.0 0.0 18.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 045331 Sigmoidoscopy and biopsy RUC Rec 1.15 13.0 1.0 1.0 15.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0
CMS-1582-PN 44

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

45331 Sigmoidoscopy and biopsy CMS Rec 1.15 5.0 5.0 5.0 10.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 047563 Laparo cholecystectomy/graph Current 12.11 32.0 0.0 25.0 143.0 29.0 0.0 0.0 0.5 0.0 0.0 1.0 0.0 0.0 047563 Laparo cholecystectomy/graph RUC Rec 12.11 40.0 10.0 15.0 90.0 25.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 047563 Laparo cholecystectomy/graph CMS Rec 11.47 40.0 10.0 15.0 90.0 25.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049507 Prp i/hern init block >5 yr Current 10.05 40.0 3.0 20.0 70.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 049507 Prp i/hern init block >5 yr RUC Rec 10.05 40.0 3.0 20.0 70.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 049507 Prp i/hern init block >5 yr CMS Rec 9.09 40.0 3.0 20.0 70.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049521 Rerepair ing hernia, blocked Current 12.44 40.0 3.0 20.0 90.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 049521 Rerepair ing hernia, blocked RUC Rec 12.44 40.0 3.0 20.0 90.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 049521 Rerepair ing hernia, blocked CMS Rec 11.48 40.0 3.0 20.0 90.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049587 Rpr umbil hern, block > 5 yr Current 8.04 40.0 3.0 20.0 60.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 049587 Rpr umbil hern, block > 5 yr RUC Rec 8.04 40.0 3.0 20.0 60.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 049587 Rpr umbil hern, block > 5 yr CMS Rec 7.08 40.0 3.0 20.0 60.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049652 Lap vent/abd hernia repair Current 12.88 45.0 15.0 15.0 90.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 049652 Lap vent/abd hernia repair RUC Rec 12.88 40.0 15.0 15.0 90.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 1.0 049652 Lap vent/abd hernia repair CMS Rec 11.92 40.0 15.0 15.0 90.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049653 Lap vent/abd hern proc comp Current 16.21 45.0 15.0 15.0 120.0 30.0 0.0 0.0 1.0 1.0 0.0 1.0 0.0 0.0 049653 Lap vent/abd hern proc comp RUC Rec 16.2 40.0 15.0 15.0 120.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 2.0 049653 Lap vent/abd hern proc comp CMS Rec 14.94 40.0 15.0 15.0 120.0 50.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049654 Lap inc hernia repair Current 15.03 45.0 15.0 15.0 120.0 30.0 0.0 0.0 1.0 1.0 0.0 1.0 0.0 0.0 049654 Lap inc hernia repair RUC Rec 15.03 40.0 15.0 15.0 120.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 2.0 049654 Lap inc hernia repair CMS Rec 13.76 40.0 15.0 15.0 120.0 50.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 049655 Lap inc hern repair comp Current 18.11 50.0 15.0 15.0 150.0 30.0 0.0 0.0 1.0 1.0 0.0 1.0 0.0 0.0 049655 Lap inc hern repair comp RUC Rec 18.11 40.0 15.0 15.0 150.0 30.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 2.0 049655 Lap inc hern repair comp CMS Rec 16.84 40.0 15.0 15.0 150.0 50.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 051710 Change of bladder tube Current 1.52 13.0 0.0 0.0 26.0 11.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 051710 Change of bladder tube RUC Rec 1.35 7.0 10.0 0.0 15.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 051710 Change of bladder tube CMS Rec 1.35 7.0 5.0 0.0 15.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0
CMS-1582-PN 45

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

52630 Remove prostate regrowth Current 7.73 23.0 0.0 25.0 49.0 20.0 0.0 0.0 1.5 0.0 0.0 1.0 0.0 0.0 052630 Remove prostate regrowth RUC Rec 7.73 33.0 5.0 15.0 60.0 25.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 052630 Remove prostate regrowth CMS Rec 6.55 33.0 5.0 15.0 60.0 35.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 052649 Prostate laser enucleation Current 17.29 70.0 10.0 15.0 180.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 052649 Prostate laser enucleation RUC Rec 15.20 33.0 5.0 15.0 120.0 25.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 052649 Prostate laser enucleation CMS Rec 14.56 33.0 5.0 15.0 120.0 25.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 053440 Male sling procedure Current 15.54 58.0 0.0 0.0 100.0 30.0 0.0 0.0 0.0 2.0 0.0 1.0 0.0 0.0 053440 Male sling procedure RUC Rec 14.00 33.0 7.0 15.0 90.0 22.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 053440 Male sling procedure CMS Rec 13.36 33.0 7.0 15.0 90.0 22.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 060220 Partial removal of thyroid Current 12.37 62.5 0.0 0.0 90.0 25.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 060220 Partial removal of thyroid RUC Rec 12.37 40.0 12.0 20.0 90.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 060220 Partial removal of thyroid CMS Rec 11.19 40.0 12.0 20.0 90.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 060240 Removal of thyroid Current 16.22 34.0 0.0 25.0 159.0 27.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 060240 Removal of thyroid RUC Rec 16.22 40.0 12.0 20.0 150.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 060240 Removal of thyroid CMS Rec 15.04 40.0 12.0 20.0 150.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 060500 Explore parathyroid glands Current 16.78 40.0 0.0 25.0 138.0 22.0 0.0 0.0 3.5 0.0 0.0 1.0 0.0 0.0 060500 Explore parathyroid glands RUC Rec 16.78 40.0 12.0 20.0 120.0 30.0 0.0 0.0 1.0 0.0 0.0 1.0 0.0 0.0 060500 Explore parathyroid glands CMS Rec 15.60 40.0 12.0 20.0 120.0 40.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 063655 Implant neuroelectrodes Current 11.6 33.0 15.0 15.0 90.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 063655 Implant neuroelectrodes RUC Rec 11.56 33.0 15.0 15.0 90.0 20.0 0.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 063655 Implant neuroelectrodes CMS Rec 10.92 33.0 15.0 15.0 90.0 20.0 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 078264 Gastric emptying study Current 0.78 0.0 0.0 0.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 078264 Gastric emptying study RUC Rec 0.95 5.0 0.0 0.0 12.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 078264 Gastric emptying study CMS Rec 0.80 5.0 0.0 0.0 12.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 092511 Nasopharyngoscopy Current 0.84 0.0 0.0 0.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 092511 Nasopharyngoscopy RUC Rec 0.61 6.0 0.0 5.0 5.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 092511 Nasopharyngoscopy CMS Rec 0.61 4.0 0.0 5.0 5.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 092950 Heart/lung resuscitation cpr Current 3.79 1.0 0.0 0.0 51.0 51.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0
CMS-1582-PN 46

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

92950 Heart/lung resuscitation cpr RUC Rec 4.50 2.0 1.0 0.0 45.0 30.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 092950 Heart/lung resuscitation cpr CMS Rec 4.00 1.0 1.0 0.0 45.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098925 Osteopathic manipulation Current 0.45 0.0 0.0 0.0 13.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098925 Osteopathic manipulation RUC Rec 0.50 2.0 1.0 0.0 10.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098925 Osteopathic manipulation CMS Rec 0.46 1.0 1.0 0.0 10.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098926 Osteopathic manipulation Current 0.65 0.0 0.0 0.0 18.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098926 Osteopathic manipulation RUC Rec 0.75 2.0 1.0 0.0 15.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098926 Osteopathic manipulation CMS Rec 0.71 1.0 1.0 0.0 15.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098927 Osteopathic manipulation Current 0.87 0.0 0.0 0.0 25.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098927 Osteopathic manipulation RUC Rec 1.00 2.0 1.0 0.0 20.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098927 Osteopathic manipulation CMS Rec 0.96 1.0 1.0 0.0 20.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098928 Osteopathic manipulation Current 1.03 0.0 0.0 0.0 29.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098928 Osteopathic manipulation RUC Rec 1.25 2.0 1.0 0.0 25.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098928 Osteopathic manipulation CMS Rec 1.21 1.0 1.0 0.0 25.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098929 Osteopathic manipulation Current 1.19 0.0 0.0 0.0 33.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098929 Osteopathic manipulation RUC Rec 1.50 2.0 1.0 0.0 30.0 3.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 098929 Osteopathic manipulation CMS Rec 1.46 1.0 1.0 0.0 30.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099218 Initial observation care Current 1.28 0.0 0.0 0.0 40.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099218 Initial observation care RUC Rec 1.92 10.0 0.0 0.0 30.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099218 Initial observation care CMS Rec 1.28 10.0 0.0 0.0 25.0 10.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099219 Initial observation care Current 2.14 0.0 0.0 0.0 67.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099219 Initial observation care RUC Rec 2.60 10.0 0.0 0.0 40.0 14.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099219 Initial observation care CMS Rec 2.14 10.0 0.0 0.0 30.0 14.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099220 Initial observation care Current 2.99 0.0 0.0 0.0 90.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099220 Initial observation care RUC Rec 3.56 15.0 0.0 0.0 45.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099220 Initial observation care CMS Rec 2.99 15.0 0.0 0.0 40.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099234 Observ/hosp same date Current 2.56 10.0 0.0 0.0 60.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099234 Observ/hosp same date RUC Rec 2.56 14.0 0.0 0.0 40.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0
CMS-1582-PN 47

HCPCS 

Code Short Descriptor Source 

Work RVU 

Pre-Service Evaluation 

Minutes 

Pre-Service Positioning 

Minutes 

Pre-Service Dress, Scrub, 

Wait Minutes 

Intra-Service Minutes 

Same Day Post-Service 

Minutes 

Critical Care, First Hour99291 

Critical Care, Addl 30 Mins99292 

Subsequent Hospital Care99231 

Subsequent Hospital Care99232 

Subsequent Hospital Care99233 

Hospital Discharge Day99238 

Hospital Discharge Day99239 

Subsequent Observation 

Care- 99224 

Subsequent Observation 

99234 Observ/hosp same date CMS Rec 1.92 14.0 0.0 0.0 35.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099235 Observ/hosp same date Current 3.41 10.0 0.0 0.0 75.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099235 Observ/hosp same date RUC Rec 3.24 14.0 0.0 0.0 50.0 19.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099235 Observ/hosp same date CMS Rec 2.78 14.0 0.0 0.0 40.0 19.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099236 Observ/hosp same date Current 4.26 0.0 0.0 0.0 110.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099236 Observ/hosp same date RUC Rec 4.20 19.0 0.0 0.0 55.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 099236 Observ/hosp same date CMS Rec 3.63 19.0 0.0 0.0 50.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0
CMS-1582-PN 48

C. Code-Specific Discussions of Proposed Alternative Work RVUs

1. Drainage of Hematoma 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUCRecommende

d Work RVU 

CMS 

Recommende

d WRVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinement

s to Time 

10140 Drainage of hematoma/fluid 1.58 1.58 1.58 Agree x 

10160 Puncture drainage of lesion 1.25 1.25 1.25 Agree 

In the Fourth Five-Year Review, we identified CPT codes 10140 and 10160 as potentially 

misvalued through the Harvard-Valued – Utilization > 30,000 screen. 

For CPT code 10140 (Incision and drainage of hematoma, seroma or fluid collection), the 

AMA RUC reviewed the survey results and determined that these data support maintaining the 

current work RVU of 1.58 for this service. The AMA RUC believed that the current work RVU 

for CPT code 10140 is appropriate and recommended a work RVU of 1.58. 

We agree with the AMA RUC-recommended work RVU for CPT code 10140 and are 

proposing a work RVU of 1.58 for CY 2012, with a refinement to the time. We believe the 

current pre-service evaluation time of 7 minutes is more appropriate than the AMA 

RUC-recommended pre-service evaluation time of 17 minutes. CPT code 10160 (Puncture 

aspiration of abscess, hematoma, bulla, or cyst) has the same description of typical pre-service 

evaluation work and an AMA RUC-recommended pre-service evaluation time of 7 minutes. 

After clinical review, we believe that 7 minutes accurately reflects the time required to conduct 

the pre-service evaluation work associated with this service. A complete list of CMS time 

refinements can be found in Table 6. 

2. Wound Repair 
CMS-1582-PN 49

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

WRVU 

CMS Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

12031 Intmd wnd repair s/tr/ext 2.20 2.00 2.00 Agree 

12032 Intmd wnd repair s/tr/ext 2.52 2.52 2.52 Agree 

12034 Intmd wnd repair s/tr/ext 2.97 2.97 2.97 Agree 

12035 Intmd wnd repair s/tr/ext 3.47 3.60 3.50 Disagree 

12036 Intmd wnd repair s/tr/ext 4.09 4.50 4.23 Disagree x 

12037 Intmd wnd repair s/tr/ext 4.71 5.25 5.00 Disagree 

12041 Intmd wnd repair n-hf/genit 2.42 2.10 2.10 Agree 

12042 Intmd wnd repair n-hg/genit 2.79 2.79 2.79 Agree 

12044 Intmd wnd repair n-hg/genit 3.19 3.19 3.19 Agree 

12045 Intmd wnd repair n-hg/genit 3.68 3.90 3.75 Disagree 

12046 Intmd wnd repair n-hg/genit 4.29 4.60 4.30 Disagree x 

12047 Intmd wnd repair n-hg/genit 4.69 5.50 4.95 Disagree x 

12051 Intmd wnd repair face/mm 2.52 2.33 2.33 Agree 

12052 Intmd wnd repair face/mm 2.87 2.87 2.87 Agree 

12053 Intmd wnd repair face/mm 3.17 3.17 3.17 Agree 

12054 Intmd wnd repair, face/mm 3.50 3.50 3.50 Agree 

12055 Intmd wnd repair face/mm 4.47 4.65 4.50 Disagree x 

12056 Intmd wnd repair face/mm 5.28 5.50 5.30 Disagree x 

12057 Intmd wnd repair face/mm 6.00 6.28 6.00 Disagree x 

13100 Repair of wound or lesion 3.17 3.17 3.17 Agree x 

13101 Repair of wound or lesion 3.96 3.96 3.96 Agree x 

In the Fourth Five-Year Review, we identified CPT codes 12031, 12051, and 13101 as 

potentially misvalued through the Harvard-Valued – Utilization > 30,000 screen. CPT codes 

12032-12047, 12052-12057, and 13100 were added as part of the family of services for review. 

In its review of this set of CPT codes, the AMA RUC determined that the original Harvard 

values led to compression within these code families, which the AMA RUC recommended 

correcting by reducing the relative values for the smallest wound size repair codes and increasing 

the relative values for the larger wound size repair codes. 

In general, the specialty society surveys of physicians furnishing these intermediate 

wound repair codes confirmed that the work of performing these services had not changed in the 

past 5 years and that the complexity of patients requiring the services had also remained 
CMS-1582-PN 50

constant. Despite the survey findings, however, the survey median work RVUs were usually 

somewhat higher than the current work RVUs for the larger wound size repair codes. For many 

of these codes, the AMA RUC recommended the survey median values as the work RVUs for 

these wound repair services, despite its common recommendation of the survey 25th percentile 

values for codes in other families. In those cases discussed below where we disagreed with the 

AMA RUC recommendations, we based our proposed work RVU on the survey 25th percentile 

value, which was also usually higher than the current work RVU for the larger wound size repair 

codes. For the smaller wound size repair codes the AMA RUC recommended a lower work 

RVU than the current work RVU, and we agreed. In this way, our proposals for the revised 

work RVUs for the wound repair codes address concerns about compression in the original 

Harvard-valued work RVUs within the family. Our proposed range of work RVUs for 

intermediate wound repair codes in various body areas, while not as large as the range that would 

have resulted from our adoption of the AMA RUC’s recommendations, nevertheless is greater 

than the current range of work RVUs for the variety of wound sizes described by the repair 

codes. 

For CPT code 12035 (Repair, intermediate, wounds of scalp, axillae, trunk and/or 

extremities (excluding hands and feet); 12.6 cm to 20.0 cm), the AMA RUC reviewed the survey 

data from physicians who frequently perform this service and determined that the survey median 

work RVU appropriately accounts for the work required for this service. The AMA RUC 

recommended a work RVU of 3.60 for CPT code 12035. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12035 and 

believe that the survey 25th percentile value of a work RVU of 3.50 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 
CMS-1582-PN 51

has not changed in the past 5 years (79 percent), and that there has been no change in complexity 

among the patients requiring this service (82 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service and is consistent with the relativity 

adjustments recommended by the AMA RUC. Therefore, we are proposing an alternative work 

RVU of 3.50 for CPT code 12035 for CY 2012. 

For CPT code 12036 (Repair, intermediate, wounds of scalp, axillae, trunk and/or 

extremities (excluding hands and feet); 20.1 cm to 30.0 cm), the AMA RUC reviewed the survey 

data from physicians who frequently perform this service and determined that the survey median 

work RVU appropriately accounts for the work required for this service. The AMA RUC 

recommended a work RVU of 4.50 for CPT code 12036. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12036 and 

believe that the survey 25th percentile value of a work RVU of 4.23 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (81 percent), and that there has been no change in complexity 

among the patients requiring this service (84 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service and is consistent with the relativity 

adjustments recommended by the AMA RUC. We are proposing an alternative work RVU of 

4.23 for CPT code 12036 for CY 2012. 

In addition to the work RVU adjustment for CPT code 12036, we are refining the time 

associated with this code. We find an intra-service time of 70 minutes, the survey median, to be 

more appropriate than the AMA RUC-recommended intra-service time of 75 minutes. Per the 

survey, this time correctly captures the intra-service time differential between this CPT code and 

the key reference code. After clinical review, we believe that 70 minutes accurately reflects the 
CMS-1582-PN 52

time required to conduct the intra-service work associated with this service. A complete list of 

CMS time refinements can be found in Table 6. 

For CPT code 12037 (Repair, intermediate, wounds of scalp, axillae, trunk and/or 

extremities (excluding hands and feet); over 30.0 cm), the AMA RUC reviewed the survey data 

from physicians who frequently perform this service and determined that the survey median 

work RVU appropriately accounts for the work required for this service. The AMA RUC 

recommended a work RVU of 5.25 for CPT code 12037. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12037 and 

believe that the survey 25th percentile value of a work RVU of 5.00 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (81 percent), and that there has been no change in complexity 

among the patients requiring this service (83 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service and is consistent with the relativity 

adjustments recommended by the AMA RUC. Therefore, we are proposing an alternative work 

RVU of 5.00 for CPT code 12037 for CY 2012. 

 For CPT code 12045 (Repair, intermediate, wounds of neck, hands, feet and/or external 

genitalia; 12.6 cm to 20.0 cm), the AMA RUC reviewed the survey data from physicians who 

frequently perform this service and determined that the survey median work RVU appropriately 

accounts for the physician work required for this service. The AMA RUC recommended a work 

RVU of 3.90 for CPT code 12045. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12045 and 

believe that the survey 25th percentile value of a work RVU of 3.75 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 
CMS-1582-PN 53

has not changed in the past 5 years (80 percent), and that there has been no change in complexity 

among the patients requiring this service (80 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service and is consistent with the relativity 

adjustments recommended by the AMA RUC. Therefore, we are proposing an alternative work 

RVU of 3.75 for CPT code 12045 for CY 2012. 

For CPT code 12046 (Repair, intermediate, wounds of neck, hands, feet and/or external 

genitalia; 20.1 cm to 30.0 cm), the AMA RUC reviewed the survey data from physicians who 

frequently perform this service and determined that the survey median work RVU appropriately 

accounts for the work required for this service. The AMA RUC recommended a work RVU of 

4.60 for CPT code 12046. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12046 and 

believe that the survey 25th percentile value of a work RVU of 4.30 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (79 percent), and that there has been no change in complexity 

among the patients requiring this service (79 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service. Therefore, we are proposing an 

alternative work RVU of 4.30 for CPT code 12046 for CY 2012. 

In addition to the work RVU adjustment for CPT code 12046, we are refining the time 

associated with this code. This service is typically performed on the same day as an E/M visit. 

We believe some of the activities conducted during the pre- and post-service times of the 

procedure code and the E/M visit overlap and, therefore, should not be counted twice in 

developing the procedure’s work value. As described in section II.A. of this proposed notice, to 

account for this overlap, we reduced the pre-service evaluation and post-service time by
CMS-1582-PN 54

one-third. We believe that 9 minutes pre-service evaluation time and 9 minutes post-service time 

accurately reflect the time required to conduct the work associated with this service. A complete 

list of CMS time refinements can be found in Table 6. 

For CPT code 12047 (Repair, intermediate, wounds of neck, hands, feet and/or external 

genitalia; over 30.0 cm) the AMA RUC reviewed the survey data from physicians who 

frequently perform this service and determined the survey median work RVU appropriately 

accounts for the work required for this service. The AMA RUC recommended a work RVU of 

5.50 for CPT code 12046. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12047 and 

believe that the survey 25th percentile value of a work RVU of 4.95 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (79 percent), and that there has been no change in complexity 

among the patients requiring this service (79 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service. Therefore, we are proposing an 

alternative work RVU of 4.95 for CPT code 12047 for CY 2012. 

In addition to the work RVU adjustment for CPT code 12047, we are refining the time 

associated with this code. Recent Medicare PFS claims data show that this service typically is 

performed on the same day as an E/M visit. We believe some of the activities conducted during 

the pre- and post-service times of the procedure code and the E/M visit overlap and, therefore, 

should not be counted twice in developing the procedure’s work value. As described in section 

II.A. of this proposed notice, to account for this overlap, we reduced the pre-service evaluation 

and post service time by one-third. We believe that 9 minutes pre-service evaluation time and 

10 minutes post-service time accurately reflect the time required to conduct the work associated 
CMS-1582-PN 55

with this service. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 12055 (Repair, intermediate, wounds of face, ears, eyelids, nose, lips 

and/or mucous membranes; 12.6 cm to 20.0 cm), the AMA RUC reviewed the survey data from 

physicians who frequently perform this service and determined that the survey median work 

RVU appropriately accounts for the work required to perform this service. The AMA RUC 

recommended a work RVU of 4.65 for CPT code 12055. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12055 and 

believe that the survey 25th percentile value of a work RVU of 4.50 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (79 percent), and that there has been no change in complexity 

among the patients requiring this service (79 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service. Therefore, we are proposing an 

alternative work RVU of 4.50 for CPT code 12055 for CY 2012. 

In addition to the work RVU adjustment for CPT code 12055, we are refining the time 

associated with this code. We find an intra-service time of 60 minutes, the survey median and 

intra-service time of the key reference code, to be more appropriate than the AMA 

RUC-recommended intra-service time of 70 minutes. After clinical review, we believe that 

60 minutes accurately reflects the time required to conduct the intra-service work associated with 

this service. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 12056 (Repair, intermediate, wounds of face, ears, eyelids, nose, lips 

and/or mucous membranes; 20.1 cm to 30.0 cm), the AMA RUC reviewed the survey data from 

physicians who frequently perform this service and determined that the survey median work 

RVU appropriately accounts for the work required to perform this service. The AMA RUC 
CMS-1582-PN 56

recommended a work RVU of 5.50 for CPT code 12056. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12056 and 

believe that the survey 25th percentile value of a work RVU of 5.30 is more appropriate for this 

service. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (80 percent), and that there has been no change in complexity 

among the patients requiring this service (81 percent). We believe that the survey 25th percentile 

value accurately reflects the work associated with this service. Therefore, we are proposing an 

alternative work RVU of 5.30 for CPT code 12056 for CY 2012. 

In addition to the work RVU adjustment for CPT code 12056, we are refining the time 

associated with this code. We find an intra-service time of 70 minutes, the survey median, to be 

more appropriate than the AMA RUC-recommended intra-service time of 85 minutes. After 

clinical review, we believe that 70 minutes accurately reflects the time required to conduct the 

intra-service work associated with this service. A complete list of CMS time refinements can be 

found in Table 6. 

For CPT code 12057 (Repair, intermediate, wounds of face, ears, eyelids, nose, lips 

and/or mucous membranes; over 30.0 cm), the AMA RUC reviewed the survey data from 

physicians who frequently perform this service and determined that the survey median work 

RVU appropriately accounts for the work required to perform this service. The AMA RUC 

recommended a work RVU of 6.28 for CPT code 12057. 

We disagree with the AMA RUC-recommended work RVU for CPT code 12057 and 

believe that the survey 25th percentile value of a work RVU of 6.00 (the current value) is more 

appropriate for this service. The majority of survey respondents indicated that the work of 

performing this service has not changed in the past 5 years (80 percent), and that there has been 
CMS-1582-PN 57

no change in complexity among the patients requiring this service (81 percent). We believe that 

the survey 25th percentile value accurately reflects the work associated with this service. 

Therefore, we are proposing an alternative work RVU of 6.00 for CPT code 12057 for CY 2012. 

In addition to the work RVU adjustment for CPT code 12057, we are refining the time 

associated with this code. We find an intra-service time of 90 minutes, the survey median, to be 

more appropriate than the AMA RUC-recommended intra-service time of 100 minutes. After 

clinical review, we believe that 90 minutes accurately reflects the time required to conduct the 

intra-service work associated with this service. A complete list of CMS time refinements can be 

found in Table 6. 

For CPT code 13100 (Repair, complex, trunk; 1.1 cm to 2.5 cm), the AMA RUC 

reviewed the survey data from physicians who frequently perform this service and agreed that 

the current work RVU of 3.17 maintains the appropriate relativity for this service. The AMA 

RUC recommended a work RVU of 3.17 for CPT code 13100. 

We note that the AMA RUC reviewed only two CPT codes in the complex wound repair 

family. While at this time we agree with the AMA RUC-recommended work RVU for CPT 

code 13100 and are proposing a work RVU of 3.17 for CY 2012, with a refinement to time, we 

request that, in order to ensure consistency, the AMA RUC review the entire set of codes in this 

family and assess the appropriate gradation of the work RVUs in this family. The majority of 

survey respondents indicated that the work of performing this service has not changed in the past 

5 years (89 percent), and that there has been no change in complexity among the patients 

requiring this service (79 percent). We believe at this time that the current work RVU (3.17) and 

current times accurately reflect the service. 

For CPT code 13101 (Repair, complex, trunk; 2.6 cm to 7.5 cm), the AMA RUC 
CMS-1582-PN 58

reviewed the survey data from physicians who frequently perform this service and determined 

that the current work RVU of 3.96 maintains the appropriate relativity for this service. The 

AMA RUC recommended a work RVU of 3.96 for CPT code 13101. As we noted previously 

for the other complex wound code, at this time we agree with the AMA RUC-recommended 

work RVU for CPT code 13101 and are proposing a work RVU of 3.96 for CY 2012, with a 

refinement to time; however, we request that the AMA RUC review the entire set of codes in this 

family. The majority of survey respondents indicated that the work of performing this service 

has not changed in the past 5 years (94 percent), and that there has been no change in complexity 

among the patients requiring this service (79 percent). We believe that the current work RVU 

(3.96) and current times accurately reflect the service. 

We are proposing to accept the values for CPT codes 13100 and 13101 on an interim 

basis only, as we appreciate that the AMA RUC reviewed only two CPT codes in the complex 

wound repair family. We request that, in order to ensure consistency and appropriate gradation 

in value of work, the AMA RUC review all of the codes in this family. Specifically, we request 

that the AMA RUC review the remaining codes in the complex wound repair family for CY 

2013, and we would maintain the values for CPT codes 13100 and 13101 interim for CY 2012 

while the AMA RUC completes its review of other codes in the family. For CY 2013, the 

revised work RVUs for all codes examined by the AMA RUC in the complex wound repair 

family, including CPT codes 13100 and 13101, would be included as interim final work RVUs in 

the CY 2013 PFS final rule with comment period, and their values would ultimately be finalized 

for CY 2014. 

3. Skin Grafts 
CMS-1582-PN 59

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommende

d Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinement

s to Time 

15120 Skn splt a-grft fac/nck/hf/g 11.16 10.15 10.15 Agree 

15121 Skn splt a-grft f/n/hf/g add 2.67 2.00 2.00 Agree 

15260 Skin full graft een & lips 11.64 11.64 11.64 Agree 

15732 Muscle-skin graft, head/neck 19.90 19.83 16.38 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 15120 and 15732 as potentially 

misvalued through the Site-of-Service Anomaly screen. CPT code 15121 was added as part of 

the family of services for AMA RUC review. In addition, we identified CPT code 15260 as 

potentially misvalued through the Harvard-Valued – Utilization > 30,000 screen. 

For CPT code 15732 (Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, 

temporalis, masseter muscle, sternocleidomastoid, levator scapulae)) the AMA RUC reviewed 

the survey results from physicians who frequently perform this service and recommended that 

this service be valued as a service performed predominately in the facility setting, as the survey 

data indicated that a majority of patients have an overnight stay. We note that it is unclear 

whether respondents were offered the option to state that the typical patient is in the hospital 

more than 24 hours, but not admitted as a hospital inpatient. The AMA RUC believes that this 

service should not be performed in the outpatient setting and that miscoding is the reason the 

Medicare utilization data reflect outpatient settings as the dominant place of service for this code. 

The AMA RUC and the surveyed specialties agreed that additional coding education needs to 

take place. 

The AMA RUC analyzed the survey’s estimated physician work and agreed that these 

data support the median work RVU of 19.83, for this service, which is slightly less than the 

current value of 19.90. The AMA RUC recommended a work RVU of 19.83 for CPT code 
CMS-1582-PN 60

15732. 

We disagree with the AMA RUC-recommended work RVU for CPT code 15732 and 

believe that an alternative work RVU of 16.38 is more appropriate for this service. We are also 

refining the time associated with this code. Although survey respondents and the AMA RUC 

indicated that patients receiving this service are typically admitted for more than 24 hours, the 

most recent Medicare PFS claims data show that CPT code 15732 is a code with a 

Site-of-Service anomaly. Upon review, it is clear that this code is being billed for services 

furnished to hospital outpatients, and we have no reason to believe that miscoding is the main 

reason that outpatient settings are the dominant place of service for this code in historical PFS 

claims data. Therefore, in accordance with the policy discussed in section II.A. of this proposed 

notice, we removed the inpatient hospital visit, reduced the discharge day management service to 

one-half, and adjusted times. These adjustments resulted in a work RVU of 16.38. We 

understand the AMA RUC’s assertion that claims data indicating that this service is performed in 

an outpatient setting is the result of miscoding but, until the claims data indicate that this service 

typically is performed in the inpatient setting (greater than 50 percent), we believe it is 

inappropriate for the service to be valued including inpatient E/M building blocks. Therefore, 

we are proposing an alternative work RVU of 16.38 for CPT code 15732 for CY 2012, with 

refinements to the time. We will continue to monitor Site-of-Service utilization for this code and 

may consider reviewing the work RVU for this code again in the future if utilization patterns 

change. A complete list of CMS time refinements can be found in Table 6. 

4. Destruction of Skin Lesions 
CMS-1582-PN 61

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

17260 Destruction of skin lesions 0.96 0.96 0.96 Agree 

17261 Destruction of skin lesions 1.22 1.22 1.22 Agree 

17262 Destruction of skin lesions 1.63 1.63 1.63 Agree 

17263 Destruction of skin lesions 1.84 1.84 1.84 Agree 

17264 Destruction of skin lesions 1.99 1.99 1.99 Agree 

17266 Destruction of skin lesions 2.39 2.39 2.39 Agree 

17270 Destruction of skin lesions 1.37 1.37 1.37 Agree x 

17271 Destruction of skin lesions 1.54 1.54 1.54 Agree x 

17272 Destruction of skin lesions 1.82 1.82 1.82 Agree 

17273 Destruction of skin lesions 2.10 2.10 2.10 Agree 

17274 Destruction of skin lesions 2.64 2.64 2.64 Agree x 

17276 Destruction of skin lesions 3.25 3.25 3.25 Agree 

17280 Destruction of skin lesions 1.22 1.22 1.22 Agree 

17281 Destruction of skin lesions 1.77 1.77 1.77 Agree 

17282 Destruction of skin lesions 2.09 2.09 2.09 Agree 

17283 Destruction of skin lesions 2.69 2.69 2.69 Agree 

17284 Destruction of skin lesions 3.26 3.20 3.20 Agree 

17286 Destruction of skin lesions 4.48 4.48 4.48 Agree 

In the Fourth Five-Year Review, we identified CPT codes 17271, 17272 and 17280 as 

potentially misvalued through the Harvard-Valued - Utilization > 30,000 screen. The dominant 

specialty for this family---dermatology---identified several other codes in the family to be 

reviewed concurrently with these services and submitted to the AMA RUC recommendations for 

CPT codes 17260 through 17286. The AMA RUC determined that, with the exception of one 

CPT code 17284, the survey data validated the current values of the destruction of skin lesion 

services. We agreed with this assessment, with a few refinements to physician time. 

For CPT code 17270 (Destruction, malignant lesion (eg, laser surgery, electrosurgery, 

cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion 

diameter 0.5 cm or less), the AMA RUC reviewed the survey results from physicians who 

frequently perform this service. The AMA RUC noted that the specialty did not provide 
CMS-1582-PN 62

compelling evidence to change the current value of the service; therefore, the AMA RUC agreed 

that the survey data support the current value of this service. The AMA RUC recommended a 

work RVU of 1.37 for CPT code 17270. 

As stated above, we agree with the AMA RUC-recommended work RVU for CPT code 

17270 and are proposing a work RVU of 1.37 for CY 2012, with a refinement to the physician 

time. After clinical review, we believe that an intra-service time of 16 minutes, the survey 

median, accurately reflects the time required to conduct the intra-service work associated with 

this service. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 17271 (Destruction, malignant lesion (eg, laser surgery, electrosurgery, 

cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion 

diameter 0.6 to 1.0 cm) the AMA RUC reviewed the survey results from physicians who 

frequently perform this service. The AMA RUC noted that the specialty did not provide 

compelling evidence to change the current value of the service; therefore, the AMA RUC agreed 

that the survey data support the current value of this service. The AMA RUC recommended a 

work RVU of 1.54 for CPT code 17271. 

As previously stated, we agree with the AMA RUC-recommended work RVU for CPT 

code 17271 and are proposing a work RVU of 1.54 for CY 2012, with a refinement to the 

physician time. After clinical review, we believe that 18 minutes, the survey median, accurately 

reflects the time required to conduct the intra-service work associated with this service. A 

complete list of CMS time refinements can be found in Table 6. 

For CPT code 17274 (Destruction, malignant lesion (eg, laser surgery, electrosurgery, 

cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion 

diameter 3.1 to 4.0 cm), the AMA RUC reviewed the survey results from physicians who 
CMS-1582-PN 63

frequently perform this service. The AMA RUC noted that the specialty did not provide 

compelling evidence to change the current value of the service; therefore, the AMA RUC agreed 

that the survey data support the current value of this service. The AMA RUC recommended a 

work RVU of 2.64 for CPT code 17274. 

As stated above, we agree with the AMA RUC-recommended work RVU for CPT code 

17274 and are proposing a work RVU of 2.64 for CY 2012, with a refinement to the physician 

time. After clinical review, we believe that 33 minutes, the survey median, accurately reflects 

the time required to conduct the intra-service work associated with this service. A complete list 

of CMS time refinements can be found in Table 6. 

5. Partial Mastectomy 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

WRVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

19302 P-mastectomy w/ln removal 13.99 13.99 13.87 Disagree 

In the Fourth Five-Year Review, we identified CPT code 19302 as potentially misvalued 

through the Site-of-Service Anomaly screen. 

For CPT code 19302 (Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, 

segmentectomy); with axillary lymphadenectomy), the AMA RUC reviewed the survey results 

and determined that the current work relative value for CPT code 19302 appropriately places this 

service relative to other similar services, specifically CPT code 38745 (Axillary 

lymphadenectomy; complete) (work RVU = 13.87) which has similar work intensity and time. 

The AMA RUC recommended a work RVU of 13.99 for CPT code 19302. 

We disagree with the AMA RUC-recommended work RVU for CPT code 19302 and 
CMS-1582-PN 64

believe that a work RVU of 13.87 is more appropriate for this service. After clinical review, we 

agree with the AMA RUC that CPT code 19302 is similar in work intensity and time to CPT 

code 38745 (Axillary lymphadenectomy; complete) (work RVU = 13.87), which overlaps 

significantly with CPT code 19302, and as such, we believe these two procedures should have 

the same work RVU. Therefore, we are proposing an alternative work RVU of 13.87 for CPT 

code 19302 for CY 2012. 

6. Percutaneous Vertebroplasty/Kyphoplasty 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

WRVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

22520 Percut vertebroplasty thor 9.22 9.22 9.22 Agree 

22521 Percut vertebroplasty lumb 8.65 8.65 8.01 Disagree 

22522 Percut vertebroplasty addl 4.30 4.30 4.30 Agree 

22523 Percut kyphoplasty, thor 9.26 9.26 8.62 Disagree 

22524 Percut kyphoplasty, lumbar 8.86 8.86 8.22 Disagree 

22525 Percut kyphoplasty, add-on 4.47 4.47 4.47 Agree 

In the Fourth Five-Year Review, we identified CPT codes 22521 as potentially misvalued 

through the Site-of-Service Anomaly screen. CPT codes 22520, 22522, 22523, 22524 and 22525 

were added as part of the family of services for AMA RUC review. 

CPT codes: 22521 (Percutaneous vertebroplasty, 1 vertebral body, unilateral or bilateral 

injection; lumbar); 22523 (Percutaneous vertebral augmentation, including cavity creation 

(fracture reduction and bone biopsy included when performed) using mechanical device, 1 

vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); thoracic); and 22524 

(Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone 

biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or 

bilateral cannulation (eg, kyphoplasty); lumbar) currently include one full discharge management 
CMS-1582-PN 65

day, a CPT code building block usually only appropriate for codes that are typically performed in 

the inpatient setting. As these CPT codes are typically performed in the outpatient setting, the 

AMA RUC recommended, and we agree, that the discharge management day should be reduced 

by half. After reviewing the recent history of valuing these codes, the AMA RUC asserted that it 

believes that an inadvertent clerical error led to these codes showing one full discharge 

management day in the documentation of their E/M blocks, rather than a half day, and that these 

codes are actually currently valued using only half a day block. As such, the AMA RUC 

concluded that the current work RVU for these codes should not be reduced to reflect the 

removal of the half discharge day. The AMA RUC recommended maintaining the current work 

RVU for the 6 CPT codes reviewed in this family. 

After reviewing the documentation the AMA RUC provided and CMS records from 

when the codes were last valued, we do not find compelling evidence that previously these codes 

were valued to include only a half discharge management day. To the contrary, it appears as 

though the codes were previously surveyed with one full discharge management day. According 

to our established policy, we believe it would be appropriate to reduce the work RVU for these 

codes by the value of the half discharge management day and, therefore, we are removing 0.64 

of a work RVU from each code. Therefore, we are proposing an alternative work RVU of 8.01 

for CPT code 22521, 8.62 for CPT code 22523, and 8.22 for CPT code 22524 for CY 2012. 

7. Closed Treatment of Distal Radial Fracture 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

25600 Treat fracture radius/ulna 2.78 2.78 2.64 Disagree x 

25605 Treat fracture radius/ulna 7.25 6.50 6.00 Disagree x 
CMS-1582-PN 66

In the Fourth Five-Year Review, we identified CPT codes 25600 and 25605 as potentially 

misvalued through the Harvard-Valued - Utilization > 30,000 screen. 

For CPT code 25600 (Closed treatment of distal radial fracture (eg, Colles or Smith type) 

or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; 

without manipulation), the AMA RUC reviewed the survey results from physicians who 

frequently perform this service. The AMA RUC reviewed the number of post-operative visits 

recommended by the specialties and agreed that they were reflective of the service. The AMA 

RUC believes that the survey data support the current value of this service, and recommended a 

work RVU of 2.78 for CPT code 25600. 

We disagree with the AMA RUC-recommended work RVU for CPT code 25600 and 

believe that a work RVU of 2.64 is more appropriate for this service. We agree with the AMA 

RUC that CPT code 25600 requires more work than key reference CPT code 26600, and find 

that CPT code 27767 (Closed treatment of posterior malleolus fracture; without manipulation) 

(work RVU = 2.64) is similar in complexity and intensity to CPT code 25600. Therefore, we are 

proposing an alternative work RVU of 2.64 for CPT code 25600 for CY 2012. 

In addition to the work RVU adjustment for CPT code 25600, we are refining the time 

associated with this code. This service typically is performed on the same day as an E/M visit. 

We believe some of the activities conducted during the pre- and post-service times of the 

procedure code and the E/M visit overlap and, therefore, should not be counted twice in 

developing the procedure’s work value. As described earlier, to account for this overlap, we 

reduced the pre-service evaluation and post service time by one-third. We believe that 5 minutes 

pre-service evaluation time and 7 minutes post-service time accurately reflect the time required 

to conduct the work associated with this service. A complete list of CMS time refinements can 
CMS-1582-PN 67

be found in Table 6. 

For CPT code 25605 (Closed treatment of distal radial fracture (eg, Colles or Smith type) 

or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; 

with manipulation), the AMA RUC reviewed the survey results from physicians who frequently 

perform this service. The AMA RUC reviewed the number of post-operative visits 

recommended by the specialties and determined that they are reflective of the service. Based on 

comparisons to similar codes, the AMA RUC determined that a work RVU of 6.50, the survey’s 

25th percentile, accurately reflects the work required to perform this service. The AMA RUC 

recommended a work RVU of 6.50 for CPT code 25605. 

We disagree with the AMA RUC-recommended work RVU for CPT code 25605 and 

believe that the survey low value of a work RVU of 6.00 is more appropriate for this service. 

We find CPT code 28113 (Ostectomy, complete excision; fifth metatarsal head) (work RVU = 

6.11) to be similar in intensity and complexity to CPT code 25605, though CPT code 28113 

includes higher intensity office visits than CPT code 25605. Therefore, we believe the survey 

low correctly reflects relativity across these services, and are proposing an alternative work RVU 

of 6.00 for CPT code 25605 for CY 2012. 

In addition to the work RVU adjustment for CPT code 25605, we are refining the time 

associated with this code. Recent Medicare PFS claims data show that this service is typically 

performed on the same day as an E/M visit. We believe some of the activities conducted during 

the pre- and post-service times of the procedure code and the E/M visit overlap and, therefore, 

should not be counted twice in developing the procedure’s work value. In its time 

recommendations to us, the AMA RUC accounted for duplicate E/M work associated with the 

pre-service period, but not the post-service period. To account for this post-service overlap, we 
CMS-1582-PN 68

reduced the post-service time by one-third, a methodology described in detail in section II.A. of 

this proposed notice. We believe that 13 minutes post-service time accurately reflect the time 

required to conduct the work associated with this service. A complete list of CMS time 

refinements can be found in Table 6. 

8. Orthopaedic Surgery – Thigh/Knee 

CPT 

Code Short Descriptor CY 2011 Work RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

WRVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

27385 Repair of thigh muscle 8.11 8.11 6.93 Disagree x 

27530 Treat knee fracture 4.09 2.81 2.65 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 27385 and 27530 as potentially 

misvalued through the Site-of-Service Anomaly screen. 

For CPT code 27385 (Suture of quadriceps or hamstring muscle rupture; primary), the 

AMA RUC reviewed the survey results from physicians who frequently perform this service and 

determined that there was no compelling evidence that the work required to perform this service 

has changed. The AMA RUC recommended that this service be valued as a service performed 

predominately in the facility setting, as the survey data indicated that half of patients have an 

overnight stay. The AMA RUC recommended a work RVU of 8.11 for CPT code 27385. 

We disagree with the AMA RUC-recommended work RVU of 8.11 for CPT code 27385 

and believe that a work RVU of 6.93 is more appropriate for this service. We are also refining 

the time associated with this code. We note the data survey indicate that of those respondents 

who stated that they typically perform the procedure in the hospital, 19 percent (6 out of 32) 

stated that the patient is "discharged the same day," 31 percent (10 out of 32) stated the patient is 

"kept overnight (less than 24 hours)," and 50 percent (16 out of 32) stated the patient is "admitted 
CMS-1582-PN 69

(more than 24 hours)." These responses make no distinction between the patient’s status as an 

inpatient or outpatient of the hospital for stays of longer than 24 hours. As indicated by the most 

recent Medicare PFS claims data, CPT code 27385 is a code with a Site-of-Service anomaly 

since more than 50 percent of the Medicare utilization is not inpatient. Therefore, in accordance 

with the policy discussed in section II.A. of this proposed notice, we removed the hospital visit, 

reduced the discharge day management service to one-half, and adjusted times. As a result, we 

are proposing an alternative work RVU of 6.93 with refinements to the time for CPT code 27385 

for CY 2012. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 27530 (Closed treatment of tibial fracture, proximal (plateau); without 

manipulation), the AMA RUC reviewed the survey responses from 33 (of 200 surveyed) 

physicians. Based on comparisons to reference codes, the AMA RUC recommended a work 

RVU of 2.81 for CPT code 27530. 

We disagree with the AMA RUC-recommended work RVU for CPT code 27530 and 

believe that a work RVU of 2.65 is more appropriate for this service. We are also refining the 

time associated with this code. Recent Medicare PFS claims data show that this service is 

typically performed on the same day as an E/M visit. We believe some of the activities 

conducted during the pre- and post-service times of the procedure code and the E/M visit overlap 

and, therefore, should not be counted twice in developing the procedure’s work value. As 

described earlier in section II.A. of this proposed notice, to account for this overlap, we reduced 

the pre-service evaluation and post service time by one-third. We believe that 5 minutes 

pre-service evaluation time and 7 minutes post-service time accurately reflect the time required 

to conduct the work associated with this service. We also removed the 2 minutes of pre-service 

positioning time, as it does not appear from the vignette that positioning is required for a non-
CMS-1582-PN 70

manipulated extremity. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU. For CPT code 27530, we removed a total of 7 minutes from the 

AMA RUC-recommended pre- and post-service time, which amounts to the removal of 0.16 of a 

work RVU. Therefore, we are proposing an alternative work RVU of 2.65 with refinement in 

time for CPT code 27530 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. Additionally, we recommend that the AMA RUC examine all of the 

non-manipulation fracture codes to determine if positioning time was incorporated into the work 

RVU for the codes and, if so, whether the need for positioning time was documented. 

9. Treatment of Ankle Fracture 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

27792 Treatment of ankle fracture 9.71 9.71 8.75 Disagree x 

 In the Fourth Five-Year Review, we identified CPT code 27792 (Open treatment of distal 

fibular fracture (lateral malleolus), includes internal fixation, when performed) as potentially 

misvalued through the Site-of-Service Anomaly screen. For CPT code 27792, the AMA RUC 

used magnitude estimation and recommended that the current value of this service, 9.71 RVUs, 

be maintained, and replaced the current inpatient hospital E/M visit block with a subsequent 

observation care service while maintaining a full discharge day management service. 

 We disagree with the AMA RUC-recommended work RVU of 9.71 for CPT code 27792. 

The AMA RUC indicated in its summary of recommendations that the survey data show 
CMS-1582-PN 71

100 percent (53 out of 53) of survey respondents stated they perform the procedure "in the 

hospital." Of those respondents who stated that they typically perform the procedure in the 

hospital, 42 percent (22 out of 53) stated that the patient is "discharged the same day," 44 percent 

(23 out of 53) stated the patient is "kept overnight (less than 24 hours)," and 13 percent (7 out of 

53) stated the patient is "admitted (more than 24 hours)." These responses make no distinction 

between the patient’s status as an inpatient or outpatient of the hospital for stays of longer than 

24 hours. As indicated by the most recent Medicare PFS claims data, CPT code 27792 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the subsequent observation care service, reduced the 

discharge day management service to one-half, and adjusted times. As a result, we are proposing 

an alternative work RVU of 8.75 with refinements to the time for CPT code 27792 for CY 2012. 

A complete list of CMS time refinements can be found in Table 6. 

10. Orthopaedic Surgery/Podiatry 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

28002 Treatment of foot infection 5.93 5.34 4.00 Disagree 

28003 Treatment of foot infection 9.06 9.06 9.06 Agree 

28120 Part removal of ankle/heel 8.27 8.27 7.31 Disagree x 

28122 Partial removal of foot bone 7.72 7.72 6.76 Disagree x 

28285 Repair of hammertoe 4.76 5.62 4.76 Disagree 

28715 Fusion of foot bones 14.60 14.60 13.42 Disagree x 

28820 Amputation of toe 5.00 7.00 5.82 Disagree x 

28825 Partial amputation of toe 6.01 6.01 5.37 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 28002, 28120, 28122, 28715, 

28820, and 28825 as potentially misvalued through the Site-of-Service Anomaly screen. CPT 

code 28003 was added as part of the family of services for AMA RUC review. CMS also 
CMS-1582-PN 72

identified CPT code 28285 as potentially misvalued through the Harvard-Valued - Utilization > 

30,000 screen. 

For CPT code 28002 (Incision and drainage below fascia, with or without tendon sheath 

involvement, foot; single bursal space), the AMA RUC reviewed the survey responses and 

determined that CPT code 28002 should be decreased to the survey 25th percentile work RVU. 

The AMA RUC recommended a work RVU of 5.34 for CPT code 28002. 

We disagree with the AMA RUC-recommended work RVU for CPT code 28002 and 

believe that the survey low value of a work RVU of 4.00 is more appropriate for this service. 

We find CPT code 28002 to be closer to the complexity and intensity of CPT code 58353 

(Endometrial ablation, thermal, without hysteroscopic guidance) (work RVU = 3.60) which has 

similar times and lower-level visits to CPT code 28002. We believe that the survey low value 

accurately reflects the work associated with this service and are proposing an alternative work 

RVU of 4.00 for CPT code 28002 for CY 2012. 

For CPT code 28120 (Partial excision (craterization, saucerization, sequestrectomy, or 

diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus), the AMA RUC used 

magnitude estimation, recommended that the current work RVU of 8.27 for this service be 

maintained, and replaced the current inpatient hospital E/M visit block with a subsequent 

observation care service while maintaining a full discharge day management service. 

 We disagree with the AMA RUC-recommended work RVU of 8.27 for CPT code 28120. 

The AMA RUC indicated in its summary of recommendations that the survey data show 

87 percent (45 out of 52) of survey respondents stated they perform the procedure "in the 

hospital." Of those respondents who stated that they typically perform the procedure in the 

hospital, 16 percent (7 out of 45) stated that the patient is "discharged the same day," 18 percent 
CMS-1582-PN 73

(8 out of 45) stated the patient is "kept overnight (less than 24 hours)," and 67 percent (30 out of 

45) stated the patient is "admitted (more than 24 hours)." These responses make no distinction 

between the patient’s status as an inpatient or outpatient of the hospital for stays of longer than 

24 hours. As indicated by the most recent Medicare PFS claims data, CPT code 28120 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the subsequent observation care service, reduced the 

discharge day management service to one-half, and adjusted times. As a result, we are proposing 

an alternative work RVU of 7.31 with refinements to the time for CPT code 28120 for CY 2012. 

A complete list of CMS time refinements can be found in Table 6. 

For CPT code 28122 (Partial excision (craterization, saucerization, sequestrectomy, or 

diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or 

calcaneus), the AMA RUC used magnitude estimation, recommended that the current work RVU 

of 7.56 for this service should be maintained for CY 2012, and replaced the current inpatient 

hospital E/M visit block with a subsequent observation care service while maintaining a full 

discharge day management service. 

We disagree with the AMA RUC-recommended work RVU of 7.56 for CPT code 28122. 

The AMA RUC indicated in its summary of recommendations that the survey data show 

83 percent (43 out of 52) of survey respondents stated they perform the procedure "in the 

hospital." Of those respondents who stated that they typically perform the procedure in the 

hospital, 12 percent (5 out of 43) stated that the patient is "discharged the same day," 30 percent 

(13 out of 43) stated the patient is "kept overnight (less than 24 hours)," and 58 percent (23 out 

of 43) stated the patient is "admitted (more than 24 hours)." These responses make no 

distinction between the patient’s status as an inpatient or outpatient of the hospital for stays of 
CMS-1582-PN 74

longer than 24 hours. As indicated by the most recent Medicare PFS claims data, CPT code 

28122 is a code with a Site-of-Service anomaly. Therefore, in accordance with the policy 

discussed in section II.A. of this proposed notice, we removed the subsequent observation care 

service, reduced the discharge day management service to one-half, and adjusted times. As a 

result, we are proposing an alternative work RVU of 6.76 with refinements to the time for CPT 

code 28122 for CY 2012. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 28285 (Correction, hammertoe (eg, interphalangeal fusion, partial or total 

phalangectomy)), the AMA RUC reviewed the survey responses and agreed that the appropriate 

work RVU for CPT code 28285 is a work RVU of 5.62,crosswalked from CPT code 28675. The 

AMA RUC recommended a work RVU of 5.62 for CPT code 28285. 

We disagree with the AMA RUC-recommended work RVU for CPT code 28285 and 

believe that a work RVU of 4.76, the current work RVU, is more appropriate for this service. 

The majority of survey respondents indicated that the work of performing this service has not 

changed in the past 5 years (67 percent), and that there has been no change in complexity among 

the patients requiring this service (81 percent). We believe that the current work RVU accurately 

reflects the work associated with this service. Therefore, we are proposing an alternative work 

RVU of 4.76 for CPT code 28675 for CY 2012. 

For CPT code 28715 (Arthrodesis; triple), the AMA RUC reviewed the survey responses 

from 30 (of 150 surveyed) physicians for CPT code 28715 and determined that the current work 

RVU of 14.60 maintains the correct relativity among similar services. The AMA RUC 

recommended that this service be valued as a service performed predominately in the facility 

setting. The AMA RUC indicated that since the typical patient is kept overnight, the AMA RUC 

believes that one inpatient hospital visit as well as one discharge day management service should 
CMS-1582-PN 75

be maintained in the post-operative visits for this service. 

We disagree with the AMA RUC-recommended work RVU for CPT code 28715 and 

believe that a work RVU of 13.42 is more appropriate for this service. While the survey data 

show 93 percent (28 out of 30) of survey respondents stated they perform the procedure "in the 

hospital," of those respondents who stated that they typically perform the procedure in the 

hospital, 7 percent (2 out of 28) stated that the patient is "discharged the same day," 32 percent (9 

out of 28) stated the patient is "kept overnight (less than 24 hours)," and 61 percent (17 out of 

28) stated the patient is "admitted (more than 24 hours)." These responses make no distinction 

between the patient’s status as an inpatient or outpatient of the hospital for stays of longer than 

24 hours. As indicated by the most recent Medicare PFS claims data, CPT code 28715 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the inpatient hospital visit, reduced the discharge day 

management service to one-half, and adjusted times. As a result, we are proposing an alternative 

work RVU of 13.42 with refinements to the time for CPT code 28715 for CY 2012. A complete 

list of CMS time refinements can be found in Table 6. 

For CPT code 28820 (Amputation, toe; metatarsophalangeal joint), the AMA RUC 

reviewed the survey responses and determined that the survey median work RVU of 7.00 

appropriately reflects the physician work required to perform this service and maintains relativity 

among similar services. Therefore, the AMA RUC recommended a work RVU of 7.00 for CPT 

code 28820. In its recommendation to us for CPT code 28820, the AMA RUC included one 

post-operative hospital visit and one full discharge management day. 

We disagree with the AMA RUC-recommended work RVU for CPT code 28820 and 

believe that a work RVU of 5.82 is more appropriate for this service. The survey data for this 
CMS-1582-PN 76

code show that 87 percent of respondents indicated that they perform this procedure in the 

hospital, but without a distinction between the patient’s status as a hospital inpatient or 

outpatient. Recent Medicare PFS claims data indicate that this service is typically (greater than 

50 percent) performed in the outpatient setting. As we discussed in section II.A. of this proposed 

notice, for codes with Site-of-Service anomalies where the service is typically performed in the 

outpatient setting but valued with inpatient inputs, our policy is to remove any post-procedure 

inpatient visits remaining in the values for the codes, and adjust the physician times and work 

RVU accordingly. Therefore, in accordance with this policy, we reduced the discharge 

management day to half a day, eliminated the post-operative hospital visit, and adjusted the time 

and work RVU accordingly. As a result, we are proposing an alternative work RVU of 5.82 with 

refinements to the time for CPT code 28820 for CY 2012. A complete list of CMS time 

refinements can be found in Table 6. 

For CPT code 28825 (Amputation, toe; interphalangeal joint), the AMA RUC used 

magnitude estimation and ultimately recommended maintaining the current work RVU of 6.01, 

while also maintaining a full discharge day management service. 

We disagree with the AMA RUC-recommended work RVU of 6.01 for CPT code 28825. 

The AMA RUC indicated in its summary of recommendations that the survey data show 

84 percent (37 out of 44) of survey respondents stated they perform the procedure "in the 

hospital." Of those respondents who stated that they typically perform the procedure in the 

hospital, 36 percent (13 out of 37) stated that the patient is "discharged the same day," 11 percent 

(4 out of 37) stated the patient is "kept overnight (less than 24 hours)," and 52 percent (19 out of 

37) stated the patient is "admitted (more than 24 hours)." These responses make no distinction 

between the patient’s status as an inpatient or outpatient of the hospital for stays of longer than 
CMS-1582-PN 77

24 hours. As indicated by the most recent Medicare PFS claims data, CPT code 28825 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we reduced the discharge day management service to one-half, and 

adjusted times. As a result, we are proposing an alternative work RVU of 5.37 with refinements 

to the time for CPT code 28825 for CY 2012. A complete list of CMS time refinements can be 

found in Table 6. 

11. Application of Cast and Strapping 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

29125 Apply forearm splint 0.59 0.59 0.50 Disagree x 

29126 Apply forearm splint 0.77 0.77 0.68 Disagree x 

29405 Apply short leg cast 0.86 0.80 0.80 Agree 

29425 Apply short leg cast 1.01 0.80 0.80 Agree 

29515 Application lower leg splint 0.73 0.73 0.73 Agree x 

In the Fourth Five-Year Review, we identified CPT codes 29125, 29405 and 29515 as 

potentially misvalued through the Harvard-Valued – Utilization > 30,000 screen. CPT codes 

29126 and 29425 were added as part of the family of services for AMA RUC review. 

For CPT code 29125 (Application of short arm splint (forearm to hand); static), the AMA 

RUC reviewed the survey results and determined that these data support maintaining the current 

work RVU of 0.59 for this service. The AMA RUC recommended a work RVU of 0.59 for CPT 

code 29125. In its recommendation to us, the AMA RUC also noted that there is typically an 

E/M service furnished on the same day as this service. 

We disagree with the AMA RUC-recommended work RVU for CPT code 29125 and 

believe that a work RVU of 0.50 is more appropriate for this service. We are also refining the 
CMS-1582-PN 78

time associated with this code. Recent Medicare PFS claims data affirm that this service is 

typically performed on the same day as an E/M visit. We believe some of the activities 

conducted during the pre- and post-service times of the procedure code and the E/M visit overlap 

and, therefore, should not be counted twice in developing the procedure’s work value. As 

described earlier in section II.A. of this proposed notice, to account for this overlap, we reduced 

the pre-service evaluation and post-service time by one-third. We believe that 5 minutes 

pre-service evaluation time and 3 minutes post-service time accurately reflect the time required 

to conduct the work associated with this service as described by the CPT code-associated 

specialties to the AMA RUC. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU. For CPT code 29125, we removed a total of 4 minutes from the 

AMA RUC-recommended pre- and post-service time, which amounts to the removal of 0.09 of a 

work RVU. Therefore, we are proposing an alternative work RVU of 0.50 with refinement in 

time for CPT code 29125 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 

For CPT code 29126 (Application of short arm splint (forearm to hand); dynamic), the 

AMA RUC reviewed the survey results and determined that the median work RVU 

overestimates the work value for this service and that there is no compelling evidence that the 

physician work has recently changed. Therefore, the AMA RUC recommended maintaining the 

current work RVU of 0.77 for CPT code 29126. In its recommendation to us, the AMA RUC 

noted that there is typically an E/M service furnished on the same day as this service. 

We disagree with the AMA RUC-recommended work RVU for CPT code 29126 and 
CMS-1582-PN 79

believe that a work RVU of 0.68 is more appropriate for this service. We are also refining the 

time associated with this code. Recent Medicare PFS claims data affirm that this service is 

typically performed on the same day as an E/M visit. We believe some of the activities 

conducted during the pre- and post-service times of the procedure code and the E/M visit overlap 

and, therefore, should not be counted twice in developing the procedure’s work value. As 

described earlier in section II.A. of this proposed notice, to account for this overlap, we reduced 

the pre-service evaluation and post-service time by one-third. We believe that 5 minutes 

pre-service evaluation time and 3 minutes post-service time accurately reflect the time required 

to conduct the work associated with this service as described by the CPT code-associated 

specialties to the AMA RUC. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU. For CPT code 29126, we removed a total of 4 minutes from the 

AMA RUC-recommended pre- and post-service time, which amounts to the removal of 0.09 of a 

work RVU. Therefore, we are proposing an alternative work RVU of 0.68 with refinement in 

time for CPT code 29126 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 

For CPT code 29515 (Application of short leg splint (calf to foot)), the AMA RUC 

reviewed the survey results and determined that these data support maintaining the current work 

RVU of 0.73 for this service. The AMA RUC recommended a work RVU of 0.73 for CPT code 

29515. In its recommendation to us, the AMA RUC noted that there is typically an E/M service 

furnished on the same day as this service. 

We agree with the AMA RUC-recommended work RVU of 0.73 for CPT code 29515, 
CMS-1582-PN 80

with a refinement to time. Recent Medicare PFS claims data affirm that this service is typically 

performed on the same day as an E/M visit. We believe some of the activities conducted during 

the pre- and post-service times of the procedure code and the E/M visit overlap and, therefore, 

should not be counted twice in developing the procedure’s work value. As described earlier in 

section II.A. of this proposed notice, to account for this overlap, we reduced the pre-service 

evaluation and post-service time by one-third. We believe that 5 minutes pre-service evaluation 

time and 3 minutes post-service time accurately reflect the time required to conduct the work 

associated with this service as described by the CPT code-associated specialties to the AMA 

RUC. Despite this reduction in time, after clinical review we believe that the AMA 

RUC-recommended work RVU of 0.73 accurately reflects the work associated with this service 

and maintains appropriate relativity with similar services. Therefore, we are proposing a work 

RVU of 0.73 for CY 2012, with a refinement to the time. 

12. Cardiothoracic Surgery 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

32851 Lung transplant, single 41.61 63.00 59.64 Disagree 

32852 Lung transplant with bypass 45.48 74.37 65.50 Disagree 

32853 Lung transplant, double 50.78 90.00 84.48 Disagree 

32854 Lung transplant with bypass 54.74 95.00 90.00 Disagree 

33030 Partial removal of heart sac 22.39 39.50 36.00 Disagree 

33031 Partial removal of heart sac 25.38 45.00 45.00 Agree 

33120 Removal of heart lesion 27.45 42.88 38.45 Disagree 

33315 Exploratory heart surgery 26.17 35.00 35.00 Agree 

33411 Replacement of aortic valve 62.07 62.07 62.07 Agree 

33412 Replacement of aortic valve 43.94 60.00 59.00 Disagree 

33468 Revision of tricuspid valve 32.94 50.00 45.13 Disagree 

33645 Revision of heart veins 28.10 33.00 31.30 Disagree 

33647 Repair heart septum defects 29.53 35.00 33.00 Disagree 

33692 Repair of heart defects 31.54 38.75 36.15 Disagree 

33710 Repair of heart defects 30.41 43.00 37.50 Disagree 

33875 Thoracic aortic graft 35.78 56.83 50.72 Disagree 
CMS-1582-PN 81

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

33910 Remove lung artery emboli 29.71 52.33 48.21 Disagree 

33916 Surgery of great vessel 28.42 78.00 78.00 Agree 

33935 Transplantation, heart/lung 62.01 100.00 91.78 Disagree 

33975 Implant ventricular device 20.97 25.00 25.00 Agree 

33976 Implant ventricular device 22.97 30.75 30.75 Agree 

33977 Remove ventricular device 20.28 20.86 20.86 Agree 

33978 Remove ventricular device 22.72 25.00 25.00 Agree 

33979 Insert intracorporeal device 45.93 37.50 37.50 Agree 

33980 Remove intracorporeal device 65.20 40.00 33.50 Disagree 

33981 Replace vad pump ext 0.00 16.11 16.11 Agree 

33982 Replace vad intra w/o bp 0.00 37.86 37.86 Agree 

33983 Replace vad intra w/bp 0.00 44.54 44.54 Agree 

36200 Place catheter in aorta 3.02 3.02 3.02 Agree 

36246 Place catheter in artery 5.27 5.27 5.27 Agree 

36247 Place catheter in artery 6.29 7.00 6.29 Disagree 

36470 Injection therapy of vein 1.10 1.10 1.10 Agree 

36471 Injection therapy of veins 1.65 1.65 1.65 Agree 

36821 Av fusion direct any site 12.11 12.11 12.11 Agree 

36825 Artery-vein autograft 15.13 15.13 14.17 Disagree x 

In the Fourth Five-Year Review, we identified CPT code 33411 (Replacement, aortic 

valve; with aortic annulus enlargement, noncoronary sinus) as potentially misvalued through the 

Site-of-Service Anomaly screen. We included a number of services that were also identified by 

the Society of Thoracic Surgeons (STS) in their public comments regarding candidate services 

for the Fourth Five-Year Review, including ventricular assist device (VAD) removal codes, 

VAD insertion and replacement codes, lung transplant codes, pulmonary artery embolectomy 

codes, descending thoracic aorta repair codes, congenital cardiac codes and general thoracic 

surgery CPT code 43415 (Suture of esophageal wound or injury; transthoracic or transabdominal 

approach). In its review of these cardiothoracic surgery codes, the AMA RUC recommended 

increasing the work RVUs for most of the codes (often substantially), while recommending that 

many of the service times be reduced. We also note that many of these codes have had the same 
CMS-1582-PN 82

work value since 1993, potentially historically supporting the longstanding appropriateness of 

the value from the perspective of interested specialties. While we discuss the proposed values 

for each revised code below, we note that for most of the codes in this family (but not all) we 

agreed with the AMA RUC that the work RVU should be increased, but believe that the survey 

25th percentile work RVU reflected a clinically more appropriate increase than the work RVU 

recommended by the AMA RUC. 

Additionally, the AMA RUC recommended global period changes for several codes in 

the category of cardiothoracic surgery. For CY 2012, we agree with the AMA RUCrecommended global period changes and work RVUs and are proposing the following: for CPT 

code 33977 (Removal of ventricular assist device; extracorporeal, single ventricle), a proposed 

work RVU of 20.86 and global period change from 090 to XXX (a global period of XXX means 

the concept does not apply); for CPT code 33978 (Removal of ventricular assist device; 

extracorporeal, biventricular), a proposed work RVU of 25 and global period change from 090 to 

XXX; for CPT code 36200 (Introduction of catheter, aorta), a proposed work RVU of 3.02 and 

global period change from XXX to 000; for CPT code 36246 (Selective catheter placement, 

arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a 

vascular family), a proposed work RVU of 5.27 and a global period change from XXX to 000; 

and for CPT code 36821 (Arteriovenous anastomosis, open; direct, any site (eg, cimino type) 

(separate procedure)), a proposed work RVU of 12.11 and a global period change from XXX to 

000. 

For CPT code 32851 (Lung transplant, single; without cardiopulmonary bypass), the 

AMA RUC reviewed the survey responses and determined that the survey 25th percentile work 

RVU of 63.00 appropriately accounts for the physician work required to perform this service. 
CMS-1582-PN 83

We disagree with the AMA RUC-recommended work RVU for CPT code 32851 and 

believe that a work RVU of 59.64 is more appropriate for this service. Comparing CPT code 

33255 (Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); 

without cardiopulmonary bypass) (work RVU = 29.04) with CPT code 33256 (Operative tissue 

ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary 

bypass) (work RVU = 34.90), there is a difference in work RVU of 5.86. This difference in 

work RVUs reflects the additional time and physician work performed while the patient is on 

cardiopulmonary bypass. We believe that this is the appropriate interval in physician work 

distinguishing CPT code 32852 (Lung transplant, single; with cardiopulmonary bypass), from 

CPT code 32851 (Lung transplant, single; without cardiopulmonary bypass). As we are 

proposing a work RVU of 65.05 for CPT code 32852 (see below), we believe a work RVU of 

59.64 accurately reflects the work associated with CPT code 32851 and maintains appropriate 

relativity among similar services. Therefore, we are proposing an alternative work RVU of 

59.64 for CPT code 32851 for CY 2012. 

For CPT code 32852 (Lung transplant, single; with cardiopulmonary bypass), the AMA 

RUC reviewed the survey responses and determined that the survey 25th percentile work RVU 

was too low and the median work RVU was too high. Therefore, the AMA RUC recommended 

a work RVU of 74.37 for CPT code 32582. 

We disagree with the AMA RUC-recommended work RVU for CPT code 32582 and 

believe that the survey 25th percentile value of a work RVU of 65.50 is more appropriate for this 

service. Therefore, we are proposing an alternative work RVU of 65.50 for CPT code 32582 for 

CY 2012. 

For CPT code 32853 (Lung transplant, double (bilateral sequential or en bloc); without 
CMS-1582-PN 84

cardiopulmonary bypass), the AMA RUC reviewed the survey responses and determined that the 

survey median work RVU of 90.00 appropriately accounts for the physician work required to 

perform this service. 

We disagree with the AMA RUC-recommended work RVU for CPT code 32853 and 

believe that the survey 25th percentile value of 84.48 is more appropriate for this service as a 

reflection of the time and intensity of the service in relation to other major surgical procedures. 

Therefore, we are proposing an alternative work RVU of 84.48 for CPT code 32853 for 

CY 2012. 

For CPT code 32854 (Lung transplant, double (bilateral sequential or en bloc); with 

cardiopulmonary bypass), the AMA RUC reviewed the survey responses and determined that the 

survey median work RVU of 95.00 appropriately accounts for the physician work required to 

perform this service. 

We disagree with the AMA RUC-recommended work RVU for CPT code 32854 and 

believe that the survey 25th percentile value of 90.00 is more appropriate for this service. A 

work RVU of 90.00 maintains the relativity between CPT code 32851 (Lung transplant, single; 

without cardiopulmonary bypass) and CPT code 32854, which describes a double lung 

transplant. We believe this work RVU reflects the increased intensity in total service for CPT 

code 32584 when compared to CPT code 32851. Therefore, we are proposing an alternative 

work RVU of 90.00 for CPT code 32854 for CY 2012. 

For CPT code 33030 (Pericardiectomy, subtotal or complete; without cardiopulmonary 

bypass), the AMA RUC reviewed the survey responses and determined that the survey median 

work RVU of 39.50 for CPT code 33030 appropriately accounts for the work required to perform 

this service. 
CMS-1582-PN 85

We disagree with the AMA RUC-recommended work RVU for CPT code 33030 and 

believe that the survey 25th percentile value of 36.00 is more appropriate for this service. 

Therefore, we are proposing an alternative work RVU of 36.00 for CPT code 33030 for 

CY 2012. 

For CPT code 33120 (Excision of intracardiac tumor, resection with cardiopulmonary 

bypass), the AMA RUC reviewed the survey responses and determined that the 25th percentile 

work RVU for CPT code 33120 appropriately accounts for the work required to perform this 

service. The AMA RUC recommended a work RVU of 42.88 for CPT code 33120. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33120 and 

believe that a work RVU of 38.45 is more appropriate for this service. We compared CPT code 

33120 with CPT code 33677 (Closure of multiple ventricular septal defects; with removal of 

pulmonary artery band, with or without gusset) (work RVU = 38.45) and found the codes to be 

the similar in complexity and intensity. We believe that a work RVU of 38.45 accurately reflects 

the work associated with CPT code 33677 and properly maintains the relativity of similar 

service. Therefore, we are proposing an alternative work RVU of 38.45 for CPT code 33120 for 

CY 2012. 

For CPT code 33412 (Replacement, aortic valve; with transventricular aortic annulus 

enlargement (Konno procedure)), the AMA RUC reviewed the survey responses and determined that 

the survey median work RVU for CPT code 33412 appropriately accounts for the work required to 

perform this service. The AMA RUC recommended a work RVU of 60.00 for CPT code 33412.

We disagree with the AMA RUC-recommended work RVU for CPT code 33412 and 

believe that the survey 25th percentile value of 59.00 is more appropriate for this service. 

Therefore, we are proposing an alternative work RVU of 59.00 for CPT code 33412 for 
CMS-1582-PN 86

CY 2012. 

For CPT code 33468 (Tricuspid valve repositioning and plication for Ebstein anomaly), 

the AMA RUC reviewed the survey responses and determined that the survey median work RVU 

for CPT code 33468 appropriately accounts for the work required to perform this service. The 

AMA RUC recommended a work RVU of 50.00 for CPT code 33468. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33468 and 

believe that the survey 25th percentile value of 45.13 is more appropriate for this service. 

Therefore, we are proposing an alternative work RVU of 45.13 for CPT code 33468 for 

CY 2012. 

For CPT code 33645 (Direct or patch closure, sinus venosus, with or without anomalous 

pulmonary venous drainage), the AMA RUC reviewed survey responses and determined that the 

survey median work RVU for CPT code 33645 appropriately accounts for the work required to 

perform this service. The AMA RUC recommended a work RVU of 33.00 for CPT code 33645. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33645 and 

believe that the survey 25th percentile value of 31.30 appropriately captures the total work for 

the service. Therefore, we are proposing an alternative work RVU of 31.30 for CPT code 33645 

for CY 2012. 

For CPT code 33647 (Repair of atrial septal defect and ventricular septal defect, with 

direct or patch closure), the AMA RUC reviewed survey responses and determined that the 

survey median work RVU for CPT code 33467 appropriately accounts for the work required to 

perform this service. The AMA RUC recommended a work RVU of 35.00 for CPT code 33647. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33647 and 

believe that the survey 25th percentile value of 33.00 is more appropriate for this service. 
CMS-1582-PN 87

Therefore, we are proposing an alternative work RVU of 33.00 for CPT code 33647 for 

CY 2012. 

For CPT code 33692 (Complete repair tetralogy of Fallot without pulmonary atresia), the 

AMA RUC reviewed survey responses, determined that the survey median work RVU for CPT 

code 33692 appropriately accounts for the work, and recommended a median work RVU of 

38.75 for CPT code 33692. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33692 and 

believe that the survey 25th percentile value of 36.15 is more appropriate for this service. 

Therefore, we are proposing an alternative work RVU of 36.15 for CPT code 33692 for 

CY 2012. 

For CPT code 33710 (Repair sinus of Valsalva fistula, with cardiopulmonary bypass; 

with repair of ventricular septal defect), the AMA RUC reviewed survey response, determined 

that the survey median work RVU for CPT code 33710 appropriately accounts for the work 

required to perform this service, and recommended a work RVU of 43.00 for CPT code 33710. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33710 and 

believe that the survey 25th percentile value of 37.50 is more appropriate for this service. We 

believe the physician time and intensity for CPT code 33710 reflects the appropriate incremental 

adjustment when compared to the reference service, CPT code 33405. Therefore, we are 

proposing an alternative work RVU of 37.50 for CPT code 33710 for CY 2012. 

For CPT code 33875 (Descending thoracic aorta graft, with or without bypass), the AMA 

RUC reviewed survey responses and determined that the 25th percentile work RVU for code 

33875 appropriately accounts for the work required to perform this service. The AMA RUC 

recommended a work RVU of 56.83 for CPT code 33875. 
CMS-1582-PN 88

We disagree with the AMA RUC-recommended work RVU for CPT code 33875 and 

believe that a work RVU of 50.72 is more appropriate for this service. We compared CPT code 

33875 with CPT code 33465 (Replacement, tricuspid valve, with cardiopulmonary bypass) 

(work RVU = 50.72) and believe that CPT code 33875 is similar to CPT code 33465, with 

similar inpatient and outpatient work. We believe this work RVU corresponds better to the value 

of the service than the survey 25th percentile work RVU. Therefore, we are proposing an 

alternative work RVU of 50.72 for CPT code 33875 for CY 2012. 

For CPT code 33910 (Pulmonary artery embolectomy; with cardiopulmonary bypass), 

the AMA RUC reviewed survey responses. After reviewing the service, the AMA RUC 

determined that it met the compelling evidence guidelines. The AMA RUC recommended a 

work RVU of 52.33 for CPT code 33910. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33910 and 

believe that a work RVU of 48.21 is more appropriate for this service. We compared CPT code 

33910 with CPT code 33542 (Myocardial resection (eg, ventricular aneurysmectomy)) (work 

RVU = 48.21), and we recognize that CPT code 33542 is not an emergency service. 

Nevertheless, this procedure requires cardiopulmonary bypass and has physician time and visits 

that are similar to CPT code 33910 and that are consistently necessary for the care required for 

the patient. We believe that a work RVU of 48.21 accurately reflects the work associated with 

CPT code 33910 and properly maintains the relativity for a similar service. Therefore, we are 

proposing an alternative work RVU of 48.21 for CPT code 33910 for CY 2012. 

For CPT code 33935 (Heart-lung transplant with recipient cardiectomypneumonectomy), the AMA RUC reviewed survey responses, determined that the survey median 

work RVU appropriately accounts for the physician work required to perform this service, and 
CMS-1582-PN 89

recommended a work RVU of 100.00 for CPT code 33935. 

We disagree with the AMA RUC-recommended work RVU for CPT code 33935 and 

believe that the survey 25th percentile value of 91.78 is more appropriate for this service. We 

believe this service is more intense and complex than CPT code 33945 and that the survey 

25th percentile work RVU accurately reflects the increased intensity and complexity when 

compared to the reference CPT code 33945. Therefore, we are proposing an alternative work 

RVU of 91.78 for CPT code 33935 for CY 2012. 

For CPT code 33980 (Removal of ventricular assist device, implantable intracorporeal, 

single ventricle), the AMA RUC reviewed the survey results and recommended the survey 

median work RVU of 40.00. Additionally the AMA RUC recommended a global period change 

from 090 to XXX. We agree with the AMA RUC-recommended global period change from 90 

to XXX. However, we disagree with the AMA RUC-recommended work RVU for CPT code 

33980 and are proposing for CY 2012 an alternative work RVU of 33.50, which is the survey 

25th percentile work RVU. We believe the work RVU of 33.50 is more appropriate, given the 

significant reduction in physician times and decrease in the number and level of post-operative 

visits that the AMA RUC included in the value of CPT code 33980. 

For CPT code 36247 (Selective catheter placement, arterial system; initial third order or 

more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family), the 

AMA RUC considered the survey results and recommended the survey median work RVU of 

7.00 for this service. Additionally, the AMA RUC recommended a global period change from 

090 to XXX. We agree with the AMA RUC-recommended global period change from 90 to 

XXX. However, we disagree with the AMA RUC-recommended work RVU of 7.00 for CPT 

code 36247. We believe maintaining the current work RVU is more appropriate given the 
CMS-1582-PN 90

change to the global period. Accordingly we are proposing a work RVU of 6.29 for CPT code 

36247 for CY 2012. 

For CPT code 36825 (Creation of arteriovenous fistula by other than direct arteriovenous 

anastomosis (separate procedure); autogenous graft), the AMA RUC considered the survey data 

and ultimately recommended that the current work RVU of this service, 15.13, be maintained. 

We disagree with the AMA RUC-recommended work RVU of 15.13 for CPT code 

36825. As indicated by the most recent Medicare PFS claims data, CPT code 28122 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the subsequent observation care service, reduced the 

discharge day management service to one-half, and adjusted times. As a result, we are proposing 

an alternative work RVU of 14.17 with refinements to the time for CPT code 36825 for 

CY 2012. A complete list of CMS time refinements can be found in Table 6. 

13. Vascular Surgery

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

35188 Repair blood vessel lesion 15.16 18.50 18.00 Disagree 

35612 Artery bypass graft 16.82 22.00 20.35 Disagree 

35800 Explore neck vessels 8.07 13.89 12.00 Disagree 

35840 Explore abdominal vessels 10.96 21.19 20.75 Disagree 

35860 Explore limb vessels 6.80 16.89 15.25 Disagree 

36600 Withdrawal of arterial blood 0.32 0.32 0.32 Agree x 

36819 Av fuse, uppr arm, basilic 14.47 14.47 13.29 Disagree x 

37140 Revision of circulation 25.23 40.00 40.00 Agree 

37145 Revision of circulation 26.24 37.00 37.00 Agree 

37160 Revision of circulation 23.24 38.00 38.00 Agree 

37180 Revision of circulation 26.24 36.50 36.50 Agree 

37181 Splice spleen/kidney veins 28.37 40.00 40.00 Agree 

In the Fourth Five-Year Review, we identified CPT code 36819 as potentially misvalued 
CMS-1582-PN 91

through the Site-of-Service Anomaly screen, and we identified CPT code 36600 as potentially 

misvalued through the Harvard-Valued – Utilization > 30,000 screen. The Society for Vascular 

Surgery submitted additional CPT codes to be included in the Fourth Five-Year Review, 

including CPT codes 35188, 35612, 35800, 35840, 35860, 37140, 37145, 37160, 37180, and 

38181. 

 The AMA RUC noted that it believed there is compelling evidence to change the work 

values for CPT codes 35188, 35612, 35800, 35840, and 35860, since vascular surgery is one of 

the predominant providers of these services and had not participated in the original Harvard 

studies. In addition, the AMA RUC believes errors occurred in extrapolation of visits during the 

Harvard study, and apparent rank order anomalies may emerge when comparing these services to 

other vascular procedures. 

For CPT code 35188 (Repair, acquired or traumatic arteriovenous fistula; head and neck), 

the AMA RUC reviewed the survey results from 25 (out of a sample size of 400) physicians and 

recommended the survey median work RVU of 18.50 for CPT code 35188. 

We disagree with the AMA RUC-recommended work RVU for CPT code 35188 and are 

proposing for CY 2012 an alternative work RVU of 18.00, which is the survey 25th percentile 

work RVU. We believe the work RVU of 18.00 is more appropriate, given the decrease in the 

number and level of post-operative visits that the AMA RUC included in the value of CPT code 

35188. 

For CPT code 35612 (Bypass graft, with other than vein; subclavian-subclavian), the 

AMA RUC reviewed the survey results from 25 (out of a sample size of 400) physicians and 

recommended a work RVU of 22.00 for CPT code 35612. 

We disagree with the AMA RUC-recommended work RVU for CPT code 35612 and are 
CMS-1582-PN 92

proposing for CY 2012 an alternative work RVU of 20.35, which is the survey 25th percentile 

work RVU. We believe the work RVU of 20.35 is more appropriate, given the decrease in the 

number and level of post-operative visits that the AMA RUC included in the value of CPT code 

35612. 

For CPT code 35800 (Exploration for postoperative hemorrhage, thrombosis or infection; 

neck), the AMA RUC reviewed the survey results from 34 (out of a sample size of 400) 

physicians. Using magnitude estimation, the AMA RUC recommended that an appropriate work 

RVU for CPT code 35800 would be between the survey 25th percentile (12.00 RVU) and 

median (15.00 RVU) work value. Accordingly, the AMA RUC recommended a work RVU of 

13.89 for CPT code 35800. 

We disagree with the AMA RUC-recommended work RVU for CPT code 35800 and are 

proposing for CY 2012 an alternative work RVU of 12.00, which is the survey 25th percentile 

work RVU. We believe the work RVU of 12.00 is more appropriate, given that two of the key 

reference codes to which this service has been compared have identical intra-service time 

(60 minutes), but significantly lower work RVUs. 

For CPT code 35840 (Exploration for postoperative hemorrhage, thrombosis or infection; 

abdomen), the AMA RUC reviewed the survey results from 34 (out of a sample size of 400) 

physicians. Using magnitude estimation, the AMA RUC recommended that an appropriate work 

RVU for CPT code 35840 would be between the survey 25th percentile (19.25 RVU) and 

median (22.30 RVU) work value. Accordingly, the AMA RUC recommended a work RVU of 

21.19 for CPT code 35840. 

We disagree with the AMA RUC-recommended work RVU for CPT code 35840 and are 

proposing for CY 2012 an alternative work RVU of 20.75, which is between the survey 
CMS-1582-PN 93

25th percentile and median work RVU. We believe the work RVU of 20.75 is more appropriate 

given the two reference codes to which this service has been compared. 

For CPT code 35860 (Exploration for postoperative hemorrhage, thrombosis or infection; 

extremity), the AMA RUC reviewed the survey results from 34 (out of a sample size of 400) 

physicians. Using magnitude estimation, the AMA RUC recommended that an appropriate work 

RVU for CPT code 35860 would be between the survey 25th percentile (15.25 RVUs) and 

median work value (18.00 RVUs). Accordingly, the AMA RUC recommended a work RVU of 

16.89 for CPT code 35860. 

We disagree with the AMA RUC-recommended work RVU for CPT code 35860 and are 

proposing for CY 2012 an alternative work RVU of 15.25, which is the survey 25th percentile 

work RVU. We believe this work RVU maintains appropriate relativity within the family of 

related services for the exploration of postoperative hemorrhage. 

For CPT code 36600 (Arterial puncture, withdrawal of blood for diagnosis), the AMA 

RUC reviewed the survey results from 38 (out of a sample size of 100) physicians and, based on 

comparisons to reference codes, recommended a work RVU of 0.32 for CPT code 36600. 

We agree with the AMA RUC’s recommended work RVU and are proposing a work 

RVU of 0.32 for CPT code 36600 for CY 2012. In addition to the work RVU adjustment for 

CPT code 36600, we are refining the time associated with this code. Recent Medicare PFS 

claims data show that this service typically is performed on the same day as an E/M visit. We 

believe some of the activities conducted during the pre- and post-service times of the procedure 

code and the E/M visit overlap and, therefore, should not be counted twice in developing the 

procedure’s work value. As described in section II.A. of this proposed notice, to account for this 

overlap, we reduced the pre-service evaluation and post-service time by one-third. We believe 
CMS-1582-PN 94

that 3 minutes pre-service evaluation time and 3 minutes post-service time accurately reflect the 

time required to conduct the work associated with this service. A complete list of CMS time 

refinements can be found in Table 6. 

For CPT code 36819 (Arteriovenous anastomosis, open; by upper arm basilic vein 

transposition), which was identified as a code with a Site-of-Service anomaly, the AMA RUC 

reviewed the survey results from 31 (out of a sample size of 400) physicians. The AMA RUC 

indicated that it believes this service should be categorized as one being typically performed in 

an inpatient hospital setting and recommended maintaining the current work RVU of 14.47. 

We disagree with the AMA RUC-recommended work RVU for CPT code 36819. The 

AMA RUC indicated in its summary of recommendations that the survey data show 97 percent 

(30 out of 31) of survey respondents stated they perform the procedure "in the hospital." Of 

those respondents who stated that they typically perform the procedure in the hospital, 33 percent 

(10 out of 30) stated that the patient is "discharged the same day," 53 percent (16 out of 30) 

stated the patient is "kept overnight (less than 24 hours)," and 13 percent (4 out of 30) stated the 

patient is "admitted (more than 24 hours)." These responses make no distinction between the 

patient’s status as an inpatient or outpatient of the hospital for stays of longer than 24 hours. As 

we discussed in section II.A. of this proposed notice, for codes with Site-of-Service anomalies, 

our policy is to remove any post-procedure inpatient visits remaining in the values for these 

codes and adjust physician times accordingly. It is also our policy for codes with Site-of-Service 

anomalies to consistently include the value of half of a discharge day management service and 

adjust physician times accordingly. We are thus proposing an alternative work RVU for 

CY 2012 of 13.29 with refinements in time for CPT code 36819. A complete list of CMS time 

refinements can be found in Table 6. 
CMS-1582-PN 95

14. Excise Parotid Gland/Lesion 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

42415 Excise parotid gland/lesion 18.12 18.12 17.16 Disagree x 

42420 Excise parotid gland/lesion 21.00 21.00 19.53 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 42415 and 42420 as Site-ofService anomaly codes. 

For CPT code 42415 (Excision of parotid tumor or parotid gland; lateral lobe, with 

dissection and preservation of facial nerve), the AMA RUC reviewed the survey data and, based 

on magnitude estimation, the AMA RUC recommended that the current work RVU of this 

service, 18.12, be maintained. 

 We disagree with the AMA RUC-recommended work RVU of 18.12 for CPT code 

42415. As indicated by the most recent Medicare PFS claims data, CPT code 42415 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the subsequent observation care service, reduced the 

discharge day management service to one-half, and adjusted times. As a result, we are proposing 

an alternative work RVU of 17.16 with refinements to the time for CPT code 42415 for 

CY 2012. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 42420 (Excision of parotid tumor or parotid gland; total, with dissection 

and preservation of facial nerve), the AMA RUC reviewed survey results and, based on 

magnitude estimation, the AMA RUC recommended that the current work RVU of this service, 

21.00, be maintained. 

We disagree with the AMA RUC-recommended work RVU of 21.00 for CPT code 
CMS-1582-PN 96

42420. As indicated by the most recent Medicare PFS claims data, CPT code 42420 is a code 

with a Site-of-Service anomaly. Therefore, in accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the subsequent observation care service, reduced the 

discharge day management service to one-half, and adjusted times. As a result, we are proposing 

an alternative work RVU of 19.53with refinements to the time for CPT code 42420 for CY 2012. 

A complete list of CMS time refinements can be found in Table 6. 

15. Endoscopic Cholangiopancreatography 

CPT 

Code Short Descriptor CY 2011 Work RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

43262 Endo cholangiopancreatograph 7.38 7.38 7.38 Agree x 

In the Fourth Five-Year Review, we identified CPT code 43262 as potentially misvalued 

through the Harvard Valued - Utilization > 30,000 screen. 

For CPT code 43262 (Endoscopic retrograde cholangiopancreatography (ERCP); with 

sphincterotomy/papillotomy), the AMA RUC reviewed the service and believes that the specialty 

did not provide compelling evidence to change the current value of the service. Therefore, the 

AMA RUC recommended maintaining the current work RVU of 7.38 for CPT code 43262. 

We are proposing to maintain the current work RVU of 7.38 and the current physician 

time for CPT code 43262 for CY 2012. However, we are requesting that the AMA RUC 

undertake a comprehensive review of the entire family of ERCP codes, including the base CPT 

code 43260, and provide CMS with work RVU recommendations. We note that based on a 

preliminary review of the intra-service times for these codes, we are concerned the codes in this 

family are potentially misvalued. 
CMS-1582-PN 97

16. Sigmoidoscopy 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

 to Time 

45331 Sigmoidoscopy and biopsy 1.15 1.15 1.15 Agree x 

In the Fourth Five-Year Review, CMS identified CPT code 45331 as potentially 

misvalued through the Harvard-Valued - Utilization > 30,000 screen. 

For CPT code 45331 (Sigmoidoscopy, flexible; with biopsy, single or multiple), the 

AMA RUC reviewed the survey results and determined that the survey data support the current 

value of this service. Taking into consideration the 75th percentile of the survey results, the 

AMA RUC recommended a pre-service time of 15 minutes, intra-service time of 15 minutes, and 

post-service time of 10 minutes. Accordingly, the AMA RUC recommended a work RVU of 

1.15 for CPT code 45331. 

We agree with the AMA RUC’s recommended work RVU and are proposing a work 

RVU of 1.15 for CPT code 45331 for CY 2012. However, while the AMA RUC recommended 

pre-service times based on the 75th percentile of the survey results, we believe it is more 

appropriate to accept the median survey physician times. Accordingly, we are refining the times 

to the following: 5 minutes for pre-evaluation; 5 minutes for pre-service other, 5 minutes for 

pre- dress, scrub, and wait; 10 minutes intra-service; and 10 minutes immediate post-service. A 

complete list of CMS time refinements can be found in Table 6. 
CMS-1582-PN 98

17. Laparoscopic Cholecystectomy 

CPT Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

47563 Laparo cholecystectomy/graph 12.11 12.11 11.47 Disagree x 

47564 Laparo cholecystectomy/explr 14.24 20.00 18.00 Disagree 

In the Fourth Five-Year Review, CMS identified CPT code 47563 as potentially 

misvalued through the Harvard Valued - Utilization > 30,000 screen and Site-of-Service 

Anomaly screen. The AMA RUC reviewed CPT codes 47564 and 47563. 

For CPT code 47563 (Laparoscopy, surgical; cholecystectomy with cholangiography), 

the AMA RUC reviewed the survey results and recommended that this service be valued as a 

service performed predominately in the facility setting, as the survey data indicated that a 

majority of patients have an overnight stay. Because some respondents stated that the typical 

patient would be kept at overnight in the hospital, the AMA RUC recommended a full day 

discharge management service be included in the value of the service. The AMA RUC 

recommended maintaining the current work RVU of 12.11 for CPT code 47563. 

We disagree with the AMA RUC-recommended work RVU for CPT code 47563. While 

the survey data show 95 percent (57 out of 60) of survey respondents stated they perform the 

procedure "in the hospital," of those respondents who stated that they typically perform the 

procedure in the hospital, 30 percent (17 out of 57) stated that the patient is "discharged the same 

day," 46 percent (26 out of 57) stated the patient is "kept overnight (less than 24 hours)," and 

25 percent (14 out of 57) stated the patient is "admitted (more than 24 hours)." These responses 

make no distinction between the patient’s status as an inpatient or outpatient of the hospital for 

stays of longer than 24 hours. As we discussed in section II.A. of this proposed notice, for codes 
CMS-1582-PN 99

with Site-of-Service anomalies, our policy is to remove any post-procedure inpatient visits 

remaining in the values for these codes and adjust physician times accordingly. It is also our 

policy for codes with Site-of-Service anomalies to consistently include the value of half of a 

discharge day management service, adjusting physician times accordingly. We are thus 

proposing an alternative work RVU of 11.47 with refinements in time for CPT code 47563 for 

CY 2012. A complete list of CMS time refinements can be found in Table 6. 

 For CPT code 47564 (Laparoscopy, surgical; cholecystectomy with exploration of 

common duct), the AMA RUC reviewed the survey results and determined that the 

25th survey percentile was appropriate for this service. Accordingly, the AMA RUC 

recommended a work RVU of 20.00 for CPT code 47564. 

We disagree with the AMA RUC-recommended work RVU for CPT code 47564 and are 

proposing for CY 2012 an alternative work RVU of 18.00, which is the survey low work RVU. 

We are accepting the AMA RUC recommended median survey times and believe the work RVU 

of 18.00 for CPT code 35860 is more appropriate given the significant reduction in 

recommended physician times in comparison to the current times. 

18. Hernia Repair 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

49507 Prp i/hern init block >5 yr 10.05 10.05 9.09 Disagree x 

49521 Rerepair ing hernia, blocked 12.44 12.44 11.48 Disagree x 

49587 Rpr umbil hern, block > 5 yr 8.04 8.04 7.08 Disagree x 

In 2007, the AMA RUC’s Relativity Assessment Workgroup identified CPT codes 49507, 

49521 and 49587 as potentially misvalued through the Site-of-Service Anomaly screen. The 
CMS-1582-PN 100

American College of Surgeons (ACS) surveyed these codes, and the AMA RUC issued 

recommended work values for these codes to CMS for CY 2010. In the CY 2011 PFS final rule 

with comment period (75 FR 73221), we reiterated that in the CY 2010 PFS final rule with 

comment period (74 FR 61776 through 61778) we indicated that although we would accept the 

AMA RUC valuations for these Site-of-Service anomaly codes on an interim basis through CY 

2010, we had ongoing concerns about the methodology used by the AMA RUC to review these 

services. We requested that the AMA RUC reexamine the Site-of-Service anomaly codes and use 

the building block methodology to revalue the services (74 FR 62777 and 75 FR 73221). CPT 

codes 49507, 49521, and 49587 were among those CY 2010 Site-of-Service anomaly codes, and 

were reviewed again by the AMA RUC as a part of the Fourth Five-Year Review. 

 For CPT code 49507 (Repair initial inguinal hernia, age 5 years or over; incarcerated or 

strangulated), the AMA RUC used magnitude estimation and recommended a work RVU of 9.97 

for CPT code 49507 for CY 2010, which was slightly higher than the survey 25th percentile 

value. In CY 2010, while CMS adopted the AMA RUC-recommended work value on an interim 

final basis and referred the service back to the AMA RUC to be reexamined, the work RVU for 

CPT code 49507 used under the PFS was increased to 10.05 based on the redistribution of RVUs 

that resulted from the CMS policy to no longer recognize the CPT consultation codes. Upon 

re-review for CY 2012 as part of the Fourth Five-Year Review of Work, the AMA RUC 

determined that CPT code 49507 had been accurately valued in its recommendation for CY 2010 

with support from reference services and specialty survey data, and stated that it found no 

compelling evidence to change the current physician work value of this service. The AMA RUC 

ultimately recommended that the current work RVU of 10.05 be maintained for CPT code 49507 

for CY 2012. 
CMS-1582-PN 101

We disagree with the AMA RUC-recommended work RVU of 10.05 for CPT code 

49507. The AMA RUC indicated in its summary of recommendations that the survey data show 

Ninety-eight percent of survey respondents stated they perform the procedure "in the hospital." 

Of those respondents who stated that they typically perform the procedure in the hospital, 

17 percent stated that the patient is "discharged the same day," 40 percent stated the patient is 

"kept overnight (less than 24 hours)," and 43 percent stated the patient is "admitted (more than 

24 hours)." These responses make no distinction between the patient’s status as an inpatient or 

outpatient of the hospital for stays of longer than 24 hours. As indicated by the most recent PFS 

claims data, CPT code 49507 is a code with a Site-of-Service anomaly. Therefore, in accordance 

with the policy discussed in section II.A. of this proposed notice, we removed the subsequent 

observation care service, reduced the discharge day management service to one-half, and 

adjusted times. As a result, we are proposing an alternative work RVU of 9.09 with refinements 

to the time for CPT code 49507 for CY 2012. A complete list of CMS time refinements can be 

found in Table 6. 

 For CPT code 49521 (Repair recurrent inguinal hernia, any age; incarcerated or 

strangulated), the AMA RUC used magnitude estimation and recommended a work RVU of 

12.36 for CY 2010, which fell between the survey 25th percentile and median work value 

estimates. In CY 2010, while CMS adopted the AMA RUC-recommended work value on an 

interim final basis and referred the service back to the AMA RUC to be reexamined, the work 

RVU for CPT code 49521 used under the PFS was increased to 12.44 based on the redistribution 

of RVUs that resulted from the CMS policy to no longer recognize the CPT consultation codes. 

Upon re-review for CY 2012, the AMA RUC determined that CPT code 49521was accurately 

valued in its recommendation for CY 2010, with support from reference services and specialty 
CMS-1582-PN 102

survey data, and stated that it found no compelling evidence to change the current physician work 

value of this service. The AMA RUC ultimately recommended that the current work RVU of 

12.44 be maintained for CPT code 49521 in CY 2012. 

We disagree with the AMA RUC-recommended work RVU of 12.44 for CPT code 

49521. The AMA RUC indicated in its summary of recommendations that the survey data show 

99 percent of survey respondents stated they perform the procedure "in the hospital." Of those 

respondents who stated that they typically perform the procedure in the hospital, 18 percent 

stated that the patient is "discharged the same day," 37 percent stated the patient is "kept 

overnight (less than 24 hours)," and 45 percent stated the patient is "admitted (more than 

24 hours)." These responses make no distinction between the patient’s status as an inpatient or 

outpatient of the hospital for stays of longer than 24 hours. As indicated by the most recent PFS 

claims data, CPT code 49521 is a code with a Site-of-Service anomaly. Therefore, in accordance 

with the policy discussed in section II.A. of this proposed notice, we removed the subsequent 

observation care service, reduced the discharge day management service to one-half, and 

adjusted times. As a result, we are proposing an alternative work RVU of 11.48 with 

refinements to the time for CPT code 49521 for CY 2012. A complete list of CMS time 

refinements can be found in Table 6. 

 For CPT code 49587 (Repair umbilical hernia, age 5 years or over; incarcerated or 

strangulated), the AMA RUC used magnitude estimation and recommended a work RVU of 7.96 

for CY 2010, which was slightly below the survey 25th percentile physician work value estimate. 

Under the CY 2010 PFS, the work RVU for CPT code 49587 was increased to 8.04 based on the 

redistribution of RVUs resulting from the CMS policy to no longer recognize the CPT 

consultation codes. Upon re-review for CY 2012, the AMA RUC determined that CPT code 
CMS-1582-PN 103

49587 was accurately valued in its CY 2010 recommendation, with support from reference 

services and specialty survey data, and stated that it found no compelling evidence to change the 

current physician work value of this service. The AMA RUC ultimately recommended that the 

current work RVU of 8.04 be maintained for CPT code 49587 for CY 2012. 

 We disagree with the AMA RUC-recommended work RVU of 8.04 for CPT code 49587. 

The AMA RUC indicated in its summary of recommendations that the survey data show 

100 percent of survey respondents stated they perform the procedure "in the hospital." Of those 

respondents who stated that they typically perform the procedure in the hospital, 30 percent 

stated that the patient is "discharged the same day," 42 percent stated the patient is "kept 

overnight (less than 24 hours)," and 29 percent stated the patient is "admitted (more than 

24 hours)." These responses make no distinction between the patient’s status as an inpatient or 

outpatient of the hospital for stays of longer than 24 hours. As indicated by the most recent PFS 

claims data, CPT code 49587 is a code with a Site-of-Service anomaly. Therefore, in accordance 

with the policy discussed in section II.A. of this proposed notice, we removed the subsequent 

observation care service, reduced the discharge day management service to one-half, and 

adjusted times. As a result, we are proposing an alternative work RVU of 7.08 with refinements 

to the time for CPT code 49587 for CY 2012. A complete list of CMS time refinements can be 

found in Table 6. 

19. Laparoscopic Hernia Repair 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

49652 Lap vent/abd hernia repair 12.88 12.88 11.92 Disagree x 

49653 Lap vent/abd hern proc comp 16.21 16.21 14.94 Disagree x 

49654 Lap inc hernia repair 15.03 15.03 13.76 Disagree x 
CMS-1582-PN 104

49655 Lap inc hern repair comp 18.11 18.11 16.84 Disagree x 

 For CY 2009, the CPT Editorial Panel created six new CPT codes to describe the specific 

levels of work associated with abdominal hernia repairs that are performed frequently with 

laparoscopic techniques. We accepted the AMA RUC’s original work RVU recommendation for 

these services for CY 2009. However, we identified 4 of these laparoscopic hernia repair CPT 

codes, specifically CPT codes 49652, 49653, 49654 and 49655, as potentially misvalued through 

the Site-of-Service Anomaly screen, and requested that they be reviewed by the AMA RUC for 

Fourth Five-Year Review. 

 For CPT code 49652 (Laparoscopy, surgical, repair, ventral, umbilical, spigelian or 

epigastric hernia (includes mesh insertion, when performed); reducible), for CY 2009, the AMA 

RUC used magnitude estimation and recommended the survey 25th percentile work RVU of 

12.80 for CPT code 49652 for CY 2009. CMS accepted this recommendation. For CY 2010, the 

work RVU for CPT code 49652 was increased to 12.88 based on the redistribution of RVUs 

resulting from the CMS policy to no longer recognize the CPT consultation codes. Upon 

re-review for CY 2012, the AMA RUC determined that CPT code 49652 was accurately valued in 

its recommendation for CY 2009, with support from reference services and specialty survey data, 

and stated that it found no compelling evidence to change the current physician work value of this 

service. The AMA RUC ultimately recommended that the current work RVU of 12.88 be 

maintained for CPT code 49652 for CY 2012. 

We disagree with the AMA RUC-recommended work RVU of 12.88 for CPT code 

49652. The AMA RUC indicated in its summary of recommendations that the survey data show 

100 percent of survey respondents stated they perform the procedure "in the hospital." Of those 
CMS-1582-PN 105

respondents who stated that they typically perform the procedure in the hospital, 16 percent 

stated that the patient is "discharged the same day," 60 percent stated the patient is "kept 

overnight (less than 24 hours)," and 24 percent stated the patient is "admitted (more than 

24 hours)." These responses make no distinction between the patient’s status as an inpatient or 

outpatient of the hospital for stays of longer than 24 hours. As indicated by the most recent PFS 

claims data, CPT code 49652 is a code with a Site-of-Service anomaly. In its recommendation to 

us, the AMA RUC asserted that Medicare claims data for this service are still new and may not 

reflect accurate Medicare utilization for this procedure. The most recent PFS claims data show that 

outpatient utilization for this code is well above the Site-of-Service anomaly threshold of greater 

than 50 percent, and we will continue to monitor the data to ensure that this CPT code, and all CPT 

codes, are valued appropriately for their site-of-service. In accordance with the policy discussed 

in section II.A. of this proposed notice, we removed the subsequent observation care service, 

reduced the discharge day management service to one-half, and adjusted times. As a result, we 

are proposing an alternative work RVU of 11.92 with refinements to the time for CPT code 

49652 for CY 2012. A complete list of CMS time refinements can be found in Table 6. 

 For CPT code 49653 (Laparoscopy, surgical, repair, ventral, umbilical, spigelian or 

epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated), for 

CY 2009, the AMA RUC used magnitude estimation and recommended the survey 25th 

percentile work RVU of 16.10 for CPT code 49653 for CY 2009. CMS accepted this 

recommendation. For CY 2010, the work RVU for CPT code 49653was increased to 16.21 

based on the redistribution of RVUs resulting from the CMS policy to no longer recognize the 

CPT consultation codes. Upon re-review for CY 2012, the AMA RUC determined that CPT code 

49653 was accurately valued in its CY 2009 recommendation, with support from reference 
CMS-1582-PN 106

services and specialty survey data, and stated that it found no compelling evidence to change the 

current physician work value of this service. The AMA RUC ultimately recommended that the 

current work RVU of 16.21 be maintained for CPT code 49653 for CY 2012. 

We disagree with the AMA RUC-recommended work RVU of 16.21 for CPT code 

49653. The AMA RUC indicated in its summary of recommendations that the survey data show 

100 percent of survey respondents stated they perform the procedure "in the hospital." Of those 

respondents who stated that they typically perform the procedure in the hospital, 9 percent stated 

that the patient is "discharged the same day," 16 percent stated the patient is "kept overnight (less 

than 24 hours)," and 76 percent stated the patient is "admitted (more than 24 hours)." These 

responses make no distinction between the patient’s status as an inpatient or outpatient of the 

hospital for stays of longer than 24 hours. As indicated by the most recent PFS claims data, CPT 

code 49653 is a code with a Site-of-Service anomaly. In its recommendation to us, the AMA 

RUC asserted that Medicare claims data for this service are still new and may not reflect accurate 

Medicare utilization for this procedure. The most recent PFS claims data show that outpatient 

utilization for this code is well above the Site-of-Service anomaly threshold of greater than 50 

percent, and we will continue to monitor the data to ensure that this CPT code, and all CPT codes, 

are valued appropriately for their site-of-service. In accordance with the policy discussed in 

section II.A. of this proposed notice, we removed the subsequent observation care service, 

reduced the discharge day management service to one-half, and adjusted times. As a result, we 

are proposing an alternative work RVU of 14.94 with refinements to the time for CPT code 

49653 for CY 2012. A complete list of CMS time refinements can be found in Table 6. 

 For CPT code 49654 (Laparoscopy, surgical, repair, incisional hernia (includes mesh 

insertion, when performed); reducible), for CY 2009 the AMA RUC used magnitude estimation 
CMS-1582-PN 107

and recommended the survey 25th percentile work RVU of 14.95 for CPT code 49654 for 

CY 2009. We accepted this recommendation. For CY 2010, the work RVU for CPT code 49654 

was increased to 15.03 based on the redistribution of RVUs resulting from the CMS policy to no 

longer recognize the CPT consultation codes. Upon re-review for CY 2012, the AMA RUC 

determined that CPT code 49654 was accurately valued in its CY 2009 recommendation, with 

support from reference services and specialty survey data, and stated that it found no compelling 

evidence to change the current physician work value of this service. The AMA RUC ultimately 

recommended that the current work RVU of 15.03 be maintained for CPT code 49654 for 

CY 2012. 

We disagree with the AMA RUC-recommended work RVU of 15.03 for CPT code 

49654. The AMA RUC indicated in its summary of recommendations that the survey data show 

100 percent of survey respondents stated they perform the procedure "in the hospital." Of those 

respondents who stated that they typically perform the procedure in the hospital, 10 percent 

stated that the patient is "discharged the same day," 33 percent stated the patient is "kept 

overnight (less than 24 hours)," and 56 percent stated the patient is "admitted (more than 

24 hours)." These responses make no distinction between the patient’s status as an inpatient or 

outpatient of the hospital for stays of longer than 24 hours. As indicated by the most recent PFS 

claims data, CPT code 49654 is a code with a Site-of-Service anomaly. In its recommendation to 

us, the AMA RUC asserted that Medicare claims data for this service are still new and may not 

reflect accurate Medicare utilization for this procedure. The most recent PFS claims data show that 

outpatient utilization for this code is well above the Site-of-Service anomaly threshold of greater 

than 50 percent, and we will continue to monitor the data to ensure that this CPT code, and all CPT 

codes, are valued appropriately for their site-of-service. In accordance with the policy discussed 
CMS-1582-PN 108

in section II.A. of this proposed notice, we removed the subsequent observation care service, 

reduced the discharge day management service to one-half, and adjusted times. As a result, we 

are proposing an alternative work RVU of 13.76 with refinements to the time for CPT code 

49654 for CY 2012. A complete list of CMS time refinements can be found in Table 6. 

 For CPT code 49655 (Laparoscopy, surgical, repair, incisional hernia (includes mesh 

insertion, when performed); incarcerated or strangulated), for CY 2009 the AMA RUC 

crosswalked CPT code 49655 to CPT code 43280 (Laparoscopy, surgical, esophagogastric 

fundoplasty (eg, Nissen, Toupet procedures)) (work RVU = 18.10), and recommended a work 

RVU of 18.00. We accepted this recommendation. For CY 2010, the work RVU for CPT code 

49655 was increased to 18.11 based on the redistribution of RVUs resulting from the CMS 

policy to no longer recognize the CPT consultation codes. Upon re-review for CY 2012, the 

AMA RUC decided that CPT code 49655 was accurately valued in its CY 2009 recommendation, 

with support from reference services and specialty survey data, and stated that it found no 

compelling evidence to change the current physician work value of this service. The AMA RUC 

ultimately recommended that the current work RVU of 18.11 be maintained for CPT code 49655 

for CY 2012. 

We disagree with the AMA RUC-recommended work RVU of 18.11 for CPT code 

49655. The AMA RUC indicated in its summary of recommendations that the survey data show 

100 percent of survey respondents stated they perform the procedure "in the hospital." Of those 

respondents who stated that they typically perform the procedure in the hospital, 5 percent stated 

that the patient is "discharged the same day," 8 percent stated the patient is "kept overnight (less 

than 24 hours)," and 87 percent stated the patient is "admitted (more than 24 hours)." These 

responses make no distinction between the patient’s status as an inpatient or outpatient of the 
CMS-1582-PN 109

hospital for stays of longer than 24 hours. As indicated by the most recent PFS claims data, CPT 

code 49655 is a code with a Site-of-Service anomaly. In its recommendation to us, the AMA 

RUC asserted that Medicare claims data for this service are still new and may not reflect accurate 

Medicare utilization for this procedure. The most recent PFS claims data show that outpatient 

utilization for this code is above the Site-of-Service anomaly threshold of greater than 50 percent, 

and we will continue to monitor the data to ensure that this CPT code, and all CPT codes, are 

valued appropriately for their site-of-service. In accordance with the policy discussed in section 

II.A. of this proposed notice, we removed the subsequent observation care service, reduced the 

discharge day management service to one-half, and adjusted times. As a result, we are proposing 

an alternative work RVU of 16.84 with refinements to the time for CPT code 49655 for 

CY 2012. A complete list of CMS time refinements can be found in Table 6. 

20. Urologic Procedures 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

51705 Change of bladder tube 1.05 0.90 0.90 Agree 

51710 Change of bladder tube 1.52 1.35 1.35 Agree x 

52005 Cystoscopy & ureter catheter 2.37 2.37 2.37 Agree 

52007 Cystoscopy and biopsy 3.02 3.02 3.02 Agree 

52310 Cystoscopy and treatment 2.81 2.81 2.81 Agree 

52315 Cystoscopy and treatment 5.20 5.20 5.20 Agree 

52630 Remove prostate regrowth 7.73 7.73 6.55 Disagree x 

52640 Relieve bladder contracture 4.79 4.79 4.79 Agree 

52649 Prostate laser enucleation 17.29 15.20 14.56 Disagree x 

53440 Male sling procedure 15.54 14.00 13.36 Disagree x 

57287 Revise/remove sling repair 11.15 11.15 11.15 Agree 

57288 Repair bladder defect 12.13 12.13 12.13 Agree 

In the Fourth Five-Year Review, we identified CPT codes 51705, 52005 and 52310 as 

potentially misvalued through the Harvard-Valued – Utilization > 30,000 screen. CPT codes 
CMS-1582-PN 110

51710, 52007 and 52315 were added as part of the family of services for AMA RUC review. In 

addition, we identified CPT codes 52630, 52649, 53440 and 57288 as potentially misvalued 

through the Site-of-Service Anomaly screen. The specialty agreed to add CPT codes 52640 and 

57287 as part of the family of services for AMA RUC review. 

For CPT code 51710 (Change of cystostomy tube; complicated), the AMA RUC noted 

that a request was sent to CMS to have the global service period changed from a 10-day global 

period (which includes RVUs for the same day pre-operative period and for a 10-day postoperative period) to a 0-day global period (which only includes RVUs for the same day pre- and 

post-operative period). The AMA RUC indicated that in the standards of care for this procedure, 

there is no hospital time and there are no follow up visits. The AMA RUC also noted that while 

the service was surveyed as a 10-day global, the respondents inadvertently included a hospital 

visit, CPT code 99231(Subsequent hospital care), and overvalued the physician work. 

Consequently, the AMA RUC did not use the survey results to value the code. Rather, 

comparing the physician work within the family of services, the AMA RUC compared CPT code 

51710 to CPT code 51705 (Change of cystostomy tube; simple) and recommended a work RVU 

of 1.35 for CPT code 51710. 

We agree with the AMA RUC’s recommended work RVU and are proposing a work 

RVU of 1.35 for CPT code 51710 for CY 2012. We also agree to change the global period from 

10 to zero days. However, we note that while we believe that changing a cystostomy tube in a 

complicated patient may be more time consuming than in a patient that requires a simple 

cystostomy tube change, we believe that the pre-positioning time is unnecessarily high given the 

recommended pre-positioning time of 5 minutes for CPT code 51705, which has an identical prepositioning work description. Hence, we are making refinements in time for CPT code 51710 
CMS-1582-PN 111

for CY 2012. A complete list of CMS time refinements can be found in Table 6. 

For CPT code 52630 (Transurethral resection; residual or regrowth of obstructive 

prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, 

cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)), 

the AMA RUC reviewed the survey results and recommended that this service be valued as a 

service performed predominately in the facility setting, as the survey data indicated that a 

majority of patients have an overnight stay. Because the majority of respondents stated that the 

typical patient would be kept at overnight in the hospital, the AMA RUC recommended that one 

inpatient hospital visit and a full day discharge management service be included in the value of 

the service for CPT code 52630. The AMA RUC stated that it ultimately did not believe there 

was compelling evidence to signal a recent change in physician work. Accordingly, the AMA 

RUC recommended maintaining the current work RVU of 7.73 for CPT code 52630. 

We disagree with the AMA RUC-recommended work RVU for CPT code 52630. While 

the survey data show 93 percent (37 out of 40) of survey respondents stated they perform the 

procedure "in the hospital," of those respondents who stated that they typically perform the 

procedure in the hospital, 3 percent (1 out of 40) stated that the patient is "discharged the same 

day," 43 percent (17 out of 40) stated the patient is "kept overnight (less than 24 hours)," and 

54 percent (22 out of 40) stated the patient is "admitted (more than 24 hours)." These responses 

make no distinction between the patient’s status as an inpatient or outpatient of the hospital for 

stays of longer than 24 hours. As we discussed in section II.A. of this proposed notice, we 

believe that the 23-hour stay issue encompasses several scenarios. The typical patient is 

commonly in the hospital for less than 24 hours, which often means the patient may indeed stay 

overnight in the hospital. On occasion, the patient may stay longer than a single night in the 
CMS-1582-PN 112

hospital; however, in both cases, the patient is considered for Medicare purposes to be a hospital 

outpatient, not an inpatient. Given that the most recent Medicare PFS claims data indicate this 

service is typically (more than 50 percent of the time) furnished in the outpatient setting, we 

believe it is appropriate to remove the post-procedure inpatient visit remaining in the AMA 

RUC-recommended value and adjust the physician times accordingly. We also reduced the 

discharge day management service to one-half. We are thus proposing an alternative work RVU 

of 6.55 with refinements in time for CPT code 47563 for CY 2012. A complete list of CMS time 

refinements can be found in Table 6. 

For CPT code 52649 (Laser enucleation of the prostate with morcellation, including 

control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral 

calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are 

included if performed)), a Site-of-Service anomaly code, the AMA RUC reviewed the survey 

results of 16 (out of a sample size of 869) physicians. The AMA RUC recommended that this 

service be valued as a service performed predominately in the facility setting. Using magnitude 

estimation, the AMA RUC agreed that the 25th percentile survey value, which is lower than the 

current work RVU, was appropriate. The AMA RUC ultimately recommended a work RVU of 

15.20 for CPT code 52649. 

We disagree with the AMA RUC-recommended work RVU for CPT code 52649. While 

the survey data show 94 percent (15 out of 16) of survey respondents stated they perform the 

procedure "in the hospital," of those respondents who stated that they typically perform the 

procedure in the hospital, 33 percent (5 out of 16) stated that the patient is "discharged the same 

day," 54 percent (9 out of 16) stated the patient is "kept overnight (less than 24 hours)," and 

13 percent (2 out of 16) stated the patient is "admitted (more than 24 hours)." These responses 
CMS-1582-PN 113

make no distinction between the patient’s status as an inpatient or outpatient of the hospital for 

stays of longer than 24 hours. Nevertheless, the survey data confirm the most recent Medicare 

PFS claims data which show that CPT code 52649 is a code with a Site-of-Service anomaly. 

Accordingly, we applied our policy for a 23-hour stay service and reduced the discharge day 

management service to one-half. We are proposing an alternative work RVU of 14.56 with 

refinements in time for CPT code 52649 for CY 2012. A complete list of CMS time refinements 

can be found in Table 6. 

For CPT code 53440 (Sling operation for correction of male urinary incontinence (eg, 

fascia or synthetic)), the AMA RUC reviewed the survey results from 30 (out of a sample size of 

717) physicians. The AMA RUC recommended that this service be valued as a service 

performed predominately in the facility setting. Using magnitude estimation, the AMA RUC 

agreed that the median survey value, which is lower than the current work RVU, was 

appropriate. The AMA RUC ultimately recommended a work RVU of 14.00 for CPT code 

53440. 

We disagree with the AMA RUC-recommended work RVU for CPT code 53440. While 

the survey data show 97 percent (29 out of 30) of survey respondents stated they perform the 

procedure "in the hospital," of those respondents who stated that they typically perform the 

procedure in the hospital, 38 percent (11 out of 30) stated that the patient is "discharged the same 

day," 59 percent (18 out of 30) stated the patient is "kept overnight (less than 24 hours)," and 

3 percent (1 out of 30) stated the patient is "admitted (more than 24 hours)." These responses 

make no distinction between the patient’s status as an inpatient or outpatient of the hospital for 

stays of longer than 24 hours. Nevertheless, the survey data show that the vast majority of 

responders indicated CPT code 53440 is typically performed in the hospital setting as an 
CMS-1582-PN 114

outpatient rather than an inpatient service. The survey data confirm the most recent Medicare 

PFS claims data which show that CPT code 53440 is a code with a Site-of-Service anomaly. 

Accordingly, we applied our policy for a 23-hour stay service and reduced the discharge day 

management service to one-half. We are proposing an alternative work RVU of 13.36 with 

refinements in time for CPT code 53440 for CY 2012. A complete list of CMS time refinements 

can be found in Table 6. 

21. Removal of Thyroid/Parathyroid 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

60220 Partial removal of thyroid 12.37 12.37 11.19 Disagree x 

60240 Removal of thyroid 16.22 16.22 15.04 Disagree x 

60500 Explore parathyroid glands 16.78 16.78 15.60 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 60220, 60240 and 60500 as 

potentially misvalued through the Site-of-Service Anomaly screen. 

For CPT code 60220 (Total thyroid lobectomy, unilateral; with or without 

isthmusectomy), the AMA RUC reviewed the survey results from 35 (out of a sample size of 

118) physicians. The AMA RUC recommended that this service be valued as a service 

performed predominately in the facility setting. The AMA RUC indicated that since the typical 

patient is kept overnight, the AMA RUC believes that one inpatient hospital visit as well as one 

discharge day management service should be maintained in the post-operative visits for this 

service. Using magnitude estimation, the AMA RUC recommended the current work RVU of 

12.37 for CPT code 60220. 

We disagree with the AMA RUC-recommended work RVU for CPT code 60220. While 
CMS-1582-PN 115

the survey data show 97 percent (34 out of 35) of survey respondents stated they perform the 

procedure "in the hospital," of those respondents who stated that they typically perform the 

procedure in the hospital, 18 percent (6 out of 34) stated that the patient is "discharged the same 

day," 79 percent (27 out of 34) stated the patient is "kept overnight (less than 24 hours)," and 

3 percent (1 out of 34) stated the patient is "admitted (more than 24 hours)." These responses 

make no distinction between the patient’s status as an inpatient or outpatient of the hospital for 

stays of longer than 24 hours. Nevertheless, the survey data show that the majority of responders 

indicated CPT code 60220 is typically performed in the hospital setting as an outpatient rather 

than an inpatient service. The survey data confirm the most recent Medicare PFS claims which 

show that CPT code 60220 is a code with a Site-of-Service anomaly. Accordingly, in applying 

the policy for a 23-hour stay service, we removed the hospital visit, reduced the discharge day 

management service to one-half, and adjusted times. We are proposing an alternative work RVU 

of 11.19 with refinements in time for CPT code 60220 for CY 2012. A complete list of CMS 

time refinements can be found in Table 6. 

For CPT code 60240 (Thyroidectomy, total or complete), the AMA RUC reviewed the 

survey results from 35 (out of a sample size of 118) physicians. Using magnitude estimation, the 

AMA RUC believed that maintaining the current work RVU is appropriate. The AMA RUC 

ultimately recommended the current work RVU of 16.22 for CPT code 60240. 

We disagree with the AMA RUC-recommended work RVU for CPT code 60220. Of the 

97 percent of respondents that stated they perform the procedure "in the hospital," 100 percent 

stated that the patient is either "discharged the same day" or "kept overnight (less than 

24 hours).” The survey data confirm the most recent Medicare PFS claims data which show that 

CPT code 60240 is a code with a Site-of-Service anomaly. Accordingly, we believe it is 
CMS-1582-PN 116

appropriate to remove the post-procedure inpatient visit remaining in the value and adjust the 

physician times accordingly. We also reduced the discharge day management service to onehalf, consistent with our 23 hour stay service policy. We are proposing an alternative work RVU 

of 15.04 with refinements in time for CPT code 60240 for CY 2012. A complete list of CMS 

time refinements can be found in Table 6. 

For CPT code 60500 (Parathyroidectomy or exploration of parathyroid(s);), the AMA 

RUC reviewed the survey results from 35 (out of a sample size of 118) physicians. The AMA 

RUC recommended that this service be valued as a service performed predominately in the 

facility setting. The AMA RUC indicated that since the typical patient is kept overnight, the 

AMA RUC believes that one hospital visit as well as one discharge day management service 

should be maintained in the post-operative visits for this service. Using magnitude estimation, 

the AMA RUC ultimately recommended the current work RVU of 16.78 for CPT code 60500. 

We disagree with the AMA RUC-recommended work RVU for CPT code 60500. While 

the survey data show 97 percent (34 out of 35) of survey respondents stated they perform the 

procedure "in the hospital," of those respondents who stated that they typically perform the 

procedure in the hospital, 18 percent (6 out of 34) stated that the patient is "discharged the same 

day," 44 percent (15 out of 34) stated the patient is "kept overnight (less than 24 hours)," and 

38 percent (13 out of 34) stated the patient is "admitted (more than 24 hours)." These responses 

make no distinction between the patient’s status as an inpatient or outpatient of the hospital for 

stays of longer than 24 hours. Nevertheless, the survey data show that the majority of responders 

indicated CPT code 60500 is typically performed in the hospital setting as an outpatient rather 

than an inpatient service. The survey data confirm the most recent Medicare PFS claims data 

which show that CPT code 60500 is a code with a Site-of-Service anomaly. Accordingly, we 
CMS-1582-PN 117

removed the hospital visit, reduced the discharge day management service to one-half, and 

adjusted times. We are proposing an alternative work RVU of 15.60 with refinements in time for 

CPT code 60500 for CY 2012. A complete list of CMS time refinements can be found in Table 

6. 

22. Implant Neuroelectrodes 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

63655 Implant neuroelectrodes 11.56 11.56 10.92 Disagree x 

In the Fourth Five-Year Review, CMS identified CPT code 63655 (Laminectomy for 

implantation of neurostimulator electrodes, plate/paddle, epidural) as potentially misvalued 

through the Site-of-Service Anomaly screen. CY 2009 Medicare PFS claims data indicated that 

for the typical case (greater than 50 percent), this service was not performed in the inpatient 

hospital setting and, therefore, we requested in the CYs 2010 and 2011 PFS final rules that the 

AMA RUC review this service again. 

For CPT code 63655 (Laminectomy for implantation of neurostimulator electrodes, 

plate/paddle, epidural), the associated specialty societies indicated that this service was recently 

surveyed and reviewed by the AMA RUC in April 2009 and concluded that there was no reason 

to believe another survey would result in different data requiring a change in the AMA RUC's 

previous discussion and recommendation. Accordingly, the AMA RUC recommended 

maintaining the current work RVU of 11.56, as well as the current physician time components. 

We disagree with the AMA RUC-recommended work RVU for CPT code 63655. We 

note that according to the survey data provided by the AMA RUC, of the 90 percent of 
CMS-1582-PN 118

respondents that stated they perform the procedure "in the hospital," 18 percent stated that the 

patient is "discharged the same day" and 55 percent stated that the patient was "kept overnight 

(less than 24 hours)." Given that the most recently available Medicare PFS claims data continue 

to show the typical case is not an inpatient, and that the survey data for this code suggest the 

typical case is a 23 hour stay service, we believe it is appropriate to apply our established policy 

and reduce the discharge day management service to one-half. We are thus proposing an 

alternative work RVU of 10.92 with refinements in time for CPT code 63655 for CY 2012. A 

complete list of CMS time refinements can be found in Table 6. 

23. Injection of Anesthetic Agent 

CPT 

Code Short Descriptor CY 2011 Work RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

64405 N block inj, occipital 1.32 1.00 0.94 Disagree 

In the Fourth Five-Year Review, CMS identified CPT code 64405 as potentially 

misvalued through the Harvard-Valued – Utilization > 30,000 screen. 

For CPT code 64405 (Injection, anesthetic agent; greater occipital nerve), the AMA RUC 

reviewed the survey results and recommended the median survey work RVU of 1.00 for CPT 

code 64405. 

We disagree with the AMA RUC-recommended work RVU for CPT code 64405. We 

believe this code is comparable to the key reference CPT code 20526 (Injection, therapeutic (eg, 

local anesthetic, corticosteroid), carpal tunnel) (work RVU = 0.94). Accordingly, we are 

proposing an alternative work RVU of 0.94 for CPT code 64405 for CY 2012. 

24. Gastric Emptying Study 
CMS-1582-PN 119

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommende

d WRVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

78264 Gastric emptying study 0.78 0.95 0.80 Disagree x 

In the Fourth Five-Year Review, we identified CPT code 78264 as potentially misvalued 

through the Harvard-Valued – Utilization > 30,000 screen. 

For CPT code 78264 (Gastric emptying study), the AMA RUC reviewed the survey 

results and recommended the survey median work RVU of 0.95 for CPT code 78264. 

We disagree with the AMA RUC-recommended work RVU for CPT code 78264. We 

believe the 25th percentile survey value is more appropriate based on its similarity in the 

physician work to other diagnostic tests. Accordingly, we are proposing an alternative work 

RVU of 0.80 for CPT code 78264 for CY 2012. 

25. Nasopharyngoscopy 

CPT 

Code Short Descriptor CY 2011 

Work RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

92511 Nasopharyngoscopy 0.84 0.61 0.61 Agree x 

In the Fourth Five-Year Review, we identified CPT code 92511 as potentially misvalued 

through the Harvard-Valued – Utilization > 30,000 screen. 

For CPT code 92511 (Nasopharyngoscopy with endoscope (separate procedure)), the 

AMA RUC reviewed the survey results of 30 (out of a sample size of 100) physicians. The 

AMA RUC noted that there is typically an E/M service furnished on the same day as this service. 

AMA RUC indicated that it believes the survey data overestimated the physician work involved 

in the surveyed code and recommended that for CPT code 92511, a direct work RVU crosswalk 
CMS-1582-PN 120

to CPT code 69210 (Removal impacted cerumen (separate procedure), 1 or both ears) was 

appropriate. Accordingly, the AMA RUC recommended a work RVU of 0.61 for CPT code 

92511. 

We agree with the AMA RUC’s recommended work RVU and are proposing a work 

RVU of 0.61 for CPT code 92511 for CY 2012. However, while the AMA RUC noted that there 

is typically an E/M service furnished on the same day as this service, we are concerned that the 

times in the surveyed code were not adjusted to account for the overlap in times. The most 

currently available Medicare PFS claims data continue to show that CPT code 92511 is 

commonly billed with an E/M visit on the same day; therefore, as described in section II.A. of 

this proposed notice, to account for this overlap, we reduced the pre-service evaluation and 

post-service time by one-third. We believe that 4 minutes pre-service evaluation time and 

3 minutes post-service time accurately reflect the time required to conduct the work associated 

with this service. A complete list of CMS time refinements can be found in Table 6. 

26. Cardiopulmonary Resuscitation 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommende

d Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

92950 Heart/lung resuscitation cpr 3.79 4.50 4.00 Disagree x 

 In the Fourth Five-Year Review, CMS identified CPT code 92950 as potentially 

misvalued through the Harvard-Valued – Utilization> 30,000 screen. 

 For CPT code 92950 (Cardiopulmonary resuscitation (eg, in cardiac arrest)), the AMA 

RUC reviewed the survey results recommended the median survey work RVU of 4.50 for CPT 

code 92950. 
CMS-1582-PN 121

We disagree with the AMA RUC-recommended work RVU for CPT code 92950. We 

recognize that patients that undergo this service are very ill; however, we do not believe that the 

typical patient meets all the criteria for the critical care codes. Furthermore, the most currently 

available Medicare PFS claims data show that CPT code 92950 is typically performed on the 

same day as an E/M visit. We believe some of the activities conducted during the pre- and 

post-service times of the procedure code and the E/M visit overlap and, therefore, should not be 

counted twice in developing the procedure’s work value. As described in section II.A. of this 

proposed notice, to account for this overlap, we reduced the pre-service evaluation and post 

service time by one-third. We believe that 1 minute pre-service evaluation time and 20 minutes 

post-service time accurately reflect the time required to conduct the work associated with this 

service. A complete list of CMS time refinements can be found in Table 6. 

27. Osteopathic Manipulative Treatment 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

98925 Osteopathic manipulation 0.45 0.50 0.46 Disagree x 

98926 Osteopathic manipulation 0.65 0.75 0.71 Disagree x 

98927 Osteopathic manipulation 0.87 1.00 0.96 Disagree x 

98928 Osteopathic manipulation 1.03 1.25 1.21 Disagree x 

98929 Osteopathic manipulation 1.19 1.50 1.46 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 98925, 98928 and 98929 as 

potentially misvalued through the Harvard-Valued – Utilization > 30,000 screen. Additionally, 

the American Osteopathic Association identified CPT codes 98926 and 98927 to be reviewed as 

part of this family since these were also identified to be reviewed by the AMA RUC Relativity 

Assessment Workgroup because these codes were identified through the Harvard-Valued – 

Utilization > 100,000 screen. 
CMS-1582-PN 122

For CPT code 98925 (Osteopathic manipulative treatment (OMT); 1-2 body regions 

involved), the AMA RUC reviewed the survey results and, based on comparisons to reference 

codes, recommended a work RVU of 0.50 for CPT code 98925. 

We disagree with the AMA RUC-recommended work RVU of 0.50 for CPT code 98925 

and believe that a work RVU of 0.46 is more appropriate for this service. We are also refining 

the time associated with this code. Recent PFS claims data show that this service is typically 

performed on the same day as an E/M visit. The AMA RUC considered this, and determined 

that the work associated with the pre- and post-service time for CPT code 98925 is separate from 

the work conducted during the E/M visit. While we understand that these services have 

differences, we believe some of the activities conducted during the pre- and post-service times of 

the osteopathic manipulative treatment code and the E/M visit overlap and, therefore, should not 

be counted twice in developing the procedure’s work value. As described earlier in section II.A. 

of this proposed notice, to account for this overlap, we reduced the pre-service evaluation and 

post-service time by 1/3. We believe that 1 minute of pre-service evaluation time and 2 minutes 

post-service time accurately reflect the time required to conduct the work associated with this 

service. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU of 0.50. For CPT code 98925, we removed a total of 2 minutes 

from the AMA RUC-recommended pre- and post-service times, which amounts to the removal 

of .04 of a work RVU, resulting in a work RVU of 0.46. We noted that 70 percent of the survey 

respondents indicated that the work of performing this service has not changed in the past 5 years 

(current RVU = 0.45). We are proposing an alternative work RVU of 0.46, with refinement in 
CMS-1582-PN 123

time for CPT code 98925 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 

For CPT code 98926 (Osteopathic manipulative treatment (OMT); 3-4 body regions 

involved), the AMA RUC reviewed the survey results and determined that the survey 25th 

percentile work RVU of 0.75 provides the appropriate incremental difference between this CPT 

code and others in the family, considering the additional intra-service time required for the 

additional body regions involved. Therefore, the AMA RUC recommended a work RVU of 0.75 

for CPT code 98926. 

We disagree with the AMA RUC-recommended work RVU of 0.75 for CPT code 98926 

and believe that a work RVU of 0.71 is more appropriate for this service. We are also refining 

the time associated with this code. Recent PFS claims data show that this service is typically 

performed on the same day as an E/M visit. The AMA RUC considered this, and determined 

that the work associated with the pre- and post-service time for CPT code 98926 is separate from 

the work conducted during the E/M visit. While we understand that these services have 

differences, we believe some of the activities conducted during the pre- and post-service times of 

the osteopathic manipulative treatment code and the E/M visit overlap and, therefore, should not 

be counted twice in developing the procedure’s work value. As described earlier in section II.A. 

of this proposed notice, to account for this overlap, we reduced the pre-service evaluation and 

post-service time by 1/3. We believe that 1 minute of pre-service evaluation time and 2 minutes 

post-service time accurately reflect the time required to conduct the work associated with this 

service. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 
CMS-1582-PN 124

RUC-recommended work RVU of 0.75. For CPT code 98926, we removed a total of 2 minutes 

from the AMA RUC-recommended pre- and post-service times, which amounts to the removal 

of .04 of a work RVU, resulting in a work RVU of 0.71. We noted that 81 percent of the survey 

respondents indicated that the work of performing this service has not changed in the past 5 years 

(current RVU = 0.65). We are proposing an alternative work RVU of 0.71, with refinement in 

time for CPT code 98926 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 

For CPT code 98927 (Osteopathic manipulative treatment (OMT); 5-6 body regions 

involved), the AMA RUC reviewed the survey results and determined that a work RVU of 1.00 

provides the appropriate incremental difference between this CPT code and others in the family, 

considering the additional intra-service time required for the additional body regions involved. 

The AMA RUC stated that this value is supported by the survey 25th percentile work RVU of 

0.97. The AMA RUC recommended a work RVU of 1.00 for CPT code 98927. 

We disagree with the AMA RUC-recommended work RVU of 1.00 for CPT code 98927 

and believe that a work RVU of 0.96 is more appropriate for this service. We are also refining 

the time associated with this code. Recent PFS claims data show that this service is typically 

performed on the same day as an E/M visit. The AMA RUC considered this, and determined 

that the work associated with the pre- and post-service time for CPT code 98927 is separate from 

the work conducted during the E/M visit. While we understand that these services have 

differences, we believe some of the activities conducted during the pre- and post-service times of 

the osteopathic manipulative treatment code and the E/M visit overlap and, therefore, should not 

be counted twice in developing the procedure’s work value. As described earlier in section II.A. 

of this proposed notice, to account for this overlap, we reduced the pre-service evaluation and 
CMS-1582-PN 125

post-service time by 1/3. We believe that 1 minute of pre-service evaluation time and 2 minutes 

post-service time accurately reflect the time required to conduct the work associated with this 

service. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU of 1.00. For CPT code 98927, we removed a total of 2 minutes 

from the AMA RUC-recommended pre- and post-service times, which amounts to the removal 

of .04 of a work RVU, resulting in a work RVU of 0.96. We noted that 77 percent of the survey 

respondents indicated that the work of performing this service has not changed in the past 5 years 

(current RVU = 0.87). We are proposing an alternative work RVU of 0.96, with refinement in 

time for CPT code 98927 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 

 For CPT code 98928 (Osteopathic manipulative treatment (OMT); 7-8 body regions 

involved), the AMA RUC reviewed the survey results and determined that a work RVU of 1.25 

provides the appropriate incremental difference between this CPT code and others in the family, 

considering the additional intra-service time required for the additional body regions involved. 

The AMA RUC stated that this value is supported by the survey 25th percentile work RVU of 

1.29. The AMA RUC recommended a work RVU of 1.25 for CPT code 98928. 

We disagree with the AMA RUC-recommended work RVU of 1.25 for CPT code 98928 

and believe that a work RVU of 1.21 is more appropriate for this service. We are also refining 

the time associated with this code. Recent PFS claims data show that this service is typically 

performed on the same day as an E/M visit. The AMA RUC considered this, and determined 

that the work associated with the pre- and post-service time for CPT code 98928 is separate from 
CMS-1582-PN 126

the work conducted during the E/M visit. While we understand that these services have 

differences, we believe some of the activities conducted during the pre- and post-service times of 

the osteopathic manipulative treatment code and the E/M visit overlap and, therefore, should not 

be counted twice in developing the procedure’s work value. As described earlier in section II.A. 

of this proposed notice, to account for this overlap, we reduced the pre-service evaluation and 

post-service time by 1/3. We believe that 1 minute of pre-service evaluation time and 2 minutes 

post-service time accurately reflect the time required to conduct the work associated with this 

service. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU of 1.25. For CPT code 98928, we removed a total of 2 minutes 

from the AMA RUC-recommended pre- and post-service times, which amounts to the removal 

of .04 of a work RVU, resulting in a work RVU of 1.21. We noted that 67 percent of the survey 

respondents indicated that the work of performing this service has not changed in the past 5 years 

(current RVU = 1.03). We are proposing an alternative work RVU of 1.21, with refinement in 

time for CPT code 98928 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 

For CPT code 98929 (Osteopathic manipulative treatment (OMT); 9-10 body regions 

involved), the AMA RUC reviewed the survey results and determined that the survey 25th 

percentile work RVU of 1.50 provides the appropriate incremental difference between this CPT 

code and others in the family, considering the additional intra-service time required for the 

additional body regions involved. The AMA RUC recommended a work RVU of 1.50 for CPT 

code 98929. 
CMS-1582-PN 127

We disagree with the AMA RUC-recommended work RVU of 1.50 for CPT code 98929 

and believe that a work RVU of 1.46 is more appropriate for this service. We are also refining 

the time associated with this code. Recent PFS claims data show that this service is typically 

performed on the same day as an E/M visit. The AMA RUC considered this, and determined 

that the work associated with the pre- and post-service time for CPT code 98929 is separate from 

the work conducted during the E/M visit. While we understand that these services have 

differences, we believe some of the activities conducted during the pre- and post-service times of 

the osteopathic manipulative treatment code and the E/M visit overlap and, therefore, should not 

be counted twice in developing the procedure’s work value. As described earlier in section II.A. 

of this proposed notice, to account for this overlap, we reduced the pre-service evaluation and 

post-service time by 1/3. We believe that 1 minute of pre-service evaluation time and 2 minutes 

post-service time accurately reflect the time required to conduct the work associated with this 

service. 

In order to determine the appropriate work RVU for this service given the time changes, 

we calculated the value of the extracted time and subtracted it from the AMA 

RUC-recommended work RVU of 1.50. For CPT code 98929, we removed a total of 2 minutes 

from the AMA RUC-recommended pre- and post-service times, which amounts to the removal 

of .04 of a work RVU, resulting in a work RVU of 1.46. We noted that 63 percent of the survey 

respondents indicated that the work of performing this service has not changed in the past 5 years 

(current RVU = 1.19). We are proposing an alternative work RVU of 1.46, with refinement in 

time for CPT code 98929 for CY 2012. A complete list of CMS time refinements can be found 

in Table 6. 
CMS-1582-PN 128

28. Observation Care 

CPT 

Code Short Descriptor 

CY 2011 

Work 

RVU 

AMA RUC 

Recommended 

WRVU 

CMS 

Recommended 

WRVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

99218 Observation care 1.28 1.92 1.28 Disagree x 

99219 Observation care 2.14 2.60 2.14 Disagree x 

99220 Observation care 2.99 3.56 2.99 Disagree x 

99234 Observ/hosp same date 2.56 2.56 1.92 Disagree x 

99235 Observ/hosp same date 3.41 3.24 2.78 Disagree x 

99236 Observ/hosp same date 4.26 4.20 3.63 Disagree x 

In the Fourth Five-Year Review, CMS identified CPT codes 99218 through 99220 as 

potentially misvalued through the Harvard-Valued – Utilization > 30,000 screen. The American 

College of Physicians (ACEP) also submitted a public comment identifying CPT codes 99218 

through 99220 to be reviewed in the Fourth Five-Year Review. The American College of 

Emergency Physicians (ACEP) also identified CPT codes 99234 through 99236 as part of the 

family of services for AMA RUC review. 

For CPT codes 99218 (Level 1 initial observation care, per day), 99219 (Level 2 initial 

observation care, per day), and 99220 (Level 3 initial observation care, per day), the AMA RUC 

believes that the patient population has changed for the initial observation care codes. The AMA 

RUC also believes that a rank order anomaly exists within this family of codes as the observation 

care codes have an analogous relationship to the initial hospital care codes (99221 through 

99223). In October 2009, the AMA RUC considered three new CPT codes for subsequent 

observation care services and recommended a direct crosswalk to the corresponding level of 

subsequent hospital care codes (99231 through 99233) for the work RVU. The AMA RUC 

determined that similarly, the initial observation codes should be valued equivalently to the 

corresponding initial hospital care codes (99221 through 99223), which includes physician times 
CMS-1582-PN 129

and work RVUs. Accordingly, for CPT codes 99218-99220, the AMA RUC reviewed the 

survey results and recommended work RVUs of 1.92 for code 99218, 2.60 for code 99219, and 

3.56 for code 99220 for CY 2012. 

 We disagree with the AMA RUC-recommended work RVU for CPT code 99218, 99219, 

and 99220. We agree with the AMA RUC that appropriate relativity must be maintained within 

and between the families of similar codes. However, we believe that while the work RVUs of 

these initial observation care codes (99218, 99219, and 99220) should be greater than those of 

the subsequent observation care codes (99224, 99225, and 99226), we do not believe the work 

RVUs of the initial observation care codes (99218, 99219, and 99220) should be equivalent (or 

close) to the initial hospital care codes (99221, 99222, and 99223). We note that in the CY 2011 

PFS final rule with comment period (75 FR 73334), we reviewed the new subsequent 

observation care codes, assigning the following work RVUs on an interim final basis for 

CY 2011: 0.54 to CPT code 99224, 0.96 to CPT code 99225, and 1.44 to CPT code 99226. 

These are all lower work RVUs than the subsequent hospital care codes (99224, 99225, and 

99226). Furthermore, we noted that CMS has stated previously that in only rare and exceptional 

cases would reasonable and necessary outpatient observation services span more than 48 hours. 

In the majority of cases, the decision whether to discharge a patient from the hospital following 

resolution of the reason for the observation care or to admit the patient as an inpatient can be 

made in less than 48 hours, usually in less than 24 hours. Consequently, we believe that the 

acuity level of the typical patient receiving outpatient observation services would generally be 

lower than that of the inpatient level. We believe that if the patient's acuity level is determined to 

be at the level of the inpatient, the patient should be admitted to the hospital as an inpatient. We 

note that CMS has publicly stated in a recent letter to the AHA that "it is not in the hospital's or 
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the beneficiary's interest to extend observation care rather than either releasing the patient from 

the hospital or admitting the patient as an inpatient..." (75 FR 73334). 

Consequently, we are not accepting the AMA RUC's recommendation to value the initial 

observation care codes at (for CPT Codes 99218 and 99219), or close to (for CPT code 99220) 

the level of initial hospital care services. Instead, we believe the work RVUs of the initial 

observation care codes should reflect the modest differences in patient acuity between the 

outpatient and inpatient settings. We compared the current work RVUs of the initial observation 

care codes to the interim final work RVUs of the subsequent observation care codes and found 

that the current relativity existing between these codes is acceptable. We also believe that the 

current work RVUs of the initial observation care codes maintain the proper rank order with the 

initial hospital care services. Therefore, we are proposing to maintain the following work RVUs 

for the initial observation care codes for CY 2012: 1.28 for CPT code 99218, 2.14 for CPT code 

99219, and 2.99 for CPT code 99220. We note we are accepting the survey median physician 

times for these codes, as recommended by the AMA RUC. A complete list of CMS time 

refinements can be found in Table 6. 

For CPT codes 99234 (Level 1, observation or inpatient hospital care, for the evaluation 

and management of a patient including admission and discharge on the same date); 99235 (Level 

2, observation or inpatient hospital care, for the evaluation and management of a patient 

including admission and discharge on the same date ); and 99236 (Level 3 observation or 

inpatient hospital care, for the evaluation and management of a patient including admission and 

discharge on the same date ), the AMA RUC reviewed the survey results from 50 internal 

medicine, family, geriatric, and emergency physicians. The specialty societies indicated and the 

AMA RUC agreed that survey results appeared flawed. The specialty societies determined that 
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the inability to accurately survey the physician time and work required to perform this service 

was due to the fact that observation same day admit/discharge services are typically performed 

by hospitalists (primarily internists) or emergency physicians who work in shifts. Therefore, the 

physician performing the admission is typically not the same physician who performs the 

discharge and the survey respondents were not including the physician time and work for both 

parts of the service. 

Consequently, the AMA RUC used a similar methodology as was established to value 

these services in 1997, by taking the corresponding initial observation care code of the same 

level, for example, CPT code 99218 (AMA RUC-recommended work RVU = 1.92) plus half the 

value of a hospital discharge day management service, CPT code 99238 (work RVU = 1.28). 

Therefore, for CPT code 99234, the AMA RUC recommended maintaining the current work 

RVU of 2.56, as using the aforementioned methodology produces the same result. For CPT code 

99235, the AMA RUC used the corresponding initial observation care code, CPT code 99219 

(AMA RUC- recommended work RVU = 2.6) plus half the value of a hospital discharge day 

management service, CPT code 99238 (work RVU = 1.28) and recommended the work RVU of 

3.24, using the aforementioned methodology. Finally, for CPT code 99236, the AMA RUC used 

the corresponding initial observation care code, CPT code 99220 (AMA RUC-recommended 

work RVU = 2.6) plus half the value of a hospital discharge day management service, CPT code 

99238 (work RVU = 1.28) and recommended the work RVU of 4.2, using the aforementioned 

methodology. 

We agree with the AMA RUC’s approach to valuing these observation same day 

admit/discharge services; however, we believe that the values for CPT codes 99218, 99219, and 

99220 that are incorporated should be the CMS proposed values discussed above rather than the 
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AMA RUC-recommended values. Therefore, using the proposed work RVU of 1.28 for CPT 

code 99218 and consistent with the aforementioned methodology, we are proposing a work RVU 

of 1.92 for CPT code 99234 for CY 2012. For CPT code 99235, using the proposed work RVU 

of 2.14 for CPT code 99219 and applying the methodology, we are proposing a work RVU of 

2.78 for CY 2012. Finally, using the proposed work RVU of 2.99 for CPT code 99220 and 

applying the methodology, we are proposing a work RVU of 3.63 for CPT code 99236 for CY 

2012. We also made corresponding physician time changes. A complete list of CMS time 

refinements can be found in Table 6. 

D. HCPAC-Recommended Work RVUs

1. Excision of Nail 

CPT 

Code Short Descriptor CY 2011 WRVU 

AMA HCPAC 

Recommended 

Work RVU 

CMS 

Recommended 

Work RVU 

CMS 

Work 

RVU 

Decision 

CMS 

Refinements 

to Time 

11732 Remove nail plate, add-on 0.57 0.48 0.44 Disagree x 

11765 Excision of nail fold, toe 0.74 1.48 1.22 Disagree x 

In the Fourth Five-Year Review, we identified CPT codes 11732 and 11765 as potentially 

misvalued through Harvard-Valued- Utilization > 30,000 screen. 

For CPT code 11723 (Avulsion of nail plate, partial or complete, simple; each additional 

nail plate (List separately in addition to code for primary procedure), the HCPAC reviewed the 

survey data and determined that the survey 25th percentile work RVU with total time of 

15 minutes, was appropriate for this service. The HCPAC recommended a work RVU of 0.48 

for CPT code 11732. 

We disagree with the HCPAC-recommended work RVU for CPT code 11723 and believe 

that a work RVU of 0.44 is more appropriate for this service. We compared CPT code 11723 to 
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MPC CPT code 92250 and determined that CPT 92250 was the more appropriate crosswalk. 

Additionally, we find the HCPAC-recommended decrease in work RVU to be too small, given 

the recommended reduction in time. Therefore, we are proposing an alternative work RVU of 

0.44 for CPT code 11723 for CY 2012. 

In addition to the work RVU adjustment for CPT code 11723, CMS is refining the time 

associated with this code. While we agree with the stated rationale justifying the 2 minutes 

pre-service time, we find the recommended 3 minutes post-service time to be excessive. Upon 

clinical review, we believe that 1 minute post-service time more accurately reflects the time 

required to conduct the post-service work associated with this service. A complete list of CMS 

time refinements can be found in Table 6. 

For CPT code 11765 (Wedge excision of skin of nail fold (eg, for ingrown toenail)), the 

HCPAC reviewed the survey results and determined that the survey median work RVU with total 

time of 59 minutes was appropriate for this service. The HCPAC recommended a work RVU of 

1.48 for CPT code 11765. 

We disagree with the HCPAC-recommended work RVU for CPT code 11765 and believe 

that a work RVU of 1.22 is more appropriate. We compared CPT code 11765 with reference 

CPT code 11422, as well as with CPT code 10060 (Incision and drainage of abscess (eg, 

carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or 

paronychia); simple or single) (work RVU = 1.22), and determined that CPT code 10060 was 

more similar in intensity and complexity to CPT code 11765, and thus the better comparator 

code for this service. Therefore, we are proposing an alternative work RVU of 1.22 for CPT 

code 11765. 

In addition to the work RVU adjustment for CPT code 11765, CMS is refining the time 
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associated with this code. This service is typically performed on the same day as an E/M visit. 

We believe some of the activities conducted during the pre- and post-service times of the 

procedure code and the E/M visit overlap and, therefore, should not be counted twice in 

developing the procedure’s work value. As described in section II.A. of this proposed notice, to 

account for this overlap, we reduced the pre-service evaluation and post-service time by onethird. We believe that 11 minutes pre-service evaluation time and 3 minutes post-service time 

accurately reflect the time required to conduct the work associated with this service. A complete 

list of CMS time refinements can be found in Table 6. 

E. CPT Codes Identified through the Five-Year Review Process, but not Reviewed by CMS

1. CPT Codes Referred to CPT Editorial Panel 

The following table lists the CPT codes that were subsequently sent to the CPT Editorial 

Panel to consider coding changes. Therefore, the work RVUs for these codes are not addressed 

in this Five-Year Review proposed notice. 

CPT Code Short Descriptor CMS Review Status 

15365 Apply cult derm sub f/n/hf/g Referred to CPT Editorial Panel 

15740 Island pedicle flap graft Referred to CPT Editorial Panel 

29590 Application of foot splint Referred to CPT Editorial Panel 

29826 Shoulder arthroscopy/surgery Referred to CPT Editorial Panel 

29880 Knee arthroscopy/surgery Referred to CPT Editorial Panel 

29881 Knee arthroscopy/surgery Referred to CPT Editorial Panel 

36010 Place catheter in vein Referred to CPT Editorial Panel 

36215 Place catheter in artery Referred to CPT Editorial Panel 

36216 Place catheter in artery Referred to CPT Editorial Panel 

37620 Revision of major vein Referred to CPT Editorial Panel 

47000 Needle biopsy of the liver Referred to CPT Editorial Panel 

64622 Destr paravertebrl nerve l/s Referred to CPT Editorial Panel 

64623 Destr paravertebral n add-on Referred to CPT Editorial Panel 

64626 Destr paravertebrl nerve c/t Referred to CPT Editorial Panel 

64627 Destr paravertebral n add-on Referred to CPT Editorial Panel 

67810 Biopsy of eyelid Referred to CPT Editorial Panel 

90801 Psy dx interview Referred to CPT Editorial Panel 

90802 Intac psy dx interview Referred to CPT Editorial Panel 
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CPT Code Short Descriptor CMS Review Status 

90804 Psytx, office, 20-30 min Referred to CPT Editorial Panel 

90805 Psytx, off, 20-30 min w/e&m Referred to CPT Editorial Panel 

90806 Psytx, off, 45-50 min Referred to CPT Editorial Panel 

90807 Psytx, off, 45-50 min w/e&m Referred to CPT Editorial Panel 

90808 Psytx, office, 75-80 min Referred to CPT Editorial Panel 

90809 Psytx, off, 75-80, w/e&m Referred to CPT Editorial Panel 

90810 Intac psytx, off, 20-30 min Referred to CPT Editorial Panel 

90811 Intac psytx, 20-30, w/e&m Referred to CPT Editorial Panel 

90812 Intac psytx, off, 45-50 min Referred to CPT Editorial Panel 

90813 Intac psytx, 45-50 min w/e&m Referred to CPT Editorial Panel 

90814 Intac psytx, off, 75-80 min Referred to CPT Editorial Panel 

90815 Intac psytx, 75-80 w/e&m Referred to CPT Editorial Panel 

90816 Psytx, hosp, 20-30 min Referred to CPT Editorial Panel 

90817 Psytx, hosp, 20-30 min w/e&m Referred to CPT Editorial Panel 

90818 Psytx, hosp, 45-50 min Referred to CPT Editorial Panel 

90819 Psytx, hosp, 45-50 min w/e&m Referred to CPT Editorial Panel 

90821 Psytx, hosp, 75-80 min Referred to CPT Editorial Panel 

90822 Psytx, hosp, 75-80 min w/e&m Referred to CPT Editorial Panel 

90823 Intac psytx, hosp, 20-30 min Referred to CPT Editorial Panel 

90824 Intac psytx, hsp 20-30 w/e&m Referred to CPT Editorial Panel 

90826 Intac psytx, hosp, 45-50 min Referred to CPT Editorial Panel 

90827 Intac psytx, hsp 45-50 w/e&m Referred to CPT Editorial Panel 

90828 Intac psytx, hosp, 75-80 min Referred to CPT Editorial Panel 

90829 Intac psytx, hsp 75-80 w/e&m Referred to CPT Editorial Panel 

90845 Psychoanalysis Referred to CPT Editorial Panel 

90846 Family psytx w/o patient Referred to CPT Editorial Panel 

90847 Family psytx w/patient Referred to CPT Editorial Panel 

90853 Group psychotherapy Referred to CPT Editorial Panel 

90857 Intac group psytx Referred to CPT Editorial Panel 

90862 Medication management Referred to CPT Editorial Panel 

92070 Fitting of contact lens Referred to CPT Editorial Panel 

92120 Tonography & eye evaluation Referred to CPT Editorial Panel 

95920 Intraop nerve test add-on Referred to CPT Editorial Panel 

99026 In-hospital on call service Referred to CPT Editorial Panel 

99027 Out-of-hosp on call service Referred to CPT Editorial Panel 

2. CPT Codes Withdrawn from the Five-Year Review 

The following table lists the CPT codes that were subsequently withdrawn from the 

Five-Year Review at the request of the medical specialty societies who submitted the codes for 

review in their public comments on the CY 2010 PFS final rule with comment period and with 
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the agreement of the AMA RUC. Therefore, the work RVUs for these codes are not addressed 

in this Five-Year Review proposed notice. 

CPT Code Short Descriptor CMS Review Status 

15240 Skin full grft face/genit/hf Withdrawn from Review 

21365 Treat cheek bone fracture Withdrawn from Review 

21470 Treat lower jaw fracture Withdrawn from Review 

90849 Multiple family group psytx Withdrawn from Review 

90875 Psychophysiological therapy Withdrawn from Review 

90876 Psychophysiological therapy Withdrawn from Review 

90880 Hypnotherapy Withdrawn from Review 

99288 Direct advanced life support Withdrawn from Review 

99341 Home visit, new patient Withdrawn from Review 

99342 Home visit, new patient Withdrawn from Review 

99343 Home visit, new patient Withdrawn from Review 

99344 Home visit, new patient Withdrawn from Review 

99345 Home visit, new patient Withdrawn from Review 

99347 Home visit, est patient Withdrawn from Review 

99348 Home visit, est patient Withdrawn from Review 

99349 Home visit, est patient Withdrawn from Review 

99350 Home visit, est patient Withdrawn from Review 

3. CPT Codes that are Interim Final for CY 2011 

The following table lists the CPT codes that were identified by CMS through the 

Five-Year Review process, but were recently addressed in the CY 2011 PFS final rule with 

comment period. The RVUs for these codes are currently interim final in CY 2011, were subject 

to public comment on the CY 2011 PFS final rule with comment period, and will be finalized in 

the CY 2012 PFS final rule with comment period. Two CPT codes on this list, 11040 and 

11041, were deleted by the CPT Editorial Panel for CY 2011 and replaced by new CPT codes on 

this list (11042 through 11047). Therefore, the work RVUs for these codes are not addressed in 

this Five-Year Review proposed notice. 

CPT Code Short Descriptor CMS Review Status 

11040 Debride skin, partial Deleted from CPT for CY 2011 

11041 Debride skin, full Deleted from CPT for CY 2011 
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CPT Code Short Descriptor CMS Review Status 

11042 Deb subq tissue 20 sq cm/< Interim for CY 2011 

11043 Deb musc/fascia 20 sq cm/< Interim for CY 2011 

11044 Deb bone 20 sq cm/< Interim for CY 2011 

11045 Deb subq tissue add-on Interim for CY 2011 

11046 Deb musc/fascia add-on Interim for CY 2011 

11047 Deb bone add-on Interim for CY 2011 

11900 Injection into skin lesions Interim for CY 2011 

11901 Added skin lesions injection Interim for CY 2011 

12001 Repair superficial wound(s) Interim for CY 2011 

12002 Repair superficial wound(s) Interim for CY 2011 

12004 Repair superficial wound(s) Interim for CY 2011 

12005 Repair superficial wound(s) Interim for CY 2011 

12006 Repair superficial wound(s) Interim for CY 2011 

12007 Repair superficial wound(s) Interim for CY 2011 

12011 Repair superficial wound(s) Interim for CY 2011 

12013 Repair superficial wound(s) Interim for CY 2011 

12014 Repair superficial wound(s) Interim for CY 2011 

12015 Repair superficial wound(s) Interim for CY 2011 

12016 Repair superficial wound(s) Interim for CY 2011 

12017 Repair superficial wound(s) Interim for CY 2011 

12018 Repair superficial wound(s) Interim for CY 2011 

29540 Strapping of ankle and/or ft Interim for CY 2011 

29550 Strapping of toes Interim for CY 2011 

49418 Insert tun ip cath perc Interim for CY 2011 

49421 Ins tun ip cath for dial opn Interim for CY 2011 

77427 Radiation tx management, x5 Interim for CY 2011 

88300 Surgical path, gross Interim for CY 2011 

88302 Tissue exam by pathologist Interim for CY 2011 

88304 Tissue exam by pathologist Interim for CY 2011 

88305 Tissue exam by pathologist Interim for CY 2011 

88307 Tissue exam by pathologist Interim for CY 2011 

88309 Tissue exam by pathologist Interim for CY 2011 

90870 Electroconvulsive therapy Interim for CY 2011 

61885 Insrt/redo neurostim 1 array Interim for CY 2011 

4. CPT Codes for Preventive Medicine Services 

The following table lists the CPT codes that were identified through the Five-Year 

Review process by commenters on the CY 2010 PFS final rule with comment period, but are 

preventive medicine services not covered by Medicare under the PFS. The AMA 

RUC-recommended RVUs associated with these codes are published in Addendum B of this 
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proposed notice for public reference, but have not been reviewed by CMS. Therefore, the work 

RVUs for these codes are not addressed in this Five-Year Review proposed notice. We note that 

Medicare covers a range of preventive services, including the initial preventive physical 

examination (IPPE) (“Welcome to Medicare Visit”) and the annual wellness visit (AWV), as 

detailed in the PFS CY 2011 final rule with comment period (75 FR 73412). 

CPT Code Short Descriptor CMS Review Status 

99381 Init pm e/m, new pat, inf Preventive Medicine 

99382 Init pm e/m, new pat 1-4 yrs Preventive Medicine 

99383 Prev visit, new, age 5-11 Preventive Medicine 

99384 Prev visit, new, age 12-17 Preventive Medicine 

99385 Prev visit, new, age 18-39 Preventive Medicine 

99386 Prev visit, new, age 40-64 Preventive Medicine 

99387 Init pm e/m, new pat 65+ yrs Preventive Medicine 

99391 Per pm reeval, est pat, inf Preventive Medicine 

99392 Prev visit, est, age 1-4 Preventive Medicine 

99393 Prev visit, est, age 5-11 Preventive Medicine 

99394 Prev visit, est, age 12-17 Preventive Medicine 

99395 Prev visit, est, age 18-39 Preventive Medicine 

99396 Prev visit, est, age 40-64 Preventive Medicine 

99397 Per pm reeval est pat 65+ yr Preventive Medicine 

F. Resource-Based Practice Expense RVUs

1. Overview 

Practice expense (PE) is the portion of the resources used in furnishing the service that 

reflects the general categories of physician and practitioner expenses, such as office rent and 

personnel wages but excluding malpractice expenses, as specified in section 1848(c)(1)(B) of the 

Act. Section 121 of the Social Security Amendments of 1994 (Pub. L. 103-432), enacted on 

October 31, 1994, required us to develop a methodology for a resource-based system for 

determining PE RVUs for each physician's service. 
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This proposed notice sets forth proposed revisions to work RVUs affecting payment for 

physicians’ services. PE RVUs were not subject to similar review. However, the proposed work 

RVU changes will have an impact on the development of PE RVUs due to the methodology we 

use to develop PE RVUs by looking at the direct and indirect physician practice resources 

involved in furnishing each service. Changes in work RVUs, changes in the intra-service 

portions of the physician time, and changes in the number or level of postoperative evaluation 

and management (E/M) visits associated with these services and their global periods result in 

corresponding changes to the direct PE inputs and other components used in the development of 

PE RVUs. 

 The sections that follow provide more detailed information about the methodology for 

translating the resources involved in furnishing each service into service-specific PE RVUs and 

the ways in which the revisions set forth in this proposed notice alter some of the inputs used in 

that methodology. We also refer readers to the CY 2010 PFS final rule with comment period 

(74 FR 61743 through 61748) for a more detailed review of the PE methodology, including 

examples. 

2. Practice Expense Methodology 

a. Direct Practice Expense 

 We use a "bottom-up" approach to determine the direct PE by adding the costs of the 

resources (that is, the clinical staff, equipment, and supplies) typically involved in furnishing 

each service. The costs of the resources are calculated using the refined direct PE inputs 

assigned to each CPT code in our PE database, which are based on our review of 

recommendations received from the American Medical Association's (AMA's) Relative Value 

Update Committee (RUC). For a detailed explanation of the bottom-up direct PE methodology, 
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including examples, we refer readers to the Five-Year Review of Work Relative Value Units 

Under the PFS and Proposed Changes to the Practice Expense Methodology proposed notice 

(71 FR 37242) and the CY 2007 PFS final rule with comment period (71 FR 69629). 

b. Indirect Practice Expense per Hour Data 

 We use survey data on indirect practice expenses incurred per hour worked (PE/HR) in 

developing the indirect portion of the PE RVUs. Prior to CY 2010, we primarily used the 

practice expense per hour (PE/HR) by specialty that was obtained from the AMA's 

Socioeconomic Monitoring Surveys (SMS). The AMA administered a new survey in CY 2007 

and CY 2008, the Physician Practice Expense Information Survey (PPIS), which was expanded 

(relative to the SMS) to include nonphysician practitioners (NPPs) paid under the PFS. 

 The PPIS is a multispecialty, nationally representative, PE survey of both physicians and 

NPPs using a consistent survey instrument and methods highly consistent with those used for the 

SMS and the supplemental surveys. The PPIS gathered information from 3,656 respondents 

across 51 physician specialty and healthcare professional groups. We believe the PPIS is the 

most comprehensive source of PE survey information available to date. Therefore, we used the 

PPIS data to update the PE/HR data for almost all of the Medicare-recognized specialties that 

participated in the survey for the CY 2010 PFS. 

 When we changed over to the PPIS data beginning in CY 2010, we did not change the PE 

RVU methodology itself or the manner in which the PE/HR data are used in that methodology. 

We only updated the PE/HR data based on the new survey. Furthermore, as we explained in the 

CY 2010 PFS final rule with comment period (74 FR 61751), because of the magnitude of 

payment reductions for some specialties resulting from the use of the PPIS data, we finalized a 

4-year transition (75 percent old/25 percent new for CY 2010, 50 percent old/50 percent new for 
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CY 2011, 25 percent old /75 percent new for CY 2012, and 100 percent new for CY 2013) from 

the previous PE RVUs to the PE RVUs developed using the new PPIS data. 

 Section 303 of the Medicare Prescription Drug, Improvement, and Modernization Act of 

2003 (MMA) (Pub. L. 108-173) added section 1848(c)(2)(H)(i) of the Act, which requires us to 

use the medical oncology supplemental survey data submitted in 2003 for oncology drug 

administration services. Therefore, the PE/HR for medical oncology, hematology, and 

hematology/oncology reflects the continued use of these supplemental survey data. 

 We do not use the PPIS data for reproductive endocrinology, sleep medicine, and spine 

surgery since these specialties are not separately recognized by Medicare, nor do we have a 

method to blend these data with Medicare-recognized specialty data. 

 Supplemental survey data on independent labs, from the College of American 

Pathologists, were implemented for payments in CY 2005. Supplemental survey data from the 

National Coalition of Quality Diagnostic Imaging Services (NCQDIS), representing independent 

diagnostic testing facilities (IDTFs), were blended with supplementary survey data from the 

American College of Radiology (ACR) and implemented for payments in CY 2007. Neither 

IDTFs nor independent labs participated in the PPIS. Therefore, we continue to use the PE/HR 

that was developed from their supplemental survey data. 

 Consistent with our past practice, the previous indirect PE/HR values from the 

supplemental surveys for medical oncology, independent laboratories, and IDTFs were updated 

to CY 2006 using the MEI to put them on a comparable basis with the PPIS data. 

 Previously, we have established PE/HR values for certain specialties without SMS or 

supplemental survey data by cross-walking them to other similar specialties to estimate a proxy 

PE/HR. For specialties that were part of the PPIS for which we previously used a crosswalked 
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PE/HR, we instead use the PPIS-based PE/HR. We continue to use the previous crosswalks for 

specialties that did not participate in the PPIS. However, beginning in CY 2010 we changed the 

PE/HR crosswalk for portable x-ray suppliers from radiology to IDTF, a more appropriate 

crosswalk because these specialties are more similar to each other with respect to physician time. 

 For registered dietician services, the proposed resource-based PE RVUs have been 

calculated in accordance with the final policy that crosswalks the specialty to the “All 

Physicians'' PE/HR data, as adopted in the CY 2010 PFS final rule with comment period (74 FR 

61752) and discussed again in more detail in the CY 2011 PFS final rule with comment period 

(75 FR 73183). 

 As provided in the CY 2010 PFS final rule with comment period (74 FR 61751), 

CY 2012 is the third year of the 4 year transition to the PE RVUs calculated using the PPIS data. 

Therefore, in general, the CY 2012 PE RVUs are a 25 percent/75 percent blend of the previous 

PE RVUs based on the SMS and supplemental survey data and the new PE RVUS developed 

using the PPIS data as described above. Note that the reductions in the PE RVUs for expensive 

diagnostic imaging equipment attributable to the change in the equipment utilization rate 

assumption to 75 percent are not subject to the transition, as discussed in the CY 2011 PFS final 

rule with comment period (75 FR 73189 through 73192). 

 Additionally, the PPIS PE RVU transition will not apply to CPT codes with changes in 

global periods. As discussed in the CY 2011 PFS final rule with comment period 

(75 FR 73183), we believe that a change in the global period of a code results in the CPT code 

describing a different service to which the previous PE RVUs would no longer be relevant when 

the code is reported for a service furnished with the new global period. The two CPT codes with 

proposed changes in global period for CY 2012 are: 51705 (Change of cystostomy tube; simple) 
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and 51710 (Change of cystostomy tube; complicated). The global period for each of these codes 

changed from a 10-day to a 0-day global period. 

c. Allocation of Practice Expense to Services 

 To establish PE RVUs for specific services, it is necessary to establish the direct and 

indirect PE associated with each service. 

(1) Direct Costs 

The relative relationship between the direct cost portions of the PE RVUs for any two 

services is determined by the relative relationship between the sum of the direct cost resources 

(that is, the clinical staff, equipment, and supplies) typically required to provide the services. The 

costs of these resources are calculated from the refined direct PE inputs in our PE database. For 

example, if one service has a direct PE input cost sum of $400 and another service has a direct 

PE input cost sum of $200, the direct portion of the PE RVUs of the first service would be twice 

as much as the direct portion of the PE RVUs for the second service. 

(2) Indirect Costs 

 Section II.F.2.b. of this proposed notice describes the current data sources for specialtyspecific indirect costs used in our PE calculations. We allocate the indirect costs to the code 

level on the basis of the direct costs specifically associated with a code and the greater of either 

the clinical labor costs or the physician work RVUs. We also incorporate the survey data 

described earlier in the PE/HR discussion. The general approach to developing the indirect 

portion of the PE RVUs is described below. 

● For a given service, we use the direct portion of the PE RVUs calculated as described 

above and the average percentage that direct costs represent of total costs (based on survey data) 

across the specialties that perform the service to determine an initial indirect allocator. For 
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example, if the direct portion of the PE RVUs for a given service were 2.00 and direct costs, on 

average, represented 25 percent of total costs for the specialties that performed the service, the 

initial indirect allocator would be 6.00 since 2.00 is 25 percent of 8.00. 

● We then add the greater of the work RVUs or clinical labor portion of the direct 

portion of the PE RVUs to this initial indirect allocator. In our example, if this service had work 

RVUs of 4.00 and the clinical labor portion of the direct PE RVUs was 1.50, we would add 6.00 

plus 4.00 (since the 4.00 work RVUs are greater than the 1.50 clinical labor portion) to get an 

indirect allocator of 10.00. In the absence of any further use of the survey data, the relative 

relationship between the indirect cost portions of the PE RVUs for any two services would be 

determined by the relative relationship between these indirect cost allocators. For example, if 

one service had an indirect cost allocator of 10.00 and another service had an indirect cost 

allocator of 5.00, the indirect portion of the PE RVUs of the first service would be twice as great 

as the indirect portion of the PE RVUs for the second service. 

● We next incorporate the specialty-specific indirect PE/HR data into the calculation. 

As a relatively extreme example for the sake of simplicity, assume in our example above that, 

based on the survey data, the average indirect cost of the specialties performing the first service 

with an allocator of 10.00 was half of the average indirect cost of the specialties performing the 

second service with an indirect allocator of 5.00. In this case, the indirect portion of the PE 

RVUs of the first service would be equal to that of the second service. 

d. Facility and Nonfacility Costs 

 For procedures that can be furnished in a physician's office, as well as in a hospital or 

other facility setting, we establish two PE RVUs: facility and nonfacility. The methodology for 

calculating PE RVUs is the same for both the facility and nonfacility RVUs, but is applied 
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independently to yield two separate PE RVUs. Because Medicare makes a separate payment to 

the facility for its costs of furnishing a service, the facility PE RVUs are generally lower than the 

nonfacility PE RVUs. 

e. Services With Technical Components and Professional Components 

 Diagnostic services are generally comprised of two components, a professional 

component (PC) and a technical component (TC), each of which may be performed 

independently by different providers, or they may be performed together as a"global" service. 

When services have PC and TC components that can be billed separately, the payment for the 

global component equals the sum of the payment for the TC and PC. This is a result of using a 

weighted average of the ratio of indirect to direct costs across all the specialties that furnish the 

global components, TCs, and PCs; that is, we apply the same weighted average 

indirect percentage factor to allocate indirect expenses to the global components, PCs, and TCs 

for a service. (The direct PE RVUs for the TC and PC sum to the global under the bottom-up 

methodology.) 

f. Practice Expense RVU Methodology 

 For a more detailed description of the PE RVU methodology, we refer readers to the 

CY 2010 PFS final rule with comment period (74 FR 61745 through 61746). 

(1) Setup File 

First, we create a setup file for the PE methodology. The setup file contains the direct 

cost inputs, the utilization for each procedure code at the specialty and facility/nonfacility place 

of service level, and the specialty-specific PE/HR data from the surveys. 

(2) Calculate the Direct Cost PE RVUs 

Sum the costs of each direct input as follows: 
CMS-1582-PN 146

● Step 1: Sum the direct costs of the inputs for each service. 

Apply a scaling adjustment to the direct inputs. 

● Step 2: Calculate the current aggregate pool of direct PE costs. This is the product of 

the current aggregate PE (aggregate direct and indirect) RVUs, the CF, and the average direct 

PE percentage from the survey data. 

● Step 3: Calculate the aggregate pool of direct costs. This is the sum of the product of 

the direct costs for each service from Step 1 and the utilization data for that service. 

● Step 4: Using the results of Step 2 and Step 3 calculate a direct PE scaling adjustment 

so that the aggregate direct cost pool does not exceed the current aggregate direct cost pool and 

apply it to the direct costs from Step 1 for each service. 

● Step 5: Convert the results of Step 4 to an RVU scale for each service. To do this, 

divide the results of Step 4 by the CF. Note that the actual value of the CF used in this 

calculation does not influence the final direct cost PE RVUs, as long as the same CF is used in 

Steps 2 and 5. Different CFs will result in different direct PE scaling factors, but this has no 

effect on the final direct cost PE RVUs since changes in the CFs and changes in the associated 

direct scaling factors offset one another. 

(3) Create the Indirect Cost PE RVUs 

Create indirect allocators as follows: 

● Step 6: Based on the survey data, calculate direct and indirect PE percentages for each 

physician specialty. 

● Step 7: Calculate direct and indirect PE percentages at the service level by taking a 

weighted average of the results of Step 6 for the specialties that furnish the service. Note that for 
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services with TCs and PCs, the direct and indirect percentages for a given service do not vary by 

the PC, TC, and global components. 

● Step 8: Calculate the service level allocators for the indirect PE RVUs based on 

the percentages calculated in Step 7. The indirect PE RVUs are allocated based on the three 

components: the direct PE RVUs, the clinical PE RVUs, and the work RVUs. 

For most services the indirect allocator is: indirect percentage * (direct PE 

RVUs/direct percentage) + work RVUs. 

There are two situations where this formula is modified as follows: 

● If the service is a global service (that is, a service with global, professional, and 

technical components), then the indirect allocator is: indirect percentage (direct 

PE RVUs/direct percentage) + clinical PE RVUs + work RVUs. 

● If the clinical labor PE RVUs exceed the work RVUs (and the service is not a global 

service), then the indirect allocator is: indirect percentage (direct 

PE RVUs/direct percentage) + clinical PE RVUs. 

(Note: For global services, the indirect allocator is based on both the work RVUs and the 

clinical labor PE RVUs. We do this to recognize that, for the PC service, indirect PEs will be 

allocated using the work RVUs, and for the TC service, indirect PEs will be allocated using the 

direct PE RVUs and the clinical labor PE RVUs. This also allows the global component RVUs 

to equal the sum of the PC and TC RVUs.) 

Apply a scaling adjustment to the indirect allocators. 

● Step 9: Calculate the current aggregate pool of indirect PE RVUs by multiplying the 

current aggregate pool of PE RVUs by the average indirect PE percentage from the survey data. 

● Step 10: Calculate an aggregate pool of indirect PE RVUs for all PFS services by 
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adding the product of the indirect PE allocators for a service from Step 8 and the utilization data 

for that service. 

● Step 11: Using the results of Step 9 and Step 10, calculate an indirect PE adjustment 

so that the aggregate indirect allocation does not exceed the available aggregate indirect PE 

RVUs and apply it to indirect allocators calculated in Step 8. 

Calculate the indirect practice cost index. 

● Step 12: Using the results of Step 11, calculate aggregate pools of specialty-specific 

adjusted indirect PE allocators for all PFS services for a specialty by adding the product of the 

adjusted indirect PE allocator for each service and the utilization data for that service. 

● Step 13: Using the specialty-specific indirect PE/HR data, calculate specialty-specific 

aggregate pools of indirect PE for all PFS services for that specialty by adding the product of the 

indirect PE/HR for the specialty, the physician time for the service, and the specialty's utilization 

for the service across all services performed by the specialty. 

● Step 14: Using the results of Step 12 and Step 13, calculate the specialty-specific 

indirect PE scaling factors. 

● Step 15: Using the results of Step 14, calculate an indirect practice cost index at the 

specialty level by dividing each specialty-specific indirect scaling factor by the average indirect 

scaling factor for the entire PFS. 

● Step 16: Calculate the indirect practice cost index at the service level to ensure the 

capture of all indirect costs. Calculate a weighted average of the practice cost index values for 

the specialties that furnish the service. (Note: For services with TCs and PCs, we calculate the 

indirect practice cost index across the global components, PCs, and TCs. Under this method, the 
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indirect practice cost index for a given service (for example, echocardiogram) does not vary by 

the PC, TC, and global component.) 

● Step 17: Apply the service level indirect practice cost index calculated in Step 16 to 

the service level adjusted indirect allocators calculated in Step 11 to get the indirect PE RVUs. 

(4) Calculate the Final PE RVUs 

● Step 18: Add the direct PE RVUs from Step 6 to the indirect PE RVUs from Step 17 

and apply the final PE budget neutrality (BN) adjustment. 

 The final PE BN adjustment is calculated by comparing the results of Step 18 to the 

current pool of PE RVUs. This final BN adjustment is required primarily because certain 

specialties are excluded from the PE RVU calculation for ratesetting purposes, but all specialties 

are included for purposes of calculating the final BN adjustment. (See"Specialties excluded 

from ratesetting calculation" in this section.) 

(5) Setup File Information 

 Specialties excluded from ratesetting calculation: For the purposes of calculating the PE 

RVUs, we exclude certain specialties, such as certain nonphysician practitioners paid at 

a percentage of the PFS and low-volume specialties, from the calculation. These specialties are 

included for the purposes of calculating the BN adjustment. They are displayed in Table 7. 

TABLE 7: SPECIALTIES EXCLUDED FROM RATESETTING CALCULATION 

Specialty 

Code Specialty Description 

42 Certified nurse midwife 

49 Ambulatory surgical center 

50 Nurse practitioner 

51 Medical supply company with certified orthotist 

52 Medical supply company with certified prosthetist 

53 Medical supply company with certified prosthetist-orthotist 
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Specialty 

Code Specialty Description 

54 Medical supply company not included in 51, 52, or 53. 

55 Individual certified orthotist 

56 Individual certified prosthestist 

57 Individual certified prosthetist-orthotist 

58 Individuals not included in 55, 56, or 57 

59 Ambulance service supplier, e.g., private ambulance companies, funeral homes, etc. 

60 Public health or welfare agencies 

61 Voluntary health or charitable agencies 

73 Mass immunization roster biller 

74 Radiation therapy centers 

87 All other suppliers (e.g., drug and department stores) 

88 Unknown supplier/provider specialty 

89 Certified clinical nurse specialist 

95 Competitive Acquisition Program (CAP) Vendor 

96 Optician 

97 Physician assistant 

A0 Hospital 

A1 SNF 

A2 Intermediate care nursing facility 

A3 Nursing facility, other 

A4 HHA 

A5 Pharmacy 

A6 Medical supply company with respiratory therapist 

A7 Department store 

1 Supplier of oxygen and/or oxygen related equipment 

2 Pedorthic personnel 

3 Medical supply company with pedorthic personnel 

● Crosswalk certain low volume physician specialties: Crosswalk the utilization of 

certain specialties with relatively low PFS utilization to the associated specialties. 

● Physical therapy utilization: Crosswalk the utilization associated with all physical 

therapy services to the specialty of physical therapy. 

● Identify professional and technical services not identified under the usual TC and 

26 modifiers: Flag the services that are PC and TC services, but do not use TC and 26 modifiers 

(for example, electrocardiograms). This flag associates the PC and TC with the associated global 
CMS-1582-PN 151

code for use in creating the indirect PE RVUs. For example, the professional service, CPT code 

93010 (Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only), is 

associated with the global service, CPT code 93000 (Electrocardiogram, routine ECG with at 

least 12 leads; with interpretation and report). 

● Payment modifiers: Payment modifiers are accounted for in the creation of the 

file. For example, services billed with the assistant at surgery modifier are paid 16 percent of the 

PFS amount for that service; therefore, the utilization file is modified to only account for 

16 percent of any service that contains the assistant at surgery modifier. 

● Work RVUs: The setup file contains the work RVUs from this proposed notice. 

(6) Equipment Cost Per Minute 

The equipment cost per minute is calculated as: 

(1/(minutes per year * usage)) * price * ((interest rate/(1-(1/((1 + interest rate)^ life of 

equipment)))) + maintenance)

Where: 

minutes per year = maximum minutes per year if usage were continuous (that is, usage = 

1); generally 150,000 minutes. 

usage = equipment utilization assumption; 0.75 for certain expensive diagnostic imaging 

equipment (see 75 FR 73189 through 73192) and 0.5 for others. 

price = price of the particular piece of equipment. 

interest rate = 0.11. 

life of equipment = useful life of the particular piece of equipment. 

maintenance = factor for maintenance; 0.05. 

3. Practice Expense RVUs for Codes Included in the Five-Year Review 
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Some direct PE inputs and other components of the PE methodology are directly affected 

by the proposed revisions in work RVUs and physician time described in section II.C. of this 

proposed notice. In the following discussion, we detail how changes in work RVUs, changes in 

the intra-service portions of the physician time, and changes in the number or level of 

postoperative visits associated with the global periods result in corresponding changes to direct 

PE inputs and other components used in the development of PE RVUs. 

a. Changes to Direct Practice Expense Inputs 

Proposed changes in the intra-service portions of the physician time, and in the number or 

level of postoperative visits within the global periods associated with particular codes, result in 

corresponding changes in the values of certain direct PE inputs (clinical labor time, equipment 

time, and supply quantity). The following sections present the logic we used in making changes 

in the direct PE inputs based on their association with physician time. These changes are 

included in the Five-Year Review of Work proposed notice direct PE database, which is 

available on the CMS Web site under the downloads for this proposed notice at: 

http://www.cms.gov/PhysicianFeeSched/. 

(1) Changes in Intra-service Physician Time in the Nonfacility Setting 

Clinical Labor: For most codes valued in the nonfacility setting, a portion of the clinical 

labor time allocated to the intra-service period reflects minutes assigned for assisting the 

physician with the procedure. To the extent that we are proposing changes in the times 

associated with the intra-service portion of such procedures, we have adjusted the corresponding 

intra-service clinical labor minutes in the nonfacility setting. 

Equipment Time: For equipment associated with the intra-service period in the 

nonfacility setting, we generally allocate time based on the typical number of minutes a piece of 
CMS-1582-PN 153

equipment is being used and, therefore, not available for use with another patient during that 

period. In general, we allocate these minutes based on the description of typical clinical labor 

activities. To the extent that we are proposing changes in the clinical labor times associated with 

the intra-service portion of procedures, we have adjusted the corresponding equipment minutes 

associated with the codes. 

(2) Changes in Hospital Discharge Management Services in the Facility Setting 

Clinical Labor: For most codes with 10 or 90 day global periods that are valued in the 

facility setting, a portion of the clinical labor time allocated to the intra-service period in the 

facility setting reflects minutes assigned for discharge day management. To the extent that we 

are proposing changes in the physician times associated with hospital discharge day 

management, we have adjusted the corresponding intra-service clinical labor minutes in the 

facility setting. 

(3) Changes in the Number or Level of Postoperative Office Visits in the Global Period 

Clinical Labor: For codes valued with post-service physician office visits during a global 

period, most of the clinical labor time allocated to the post-service period reflects a standard 

number of minutes allocated for each of those visits. To the extent that we are proposing a 

change in the number or level of postoperative visits, we have modified the clinical staff time in 

the post-service period to reflect the change. 

Equipment Time: For codes valued with post-service physician office visits during a 

global period, we allocate standard equipment for each of those visits. To the extent that we are 

proposing a change in the number or level of postoperative visits associated with a code, we have 

adjusted the corresponding equipment minutes. 
CMS-1582-PN 154

Supplies: For codes valued with post-service physician office visits during a global 

period, a certain number of supply items are allocated for each of those office visits. To the 

extent that we are proposing a change in the number of postoperative visits, we have adjusted the 

corresponding supply item quantities associated with the codes. We note that many supply items 

associated with post-service physician office visits are allocated for each office visit (for 

example, a minimum multi-specialty visit pack (SA048) in the proposed notice direct PE 

database). For these supply items, the quantities in the proposed notice direct PE database 

should reflect the proposed number of office visits associated with the code’s global period. 

However, some supply items are associated with post-service physician office visits but are only 

allocated once during the global period because they are typically used during only one of the 

post-service office visits (for example, pack, post-op incision care (suture) (SA054) in the 

proposed notice direct PE database). For these supply items, the quantities in the proposed 

notice direct PE database reflect that single quantity. 

b. Changes in Components of the Indirect Practice Expense Methodology 

(1) Work RVUs, Direct PE RVUs, and Clinical Labor PE RVUs 

In calculating the allocations for indirect PE RVUs, as we describe in section II.F.2.f. of 

this proposed notice, we calculate the service level allocators for the indirect PEs based on the 

three components: direct PE RVUs, clinical labor PE RVUs, and work RVUs. Therefore, 

changes in the values of those components result in corresponding changes in the allocation of 

indirect PE RVUs. 

(2) Physician Time 

Similarly, in creating the indirect practice cost index, as we describe in section II.F.2.f. of 

this proposed notice, we calculate specialty-specific aggregate pools of indirect PE for all PFS 
CMS-1582-PN 155

services for that specialty by adding the product of the indirect PE/HR for the specialty, the 

physician time for the service, and the specialty's utilization for the service across all services 

performed by the specialty. Therefore, changes in the physician time result in corresponding 

changes in the calculation of specialty-specific aggregate pools of indirect PE for all PFS 

services for that specialty and. consequently, the allocation of indirect PE RVUs. 

G. Malpractice RVUs

Section 1848(c) of the Act requires that each service paid under the PFS be comprised of 

three components: work, PE, and malpractice. From 1992 to 1999, malpractice RVUs were 

charge-based, using weighted specialty-specific malpractice expense percentages and 1991 

average allowed charges. Malpractice RVUs for new codes after 1991 were extrapolated from 

similar existing codes or as a percentage of the corresponding work RVU. Section 

1848(c)(2)(C)(iii) of the Act required us to implement resource-based malpractice RVUs for 

services furnished beginning in 2000. Therefore, initial implementation of resource-based 

malpractice RVUs occurred in 2000. 

The statute also requires that we review, and if necessary adjust, RVUs no less often than 

every 5 years. The first review and update of resource-based malpractice RVUs was addressed 

in the CY 2005 PFS final rule with comment period (69 FR 66263). Minor modifications to the 

methodology were addressed in the CY 2006 PFS final rule with comment period 

(70 FR 70153). In the CY 2010 PFS final rule with comment period, we implemented the 

second review and update of malpractice RVUs. For a discussion of the second review and 

update of malpractice RVUs, see the CY 2010 PFS proposed rule (74 FR 33537) and final rule 

with comment period (74 FR 61758). 

As established in the CY 2011 PFS final rule with comment period (75 FR 73208), 
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malpractice RVUs for new and revised codes effective before the next Five-Year Review (for 

example, effective CY 2011 through CY 2014) are determined by a direct crosswalk to a similar 

"source" code or a modified crosswalk to account for differences in work RVU between the 

new/revised code and the source code. For the modified crosswalk approach, we adjust the 

malpractice RVU for the new/revised code to reflect the difference in work RVU between the 

source code and the new/revised work value (or, if greater, the clinical labor portion of the fully 

implemented PE RVU) for the new code. For example, if the proposed work RVU for a revised 

code is 10 percent higher than the work RVU for its source code, the malpractice RVU for the 

revised code would be increased by 10 percent over the source code RVU. This approach 

presumes the same risk factor for the new/revised code and source code but uses the work RVU 

for the new/revised code to adjust for risk-of-service. The assigned malpractice RVUs for 

new/revised codes effective between updates remain in place until the next Five-Year Review. 

For this Fourth Five-Year Review, with the exception of 3 CPT codes (33981, 33982, and 

33983), the source code for each code reviewed in the Five-Year Review is the code itself. 

Under this usual circumstance, we calculated the revised malpractice RVU for these codes by 

scaling the current malpractice RVU by the percent difference in work RVU between the current 

(CY 2011) work RVU and the work RVU proposed in section II.C. of this proposed notice. 

CPT codes 33981 (Replacement of extracorporeal ventricular assist device, single or 

biventricular, pump(s), single or each pump); 33982 (Replacement of ventricular assist device 

pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass); and 

33983 (Replacement of ventricular assist device pump(s); implantable intracorporeal, single 

ventricle, with cardiopulmonary bypass) were previously contractor-priced and do not have 

current work RVUs. Therefore we applied the AMA RUC-recommended crosswalks to obtain 
CMS-1582-PN 157

the appropriate malpractice RVUs. The crosswalk source code for CPT code 33981 is CPT code 

33976 (Insertion of ventricular assist device; extracorporeal, biventricular), and the crosswalk 

source for CPT code 33982 and 33983 is CPT code 33979 (Insertion of ventricular assist device, 

implantable intracorporeal, single ventricle). Consistent with the methodology described above, 

the malpractice RVUs for these three newly-valued codes were developed by adjusting the 

malpractice RVU of the source code for the difference in work RVU between the source code 

and the newly-valued code. All malpractice RVUs are listed in Addendum B of this proposed 

notice. 

H. Budget Neutrality

Section 1848(c)(2)(B)(ii) of the Act requires that increases or decreases in RVUs for a 

year may not cause the amount of expenditures for the year to differ by more than $20 million 

from what expenditures would have been in the absence of these changes. If this threshold is 

exceeded, we must make adjustments to preserve budget neutrality. We estimate that the net 

effect on the PFS overall from the Fourth Five-Year Review changes discussed in this proposed 

notice would be under $20 million for CY 2012, as compared to CY 2011, based on CY 2009 

Medicare PFS utilization data. The current law estimate of the CY 2012 CF is $23.9396. Since 

the net impact on the PFS is under the $20 million threshold, we will not apply a budget 

neutrality adjustment to the CY 2012 conversion factor (CF). We note that additional changes to 

PFS payment policies, including the establishment of interim and final RVUs for coding changes 

that will be announced later this year, may result in the application of budget-neutrality 

adjustments for CY 2012. 
CMS-1582-PN 158

III. Response to Comments 

Because of the large number of public comments we normally receive on Federal 

Register documents, we are not able to acknowledge or respond to them individually. We will 

consider all comments received by the date and time specified in the "DATES" section of this 

preamble, and we will respond to the comments in the CY 2012 PFS final rule with comment 

period. 

IV. 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 (44 U.S.C. Chapter 35) 

V. Regulatory Impact Analysis 

A. Overall Impact

We have examined the impact of this rule as required by Executive Order 12866 on 

Regulatory Planning and Review (September 30, 1993), Executive Order 13563 on Improving 

Regulation and Regulatory Review (February 2, 2011), the Regulatory Flexibility Act (RFA) 

(September 19, 1980, Pub. L. 96-354), section 1102(b) of the Act, section 202 of the Unfunded 

Mandates Reform Act of 1995 (March 22, 1995; Pub. L. 104-4), Executive Order 13132 on 

Federalism (August 4, 1999) and the Congressional Review Act (5 U.S.C. 804(2)). 

Executive Orders 12866 and 13563 direct agencies to assess all costs and benefits of 

available regulatory alternatives and, if regulation is necessary, to select regulatory approaches 

that maximize net benefits (including potential economic, environmental, public health and 

safety effects, distributive impacts, and equity). A regulatory impact analysis must be prepared 

for major rules with economically significant effects ($100 million or more in any 1 year). We 
CMS-1582-PN 159

estimate that this proposed notice will redistribute less than $100 million of PFS expenditures in 

1 year. Therefore, we estimate that this rulemaking is not "economically significant" as 

measured by the $100 million threshold, and hence not a major rule under the Congressional 

Review Act. Accordingly, we are not including a formal regulatory impact analysis. 

While we are not including a formal regulatory impact analysis, we are providing the 

following discussion for informational purposes. Of the CPT codes reviewed during the Fourth 

Five-Year Review of Work, there are both proposed increases and decreases in work values and 

changes in physician time. The changes in work values and physician time values result in 

corresponding changes to the PE and malpractice RVUs, as discussed in sections II.F.3. and II.G. 

of this proposed notice. Overall, we estimate that the net effect on PFS spending would be under 

$20 million for CY 2012, as compared to CY 2011. At the specialty level, this Five-Year 

Review of Work is estimated to have no significant impact based on the aggregate services that 

each specialty performed during CY 2009. We note that CY 2009 is the most recent year for 

which complete PFS utilization data are available at the time of the analysis for this proposed 

notice. 

The RFA requires agencies to analyze options for regulatory relief of small entities, if a 

rule has a significant impact on a substantial number of small entities. The great majority of 

hospitals and most other health care providers and suppliers are small entities, either by being 

nonprofit organizations or by meeting the SBA definition of a small business (having revenues of 

less than $7.0 million to $34.5 million in any 1 year). For purposes of the RFA, physicians, 

nonphysician practitioners (NPPs), and other suppliers, including independent diagnostic testing 

facilities (IDTFs), are considered small businesses if they generate revenues of $10 million or 

less based on SBA size standards. Approximately 95 percent of physicians are considered to be 
CMS-1582-PN 160

small entities. There are over 1 million physicians, other practitioners, and medical suppliers 

that receive Medicare payment under the PFS. Since we estimate that there are no significant 

impacts at the specialty level due to the proposed changes in RVUs resulting from the Fourth 

Five-Year Review of Work, the Secretary has determined that this proposed notice will not have 

a significant impact on the operations of a substantial number of small businesses or other small 

entities. Therefore, the Secretary has determined that this proposed notice will not have a 

significant economic impact on a substantial number of 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 603 of the RFA. For purposes 

of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside 

of a metropolitan statistical area and has fewer than 100 beds. We do not believe that there will 

be significant impacts on small rural hospitals given the overall insignificant impact attributable 

to proposed RVU changes resulting from this Five-Year Review of Work. Therefore, the 

Secretary has determined that this proposed notice will not have a significant impact on the 

operations of a substantial number of small rural hospitals. 

Section 202 of the Unfunded Mandates Reform Act of 1995 (UMRA) also requires that 

agencies assess anticipated costs and benefits before issuing any rule whose mandates require 

spending in any 1 year of $100 million in 1995 dollars, updated annually for inflation. In 2011, 

that threshold is approximately $136 million. This proposed notice will not mandate any 

requirements for State, local, or tribal governments in the aggregate, or by the private sector, of 

$135 million. Medicare beneficiaries are considered to be part of the private sector and as a 

result a more detailed discussion is presented on the Impact of Beneficiaries in section V.C. of 
CMS-1582-PN 161

this proposed notice. 

Executive Order 13132 establishes certain requirements that an agency must meet when it 

promulgates a proposed rule (and subsequent final rule) that imposes substantial direct 

requirement costs on State and local governments, preempts State law, or otherwise has 

Federalism implications. We have examined this proposed notice in accordance with Executive 

Order 13132 and have determined that this regulation would not have any substantial direct 

effect on State or local governments, preempt States, or otherwise have a Federalism implication. 

B. Anticipated Effects: Impact on Beneficiaries

Overall, we believe these changes would improve beneficiary access to reasonable and 

necessary services since services would be more appropriately valued. The payment changes 

could also affect beneficiary liability. Any changes in aggregate beneficiary liability from a 

particular work RVU change would be negligible; however, an individual beneficiary’s liability 

would be a function of the coinsurance (20 percent, if applicable, for the particular service after 

the beneficiary has met the deductible) and the effect of the work RVU changes on the 

calculation of the Medicare Part B payment rate for the service. 

C. Alternatives Considered

 This proposed notice discusses the proposed revisions to the work RVUs and 

corresponding changes to the PE and malpractice RVUs under the PFS. The preamble provides 

descriptions of the statutory provisions that are addressed, identifies those areas when discretion 

has been exercised, presents rationale for our decisions, and where relevant, alternatives that 

were considered.

D. Accounting Statement and Table 

As required by OMB Circular A-4 (available at 
CMS-1582-PN 162

http://www.whitehouse.gov/sites/default/files/omb/assets/omb/circulars/a004/a-4.pdf), in 

Table 8, we have prepared an accounting statement showing the estimated expenditures 

associated with this proposed notice. 

TABLE 8: ACCOUNTING STATEMENT: 

CLASSIFICATION OF ESTIMATED EXPENDITURES 

CATEGORY TRANSFERS 

CY 2012 Annualized Monetized Transfers Estimated decrease in expenditures of approximately 

$0. 

From Whom To Whom? Federal Government to physicians, other 

practitioners, and providers and suppliers who 

receive payment under the Medicare PFS. 

E. Conclusion 

As stated previously, the Secretary determined that the economic impacts of this 

proposed notice do not meet the level required by section 1102(b) of the Act or the RFA and, 

therefore, we are not providing a regulatory impact analysis. 

 In accordance with the provisions of Executive Order 12866, this proposed notice was 

reviewed by the Office of Management and Budget. 
CMS-1582-PN 

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare--Hospital Insurance; 

and Program No. 93.774, Medicare--Supplementary Medical Insurance Program) 

Dated: March 31, 2011

 __________________________________ 

 Donald M. Berwick 

Administrator,

 Centers for Medicare & Medicaid Services.

Approved: April 28, 2011

 __________________________________ 

Kathleen Sebelius 

Secretary,

Department of Health and Human Services. 

BILLING CODE 4120-01-P
CMS-1582-PN 164 

ADDENDUM A: EXPLANATION AND USE OF ADDENDA, B, AND C 

The Addenda on the following pages provide various data pertaining to the Medicare fee 

schedule for physicians' services furnished in CY 2012. Addendum B contains the RVUs for 

work, nonfacility PE, facility PE, and malpractice expense, and other information for all services 

included in the PFS. We note that for this proposed notice, to create Addendum B, we retained 

the current CY 2011 RVUs from the CY 2011 payment file for most codes and displayed new 

RVUs for only those codes involved in the Fourth Five-Year Review of Work. PE RVUs for 

these Five-Year Review codes were calculated using CY 2009 Medicare utilization data in order 

to maintain consistency with the current CY 2011 RVUs displayed for all other services. 

Addendum C contains the list of CPT codes that were reviewed for the Fourth Five-Year Review 

of Work. 

(1) Addendum B: Relative Value Units and Related Information Used in Determining Payments 

for CY 2012 (Changes from CY 2011 for Services Reviewed in the Fourth Five-Year Review 

Only) 

In previous years, we have listed many services in Addendum B that are not paid under 

the PFS. To avoid publishing as many pages of codes for these services, we are not including 

clinical laboratory codes or the alpha-numeric codes (Healthcare Common Procedure Coding 

System (HCPCS) codes not included in CPT) not paid under the PFS in Addendum B. 

Addendum B contains the following information for each CPT code and alpha-numeric 

HCPCS code, except for: alpha-numeric 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. Please also note the following: 
CMS-1582-PN 165 

• An "NA" in the "Nonfacility PE RVUs" column of Addendum B means that CMS has 

not developed a PE RVU in the nonfacility setting for the service because it is typically 

performed in the hospital (for example, an open heart surgery is generally performed in the 

hospital setting and not a physician's office). If there is an "NA" in the nonfacility PE RVU 

column, and the contractor determines that this service can be performed in the nonfacility 

setting, the service will be paid at the facility PE RVU rate. 

• Services that have an "NA" in the "Facility PE RVUs" column of Addendum B are 

typically not paid under the PFS when provided in a facility setting. These services (which 

include "incident to" services and the technical portion of diagnostic tests) are generally paid 

under either the hospital outpatient prospective payment system or bundled into the hospital 

inpatient prospective payment system payment. In some cases, these services may be paid in a 

facility setting at the PFS rate (for example, therapy services), but there would be no payment 

made to the practitioner under the PFS in these situations. 

 1. CPT/HCPCS code. This is the CPT or alpha-numeric HCPCS number for the service. 

Alpha-numeric HCPCS codes are included at the end of this Addendum. 

 2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a 

professional component (PC) (modifier-26) for the service. If there is a PC and a TC for the 

service, Addendum B contains three entries for the code. A code for: the global values (both 

professional and technical); modifier-26 (PC); and modifier TC. The global service is not 

designated by a modifier, and physicians must bill using the code without a modifier if the 

physician furnishes both the PC and the TC of the service. Modifier-53 is shown for a 

discontinued procedure, for example, a colonoscopy that is not completed. There will be RVUs 
CMS-1582-PN 166 

for a code with this modifier. 

 3. Status indicator. This indicator shows whether the CPT/HCPCS code is included in 

the PFS and whether it is separately payable if the service is covered. An explanation of types of 

status indicators follows: 

 A = Active code. These codes are separately payable under the PFS if covered. There 

will be RVUs for codes with this status. The presence of an "A" indicator does not mean that 

Medicare has made a national coverage determination regarding the service. Contractors remain 

responsible for coverage decisions in the absence of a national Medicare policy. 

 B = Bundled code. Payments for covered services are always bundled into payment for 

other services not specified. If RVUs are shown, they are not used for Medicare payment. If 

these services are covered, payment for them is subsumed by the payment for the services to 

which they are incident (for example, a telephone call from a hospital nurse regarding care of a 

patient). 

 C = Contractors price the code. Contractors establish RVUs and payment amounts for 

these services, generally on an individual case basis following review of documentation, such as 

an operative report. 

 E = Excluded from the PFS by regulation. These codes are for items and services that 

CMS chose to exclude from the PFS by regulation. No RVUs are shown, and no payment may 

be made under the PFS for these codes. Payment for them, when covered, continues under 

reasonable charge procedures. 

 I = Not valid for Medicare purposes. Medicare uses another code for the reporting of, 

and the payment for these services. (Codes not subject to a 90 day grace period.) 
CMS-1582-PN 167 

 M = Measurement codes, used for reporting purposes only. There are no RVUs and no 

payment amounts for these codes. CMS uses them to aid with performance measurement. No 

separate payment is made. These codes should be billed with a zero (($0.00) charge and are 

denied) on the MPFSDB. 

 N = Non-covered service. These codes are noncovered services. Medicare payment may 

not be made for these codes. If RVUs are shown, they are not used for Medicare payment. 

 R = Restricted coverage. Special coverage instructions apply. If the service is covered 

and no RVUs are shown, it is contractor-priced. 

 T = There are RVUs for these services, but they are only paid if there are no other 

services payable under the PFS billed on the same date by the same provider. If any other 

services payable under the PFS are billed on the same date by the same provider, these services 

are bundled into the service(s) for which payment is made. 

 X = Statutory exclusion. These codes represent an item or service that is not within the 

statutory definition of "physicians' services" for PFS payment purposes. No RVUs are shown for 

these codes, and no payment may be made under the PFS, (for example, ambulance services and 

clinical diagnostic laboratory services.) 

 4. Description of code. This is the code's short descriptor, which is an abbreviated 

version of the narrative description of the code. 

 5. Physician work RVUs. These are the RVUs for the physician work in CY 2011. 

 6. Fully implemented nonfacility PE RVUs. These are the fully implemented resourcebased PE RVUs for nonfacility settings. 

 7. CY 2011 transitional nonfacility PE RVUs. These are the CY 2011 resource-based PE 
CMS-1582-PN 168 

RVUs for nonfacility settings. 

 8. Fully implemented facility PE RVUs. These are the fully implemented resource-based 

PE RVUs for facility settings. 

 9. CY 2011 Transitional facility PE RVUs. These are the CY 2011 resource-based PE 

RVUs for facility settings. 

 10. Malpractice expense RVUs. These are the RVUs for the malpractice expense for 

CY 2011. 

 11. Global period. This indicator shows the number of days in the global period for the 

code (0, 10, or 90 days). An explanation of the alpha codes follows: 

 MMM = Code describes a service furnished in uncomplicated maternity cases, including 

ante partum care, delivery, and postpartum care. The usual global surgical concept does not 

apply. See the Physicians' Current Procedural Terminology for specific definitions. 

 XXX = The global concept does not apply. 

 YYY = The global period is to be set by the contractor (for example, unlisted surgery 

codes). 

 ZZZ = Code related to another service that is always included in the global period of the 

other service. 

(2) Addendum C: Codes with Proposed RVUs Subject to Comment for Fourth Five-Year 

Review of Work 

 Addendum C includes the columns and indicators described above for Addendum B for 

codes with proposed RVUs subject to comment for the Fourth Five-Year Review of Work.
CMS-1582-PN 169 

ADDENDUM B. - RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMI

PAYMENTS FOR CY 2012 (CHANGES FROM CY 2011 FOR SERVICES REVIEWED IN THE FOU

REVIEW ONLY) 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

0001F I Heart failure composite 0.00 0.00 0.00 0.00 0.00 0.00005F I Osteoarthritis composite 0.00 0.00 0.00 0.00 0.00 0.00012F I Cap bacterial assess 0.00 0.00 0.00 0.00 0.00 0.00014F I Comp preop assess cat surg 0.00 0.00 0.00 0.00 0.00 0.00015F I Melan follow-up complete 0.00 0.00 0.00 0.00 0.00 0.00019T C Extracorp shock wv tx ms nos 0.00 0.00 0.00 0.00 0.00 0.00030T C Antiprothrombin antibody 0.00 0.00 0.00 0.00 0.00 0.00042T C Ct perfusion w/contrast cbf 0.00 0.00 0.00 0.00 0.00 0.00048T C Implant ventricular device 0.00 0.00 0.00 0.00 0.00 0.00050T C Removal circulation assist 0.00 0.00 0.00 0.00 0.00 0.00051T C Implant total heart system 0.00 0.00 0.00 0.00 0.00 0.00052T C Replace component heart syst 0.00 0.00 0.00 0.00 0.00 0.00053T C Replace component heart syst 0.00 0.00 0.00 0.00 0.00 0.00054T C Bone surgery using computer 0.00 0.00 0.00 0.00 0.00 0.00055T C Bone surgery using computer 0.00 0.00 0.00 0.00 0.00 0.00058T C Cryopreservation ovary tiss 0.00 0.00 0.00 0.00 0.00 0.00059T C Cryopreservation oocyte 0.00 0.00 0.00 0.00 0.00 0.00071T C U/s leiomyomata ablate <200 0.00 0.00 0.00 0.00 0.00 0.00072T C U/s leiomyomata ablate >200 0.00 0.00 0.00 0.00 0.00 0.00073T A Delivery comp imrt 0.00 13.27 15.29 NA NA 0.00075T C Perq stent/chest vert art 0.00 0.00 0.00 NA NA 0.00075T TC C Perq stent/chest vert art 0.00 0.00 0.00 NA NA 0.00075T 26 C Perq stent/chest vert art 0.00 0.00 0.00 0.00 0.00 0.00076T C S&i stent/chest vert art 0.00 0.00 0.00 NA NA 0.00076T TC C S&i stent/chest vert art 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 170 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

0076T 26 C S&i stent/chest vert art 0.00 0.00 0.00 0.00 0.00 0.00078T C Endovasc aort repr w/device 0.00 0.00 0.00 0.00 0.00 0.00079T C Endovasc visc extnsn repr 0.00 0.00 0.00 0.00 0.00 0.00080T C Endovasc aort repr rad s&i 0.00 0.00 0.00 0.00 0.00 0.00081T C Endovasc visc extnsn s&i 0.00 0.00 0.00 0.00 0.00 0.00085T N Breath test heart reject 0.00 0.00 0.00 0.00 0.00 0.00092T C Artific disc addl 0.00 0.00 0.00 0.00 0.00 0.00095T C Artific diskectomy addl 0.00 0.00 0.00 0.00 0.00 0.00098T C Rev artific disc addl 0.00 0.00 0.00 0.00 0.00 0.00099T C Implant corneal ring 0.00 0.00 0.00 0.00 0.00 0.00100T C Prosth retina receive&gen 0.00 0.00 0.00 0.00 0.00 0.00101T C Extracorp shockwv tx hi enrg 0.00 0.00 0.00 0.00 0.00 0.00102T C Extracorp shockwv tx anesth 0.00 0.00 0.00 0.00 0.00 0.00103T C Holotranscobalamin 0.00 0.00 0.00 0.00 0.00 0.00106T C Touch quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00107T C Vibrate quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00108T C Cool quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00109T C Heat quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00110T C Nos quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00111T C Rbc membranes fatty acids 0.00 0.00 0.00 0.00 0.00 0.00123T C Scleral fistulization 0.00 0.00 0.00 0.00 0.00 0.00124T C Conjunctival drug placement 0.00 0.00 0.00 0.00 0.00 0.00126T C Chd risk imt study 0.00 0.00 0.00 0.00 0.00 0.00141T I Perq islet transplant 0.00 0.00 0.00 0.00 0.00 0.00142T I Open islet transplant 0.00 0.00 0.00 0.00 0.00 0.00143T I Laparoscopic islet transplnt 0.00 0.00 0.00 0.00 0.00 0.00155T C Lap impl gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00156T C Lap remv gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00157T C Open impl gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00158T C Open remv gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 171 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

0159T C Cad breast mri 0.00 0.00 0.00 NA NA 0.00159T TC C Cad breast mri 0.00 0.00 0.00 NA NA 0.00159T 26 C Cad breast mri 0.00 0.00 0.00 0.00 0.00 0.00163T C Lumb artif diskectomy addl 0.00 0.00 0.00 0.00 0.00 0.00164T C Remove lumb artif disc addl 0.00 0.00 0.00 0.00 0.00 0.00165T C Revise lumb artif disc addl 0.00 0.00 0.00 0.00 0.00 0.00166T C Tcath vsd close w/o bypass 0.00 0.00 0.00 0.00 0.00 0.00167T C Tcath vsd close w/bypass 0.00 0.00 0.00 0.00 0.00 0.00168T C Rhinophototx light app bilat 0.00 0.00 0.00 0.00 0.00 0.00169T C Place stereo cath brain 0.00 0.00 0.00 0.00 0.00 0.00171T C Lumbar spine proces distract 0.00 0.00 0.00 0.00 0.00 0.00172T C Lumbar spine process addl 0.00 0.00 0.00 0.00 0.00 0.00173T C Iop monit io pressure 0.00 0.00 0.00 0.00 0.00 0.00174T C Cad cxr with interp 0.00 0.00 0.00 0.00 0.00 0.00175T C Cad cxr remote 0.00 0.00 0.00 0.00 0.00 0.00178T C 64 lead ecg w/i&r 0.00 0.00 0.00 0.00 0.00 0.00179T C 64 lead ecg w/tracing 0.00 0.00 0.00 0.00 0.00 0.00180T C 64 lead ecg w/i&r only 0.00 0.00 0.00 0.00 0.00 0.00181T C Corneal hysteresis 0.00 0.00 0.00 0.00 0.00 0.00182T C Hdr elect brachytherapy 0.00 0.00 0.00 NA NA 0.00182T TC C Hdr elect brachytherapy 0.00 0.00 0.00 NA NA 0.00182T 26 C Hdr elect brachytherapy 0.00 0.00 0.00 0.00 0.00 0.00183T C Wound ultrasound 0.00 0.00 0.00 0.00 0.00 0.00184T C Exc rectal tumor endoscopic 0.00 0.00 0.00 0.00 0.00 0.00185T C Comptr probability analysis 0.00 0.00 0.00 0.00 0.00 0.00186T C Suprachoroidal drug delivery 0.00 0.00 0.00 0.00 0.00 0.00188T N Videoconf crit care 74 min 0.00 0.00 0.00 0.00 0.00 0.00189T N Videoconf crit care addl 30 0.00 0.00 0.00 0.00 0.00 0.00190T C Place intraoc radiation src 0.00 0.00 0.00 0.00 0.00 0.00191T C Insert ant segment drain int 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 172 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

0192T C Insert ant segment drain ext 0.00 0.00 0.00 0.00 0.00 0.00195T C Arthrod presac interbody 0.00 0.00 0.00 0.00 0.00 0.00196T C Arthrod presac interbody eac 0.00 0.00 0.00 0.00 0.00 0.00197T C Intrafraction track motion 0.00 0.00 0.00 0.00 0.00 0.00198T C Ocular blood flow measure 0.00 0.00 0.00 0.00 0.00 0.00199T C Physiologic tremor record 0.00 0.00 0.00 0.00 0.00 0.00200T C Perq sacral augmt unilat inj 0.00 0.00 0.00 0.00 0.00 0.00201T C Perq sacral augmt bilat inj 0.00 0.00 0.00 0.00 0.00 0.00202T C Post vert arthrplst 1 lumbar 0.00 0.00 0.00 0.00 0.00 0.00205T C Inirs each vessel add-on 0.00 0.00 0.00 0.00 0.00 0.00206T C Remote algorithm analys ecg 0.00 0.00 0.00 0.00 0.00 0.00207T C Clear eyelid gland w/heat 0.00 0.00 0.00 0.00 0.00 0.00208T C Audiometry air only 0.00 0.00 0.00 0.00 0.00 0.00209T C Audiometry air & bone 0.00 0.00 0.00 0.00 0.00 0.00210T C Speech audiometry threshold 0.00 0.00 0.00 0.00 0.00 0.00211T C Speech audiom thresh & recog 0.00 0.00 0.00 0.00 0.00 0.00212T C Compre audiometry evaluation 0.00 0.00 0.00 0.00 0.00 0.00213T C Njx paravert w/us cer/thor 0.00 0.00 0.00 0.00 0.00 0.00214T C Njx paravert w/us cer/thor 0.00 0.00 0.00 0.00 0.00 0.00215T C Njx paravert w/us cer/thor 0.00 0.00 0.00 0.00 0.00 0.00216T C Njx paravert w/us lumb/sac 0.00 0.00 0.00 0.00 0.00 0.00217T C Njx paravert w/us lumb/sac 0.00 0.00 0.00 0.00 0.00 0.00218T C Njx paravert w/us lumb/sac 0.00 0.00 0.00 0.00 0.00 0.00219T C Plmt post facet implt cerv 0.00 0.00 0.00 0.00 0.00 0.00220T C Plmt post facet implt thor 0.00 0.00 0.00 0.00 0.00 0.00221T C Plmt post facet implt lumb 0.00 0.00 0.00 0.00 0.00 0.00222T C Plmt post facet implt addl 0.00 0.00 0.00 0.00 0.00 0.00223T C Acoustic ecg w/i&r 0.00 0.00 0.00 0.00 0.00 0.00224T C Acoustic ecg 1+ analysis 0.00 0.00 0.00 0.00 0.00 0.00225T C Acoustic ecg analy & reprog 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 173 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

0226T C Anoscopy hra w/spec collect 0.00 0.00 0.00 0.00 0.00 0.00227T C Anoscopy hra w/biopsy 0.00 0.00 0.00 0.00 0.00 0.00228T C Njx tfrml eprl w/us cer/thor 0.00 0.00 0.00 0.00 0.00 0.00229T C Njx tfrml eprl w/us cer/thor 0.00 0.00 0.00 0.00 0.00 0.00230T C Njx tfrml eprl w/us lumb/sac 0.00 0.00 0.00 0.00 0.00 0.00231T C Njx tfrml eprl w/us lumb/sac 0.00 0.00 0.00 0.00 0.00 0.00232T C Njx platelet plasma 0.00 0.00 0.00 0.00 0.00 0.00233T C Skin glycation spectroscopy 0.00 0.00 0.00 0.00 0.00 0.00234T C Trluml perip athrc renal art 0.00 0.00 0.00 0.00 0.00 0.00235T C Trluml perip athrc visceral 0.00 0.00 0.00 0.00 0.00 0.00236T C Trluml perip athrc abd aorta 0.00 0.00 0.00 0.00 0.00 0.00237T C Trluml perip athrc brchiocph 0.00 0.00 0.00 0.00 0.00 0.00238T C Trluml perip athrc iliac art 0.00 0.00 0.00 0.00 0.00 0.00239T C Bioimpedance spectroscopy 0.00 0.00 0.00 0.00 0.00 0.00240T C Esoph motility 3d topography 0.00 0.00 0.00 0.00 0.00 0.00240T TC C Esoph motility 3d topography 0.00 0.00 0.00 0.00 0.00 0.00240T 26 C Esoph motility 3d topography 0.00 0.00 0.00 0.00 0.00 0.00241T C Esoph motility w/stim/perf 0.00 0.00 0.00 0.00 0.00 0.00241T TC C Esoph motility w/stim/perf 0.00 0.00 0.00 0.00 0.00 0.00241T 26 C Esoph motility w/stim/perf 0.00 0.00 0.00 0.00 0.00 0.00242T C Gi tract transit & pres meas 0.00 0.00 0.00 0.00 0.00 0.00242T TC C Gi tract transit & pres meas 0.00 0.00 0.00 0.00 0.00 0.00242T 26 C Gi tract transit & pres meas 0.00 0.00 0.00 0.00 0.00 0.00243T C Intm msr bronchodil wheeze 0.00 0.00 0.00 0.00 0.00 0.00243T TC C Intm msr bronchodil wheeze 0.00 0.00 0.00 0.00 0.00 0.00243T 26 C Intm msr bronchodil wheeze 0.00 0.00 0.00 0.00 0.00 0.00244T C Cont msr bronchodil wheeze 0.00 0.00 0.00 0.00 0.00 0.00244T TC C Cont msr bronchodil wheeze 0.00 0.00 0.00 0.00 0.00 0.00244T 26 C Cont msr bronchodil wheeze 0.00 0.00 0.00 0.00 0.00 0.00245T C Opn tx rib fx 1-2 ribs 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 174 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

0246T C Opn tx rib fx 3-4 ribs 0.00 0.00 0.00 0.00 0.00 0.00247T C Opn tx rib fx 5-6 ribs 0.00 0.00 0.00 0.00 0.00 0.00248T C Opn tx rib fx 7+ ribs 0.00 0.00 0.00 0.00 0.00 0.00249T C Ligation hemorrhoid w/us 0.00 0.00 0.00 0.00 0.00 0.00250T C Insert bronchial valve 0.00 0.00 0.00 0.00 0.00 0.00251T C Remov bronchial valve addl 0.00 0.00 0.00 0.00 0.00 0.00252T C Bronchscpc rmvl bronch valve 0.00 0.00 0.00 0.00 0.00 0.00253T C Insert aqueous drain device 0.00 0.00 0.00 0.00 0.00 0.00254T C Evasc rpr iliac art bifur 0.00 0.00 0.00 0.00 0.00 0.00255T C Evasc rpr iliac art bifr s&i 0.00 0.00 0.00 0.00 0.00 0.00255T TC C Evasc rpr iliac art bifr s&i 0.00 0.00 0.00 0.00 0.00 0.00255T 26 C Evasc rpr iliac art bifr s&i 0.00 0.00 0.00 0.00 0.00 0.00256T C Evasc aortic hrt valve 0.00 0.00 0.00 0.00 0.00 0.00257T C Opn tthrc aortic hrt valve 0.00 0.00 0.00 0.00 0.00 0.00258T C Aortic hrt valv w/o card byp 0.00 0.00 0.00 0.00 0.00 0.00259T C Aortic hrt valve w/card byp 0.00 0.00 0.00 0.00 0.00 0.00260T C Hypthrm bdy neonate 28d/< 0.00 0.00 0.00 0.00 0.00 0.00261T C Hypthrm head neonate 28d/< 0.00 0.00 0.00 0.00 0.00 0.00501F I Prenatal flow sheet 0.00 0.00 0.00 0.00 0.00 0.00502F I Subsequent prenatal care 0.00 0.00 0.00 0.00 0.00 0.00503F I Postpartum care visit 0.00 0.00 0.00 0.00 0.00 0.00516F I Anemia plan of care docd 0.00 0.00 0.00 0.00 0.00 0.00519F I Pland chemo docd b/4 txmnt 0.00 0.00 0.00 0.00 0.00 0.00525F I Initial visit for episode 0.00 0.00 0.00 0.00 0.00 0.00528F I Rcmnd flw-up 10 yrs docd 0.00 0.00 0.00 0.00 0.00 0.00535F I Dyspnea mngmnt plan docd 0.00 0.00 0.00 0.00 0.00 0.00545F I Follow up care plan mdd docd 0.00 0.00 0.00 0.00 0.00 0.01000F I Tobacco use assessed 0.00 0.00 0.00 0.00 0.00 0.0

10021 A Fna w/o image 1.27 2.77 2.70 0.64 0.58 0.210022 A Fna w/image 1.27 2.46 2.61 0.52 0.52 0.1
CMS-1582-PN 175 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

1003F I Level of activity assess 0.00 0.00 0.00 0.00 0.00 0.0

10040 A Acne surgery 1.21 1.64 1.59 1.28 1.22 0.1

1004F I Clin symp vol ovrld assess 0.00 0.00 0.00 0.00 0.00 0.0

10060 A Drainage of skin abscess 1.22 1.99 1.86 1.46 1.37 0.110061 A Drainage of skin abscess 2.45 2.74 2.59 2.03 1.93 0.310080 A Drainage of pilonidal cyst 1.22 3.60 3.48 1.58 1.46 0.210081 A Drainage of pilonidal cyst 2.50 4.76 4.61 2.13 1.97 0.4

1008F I Gi/renal risk assess 0.00 0.00 0.00 0.00 0.00 0.0

10120 A Remove foreign body 1.25 2.65 2.54 1.33 1.25 0.110121 A Remove foreign body 2.74 4.79 4.52 2.36 2.21 0.410140 A Drainage of hematoma/fluid 1.58 2.97 2.85 1.69 1.65 0.2

1015F I Copd symptoms assess 0.00 0.00 0.00 0.00 0.00 0.0

10160 A Puncture drainage of lesion 1.25 2.40 2.32 1.41 1.37 0.110180 A Complex drainage wound 2.30 4.33 4.11 2.49 2.38 0.4

1018F I Assess dyspnea not present 0.00 0.00 0.00 0.00 0.00 0.01019F I Assess dyspnea present 0.00 0.00 0.00 0.00 0.00 0.01022F I Pneumo imm status assess 0.00 0.00 0.00 0.00 0.00 0.01026F I Co-morbid condition assess 0.00 0.00 0.00 0.00 0.00 0.01030F I Influenza imm status assess 0.00 0.00 0.00 0.00 0.00 0.01034F I Current tobacco smoker 0.00 0.00 0.00 0.00 0.00 0.01035F I Smokeless tobacco user 0.00 0.00 0.00 0.00 0.00 0.01050F I History of mole changes 0.00 0.00 0.00 0.00 0.00 0.01055F I Visual funct status assess 0.00 0.00 0.00 0.00 0.00 0.01060F I Doc perm/cont/parox atr fib 0.00 0.00 0.00 0.00 0.00 0.01061F I Doc lack perm+cont+parox fib 0.00 0.00 0.00 0.00 0.00 0.01065F I Ischm stroke symp lt3 hrsb/4 0.00 0.00 0.00 0.00 0.00 0.01066F I Ischm stroke symp ge3 hrsb/4 0.00 0.00 0.00 0.00 0.00 0.01070F I Alarm symp assessed-absent 0.00 0.00 0.00 0.00 0.00 0.01071F I Alarm symp assessed-1+ prsnt 0.00 0.00 0.00 0.00 0.00 0.0

11000 A Debride infected skin 0.60 0.92 0.88 0.21 0.22 0.0
CMS-1582-PN 176 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

11001 A Debride infected skin add-on 0.30 0.29 0.29 0.10 0.11 0.011004 A Debride genitalia & perineum 10.80 NA NA 4.70 4.53 1.811005 A Debride abdom wall 14.24 NA NA 6.30 5.87 2.911006 A Debride genit/per/abdom wall 13.10 NA NA 5.82 5.57 2.311008 A Remove mesh from abd wall 5.00 NA NA 2.20 2.06 1.011010 A Debride skin at fx site 4.19 9.41 8.91 3.48 3.27 0.711011 A Debride skin musc at fx site 4.94 9.58 9.29 3.10 2.91 0.911012 A Deb skin bone at fx site 6.87 12.44 12.23 4.66 4.44 1.311042 A Deb subq tissue 20 sq cm/< 0.80 2.12 1.65 0.61 0.49 0.111043 A Deb musc/fascia 20 sq cm/< 2.00 3.28 3.28 1.27 1.27 0.311044 A Deb bone 20 sq cm/< 3.60 4.33 4.33 2.02 2.02 0.611045 A Deb subq tissue add-on 0.33 0.51 0.51 0.13 0.13 0.011046 A Deb musc/fascia add-on 0.70 0.76 0.76 0.30 0.30 0.111047 A Deb bone add-on 1.20 1.18 1.18 0.53 0.53 0.211055 R Trim skin lesion 0.43 1.00 0.95 0.13 0.14 0.011056 R Trim skin lesions 2 to 4 0.61 1.09 1.04 0.18 0.20 0.011057 R Trim skin lesions over 4 0.79 1.22 1.16 0.24 0.26 0.011100 A Biopsy skin lesion 0.81 2.09 2.09 0.58 0.54 0.111101 A Biopsy skin add-on 0.41 0.51 0.50 0.30 0.28 0.0

1118F I Gerd symps assessed 12 month 0.00 0.00 0.00 0.00 0.00 0.0

11200 A Removal of skin tags 0.82 1.60 1.53 1.21 1.14 0.111201 A Remove skin tags add-on 0.29 0.24 0.22 0.18 0.16 0.011300 A Shave skin lesion 0.51 1.44 1.41 0.33 0.30 0.011301 A Shave skin lesion 0.85 1.77 1.74 0.59 0.54 0.111302 A Shave skin lesion 1.05 2.07 2.04 0.74 0.68 0.111303 A Shave skin lesion 1.24 2.44 2.39 0.86 0.78 0.111305 A Shave skin lesion 0.67 1.32 1.27 0.26 0.27 0.011306 A Shave skin lesion 0.99 1.71 1.66 0.52 0.51 0.111307 A Shave skin lesion 1.14 2.03 1.99 0.68 0.65 0.111308 A Shave skin lesion 1.41 2.14 2.07 0.70 0.68 0.1
CMS-1582-PN 177 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

11310 A Shave skin lesion 0.73 1.66 1.63 0.49 0.45 0.111311 A Shave skin lesion 1.05 1.94 1.91 0.74 0.68 0.111312 A Shave skin lesion 1.20 2.26 2.23 0.86 0.79 0.111313 A Shave skin lesion 1.62 2.68 2.62 1.14 1.04 0.2

1134F I Epsd bk pain for =< 6 wks 0.00 0.00 0.00 0.00 0.00 0.01135F I Epsd bk pain for > 6 wks 0.00 0.00 0.00 0.00 0.00 0.01136F I Epsd bk pain for <= 12 wks 0.00 0.00 0.00 0.00 0.00 0.01137F I Epsd bk pain for > 12 wks 0.00 0.00 0.00 0.00 0.00 0.0

11400 A Exc tr-ext b9+marg 0.5 < cm 0.90 2.49 2.42 1.31 1.23 0.111401 A Exc tr-ext b9+marg 0.6-1 cm 1.28 2.82 2.73 1.60 1.49 0.211402 A Exc tr-ext b9+marg 1.1-2 cm 1.45 3.10 3.00 1.70 1.59 0.211403 A Exc tr-ext b9+marg 2.1-3 cm 1.84 3.39 3.24 2.20 2.03 0.311404 A Exc tr-ext b9+marg 3.1-4 cm 2.11 3.81 3.65 2.32 2.15 0.311406 A Exc tr-ext b9+marg > 4.0 cm 3.52 4.88 4.55 3.09 2.79 0.611420 A Exc h-f-nk-sp b9+marg 0.5 < 1.03 2.37 2.28 1.26 1.20 0.111421 A Exc h-f-nk-sp b9+marg 0.6-1 1.47 2.88 2.77 1.61 1.52 0.211422 A Exc h-f-nk-sp b9+marg 1.1-2 1.68 3.15 3.03 2.08 1.95 0.211423 A Exc h-f-nk-sp b9+marg 2.1-3 2.06 3.50 3.37 2.29 2.14 0.311424 A Exc h-f-nk-sp b9+marg 3.1-4 2.48 3.88 3.73 2.45 2.29 0.411426 A Exc h-f-nk-sp b9+marg > 4 cm 4.09 4.93 4.67 3.36 3.10 0.711440 A Exc face-mm b9+marg 0.5 < cm 1.05 2.65 2.58 1.81 1.71 0.111441 A Exc face-mm b9+marg 0.6-1 cm 1.53 3.10 3.00 2.13 2.01 0.211442 A Exc face-mm b9+marg 1.1-2 cm 1.77 3.43 3.32 2.28 2.15 0.211443 A Exc face-mm b9+marg 2.1-3 cm 2.34 3.84 3.69 2.61 2.45 0.311444 A Exc face-mm b9+marg 3.1-4 cm 3.19 4.56 4.35 3.11 2.88 0.511446 A Exc face-mm b9+marg > 4 cm 4.80 5.93 5.50 4.19 3.80 0.811450 A Removal sweat gland lesion 3.22 7.02 6.63 3.52 3.20 0.611451 A Removal sweat gland lesion 4.43 8.40 8.09 4.16 3.82 0.911462 A Removal sweat gland lesion 3.00 7.02 6.71 3.47 3.19 0.611463 A Removal sweat gland lesion 4.43 8.61 8.39 4.31 3.99 0.8
CMS-1582-PN 178 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

11470 A Removal sweat gland lesion 3.74 7.50 7.03 3.90 3.53 0.711471 A Removal sweat gland lesion 4.89 8.89 8.40 4.49 4.07 0.9

1150F I Doc pt rsk death w/in 1yr 0.00 0.00 0.00 0.00 0.00 0.01151F I Doc no pt rsk death w/in 1yr 0.00 0.00 0.00 0.00 0.00 0.01152F I Doc advncd dis comfort 1st 0.00 0.00 0.00 0.00 0.00 0.01153F I Doc advncd dis cmfrt not 1st 0.00 0.00 0.00 0.00 0.00 0.01157F I Advnc care plan in rcrd 0.00 0.00 0.00 0.00 0.00 0.01158F I Advnc care plan tlk docd 0.00 0.00 0.00 0.00 0.00 0.01159F I Med list docd in rcrd 0.00 0.00 0.00 0.00 0.00 0.0

11600 A Exc tr-ext mlg+marg 0.5 < cm 1.63 3.64 3.47 1.68 1.52 0.211601 A Exc tr-ext mlg+marg 0.6-1 cm 2.07 4.28 4.14 2.11 1.96 0.311602 A Exc tr-ext mlg+marg 1.1-2 cm 2.27 4.64 4.52 2.34 2.17 0.311603 A Exc tr-ext mlg+marg 2.1-3 cm 2.82 5.05 4.86 2.67 2.44 0.411604 A Exc tr-ext mlg+marg 3.1-4 cm 3.17 5.51 5.29 2.81 2.56 0.511606 A Exc tr-ext mlg+marg > 4 cm 5.02 7.29 6.82 3.76 3.34 0.8

1160F I Rvw meds by rx/dr in rcrd 0.00 0.00 0.00 0.00 0.00 0.0

11620 A Exc h-f-nk-sp mlg+marg 0.5 < 1.64 3.71 3.56 1.73 1.57 0.211621 A Exc h-f-nk-sp mlg+marg 0.6-1 2.08 4.32 4.18 2.14 1.99 0.311622 A Exc h-f-nk-sp mlg+marg 1.1-2 2.41 4.74 4.62 2.43 2.27 0.311623 A Exc h-f-nk-sp mlg+marg 2.1-3 3.11 5.25 5.05 2.85 2.61 0.411624 A Exc h-f-nk-sp mlg+marg 3.1-4 3.62 5.75 5.50 3.07 2.81 0.611626 A Exc h-f-nk-sp mlg+mar > 4 cm 4.61 6.64 6.33 3.54 3.26 0.811640 A Exc face-mm malig+marg 0.5 < 1.67 3.88 3.74 1.83 1.69 0.211641 A Exc face-mm malig+marg 0.6-1 2.17 4.46 4.36 2.25 2.12 0.311642 A Exc face-mm malig+marg 1.1-2 2.62 4.96 4.85 2.59 2.43 0.311643 A Exc face-mm malig+marg 2.1-3 3.42 5.49 5.30 3.07 2.84 0.511644 A Exc face-mm malig+marg 3.1-4 4.34 6.62 6.36 3.66 3.38 0.711646 A Exc face-mm mlg+marg > 4 cm 6.26 8.02 7.63 4.80 4.44 1.011719 R Trim nail(s) 0.17 0.47 0.44 0.05 0.06 0.011720 A Debride nail 1-5 0.32 0.58 0.55 0.10 0.10 0.0
CMS-1582-PN 179 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

11721 A Debride nail 6 or more 0.54 0.67 0.65 0.16 0.18 0.011730 A Removal of nail plate 1.10 1.65 1.58 0.33 0.36 0.011732 A Remove nail plate add-on 0.44 0.56 0.57 0.12 0.14 0.011740 A Drain blood from under nail 0.37 1.00 0.94 0.54 0.52 0.011750 A Removal of nail bed 2.50 3.73 3.52 2.37 2.30 0.211752 A Remove nail bed/finger tip 3.63 5.36 4.98 3.69 3.57 0.311755 A Biopsy nail unit 1.31 2.48 2.39 0.93 0.93 0.111760 A Repair of nail bed 1.63 4.69 4.30 2.03 1.94 0.211762 A Reconstruction of nail bed 2.94 4.86 4.54 2.22 2.24 0.311765 A Excision of nail fold toe 1.22 3.51 3.33 1.42 1.34 0.011770 A Removal of pilonidal lesion 2.66 4.75 4.49 2.25 2.06 0.511771 A Removal of pilonidal lesion 6.09 9.25 8.58 5.45 4.98 1.211772 A Removal of pilonidal lesion 7.35 10.88 10.25 7.80 7.24 1.4

1180F I Thromboemb risk assessed 0.00 0.00 0.00 0.00 0.00 0.0

11900 A Injection into skin lesions 0.52 1.04 1.04 0.38 0.34 0.011901 A Added skin lesions injection 0.80 1.17 1.15 0.59 0.54 0.111920 R Correct skin color defects 1.61 3.11 3.20 1.58 1.48 0.311921 R Correct skin color defects 1.93 3.58 3.60 1.84 1.71 0.311922 R Correct skin color defects 0.49 1.22 1.20 0.35 0.31 0.011950 R Therapy for contour defects 0.84 1.05 1.12 0.48 0.49 0.111951 R Therapy for contour defects 1.19 1.50 1.50 0.74 0.69 0.211952 R Therapy for contour defects 1.69 1.61 1.84 0.80 0.88 0.211954 R Therapy for contour defects 1.85 2.55 2.49 1.38 1.23 0.311960 A Insert tissue expander(s) 11.49 NA NA 12.99 13.02 1.811970 A Replace tissue expander 8.01 NA NA 9.01 8.32 1.511971 A Remove tissue expander(s) 3.41 9.46 9.44 5.35 5.08 0.611975 N Insert contraceptive cap 1.48 2.13 2.11 0.65 0.64 0.111976 R Removal of contraceptive cap 1.78 2.13 2.16 0.83 0.75 0.311977 N Removal/reinsert contra cap 3.30 2.96 2.95 1.45 1.43 0.211980 A Implant hormone pellet(s) 1.48 1.36 1.33 0.73 0.68 0.2
CMS-1582-PN 180 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

11981 A Insert drug implant device 1.48 2.17 2.21 0.71 0.74 0.211982 A Remove drug implant device 1.78 2.23 2.36 0.84 0.90 0.211983 A Remove/insert drug implant 3.30 2.54 2.86 1.35 1.55 0.312001 A Repair superficial wound(s) 0.84 1.51 1.83 0.37 0.64 0.112002 A Repair superficial wound(s) 1.14 1.71 1.97 0.46 0.75 0.112004 A Repair superficial wound(s) 1.44 1.91 2.24 0.55 0.85 0.212005 A Repair superficial wound(s) 1.97 2.38 2.75 0.72 1.03 0.312006 A Repair superficial wound(s) 2.39 2.86 3.30 0.90 1.27 0.412007 A Repair superficial wound(s) 2.90 3.19 3.71 1.07 1.49 0.5

1200F I Seizure type& frequ docd 0.00 0.00 0.00 0.00 0.00 0.0

12011 A Repair superficial wound(s) 1.07 1.86 2.11 0.43 0.68 0.112013 A Repair superficial wound(s) 1.22 1.87 2.20 0.46 0.77 0.212014 A Repair superficial wound(s) 1.57 2.07 2.46 0.57 0.89 0.212015 A Repair superficial wound(s) 1.98 2.45 2.95 0.66 1.03 0.312016 A Repair superficial wound(s) 2.68 2.91 3.44 0.91 1.29 0.412017 A Repair superficial wound(s) 3.18 NA NA 0.76 1.34 0.512018 A Repair superficial wound(s) 3.61 NA NA 0.85 1.77 0.612020 A Closure of split wound 2.67 4.91 4.71 2.46 2.33 0.412021 A Closure of split wound 1.89 2.62 2.44 1.93 1.80 0.312031 A Intmd wnd repair s/tr/ext 2.00 4.66 4.53 2.24 2.16 0.312032 A Intmd wnd repair s/tr/ext 2.52 6.02 5.95 2.91 2.83 0.312034 A Intmd wnd repair s/tr/ext 2.97 5.67 5.50 2.65 2.55 0.512035 A Intmd wnd repair s/tr/ext 3.50 7.03 6.82 2.97 2.87 0.612036 A Intmd wnd repair s/tr/ext 4.23 7.26 7.03 3.26 3.14 0.812037 A Intmd wnd repair s/tr/ext 5.00 8.02 7.77 3.74 3.62 0.912041 A Intmd wnd repair n-hf/genit 2.10 4.69 4.56 2.24 2.17 0.312042 A Intmd wnd repair n-hg/genit 2.79 5.30 5.21 2.77 2.67 0.412044 A Intmd wnd repair n-hg/genit 3.19 6.76 6.49 2.64 2.54 0.512045 A Intmd wnd repair n-hg/genit 3.75 7.24 6.94 3.58 3.32 0.612046 A Intmd wnd repair n-hg/genit 4.30 8.55 8.21 4.02 3.77 0.8
CMS-1582-PN 181 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

12047 A Intmd wnd repair n-hg/genit 4.95 9.57 9.07 4.24 4.01 0.912051 A Intmd wnd repair face/mm 2.33 4.94 4.85 2.44 2.38 0.312052 A Intmd wnd repair face/mm 2.87 5.38 5.35 2.79 2.78 0.412053 A Intmd wnd repair face/mm 3.17 6.48 6.28 2.80 2.70 0.512054 A Intmd wnd repair face/mm 3.50 6.71 6.48 2.71 2.62 0.512055 A Intmd wnd repair face/mm 4.50 8.49 8.02 3.62 3.34 0.712056 A Intmd wnd repair face/mm 5.30 10.36 9.70 5.38 4.85 0.612057 A Intmd wnd repair face/mm 6.00 12.09 11.21 5.38 5.00 0.7

1205F I Epi etiol synd rvwd and docd 0.00 0.00 0.00 0.00 0.00 0.01220F I Pt screened for depression 0.00 0.00 0.00 0.00 0.00 0.0

13100 A Repair of wound or lesion 3.17 5.53 5.45 3.27 3.20 0.513101 A Repair of wound or lesion 3.96 7.13 7.01 3.88 3.79 0.613102 A Repair wound/lesion add-on 1.24 1.76 1.68 0.83 0.76 0.213120 A Repair of wound or lesion 3.35 5.68 5.61 3.53 3.36 0.513121 A Repair of wound or lesion 4.42 7.97 7.82 4.81 4.56 0.613122 A Repair wound/lesion add-on 1.44 1.84 1.78 0.93 0.85 0.213131 A Repair of wound or lesion 3.83 6.14 6.05 3.90 3.73 0.513132 A Repair of wound or lesion 6.58 9.67 9.40 6.68 6.34 0.913133 A Repair wound/lesion add-on 2.19 2.49 2.39 1.53 1.41 0.313150 A Repair of wound or lesion 3.85 6.06 5.95 3.84 3.63 0.613151 A Repair of wound or lesion 4.49 6.82 6.70 4.43 4.23 0.613152 A Repair of wound or lesion 6.37 9.31 9.08 5.55 5.28 0.913153 A Repair wound/lesion add-on 2.38 2.78 2.64 1.62 1.48 0.313160 A Late closure of wound 12.04 NA NA 10.00 9.41 2.214000 A Skin tissue rearrangement 6.37 10.96 10.64 7.72 7.38 1.114001 A Skin tissue rearrangement 8.78 13.51 13.11 9.59 9.22 1.5

1400F I Prkns diag rviewed 0.00 0.00 0.00 0.00 0.00 0.0

14020 A Skin tissue rearrangement 7.22 12.28 11.94 8.83 8.50 1.214021 A Skin tissue rearrangement 9.72 14.74 14.33 10.68 10.34 1.514040 A Skin tissue rearrangement 8.60 12.92 12.54 9.45 9.12 1.3
CMS-1582-PN 182 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

14041 A Skin tissue rearrangement 10.83 15.79 15.39 11.39 11.02 1.614060 A Skin tissue rearrangement 9.23 12.64 12.18 9.92 9.50 1.414061 A Skin tissue rearrangement 11.48 17.11 16.69 12.26 11.86 1.714301 A Skin tissue rearrangement 12.65 17.47 17.47 12.25 12.25 2.114302 A Skin tissue rearrange add-on 3.73 2.54 2.54 2.54 2.54 0.614350 A Skin tissue rearrangement 11.05 NA NA 8.67 8.58 1.515002 A Wound prep trk/arm/leg 3.65 5.83 5.48 2.59 2.36 0.615003 A Wound prep addl 100 cm 0.80 1.23 1.17 0.42 0.38 0.115004 A Wound prep f/n/hf/g 4.58 6.49 6.25 2.98 2.80 0.615005 A Wnd prep f/n/hf/g addl cm 1.60 1.73 1.62 0.85 0.76 0.315040 A Harvest cultured skin graft 2.00 5.03 4.99 1.46 1.37 0.315050 A Skin pinch graft 5.57 10.46 9.77 7.09 6.64 0.915100 A Skin splt grft trnk/arm/leg 9.90 13.60 13.24 9.76 9.22 1.915101 A Skin splt grft t/a/l add-on 1.72 3.33 3.36 1.28 1.22 0.315110 A Epidrm autogrft trnk/arm/leg 10.97 12.14 11.63 9.08 8.48 2.115111 A Epidrm autogrft t/a/l add-on 1.85 1.22 1.23 0.90 0.88 0.315115 A Epidrm a-grft face/nck/hf/g 11.28 12.84 12.01 9.83 9.13 1.815116 A Epidrm a-grft f/n/hf/g addl 2.50 2.23 1.98 1.80 1.54 0.415120 A Skn splt a-grft fac/nck/hf/g 10.15 13.51 13.44 9.09 9.07 1.715121 A Skn splt a-grft f/n/hf/g add 2.00 3.76 3.90 1.58 1.60 0.315130 A Derm autograft trnk/arm/leg 7.53 10.99 10.62 8.00 7.53 1.415131 A Derm autograft t/a/l add-on 1.50 1.30 1.16 1.08 0.90 0.315135 A Derm autograft face/nck/hf/g 11.03 13.27 12.41 10.27 9.58 1.815136 A Derm autograft f/n/hf/g add 1.50 1.17 0.98 1.00 0.80 0.115150 A Cult epiderm grft t/arm/leg 9.39 8.93 8.81 7.29 7.14 1.915151 A Cult epiderm grft t/a/l addl 2.00 1.66 1.45 1.40 1.17 0.415152 A Cult epiderm graft t/a/l +% 2.50 1.37 1.56 1.12 1.26 0.415155 A Cult epiderm graft f/n/hf/g 10.14 6.90 7.90 5.54 6.52 0.715156 A Cult epidrm grft f/n/hfg add 2.75 1.46 1.62 1.20 1.34 0.515157 A Cult epiderm grft f/n/hfg +% 3.00 1.20 1.60 0.89 1.24 0.2
CMS-1582-PN 183 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

15170 A Acell graft trunk/arms/legs 5.99 6.07 5.56 4.26 3.80 1.015171 A Acell graft t/arm/leg add-on 1.55 0.98 0.90 0.81 0.75 0.315175 A Acellular graft f/n/hf/g 7.99 6.20 6.02 4.51 4.37 1.015176 A Acell graft f/n/hf/g add-on 2.45 1.57 1.47 1.26 1.18 0.315200 A Skin full graft trunk 9.15 13.84 13.04 9.57 8.81 1.615201 A Skin full graft trunk add-on 1.32 2.80 2.74 0.90 0.80 0.215220 A Skin full graft sclp/arm/leg 8.09 13.46 12.96 9.25 8.79 1.315221 A Skin full graft add-on 1.19 2.61 2.58 0.79 0.73 0.215240 A Skin full grft face/genit/hf 10.41 15.76 15.02 12.25 11.53 1.715241 A Skin full graft add-on 1.86 3.33 3.20 1.29 1.18 0.315260 A Skin full graft een & lips 11.64 16.71 16.21 12.42 12.08 1.715261 A Skin full graft add-on 2.23 3.83 3.69 1.77 1.66 0.315300 A Apply skinallogrft t/arm/lg 4.65 5.03 4.62 3.35 3.05 0.815301 A Apply sknallogrft t/a/l addl 1.00 0.68 0.64 0.51 0.48 0.215320 A Apply skin allogrft f/n/hf/g 5.36 4.96 4.77 3.16 3.07 0.715321 A Aply sknallogrft f/n/hfg add 1.50 1.03 0.96 0.81 0.75 0.315330 A Aply acell alogrft t/arm/leg 3.99 5.09 4.67 3.36 3.06 0.715331 A Aply acell grft t/a/l add-on 1.00 0.75 0.67 0.59 0.53 0.215335 A Apply acell graft f/n/hf/g 4.50 4.43 4.25 2.78 2.70 0.515336 A Aply acell grft f/n/hf/g add 1.43 1.33 1.06 1.03 0.80 0.115340 A Apply cult skin substitute 3.82 4.90 4.75 3.56 3.41 0.515341 A Apply cult skin sub add-on 0.50 0.82 0.79 0.20 0.20 0.015360 A Apply cult derm sub t/a/l 4.02 5.84 5.75 4.33 4.21 0.615361 A Aply cult derm sub t/a/l add 1.15 0.50 0.57 0.34 0.40 0.215365 A Apply cult derm sub f/n/hf/g 4.30 5.31 5.20 3.90 3.80 0.415366 A Apply cult derm f/hf/g add 1.45 0.75 0.76 0.53 0.54 0.115400 A Apply skin xenograft t/a/l 4.47 7.09 6.59 5.50 5.22 0.615401 A Apply skn xenogrft t/a/l add 1.00 1.36 1.43 0.51 0.47 0.215420 A Apply skin xgraft f/n/hf/g 4.98 7.29 7.11 5.78 5.61 0.615421 A Apply skn xgrft f/n/hf/g add 1.50 1.69 1.58 0.82 0.74 0.3
CMS-1582-PN 184 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

15430 A Apply acellular xenograft 6.20 9.01 8.46 8.30 7.82 1.015431 C Apply acellular xgraft add 0.00 0.00 0.00 0.00 0.00 0.015570 A Form skin pedicle flap 10.21 14.38 13.72 9.63 8.96 2.015572 A Form skin pedicle flap 10.12 14.34 13.40 10.60 9.69 1.815574 A Form skin pedicle flap 10.70 14.79 13.98 10.84 10.07 1.815576 A Form skin pedicle flap 9.37 13.26 12.63 9.63 8.97 1.515600 A Skin graft 2.01 6.96 7.04 3.76 3.61 0.315610 A Skin graft 2.52 7.35 6.93 4.23 4.05 0.415620 A Skin graft 3.75 8.47 8.37 5.39 5.09 0.615630 A Skin graft 4.08 8.85 8.73 5.75 5.51 0.615650 A Transfer skin pedicle flap 4.77 9.37 9.33 6.05 5.86 0.715731 A Forehead flap w/vasc pedicle 14.38 17.56 16.62 14.38 13.43 2.415732 A Muscle-skin graft head/neck 16.38 19.29 19.11 14.67 14.45 2.915734 A Muscle-skin graft trunk 19.86 21.62 20.86 16.83 15.88 3.915736 A Muscle-skin graft arm 17.04 19.62 18.94 14.86 13.81 3.315738 A Muscle-skin graft leg 19.04 19.68 19.03 15.19 14.25 3.815740 A Island pedicle flap graft 11.80 17.05 16.41 12.77 12.12 1.715750 A Neurovascular pedicle graft 12.96 NA NA 12.47 11.71 2.215756 A Free myo/skin flap microvasc 36.94 NA NA 28.89 26.52 6.315757 A Free skin flap microvasc 37.15 NA NA 28.34 26.05 5.915758 A Free fascial flap microvasc 36.90 NA NA 28.16 26.00 5.915760 A Composite skin graft 9.86 14.16 13.44 10.26 9.57 1.515770 A Derma-fat-fascia graft 8.96 NA NA 9.78 9.05 1.615775 R Hair transplant punch grafts 3.95 3.83 4.16 1.99 1.97 0.215776 R Hair transplant punch grafts 5.53 6.61 6.39 3.36 3.15 0.315780 A Abrasion treatment of skin 8.73 14.13 14.03 8.59 8.61 1.215781 A Abrasion treatment of skin 5.02 10.41 10.05 7.17 6.90 0.715782 A Abrasion treatment of skin 4.44 10.78 11.04 6.37 6.58 0.615783 A Abrasion treatment of skin 4.41 9.29 9.15 6.29 5.98 0.615786 A Abrasion lesion single 2.08 4.70 4.62 1.74 1.67 0.3
CMS-1582-PN 185 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

15787 A Abrasion lesions add-on 0.33 1.00 1.02 0.16 0.15 0.015788 R Chemical peel face epiderm 2.09 11.08 10.58 5.05 4.77 0.315789 R Chemical peel face dermal 4.91 10.71 10.75 7.11 6.91 0.615792 R Chemical peel nonfacial 1.86 10.56 10.34 5.62 5.54 0.315793 A Chemical peel nonfacial 3.96 9.95 9.62 6.49 6.17 0.515819 A Plastic surgery neck 10.65 NA NA 7.58 8.13 2.115820 A Revision of lower eyelid 6.27 9.43 8.81 7.98 7.33 1.215821 A Revision of lower eyelid 6.84 10.02 9.24 8.37 7.59 1.315822 A Revision of upper eyelid 4.62 7.72 7.21 6.29 5.77 0.815823 A Revision of upper eyelid 6.81 10.11 9.75 8.45 8.13 1.215824 R Removal of forehead wrinkles 0.00 0.00 0.00 0.00 0.00 0.015825 R Removal of neck wrinkles 0.00 0.00 0.00 0.00 0.00 0.015826 R Removal of brow wrinkles 0.00 0.00 0.00 0.00 0.00 0.015828 R Removal of face wrinkles 0.00 0.00 0.00 0.00 0.00 0.015829 R Removal of skin wrinkles 0.00 0.00 0.00 0.00 0.00 0.015830 R Exc skin abd 17.11 NA NA 15.07 13.76 3.315832 A Excise excessive skin tissue 12.85 NA NA 13.22 11.70 2.515833 A Excise excessive skin tissue 11.90 NA NA 12.54 11.24 2.315834 A Excise excessive skin tissue 12.17 NA NA 12.73 11.07 2.415835 A Excise excessive skin tissue 12.99 NA NA 13.30 11.58 2.515836 A Excise excessive skin tissue 10.61 NA NA 8.50 8.49 2.015837 A Excise excessive skin tissue 9.55 14.45 12.61 10.00 8.91 2.015838 A Excise excessive skin tissue 8.25 NA NA 8.16 7.62 1.015839 A Excise excessive skin tissue 10.50 13.44 12.71 9.49 8.88 1.915840 A Graft for face nerve palsy 14.99 NA NA 13.81 12.70 2.415841 A Graft for face nerve palsy 25.99 NA NA 22.80 20.34 3.315842 A Flap for face nerve palsy 41.01 NA NA 29.27 28.26 5.215845 A Skin and muscle repair face 14.32 NA NA 14.17 12.58 1.815847 C Exc skin abd add-on 0.00 0.00 0.00 0.00 0.00 0.015850 B Removal of sutures 0.78 1.61 1.68 0.34 0.34 0.0
CMS-1582-PN 186 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

15851 A Removal of sutures 0.86 1.84 1.77 0.42 0.37 0.115852 A Dressing change not for burn 0.86 NA NA 0.41 0.38 0.115860 A Test for blood flow in graft 1.95 NA NA 0.90 0.89 0.315876 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.015877 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.015878 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.015879 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.015920 A Removal of tail bone ulcer 8.29 NA NA 8.19 7.54 1.715922 A Removal of tail bone ulcer 10.38 NA NA 11.51 10.18 2.015931 A Remove sacrum pressure sore 10.07 NA NA 8.04 7.49 2.015933 A Remove sacrum pressure sore 11.77 NA NA 10.89 10.14 2.415934 A Remove sacrum pressure sore 13.68 NA NA 11.51 10.57 2.715935 A Remove sacrum pressure sore 15.78 NA NA 13.93 13.04 3.115936 A Remove sacrum pressure sore 13.16 NA NA 11.10 10.26 2.615937 A Remove sacrum pressure sore 15.14 NA NA 13.34 12.33 3.015940 A Remove hip pressure sore 10.20 NA NA 8.63 7.96 2.015941 A Remove hip pressure sore 12.41 NA NA 12.07 11.34 2.415944 A Remove hip pressure sore 12.44 NA NA 12.13 11.15 2.515945 A Remove hip pressure sore 13.75 NA NA 13.57 12.47 2.715946 A Remove hip pressure sore 24.12 NA NA 20.86 19.21 4.815950 A Remove thigh pressure sore 8.03 NA NA 7.38 7.01 1.515951 A Remove thigh pressure sore 11.58 NA NA 13.04 11.20 2.215952 A Remove thigh pressure sore 12.31 NA NA 9.52 9.54 2.615953 A Remove thigh pressure sore 13.57 NA NA 10.45 10.62 2.615956 A Remove thigh pressure sore 16.79 NA NA 14.86 13.63 3.415958 A Remove thigh pressure sore 16.75 NA NA 15.65 14.39 3.315999 C Removal of pressure sore 0.00 0.00 0.00 0.00 0.00 0.016000 A Initial treatment of burn(s) 0.89 1.02 0.97 0.39 0.34 0.116020 A Dress/debrid p-thick burn s 0.80 1.56 1.48 0.82 0.75 0.116025 A Dress/debrid p-thick burn m 1.85 2.26 2.13 1.33 1.22 0.3
CMS-1582-PN 187 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

16030 A Dress/debrid p-thick burn l 2.08 2.86 2.71 1.52 1.40 0.316035 A Incision of burn scab initi 3.74 NA NA 1.57 1.62 0.616036 A Escharotomy addl incision 1.50 NA NA 0.67 0.65 0.217000 A Destruct premalg lesion 0.65 1.63 1.61 0.94 0.90 0.017003 A Destruct premalg les 2-14 0.07 0.12 0.13 0.05 0.05 0.017004 A Destroy premlg lesions 15+ 1.85 2.92 2.94 1.85 1.83 0.217106 A Destruction of skin lesions 3.69 5.85 5.76 4.02 3.92 0.517107 A Destruction of skin lesions 4.79 7.37 7.43 4.94 4.98 0.717108 A Destruction of skin lesions 7.49 10.06 9.70 6.85 6.65 1.317110 A Destruct b9 lesion 1-14 0.70 2.40 2.41 1.28 1.23 0.017111 A Destruct lesion 15 or more 0.97 2.72 2.71 1.46 1.41 0.117250 A Chemical cautery tissue 0.50 1.74 1.68 0.51 0.49 0.017260 A Destruction of skin lesions 0.96 1.69 1.67 0.99 0.95 0.117261 A Destruction of skin lesions 1.22 2.84 2.80 1.34 1.31 0.117262 A Destruction of skin lesions 1.63 3.30 3.24 1.62 1.58 0.217263 A Destruction of skin lesions 1.84 3.53 3.48 1.75 1.71 0.217264 A Destruction of skin lesions 1.99 3.76 3.70 1.83 1.78 0.217266 A Destruction of skin lesions 2.39 4.09 4.03 2.06 2.00 0.317270 A Destruction of skin lesions 1.37 2.87 2.81 1.41 1.37 0.217271 A Destruction of skin lesions 1.54 3.06 3.01 1.56 1.52 0.217272 A Destruction of skin lesions 1.82 3.41 3.37 1.75 1.71 0.217273 A Destruction of skin lesions 2.10 3.73 3.67 1.92 1.87 0.317274 A Destruction of skin lesions 2.64 4.20 4.14 2.24 2.19 0.317276 A Destruction of skin lesions 3.25 4.63 4.55 2.58 2.51 0.417280 A Destruction of skin lesions 1.22 2.75 2.70 1.32 1.28 0.117281 A Destruction of skin lesions 1.77 3.23 3.17 1.71 1.67 0.217282 A Destruction of skin lesions 2.09 3.64 3.59 1.92 1.88 0.317283 A Destruction of skin lesions 2.69 4.14 4.09 2.30 2.25 0.317284 A Destruction of skin lesions 3.20 4.57 4.53 2.60 2.55 0.417286 A Destruction of skin lesions 4.48 5.50 5.39 3.35 3.28 0.6
CMS-1582-PN 188 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

17311 A Mohs 1 stage h/n/hf/g 6.20 12.16 12.59 4.65 4.32 0.817312 A Mohs addl stage 3.30 7.64 7.98 2.47 2.30 0.417313 A Mohs 1 stage t/a/l 5.56 11.18 11.59 4.17 3.88 0.717314 A Mohs addl stage t/a/l 3.06 7.08 7.40 2.29 2.13 0.417315 A Mohs surg addl block 0.87 1.36 1.38 0.65 0.61 0.117340 A Cryotherapy of skin 0.77 0.65 0.58 0.59 0.52 0.117360 A Skin peel therapy 1.46 2.20 2.18 1.38 1.31 0.217380 R Hair removal by electrolysis 0.00 0.00 0.00 0.00 0.00 0.017999 C Skin tissue procedure 0.00 0.00 0.00 0.00 0.00 0.019000 A Drainage of breast lesion 0.84 2.14 2.25 0.33 0.35 0.119001 A Drain breast lesion add-on 0.42 0.29 0.31 0.16 0.17 0.019020 A Incision of breast lesion 3.83 8.85 8.42 4.30 3.97 0.719030 A Injection for breast x-ray 1.53 2.82 3.08 0.57 0.63 0.119100 A Bx breast percut w/o image 1.27 2.76 2.65 0.55 0.50 0.219101 A Biopsy of breast open 3.23 5.88 5.63 2.61 2.43 0.619102 A Bx breast percut w/image 2.00 3.72 4.04 0.76 0.82 0.219103 A Bx breast percut w/device 3.69 11.10 11.92 1.43 1.51 0.419105 A Cryosurg ablate fa each 3.69 49.17 55.82 1.61 1.60 0.319110 A Nipple exploration 4.44 8.71 8.16 4.68 4.28 0.919112 A Excise breast duct fistula 3.81 8.58 8.09 4.50 4.13 0.819120 A Removal of breast lesion 5.92 7.14 6.62 4.96 4.54 1.219125 A Excision breast lesion 6.69 7.80 7.20 5.39 4.91 1.419126 A Excision addl breast lesion 2.93 NA NA 1.27 1.16 0.619260 A Removal of chest wall lesion 17.78 NA NA 14.15 13.56 3.919271 A Revision of chest wall 22.19 NA NA 20.89 20.64 5.019272 A Extensive chest wall surgery 25.17 NA NA 22.01 21.89 5.919290 A Place needle wire breast 1.27 3.07 3.30 0.48 0.53 0.119291 A Place needle wire breast 0.63 1.21 1.31 0.24 0.26 0.019295 A Place breast clip percut 0.00 2.44 2.65 NA NA 0.019296 A Place po breast cath for rad 3.63 108.19 111.86 1.89 1.75 0.7
CMS-1582-PN 189 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

19297 A Place breast cath for rad 1.72 NA NA 0.75 0.69 0.319298 A Place breast rad tube/caths 6.00 24.78 28.90 2.83 2.81 0.719300 A Removal of breast tissue 5.31 8.53 8.19 5.53 5.07 1.119301 A Partical mastectomy 10.13 NA NA 7.01 6.23 2.119302 A P-mastectomy w/ln removal 13.87 NA NA 9.40 8.93 2.919303 A Mast simple complete 15.85 NA NA 10.66 9.43 3.319304 A Mast subq 7.95 NA NA 7.31 6.68 1.619305 A Mast radical 17.46 NA NA 12.28 11.19 3.719306 A Mast rad urban type 18.13 NA NA 13.42 12.11 3.819307 A Mast mod rad 18.23 NA NA 13.22 12.02 3.819316 A Suspension of breast 11.09 NA NA 10.17 9.46 2.119318 A Reduction of large breast 16.03 NA NA 14.84 13.82 3.119324 A Enlarge breast 6.80 NA NA 6.14 5.84 1.419325 A Enlarge breast with implant 8.64 NA NA 9.41 8.71 1.619328 A Removal of breast implant 6.48 NA NA 7.31 6.76 1.219330 A Removal of implant material 8.54 NA NA 9.06 8.35 1.619340 A Immediate breast prosthesis 13.99 NA NA 14.04 8.94 2.719342 A Delayed breast prosthesis 12.63 NA NA 13.23 12.19 2.419350 A Breast reconstruction 9.11 13.79 13.55 9.68 9.02 1.719355 A Correct inverted nipple(s) 8.52 10.09 10.10 6.49 6.21 1.819357 A Breast reconstruction 18.50 NA NA 23.69 21.46 3.619361 A Breast reconstr w/lat flap 23.36 NA NA 24.33 21.92 4.619364 A Breast reconstruction 42.58 NA NA 34.42 31.56 8.219366 A Breast reconstruction 21.84 NA NA 15.66 14.35 4.419367 A Breast reconstruction 26.80 NA NA 23.19 21.40 5.219368 A Breast reconstruction 33.90 NA NA 28.01 25.53 6.619369 A Breast reconstruction 31.31 NA NA 26.14 23.56 6.119370 A Surgery of breast capsule 9.17 NA NA 10.00 9.24 1.819371 A Removal of breast capsule 10.62 NA NA 11.33 10.47 2.019380 A Revise breast reconstruction 10.41 NA NA 11.17 10.33 2.0
CMS-1582-PN 190 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

19396 A Design custom breast implant 2.17 5.12 4.42 1.58 1.39 0.419499 C Breast surgery procedure 0.00 0.00 0.00 0.00 0.00 0.020005 A I&d abscess subfascial 3.58 4.62 4.53 2.65 2.61 0.5

2001F I Weight record 0.00 0.00 0.00 0.00 0.00 0.02002F I Clin sign vol ovrld assess 0.00 0.00 0.00 0.00 0.00 0.02004F I Initial exam involved joints 0.00 0.00 0.00 0.00 0.00 0.0

20100 A Explore wound neck 10.38 NA NA 5.73 5.13 1.920101 A Explore wound chest 3.23 7.88 7.71 2.03 1.97 0.620102 A Explore wound abdomen 3.98 9.25 8.94 2.78 2.57 0.820103 A Explore wound extremity 5.34 10.58 10.17 4.13 3.91 0.920150 A Excise epiphyseal bar 14.75 NA NA 12.53 11.25 2.9

2018F I Hydration status assess 0.00 0.00 0.00 0.00 0.00 0.0

20200 A Muscle biopsy 1.46 4.11 3.94 1.03 0.96 0.320205 A Deep muscle biopsy 2.35 5.26 4.98 1.67 1.55 0.520206 A Needle biopsy muscle 0.99 5.63 6.18 0.63 0.69 0.1

2020F I Dilated fundus eval done 0.00 0.00 0.00 0.00 0.00 0.0

20220 A Bone biopsy trocar/needle 1.27 2.93 3.40 0.74 0.82 0.120225 A Bone biopsy trocar/needle 1.87 13.27 15.82 1.14 1.24 0.220240 A Bone biopsy excisional 3.28 NA NA 2.84 2.76 0.520245 A Bone biopsy excisional 8.95 NA NA 8.30 7.84 1.620250 A Open bone biopsy 5.19 NA NA 4.96 4.68 1.220251 A Open bone biopsy 5.72 NA NA 5.26 5.08 1.3

2029F I Complete phys skin exam done 0.00 0.00 0.00 0.00 0.00 0.02030F I H2o stat docd normal 0.00 0.00 0.00 0.00 0.00 0.02031F I H2o stat docd dehydrated 0.00 0.00 0.00 0.00 0.00 0.02044F I Doc mntl tst b/4 bk trxmnt 0.00 0.00 0.00 0.00 0.00 0.0

20500 A Injection of sinus tract 1.28 1.66 1.79 1.10 1.20 0.120501 A Inject sinus tract for x-ray 0.76 2.52 2.79 0.28 0.32 0.0

2050F I Wound char size etc docd 0.00 0.00 0.00 0.00 0.00 0.0

20520 A Removal of foreign body 1.90 3.61 3.43 2.09 1.98 0.3
CMS-1582-PN 191 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

20525 A Removal of foreign body 3.54 9.64 9.46 3.23 3.06 0.620526 A Ther injection carp tunnel 0.94 1.13 1.09 0.62 0.59 0.120550 A Inj tendon sheath/ligament 0.75 0.85 0.82 0.40 0.37 0.020551 A Inj tendon origin/insertion 0.75 0.91 0.85 0.44 0.41 0.020552 A Inj trigger point 1/2 muscl 0.66 0.86 0.81 0.40 0.35 0.020553 A Inject trigger points =/> 3 0.75 1.00 0.92 0.45 0.39 0.020555 A Place ndl musc/tis for rt 6.00 NA NA 2.81 2.83 0.820600 A Drain/inject joint/bursa 0.66 0.86 0.83 0.42 0.41 0.020605 A Drain/inject joint/bursa 0.68 0.98 0.94 0.45 0.44 0.0

2060F I Pt talk eval hlthwkr re mdd 0.00 0.00 0.00 0.00 0.00 0.0

20610 A Drain/inject joint/bursa 0.79 1.43 1.35 0.58 0.55 0.120612 A Aspirate/inj ganglion cyst 0.70 0.96 0.91 0.46 0.44 0.020615 A Treatment of bone cyst 2.33 3.76 3.68 2.07 1.99 0.220650 A Insert and remove bone pin 2.28 3.30 3.13 1.95 1.88 0.220660 A Apply rem fixation device 4.00 NA NA 2.22 2.09 1.120661 A Application of head brace 5.26 NA NA 7.74 7.33 1.620662 A Application of pelvis brace 6.38 NA NA 4.72 5.59 0.620663 A Application of thigh brace 5.74 NA NA 6.96 6.43 1.120664 A Application of halo 10.06 NA NA 10.58 10.12 3.620665 A Removal of fixation device 1.36 1.55 1.73 1.16 1.24 0.120670 A Removal of support implant 1.79 8.78 9.12 2.29 2.23 0.320680 A Removal of support implant 5.96 11.12 10.63 5.72 5.34 1.020690 A Apply bone fixation device 8.78 NA NA 7.24 6.39 1.620692 A Apply bone fixation device 16.27 NA NA 14.32 12.48 2.820693 A Adjust bone fixation device 6.06 NA NA 6.36 6.14 1.020694 A Remove bone fixation device 4.28 7.37 7.23 4.99 4.76 0.720696 A Comp multiplane ext fixation 17.56 NA NA 15.44 12.64 1.220697 A Comp ext fixate strut change 0.00 57.76 49.27 NA NA 0.020802 A Replantation arm complete 42.62 NA NA 23.00 22.04 3.020805 A Replant forearm complete 51.46 NA NA 17.98 22.17 10.1
CMS-1582-PN 192 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

20808 A Replantation hand complete 63.09 NA NA 50.11 47.03 12.420816 A Replantation digit complete 31.95 NA NA 26.83 27.11 3.920822 A Replantation digit complete 26.66 NA NA 23.99 23.80 5.220824 A Replantation thumb complete 31.95 NA NA 24.04 25.52 6.220827 A Replantation thumb complete 27.48 NA NA 24.59 24.97 5.420838 A Replantation foot complete 42.88 NA NA 23.42 23.57 3.020900 A Removal of bone for graft 3.00 8.59 8.46 2.76 3.23 0.520902 A Removal of bone for graft 4.58 NA NA 3.73 4.15 0.820910 A Remove cartilage for graft 5.53 NA NA 6.28 6.13 0.720912 A Remove cartilage for graft 6.54 NA NA 7.21 6.79 0.920920 A Removal of fascia for graft 5.51 NA NA 5.86 5.58 0.620922 A Removal of fascia for graft 6.93 8.97 9.24 6.19 6.25 1.220924 A Removal of tendon for graft 6.68 NA NA 7.18 6.85 1.220926 A Removal of tissue for graft 5.79 NA NA 5.96 5.80 1.120930 B Sp bone algrft morsel add-on 0.00 0.00 0.00 0.00 0.00 0.020931 A Sp bone algrft struct add-on 1.81 NA NA 1.02 0.99 0.520936 B Sp bone agrft local add-on 0.00 0.00 0.00 0.00 0.00 0.020937 A Sp bone agrft morsel add-on 2.79 NA NA 1.62 1.56 0.620938 A Sp bone agrft struct add-on 3.02 NA NA 1.74 1.67 0.820950 A Fluid pressure muscle 1.26 5.58 5.65 1.21 1.16 0.220955 A Fibula bone graft microvasc 40.26 NA NA 30.82 28.46 6.620956 A Iliac bone graft microvasc 41.18 NA NA 30.52 28.61 8.120957 A Mt bone graft microvasc 42.61 NA NA 28.51 24.83 8.420962 A Other bone graft microvasc 39.21 NA NA 33.05 30.31 7.720969 A Bone/skin graft microvasc 45.43 NA NA 33.65 31.04 6.620970 A Bone/skin graft iliac crest 44.58 NA NA 31.25 29.83 8.820972 A Bone/skin graft metatarsal 44.51 NA NA 17.67 19.65 3.420973 A Bone/skin graft great toe 47.27 NA NA 34.47 28.38 3.320974 A Electrical bone stimulation 0.62 1.42 1.28 0.72 0.67 0.120975 A Electrical bone stimulation 2.60 NA NA 2.09 2.01 0.5
CMS-1582-PN 193 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

20979 A Us bone stimulation 0.62 0.84 0.82 0.29 0.29 0.020982 A Ablate bone tumor(s) perq 7.27 88.57 97.10 3.05 3.30 0.820985 A Cptr-asst dir ms px 2.50 NA NA 1.49 1.39 0.420999 C Musculoskeletal surgery 0.00 0.00 0.00 0.00 0.00 0.021010 A Incision of jaw joint 11.04 NA NA 9.51 8.76 1.421011 A Exc face les sc < 2 cm 2.99 6.23 6.23 3.93 3.93 0.421012 A Exc face les sbq 2+ cm 4.45 NA NA 5.02 5.02 0.721013 A Exc face tum deep < 2 cm 5.42 8.70 8.70 5.63 5.63 0.821014 A Exc face tum deep 2+ cm 7.13 NA NA 7.43 7.43 1.121015 A Resect face tum < 2 cm 9.89 NA NA 9.46 7.56 1.821016 A Resect face tum + cm 15.26 NA NA 13.01 13.01 2.921025 A Excision of bone lower jaw 10.03 15.10 14.36 11.25 10.46 1.421026 A Excision of facial bone(s) 5.70 11.70 11.09 8.38 7.90 0.821029 A Contour of face bone lesion 8.39 13.15 12.43 9.52 8.88 1.621030 A Excise max/zygoma b9 tumor 4.91 9.67 9.10 6.84 6.37 0.721031 A Remove exostosis mandible 3.30 7.77 7.41 5.04 4.70 0.421032 A Remove exostosis maxilla 3.34 7.92 7.55 4.92 4.57 0.421034 A Excise max/zygoma mlg tumor 17.38 20.51 19.22 15.98 14.74 2.421040 A Excise mandible lesion 4.91 9.80 9.22 6.92 6.37 0.721044 A Removal of jaw bone lesion 12.80 NA NA 12.31 11.42 1.721045 A Extensive jaw surgery 18.37 NA NA 16.65 15.34 2.521046 A Remove mandible cyst complex 14.21 NA NA 17.33 15.96 1.821047 A Excise lwr jaw cyst w/repair 20.07 NA NA 17.15 15.59 2.521048 A Remove maxilla cyst complex 14.71 NA NA 17.74 16.11 1.821049 A Excis uppr jaw cyst w/repair 19.32 NA NA 15.75 14.90 2.421050 A Removal of jaw joint 11.76 NA NA 12.40 11.75 2.321060 A Remove jaw joint cartilage 11.07 NA NA 11.65 10.65 2.321070 A Remove coronoid process 8.62 NA NA 9.08 8.62 1.121073 A Mnpj of tmj w/anesth 3.45 7.61 7.12 3.68 3.27 0.621076 A Prepare face/oral prosthesis 13.40 14.99 13.26 10.44 9.11 1.7
CMS-1582-PN 194 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

21077 A Prepare face/oral prosthesis 33.70 37.39 32.64 26.42 23.35 4.321079 A Prepare face/oral prosthesis 22.31 25.68 22.81 17.65 15.48 2.821080 A Prepare face/oral prosthesis 25.06 28.92 25.90 19.55 17.21 3.221081 A Prepare face/oral prosthesis 22.85 26.78 23.93 17.80 15.73 2.921082 A Prepare face/oral prosthesis 20.84 26.20 23.14 17.50 15.23 2.621083 A Prepare face/oral prosthesis 19.27 25.56 22.66 16.33 14.18 1.321084 A Prepare face/oral prosthesis 22.48 28.68 25.71 18.72 16.45 2.921085 A Prepare face/oral prosthesis 8.99 12.59 10.82 7.20 6.36 3.321086 A Prepare face/oral prosthesis 24.88 27.93 23.82 19.30 16.82 3.221087 A Prepare face/oral prosthesis 24.88 27.71 23.72 18.95 16.67 3.221088 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.021089 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.021100 A Maxillofacial fixation 4.73 11.81 13.63 4.69 5.45 0.621110 A Interdental fixation 5.99 16.65 15.73 13.03 12.24 0.721116 A Injection jaw joint x-ray 0.81 3.32 3.41 0.38 0.35 0.021120 A Reconstruction of chin 5.10 12.98 12.53 9.44 8.93 1.021121 A Reconstruction of chin 7.81 15.00 14.05 11.18 10.44 0.521122 A Reconstruction of chin 8.71 NA NA 11.73 11.12 0.621123 A Reconstruction of chin 11.34 NA NA 15.49 13.41 0.821125 A Augmentation lower jaw bone 10.80 74.00 75.92 11.43 10.28 2.121127 A Augmentation lower jaw bone 12.44 96.07 94.49 13.18 11.83 1.521137 A Reduction of forehead 10.24 NA NA 9.21 8.87 2.021138 A Reduction of forehead 12.87 NA NA 12.30 11.39 1.821139 A Reduction of forehead 15.02 NA NA 14.11 12.87 1.021141 A Reconstruct midface lefort 19.57 NA NA 18.17 17.01 3.821142 A Reconstruct midface lefort 20.28 NA NA 18.51 16.48 4.021143 A Reconstruct midface lefort 21.05 NA NA 19.67 17.66 4.421145 A Reconstruct midface lefort 23.94 NA NA 20.34 18.27 1.621146 A Reconstruct midface lefort 24.87 NA NA 23.12 20.64 4.921147 A Reconstruct midface lefort 26.47 NA NA 20.90 19.77 1.8
CMS-1582-PN 195 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

21150 A Reconstruct midface lefort 25.96 NA NA 22.65 20.40 1.821151 A Reconstruct midface lefort 29.02 NA NA 24.43 24.96 3.721154 A Reconstruct midface lefort 31.29 NA NA 31.19 27.25 4.021155 A Reconstruct midface lefort 35.22 NA NA 28.50 26.00 2.521159 A Reconstruct midface lefort 43.14 NA NA 39.72 33.69 5.521160 A Reconstruct midface lefort 47.19 NA NA 28.73 28.47 3.321172 A Reconstruct orbit/forehead 28.20 NA NA 23.86 20.75 3.621175 A Reconstruct orbit/forehead 33.56 NA NA 28.70 25.08 12.021179 A Reconstruct entire forehead 22.65 NA NA 20.10 17.84 4.421180 A Reconstruct entire forehead 25.58 NA NA 22.30 20.06 3.221181 A Contour cranial bone lesion 10.28 NA NA 10.54 9.35 1.321182 A Reconstruct cranial bone 32.58 NA NA 22.59 21.74 4.121183 A Reconstruct cranial bone 35.70 NA NA 24.42 23.80 7.021184 A Reconstruct cranial bone 38.62 NA NA 30.48 27.00 7.621188 A Reconstruction of midface 23.15 NA NA 22.12 21.32 2.921193 A Reconst lwr jaw w/o graft 18.90 NA NA 17.86 15.70 4.021194 A Reconst lwr jaw w/graft 21.82 NA NA 17.50 16.51 2.821195 A Reconst lwr jaw w/o fixation 19.16 NA NA 19.33 17.94 2.421196 A Reconst lwr jaw w/fixation 20.83 NA NA 21.71 19.78 2.621198 A Reconstr lwr jaw segment 15.71 NA NA 17.54 16.30 2.121199 A Reconstr lwr jaw w/advance 16.73 NA NA 12.27 11.25 2.121206 A Reconstruct upper jaw bone 15.59 NA NA 19.43 17.12 3.021208 A Augmentation of facial bones 11.42 40.95 39.19 11.44 11.05 2.221209 A Reduction of facial bones 7.82 15.66 15.11 10.65 10.03 1.521210 A Face bone graft 11.69 52.78 50.02 12.81 11.50 1.521215 A Lower jaw bone graft 12.23 100.91 95.64 13.08 11.74 2.421230 A Rib cartilage graft 11.17 NA NA 10.20 9.54 2.121235 A Ear cartilage graft 7.50 13.27 12.81 8.75 8.26 1.121240 A Reconstruction of jaw joint 16.07 NA NA 15.56 14.19 2.021242 A Reconstruction of jaw joint 14.59 NA NA 14.20 13.16 1.8
CMS-1582-PN 196 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

21243 A Reconstruction of jaw joint 24.53 NA NA 23.17 21.08 3.121244 A Reconstruction of lower jaw 13.62 NA NA 16.73 15.62 1.921245 A Reconstruction of jaw 13.12 19.00 18.33 12.48 11.87 1.621246 A Reconstruction of jaw 12.92 NA NA 10.74 10.07 1.621247 A Reconstruct lower jaw bone 24.37 NA NA 19.67 18.76 4.821248 A Reconstruction of jaw 12.74 18.55 17.16 12.86 11.56 1.621249 A Reconstruction of jaw 18.77 24.30 22.21 17.84 15.61 2.421255 A Reconstruct lower jaw bone 18.46 NA NA 19.71 19.79 2.321256 A Reconstruction of orbit 17.66 NA NA 16.50 14.90 2.221260 A Revise eye sockets 17.90 NA NA 21.70 19.86 1.221261 A Revise eye sockets 34.07 NA NA 23.56 24.21 6.721263 A Revise eye sockets 31.01 NA NA 22.22 22.29 2.221267 A Revise eye sockets 20.69 NA NA 24.03 22.45 4.021268 A Revise eye sockets 27.07 NA NA 20.50 21.64 5.321270 A Augmentation cheek bone 10.63 17.21 15.63 10.57 9.26 1.521275 A Revision orbitofacial bones 11.76 NA NA 11.79 10.58 2.321280 A Revision of eyelid 7.13 NA NA 8.86 8.00 1.421282 A Revision of eyelid 4.27 NA NA 6.34 5.83 0.721295 A Revision of jaw muscle/bone 1.90 NA NA 2.89 2.91 0.321296 A Revision of jaw muscle/bone 4.78 NA NA 5.91 6.37 0.621299 C Cranio/maxillofacial surgery 0.00 0.00 0.00 0.00 0.00 0.021310 A Treatment of nose fracture 0.58 2.72 2.59 0.16 0.15 0.121315 A Treatment of nose fracture 1.83 6.01 5.77 2.44 2.32 0.221320 A Treatment of nose fracture 1.88 5.49 5.29 1.99 1.88 0.221325 A Treatment of nose fracture 4.18 NA NA 9.11 9.02 0.621330 A Treatment of nose fracture 5.79 NA NA 10.49 10.22 0.721335 A Treatment of nose fracture 9.02 NA NA 11.81 11.34 1.221336 A Treat nasal septal fracture 6.77 NA NA 11.87 11.39 0.921337 A Treat nasal septal fracture 3.39 8.08 7.78 4.99 4.69 0.521338 A Treat nasoethmoid fracture 6.87 NA NA 14.21 13.74 1.3
CMS-1582-PN 197 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

21339 A Treat nasoethmoid fracture 8.50 NA NA 13.36 13.51 1.621340 A Treatment of nose fracture 11.49 NA NA 10.10 9.93 1.421343 A Treatment of sinus fracture 14.32 NA NA 17.05 16.77 2.821344 A Treatment of sinus fracture 21.57 NA NA 22.00 19.88 7.721345 A Treat nose/jaw fracture 9.06 13.05 12.81 8.72 8.53 1.121346 A Treat nose/jaw fracture 11.45 NA NA 14.75 14.46 1.421347 A Treat nose/jaw fracture 13.53 NA NA 18.39 17.21 1.721348 A Treat nose/jaw fracture 17.52 NA NA 16.50 14.40 2.221355 A Treat cheek bone fracture 4.45 8.45 8.01 5.14 4.71 0.521356 A Treat cheek bone fracture 4.83 9.27 8.93 5.83 5.51 0.721360 A Treat cheek bone fracture 7.19 NA NA 8.12 7.50 0.921365 A Treat cheek bone fracture 16.77 NA NA 14.60 13.34 2.821366 A Treat cheek bone fracture 18.60 NA NA 17.29 15.07 3.621385 A Treat eye socket fracture 9.57 NA NA 10.14 9.74 1.221386 A Treat eye socket fracture 9.57 NA NA 8.44 8.16 1.821387 A Treat eye socket fracture 10.11 NA NA 10.45 9.99 1.921390 A Treat eye socket fracture 11.23 NA NA 11.26 10.21 1.821395 A Treat eye socket fracture 14.70 NA NA 13.68 12.08 1.821400 A Treat eye socket fracture 1.50 3.79 3.60 2.78 2.62 0.221401 A Treat eye socket fracture 3.68 9.52 9.47 4.59 4.41 0.721406 A Treat eye socket fracture 7.42 NA NA 8.69 7.79 0.921407 A Treat eye socket fracture 9.02 NA NA 9.18 8.47 1.521408 A Treat eye socket fracture 12.78 NA NA 12.55 11.30 2.521421 A Treat mouth roof fracture 6.02 15.22 14.66 11.93 11.43 1.121422 A Treat mouth roof fracture 8.73 NA NA 10.25 9.63 1.121423 A Treat mouth roof fracture 10.85 NA NA 12.35 11.20 2.121431 A Treat craniofacial fracture 7.90 NA NA 12.48 12.36 1.521432 A Treat craniofacial fracture 8.82 NA NA 11.29 10.12 1.721433 A Treat craniofacial fracture 26.29 NA NA 18.87 18.31 5.121435 A Treat craniofacial fracture 20.26 NA NA 16.14 15.53 2.6
CMS-1582-PN 198 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

21436 A Treat craniofacial fracture 30.30 NA NA 27.24 24.22 5.921440 A Treat dental ridge fracture 3.44 12.52 12.04 9.55 9.21 0.621445 A Treat dental ridge fracture 6.26 15.50 14.99 11.49 11.03 0.821450 A Treat lower jaw fracture 3.71 13.23 12.57 9.90 9.55 0.621451 A Treat lower jaw fracture 5.65 16.56 15.59 12.67 12.03 0.721452 A Treat lower jaw fracture 2.40 13.35 14.13 7.20 7.08 0.421453 A Treat lower jaw fracture 6.64 19.09 17.96 15.44 14.71 1.021454 A Treat lower jaw fracture 7.36 NA NA 8.72 8.03 0.921461 A Treat lower jaw fracture 9.31 51.58 48.52 17.48 16.62 1.421462 A Treat lower jaw fracture 11.01 53.07 50.40 18.68 17.55 1.421465 A Treat lower jaw fracture 13.12 NA NA 13.70 12.26 2.521470 A Treat lower jaw fracture 17.54 NA NA 16.63 15.09 2.921480 A Reset dislocated jaw 0.61 2.01 1.97 0.26 0.24 0.121485 A Reset dislocated jaw 4.77 15.22 14.36 11.91 11.28 0.621490 A Repair dislocated jaw 12.95 NA NA 12.84 11.92 2.521495 A Treat hyoid bone fracture 6.79 NA NA 13.77 12.98 0.821497 A Interdental wiring 4.64 14.66 14.25 11.66 11.33 0.921499 C Head surgery procedure 0.00 0.00 0.00 0.00 0.00 0.021501 A Drain neck/chest lesion 3.98 8.59 8.28 4.86 4.65 0.721502 A Drain chest lesion 7.55 NA NA 5.71 5.85 1.621510 A Drainage of bone lesion 6.20 NA NA 6.32 6.16 1.421550 A Biopsy of neck/chest 2.11 5.19 5.09 2.29 2.23 0.321552 A Exc neck les sc 3+ cm 6.49 NA NA 5.61 5.61 1.221554 A Exc neck tum deep 5+ cm 11.13 NA NA 8.75 8.75 2.021555 A Exc neck les sc < 3 cm 3.96 7.42 7.22 4.36 4.27 0.721556 A Exc neck tum deep < 5 cm 7.66 NA NA 6.89 6.02 1.421557 A Resect neck tum < 5 cm 14.75 NA NA 11.35 8.69 2.721558 A Resect neck tum 5+ cm 21.58 NA NA 15.18 15.18 4.021600 A Partial removal of rib 7.26 NA NA 8.08 7.67 1.521610 A Partial removal of rib 15.91 NA NA 14.01 12.44 5.7
CMS-1582-PN 199 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

21615 A Removal of rib 10.45 NA NA 6.49 6.64 2.421616 A Removal of rib and nerves 12.69 NA NA 6.92 8.16 3.021620 A Partial removal of sternum 7.28 NA NA 6.71 6.55 1.621627 A Sternal debridement 7.30 NA NA 7.33 7.24 1.621630 A Extensive sternum surgery 19.18 NA NA 14.84 14.23 4.021632 A Extensive sternum surgery 19.68 NA NA 12.81 12.65 4.921685 A Hyoid myotomy & suspension 15.26 NA NA 13.48 12.43 1.921700 A Revision of neck muscle 6.31 NA NA 4.69 4.86 1.521705 A Revision of neck muscle/rib 9.92 NA NA 4.71 5.67 2.321720 A Revision of neck muscle 5.80 NA NA 5.84 5.30 2.021725 A Revision of neck muscle 7.19 NA NA 7.42 6.99 1.421740 A Reconstruction of sternum 17.57 NA NA 9.32 9.76 3.421742 C Repair stern/nuss w/o scope 0.00 0.00 0.00 0.00 0.00 0.021743 C Repair sternum/nuss w/scope 0.00 0.00 0.00 0.00 0.00 0.021750 A Repair of sternum separation 11.40 NA NA 6.65 6.83 2.721800 A Treatment of rib fracture 1.01 1.91 1.78 2.00 1.85 0.121805 A Treatment of rib fracture 2.88 NA NA 4.21 4.14 0.621810 A Treatment of rib fracture(s) 7.03 NA NA 7.23 6.62 1.621820 A Treat sternum fracture 1.36 2.49 2.32 2.58 2.39 0.221825 A Treat sternum fracture 7.76 NA NA 7.10 7.07 1.821899 C Neck/chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.021920 A Biopsy soft tissue of back 2.11 5.12 5.06 2.41 2.29 0.321925 A Biopsy soft tissue of back 4.63 7.34 6.94 4.82 4.48 0.921930 A Exc back les sc < 3 cm 4.94 7.76 7.53 4.76 4.66 1.021931 A Exc back les sc 3+ cm 6.88 NA NA 5.68 5.68 1.421932 A Exc back tum deep < 5 cm 9.82 NA NA 8.05 8.05 2.021933 A Exc back tum deep 5+ cm 11.13 NA NA 8.50 8.50 2.321935 A Resect back tum < 5 cm 15.72 NA NA 11.67 11.36 3.221936 A Resect back tum 5+ cm 22.55 NA NA 15.43 15.43 4.622010 A I&d p-spine c/t/cerv-thor 12.75 NA NA 11.97 11.31 3.2
CMS-1582-PN 200 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

22015 A I&d p-spine l/s/ls 12.64 NA NA 11.74 11.20 3.022100 A Remove part of neck vertebra 11.00 NA NA 11.28 10.57 3.922101 A Remove part thorax vertebra 11.08 NA NA 10.02 9.94 3.922102 A Remove part lumbar vertebra 11.08 NA NA 10.72 10.26 2.622103 A Remove extra spine segment 2.34 NA NA 1.36 1.31 0.622110 A Remove part of neck vertebra 14.00 NA NA 13.05 12.36 5.022112 A Remove part thorax vertebra 14.07 NA NA 12.88 11.84 5.022114 A Remove part lumbar vertebra 14.07 NA NA 12.75 12.11 2.722116 A Remove extra spine segment 2.32 NA NA 1.32 1.27 0.622206 A Cut spine 3 col thor 37.18 NA NA 26.32 24.60 7.322207 A Cut spine 3 col lumb 36.68 NA NA 26.02 24.34 9.222208 A Cut spine 3 col addl seg 9.66 NA NA 5.60 5.25 2.522210 A Revision of neck spine 25.38 NA NA 20.66 19.65 6.722212 A Revision of thorax spine 20.99 NA NA 17.94 16.96 4.922214 A Revision of lumbar spine 21.02 NA NA 17.90 17.06 5.122216 A Revise extra spine segment 6.03 NA NA 3.50 3.38 1.522220 A Revision of neck spine 22.94 NA NA 18.96 17.77 6.422222 A Revision of thorax spine 23.09 NA NA 19.26 16.09 4.522224 A Revision of lumbar spine 23.09 NA NA 18.80 17.71 5.322226 A Revise extra spine segment 6.03 NA NA 3.47 3.34 1.522305 A Treat spine process fracture 2.13 3.06 2.88 2.59 2.43 0.422310 A Treat spine fracture 3.89 4.35 4.01 3.70 3.40 0.722315 A Treat spine fracture 10.11 13.50 12.76 10.42 9.79 2.522318 A Treat odontoid fx w/o graft 22.72 NA NA 18.20 17.36 7.622319 A Treat odontoid fx w/graft 25.33 NA NA 20.03 18.76 9.122325 A Treat spine fracture 19.87 NA NA 17.09 16.18 5.622326 A Treat neck spine fracture 20.84 NA NA 17.09 16.22 6.322327 A Treat thorax spine fracture 20.77 NA NA 17.81 16.67 5.622328 A Treat each add spine fx 4.60 NA NA 2.61 2.51 1.322505 A Manipulation of spine 1.87 NA NA 1.42 1.30 0.2
CMS-1582-PN 201 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

22520 A Percut vertebroplasty thor 9.22 55.61 55.64 4.57 4.75 1.022521 A Percut vertebroplasty lumb 8.01 55.13 55.03 4.24 4.45 0.922522 A Percut vertebroplasty addl 4.30 NA NA 1.75 1.81 0.522523 A Percut kyphoplasty thor 8.62 NA NA 5.60 5.72 1.622524 A Percut kyphoplasty lumbar 8.22 NA NA 5.44 5.55 1.622525 A Percut kyphoplasty add-on 4.47 NA NA 2.17 2.19 0.922526 N Idet single level 6.10 58.74 54.88 3.48 2.92 0.522527 N Idet 1 or more levels 3.03 50.43 46.21 1.33 1.02 0.222532 A Lat thorax spine fusion 25.99 NA NA 19.82 18.75 7.522533 A Lat lumbar spine fusion 24.79 NA NA 19.15 18.11 6.322534 A Lat thor/lumb addl seg 5.99 NA NA 3.41 3.30 1.522548 A Neck spine fusion 27.06 NA NA 21.72 20.26 9.722551 A Neck spine fuse&remove addl 25.00 NA NA 18.57 18.57 7.522552 A Addl neck spine fusion 6.50 NA NA 3.64 3.64 1.722554 A Neck spine fusion 17.69 NA NA 14.64 14.22 5.422556 A Thorax spine fusion 24.70 NA NA 18.56 17.70 6.622558 A Lumbar spine fusion 23.53 NA NA 17.08 16.12 5.622585 A Additional spinal fusion 5.52 NA NA 3.09 2.98 1.522590 A Spine & skull spinal fusion 21.76 NA NA 18.18 17.30 7.022595 A Neck spinal fusion 20.64 NA NA 17.48 16.62 6.522600 A Neck spine fusion 17.40 NA NA 15.47 14.71 5.322610 A Thorax spine fusion 17.28 NA NA 15.28 14.53 4.822612 A Lumbar spine fusion 23.53 NA NA 17.97 17.15 6.222614 A Spine fusion extra segment 6.43 NA NA 3.67 3.56 1.722630 A Lumbar spine fusion 22.09 NA NA 17.60 16.84 6.222632 A Spine fusion extra segment 5.22 NA NA 2.97 2.87 1.522800 A Fusion of spine 19.50 NA NA 15.99 15.30 4.922802 A Fusion of spine 32.11 NA NA 23.55 22.55 7.522804 A Fusion of spine 37.50 NA NA 26.80 25.63 8.522808 A Fusion of spine 27.51 NA NA 20.13 19.27 7.2
CMS-1582-PN 202 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

22810 A Fusion of spine 31.50 NA NA 21.62 20.69 7.922812 A Fusion of spine 34.25 NA NA 25.73 23.99 6.722818 A Kyphectomy 1-2 segments 34.33 NA NA 24.74 23.17 6.722819 A Kyphectomy 3 or more 39.38 NA NA 28.59 26.77 14.122830 A Exploration of spinal fusion 11.22 NA NA 9.95 9.54 2.922840 A Insert spine fixation device 12.52 NA NA 7.14 6.91 3.422841 B Insert spine fixation device 0.00 0.00 0.00 0.00 0.00 0.022842 A Insert spine fixation device 12.56 NA NA 7.18 6.95 3.422843 A Insert spine fixation device 13.44 NA NA 7.74 7.43 3.522844 A Insert spine fixation device 16.42 NA NA 9.58 9.31 3.622845 A Insert spine fixation device 11.94 NA NA 6.73 6.50 3.622846 A Insert spine fixation device 12.40 NA NA 6.99 6.76 3.722847 A Insert spine fixation device 13.78 NA NA 7.68 7.48 4.922848 A Insert pelv fixation device 5.99 NA NA 3.50 3.40 1.322849 A Reinsert spinal fixation 19.17 NA NA 14.59 13.99 5.122850 A Remove spine fixation device 9.82 NA NA 8.96 8.58 2.622851 A Apply spine prosth device 6.70 NA NA 3.81 3.67 1.822852 A Remove spine fixation device 9.37 NA NA 8.69 8.30 2.422855 A Remove spine fixation device 15.86 NA NA 12.74 12.19 4.722856 A Cerv artific diskectomy 24.05 NA NA 18.08 17.40 7.222857 R Lumbar artif diskectomy 27.13 NA NA 16.12 16.47 5.722861 A Revise cerv artific disc 33.36 NA NA 17.36 16.97 9.122862 R Revise lumbar artif disc 32.63 NA NA 17.53 17.17 6.422864 A Remove cerv artif disc 29.40 NA NA 21.67 18.37 8.022865 R Remove lumb artif disc 31.75 NA NA 21.07 21.67 6.222899 C Spine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.022900 A Exc back tum deep < 5 cm 8.32 NA NA 6.58 5.46 1.722901 A Exc back tum deep 5+ cm 10.11 NA NA 7.36 7.36 2.122902 A Exc abd les sc < 3 cm 4.42 7.72 7.72 4.93 4.93 0.722903 A Exc abd les sc > 3 cm 6.39 NA NA 5.54 5.54 1.2
CMS-1582-PN 203 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

22904 A Resect abd tum < 5 cm 16.69 NA NA 10.36 10.36 3.522905 A Resect abd tum > 5 cm 21.58 NA NA 13.62 13.62 4.622999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.023000 A Removal of calcium deposits 4.48 11.32 10.62 5.56 5.23 0.823020 A Release shoulder joint 9.36 NA NA 9.21 8.83 1.823030 A Drain shoulder lesion 3.47 8.55 8.27 3.45 3.30 0.623031 A Drain shoulder bursa 2.79 8.66 8.24 3.10 2.91 0.523035 A Drain shoulder bone lesion 9.16 NA NA 9.17 8.88 1.823040 A Exploratory shoulder surgery 9.75 NA NA 9.70 9.25 1.923044 A Exploratory shoulder surgery 7.59 NA NA 7.79 7.49 1.523065 A Biopsy shoulder tissues 2.30 3.70 3.58 2.35 2.23 0.323066 A Biopsy shoulder tissues 4.30 10.45 9.94 5.13 4.85 0.823071 A Exc shoulder les sc > 3 cm 5.91 NA NA 5.34 5.34 1.223073 A Exc shoulder tum deep > 5 cm 10.13 NA NA 8.47 8.47 2.023075 A Exc shoulder les sc < 3 cm 4.21 8.46 6.51 4.51 3.35 0.823076 A Exc shoulder tum deep < 5 cm 7.41 NA NA 6.99 6.82 1.523077 A Resect shoulder tum < 5 cm 17.66 NA NA 13.10 12.66 3.523078 A Resect shoulder tum > 5 cm 22.55 NA NA 14.04 14.04 4.823100 A Biopsy of shoulder joint 6.20 NA NA 7.34 6.91 1.223101 A Shoulder joint surgery 5.72 NA NA 6.42 6.17 1.123105 A Remove shoulder joint lining 8.48 NA NA 8.74 8.35 1.623106 A Incision of collarbone joint 6.13 NA NA 7.30 6.77 1.223107 A Explore treat shoulder joint 8.87 NA NA 8.99 8.59 1.723120 A Partial removal collar bone 7.39 NA NA 8.41 7.98 1.423125 A Removal of collar bone 9.64 NA NA 9.53 8.98 1.823130 A Remove shoulder bone part 7.77 NA NA 8.72 8.31 1.523140 A Removal of bone lesion 7.12 NA NA 6.98 6.55 1.423145 A Removal of bone lesion 9.40 NA NA 9.39 8.91 1.823146 A Removal of bone lesion 8.08 NA NA 8.71 8.06 1.523150 A Removal of humerus lesion 8.91 NA NA 8.87 8.46 1.7
CMS-1582-PN 204 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

23155 A Removal of humerus lesion 10.86 NA NA 10.59 10.04 2.123156 A Removal of humerus lesion 9.11 NA NA 9.22 8.73 1.823170 A Remove collar bone lesion 7.21 NA NA 7.94 7.21 1.423172 A Remove shoulder blade lesion 7.31 NA NA 8.00 7.43 1.423174 A Remove humerus lesion 10.05 NA NA 10.47 9.95 1.923180 A Remove collar bone lesion 8.99 NA NA 9.09 8.94 1.823182 A Remove shoulder blade lesion 8.61 NA NA 9.36 8.99 1.623184 A Remove humerus lesion 9.90 NA NA 9.95 9.68 1.923190 A Partial removal of scapula 7.47 NA NA 7.99 7.46 1.423195 A Removal of head of humerus 10.36 NA NA 10.07 9.53 2.023200 A Resect clavicle tumor 22.71 NA NA 18.34 14.19 4.423210 A Resect scapula tumor 27.21 NA NA 21.02 15.85 5.323220 A Resect prox humerus tumor 30.21 NA NA 22.49 17.29 5.923330 A Remove shoulder foreign body 1.90 4.52 4.36 2.17 2.09 0.323331 A Remove shoulder foreign body 7.63 NA NA 8.36 7.98 1.523332 A Remove shoulder foreign body 12.37 NA NA 11.47 10.96 2.423350 A Injection for shoulder x-ray 1.00 2.97 3.26 0.40 0.42 0.123395 A Muscle transfer shoulder/arm 18.54 NA NA 16.23 15.44 3.523397 A Muscle transfers 16.76 NA NA 14.10 13.42 3.323400 A Fixation of shoulder blade 13.87 NA NA 12.38 11.82 2.723405 A Incision of tendon & muscle 8.54 NA NA 8.37 8.06 1.623406 A Incise tendon(s) & muscle(s) 11.01 NA NA 9.97 9.58 2.123410 A Repair rotator cuff acute 11.39 NA NA 10.82 10.42 2.223412 A Repair rotator cuff chronic 11.93 NA NA 11.14 10.76 2.323415 A Release of shoulder ligament 9.23 NA NA 9.60 9.17 1.823420 A Repair of shoulder 13.54 NA NA 12.68 12.17 2.623430 A Repair biceps tendon 10.17 NA NA 10.03 9.47 1.923440 A Remove/transplant tendon 10.64 NA NA 9.75 9.35 2.023450 A Repair shoulder capsule 13.70 NA NA 11.87 11.32 2.723455 A Repair shoulder capsule 14.67 NA NA 12.47 11.93 2.8
CMS-1582-PN 205 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

23460 A Repair shoulder capsule 15.82 NA NA 13.65 13.05 3.123462 A Repair shoulder capsule 15.72 NA NA 13.27 12.61 3.123465 A Repair shoulder capsule 16.30 NA NA 13.86 13.21 3.223466 A Repair shoulder capsule 15.80 NA NA 14.45 13.76 3.123470 A Reconstruct shoulder joint 17.89 NA NA 14.75 14.12 3.523472 A Reconstruct shoulder joint 22.65 NA NA 17.76 16.94 4.423480 A Revision of collar bone 11.54 NA NA 10.66 10.13 2.223485 A Revision of collar bone 13.91 NA NA 12.00 11.48 2.723490 A Reinforce clavicle 12.16 NA NA 12.09 10.93 2.423491 A Reinforce shoulder bones 14.54 NA NA 12.84 12.25 2.823500 A Treat clavicle fracture 2.21 3.66 3.48 3.75 3.51 0.423505 A Treat clavicle fracture 3.83 5.65 5.36 5.12 4.83 0.723515 A Treat clavicle fracture 9.69 NA NA 10.05 9.36 1.823520 A Treat clavicle dislocation 2.29 3.97 3.68 4.06 3.75 0.423525 A Treat clavicle dislocation 3.79 6.89 5.98 5.83 5.13 0.723530 A Treat clavicle dislocation 7.48 NA NA 7.99 7.19 1.423532 A Treat clavicle dislocation 8.20 NA NA 8.67 8.25 1.623540 A Treat clavicle dislocation 2.36 3.61 3.44 3.71 3.45 0.423545 A Treat clavicle dislocation 3.43 5.40 5.08 4.58 4.31 0.623550 A Treat clavicle dislocation 7.59 NA NA 7.85 7.52 1.423552 A Treat clavicle dislocation 8.82 NA NA 9.00 8.59 1.723570 A Treat shoulder blade fx 2.36 3.89 3.69 4.08 3.83 0.423575 A Treat shoulder blade fx 4.23 6.62 6.17 5.92 5.50 0.823585 A Treat scapula fracture 14.23 NA NA 12.35 11.43 2.723600 A Treat humerus fracture 3.11 5.65 5.40 5.09 4.77 0.623605 A Treat humerus fracture 5.06 7.54 7.20 6.48 6.16 0.923615 A Treat humerus fracture 12.30 NA NA 11.67 11.03 2.423616 A Treat humerus fracture 18.37 NA NA 15.25 14.80 3.523620 A Treat humerus fracture 2.55 4.74 4.49 4.38 4.10 0.423625 A Treat humerus fracture 4.10 6.19 5.89 5.48 5.20 0.7
CMS-1582-PN 206 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

23630 A Treat humerus fracture 10.57 NA NA 10.63 9.84 2.023650 A Treat shoulder dislocation 3.53 4.56 4.34 3.92 3.65 0.623655 A Treat shoulder dislocation 4.76 NA NA 5.98 5.57 0.823660 A Treat shoulder dislocation 7.66 NA NA 8.12 7.72 1.523665 A Treat dislocation/fracture 4.66 6.80 6.47 6.02 5.72 0.823670 A Treat dislocation/fracture 12.28 NA NA 11.40 10.53 2.423675 A Treat dislocation/fracture 6.27 8.63 8.17 7.30 6.91 1.223680 A Treat dislocation/fracture 13.15 NA NA 11.96 11.18 2.523700 A Fixation of shoulder 2.57 NA NA 2.69 2.57 0.423800 A Fusion of shoulder joint 14.73 NA NA 13.00 12.36 2.923802 A Fusion of shoulder joint 18.42 NA NA 16.33 15.08 3.623900 A Amputation of arm & girdle 20.72 NA NA 16.83 14.96 4.123920 A Amputation at shoulder joint 16.23 NA NA 14.27 12.87 3.223921 A Amputation follow-up surgery 5.72 NA NA 6.94 5.73 1.323929 C Shoulder surgery procedure 0.00 0.00 0.00 0.00 0.00 0.023930 A Drainage of arm lesion 2.99 6.66 6.59 2.82 2.70 0.623931 A Drainage of arm bursa 1.84 6.00 5.88 2.51 2.40 0.323935 A Drain arm/elbow bone lesion 6.38 NA NA 7.40 6.94 1.224000 A Exploratory elbow surgery 6.08 NA NA 6.88 6.52 1.124006 A Release elbow joint 9.74 NA NA 9.62 9.12 1.824065 A Biopsy arm/elbow soft tissue 2.13 5.03 4.91 2.56 2.44 0.324066 A Biopsy arm/elbow soft tissue 5.35 11.40 10.86 5.72 5.33 1.024071 A Exc arm/elbow les sc 3+ cm 5.70 NA NA 5.29 5.29 1.124073 A Ex arm/elbow tum deep > 5 cm 10.13 NA NA 8.57 8.57 2.024075 A Exc arm/elbow les sc < 3 cm 4.24 9.11 8.96 4.64 4.37 0.824076 A Ex arm/elbow tum deep < 5 cm 7.41 NA NA 7.14 6.47 1.424077 A Resect arm/elbow tum < 5 cm 15.72 NA NA 12.10 10.47 3.124079 A Resect arm/elbow tum > 5 cm 20.61 NA NA 13.20 13.20 4.324100 A Biopsy elbow joint lining 5.07 NA NA 6.23 5.81 1.024101 A Explore/treat elbow joint 6.30 NA NA 7.28 6.94 1.2
CMS-1582-PN 207 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

24102 A Remove elbow joint lining 8.26 NA NA 8.44 8.01 1.524105 A Removal of elbow bursa 3.78 NA NA 5.74 5.41 0.724110 A Remove humerus lesion 7.58 NA NA 8.30 7.88 1.524115 A Remove/graft bone lesion 10.12 NA NA 9.82 9.24 1.924116 A Remove/graft bone lesion 12.23 NA NA 11.07 10.51 2.424120 A Remove elbow lesion 6.82 NA NA 7.53 7.10 1.224125 A Remove/graft bone lesion 8.14 NA NA 8.64 8.10 1.524126 A Remove/graft bone lesion 8.62 NA NA 8.92 8.47 1.624130 A Removal of head of radius 6.42 NA NA 7.36 7.02 1.224134 A Removal of arm bone lesion 10.22 NA NA 9.99 9.60 2.024136 A Remove radius bone lesion 8.40 NA NA 8.65 7.76 1.624138 A Remove elbow bone lesion 8.50 NA NA 9.76 9.25 1.624140 A Partial removal of arm bone 9.55 NA NA 9.59 9.32 1.724145 A Partial removal of radius 7.81 NA NA 8.19 8.02 1.524147 A Partial removal of elbow 7.84 NA NA 9.09 8.81 1.524149 A Radical resection of elbow 16.22 NA NA 15.86 14.84 2.924150 A Resect distal humerus tumor 23.46 NA NA 18.67 14.97 4.624152 A Resect radius tumor 19.99 NA NA 16.61 12.70 3.924155 A Removal of elbow joint 12.09 NA NA 10.98 10.36 2.324160 A Remove elbow joint implant 8.00 NA NA 8.51 8.07 1.524164 A Remove radius head implant 6.43 NA NA 7.02 6.71 1.224200 A Removal of arm foreign body 1.81 3.84 3.67 2.02 1.88 0.324201 A Removal of arm foreign body 4.70 10.49 10.30 5.19 4.96 0.924220 A Injection for elbow x-ray 1.31 2.99 3.31 0.57 0.59 0.124300 A Manipulate elbow w/anesth 4.04 NA NA 7.20 6.84 0.724301 A Muscle/tendon transfer 10.38 NA NA 9.90 9.47 2.024305 A Arm tendon lengthening 7.62 NA NA 8.23 7.81 1.324310 A Revision of arm tendon 6.12 NA NA 6.81 6.49 1.124320 A Repair of arm tendon 10.86 NA NA 10.25 9.67 2.124330 A Revision of arm muscles 9.79 NA NA 9.61 9.15 1.9
CMS-1582-PN 208 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

24331 A Revision of arm muscles 10.95 NA NA 11.21 10.33 2.124332 A Tenolysis triceps 7.91 NA NA 8.66 8.22 1.524340 A Repair of biceps tendon 8.08 NA NA 8.53 8.14 1.524341 A Repair arm tendon/muscle 9.49 NA NA 10.78 10.13 1.824342 A Repair of ruptured tendon 10.86 NA NA 10.24 9.78 2.024343 A Repr elbow lat ligmnt w/tiss 9.16 NA NA 10.05 9.58 1.624344 A Reconstruct elbow lat ligmnt 15.21 NA NA 14.51 13.73 3.024345 A Repr elbw med ligmnt w/tissu 9.16 NA NA 9.95 9.46 1.624346 A Reconstruct elbow med ligmnt 15.21 NA NA 14.51 13.78 3.024357 A Repair elbow perc 5.44 NA NA 6.69 6.40 1.024358 A Repair elbow w/deb open 6.66 NA NA 7.62 7.24 1.224359 A Repair elbow deb/attch open 8.98 NA NA 9.01 8.41 1.624360 A Reconstruct elbow joint 12.67 NA NA 11.65 11.11 2.424361 A Reconstruct elbow joint 14.41 NA NA 12.79 12.24 2.824362 A Reconstruct elbow joint 15.32 NA NA 13.33 12.68 3.024363 A Replace elbow joint 22.65 NA NA 18.11 17.03 4.224365 A Reconstruct head of radius 8.62 NA NA 8.65 8.28 1.624366 A Reconstruct head of radius 9.36 NA NA 9.16 8.73 1.724400 A Revision of humerus 11.33 NA NA 10.83 10.37 2.124410 A Revision of humerus 15.11 NA NA 13.48 12.62 2.924420 A Revision of humerus 13.73 NA NA 13.08 12.45 2.724430 A Repair of humerus 15.25 NA NA 13.47 12.66 2.924435 A Repair humerus with graft 14.99 NA NA 14.27 13.47 2.924470 A Revision of elbow joint 8.93 NA NA 9.21 8.21 1.724495 A Decompression of forearm 8.41 NA NA 9.04 8.94 1.824498 A Reinforce humerus 12.28 NA NA 11.15 10.66 2.424500 A Treat humerus fracture 3.41 6.20 5.89 5.34 5.00 0.624505 A Treat humerus fracture 5.39 8.14 7.77 6.85 6.52 1.024515 A Treat humerus fracture 12.12 NA NA 11.62 11.07 2.324516 A Treat humerus fracture 12.19 NA NA 11.08 10.58 2.3
CMS-1582-PN 209 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

24530 A Treat humerus fracture 3.69 6.60 6.27 5.63 5.29 0.624535 A Treat humerus fracture 7.11 9.58 9.16 8.30 7.90 1.324538 A Treat humerus fracture 9.77 NA NA 10.35 9.92 1.924545 A Treat humerus fracture 13.15 NA NA 12.04 11.27 2.524546 A Treat humerus fracture 14.91 NA NA 13.27 12.72 2.924560 A Treat humerus fracture 2.98 5.66 5.39 4.76 4.44 0.524565 A Treat humerus fracture 5.78 8.64 7.99 7.44 6.83 1.124566 A Treat humerus fracture 9.06 NA NA 10.35 9.81 1.824575 A Treat humerus fracture 9.71 NA NA 10.15 9.70 1.824576 A Treat humerus fracture 3.06 6.15 5.82 5.21 4.88 0.524577 A Treat humerus fracture 6.01 8.84 8.24 7.58 7.01 1.124579 A Treat humerus fracture 11.44 NA NA 11.21 10.64 2.224582 A Treat humerus fracture 10.14 NA NA 11.75 11.03 1.924586 A Treat elbow fracture 15.78 NA NA 13.64 13.02 3.024587 A Treat elbow fracture 15.79 NA NA 13.78 13.07 2.924600 A Treat elbow dislocation 4.37 5.24 5.08 4.46 4.22 0.724605 A Treat elbow dislocation 5.64 NA NA 7.02 6.63 1.024615 A Treat elbow dislocation 9.83 NA NA 9.50 9.07 1.824620 A Treat elbow fracture 7.22 NA NA 7.76 7.39 1.324635 A Treat elbow fracture 8.80 NA NA 9.47 9.98 1.624640 A Treat elbow dislocation 1.25 2.35 2.13 1.18 1.07 0.224650 A Treat radius fracture 2.31 4.76 4.53 4.18 3.90 0.424655 A Treat radius fracture 4.62 7.09 6.83 6.08 5.80 0.824665 A Treat radius fracture 8.36 NA NA 9.37 8.90 1.524666 A Treat radius fracture 9.86 NA NA 10.04 9.56 1.824670 A Treat ulnar fracture 2.69 5.17 4.93 4.40 4.13 0.524675 A Treat ulnar fracture 4.91 7.45 7.13 6.38 6.08 0.924685 A Treat ulnar fracture 8.37 NA NA 9.36 8.90 1.624800 A Fusion of elbow joint 11.41 NA NA 11.02 10.07 2.224802 A Fusion/graft of elbow joint 14.32 NA NA 12.75 12.08 2.8
CMS-1582-PN 210 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

24900 A Amputation of upper arm 10.18 NA NA 9.59 8.97 2.024920 A Amputation of upper arm 10.13 NA NA 9.67 8.93 1.924925 A Amputation follow-up surgery 7.30 NA NA 7.99 7.57 1.424930 A Amputation follow-up surgery 10.83 NA NA 10.09 9.34 2.124931 A Amputate upper arm & implant 13.44 NA NA 8.38 8.14 0.924935 A Revision of amputation 16.45 NA NA 7.55 8.53 3.224940 C Revision of upper arm 0.00 0.00 0.00 0.00 0.00 0.024999 C Upper arm/elbow surgery 0.00 0.00 0.00 0.00 0.00 0.025000 A Incision of tendon sheath 3.55 NA NA 5.65 5.73 0.625001 A Incise flexor carpi radialis 3.79 NA NA 5.67 5.31 0.625020 A Decompress forearm 1 space 6.06 NA NA 9.85 9.56 1.025023 A Decompress forearm 1 space 13.83 NA NA 16.15 15.54 2.725024 A Decompress forearm 2 spaces 10.79 NA NA 10.23 9.72 2.125025 A Decompress forearm 2 spaces 17.94 NA NA 15.21 13.97 3.525028 A Drainage of forearm lesion 5.39 NA NA 8.78 8.54 1.025031 A Drainage of forearm bursa 4.26 NA NA 5.12 5.41 0.825035 A Treat forearm bone lesion 7.65 NA NA 8.16 8.76 1.425040 A Explore/treat wrist joint 7.50 NA NA 7.81 7.58 1.325065 A Biopsy forearm soft tissues 2.04 5.09 4.98 2.57 2.48 0.325066 A Biopsy forearm soft tissues 4.27 NA NA 5.46 5.59 0.825071 A Exc forearm les sc > 3 cm 5.91 NA NA 5.69 5.69 1.125073 A Exc forearm tum deep 3+ cm 7.13 NA NA 7.47 7.47 1.325075 A Exc forearm les sc < 3 cm 3.96 9.16 9.16 4.64 4.75 0.725076 A Exc forearm tum deep < 3 cm 6.74 NA NA 7.25 7.01 1.225077 A Resect forearm/wrist tum<3cm 12.93 NA NA 10.88 10.20 2.625078 A Resect forearm/wrist tum3+cm 17.69 NA NA 11.93 11.93 3.725085 A Incision of wrist capsule 5.64 NA NA 6.59 6.55 1.125100 A Biopsy of wrist joint 4.02 NA NA 5.34 5.21 0.725101 A Explore/treat wrist joint 4.83 NA NA 6.18 6.01 0.925105 A Remove wrist joint lining 6.02 NA NA 7.15 7.02 1.1
CMS-1582-PN 211 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

25107 A Remove wrist joint cartilage 7.70 NA NA 9.23 8.87 1.325109 A Excise tendon forearm/wrist 6.94 NA NA 7.80 7.25 1.225110 A Remove wrist tendon lesion 4.04 NA NA 5.20 5.36 0.725111 A Remove wrist tendon lesion 3.53 NA NA 5.17 4.99 0.625112 A Reremove wrist tendon lesion 4.67 NA NA 5.85 5.61 0.825115 A Remove wrist/forearm lesion 10.09 NA NA 10.78 10.99 1.825116 A Remove wrist/forearm lesion 7.56 NA NA 8.91 9.35 1.325118 A Excise wrist tendon sheath 4.51 NA NA 5.95 5.78 0.825119 A Partial removal of ulna 6.21 NA NA 7.26 7.17 1.225120 A Removal of forearm lesion 6.27 NA NA 7.29 7.88 1.125125 A Remove/graft forearm lesion 7.67 NA NA 8.36 8.91 1.525126 A Remove/graft forearm lesion 7.74 NA NA 8.40 8.90 1.525130 A Removal of wrist lesion 5.43 NA NA 6.85 6.64 0.925135 A Remove & graft wrist lesion 7.08 NA NA 8.00 7.80 1.325136 A Remove & graft wrist lesion 6.14 NA NA 7.19 6.98 1.225145 A Remove forearm bone lesion 6.54 NA NA 7.43 8.00 1.225150 A Partial removal of ulna 7.38 NA NA 8.00 7.88 1.325151 A Partial removal of radius 7.68 NA NA 8.14 8.68 1.525170 A Resect radius/ulnar tumor 22.21 NA NA 17.82 14.83 4.325210 A Removal of wrist bone 6.12 NA NA 7.29 7.05 1.025215 A Removal of wrist bones 8.14 NA NA 8.83 8.61 1.425230 A Partial removal of radius 5.37 NA NA 6.49 6.29 0.925240 A Partial removal of ulna 5.31 NA NA 6.43 6.37 0.925246 A Injection for wrist x-ray 1.45 2.93 3.23 0.59 0.62 0.125248 A Remove forearm foreign body 5.31 NA NA 5.79 6.07 1.025250 A Removal of wrist prosthesis 6.77 NA NA 7.55 7.20 1.325251 A Removal of wrist prosthesis 9.82 NA NA 9.62 9.17 1.925259 A Manipulate wrist w/anesthes 4.04 NA NA 7.28 6.91 0.725260 A Repair forearm tendon/muscle 8.04 NA NA 9.21 9.61 1.425263 A Repair forearm tendon/muscle 8.04 NA NA 8.92 9.44 1.5
CMS-1582-PN 212 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

25265 A Repair forearm tendon/muscle 10.10 NA NA 10.13 10.59 1.925270 A Repair forearm tendon/muscle 6.17 NA NA 7.26 7.81 1.125272 A Repair forearm tendon/muscle 7.21 NA NA 7.90 8.47 1.325274 A Repair forearm tendon/muscle 8.94 NA NA 9.11 9.65 1.725275 A Repair forearm tendon sheath 8.96 NA NA 9.28 8.89 1.725280 A Revise wrist/forearm tendon 7.39 NA NA 8.06 8.57 1.225290 A Incise wrist/forearm tendon 5.43 NA NA 6.50 7.64 0.925295 A Release wrist/forearm tendon 6.72 NA NA 7.62 8.15 1.125300 A Fusion of tendons at wrist 9.02 NA NA 9.48 9.17 1.725301 A Fusion of tendons at wrist 8.59 NA NA 8.97 8.65 1.525310 A Transplant forearm tendon 8.08 NA NA 8.90 9.32 1.325312 A Transplant forearm tendon 9.82 NA NA 9.80 10.22 1.725315 A Revise palsy hand tendon(s) 10.68 NA NA 10.14 10.65 2.125316 A Revise palsy hand tendon(s) 12.90 NA NA 11.80 12.05 1.625320 A Repair/revise wrist joint 12.75 NA NA 14.40 13.58 2.225332 A Revise wrist joint 11.74 NA NA 11.30 10.70 2.125335 A Realignment of hand 13.39 NA NA 8.58 10.00 0.925337 A Reconstruct ulna/radioulnar 11.73 NA NA 12.76 12.17 2.025350 A Revision of radius 9.09 NA NA 9.31 9.82 1.625355 A Revision of radius 10.53 NA NA 10.17 10.66 2.025360 A Revision of ulna 8.74 NA NA 9.00 9.57 1.625365 A Revise radius & ulna 12.91 NA NA 11.81 12.08 2.525370 A Revise radius or ulna 14.10 NA NA 13.10 13.30 2.725375 A Revise radius & ulna 13.55 NA NA 12.19 12.60 0.925390 A Shorten radius or ulna 10.70 NA NA 10.37 10.77 1.825391 A Lengthen radius or ulna 14.28 NA NA 12.63 12.93 2.825392 A Shorten radius & ulna 14.58 NA NA 12.80 13.12 2.925393 A Lengthen radius & ulna 16.56 NA NA 15.42 14.99 3.225394 A Repair carpal bone shorten 10.85 NA NA 10.32 9.80 2.125400 A Repair radius or ulna 11.28 NA NA 10.61 11.08 2.0
CMS-1582-PN 213 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

25405 A Repair/graft radius or ulna 15.01 NA NA 13.20 13.52 2.725415 A Repair radius & ulna 13.80 NA NA 12.84 13.12 2.725420 A Repair/graft radius & ulna 17.04 NA NA 14.52 14.84 3.325425 A Repair/graft radius or ulna 13.72 NA NA 12.29 13.39 2.725426 A Repair/graft radius & ulna 16.45 NA NA 13.92 13.13 3.225430 A Vasc graft into carpal bone 9.71 NA NA 10.06 9.46 1.225431 A Repair nonunion carpal bone 10.89 NA NA 10.43 9.82 2.125440 A Repair/graft wrist bone 10.68 NA NA 10.26 9.89 1.825441 A Reconstruct wrist joint 13.29 NA NA 13.13 12.09 1.625442 A Reconstruct wrist joint 11.12 NA NA 11.04 10.46 1.325443 A Reconstruct wrist joint 10.66 NA NA 10.45 10.01 2.125444 A Reconstruct wrist joint 11.42 NA NA 11.82 10.88 0.825445 A Reconstruct wrist joint 9.88 NA NA 9.78 9.29 1.825446 A Wrist replacement 17.30 NA NA 14.88 14.04 2.925447 A Repair wrist joint(s) 11.14 NA NA 11.54 10.83 1.925449 A Remove wrist joint implant 14.94 NA NA 13.45 12.64 2.925450 A Revision of wrist joint 8.06 NA NA 6.03 6.80 1.525455 A Revision of wrist joint 9.71 NA NA 6.97 7.72 0.625490 A Reinforce radius 9.73 NA NA 8.80 9.51 1.225491 A Reinforce ulna 10.15 NA NA 9.84 10.35 1.925492 A Reinforce radius and ulna 12.66 NA NA 11.77 12.08 2.425500 A Treat fracture of radius 2.60 4.73 4.43 4.13 3.80 0.425505 A Treat fracture of radius 5.45 8.10 7.75 6.98 6.64 1.025515 A Treat fracture of radius 8.80 NA NA 9.33 8.88 1.625520 A Treat fracture of radius 6.50 8.85 8.17 8.04 7.39 1.225525 A Treat fracture of radius 10.55 NA NA 10.72 10.41 2.025526 A Treat fracture of radius 13.15 NA NA 12.66 12.55 2.625530 A Treat fracture of ulna 2.24 4.84 4.60 4.17 3.90 0.425535 A Treat fracture of ulna 5.36 7.88 7.47 6.91 6.54 1.025545 A Treat fracture of ulna 7.94 NA NA 8.96 8.59 1.5
CMS-1582-PN 214 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

25560 A Treat fracture radius & ulna 2.59 4.81 4.53 4.11 3.78 0.425565 A Treat fracture radius & ulna 5.85 8.26 7.91 6.94 6.62 1.125574 A Treat fracture radius & ulna 8.80 NA NA 9.41 8.90 1.725575 A Treat fracture radius/ulna 12.29 NA NA 12.08 11.47 2.325600 A Treat fracture radius/ulna 2.64 6.27 5.82 5.76 5.24 0.425605 A Treat fracture radius/ulna 6.00 8.67 8.57 7.73 7.64 1.125606 A Treat fx distal radial 8.31 NA NA 9.66 9.35 1.625607 A Treat fx rad extra-articul 9.56 NA NA 10.41 9.73 1.825608 A Treat fx rad intra-articul 11.07 NA NA 11.32 10.58 2.025609 A Treat fx radial 3+ frag 14.38 NA NA 14.14 13.18 2.625622 A Treat wrist bone fracture 2.79 5.44 5.15 4.71 4.37 0.525624 A Treat wrist bone fracture 4.77 7.69 7.42 6.57 6.28 0.825628 A Treat wrist bone fracture 9.67 NA NA 9.98 9.46 1.725630 A Treat wrist bone fracture 3.03 5.23 4.98 4.56 4.23 0.525635 A Treat wrist bone fracture 4.61 7.72 7.17 6.63 5.96 0.925645 A Treat wrist bone fracture 7.42 NA NA 7.95 7.57 1.425650 A Treat wrist bone fracture 3.23 5.44 5.16 4.91 4.53 0.625651 A Pin ulnar styloid fracture 5.82 NA NA 7.42 6.97 1.125652 A Treat fracture ulnar styloid 8.06 NA NA 8.93 8.45 1.425660 A Treat wrist dislocation 4.98 NA NA 5.90 5.67 0.925670 A Treat wrist dislocation 8.09 NA NA 8.30 7.97 1.525671 A Pin radioulnar dislocation 6.46 NA NA 7.97 7.51 1.225675 A Treat wrist dislocation 4.89 6.82 6.50 5.81 5.51 0.825676 A Treat wrist dislocation 8.29 NA NA 8.90 8.47 1.525680 A Treat wrist fracture 6.23 NA NA 6.34 5.96 1.025685 A Treat wrist fracture 10.09 NA NA 9.79 9.26 1.925690 A Treat wrist dislocation 5.72 NA NA 7.27 6.77 1.125695 A Treat wrist dislocation 8.51 NA NA 8.60 8.21 1.625800 A Fusion of wrist joint 10.07 NA NA 9.91 9.57 1.825805 A Fusion/graft of wrist joint 11.73 NA NA 11.10 10.79 2.3
CMS-1582-PN 215 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

25810 A Fusion/graft of wrist joint 11.95 NA NA 11.82 11.24 2.125820 A Fusion of hand bones 7.64 NA NA 9.16 8.76 1.325825 A Fuse hand bones with graft 9.69 NA NA 11.08 10.56 1.625830 A Fusion radioulnar jnt/ulna 10.88 NA NA 14.94 14.60 2.125900 A Amputation of forearm 9.61 NA NA 9.72 9.92 1.825905 A Amputation of forearm 9.59 NA NA 9.36 9.56 1.825907 A Amputation follow-up surgery 8.09 NA NA 8.47 8.73 1.525909 A Amputation follow-up surgery 9.31 NA NA 9.19 9.45 1.825915 A Amputation of forearm 17.52 NA NA 10.13 12.55 3.125920 A Amputate hand at wrist 9.03 NA NA 9.80 9.30 1.725922 A Amputate hand at wrist 7.65 NA NA 6.20 6.81 0.525924 A Amputation follow-up surgery 8.81 NA NA 7.63 8.10 1.725927 A Amputation of hand 9.09 NA NA 12.86 12.25 1.825929 A Amputation follow-up surgery 7.82 NA NA 8.90 7.79 1.525931 A Amputation follow-up surgery 8.04 NA NA 9.96 10.43 1.725999 C Forearm or wrist surgery 0.00 0.00 0.00 0.00 0.00 0.026010 A Drainage of finger abscess 1.59 5.50 5.44 2.15 2.03 0.226011 A Drainage of finger abscess 2.24 8.47 8.43 2.83 2.69 0.326020 A Drain hand tendon sheath 5.08 NA NA 6.82 6.44 0.926025 A Drainage of palm bursa 5.08 NA NA 6.45 6.09 0.926030 A Drainage of palm bursa(s) 6.25 NA NA 7.22 6.82 1.126034 A Treat hand bone lesion 6.63 NA NA 8.03 7.61 1.226035 A Decompress fingers/hand 11.37 NA NA 11.82 10.92 2.226037 A Decompress fingers/hand 7.57 NA NA 8.00 7.55 1.426040 A Release palm contracture 3.46 NA NA 5.14 4.86 0.526045 A Release palm contracture 5.73 NA NA 6.97 6.64 1.026055 A Incise finger tendon sheath 3.11 12.26 12.42 5.39 5.07 0.526060 A Incision of finger tendon 2.91 NA NA 4.43 4.20 0.526070 A Explore/treat hand joint 3.81 NA NA 4.66 4.31 0.626075 A Explore/treat finger joint 3.91 NA NA 4.93 4.63 0.6
CMS-1582-PN 216 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

26080 A Explore/treat finger joint 4.47 NA NA 6.22 5.87 0.726100 A Biopsy hand joint lining 3.79 NA NA 5.27 4.93 0.726105 A Biopsy finger joint lining 3.83 NA NA 5.29 5.01 0.726110 A Biopsy finger joint lining 3.65 NA NA 5.18 4.89 0.626111 A Exc hand les sc > 1.5 cm 5.42 NA NA 6.06 6.06 0.926113 A Exc hand tum deep > 1.5 cm 7.13 NA NA 7.96 7.96 1.226115 A Exc hand les sc < 1.5 cm 3.96 9.88 11.38 5.15 5.26 0.726116 A Exc hand tum deep < 1.5 cm 6.74 NA NA 7.72 7.26 1.226117 A Exc hand tum ra < 3 cm 10.13 NA NA 10.48 9.25 1.826118 A Exc hand tum ra > 3 cm 14.81 NA NA 14.22 14.22 2.926121 A Release palm contracture 7.73 NA NA 8.62 8.17 1.426123 A Release palm contracture 10.88 NA NA 12.02 11.24 1.926125 A Release palm contracture 4.60 NA NA 2.94 2.77 0.826130 A Remove wrist joint lining 5.59 NA NA 7.02 6.59 1.026135 A Revise finger joint each 7.13 NA NA 7.97 7.55 1.226140 A Revise finger joint each 6.34 NA NA 7.49 7.10 1.126145 A Tendon excision palm/finger 6.49 NA NA 7.52 7.13 1.126160 A Remove tendon sheath lesion 3.57 12.22 12.10 5.58 5.25 0.626170 A Removal of palm tendon each 4.91 NA NA 6.24 5.92 0.826180 A Removal of finger tendon 5.35 NA NA 6.75 6.44 0.926185 A Remove finger bone 6.52 NA NA 8.38 7.87 1.226200 A Remove hand bone lesion 5.65 NA NA 6.65 6.33 1.026205 A Remove/graft bone lesion 7.93 NA NA 8.33 7.98 1.526210 A Removal of finger lesion 5.32 NA NA 6.80 6.45 0.926215 A Remove/graft finger lesion 7.27 NA NA 7.93 7.52 1.426230 A Partial removal of hand bone 6.47 NA NA 7.20 6.85 1.126235 A Partial removal finger bone 6.33 NA NA 7.26 6.86 1.126236 A Partial removal finger bone 5.46 NA NA 6.61 6.28 0.926250 A Extensive hand surgery 15.21 NA NA 13.76 10.62 3.026260 A Resect prox finger tumor 11.16 NA NA 11.49 9.25 2.1
CMS-1582-PN 217 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

26262 A Resect distal finger tumor 8.29 NA NA 8.86 7.46 1.626320 A Removal of implant from hand 4.10 NA NA 5.45 5.16 0.726340 A Manipulate finger w/anesth 2.80 NA NA 6.40 6.05 0.526350 A Repair finger/hand tendon 6.21 NA NA 13.07 13.12 1.126352 A Repair/graft hand tendon 7.87 NA NA 14.02 13.95 1.526356 A Repair finger/hand tendon 10.62 NA NA 19.12 18.68 1.926357 A Repair finger/hand tendon 8.77 NA NA 14.55 14.48 1.726358 A Repair/graft hand tendon 9.36 NA NA 15.74 15.45 1.826370 A Repair finger/hand tendon 7.28 NA NA 13.35 13.39 1.326372 A Repair/graft hand tendon 9.01 NA NA 14.70 14.74 1.726373 A Repair finger/hand tendon 8.41 NA NA 14.34 14.33 1.626390 A Revise hand/finger tendon 9.43 NA NA 12.96 12.71 1.826392 A Repair/graft hand tendon 10.50 NA NA 15.59 15.42 2.026410 A Repair hand tendon 4.77 NA NA 10.53 10.60 0.826412 A Repair/graft hand tendon 6.48 NA NA 12.07 12.05 1.126415 A Excision hand/finger tendon 8.51 NA NA 10.23 10.41 1.126416 A Graft hand or finger tendon 9.56 NA NA 14.31 12.69 1.826418 A Repair finger tendon 4.47 NA NA 11.17 11.19 0.826420 A Repair/graft finger tendon 6.94 NA NA 12.04 12.12 1.326426 A Repair finger/hand tendon 6.32 NA NA 7.39 8.12 1.126428 A Repair/graft finger tendon 7.40 NA NA 12.87 12.79 1.426432 A Repair finger tendon 4.16 NA NA 9.36 9.36 0.726433 A Repair finger tendon 4.70 NA NA 9.67 9.69 0.826434 A Repair/graft finger tendon 6.26 NA NA 11.07 10.95 1.226437 A Realignment of tendons 5.99 NA NA 10.91 10.81 1.026440 A Release palm/finger tendon 5.16 NA NA 11.68 11.80 0.926442 A Release palm & finger tendon 9.75 NA NA 16.49 16.12 1.726445 A Release hand/finger tendon 4.45 NA NA 11.25 11.38 0.726449 A Release forearm/hand tendon 8.59 NA NA 10.63 11.15 1.526450 A Incision of palm tendon 3.79 NA NA 7.19 7.10 0.6
CMS-1582-PN 218 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

26455 A Incision of finger tendon 3.76 NA NA 7.20 7.08 0.626460 A Incise hand/finger tendon 3.58 NA NA 7.14 7.01 0.626471 A Fusion of finger tendons 5.90 NA NA 10.83 10.69 1.026474 A Fusion of finger tendons 5.49 NA NA 10.83 10.62 1.026476 A Tendon lengthening 5.35 NA NA 10.73 10.42 1.026477 A Tendon shortening 5.32 NA NA 10.46 10.36 1.026478 A Lengthening of hand tendon 5.97 NA NA 10.86 10.86 1.026479 A Shortening of hand tendon 5.91 NA NA 10.86 10.79 1.126480 A Transplant hand tendon 6.90 NA NA 13.53 13.51 1.226483 A Transplant/graft hand tendon 8.48 NA NA 14.27 14.26 1.526485 A Transplant palm tendon 7.89 NA NA 13.99 13.99 1.426489 A Transplant/graft palm tendon 9.86 NA NA 15.20 14.35 1.926490 A Revise thumb tendon 8.60 NA NA 12.86 12.56 1.626492 A Tendon transfer with graft 9.84 NA NA 13.78 13.54 1.926494 A Hand tendon/muscle transfer 8.66 NA NA 12.75 12.58 1.626496 A Revise thumb tendon 9.78 NA NA 13.51 13.22 1.626497 A Finger tendon transfer 9.76 NA NA 13.40 13.20 1.926498 A Finger tendon transfer 14.21 NA NA 16.39 16.05 2.826499 A Revision of finger 9.17 NA NA 13.05 12.83 1.826500 A Hand tendon reconstruction 6.13 NA NA 10.87 10.75 1.126502 A Hand tendon reconstruction 7.31 NA NA 12.09 11.76 1.426508 A Release thumb contracture 6.18 NA NA 11.02 10.82 1.126510 A Thumb tendon transfer 5.60 NA NA 10.53 10.52 0.926516 A Fusion of knuckle joint 7.32 NA NA 11.64 11.51 1.226517 A Fusion of knuckle joints 9.08 NA NA 13.00 12.86 1.826518 A Fusion of knuckle joints 9.27 NA NA 13.34 13.06 1.826520 A Release knuckle contracture 5.47 NA NA 12.22 12.29 0.926525 A Release finger contracture 5.50 NA NA 12.22 12.31 0.926530 A Revise knuckle joint 6.88 NA NA 7.81 7.39 1.226531 A Revise knuckle with implant 8.13 NA NA 9.02 8.51 1.3
CMS-1582-PN 219 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

26535 A Revise finger joint 5.41 NA NA 6.05 5.53 0.826536 A Revise/implant finger joint 6.56 NA NA 12.88 12.17 1.126540 A Repair hand joint 6.60 NA NA 11.23 11.15 1.126541 A Repair hand joint with graft 8.81 NA NA 12.77 12.65 1.526542 A Repair hand joint with graft 6.95 NA NA 11.50 11.39 1.226545 A Reconstruct finger joint 7.11 NA NA 11.83 11.63 1.226546 A Repair nonunion hand 10.83 NA NA 16.11 15.66 1.826548 A Reconstruct finger joint 8.22 NA NA 12.48 12.27 1.526550 A Construct thumb replacement 21.68 NA NA 22.42 19.65 4.226551 A Great toe-hand transfer 48.48 NA NA 28.76 30.75 9.526553 A Single transfer toe-hand 48.17 NA NA 44.59 35.13 3.426554 A Double transfer toe-hand 57.01 NA NA 32.81 34.07 4.026555 A Positional change of finger 17.08 NA NA 19.68 19.23 3.326556 A Toe joint transfer 49.75 NA NA 32.40 29.36 3.926560 A Repair of web finger 5.52 NA NA 10.54 10.13 1.026561 A Repair of web finger 11.10 NA NA 14.96 13.86 2.326562 A Repair of web finger 16.68 NA NA 19.31 18.62 1.126565 A Correct metacarpal flaw 6.91 NA NA 11.35 11.25 1.326567 A Correct finger deformity 6.99 NA NA 11.39 11.31 1.226568 A Lengthen metacarpal/finger 9.27 NA NA 14.85 14.71 1.826580 A Repair hand deformity 19.75 NA NA 15.15 15.82 3.826587 A Reconstruct extra finger 14.50 NA NA 14.76 12.47 3.126590 A Repair finger deformity 18.67 NA NA 15.11 14.34 3.726591 A Repair muscles of hand 3.38 NA NA 8.45 8.54 0.626593 A Release muscles of hand 5.50 NA NA 10.82 10.71 0.926596 A Excision constricting tissue 9.14 NA NA 11.29 10.60 1.826600 A Treat metacarpal fracture 2.60 5.35 4.99 4.89 4.46 0.426605 A Treat metacarpal fracture 3.03 5.70 5.43 4.93 4.64 0.526607 A Treat metacarpal fracture 5.48 NA NA 6.93 6.35 1.026608 A Treat metacarpal fracture 5.55 NA NA 7.47 7.14 1.0
CMS-1582-PN 220 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

26615 A Treat metacarpal fracture 7.07 NA NA 8.71 8.00 1.226641 A Treat thumb dislocation 4.13 5.42 5.33 4.64 4.50 0.726645 A Treat thumb fracture 4.58 6.98 6.47 6.02 5.53 0.826650 A Treat thumb fracture 5.35 NA NA 7.68 7.37 1.026665 A Treat thumb fracture 7.94 NA NA 9.16 8.57 1.426670 A Treat hand dislocation 3.83 5.04 4.80 4.25 3.95 0.626675 A Treat hand dislocation 4.83 7.46 6.92 6.46 5.94 0.926676 A Pin hand dislocation 5.74 NA NA 7.89 7.57 1.026685 A Treat hand dislocation 7.07 NA NA 8.62 8.07 1.326686 A Treat hand dislocation 8.17 NA NA 8.67 8.24 1.626700 A Treat knuckle dislocation 3.83 4.66 4.41 4.17 3.86 0.626705 A Treat knuckle dislocation 4.38 7.02 6.50 6.04 5.53 0.826706 A Pin knuckle dislocation 5.31 NA NA 6.77 6.32 0.926715 A Treat knuckle dislocation 7.03 NA NA 8.59 7.95 1.326720 A Treat finger fracture each 1.76 3.56 3.38 3.19 2.96 0.326725 A Treat finger fracture each 3.48 5.67 5.44 4.79 4.50 0.626727 A Treat finger fracture each 5.42 NA NA 7.43 7.10 0.926735 A Treat finger fracture each 7.42 NA NA 8.90 8.20 1.326740 A Treat finger fracture each 2.07 4.19 3.94 3.81 3.55 0.326742 A Treat finger fracture each 3.99 5.90 5.69 4.98 4.75 0.726746 A Treat finger fracture each 9.80 NA NA 10.50 9.51 1.726750 A Treat finger fracture each 1.80 3.11 2.96 3.12 2.90 0.326755 A Treat finger fracture each 3.23 5.18 4.98 4.11 3.88 0.526756 A Pin finger fracture each 4.58 NA NA 6.86 6.55 0.826765 A Treat finger fracture each 5.86 NA NA 7.88 7.16 1.026770 A Treat finger dislocation 3.15 4.09 3.88 3.58 3.31 0.526775 A Treat finger dislocation 3.90 6.46 6.16 5.47 5.12 0.626776 A Pin finger dislocation 4.99 NA NA 7.10 6.79 0.926785 A Treat finger dislocation 6.60 NA NA 8.38 7.58 1.226820 A Thumb fusion with graft 8.45 NA NA 12.62 12.51 1.6
CMS-1582-PN 221 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

26841 A Fusion of thumb 7.35 NA NA 12.32 12.22 1.326842 A Thumb fusion with graft 8.49 NA NA 12.67 12.58 1.626843 A Fusion of hand joint 7.78 NA NA 11.97 11.84 1.526844 A Fusion/graft of hand joint 8.98 NA NA 12.94 12.79 1.726850 A Fusion of knuckle 7.14 NA NA 11.65 11.53 1.226852 A Fusion of knuckle with graft 8.71 NA NA 12.90 12.67 1.426860 A Fusion of finger joint 4.88 NA NA 10.45 10.39 0.826861 A Fusion of finger jnt add-on 1.74 NA NA 1.10 1.03 0.326862 A Fusion/graft of finger joint 7.56 NA NA 12.15 11.96 1.326863 A Fuse/graft added joint 3.89 NA NA 2.32 2.25 0.726910 A Amputate metacarpal bone 7.79 NA NA 11.54 11.32 1.526951 A Amputation of finger/thumb 6.04 NA NA 11.62 11.21 1.126952 A Amputation of finger/thumb 6.48 NA NA 11.03 10.94 1.226989 C Hand/finger surgery 0.00 0.00 0.00 0.00 0.00 0.026990 A Drainage of pelvis lesion 7.95 NA NA 8.91 8.49 1.526991 A Drainage of pelvis bursa 7.06 12.18 11.81 7.15 6.74 1.326992 A Drainage of bone lesion 13.48 NA NA 12.48 11.88 2.627000 A Incision of hip tendon 5.74 NA NA 6.04 5.93 1.027001 A Incision of hip tendon 7.14 NA NA 7.47 7.13 1.427003 A Incision of hip tendon 7.81 NA NA 8.30 7.81 1.527005 A Incision of hip tendon 10.07 NA NA 9.57 9.13 1.927006 A Incision of hip tendons 10.11 NA NA 9.86 9.38 1.927025 A Incision of hip/thigh fascia 12.89 NA NA 11.77 11.02 2.527027 A Buttock fasciotomy 13.04 NA NA 11.40 10.35 0.927030 A Drainage of hip joint 13.65 NA NA 11.52 11.09 2.627033 A Exploration of hip joint 14.11 NA NA 12.19 11.64 2.727035 A Denervation of hip joint 17.37 NA NA 14.47 12.68 3.427036 A Excision of hip joint/muscle 14.38 NA NA 12.86 12.22 2.727040 A Biopsy of soft tissues 2.92 6.35 6.39 2.44 2.43 0.427041 A Biopsy of soft tissues 10.18 NA NA 7.96 7.78 1.8
CMS-1582-PN 222 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27043 A Exc hip pelvis les sc > 3 cm 6.88 NA NA 5.68 5.68 1.427045 A Exc hip/pelv tum deep > 5 cm 11.13 NA NA 8.79 8.79 2.227047 A Exc hip/pelvis les sc < 3 cm 4.94 7.70 8.16 4.76 5.20 1.027048 A Exc hip/pelv tum deep < 5 cm 8.85 NA NA 7.50 6.66 1.827049 A Resect hip/pelv tum < 5 cm 21.55 NA NA 14.88 12.62 4.327050 A Biopsy of sacroiliac joint 4.74 NA NA 6.14 5.27 0.927052 A Biopsy of hip joint 7.42 NA NA 8.15 7.61 1.427054 A Removal of hip joint lining 9.21 NA NA 9.30 8.84 1.827057 A Buttock fasciotomy w/dbrdmt 14.91 NA NA 12.52 11.37 1.027059 A Resect hip/pelv tum > 5 cm 29.35 NA NA 19.17 19.17 5.727060 A Removal of ischial bursa 5.87 NA NA 6.70 6.01 1.127062 A Remove femur lesion/bursa 5.75 NA NA 6.62 6.27 1.127065 A Remove hip bone les super 6.55 NA NA 7.11 6.79 1.227066 A Remove hip bone les deep 11.20 NA NA 10.76 10.22 2.227067 A Remove/graft hip bone lesion 14.72 NA NA 13.25 12.61 2.927070 A Part remove hip bone super 11.56 NA NA 11.47 10.95 2.227071 A Part removal hip bone deep 12.39 NA NA 12.23 11.71 2.427075 A Resect hip tumor 32.71 NA NA 23.19 22.51 6.427076 A Resect hip tum incl acetabul 40.21 NA NA 28.11 22.44 7.927077 A Resect hip tum w/innom bone 45.21 NA NA 31.64 28.61 8.927078 A Rsect hip tum incl femur 32.21 NA NA 23.89 17.82 6.327080 A Removal of tail bone 6.89 NA NA 6.83 6.36 1.427086 A Remove hip foreign body 1.92 4.89 4.84 2.12 2.04 0.327087 A Remove hip foreign body 8.83 NA NA 8.10 7.80 1.727090 A Removal of hip prosthesis 11.69 NA NA 10.75 10.25 2.227091 A Removal of hip prosthesis 24.35 NA NA 18.88 17.81 4.827093 A Injection for hip x-ray 1.30 4.02 4.13 0.66 0.63 0.127095 A Injection for hip x-ray 1.50 5.05 5.14 0.78 0.73 0.127096 A Inject sacroiliac joint 1.40 4.14 3.91 0.68 0.56 0.127097 A Revision of hip tendon 9.27 NA NA 9.16 8.51 1.8
CMS-1582-PN 223 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27098 A Transfer tendon to pelvis 9.32 NA NA 9.44 8.21 1.827100 A Transfer of abdominal muscle 11.35 NA NA 10.98 10.42 2.227105 A Transfer of spinal muscle 12.04 NA NA 11.39 10.84 2.327110 A Transfer of iliopsoas muscle 13.77 NA NA 12.42 11.65 2.727111 A Transfer of iliopsoas muscle 12.60 NA NA 11.73 10.54 2.427120 A Reconstruction of hip socket 19.25 NA NA 15.93 14.91 3.827122 A Reconstruction of hip socket 16.09 NA NA 13.70 13.06 3.127125 A Partial hip replacement 16.64 NA NA 14.02 13.24 3.227130 A Total hip arthroplasty 21.79 NA NA 17.19 16.31 4.227132 A Total hip arthroplasty 25.69 NA NA 19.69 18.74 5.027134 A Revise hip joint replacement 30.28 NA NA 21.62 20.68 5.927137 A Revise hip joint replacement 22.70 NA NA 17.20 16.41 4.427138 A Revise hip joint replacement 23.70 NA NA 17.79 16.97 4.627140 A Transplant femur ridge 12.78 NA NA 11.35 10.89 2.527146 A Incision of hip bone 18.92 NA NA 15.86 14.77 3.727147 A Revision of hip bone 22.07 NA NA 17.74 16.75 4.327151 A Incision of hip bones 24.12 NA NA 18.96 16.93 4.727156 A Revision of hip bones 26.23 NA NA 20.22 18.98 5.127158 A Revision of pelvis 21.04 NA NA 16.90 15.69 4.127161 A Incision of neck of femur 17.89 NA NA 14.94 14.27 3.527165 A Incision/fixation of femur 20.29 NA NA 16.92 15.99 3.927170 A Repair/graft femur head/neck 17.61 NA NA 14.22 13.53 3.427175 A Treat slipped epiphysis 9.38 NA NA 8.65 8.19 1.827176 A Treat slipped epiphysis 12.92 NA NA 11.92 11.25 2.527177 A Treat slipped epiphysis 16.09 NA NA 14.06 13.32 3.127178 A Treat slipped epiphysis 12.92 NA NA 11.92 11.16 2.527179 A Revise head/neck of femur 13.97 NA NA 12.43 11.78 2.727181 A Treat slipped epiphysis 16.18 NA NA 14.23 13.34 3.227185 A Revision of femur epiphysis 9.79 NA NA 6.78 7.05 0.627187 A Reinforce hip bones 14.23 NA NA 12.56 12.01 2.8
CMS-1582-PN 224 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27193 A Treat pelvic ring fracture 6.09 6.64 6.28 6.82 6.43 1.227194 A Treat pelvic ring fracture 10.20 NA NA 8.52 8.34 1.627200 A Treat tail bone fracture 1.92 2.96 2.77 3.16 2.92 0.327202 A Treat tail bone fracture 7.31 NA NA 7.82 8.75 1.427215 I Treat pelvic fracture(s) 10.45 NA NA 6.55 7.37 0.727216 I Treat pelvic ring fracture 15.73 NA NA 9.48 10.56 1.127217 I Treat pelvic ring fracture 14.65 NA NA 9.01 10.18 1.027218 I Treat pelvic ring fracture 20.93 NA NA 11.76 13.01 1.527220 A Treat hip socket fracture 6.83 7.52 7.11 7.39 6.99 1.327222 A Treat hip socket fracture 14.11 NA NA 12.22 11.68 2.727226 A Treat hip wall fracture 15.57 NA NA 13.13 12.08 3.027227 A Treat hip fracture(s) 25.41 NA NA 19.64 18.63 5.027228 A Treat hip fracture(s) 29.33 NA NA 21.92 20.89 5.727230 A Treat thigh fracture 5.81 7.00 6.66 6.91 6.53 1.127232 A Treat thigh fracture 11.72 NA NA 8.85 8.46 2.227235 A Treat thigh fracture 13.00 NA NA 11.63 11.08 2.527236 A Treat thigh fracture 17.61 NA NA 14.78 13.95 3.427238 A Treat thigh fracture 5.75 NA NA 6.63 6.30 1.127240 A Treat thigh fracture 13.81 NA NA 12.00 11.41 2.627244 A Treat thigh fracture 18.18 NA NA 15.15 14.29 3.527245 A Treat thigh fracture 18.18 NA NA 15.17 14.68 3.527246 A Treat thigh fracture 4.83 5.57 5.31 5.62 5.34 0.927248 A Treat thigh fracture 10.78 NA NA 9.30 8.97 2.127250 A Treat hip dislocation 3.82 NA NA 0.98 1.53 0.627252 A Treat hip dislocation 11.03 NA NA 9.33 8.88 2.127253 A Treat hip dislocation 13.58 NA NA 11.87 11.34 2.627254 A Treat hip dislocation 18.94 NA NA 15.26 14.52 3.727256 A Treat hip dislocation 4.28 3.52 3.42 1.78 1.85 0.727257 A Treat hip dislocation 5.38 NA NA 3.57 3.39 0.927258 A Treat hip dislocation 16.18 NA NA 13.86 13.11 3.2
CMS-1582-PN 225 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27259 A Treat hip dislocation 23.26 NA NA 18.78 17.73 4.527265 A Treat hip dislocation 5.24 NA NA 5.28 5.14 0.927266 A Treat hip dislocation 7.78 NA NA 7.95 7.56 1.527267 A Cltx thigh fx 5.50 NA NA 6.23 5.74 1.027268 A Cltx thigh fx w/mnpj 7.12 NA NA 7.44 6.75 1.427269 A Optx thigh fx 18.89 NA NA 14.53 13.34 3.727275 A Manipulation of hip joint 2.32 NA NA 2.53 2.44 0.327280 A Fusion of sacroiliac joint 14.64 NA NA 13.05 12.42 3.027282 A Fusion of pubic bones 11.85 NA NA 11.28 10.10 2.327284 A Fusion of hip joint 25.06 NA NA 18.77 16.60 4.927286 A Fusion of hip joint 25.17 NA NA 19.59 18.64 4.927290 A Amputation of leg at hip 24.55 NA NA 19.43 17.67 4.827295 A Amputation of leg at hip 19.66 NA NA 14.42 13.64 4.027299 C Pelvis/hip joint surgery 0.00 0.00 0.00 0.00 0.00 0.027301 A Drain thigh/knee lesion 6.78 11.38 11.03 6.71 6.35 1.327303 A Drainage of bone lesion 8.63 NA NA 8.66 8.25 1.627305 A Incise thigh tendon & fascia 6.18 NA NA 6.77 6.33 1.227306 A Incision of thigh tendon 4.74 NA NA 5.35 5.20 0.927307 A Incision of thigh tendons 6.06 NA NA 6.92 6.44 1.227310 A Exploration of knee joint 10.00 NA NA 9.78 9.27 1.927323 A Biopsy thigh soft tissues 2.33 5.21 5.06 2.59 2.49 0.427324 A Biopsy thigh soft tissues 5.04 NA NA 5.52 5.20 1.027325 A Neurectomy hamstring 7.20 NA NA 7.86 7.15 1.427326 A Neurectomy popliteal 6.47 NA NA 7.43 6.77 1.227327 A Exc thigh/knee les sc < 3 cm 3.96 8.45 7.92 4.42 4.45 0.827328 A Exc thigh/knee tum deep <5cm 8.85 NA NA 7.75 6.48 1.827329 A Resect thigh/knee tum < 5 cm 15.72 NA NA 12.26 11.56 3.127330 A Biopsy knee joint lining 5.11 NA NA 6.11 5.68 0.927331 A Explore/treat knee joint 6.02 NA NA 6.85 6.53 1.127332 A Removal of knee cartilage 8.46 NA NA 8.88 8.46 1.6
CMS-1582-PN 226 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27333 A Removal of knee cartilage 7.55 NA NA 8.29 7.87 1.527334 A Remove knee joint lining 9.19 NA NA 9.31 8.82 1.827335 A Remove knee joint lining 10.55 NA NA 10.08 9.63 2.027337 A Exc thigh/knee les sc 3+ cm 5.91 NA NA 5.38 5.38 1.227339 A Exc thigh/knee tum deep 5+cm 11.13 NA NA 9.09 9.09 2.227340 A Removal of kneecap bursa 4.32 NA NA 5.76 5.47 0.827345 A Removal of knee cyst 6.09 NA NA 6.91 6.62 1.227347 A Remove knee cyst 6.73 NA NA 7.57 7.12 1.327350 A Removal of kneecap 8.66 NA NA 8.98 8.56 1.627355 A Remove femur lesion 8.00 NA NA 8.28 7.92 1.527356 A Remove femur lesion/graft 10.09 NA NA 9.81 9.36 1.927357 A Remove femur lesion/graft 11.16 NA NA 10.86 10.33 2.227358 A Remove femur lesion/fixation 4.73 NA NA 2.82 2.72 0.927360 A Partial removal leg bone(s) 11.46 NA NA 11.56 11.04 2.227364 A Resect thigh/knee tum 5+ cm 24.49 NA NA 17.23 17.23 4.927365 A Resect femur/knee tumor 32.21 NA NA 23.74 18.72 6.327370 A Injection for knee x-ray 0.96 3.83 3.84 0.51 0.47 0.127372 A Removal of foreign body 5.21 11.37 11.06 5.77 5.51 1.027380 A Repair of kneecap tendon 7.45 NA NA 8.58 8.25 1.427381 A Repair/graft kneecap tendon 10.76 NA NA 10.79 10.37 2.127385 A Repair of thigh muscle 6.93 NA NA 8.72 8.54 1.327386 A Repair/graft of thigh muscle 11.13 NA NA 11.34 10.86 2.127390 A Incision of thigh tendon 5.53 NA NA 6.60 6.24 1.027391 A Incision of thigh tendons 7.49 NA NA 8.10 7.69 1.427392 A Incision of thigh tendons 9.63 NA NA 9.63 9.04 1.827393 A Lengthening of thigh tendon 6.59 NA NA 7.06 6.78 1.227394 A Lengthening of thigh tendons 8.79 NA NA 8.73 8.38 1.727395 A Lengthening of thigh tendons 12.24 NA NA 11.51 10.97 2.427396 A Transplant of thigh tendon 8.15 NA NA 8.49 8.11 1.627397 A Transplants of thigh tendons 12.66 NA NA 12.13 11.45 2.4
CMS-1582-PN 227 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27400 A Revise thigh muscles/tendons 9.33 NA NA 9.45 8.95 1.827403 A Repair of knee cartilage 8.62 NA NA 8.70 8.32 1.627405 A Repair of knee ligament 9.08 NA NA 9.21 8.80 1.827407 A Repair of knee ligament 10.85 NA NA 10.57 9.77 2.127409 A Repair of knee ligaments 13.71 NA NA 12.39 11.77 2.727412 A Autochondrocyte implant knee 24.74 NA NA 19.87 18.79 4.827415 A Osteochondral knee allograft 20.00 NA NA 17.22 16.19 3.927416 A Osteochondral knee autograft 14.16 NA NA 12.36 11.50 2.727418 A Repair degenerated kneecap 11.60 NA NA 10.87 10.41 2.227420 A Revision of unstable kneecap 10.26 NA NA 9.91 9.47 2.027422 A Revision of unstable kneecap 10.21 NA NA 9.88 9.44 1.927424 A Revision/removal of kneecap 10.24 NA NA 9.82 9.43 2.027425 A Lat retinacular release open 5.39 NA NA 6.74 6.42 1.027427 A Reconstruction knee 9.79 NA NA 9.60 9.17 1.927428 A Reconstruction knee 15.58 NA NA 14.53 13.77 3.027429 A Reconstruction knee 17.54 NA NA 16.06 15.28 3.427430 A Revision of thigh muscles 10.16 NA NA 9.84 9.39 1.927435 A Incision of knee joint 10.88 NA NA 10.92 10.36 2.127437 A Revise kneecap 8.93 NA NA 8.94 8.52 1.727438 A Revise kneecap with implant 11.89 NA NA 10.83 10.30 2.327440 A Revision of knee joint 11.09 NA NA 10.49 9.57 2.127441 A Revision of knee joint 11.54 NA NA 10.76 9.78 2.227442 A Revision of knee joint 12.37 NA NA 11.15 10.57 2.427443 A Revision of knee joint 11.41 NA NA 10.68 10.15 2.227445 A Revision of knee joint 18.66 NA NA 15.19 14.49 3.727446 A Revision of knee joint 16.38 NA NA 13.48 12.93 3.227447 A Total knee arthroplasty 23.25 NA NA 18.37 17.49 4.527448 A Incision of thigh 11.60 NA NA 10.51 10.02 2.227450 A Incision of thigh 14.61 NA NA 12.75 12.22 2.927454 A Realignment of thigh bone 19.17 NA NA 16.01 14.94 3.7
CMS-1582-PN 228 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27455 A Realignment of knee 13.36 NA NA 12.13 11.54 2.627457 A Realignment of knee 14.03 NA NA 12.01 11.47 2.727465 A Shortening of thigh bone 18.60 NA NA 15.32 14.19 3.627466 A Lengthening of thigh bone 17.28 NA NA 14.47 13.87 3.427468 A Shorten/lengthen thighs 19.97 NA NA 16.37 15.39 3.927470 A Repair of thigh 17.14 NA NA 14.75 14.05 3.327472 A Repair/graft of thigh 18.72 NA NA 15.45 14.79 3.727475 A Surgery to stop leg growth 8.93 NA NA 6.31 7.18 1.727477 A Surgery to stop leg growth 10.14 NA NA 9.68 9.21 1.927479 A Surgery to stop leg growth 13.16 NA NA 11.73 11.19 0.927485 A Surgery to stop leg growth 9.13 NA NA 9.00 8.59 1.827486 A Revise/replace knee joint 21.12 NA NA 16.98 16.16 4.127487 A Revise/replace knee joint 27.11 NA NA 20.50 19.56 5.327488 A Removal of knee prosthesis 17.60 NA NA 14.90 14.16 3.427495 A Reinforce thigh 16.54 NA NA 13.96 13.34 3.227496 A Decompression of thigh/knee 6.78 NA NA 7.93 7.12 1.327497 A Decompression of thigh/knee 7.79 NA NA 7.95 7.09 1.527498 A Decompression of thigh/knee 8.66 NA NA 9.05 7.84 1.627499 A Decompression of thigh/knee 9.43 NA NA 9.51 8.49 1.827500 A Treatment of thigh fracture 6.30 7.73 7.33 6.67 6.28 1.227501 A Treatment of thigh fracture 6.45 7.18 6.84 7.06 6.68 1.227502 A Treatment of thigh fracture 11.36 NA NA 9.65 9.27 2.127503 A Treatment of thigh fracture 11.27 NA NA 10.49 9.95 2.227506 A Treatment of thigh fracture 19.65 NA NA 16.59 15.71 3.827507 A Treatment of thigh fracture 14.48 NA NA 11.85 11.34 2.827508 A Treatment of thigh fracture 6.20 7.98 7.62 7.14 6.77 1.227509 A Treatment of thigh fracture 8.14 NA NA 9.37 8.99 1.527510 A Treatment of thigh fracture 9.80 NA NA 8.80 8.51 1.827511 A Treatment of thigh fracture 15.11 NA NA 11.90 11.57 2.927513 A Treatment of thigh fracture 19.25 NA NA 14.35 14.02 3.8
CMS-1582-PN 229 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27514 A Treatment of thigh fracture 14.60 NA NA 11.58 11.63 2.827516 A Treat thigh fx growth plate 5.59 8.18 7.67 7.32 6.84 1.127517 A Treat thigh fx growth plate 9.12 NA NA 9.43 8.95 1.827519 A Treat thigh fx growth plate 13.25 NA NA 10.87 10.77 2.627520 A Treat kneecap fracture 3.04 5.70 5.43 4.94 4.62 0.527524 A Treat kneecap fracture 10.37 NA NA 10.00 9.55 2.027530 A Treat knee fracture 2.65 5.74 5.77 5.10 5.10 0.527532 A Treat knee fracture 7.55 9.17 8.71 8.13 7.71 1.427535 A Treat knee fracture 13.41 NA NA 10.89 10.57 2.627536 A Treat knee fracture 17.39 NA NA 14.88 14.10 3.427538 A Treat knee fracture(s) 5.09 7.73 7.36 6.91 6.53 0.927540 A Treat knee fracture 11.30 NA NA 10.72 10.36 2.227550 A Treat knee dislocation 5.98 7.44 7.10 6.46 6.12 1.127552 A Treat knee dislocation 8.18 NA NA 8.79 8.33 1.627556 A Treat knee dislocation 13.00 NA NA 10.72 10.62 2.527557 A Treat knee dislocation 15.90 NA NA 12.45 12.31 3.127558 A Treat knee dislocation 18.39 NA NA 13.93 13.56 3.627560 A Treat kneecap dislocation 3.99 6.34 5.95 5.62 5.10 0.727562 A Treat kneecap dislocation 5.98 NA NA 7.10 6.53 1.127566 A Treat kneecap dislocation 12.71 NA NA 11.36 10.85 2.527570 A Fixation of knee joint 1.79 NA NA 2.30 2.18 0.327580 A Fusion of knee 21.10 NA NA 17.83 17.04 4.127590 A Amputate leg at thigh 13.47 NA NA 8.41 8.08 2.927591 A Amputate leg at thigh 13.94 NA NA 10.13 9.91 2.927592 A Amputate leg at thigh 10.98 NA NA 7.79 7.48 2.327594 A Amputation follow-up surgery 7.29 NA NA 6.42 6.23 1.527596 A Amputation follow-up surgery 11.29 NA NA 8.33 8.04 2.427598 A Amputate lower leg at knee 11.22 NA NA 8.82 8.48 2.327599 C Leg surgery procedure 0.00 0.00 0.00 0.00 0.00 0.027600 A Decompression of lower leg 6.03 NA NA 5.12 5.07 1.2
CMS-1582-PN 230 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27601 A Decompression of lower leg 6.05 NA NA 5.98 5.76 1.227602 A Decompression of lower leg 7.82 NA NA 5.66 5.63 1.727603 A Drain lower leg lesion 5.23 9.60 9.17 5.51 5.21 1.027604 A Drain lower leg bursa 4.59 8.60 8.11 4.68 4.49 0.727605 A Incision of achilles tendon 2.92 6.53 6.78 2.19 2.26 0.327606 A Incision of achilles tendon 4.18 NA NA 3.66 3.58 0.727607 A Treat lower leg bone lesion 8.62 NA NA 8.11 7.72 1.527610 A Explore/treat ankle joint 9.13 NA NA 8.71 8.32 1.627612 A Exploration of ankle joint 8.15 NA NA 7.34 7.07 1.127613 A Biopsy lower leg soft tissue 2.22 4.90 4.75 2.38 2.30 0.327614 A Biopsy lower leg soft tissue 5.80 10.09 9.62 5.28 5.12 1.027615 A Resect leg/ankle tum < 5 cm 15.72 NA NA 12.21 10.98 3.127616 A Resect leg/ankle tum 5+ cm 19.63 NA NA 14.60 14.60 3.927618 A Exc leg/ankle tum < 3 cm 3.96 8.32 8.04 4.38 4.57 0.727619 A Exc leg/ankle tum deep <5 cm 6.91 NA NA 6.31 6.49 1.227620 A Explore/treat ankle joint 6.15 NA NA 6.41 6.18 1.027625 A Remove ankle joint lining 8.49 NA NA 7.31 7.15 1.227626 A Remove ankle joint lining 9.10 NA NA 8.09 7.82 1.527630 A Removal of tendon lesion 4.94 10.59 10.04 5.16 4.99 0.727632 A Exc leg/ankle les sc 3+ cm 5.91 NA NA 5.33 5.33 1.127634 A Exc leg/ankle tum deep 5+ cm 10.13 NA NA 8.13 8.13 1.827635 A Remove lower leg bone lesion 8.03 NA NA 8.13 7.78 1.527637 A Remove/graft leg bone lesion 10.31 NA NA 10.37 9.82 2.027638 A Remove/graft leg bone lesion 10.99 NA NA 9.89 9.56 2.127640 A Partial removal of tibia 12.24 NA NA 10.69 10.48 2.227641 A Partial removal of fibula 9.84 NA NA 8.45 8.34 1.627645 A Resect tibia tumor 27.21 NA NA 21.02 16.69 5.327646 A Resect fibula tumor 23.21 NA NA 18.64 14.73 4.527647 A Resect talus/calcaneus tum 20.26 NA NA 10.84 9.49 2.027648 A Injection for ankle x-ray 0.96 3.62 3.64 0.49 0.46 0.1
CMS-1582-PN 231 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27650 A Repair achilles tendon 9.21 NA NA 9.15 8.80 1.527652 A Repair/graft achilles tendon 10.78 NA NA 8.57 8.50 1.527654 A Repair of achilles tendon 10.53 NA NA 9.15 8.78 1.527656 A Repair leg fascia defect 4.71 12.62 11.28 6.04 5.29 0.927658 A Repair of leg tendon each 5.12 NA NA 5.28 5.13 0.727659 A Repair of leg tendon each 7.10 NA NA 6.42 6.23 0.927664 A Repair of leg tendon each 4.73 NA NA 5.37 5.15 0.727665 A Repair of leg tendon each 5.57 NA NA 5.71 5.58 0.827675 A Repair lower leg tendons 7.35 NA NA 6.16 6.08 1.027676 A Repair lower leg tendons 8.73 NA NA 8.10 7.80 1.727680 A Release of lower leg tendon 5.88 NA NA 6.04 5.77 0.927681 A Release of lower leg tendons 7.05 NA NA 7.74 7.11 1.327685 A Revision of lower leg tendon 6.69 11.82 11.01 6.23 6.06 0.927686 A Revise lower leg tendons 7.75 NA NA 7.46 7.23 1.227687 A Revision of calf tendon 6.41 NA NA 6.19 5.98 0.927690 A Revise lower leg tendon 9.17 NA NA 8.52 8.08 1.327691 A Revise lower leg tendon 10.49 NA NA 10.15 9.66 1.827692 A Revise additional leg tendon 1.87 NA NA 1.05 1.01 0.327695 A Repair of ankle ligament 6.70 NA NA 6.49 6.39 1.027696 A Repair of ankle ligaments 8.58 NA NA 7.00 6.88 1.127698 A Repair of ankle ligament 9.61 NA NA 8.08 7.83 1.527700 A Revision of ankle joint 9.66 NA NA 6.78 6.67 1.227702 A Reconstruct ankle joint 14.42 NA NA 12.13 11.77 2.627703 A Reconstruction ankle joint 16.94 NA NA 13.72 13.29 3.127704 A Removal of ankle implant 7.81 NA NA 7.97 7.49 1.427705 A Incision of tibia 10.86 NA NA 9.91 9.47 2.027707 A Incision of fibula 4.78 NA NA 6.33 6.00 0.927709 A Incision of tibia & fibula 17.48 NA NA 14.60 13.27 3.327712 A Realignment of lower leg 15.87 NA NA 14.05 13.30 3.127715 A Revision of lower leg 15.50 NA NA 12.98 12.54 3.0
CMS-1582-PN 232 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27720 A Repair of tibia 12.36 NA NA 11.37 10.91 2.427722 A Repair/graft of tibia 12.45 NA NA 11.64 10.96 2.427724 A Repair/graft of tibia 19.31 NA NA 15.06 14.39 3.827725 A Repair of lower leg 17.41 NA NA 15.63 14.72 3.427726 A Repair fibula nonunion 14.34 NA NA 12.08 10.88 2.727727 A Repair of lower leg 14.84 NA NA 13.21 11.66 2.927730 A Repair of tibia epiphysis 7.70 NA NA 8.15 7.74 1.527732 A Repair of fibula epiphysis 5.46 NA NA 6.65 5.85 1.027734 A Repair lower leg epiphyses 8.83 NA NA 8.91 7.76 0.627740 A Repair of leg epiphyses 9.61 NA NA 6.73 7.08 1.827742 A Repair of leg epiphyses 10.63 NA NA 8.98 8.07 2.027745 A Reinforce tibia 10.49 NA NA 9.89 9.49 2.027750 A Treatment of tibia fracture 3.37 6.01 5.72 5.23 4.93 0.627752 A Treatment of tibia fracture 6.27 8.34 7.96 7.22 6.86 1.227756 A Treatment of tibia fracture 7.45 NA NA 8.12 7.73 1.427758 A Treatment of tibia fracture 12.54 NA NA 11.61 11.03 2.427759 A Treatment of tibia fracture 14.45 NA NA 12.60 12.03 2.827760 A Cltx medial ankle fx 3.21 5.87 5.60 5.07 4.77 0.527762 A Cltx med ankle fx w/mnpj 5.47 7.57 7.30 6.45 6.20 1.027766 A Optx medial ankle fx 7.89 NA NA 8.74 8.35 1.527767 A Cltx post ankle fx 2.64 5.05 4.65 5.10 4.69 0.527768 A Cltx post ankle fx w/mnpj 5.14 NA NA 6.78 6.10 1.027769 A Optx post ankle fx 10.14 NA NA 9.81 8.80 1.927780 A Treatment of fibula fracture 2.83 5.45 5.15 4.70 4.38 0.527781 A Treatment of fibula fracture 4.59 6.95 6.61 6.11 5.78 0.827784 A Treatment of fibula fracture 9.67 NA NA 9.84 9.15 1.827786 A Treatment of ankle fracture 3.02 5.59 5.33 4.77 4.48 0.527788 A Treatment of ankle fracture 4.64 6.86 6.58 5.87 5.61 0.827792 A Treatment of ankle fracture 8.75 NA NA 8.97 8.79 1.627808 A Treatment of ankle fracture 3.03 6.04 5.77 5.12 4.83 0.5
CMS-1582-PN 233 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27810 A Treatment of ankle fracture 5.32 7.41 7.16 6.26 6.04 1.027814 A Treatment of ankle fracture 10.62 NA NA 10.39 9.94 2.027816 A Treatment of ankle fracture 3.07 5.60 5.28 4.70 4.39 0.527818 A Treatment of ankle fracture 5.69 7.30 7.09 6.00 5.82 1.027822 A Treatment of ankle fracture 11.21 NA NA 11.71 11.36 2.127823 A Treatment of ankle fracture 13.16 NA NA 12.86 12.42 2.527824 A Treat lower leg fracture 3.31 5.18 4.93 4.93 4.64 0.627825 A Treat lower leg fracture 6.69 8.13 7.79 6.75 6.45 1.227826 A Treat lower leg fracture 11.10 NA NA 11.72 11.08 2.127827 A Treat lower leg fracture 14.79 NA NA 14.68 14.11 2.927828 A Treat lower leg fracture 18.43 NA NA 16.80 16.06 3.527829 A Treat lower leg joint 8.80 NA NA 9.84 9.24 1.627830 A Treat lower leg dislocation 3.96 6.37 5.83 5.65 5.14 0.727831 A Treat lower leg dislocation 4.73 NA NA 6.10 5.62 0.927832 A Treat lower leg dislocation 10.17 NA NA 10.31 9.37 1.927840 A Treat ankle dislocation 4.77 NA NA 4.94 4.68 0.827842 A Treat ankle dislocation 6.46 NA NA 7.04 6.58 1.227846 A Treat ankle dislocation 10.28 NA NA 9.63 9.26 1.927848 A Treat ankle dislocation 11.68 NA NA 10.50 10.24 2.227860 A Fixation of ankle joint 2.39 NA NA 2.36 2.32 0.327870 A Fusion of ankle joint open 15.41 NA NA 12.92 12.40 2.827871 A Fusion of tibiofibular joint 9.54 NA NA 9.26 8.87 1.827880 A Amputation of lower leg 15.37 NA NA 9.50 9.03 3.327881 A Amputation of lower leg 13.47 NA NA 10.24 9.97 2.827882 A Amputation of lower leg 9.79 NA NA 6.68 6.63 2.127884 A Amputation follow-up surgery 8.76 NA NA 7.00 6.77 1.827886 A Amputation follow-up surgery 10.02 NA NA 7.90 7.66 2.127888 A Amputation of foot at ankle 10.37 NA NA 8.15 8.11 1.927889 A Amputation of foot at ankle 10.86 NA NA 7.04 7.02 2.427892 A Decompression of leg 7.94 NA NA 7.00 6.64 1.6
CMS-1582-PN 234 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

27893 A Decompression of leg 7.90 NA NA 8.60 7.58 1.627894 A Decompression of leg 12.67 NA NA 10.44 9.97 2.627899 C Leg/ankle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.028001 A Drainage of bursa of foot 2.78 4.98 4.73 1.97 2.01 0.228002 A Treatment of foot infection 4.00 6.94 7.03 3.19 3.47 0.428003 A Treatment of foot infection 9.06 10.94 10.37 6.70 6.43 1.028005 A Treat foot bone lesion 9.44 NA NA 7.11 7.03 1.028008 A Incision of foot fascia 4.59 7.62 7.24 3.67 3.66 0.428010 A Incision of toe tendon 2.97 3.63 3.47 2.97 2.91 0.228011 A Incision of toe tendons 4.28 5.05 4.77 4.04 3.92 0.428020 A Exploration of foot joint 5.15 9.85 9.15 4.83 4.68 0.628022 A Exploration of foot joint 4.81 8.72 8.25 4.17 4.18 0.428024 A Exploration of toe joint 4.52 8.25 7.86 3.91 3.97 0.428035 A Decompression of tibia nerve 5.23 9.46 8.96 4.63 4.59 0.628039 A Exc foot/toe tum sc > 1.5 cm 5.42 8.34 8.34 4.04 4.04 0.528041 A Exc foot/toe tum deep 1.5cm+ 7.13 NA NA 5.27 5.27 0.728043 A Exc foot/toe tum sc < 1.5 cm 3.96 7.50 6.49 3.52 3.48 0.328045 A Exc foot/toe tum deep <1.5cm 5.45 8.86 8.42 4.53 4.30 0.528046 A Resect foot/toe tumor < 3 cm 12.38 NA NA 8.52 7.91 1.628047 A Resect foot/toe tumor > 3 cm 17.45 NA NA 8.52 8.52 1.328050 A Biopsy of foot joint lining 4.39 7.69 7.69 3.55 3.81 0.328052 A Biopsy of foot joint lining 4.06 8.03 7.57 3.66 3.65 0.428054 A Biopsy of toe joint lining 3.57 7.11 7.05 3.11 3.31 0.228055 A Neurectomy foot 6.29 NA NA 4.40 4.36 0.528060 A Partial removal foot fascia 5.40 9.16 8.61 4.58 4.50 0.528062 A Removal of foot fascia 6.69 9.92 9.48 4.80 4.76 0.628070 A Removal of foot joint lining 5.24 9.87 8.99 4.77 4.55 0.528072 A Removal of foot joint lining 4.72 9.77 9.16 4.67 4.66 0.628080 A Removal of foot lesion 4.86 9.83 9.13 5.38 5.14 0.428086 A Excise foot tendon sheath 4.92 10.22 9.77 5.01 4.91 0.7
CMS-1582-PN 235 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

28088 A Excise foot tendon sheath 3.98 9.81 9.00 4.56 4.37 0.528090 A Removal of foot lesion 4.55 8.70 8.17 4.08 4.01 0.428092 A Removal of toe lesions 3.78 8.31 7.83 3.85 3.80 0.328100 A Removal of ankle/heel lesion 5.83 10.80 10.32 5.41 5.29 0.728102 A Remove/graft foot lesion 7.92 NA NA 8.50 7.78 0.628103 A Remove/graft foot lesion 6.67 NA NA 4.44 4.90 0.528104 A Removal of foot lesion 5.26 9.19 8.66 4.39 4.36 0.528106 A Remove/graft foot lesion 7.35 NA NA 4.81 5.05 0.528107 A Remove/graft foot lesion 5.73 8.96 9.07 4.16 4.46 0.428108 A Removal of toe lesions 4.30 8.08 7.58 3.78 3.73 0.328110 A Part removal of metatarsal 4.22 8.83 8.31 3.89 3.82 0.428111 A Part removal of metatarsal 5.15 9.18 8.78 4.18 4.13 0.628112 A Part removal of metatarsal 4.63 9.29 8.77 4.20 4.13 0.528113 A Part removal of metatarsal 6.11 10.76 10.08 5.94 5.73 0.628114 A Removal of metatarsal heads 12.00 17.97 16.85 11.25 10.73 1.628116 A Revision of foot 9.14 12.17 11.31 6.86 6.61 0.928118 A Removal of heel bone 6.13 10.43 9.81 5.33 5.21 0.728119 A Removal of heel spur 5.56 9.25 8.68 4.56 4.47 0.528120 A Part removal of ankle/heel 7.31 11.86 11.19 6.46 6.05 1.028122 A Partial removal of foot bone 6.76 10.37 10.13 5.58 5.63 0.728124 A Partial removal of toe 5.00 8.53 8.06 4.33 4.29 0.428126 A Partial removal of toe 3.64 7.55 7.09 3.35 3.34 0.328130 A Removal of ankle bone 9.50 NA NA 10.25 8.91 1.828140 A Removal of metatarsal 7.14 9.84 9.56 5.22 5.23 0.928150 A Removal of toe 4.23 8.09 7.63 3.79 3.74 0.428153 A Partial removal of toe 3.80 7.96 7.42 3.69 3.57 0.328160 A Partial removal of toe 3.88 8.10 7.59 3.75 3.72 0.328171 A Resect tarsal tumor 16.41 NA NA 7.68 7.05 1.228173 A Resect metatarsal tumor 14.16 NA NA 7.45 6.65 1.528175 A Resect phalanx of toe tumor 8.29 NA NA 5.56 5.00 0.8
CMS-1582-PN 236 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

28190 A Removal of foot foreign body 2.01 5.20 4.92 1.75 1.71 0.228192 A Removal of foot foreign body 4.78 8.58 8.12 4.08 4.04 0.428193 A Removal of foot foreign body 5.90 9.18 8.73 4.53 4.50 0.528200 A Repair of foot tendon 4.74 8.77 8.24 4.09 4.06 0.428202 A Repair/graft of foot tendon 7.07 9.48 9.34 4.73 4.85 0.628208 A Repair of foot tendon 4.51 8.72 8.12 4.15 4.03 0.428210 A Repair/graft of foot tendon 6.52 9.60 9.16 4.91 4.86 0.628220 A Release of foot tendon 4.67 8.05 7.60 3.82 3.82 0.428222 A Release of foot tendons 5.76 8.74 8.26 4.18 4.22 0.528225 A Release of foot tendon 3.78 7.54 7.06 3.37 3.33 0.328226 A Release of foot tendons 4.67 8.89 8.31 4.19 4.17 0.328230 A Incision of foot tendon(s) 4.36 7.85 7.44 3.57 3.64 0.328232 A Incision of toe tendon 3.51 7.60 7.15 3.41 3.43 0.328234 A Incision of foot tendon 3.54 8.18 7.65 3.97 3.90 0.328238 A Revision of foot tendon 7.96 11.09 10.44 5.78 5.65 0.828240 A Release of big toe 4.48 7.94 7.58 3.65 3.72 0.428250 A Revision of foot fascia 6.06 10.08 9.37 5.13 4.99 0.728260 A Release of midfoot joint 8.19 11.47 10.49 6.32 6.02 1.028261 A Revision of foot tendon 13.11 14.07 13.22 8.35 8.22 1.228262 A Revision of foot and ankle 17.21 21.00 19.62 13.47 12.92 3.028264 A Release of midfoot joint 10.65 16.92 14.59 10.17 9.12 0.828270 A Release of foot contracture 4.93 9.04 8.39 4.49 4.39 0.528272 A Release of toe joint each 3.92 7.27 6.87 3.27 3.26 0.328280 A Fusion of toes 5.33 9.31 8.90 4.50 4.56 0.628285 A Repair of hammertoe 4.76 9.32 8.80 4.63 4.46 0.428286 A Repair of hammertoe 4.70 8.28 7.78 3.85 3.80 0.328288 A Partial removal of foot bone 6.02 11.29 10.40 6.19 5.96 0.628289 A Repair hallux rigidus 8.31 12.41 11.66 7.06 6.84 1.028290 A Correction of bunion 5.83 10.77 10.01 5.23 5.14 0.628292 A Correction of bunion 9.05 13.35 12.49 7.94 7.62 0.8
CMS-1582-PN 237 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

28293 A Correction of bunion 11.48 18.18 17.20 8.63 8.38 0.928294 A Correction of bunion 8.75 11.60 11.20 5.77 5.79 0.928296 A Correction of bunion 8.35 11.87 11.37 6.35 6.29 0.728297 A Correction of bunion 9.43 13.59 12.89 6.94 6.88 1.128298 A Correction of bunion 8.13 12.21 11.43 6.03 5.90 0.828299 A Correction of bunion 11.57 13.70 12.99 7.42 7.29 1.128300 A Incision of heel bone 9.73 NA NA 8.42 8.12 1.628302 A Incision of ankle bone 9.74 NA NA 9.63 8.68 1.928304 A Incision of midfoot bones 9.41 13.22 12.24 7.13 6.84 1.228305 A Incise/graft midfoot bones 10.77 NA NA 7.64 7.69 0.828306 A Incision of metatarsal 6.00 11.36 10.59 5.31 5.12 0.828307 A Incision of metatarsal 6.50 12.49 12.41 5.92 5.92 1.228308 A Incision of metatarsal 5.48 10.39 9.67 5.03 4.84 0.628309 A Incision of metatarsals 14.16 NA NA 10.56 9.96 2.128310 A Revision of big toe 5.57 9.78 9.16 4.42 4.31 0.528312 A Revision of toe 4.69 9.57 8.96 4.19 4.14 0.528313 A Repair deformity of toe 5.15 9.77 9.10 4.88 4.91 0.628315 A Removal of sesamoid bone 5.00 8.48 7.96 4.06 4.00 0.428320 A Repair of foot bones 9.37 NA NA 7.47 7.34 1.328322 A Repair of metatarsals 8.53 13.35 12.51 7.40 7.13 1.328340 A Resect enlarged toe tissue 7.15 9.34 9.17 4.58 4.72 0.528341 A Resect enlarged toe 8.72 10.41 10.08 5.25 5.33 0.628344 A Repair extra toe(s) 4.40 7.81 8.08 3.63 3.94 0.328345 A Repair webbed toe(s) 6.09 8.79 8.89 4.27 4.64 0.428360 A Reconstruct cleft foot 14.92 NA NA 14.46 12.51 3.128400 A Treatment of heel fracture 2.31 4.53 4.34 3.94 3.76 0.328405 A Treatment of heel fracture 4.74 6.20 5.82 5.17 4.94 0.628406 A Treatment of heel fracture 6.56 NA NA 7.81 7.54 1.128415 A Treat heel fracture 16.19 NA NA 14.37 13.98 2.828420 A Treat/graft heel fracture 17.52 NA NA 16.46 15.10 3.4
CMS-1582-PN 238 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

28430 A Treatment of ankle fracture 2.22 4.25 4.04 3.53 3.31 0.328435 A Treatment of ankle fracture 3.54 6.27 5.54 5.21 4.66 0.628436 A Treatment of ankle fracture 4.90 NA NA 7.30 6.84 0.928445 A Treat ankle fracture 15.76 NA NA 13.08 12.62 2.728446 A Osteochondral talus autogrft 17.71 NA NA 15.45 14.26 3.528450 A Treat midfoot fracture each 2.03 3.92 3.75 3.27 3.10 0.328455 A Treat midfoot fracture each 3.24 4.97 4.68 4.13 3.98 0.428456 A Treat midfoot fracture 2.86 NA NA 6.08 5.32 0.528465 A Treat midfoot fracture each 8.80 NA NA 8.04 7.75 1.228470 A Treat metatarsal fracture 2.03 3.80 3.65 3.22 3.06 0.328475 A Treat metatarsal fracture 3.01 4.12 3.99 3.31 3.29 0.328476 A Treat metatarsal fracture 3.60 NA NA 6.04 5.80 0.528485 A Treat metatarsal fracture 7.44 NA NA 7.40 7.08 0.928490 A Treat big toe fracture 1.17 2.82 2.66 2.26 2.14 0.128495 A Treat big toe fracture 1.68 3.31 3.10 2.51 2.42 0.228496 A Treat big toe fracture 2.48 9.83 9.43 4.01 3.83 0.328505 A Treat big toe fracture 7.44 11.34 10.75 6.51 6.08 0.928510 A Treatment of toe fracture 1.17 2.25 2.11 2.15 2.03 0.128515 A Treatment of toe fracture 1.56 2.92 2.75 2.39 2.31 0.128525 A Treat toe fracture 5.62 10.43 9.89 5.57 5.21 0.728530 A Treat sesamoid bone fracture 1.11 2.17 2.03 1.79 1.72 0.128531 A Treat sesamoid bone fracture 2.57 7.20 7.32 2.60 2.58 0.528540 A Treat foot dislocation 2.19 3.52 3.33 2.95 2.85 0.228545 A Treat foot dislocation 2.60 5.48 4.70 4.54 3.95 0.528546 A Treat foot dislocation 3.40 12.53 10.94 5.85 5.25 0.628555 A Repair foot dislocation 9.65 14.60 13.84 8.65 8.18 1.628570 A Treat foot dislocation 1.76 2.85 2.84 2.19 2.26 0.128575 A Treat foot dislocation 3.49 6.46 5.84 5.48 5.03 0.628576 A Treat foot dislocation 4.60 NA NA 6.14 5.43 0.928585 A Repair foot dislocation 11.13 14.46 13.66 8.73 8.51 1.6
CMS-1582-PN 239 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

28600 A Treat foot dislocation 2.02 4.11 3.85 3.24 3.10 0.228605 A Treat foot dislocation 2.89 4.96 4.61 4.19 3.97 0.528606 A Treat foot dislocation 5.09 NA NA 5.70 5.42 0.828615 A Repair foot dislocation 10.70 NA NA 11.03 10.50 1.728630 A Treat toe dislocation 1.75 2.53 2.34 1.26 1.20 0.228635 A Treat toe dislocation 1.96 3.09 2.89 1.82 1.76 0.228636 A Treat toe dislocation 2.77 4.42 4.67 1.98 2.28 0.328645 A Repair toe dislocation 7.44 10.81 9.96 5.98 5.63 0.828660 A Treat toe dislocation 1.28 1.83 1.70 1.11 1.04 0.228665 A Treat toe dislocation 1.97 2.38 2.24 1.73 1.69 0.228666 A Treat toe dislocation 2.66 NA NA 3.08 2.77 0.528675 A Repair of toe dislocation 5.62 10.64 10.21 5.77 5.48 0.728705 A Fusion of foot bones 20.33 NA NA 14.90 14.40 3.428715 A Fusion of foot bones 13.42 NA NA 12.12 11.74 2.228725 A Fusion of foot bones 12.18 NA NA 9.57 9.21 1.828730 A Fusion of foot bones 12.42 NA NA 10.86 10.35 1.928735 A Fusion of foot bones 12.23 NA NA 9.70 9.31 1.728737 A Revision of foot bones 11.03 NA NA 7.75 7.74 1.228740 A Fusion of foot bones 9.29 14.62 13.90 8.17 7.83 1.328750 A Fusion of big toe joint 8.57 14.51 13.99 8.04 7.78 1.328755 A Fusion of big toe joint 4.88 9.36 8.90 4.32 4.27 0.528760 A Fusion of big toe joint 9.14 13.36 12.43 7.18 6.89 1.028800 A Amputation of midfoot 8.79 NA NA 6.55 6.47 1.328805 A Amputation thru metatarsal 12.71 NA NA 7.80 7.53 2.128810 A Amputation toe & metatarsal 6.64 NA NA 5.36 5.24 1.128820 A Amputation of toe 5.82 10.40 10.02 5.24 4.99 0.828825 A Partial amputation of toe 5.37 10.28 9.99 5.08 4.98 0.728890 A High energy eswt plantar f 3.45 6.21 6.04 3.02 2.84 0.328899 C Foot/toes surgery procedure 0.00 0.00 0.00 0.00 0.00 0.029000 A Application of body cast 2.25 6.97 5.94 2.76 2.46 0.1
CMS-1582-PN 240 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

29010 A Application of body cast 2.06 6.87 5.64 2.65 2.30 0.329015 A Application of body cast 2.41 4.11 3.99 1.91 1.84 0.429020 A Application of body cast 2.11 3.89 3.91 1.52 1.58 0.029025 A Application of body cast 2.40 4.25 4.30 1.98 2.05 0.429035 A Application of body cast 1.77 5.22 4.96 2.15 2.03 0.329040 A Application of body cast 2.22 4.43 4.13 1.98 1.89 0.429044 A Application of body cast 2.12 5.72 5.27 2.45 2.29 0.429046 A Application of body cast 2.41 4.53 4.81 2.05 2.24 0.429049 A Application of figure eight 0.89 1.80 1.58 1.01 0.85 0.129055 A Application of shoulder cast 1.78 4.29 3.98 1.99 1.85 0.329058 A Application of shoulder cast 1.31 1.23 1.38 0.79 0.80 0.229065 A Application of long arm cast 0.87 1.74 1.66 0.99 0.94 0.129075 A Application of forearm cast 0.77 1.68 1.60 0.93 0.88 0.129085 A Apply hand/wrist cast 0.87 1.74 1.65 0.98 0.91 0.129086 A Apply finger cast 0.62 1.55 1.41 0.81 0.74 0.029105 A Apply long arm splint 0.87 1.49 1.43 0.75 0.70 0.129125 A Apply forearm splint 0.50 1.31 1.27 0.58 0.56 0.029126 A Apply forearm splint 0.68 1.49 1.42 0.65 0.63 0.129130 A Application of finger splint 0.50 0.61 0.58 0.28 0.26 0.029131 A Application of finger splint 0.55 0.88 0.83 0.37 0.34 0.029200 A Strapping of chest 0.65 0.86 0.81 0.49 0.45 0.029240 A Strapping of shoulder 0.71 0.88 0.87 0.51 0.49 0.029260 A Strapping of elbow or wrist 0.55 0.90 0.86 0.51 0.47 0.029280 A Strapping of hand or finger 0.51 0.91 0.87 0.52 0.47 0.029305 A Application of hip cast 2.03 4.71 4.41 2.30 2.18 0.329325 A Application of hip casts 2.32 5.14 4.82 2.54 2.41 0.429345 A Application of long leg cast 1.40 2.29 2.18 1.34 1.28 0.229355 A Application of long leg cast 1.53 2.32 2.18 1.38 1.31 0.229358 A Apply long leg cast brace 1.43 2.94 2.73 1.39 1.31 0.229365 A Application of long leg cast 1.18 2.17 2.06 1.21 1.16 0.2
CMS-1582-PN 241 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

29405 A Apply short leg cast 0.80 1.50 1.47 0.86 0.84 0.129425 A Apply short leg cast 0.80 1.41 1.42 0.77 0.78 0.129435 A Apply short leg cast 1.18 2.04 1.96 1.11 1.08 0.229440 A Addition of walker to cast 0.57 0.66 0.73 0.25 0.28 0.029445 A Apply rigid leg cast 1.78 2.07 2.02 1.19 1.15 0.229450 A Application of leg cast 2.08 1.91 1.88 1.06 1.10 0.229505 A Application long leg splint 0.69 1.46 1.39 0.63 0.59 0.129515 A Application lower leg splint 0.73 1.25 1.21 0.62 0.60 0.129520 A Strapping of hip 0.54 0.85 0.83 0.47 0.46 0.029530 A Strapping of knee 0.57 0.90 0.86 0.50 0.46 0.029540 A Strapping of ankle and/or ft 0.32 0.62 0.62 0.32 0.34 0.029550 A Strapping of toes 0.15 0.62 0.62 0.27 0.31 0.029580 A Application of paste boot 0.55 0.92 0.88 0.44 0.43 0.029581 A Apply multlay comprs lwr leg 0.60 2.03 2.03 0.27 0.27 0.029590 A Application of foot splint 0.76 0.74 0.71 0.31 0.32 0.029700 A Removal/revision of cast 0.57 1.25 1.19 0.36 0.34 0.129705 A Removal/revision of cast 0.76 1.07 1.02 0.53 0.50 0.129710 A Removal/revision of cast 1.34 2.02 1.86 0.92 0.85 0.229715 A Removal/revision of cast 0.94 1.31 1.38 0.53 0.53 0.129720 A Repair of body cast 0.68 1.61 1.51 0.51 0.48 0.129730 A Windowing of cast 0.75 1.03 0.98 0.49 0.46 0.129740 A Wedging of cast 1.12 1.30 1.29 0.59 0.59 0.129750 A Wedging of clubfoot cast 1.26 1.46 1.40 0.78 0.74 0.229799 C Casting/strapping procedure 0.00 0.00 0.00 0.00 0.00 0.029800 A Jaw arthroscopy/surgery 6.84 NA NA 7.45 7.09 1.329804 A Jaw arthroscopy/surgery 8.87 NA NA 9.14 8.47 1.729805 A Shoulder arthroscopy dx 6.03 NA NA 6.77 6.47 1.129806 A Shoulder arthroscopy/surgery 15.14 NA NA 13.55 12.96 2.929807 A Shoulder arthroscopy/surgery 14.67 NA NA 13.42 12.79 2.829819 A Shoulder arthroscopy/surgery 7.79 NA NA 8.13 7.78 1.5
CMS-1582-PN 242 

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HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

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Implemented 

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RVUs2

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2011 

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PE 

RVUs2

Ma

Pract

RVU

29820 A Shoulder arthroscopy/surgery 7.21 NA NA 7.42 7.12 1.429821 A Shoulder arthroscopy/surgery 7.89 NA NA 8.12 7.78 1.529822 A Shoulder arthroscopy/surgery 7.60 NA NA 7.96 7.64 1.529823 A Shoulder arthroscopy/surgery 8.36 NA NA 8.62 8.28 1.629824 A Shoulder arthroscopy/surgery 8.98 NA NA 9.31 8.90 1.729825 A Shoulder arthroscopy/surgery 7.79 NA NA 8.07 7.74 1.529826 A Shoulder arthroscopy/surgery 9.16 NA NA 8.87 8.52 1.829827 A Arthroscop rotator cuff repr 15.59 NA NA 13.50 12.98 3.029828 A Arthroscopy biceps tenodesis 13.16 NA NA 11.81 11.09 2.529830 A Elbow arthroscopy 5.88 NA NA 6.45 6.16 1.129834 A Elbow arthroscopy/surgery 6.42 NA NA 6.98 6.68 1.229835 A Elbow arthroscopy/surgery 6.62 NA NA 7.14 6.82 1.229836 A Elbow arthroscopy/surgery 7.72 NA NA 8.09 7.75 1.529837 A Elbow arthroscopy/surgery 7.01 NA NA 7.36 7.04 1.329838 A Elbow arthroscopy/surgery 7.88 NA NA 8.23 7.86 1.529840 A Wrist arthroscopy 5.68 NA NA 6.58 6.28 1.129843 A Wrist arthroscopy/surgery 6.15 NA NA 6.97 6.66 1.229844 A Wrist arthroscopy/surgery 6.51 NA NA 7.17 6.77 1.129845 A Wrist arthroscopy/surgery 7.69 NA NA 8.14 7.64 1.329846 A Wrist arthroscopy/surgery 6.89 NA NA 7.44 7.06 1.229847 A Wrist arthroscopy/surgery 7.22 NA NA 7.49 7.18 1.429848 A Wrist endoscopy/surgery 6.39 NA NA 7.64 7.16 1.129850 A Knee arthroscopy/surgery 8.27 NA NA 8.64 7.55 1.629851 A Knee arthroscopy/surgery 13.26 NA NA 11.99 11.42 2.629855 A Tibial arthroscopy/surgery 10.76 NA NA 10.54 10.08 2.129856 A Tibial arthroscopy/surgery 14.28 NA NA 12.71 12.15 2.829860 A Hip arthroscopy dx 9.00 NA NA 9.07 8.49 1.729861 A Hip arthro w/fb removal 10.10 NA NA 9.73 9.14 1.929862 A Hip arthr0 w/debridement 11.17 NA NA 11.04 10.44 2.129863 A Hip arthr0 w/synovectomy 11.17 NA NA 10.98 10.36 2.2
CMS-1582-PN 243 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

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RVUs2

Year 

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RVUs2

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Ma

Pract

RVU

29866 A Autgrft implnt knee w/scope 14.67 NA NA 13.76 13.07 2.929867 A Allgrft implnt knee w/scope 18.39 NA NA 16.26 15.30 3.629868 A Meniscal trnspl knee w/scpe 25.10 NA NA 20.26 19.12 4.929870 A Knee arthroscopy dx 5.19 10.79 10.79 6.02 5.73 1.029871 A Knee arthroscopy/drainage 6.69 NA NA 7.27 6.92 1.329873 A Knee arthroscopy/surgery 6.24 NA NA 8.02 7.64 1.229874 A Knee arthroscopy/surgery 7.19 NA NA 7.45 7.10 1.429875 A Knee arthroscopy/surgery 6.45 NA NA 7.01 6.70 1.229876 A Knee arthroscopy/surgery 8.87 NA NA 8.97 8.50 1.729877 A Knee arthroscopy/surgery 8.30 NA NA 8.63 8.18 1.629879 A Knee arthroscopy/surgery 8.99 NA NA 9.02 8.56 1.729880 A Knee arthroscopy/surgery 9.45 NA NA 9.31 8.84 1.829881 A Knee arthroscopy/surgery 8.71 NA NA 8.87 8.41 1.729882 A Knee arthroscopy/surgery 9.60 NA NA 9.37 8.86 1.829883 A Knee arthroscopy/surgery 11.77 NA NA 10.97 10.50 2.329884 A Knee arthroscopy/surgery 8.28 NA NA 8.60 8.15 1.629885 A Knee arthroscopy/surgery 10.21 NA NA 10.20 9.66 2.029886 A Knee arthroscopy/surgery 8.49 NA NA 8.77 8.31 1.629887 A Knee arthroscopy/surgery 10.16 NA NA 10.11 9.58 1.929888 A Knee arthroscopy/surgery 14.30 NA NA 12.47 11.90 2.829889 A Knee arthroscopy/surgery 17.41 NA NA 15.61 14.86 3.429891 A Ankle arthroscopy/surgery 9.67 NA NA 9.22 8.88 1.629892 A Ankle arthroscopy/surgery 10.27 NA NA 6.15 7.18 2.029893 A Scope plantar fasciotomy 6.32 11.00 10.39 5.77 5.59 0.529894 A Ankle arthroscopy/surgery 7.35 NA NA 6.86 6.50 1.229895 A Ankle arthroscopy/surgery 7.13 NA NA 6.39 6.15 1.129897 A Ankle arthroscopy/surgery 7.32 NA NA 6.72 6.54 1.229898 A Ankle arthroscopy/surgery 8.49 NA NA 7.24 7.00 1.229899 A Ankle arthroscopy/surgery 15.41 NA NA 12.93 12.42 2.829900 A Mcp joint arthroscopy dx 5.88 NA NA 7.56 6.83 0.4
CMS-1582-PN 244 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

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Implemented 

Facility 

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RVUs2

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2011 

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RVUs2

Ma

Pract

RVU

29901 A Mcp joint arthroscopy surg 6.59 NA NA 7.87 7.17 1.229902 A Mcp joint arthroscopy surg 7.16 NA NA 5.74 6.24 2.529904 A Subtalar arthro w/fb rmvl 8.65 NA NA 8.64 8.05 1.629905 A Subtalar arthro w/exc 9.18 NA NA 9.54 8.89 1.829906 A Subtalar arthro w/deb 9.65 NA NA 10.06 9.38 1.829907 A Subtalar arthro w/fusion 12.18 NA NA 11.57 10.79 2.429914 A Hip arthro w/femoroplasty 14.67 NA NA 12.74 12.74 2.929915 A Hip arthro acetabuloplasty 15.00 NA NA 12.94 12.94 2.929916 A Hip arthro w/labral repair 15.00 NA NA 12.94 12.94 2.929999 C Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.030000 A Drainage of nose lesion 1.48 5.13 5.04 1.90 1.80 0.230020 A Drainage of nose lesion 1.48 5.24 4.99 1.94 1.83 0.2

3006F I Cxr doc rev 0.00 0.00 0.00 0.00 0.00 0.03008F I Body mass index docd 0.00 0.00 0.00 0.00 0.00 0.0

30100 A Intranasal biopsy 0.94 3.17 3.06 1.02 0.99 0.130110 A Removal of nose polyp(s) 1.68 4.97 4.76 2.06 1.95 0.230115 A Removal of nose polyp(s) 4.44 NA NA 7.97 7.62 0.530117 A Removal of intranasal lesion 3.26 22.07 21.25 6.46 6.19 0.430118 A Removal of intranasal lesion 9.92 NA NA 11.99 11.38 1.3

3011F I Lipid panel doc rev 0.00 0.00 0.00 0.00 0.00 0.0

30120 A Revision of nose 5.39 9.28 8.97 6.99 6.85 0.830124 A Removal of nose lesion 3.20 NA NA 4.66 4.41 0.430125 A Removal of nose lesion 7.30 NA NA 10.18 9.75 0.930130 A Excise inferior turbinate 3.47 NA NA 7.46 7.17 0.430140 A Resect inferior turbinate 3.57 NA NA 9.12 8.75 0.430150 A Partial removal of nose 9.55 NA NA 12.31 11.98 1.4

3015F I Cerv cancer screen docd 0.00 0.00 0.00 0.00 0.00 0.0

30160 A Removal of nose 9.99 NA NA 12.22 11.75 1.2

3018F I Pre-prxd rsk et al docd 0.00 0.00 0.00 0.00 0.00 0.0

30200 A Injection treatment of nose 0.78 2.52 2.42 0.94 0.89 0.1
CMS-1582-PN 245 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

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2011 

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Implemented 

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RVUs2

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2011 

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Ma

Pract

RVU

30210 A Nasal sinus therapy 1.13 3.21 3.08 1.74 1.66 0.130220 A Insert nasal septal button 1.59 7.20 6.89 2.01 1.91 0.230300 A Remove nasal foreign body 1.09 5.51 5.41 2.52 2.40 0.130310 A Remove nasal foreign body 2.01 NA NA 3.89 3.75 0.230320 A Remove nasal foreign body 4.64 NA NA 8.36 8.03 0.6

3035F I O2 saturation<=88% /pao<=55 0.00 0.00 0.00 0.00 0.00 0.03037F I O2 saturation> 88% /pao>55 0.00 0.00 0.00 0.00 0.00 0.0

30400 R Reconstruction of nose 10.86 NA NA 18.13 17.84 1.3

3040F I Fev<40% predicted value 0.00 0.00 0.00 0.00 0.00 0.0

30410 R Reconstruction of nose 14.00 NA NA 19.98 19.59 1.830420 R Reconstruction of nose 16.90 NA NA 22.17 21.20 2.4

3042F I Fev>=40% predicted value 0.00 0.00 0.00 0.00 0.00 0.0

30430 R Revision of nose 8.24 NA NA 16.60 16.81 1.630435 R Revision of nose 12.73 NA NA 22.18 21.08 1.630450 R Revision of nose 19.66 NA NA 23.30 23.00 2.530460 A Revision of nose 10.32 NA NA 10.59 10.24 2.030462 A Revision of nose 20.28 NA NA 23.40 21.76 4.030465 A Repair nasal stenosis 12.36 NA NA 15.66 14.83 1.730520 A Repair of nasal septum 7.01 NA NA 10.94 10.21 0.930540 A Repair nasal defect 7.92 NA NA 11.84 11.05 1.030545 A Repair nasal defect 11.62 NA NA 12.24 13.07 0.830560 A Release of nasal adhesions 1.31 6.53 6.39 2.67 2.59 0.130580 A Repair upper jaw fistula 6.88 11.40 10.69 7.54 6.90 0.830600 A Repair mouth/nose fistula 6.16 10.31 9.89 6.15 5.84 0.730620 A Intranasal reconstruction 6.16 NA NA 11.59 11.17 0.830630 A Repair nasal septum defect 7.29 NA NA 10.62 10.11 0.9

3073F I Pre-surg eye measures docd 0.00 0.00 0.00 0.00 0.00 0.0

30801 A Ablate inf turbinate superf 1.14 5.44 5.32 2.79 2.67 0.130802 A Ablate inf turbinate submuc 2.08 6.30 6.12 3.39 3.22 0.2

3088F I Mdd mild 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 246 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

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RVUs2

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2011 

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Ma

Pract

RVU

3089F I Mdd moderate 0.00 0.00 0.00 0.00 0.00 0.0

30901 A Control of nosebleed 1.10 1.54 1.56 0.46 0.43 0.130903 A Control of nosebleed 1.54 4.21 4.00 0.70 0.63 0.230905 A Control of nosebleed 1.97 5.13 4.89 0.83 0.78 0.330906 A Repeat control of nosebleed 2.45 5.55 5.33 1.30 1.21 0.3

3090F I Mdd severe w/o psych 0.00 0.00 0.00 0.00 0.00 0.0

30915 A Ligation nasal sinus artery 7.44 NA NA 9.07 8.57 0.9

3091F I Mdd severe w/psych 0.00 0.00 0.00 0.00 0.00 0.0

30920 A Ligation upper jaw artery 11.14 NA NA 12.75 11.93 1.430930 A Ther fx nasal inf turbinate 1.31 NA NA 2.24 2.12 0.1

3093F I Doc new diag 1st/addl mdd 0.00 0.00 0.00 0.00 0.00 0.0

30999 C Nasal surgery procedure 0.00 0.00 0.00 0.00 0.00 0.031000 A Irrigation maxillary sinus 1.20 4.03 3.91 1.81 1.74 0.131002 A Irrigation sphenoid sinus 1.96 NA NA 3.76 3.67 0.231020 A Exploration maxillary sinus 3.07 10.77 10.60 7.17 6.92 0.331030 A Exploration maxillary sinus 6.01 13.68 13.39 8.96 8.51 0.731032 A Explore sinus remove polyps 6.69 NA NA 9.69 9.20 0.831040 A Exploration behind upper jaw 9.77 NA NA 11.50 10.87 1.331050 A Exploration sphenoid sinus 5.37 NA NA 8.55 8.29 0.631051 A Sphenoid sinus surgery 7.25 NA NA 11.29 10.76 0.931070 A Exploration of frontal sinus 4.40 NA NA 8.21 7.86 0.531075 A Exploration of frontal sinus 9.51 NA NA 12.92 12.31 1.231080 A Removal of frontal sinus 12.74 NA NA 16.83 15.63 1.631081 A Removal of frontal sinus 14.19 NA NA 24.08 21.30 5.031084 A Removal of frontal sinus 14.95 NA NA 18.13 17.51 1.931085 A Removal of frontal sinus 15.64 NA NA 18.53 18.10 5.631086 A Removal of frontal sinus 14.36 NA NA 17.78 16.79 1.831087 A Removal of frontal sinus 14.57 NA NA 16.43 15.66 1.831090 A Exploration of sinuses 11.17 NA NA 18.19 17.20 1.431200 A Removal of ethmoid sinus 5.14 NA NA 10.57 10.15 0.7
CMS-1582-PN 247 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

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Implemented 

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RVUs2

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2011 

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RVUs2

Ma

Pract

RVU

31201 A Removal of ethmoid sinus 8.60 NA NA 12.49 11.81 1.131205 A Removal of ethmoid sinus 10.58 NA NA 14.55 13.61 1.531225 A Removal of upper jaw 26.70 NA NA 26.67 24.55 3.531230 A Removal of upper jaw 30.82 NA NA 28.72 26.37 3.931231 A Nasal endoscopy dx 1.10 4.46 4.37 1.12 1.06 0.131233 A Nasal/sinus endoscopy dx 2.18 5.47 5.34 1.75 1.64 0.231235 A Nasal/sinus endoscopy dx 2.64 5.97 5.88 1.99 1.87 0.331237 A Nasal/sinus endoscopy surg 2.98 6.37 6.22 2.23 2.07 0.331238 A Nasal/sinus endoscopy surg 3.26 6.34 6.19 2.39 2.23 0.431239 A Nasal/sinus endoscopy surg 9.33 NA NA 10.07 9.33 1.231240 A Nasal/sinus endoscopy surg 2.61 NA NA 2.01 1.88 0.331254 A Revision of ethmoid sinus 4.64 NA NA 3.21 2.99 0.631255 A Removal of ethmoid sinus 6.95 NA NA 4.56 4.23 0.831256 A Exploration maxillary sinus 3.29 NA NA 2.41 2.25 0.431267 A Endoscopy maxillary sinus 5.45 NA NA 3.68 3.42 0.631276 A Sinus endoscopy surgical 8.84 NA NA 5.66 5.24 1.131287 A Nasal/sinus endoscopy surg 3.91 NA NA 2.77 2.58 0.531288 A Nasal/sinus endoscopy surg 4.57 NA NA 3.17 2.95 0.631290 A Nasal/sinus endoscopy surg 18.61 NA NA 14.39 13.40 2.631291 A Nasal/sinus endoscopy surg 19.56 NA NA 15.10 14.04 3.131292 A Nasal/sinus endoscopy surg 15.90 NA NA 12.74 11.88 2.031293 A Nasal/sinus endoscopy surg 17.47 NA NA 13.73 12.79 2.231294 A Nasal/sinus endoscopy surg 20.31 NA NA 15.40 14.31 2.631295 A Sinus endo w/balloon dil 2.70 56.78 56.78 2.11 2.11 0.331296 A Sinus endo w/balloon dil 3.29 108.31 108.31 2.45 2.45 0.431297 A Sinus endo w/balloon dil 2.64 107.99 107.99 2.07 2.07 0.331299 C Sinus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.031300 A Removal of larynx lesion 15.91 NA NA 20.47 19.36 2.0

3130F I Upper gi endoscopy performed 0.00 0.00 0.00 0.00 0.00 0.0

31320 A Diagnostic incision larynx 5.73 NA NA 13.21 12.77 0.7
CMS-1582-PN 248 

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HCPCS Mod Status Description 

Physician 

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Implemented

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Pract

RVU

3132F I Doc ref upper gi endoscopy 0.00 0.00 0.00 0.00 0.00 0.0

31360 A Removal of larynx 29.91 NA NA 29.73 26.91 3.931365 A Removal of larynx 38.81 NA NA 34.91 31.53 5.031367 A Partial removal of larynx 30.57 NA NA 32.73 30.31 3.931368 A Partial removal of larynx 34.19 NA NA 36.00 33.45 4.331370 A Partial removal of larynx 27.57 NA NA 31.95 29.81 3.531375 A Partial removal of larynx 26.07 NA NA 30.43 28.33 3.331380 A Partial removal of larynx 25.57 NA NA 30.14 28.03 3.231382 A Partial removal of larynx 28.57 NA NA 32.54 30.17 3.631390 A Removal of larynx & pharynx 42.51 NA NA 38.78 35.48 5.831395 A Reconstruct larynx & pharynx 43.80 NA NA 42.53 39.07 5.631400 A Revision of larynx 11.60 NA NA 17.10 16.47 1.5

3140F I Upper gi endo shows barrtts 0.00 0.00 0.00 0.00 0.00 0.03141F I Upper gi endo not barrtts 0.00 0.00 0.00 0.00 0.00 0.0

31420 A Removal of epiglottis 11.43 NA NA 12.58 11.84 1.4

3142F I Barium swallow test ordered 0.00 0.00 0.00 0.00 0.00 0.0

31500 A Insert emergency airway 2.33 NA NA 0.64 0.60 0.331502 A Change of windpipe airway 0.65 NA NA 0.34 0.32 0.031505 A Diagnostic laryngoscopy 0.61 1.78 1.76 0.80 0.77 0.0

3150F I Forceps esoph biopsy done 0.00 0.00 0.00 0.00 0.00 0.0

31510 A Laryngoscopy with biopsy 1.92 4.13 4.05 1.54 1.44 0.231511 A Remove foreign body larynx 2.16 3.83 3.75 1.41 1.36 0.331512 A Removal of larynx lesion 2.07 3.93 3.82 1.70 1.57 0.231513 A Injection into vocal cord 2.10 NA NA 1.71 1.60 0.231515 A Laryngoscopy for aspiration 1.80 4.14 4.10 1.31 1.24 0.231520 A Dx laryngoscopy newborn 2.56 NA NA 1.98 1.79 0.331525 A Dx laryngoscopy excl nb 2.63 4.60 4.44 1.94 1.82 0.331526 A Dx laryngoscopy w/oper scope 2.57 NA NA 1.98 1.86 0.331527 A Laryngoscopy for treatment 3.27 NA NA 2.40 2.18 0.431528 A Laryngoscopy and dilation 2.37 NA NA 1.81 1.68 0.3
CMS-1582-PN 249 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

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Implemented

NonFacility

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RVUs2

Year 

2011 

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Pract

RVU

31529 A Laryngoscopy and dilation 2.68 NA NA 1.99 1.86 0.331530 A Laryngoscopy w/fb removal 3.38 NA NA 2.32 2.15 0.431531 A Laryngoscopy w/fb & op scope 3.58 NA NA 2.55 2.39 0.431535 A Laryngoscopy w/biopsy 3.16 NA NA 2.32 2.16 0.431536 A Laryngoscopy w/bx & op scope 3.55 NA NA 2.56 2.39 0.431540 A Laryngoscopy w/exc of tumor 4.12 NA NA 2.89 2.69 0.531541 A Larynscop w/tumr exc + scope 4.52 NA NA 3.13 2.91 0.531545 A Remove vc lesion w/scope 6.30 NA NA 4.20 3.87 0.831546 A Remove vc lesion scope/graft 9.73 NA NA 6.23 5.64 1.231560 A Laryngoscop w/arytenoidectom 5.45 NA NA 3.64 3.36 0.631561 A Larynscop remve cart + scop 5.99 NA NA 3.94 3.64 0.731570 A Laryngoscope w/vc inj 3.86 5.87 5.78 2.71 2.52 0.531571 A Laryngoscop w/vc inj + scope 4.26 NA NA 2.97 2.76 0.531575 A Diagnostic laryngoscopy 1.10 2.20 2.17 1.11 1.05 0.131576 A Laryngoscopy with biopsy 1.97 4.50 4.43 1.59 1.50 0.231577 A Remove foreign body larynx 2.47 4.50 4.37 1.77 1.67 0.331578 A Removal of larynx lesion 2.84 5.27 5.13 2.15 1.95 0.331579 A Diagnostic laryngoscopy 2.26 3.83 3.81 1.80 1.68 0.331580 A Revision of larynx 14.66 NA NA 20.52 19.36 1.831582 A Revision of larynx 23.22 NA NA 31.32 30.12 2.931584 A Treat larynx fracture 20.47 NA NA 22.91 21.64 2.631587 A Revision of larynx 15.27 NA NA 13.55 12.38 1.931588 A Revision of larynx 14.99 NA NA 17.86 16.86 1.931590 A Reinnervate larynx 7.85 NA NA 17.85 17.46 1.031595 A Larynx nerve surgery 8.84 NA NA 13.16 12.65 1.131599 C Larynx surgery procedure 0.00 0.00 0.00 0.00 0.00 0.031600 A Incision of windpipe 7.17 NA NA 3.64 3.43 1.231601 A Incision of windpipe 4.44 NA NA 3.04 2.82 0.531603 A Incision of windpipe 4.14 NA NA 2.01 1.86 0.631605 A Incision of windpipe 3.57 NA NA 1.34 1.26 0.6
CMS-1582-PN 250 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

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NonFacility 

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RVUs2

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Pract

RVU

31610 A Incision of windpipe 9.38 NA NA 10.93 10.34 1.331611 A Surgery/speech prosthesis 6.00 NA NA 9.55 9.12 0.731612 A Puncture/clear windpipe 0.91 1.44 1.37 0.44 0.40 0.131613 A Repair windpipe opening 4.71 NA NA 8.12 7.81 0.731614 A Repair windpipe opening 8.63 NA NA 13.04 12.30 1.131615 A Visualization of windpipe 2.09 3.10 3.04 1.58 1.47 0.231620 A Endobronchial us add-on 1.40 6.25 6.66 0.50 0.49 0.131622 A Dx bronchoscope/wash 2.78 5.82 6.12 1.26 1.22 0.331623 A Dx bronchoscope/brush 2.88 6.26 6.77 1.24 1.20 0.231624 A Dx bronchoscope/lavage 2.88 5.73 6.12 1.26 1.21 0.231625 A Bronchoscopy w/biopsy(s) 3.36 5.89 6.28 1.42 1.37 0.331626 A Bronchoscopy w/markers 4.16 8.56 8.56 1.72 1.72 0.331627 A Navigational bronchoscopy 2.00 35.28 35.28 0.88 0.88 0.131628 A Bronchoscopy/lung bx each 3.80 6.78 7.55 1.56 1.50 0.331629 A Bronchoscopy/needle bx each 4.09 12.40 13.68 1.68 1.61 0.331630 A Bronchoscopy dilate/fx repr 3.81 NA NA 1.76 1.75 0.431631 A Bronchoscopy dilate w/stent 4.36 NA NA 1.97 1.94 0.631632 A Bronchoscopy/lung bx addl 1.03 0.98 1.00 0.37 0.35 0.031633 A Bronchoscopy/needle bx addl 1.32 1.14 1.15 0.47 0.44 0.131634 A Bronch w/balloon occlusion 4.00 48.76 48.76 1.75 1.75 0.331635 A Bronchoscopy w/fb removal 3.67 5.77 6.15 1.59 1.55 0.331636 A Bronchoscopy bronch stents 4.30 NA NA 1.82 1.82 0.531637 A Bronchoscopy stent add-on 1.58 NA NA 0.61 0.59 0.131638 A Bronchoscopy revise stent 4.88 NA NA 2.14 2.11 0.631640 A Bronchoscopy w/tumor excise 4.93 NA NA 2.16 2.14 0.631641 A Bronchoscopy treat blockage 5.02 NA NA 2.17 2.08 0.531643 A Diag bronchoscope/catheter 3.49 NA NA 1.44 1.40 0.231645 A Bronchoscopy clear airways 3.16 5.15 5.47 1.36 1.30 0.231646 A Bronchoscopy reclear airway 2.72 4.85 5.15 1.19 1.15 0.231656 A Bronchoscopy inj for x-ray 2.17 6.05 6.71 0.93 0.92 0.1
CMS-1582-PN 251 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

31715 A Injection for bronchus x-ray 1.11 NA NA 0.37 0.39 0.031717 A Bronchial brush biopsy 2.12 5.41 6.12 1.03 0.97 0.131720 A Clearance of airways 1.06 NA NA 0.41 0.38 0.031725 A Clearance of airways 1.96 NA NA 0.73 0.65 0.231730 A Intro windpipe wire/tube 2.85 29.64 26.66 1.19 1.12 0.431750 A Repair of windpipe 15.39 NA NA 23.62 22.58 2.231755 A Repair of windpipe 17.54 NA NA 32.25 31.06 2.231760 A Repair of windpipe 23.48 NA NA 12.32 12.74 5.431766 A Reconstruction of windpipe 31.67 NA NA 14.61 14.95 7.431770 A Repair/graft of bronchus 23.54 NA NA 11.15 11.40 5.531775 A Reconstruct bronchus 24.59 NA NA 10.45 11.06 5.731780 A Reconstruct windpipe 19.84 NA NA 13.47 12.69 3.231781 A Reconstruct windpipe 24.85 NA NA 11.16 12.12 5.831785 A Remove windpipe lesion 18.35 NA NA 12.13 11.33 2.631786 A Remove windpipe lesion 25.42 NA NA 12.14 12.98 5.931800 A Repair of windpipe injury 8.18 NA NA 11.98 11.44 1.031805 A Repair of windpipe injury 13.42 NA NA 7.91 8.15 3.131820 A Closure of windpipe lesion 4.64 7.85 7.49 4.74 4.46 0.631825 A Repair of windpipe defect 7.07 10.23 9.75 6.69 6.30 0.931830 A Revise windpipe scar 4.62 7.96 7.60 5.11 4.83 0.731899 C Airways surgical procedure 0.00 0.00 0.00 0.00 0.00 0.0

3200F I Barium swallow test not req 0.00 0.00 0.00 0.00 0.00 0.0

32035 A Exploration of chest 11.29 NA NA 7.97 7.78 2.532036 A Exploration of chest 12.30 NA NA 8.24 8.18 2.932095 A Biopsy through chest wall 10.14 NA NA 6.57 6.57 2.332100 A Exploration/biopsy of chest 16.16 NA NA 8.92 9.05 3.832110 A Explore/repair chest 25.28 NA NA 13.25 13.05 5.732120 A Re-exploration of chest 14.39 NA NA 8.61 8.67 3.432124 A Explore chest free adhesions 15.45 NA NA 8.99 8.97 3.632140 A Removal of lung lesion(s) 16.66 NA NA 9.34 9.39 3.8
CMS-1582-PN 252 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

32141 A Remove/treat lung lesions 27.18 NA NA 12.96 12.70 6.432150 A Removal of lung lesion(s) 16.82 NA NA 9.56 9.51 3.932151 A Remove lung foreign body 16.94 NA NA 9.40 9.70 3.932160 A Open chest heart massage 13.10 NA NA 7.50 7.36 2.932200 A Drain open lung lesion 18.68 NA NA 11.41 11.23 4.232201 A Drain percut lung lesion 3.99 21.19 22.83 1.48 1.66 0.332215 A Treat chest lining 13.05 NA NA 8.03 8.12 3.032220 A Release of lung 26.65 NA NA 15.16 15.34 6.332225 A Partial release of lung 16.75 NA NA 9.48 9.51 3.9

3230F I Note hring tst w/in 6 mon 0.00 0.00 0.00 0.00 0.00 0.0

32310 A Removal of chest lining 15.28 NA NA 8.79 8.87 3.632320 A Free/remove chest lining 27.25 NA NA 14.89 14.89 6.332400 A Needle biopsy chest lining 1.76 2.30 2.48 0.65 0.69 0.132402 A Open biopsy chest lining 8.97 NA NA 6.03 6.09 2.032405 A Biopsy lung or mediastinum 1.93 0.66 0.71 0.66 0.71 0.132420 A Puncture/clear lung 2.18 NA NA 0.82 0.87 0.232421 A Thoracentesis for aspiration 1.54 2.65 2.89 0.58 0.60 0.132422 A Thoracentesis w/tube insert 2.19 3.13 3.38 1.20 1.26 0.232440 A Removal of lung 27.28 NA NA 13.83 14.21 6.332442 A Sleeve pneumonectomy 56.47 NA NA 23.12 22.70 4.232445 A Removal of lung 63.84 NA NA 28.12 27.27 14.932480 A Partial removal of lung 25.82 NA NA 13.11 13.39 6.032482 A Bilobectomy 27.44 NA NA 14.26 14.53 6.432484 A Segmentectomy 25.38 NA NA 12.34 12.59 5.932486 A Sleeve lobectomy 42.88 NA NA 18.59 18.57 10.132488 A Completion pneumonectomy 42.99 NA NA 19.78 19.52 10.132491 R Lung volume reduction 25.24 NA NA 13.48 13.99 5.832500 A Partial removal of lung 24.64 NA NA 13.12 13.45 5.832501 A Repair bronchus add-on 4.68 NA NA 1.70 1.76 1.032503 A Resect apical lung tumor 31.74 NA NA 15.55 15.93 7.5
CMS-1582-PN 253 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

32504 A Resect apical lung tum/chest 36.54 NA NA 16.81 17.67 8.532540 A Removal of lung lesion 30.35 NA NA 14.79 14.66 7.132550 A Insert pleural cath 4.17 17.43 18.58 1.85 1.93 0.632551 A Insertion of chest tube 3.29 NA NA 1.29 1.34 0.532552 A Remove lung catheter 2.53 2.42 2.42 1.75 1.75 0.632553 A Ins mark thor for rt perq 3.80 13.57 13.57 1.53 1.53 0.832560 A Treat pleurodesis w/agent 1.54 5.19 5.86 0.57 0.68 0.232561 A Lyse chest fibrin init day 1.39 1.21 1.21 0.51 0.51 0.232562 A Lyse chest fibrin subq day 1.24 1.07 1.07 0.46 0.46 0.232601 A Thoracoscopy diagnostic 5.45 NA NA 2.63 2.69 1.232602 A Thoracoscopy diagnostic 5.95 NA NA 2.82 2.88 1.332603 A Thoracoscopy diagnostic 7.80 NA NA 3.42 3.55 1.932604 A Thoracoscopy diagnostic 8.77 NA NA 3.76 3.95 2.032605 A Thoracoscopy diagnostic 6.92 NA NA 3.11 3.19 1.632606 A Thoracoscopy diagnostic 8.39 NA NA 3.71 3.82 1.932650 A Thoracoscopy surgical 10.83 NA NA 6.78 6.94 2.432651 A Thoracoscopy surgical 18.78 NA NA 10.07 9.85 4.332652 A Thoracoscopy surgical 29.13 NA NA 14.37 14.17 6.732653 A Thoracoscopy surgical 18.17 NA NA 9.59 9.45 4.132654 A Thoracoscopy surgical 20.52 NA NA 10.42 10.27 4.632655 A Thoracoscopy surgical 16.17 NA NA 9.00 8.94 3.732656 A Thoracoscopy surgical 13.26 NA NA 7.80 7.97 3.032657 A Thoracoscopy surgical 12.93 NA NA 7.78 7.95 3.032658 A Thoracoscopy surgical 11.71 NA NA 6.99 7.32 2.732659 A Thoracoscopy surgical 11.94 NA NA 7.34 7.58 2.832660 A Thoracoscopy surgical 17.77 NA NA 9.31 9.67 4.432661 A Thoracoscopy surgical 13.33 NA NA 7.56 7.88 3.132662 A Thoracoscopy surgical 14.99 NA NA 8.49 8.79 3.532663 A Thoracoscopy surgical 24.64 NA NA 11.97 12.24 5.732664 A Thoracoscopy surgical 14.28 NA NA 7.90 8.12 3.3
CMS-1582-PN 254 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

32665 A Thoracoscopy surgical 21.53 NA NA 10.63 10.70 4.6

3268F I Psa/t/glsc docd b/4 txmnt 0.00 0.00 0.00 0.00 0.00 0.0

32800 A Repair lung hernia 15.71 NA NA 8.98 9.01 3.632810 A Close chest after drainage 14.95 NA NA 8.65 8.85 3.532815 A Close bronchial fistula 50.03 NA NA 23.21 22.34 11.932820 A Reconstruct injured chest 22.51 NA NA 12.28 12.87 5.232850 X Donor pneumonectomy 0.00 0.00 0.00 0.00 0.00 0.032851 A Lung transplant single 59.64 NA NA 25.28 25.80 14.032852 A Lung transplant with bypass 65.50 NA NA 27.10 28.13 15.332853 A Lung transplant double 84.48 NA NA 33.67 32.99 20.032854 A Lung transplant with bypass 90.00 NA NA 35.65 35.47 21.232855 C Prepare donor lung single 0.00 0.00 0.00 0.00 0.00 0.032856 C Prepare donor lung double 0.00 0.00 0.00 0.00 0.00 0.032900 A Removal of rib(s) 23.81 NA NA 13.07 12.70 5.432905 A Revise & repair chest wall 23.29 NA NA 11.59 11.89 5.432906 A Revise & repair chest wall 29.30 NA NA 13.71 14.14 6.8

3290F I Pt=d(rh)- and unsensitized 0.00 0.00 0.00 0.00 0.00 0.03291F I Pt=d(rh)+ or sensitized 0.00 0.00 0.00 0.00 0.00 0.03292F I Hiv tstng asked/docd/revwd 0.00 0.00 0.00 0.00 0.00 0.03293F I Abo rh blood typing docd 0.00 0.00 0.00 0.00 0.00 0.0

32940 A Revision of lung 21.34 NA NA 10.99 11.09 5.0

3294F I Grp b strep screening docd 0.00 0.00 0.00 0.00 0.00 0.0

32960 A Therapeutic pneumothorax 1.84 1.75 1.91 0.83 0.86 0.432997 A Total lung lavage 7.31 NA NA 2.42 2.35 0.932998 A Perq rf ablate tx pul tumor 5.68 74.08 78.71 2.21 2.54 0.632999 C Chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.033010 A Drainage of heart sac 2.24 NA NA 0.84 1.03 0.433011 A Repeat drainage of heart sac 2.24 NA NA 0.87 0.99 0.433015 A Incision of heart sac 8.52 NA NA 4.78 5.62 1.633020 A Incision of heart sac 14.95 NA NA 8.18 8.24 3.5
CMS-1582-PN 255 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33025 A Incision of heart sac 13.70 NA NA 7.33 7.49 3.233030 A Partial removal of heart sac 36.00 NA NA 16.13 14.94 8.533031 A Partial removal of heart sac 45.00 NA NA 19.22 17.47 10.833050 A Removal of heart sac lesion 16.97 NA NA 9.62 9.60 3.933120 A Removal of heart lesion 38.45 NA NA 15.81 15.24 9.233130 A Removal of heart lesion 24.17 NA NA 11.90 12.22 6.033140 A Heart revascularize (tmr) 28.34 NA NA 13.01 13.39 7.033141 A Heart tmr w/other procedure 2.54 NA NA 0.93 1.09 0.6

3317F I Path rpt malig cancer docd 0.00 0.00 0.00 0.00 0.00 0.03318F I Path rpt malig cancer docd 0.00 0.00 0.00 0.00 0.00 0.0

33202 A Insert epicard eltrd open 13.20 NA NA 7.08 7.40 3.133203 A Insert epicard eltrd endo 13.97 NA NA 6.97 7.68 3.233206 A Insertion of heart pacemaker 7.39 NA NA 4.34 5.20 1.633207 A Insertion of heart pacemaker 8.05 NA NA 4.39 5.32 1.733208 A Insertion of heart pacemaker 8.77 NA NA 4.66 5.66 1.933210 A Insertion of heart electrode 3.30 NA NA 1.28 1.60 0.733211 A Insertion of heart electrode 3.39 NA NA 1.30 1.56 0.733212 A Insertion of pulse generator 5.52 NA NA 3.16 3.80 1.233213 A Insertion of pulse generator 6.37 NA NA 3.47 4.24 1.433214 A Upgrade of pacemaker system 7.84 NA NA 4.58 5.45 1.733215 A Reposition pacing-defib lead 4.92 NA NA 2.88 3.51 1.033216 A Insert 1 electrode pm-defib 5.87 NA NA 3.74 4.59 1.233217 A Insert 2 electrode pm-defib 5.84 NA NA 3.75 4.55 1.233218 A Repair lead pace-defib one 6.07 NA NA 4.03 4.85 1.333220 A Repair lead pace-defib dual 6.15 NA NA 4.03 4.86 1.333222 A Revise pocket pacemaker 5.10 NA NA 3.83 4.53 1.133223 A Revise pocket for defib 6.55 NA NA 4.00 4.92 1.433224 A Insert pacing lead & connect 9.04 NA NA 3.86 4.81 1.933225 A L ventric pacing lead add-on 8.33 NA NA 3.25 4.13 1.833226 A Reposition l ventric lead 8.68 NA NA 3.75 4.66 1.9
CMS-1582-PN 256 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33233 A Removal of pacemaker system 3.39 NA NA 2.72 3.32 0.733234 A Removal of pacemaker system 7.91 NA NA 4.53 5.52 1.733235 A Removal pacemaker electrode 10.15 NA NA 6.12 7.40 2.233236 A Remove electrode/thoracotomy 12.73 NA NA 7.86 8.15 3.133237 A Remove electrode/thoracotomy 13.84 NA NA 7.58 8.69 3.233238 A Remove electrode/thoracotomy 15.40 NA NA 9.34 9.57 3.633240 A Insert pulse generator 7.64 NA NA 4.11 5.15 1.633241 A Remove pulse generator 3.29 NA NA 2.42 3.01 0.733243 A Remove eltrd/thoracotomy 23.57 NA NA 12.07 13.01 5.533244 A Remove eltrd transven 13.99 NA NA 7.77 9.57 3.133249 A Eltrd/insert pace-defib 15.17 NA NA 7.91 9.84 3.3

3324F I Mri ct scan ord rvwd rqstd 0.00 0.00 0.00 0.00 0.00 0.0

33250 A Ablate heart dysrhythm focus 25.90 NA NA 12.51 12.91 6.433251 A Ablate heart dysrhythm focus 28.92 NA NA 14.11 14.27 7.033254 A Ablate atria lmtd 23.71 NA NA 12.21 12.45 5.933255 A Ablate atria w/o bypass ext 29.04 NA NA 13.97 14.77 7.233256 A Ablate atria w/bypass exten 34.90 NA NA 16.09 17.04 8.733257 A Ablate atria lmtd add-on 9.63 NA NA 5.82 6.00 2.333258 A Ablate atria x10sv add-on 11.00 NA NA 6.34 6.55 2.633259 A Ablate atria w/bypass add-on 14.14 NA NA 8.21 8.49 3.4

3325F I Preop asses 4 cataract surg 0.00 0.00 0.00 0.00 0.00 0.0

33261 A Ablate heart dysrhythm focus 28.92 NA NA 13.43 13.85 7.233265 A Ablate atria lmtd endo 23.71 NA NA 11.84 12.22 5.633266 A Ablate atria x10sv endo 33.04 NA NA 15.23 15.83 7.933282 A Implant pat-active ht record 4.80 NA NA 3.43 4.24 1.033284 A Remove pat-active ht record 3.14 NA NA 2.79 3.44 0.633300 A Repair of heart wound 44.97 NA NA 19.17 18.53 10.733305 A Repair of heart wound 76.93 NA NA 30.48 29.49 18.4

3330F I Imaging study ordered (bkp) 0.00 0.00 0.00 0.00 0.00 0.0

33310 A Exploratory heart surgery 20.34 NA NA 10.44 10.73 4.4
CMS-1582-PN 257 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33315 A Exploratory heart surgery 35.00 NA NA 14.60 14.24 8.4

3331F I Bk imaging tst not ordered 0.00 0.00 0.00 0.00 0.00 0.0

33320 A Repair major blood vessel(s) 18.54 NA NA 9.52 9.78 4.333321 A Repair major vessel 20.81 NA NA 10.55 10.78 4.833322 A Repair major blood vessel(s) 24.42 NA NA 12.26 12.57 5.833330 A Insert major vessel graft 25.29 NA NA 12.17 12.22 6.333332 A Insert major vessel graft 24.56 NA NA 11.75 12.33 6.133335 A Insert major vessel graft 33.91 NA NA 15.58 15.96 8.133400 A Repair of aortic valve 41.50 NA NA 18.50 19.12 9.833401 A Valvuloplasty open 24.63 NA NA 12.33 14.14 5.333403 A Valvuloplasty w/cp bypass 25.61 NA NA 13.23 14.13 6.433404 A Prepare heart-aorta conduit 31.37 NA NA 14.69 15.48 7.333405 A Replacement of aortic valve 41.32 NA NA 18.83 19.65 9.933406 A Replacement of aortic valve 52.68 NA NA 22.65 23.36 12.733410 A Replacement of aortic valve 46.41 NA NA 20.63 21.04 11.133411 A Replacement of aortic valve 62.07 NA NA 24.85 25.09 14.933412 A Replacement of aortic valve 59.00 NA NA 22.90 22.61 14.733413 A Replacement of aortic valve 59.87 NA NA 24.98 25.98 14.033414 A Repair of aortic valve 39.37 NA NA 16.93 17.80 9.833415 A Revision subvalvular tissue 37.27 NA NA 16.29 16.37 8.533416 A Revise ventricle muscle 36.56 NA NA 17.07 17.20 8.833417 A Repair of aortic valve 29.33 NA NA 14.56 15.13 7.033420 A Revision of mitral valve 25.79 NA NA 15.71 13.64 3.533422 A Revision of mitral valve 29.73 NA NA 14.39 14.95 7.433425 A Repair of mitral valve 49.96 NA NA 21.93 21.63 11.933426 A Repair of mitral valve 43.28 NA NA 19.61 20.20 10.433427 A Repair of mitral valve 44.83 NA NA 19.50 20.46 10.733430 A Replacement of mitral valve 50.93 NA NA 23.06 23.34 12.233460 A Revision of tricuspid valve 44.70 NA NA 18.33 18.54 11.133463 A Valvuloplasty tricuspid 57.08 NA NA 24.16 23.79 13.7
CMS-1582-PN 258 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33464 A Valvuloplasty tricuspid 44.62 NA NA 19.99 19.86 10.733465 A Replace tricuspid valve 50.72 NA NA 21.76 21.54 12.233468 A Revision of tricuspid valve 45.13 NA NA 18.15 17.91 11.333470 A Revision of pulmonary valve 21.54 NA NA 12.45 12.11 5.033471 A Valvotomy pulmonary valve 22.96 NA NA 13.03 12.75 1.633472 A Revision of pulmonary valve 23.06 NA NA 11.04 11.84 1.633474 A Revision of pulmonary valve 39.40 NA NA 17.25 16.70 9.233475 A Replacement pulmonary valve 42.40 NA NA 18.71 19.12 10.633476 A Revision of heart chamber 26.57 NA NA 13.27 13.32 6.633478 A Revision of heart chamber 27.54 NA NA 13.47 14.02 6.833496 A Repair prosth valve clot 29.84 NA NA 14.15 14.62 6.933500 A Repair heart vessel fistula 27.94 NA NA 13.22 13.73 6.933501 A Repair heart vessel fistula 19.51 NA NA 9.87 10.11 4.833502 A Coronary artery correction 21.85 NA NA 11.49 11.88 5.433503 A Coronary artery graft 22.51 NA NA 11.53 13.49 4.933504 A Coronary artery graft 25.46 NA NA 12.79 13.09 6.333505 A Repair artery w/tunnel 38.40 NA NA 15.32 15.65 9.633506 A Repair artery translocation 37.85 NA NA 22.85 20.01 8.833507 A Repair art intramural 31.40 NA NA 13.42 14.26 7.333508 A Endoscopic vein harvest 0.31 NA NA 0.11 0.12 0.033510 A Cabg vein single 34.98 NA NA 16.23 16.97 8.433511 A Cabg vein two 38.45 NA NA 17.68 18.43 9.233512 A Cabg vein three 43.98 NA NA 19.73 20.43 10.633513 A Cabg vein four 45.37 NA NA 20.10 20.53 10.933514 A Cabg vein five 48.08 NA NA 20.98 21.75 11.533516 A Cabg vein six or more 49.76 NA NA 21.68 22.62 12.433517 A Cabg artery-vein single 3.61 NA NA 1.31 1.33 0.833518 A Cabg artery-vein two 7.93 NA NA 2.89 2.88 1.933519 A Cabg artery-vein three 10.49 NA NA 3.82 3.85 2.5

3351F I Neg scrn dep symp by deptool 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 259 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33521 A Cabg artery-vein four 12.59 NA NA 4.60 4.67 3.033522 A Cabg artery-vein five 14.14 NA NA 5.17 5.30 3.433523 A Cabg art-vein six or more 16.08 NA NA 5.83 6.01 3.8

3352F I No sig dep symp by dep tool 0.00 0.00 0.00 0.00 0.00 0.0

33530 A Coronary artery bypass/reop 10.13 NA NA 3.68 3.65 2.433533 A Cabg arterial single 33.75 NA NA 15.61 16.52 8.133534 A Cabg arterial two 39.88 NA NA 18.18 19.06 9.533535 A Cabg arterial three 44.75 NA NA 19.95 20.82 10.733536 A Cabg arterial four or more 48.43 NA NA 21.34 21.96 11.7

3353F I Mild-mod dep symp by deptool 0.00 0.00 0.00 0.00 0.00 0.0

33542 A Removal of heart lesion 48.21 NA NA 21.06 20.83 11.633545 A Repair of heart damage 57.06 NA NA 24.16 24.08 13.633548 A Restore/remodel ventricle 54.14 NA NA 23.96 24.76 13.1

3354F I Clin sig dep sym by dep tool 0.00 0.00 0.00 0.00 0.00 0.0

33572 A Open coronary endarterectomy 4.44 NA NA 1.61 1.69 1.033600 A Closure of valve 30.31 NA NA 14.64 14.96 7.033602 A Closure of valve 29.34 NA NA 14.29 14.31 6.233606 A Anastomosis/artery-aorta 31.53 NA NA 16.97 16.46 6.733608 A Repair anomaly w/conduit 31.88 NA NA 15.19 15.98 7.433610 A Repair by enlargement 31.40 NA NA 14.86 15.46 7.333611 A Repair double ventricle 35.57 NA NA 15.36 16.04 8.933612 A Repair double ventricle 36.57 NA NA 15.54 16.18 7.933615 A Repair modified fontan 35.89 NA NA 16.21 17.26 8.433617 A Repair single ventricle 39.09 NA NA 17.38 17.73 9.133619 A Repair single ventricle 48.76 NA NA 25.72 23.63 11.433620 A Apply r&l pulm art bands 30.00 NA NA 13.40 13.40 7.533621 A Transthor cath for stent 16.18 NA NA 7.39 7.39 3.733622 A Redo compl cardiac anomaly 64.00 NA NA 28.20 28.20 14.933641 A Repair heart septum defect 29.58 NA NA 13.76 13.70 7.133645 A Revision of heart veins 31.30 NA NA 13.46 13.55 7.8
CMS-1582-PN 260 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33647 A Repair heart septum defects 33.00 NA NA 14.07 14.49 8.233660 A Repair of heart defects 31.83 NA NA 20.04 17.56 7.933665 A Repair of heart defects 34.85 NA NA 15.11 15.75 8.733670 A Repair of heart chambers 36.63 NA NA 14.78 15.45 9.133675 A Close mult vsd 35.95 NA NA 15.37 16.00 8.933676 A Close mult vsd w/resection 36.95 NA NA 18.56 18.12 2.633677 A Cl mult vsd w/rem pul band 38.45 NA NA 13.36 15.78 2.733681 A Repair heart septum defect 32.34 NA NA 16.15 16.46 7.833684 A Repair heart septum defect 34.37 NA NA 14.94 15.57 8.633688 A Repair heart septum defect 34.75 NA NA 14.22 14.56 8.733690 A Reinforce pulmonary artery 20.36 NA NA 13.21 12.29 4.733692 A Repair of heart defects 36.15 NA NA 16.58 16.19 2.533694 A Repair of heart defects 35.57 NA NA 15.19 16.18 8.933697 A Repair of heart defects 37.57 NA NA 16.36 18.53 8.133702 A Repair of heart defects 27.24 NA NA 13.21 13.52 6.833710 A Repair of heart defects 37.50 NA NA 15.48 16.44 8.733720 A Repair of heart defect 27.26 NA NA 13.08 13.71 6.333722 A Repair of heart defect 29.21 NA NA 15.24 14.53 7.233724 A Repair venous anomaly 27.63 NA NA 12.54 13.49 6.433726 A Repair pul venous stenosis 37.12 NA NA 19.30 18.54 9.233730 A Repair heart-vein defect(s) 36.14 NA NA 16.05 15.93 9.033732 A Repair heart-vein defect 28.96 NA NA 14.16 14.68 7.233735 A Revision of heart chamber 22.20 NA NA 11.66 11.92 5.533736 A Revision of heart chamber 24.32 NA NA 12.40 12.86 6.033737 A Revision of heart chamber 22.47 NA NA 11.41 11.89 5.233750 A Major vessel shunt 22.22 NA NA 9.50 12.09 7.933755 A Major vessel shunt 22.60 NA NA 11.92 11.96 4.933762 A Major vessel shunt 22.60 NA NA 12.35 12.19 1.633764 A Major vessel shunt & graft 22.60 NA NA 13.16 12.34 4.833766 A Major vessel shunt 23.57 NA NA 11.15 12.55 5.1
CMS-1582-PN 261 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33767 A Major vessel shunt 25.30 NA NA 11.88 12.05 6.333768 A Cavopulmonary shunting 8.00 NA NA 3.51 3.40 0.533770 A Repair great vessels defect 39.07 NA NA 15.94 16.78 9.133771 A Repair great vessels defect 40.63 NA NA 19.28 18.41 2.933774 A Repair great vessels defect 31.73 NA NA 15.18 15.89 7.933775 A Repair great vessels defect 32.99 NA NA 17.61 17.45 2.333776 A Repair great vessels defect 34.75 NA NA 18.72 18.53 2.433777 A Repair great vessels defect 34.17 NA NA 12.30 14.80 2.433778 A Repair great vessels defect 42.75 NA NA 21.61 21.14 3.033779 A Repair great vessels defect 43.23 NA NA 20.70 20.08 3.033780 A Repair great vessels defect 43.90 NA NA 21.18 21.07 3.133781 A Repair great vessels defect 43.21 NA NA 20.41 19.52 3.033782 A Nikaidoh proc 60.08 NA NA 24.03 24.03 14.033783 A Nikaidoh proc w/ostia implt 65.08 NA NA 25.79 25.79 15.233786 A Repair arterial trunk 41.87 NA NA 17.27 18.27 2.933788 A Revision of pulmonary artery 27.42 NA NA 12.49 13.26 1.933800 A Aortic suspension 17.28 NA NA 8.48 8.59 4.333802 A Repair vessel defect 18.37 NA NA 11.96 11.01 4.633803 A Repair vessel defect 20.31 NA NA 9.68 9.78 5.033813 A Repair septal defect 21.36 NA NA 12.33 13.02 5.033814 A Repair septal defect 26.57 NA NA 13.18 13.72 6.633820 A Revise major vessel 16.69 NA NA 8.71 9.16 4.133822 A Revise major vessel 17.71 NA NA 10.09 10.08 1.233824 A Revise major vessel 20.23 NA NA 11.80 11.56 4.733840 A Remove aorta constriction 21.34 NA NA 13.25 12.10 5.333845 A Remove aorta constriction 22.93 NA NA 11.91 13.02 5.733851 A Remove aorta constriction 21.98 NA NA 18.42 15.11 5.433852 A Repair septal defect 24.41 NA NA 11.77 12.41 6.133853 A Repair septal defect 32.51 NA NA 15.25 16.71 8.133860 A Ascending aortic graft 59.46 NA NA 24.99 25.06 14.2
CMS-1582-PN 262 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33863 A Ascending aortic graft 58.79 NA NA 23.92 24.53 14.033864 A Ascending aortic graft 60.08 NA NA 24.32 25.30 14.333870 A Transverse aortic arch graft 46.06 NA NA 20.01 20.87 11.033875 A Thoracic aortic graft 50.72 NA NA 22.33 20.86 12.133877 A Thoracoabdominal graft 69.03 NA NA 26.54 26.18 16.333880 A Endovasc taa repr incl subcl 34.58 NA NA 13.59 14.32 7.733881 A Endovasc taa repr w/o subcl 29.58 NA NA 11.96 12.53 6.633883 A Insert endovasc prosth taa 21.09 NA NA 9.12 9.52 4.733884 A Endovasc prosth taa add-on 8.20 NA NA 2.76 2.83 1.833886 A Endovasc prosth delayed 18.09 NA NA 7.94 8.26 4.333889 A Artery transpose/endovas taa 15.92 NA NA 5.46 5.49 3.733891 A Car-car bp grft/endovas taa 20.00 NA NA 5.94 6.36 4.733910 A Remove lung artery emboli 48.21 NA NA 20.26 18.80 12.033915 A Remove lung artery emboli 24.95 NA NA 11.10 11.40 5.433916 A Surgery of great vessel 78.00 NA NA 29.74 26.33 19.433917 A Repair pulmonary artery 25.30 NA NA 12.87 14.10 5.933920 A Repair pulmonary atresia 32.74 NA NA 14.50 15.15 8.133922 A Transect pulmonary artery 24.22 NA NA 12.02 12.42 6.033924 A Remove pulmonary shunt 5.49 NA NA 1.91 1.99 1.233925 A Rpr pul art unifocal w/o cpb 31.30 NA NA 13.54 14.60 7.333926 A Repr pul art unifocal w/cpb 44.73 NA NA 26.73 21.91 11.133930 X Removal of donor heart/lung 0.00 0.00 0.00 0.00 0.00 0.033933 C Prepare donor heart/lung 0.00 0.00 0.00 0.00 0.00 0.033935 R Transplantation heart/lung 91.78 NA NA 36.50 34.78 22.933940 X Removal of donor heart 0.00 0.00 0.00 0.00 0.00 0.033944 C Prepare donor heart 0.00 0.00 0.00 0.00 0.00 0.033945 R Transplantation of heart 89.50 NA NA 37.34 37.02 21.333960 A External circulation assist 19.33 NA NA 7.10 7.08 3.833961 A External circulation assist 10.91 NA NA 4.00 4.13 1.633967 A Insert ia percut device 4.84 NA NA 1.87 2.34 1.0
CMS-1582-PN 263 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

33968 A Remove aortic assist device 0.64 NA NA 0.25 0.28 0.133970 A Aortic circulation assist 6.74 NA NA 2.49 2.84 1.533971 A Aortic circulation assist 11.99 NA NA 6.70 7.20 2.833973 A Insert balloon device 9.75 NA NA 3.65 4.17 2.233974 A Remove intra-aortic balloon 15.03 NA NA 7.89 8.94 3.733975 A Implant ventricular device 25.00 NA NA 8.47 8.38 5.933976 A Implant ventricular device 30.75 NA NA 10.16 10.00 7.633977 A Remove ventricular device 20.86 NA NA 8.16 9.14 4.933978 A Remove ventricular device 25.00 NA NA 9.60 10.36 6.233979 A Insert intracorporeal device 37.50 NA NA 12.55 13.82 8.933980 A Remove intracorporeal device 33.50 NA NA 12.48 16.96 8.033981 A Replace vad pump ext 16.11 NA NA 6.56 6.56 4.033982 A Replace vad intra w/o bp 37.86 NA NA 15.43 15.43 9.033983 A Replace vad intra w/bp 44.54 NA NA 18.15 18.15 10.633999 C Cardiac surgery procedure 0.00 0.00 0.00 0.00 0.00 0.034001 A Removal of artery clot 17.88 NA NA 8.81 8.60 4.034051 A Removal of artery clot 16.99 NA NA 9.07 9.16 4.234101 A Removal of artery clot 10.93 NA NA 5.65 5.69 2.434111 A Removal of arm artery clot 10.93 NA NA 5.67 5.70 2.434151 A Removal of artery clot 26.52 NA NA 11.75 11.58 5.934201 A Removal of artery clot 19.48 NA NA 8.77 8.36 4.434203 A Removal of leg artery clot 17.86 NA NA 8.43 8.51 4.134401 A Removal of vein clot 26.52 NA NA 14.53 13.90 5.634421 A Removal of vein clot 13.37 NA NA 6.83 6.86 2.934451 A Removal of vein clot 28.52 NA NA 10.32 11.37 6.734471 A Removal of vein clot 21.11 NA NA 12.18 10.41 4.534490 A Removal of vein clot 10.91 NA NA 6.03 5.95 2.434501 A Repair valve femoral vein 16.85 NA NA 7.48 8.24 4.034502 A Reconstruct vena cava 28.07 NA NA 13.11 13.45 5.8

3450F I Dyspnea scrnd no-mild dysp 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 264 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

34510 A Transposition of vein valve 19.91 NA NA 11.68 10.62 4.2

3451F I Dyspnea scrnd mod-high dysp 0.00 0.00 0.00 0.00 0.00 0.0

34520 A Cross-over vein graft 19.18 NA NA 7.66 8.35 4.5

3452F I Dyspnea not screened 0.00 0.00 0.00 0.00 0.00 0.0

34530 A Leg vein fusion 17.93 NA NA 7.59 8.30 3.834800 A Endovas aaa repr w/sm tube 21.54 NA NA 9.02 9.52 4.534802 A Endovas aaa repr w/2-p part 23.79 NA NA 10.09 10.50 5.034803 A Endovas aaa repr w/3-p part 24.82 NA NA 10.18 10.53 5.334804 A Endovas aaa repr w/1-p part 23.79 NA NA 10.07 10.49 5.134805 A Endovas aaa repr w/long tube 22.67 NA NA 9.58 9.77 5.034806 A Aneurysm press sensor add-on 2.06 NA NA 0.69 0.74 0.434808 A Endovas iliac a device addon 4.12 NA NA 1.42 1.44 0.934812 A Xpose for endoprosth femorl 6.74 NA NA 2.33 2.33 1.534813 A Femoral endovas graft add-on 4.79 NA NA 1.61 1.61 1.134820 A Xpose for endoprosth iliac 9.74 NA NA 3.33 3.39 2.134825 A Endovasc extend prosth init 12.80 NA NA 6.25 6.54 2.734826 A Endovasc exten prosth addl 4.12 NA NA 1.43 1.48 0.834830 A Open aortic tube prosth repr 35.23 NA NA 12.40 13.45 8.334831 A Open aortoiliac prosth repr 37.98 NA NA 13.22 13.86 9.034832 A Open aortofemor prosth repr 37.98 NA NA 13.22 14.33 9.034833 A Xpose for endoprosth iliac 11.98 NA NA 4.38 4.48 2.734834 A Xpose endoprosth brachial 5.34 NA NA 2.05 2.12 1.234900 A Endovasc iliac repr w/graft 16.85 NA NA 7.60 7.93 3.5

3491F I Hiv unsure baby of hiv+moms 0.00 0.00 0.00 0.00 0.00 0.03497F I Cd4+ cell percentage <15% 0.00 0.00 0.00 0.00 0.00 0.03498F I Cd4+ cell % >=15% (hiv) 0.00 0.00 0.00 0.00 0.00 0.0

35001 A Repair defect of artery 20.81 NA NA 9.69 10.00 4.835002 A Repair artery rupture neck 22.23 NA NA 8.53 9.52 4.735005 A Repair defect of artery 19.29 NA NA 11.52 10.75 4.535011 A Repair defect of artery 18.58 NA NA 8.66 8.62 4.2
CMS-1582-PN 265 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

35013 A Repair artery rupture arm 23.23 NA NA 11.10 10.81 5.235021 A Repair defect of artery 22.17 NA NA 8.74 9.93 5.235022 A Repair artery rupture chest 25.70 NA NA 12.10 11.99 6.035045 A Repair defect of arm artery 18.01 NA NA 9.15 8.80 4.035081 A Repair defect of artery 33.53 NA NA 14.38 14.14 7.735082 A Repair artery rupture aorta 42.09 NA NA 17.66 17.39 9.635091 A Repair defect of artery 35.35 NA NA 13.33 13.62 8.135092 A Repair artery rupture aorta 50.97 NA NA 19.63 19.62 11.735102 A Repair defect of artery 36.53 NA NA 15.01 14.90 8.435103 A Repair artery rupture groin 43.62 NA NA 17.28 17.32 9.9

3510F I Doc tb scrng-rslts interpd 0.00 0.00 0.00 0.00 0.00 0.0

35111 A Repair defect of artery 26.28 NA NA 14.43 13.01 5.635112 A Repair artery rupture spleen 32.57 NA NA 17.32 15.60 6.935121 A Repair defect of artery 31.52 NA NA 13.58 13.36 7.235122 A Repair artery rupture belly 37.89 NA NA 13.19 14.50 8.035131 A Repair defect of artery 26.40 NA NA 11.54 11.63 6.135132 A Repair artery rupture groin 32.57 NA NA 11.61 12.57 7.4

3513F I Hep b scrng docd as done 0.00 0.00 0.00 0.00 0.00 0.0

35141 A Repair defect of artery 20.91 NA NA 9.30 9.35 4.835142 A Repair artery rupture thigh 25.16 NA NA 10.96 11.09 5.7

3514F I Hep c scrng docd as done 0.00 0.00 0.00 0.00 0.00 0.0

35151 A Repair defect of artery 23.72 NA NA 10.35 10.42 5.435152 A Repair artery rupture knee 27.66 NA NA 10.15 11.14 6.5

3515F I Pt has docd immun to hep c 0.00 0.00 0.00 0.00 0.00 0.0

35180 A Repair blood vessel lesion 15.10 NA NA 11.34 10.08 3.535182 A Repair blood vessel lesion 31.71 NA NA 14.73 14.96 6.735184 A Repair blood vessel lesion 18.82 NA NA 9.29 9.07 4.035188 A Repair blood vessel lesion 18.00 NA NA 6.46 6.82 3.835189 A Repair blood vessel lesion 29.98 NA NA 16.19 14.69 7.535190 A Repair blood vessel lesion 13.42 NA NA 7.11 7.05 3.0
CMS-1582-PN 266 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

35201 A Repair blood vessel lesion 16.93 NA NA 8.76 8.66 3.735206 A Repair blood vessel lesion 13.84 NA NA 7.37 7.20 3.035207 A Repair blood vessel lesion 10.94 NA NA 9.85 9.19 1.935211 A Repair blood vessel lesion 24.58 NA NA 12.00 12.26 5.935216 A Repair blood vessel lesion 36.61 NA NA 17.86 16.92 8.635221 A Repair blood vessel lesion 26.62 NA NA 12.22 11.72 5.835226 A Repair blood vessel lesion 15.30 NA NA 7.36 7.56 3.535231 A Repair blood vessel lesion 21.16 NA NA 11.47 11.15 4.135236 A Repair blood vessel lesion 18.02 NA NA 8.69 8.62 3.935241 A Repair blood vessel lesion 25.58 NA NA 13.22 13.13 6.335246 A Repair blood vessel lesion 28.23 NA NA 10.44 12.01 6.735251 A Repair blood vessel lesion 31.91 NA NA 13.92 13.41 7.035256 A Repair blood vessel lesion 19.06 NA NA 8.59 8.68 4.335261 A Repair blood vessel lesion 18.96 NA NA 9.51 9.40 4.635266 A Repair blood vessel lesion 15.83 NA NA 7.72 7.67 3.635271 A Repair blood vessel lesion 24.58 NA NA 12.01 12.24 6.135276 A Repair blood vessel lesion 25.83 NA NA 12.55 12.75 6.035281 A Repair blood vessel lesion 30.06 NA NA 13.68 13.29 6.735286 A Repair blood vessel lesion 17.19 NA NA 8.39 8.47 3.935301 A Rechanneling of artery 19.61 NA NA 9.03 9.05 4.535302 A Rechanneling of artery 21.35 NA NA 9.38 9.15 4.935303 A Rechanneling of artery 23.60 NA NA 10.40 10.05 5.435304 A Rechanneling of artery 24.60 NA NA 10.46 10.22 5.635305 A Rechanneling of artery 23.60 NA NA 10.27 9.96 5.435306 A Rechanneling of artery 9.25 NA NA 4.02 3.50 2.135311 A Rechanneling of artery 28.60 NA NA 12.22 12.45 6.735321 A Rechanneling of artery 16.59 NA NA 7.83 7.84 3.735331 A Rechanneling of artery 27.72 NA NA 12.12 12.27 6.435341 A Rechanneling of artery 26.21 NA NA 10.89 11.14 6.035351 A Rechanneling of artery 24.61 NA NA 10.49 10.45 5.6
CMS-1582-PN 267 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

35355 A Rechanneling of artery 19.86 NA NA 8.54 8.60 4.535361 A Rechanneling of artery 30.24 NA NA 10.92 11.89 7.135363 A Rechanneling of artery 32.35 NA NA 14.26 14.57 7.535371 A Rechanneling of artery 15.31 NA NA 7.24 7.24 3.535372 A Rechanneling of artery 18.58 NA NA 8.26 8.32 4.235390 A Reoperation carotid add-on 3.19 NA NA 1.11 1.12 0.735400 A Angioscopy 3.00 NA NA 1.01 1.05 0.635450 A Repair arterial blockage 10.05 NA NA 3.80 3.91 2.235452 A Repair arterial blockage 6.90 NA NA 2.78 2.80 1.535458 A Repair arterial blockage 9.48 NA NA 3.78 3.78 2.135460 A Repair venous blockage 6.03 NA NA 2.53 2.47 1.335471 A Repair arterial blockage 10.05 60.97 74.92 3.97 4.78 1.935472 A Repair arterial blockage 6.90 47.54 54.63 2.78 3.09 1.435475 R Repair arterial blockage 9.48 53.95 57.34 3.76 4.08 1.535476 A Repair venous blockage 6.03 42.20 44.78 2.51 2.70 0.835500 A Harvest vein for bypass 6.44 NA NA 2.21 2.21 1.535501 A Artery bypass graft 29.09 NA NA 14.22 13.89 6.735506 A Artery bypass graft 25.33 NA NA 10.69 11.00 6.035508 A Artery bypass graft 26.09 NA NA 12.28 12.11 6.535509 A Artery bypass graft 28.09 NA NA 11.98 12.42 6.6

3550F I Low rsk thromboembolism 0.00 0.00 0.00 0.00 0.00 0.0

35510 A Artery bypass graft 24.39 NA NA 8.92 9.82 5.735511 A Artery bypass graft 22.20 NA NA 12.92 11.62 5.235512 A Artery bypass graft 23.89 NA NA 8.77 9.53 5.635515 A Artery bypass graft 26.09 NA NA 9.93 10.13 6.135516 A Artery bypass graft 24.21 NA NA 8.83 9.03 5.735518 A Artery bypass graft 22.65 NA NA 8.27 9.29 5.3

3551F I Intrmed rsk thromboembolism 0.00 0.00 0.00 0.00 0.00 0.0

35521 A Artery bypass graft 24.13 NA NA 13.65 12.15 5.735522 A Artery bypass graft 23.15 NA NA 10.14 10.20 5.4
CMS-1582-PN 268 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

35523 A Artery bypass graft 24.13 NA NA 10.83 11.14 5.435525 A Artery bypass graft 21.69 NA NA 9.76 9.67 4.835526 A Artery bypass graft 31.55 NA NA 11.34 12.76 7.8

3552F I Hgh risk for thromboembolism 0.00 0.00 0.00 0.00 0.00 0.0

35531 A Artery bypass graft 39.11 NA NA 16.17 16.07 8.935533 A Artery bypass graft 29.92 NA NA 16.16 14.60 7.135535 A Artery bypass graft 38.13 NA NA 13.31 14.94 2.735536 A Artery bypass graft 33.73 NA NA 11.96 12.80 8.035537 A Artery bypass graft 41.88 NA NA 21.49 19.21 9.935538 A Artery bypass graft 47.03 NA NA 23.78 21.43 11.135539 A Artery bypass graft 44.11 NA NA 15.12 15.96 10.435540 A Artery bypass graft 49.33 NA NA 20.90 19.93 11.335548 A Artery bypass graft 22.68 NA NA 8.67 9.47 5.335549 A Artery bypass graft 24.45 NA NA 16.06 13.75 5.235551 A Artery bypass graft 27.83 NA NA 15.24 14.13 5.935556 A Artery bypass graft 26.75 NA NA 11.63 11.46 6.135558 A Artery bypass graft 23.13 NA NA 10.80 10.66 5.3

3555F I Pt inr measurement performed 0.00 0.00 0.00 0.00 0.00 0.0

35560 A Artery bypass graft 34.03 NA NA 12.05 13.22 8.035563 A Artery bypass graft 26.12 NA NA 9.70 10.41 6.135565 A Artery bypass graft 25.13 NA NA 11.01 11.06 5.735566 A Artery bypass graft 32.35 NA NA 13.46 13.30 7.535570 A Artery bypass graft 29.15 NA NA 10.74 12.05 2.035571 A Artery bypass graft 25.52 NA NA 10.92 11.05 5.835572 A Harvest femoropopliteal vein 6.81 NA NA 2.47 2.54 1.535583 A Vein bypass graft 27.75 NA NA 11.99 11.76 6.335585 A Vein bypass graft 32.35 NA NA 13.77 13.59 7.435587 A Vein bypass graft 26.21 NA NA 11.66 11.67 6.035600 A Harvest art for cabg add-on 4.94 NA NA 1.84 1.92 1.235601 A Artery bypass graft 27.09 NA NA 13.22 12.78 6.3
CMS-1582-PN 269 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

35606 A Artery bypass graft 22.46 NA NA 9.59 9.70 5.235612 A Artery bypass graft 20.35 NA NA 7.50 7.72 4.835616 A Artery bypass graft 21.82 NA NA 12.00 10.67 4.635621 A Artery bypass graft 21.03 NA NA 9.07 9.13 4.835623 A Bypass graft not vein 25.92 NA NA 14.42 12.88 6.135626 A Artery bypass graft 29.14 NA NA 12.85 13.20 6.935631 A Artery bypass graft 36.03 NA NA 14.10 14.29 8.435632 A Artery bypass graft 36.13 NA NA 12.72 14.27 2.535633 A Artery bypass graft 39.11 NA NA 15.01 15.99 2.735634 A Artery bypass graft 35.33 NA NA 13.53 14.54 2.535636 A Artery bypass graft 31.75 NA NA 16.96 15.22 7.535637 A Artery bypass graft 33.05 NA NA 13.98 13.73 7.635638 A Artery bypass graft 33.60 NA NA 14.43 14.21 7.835642 A Artery bypass graft 18.94 NA NA 11.89 10.88 4.435645 A Artery bypass graft 18.43 NA NA 10.87 9.68 4.635646 A Artery bypass graft 32.98 NA NA 13.87 13.98 7.535647 A Artery bypass graft 29.73 NA NA 12.91 12.91 6.935650 A Artery bypass graft 20.16 NA NA 9.25 9.16 4.635651 A Artery bypass graft 26.08 NA NA 9.68 10.77 5.535654 A Artery bypass graft 26.28 NA NA 11.31 11.33 6.035656 A Artery bypass graft 20.47 NA NA 9.23 9.23 4.735661 A Artery bypass graft 20.35 NA NA 9.48 9.51 4.735663 A Artery bypass graft 23.93 NA NA 10.23 10.44 5.435665 A Artery bypass graft 22.35 NA NA 9.82 9.91 5.135666 A Artery bypass graft 23.66 NA NA 11.24 11.32 5.435671 A Artery bypass graft 20.77 NA NA 9.96 10.06 4.735681 A Composite bypass graft 1.60 NA NA 0.56 0.56 0.335682 A Composite bypass graft 7.19 NA NA 2.37 2.41 1.635683 A Composite bypass graft 8.49 NA NA 2.52 2.70 2.035685 A Bypass graft patency/patch 4.04 NA NA 1.37 1.37 0.9
CMS-1582-PN 270 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

35686 A Bypass graft/av fist patency 3.34 NA NA 1.13 1.17 0.735691 A Arterial transposition 18.41 NA NA 7.23 7.94 4.335693 A Arterial transposition 15.73 NA NA 7.01 7.75 3.735694 A Arterial transposition 19.28 NA NA 8.52 8.58 4.535695 A Arterial transposition 20.06 NA NA 7.72 8.39 4.735697 A Reimplant artery each 3.00 NA NA 1.02 1.03 0.635700 A Reoperation bypass graft 3.08 NA NA 1.06 1.07 0.735701 A Exploration carotid artery 9.19 NA NA 6.54 6.15 1.835721 A Exploration femoral artery 7.72 NA NA 4.72 4.82 1.7

3572F I Pt consid poss risk fx 0.00 0.00 0.00 0.00 0.00 0.03573F I Pt not consid poss risk fx 0.00 0.00 0.00 0.00 0.00 0.0

35741 A Exploration popliteal artery 8.69 NA NA 5.30 5.21 1.935761 A Exploration of artery/vein 5.93 NA NA 4.81 4.65 1.235800 A Explore neck vessels 12.00 NA NA 7.27 6.71 2.535820 A Explore chest vessels 36.89 NA NA 15.96 15.46 8.835840 A Explore abdominal vessels 20.75 NA NA 10.33 9.24 4.435860 A Explore limb vessels 15.25 NA NA 7.42 6.64 3.435870 A Repair vessel graft defect 24.50 NA NA 13.79 12.26 5.835875 A Removal of clot in graft 10.72 NA NA 5.71 5.68 2.435876 A Removal of clot in graft 17.82 NA NA 8.10 8.09 4.035879 A Revise graft w/vein 17.41 NA NA 8.04 8.05 4.035881 A Revise graft w/vein 19.35 NA NA 8.65 8.79 4.435883 A Revise graft w/nonauto graft 23.15 NA NA 9.99 9.71 5.335884 A Revise graft w/vein 24.65 NA NA 8.93 9.26 5.835901 A Excision graft neck 8.38 NA NA 5.59 5.60 1.935903 A Excision graft extremity 9.53 NA NA 6.14 6.18 2.135905 A Excision graft thorax 33.52 NA NA 11.90 12.93 7.935907 A Excision graft abdomen 37.27 NA NA 15.18 15.07 8.536000 A Place needle in vein 0.18 0.48 0.53 0.08 0.08 0.036002 A Pseudoaneurysm injection trt 1.96 2.44 2.70 0.95 1.04 0.3
CMS-1582-PN 271 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

36005 A Injection ext venography 0.95 8.54 9.19 0.35 0.40 0.136010 A Place catheter in vein 2.43 11.95 13.93 0.88 0.95 0.336011 A Place catheter in vein 3.14 21.52 23.82 1.17 1.25 0.436012 A Place catheter in vein 3.51 21.16 22.54 1.29 1.44 0.536013 A Place catheter in artery 2.52 19.50 21.22 0.94 1.01 0.436014 A Place catheter in artery 3.02 20.49 22.01 1.12 1.27 0.336015 A Place catheter in artery 3.51 21.82 23.68 1.29 1.46 0.336100 A Establish access to artery 3.02 10.80 12.14 1.13 1.29 0.636120 A Establish access to artery 2.01 10.39 11.10 0.71 0.75 0.336140 A Establish access to artery 2.01 10.60 11.95 0.73 0.81 0.336147 A Access av dial grft for eval 3.72 20.11 20.11 1.43 1.43 0.536148 A Access av dial grft for proc 1.00 6.55 6.55 0.37 0.37 0.136160 A Establish access to aorta 2.52 11.11 12.64 0.90 1.06 0.336200 A Place catheter in aorta 3.02 12.93 13.90 0.98 1.05 0.636215 A Place catheter in artery 4.67 26.51 29.00 1.80 2.05 0.836216 A Place catheter in artery 5.27 29.29 31.75 2.08 2.33 0.936217 A Place catheter in artery 6.29 50.61 54.62 2.53 2.79 1.036218 A Place catheter in artery 1.01 4.16 4.57 0.40 0.44 0.136245 A Place catheter in artery 4.67 26.43 30.85 1.78 2.14 0.836246 A Place catheter in artery 5.27 22.83 25.31 1.78 1.94 0.936247 A Place catheter in artery 6.29 41.60 44.68 2.11 2.30 1.136248 A Place catheter in artery 1.01 3.20 3.65 0.36 0.42 0.136260 A Insertion of infusion pump 9.91 NA NA 7.17 6.52 2.136261 A Revision of infusion pump 5.63 NA NA 4.99 4.59 1.336262 A Removal of infusion pump 4.11 NA NA 4.05 3.73 0.836299 C Vessel injection procedure 0.00 0.00 0.00 0.00 0.00 0.036400 A Bl draw < 3 yrs fem/jugular 0.38 0.52 0.43 0.08 0.09 0.036405 A Bl draw < 3 yrs scalp vein 0.31 0.35 0.35 0.13 0.12 0.036406 A Bl draw < 3 yrs other vein 0.18 0.28 0.30 0.07 0.07 0.036410 A Non-routine bl draw > 3 yrs 0.18 0.27 0.33 0.08 0.07 0.0
CMS-1582-PN 272 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

36415 X Routine venipuncture 0.00 0.00 0.00 0.00 0.00 0.036416 B Capillary blood draw 0.00 0.00 0.00 0.00 0.00 0.036420 A Vein access cutdown < 1 yr 1.01 NA NA 0.23 0.27 0.136425 A Vein access cutdown > 1 yr 0.76 NA NA 0.34 0.31 0.136430 A Blood transfusion service 0.00 0.90 1.02 NA NA 0.036440 A Bl push transfuse 2 yr or < 1.03 NA NA 0.50 0.42 0.236450 A Bl exchange/transfuse nb 2.23 NA NA 1.09 1.03 0.136455 A Bl exchange/transfuse non-nb 2.43 NA NA 0.85 0.99 0.136460 A Transfusion service fetal 6.58 NA NA 3.06 2.71 1.436468 R Injection(s) spider veins 0.00 0.00 0.00 0.00 0.00 0.036469 R Injection(s) spider veins 0.00 0.00 0.00 0.00 0.00 0.036470 A Injection therapy of vein 1.10 3.24 3.15 1.25 1.13 0.236471 A Injection therapy of veins 1.65 3.18 3.18 1.04 1.03 0.336475 A Endovenous rf 1st vein 6.72 43.76 46.32 2.77 2.73 1.436476 A Endovenous rf vein add-on 3.38 7.57 7.80 1.23 1.22 0.736478 A Endovenous laser 1st vein 6.72 31.30 35.01 2.72 2.76 1.336479 A Endovenous laser vein addon 3.38 7.78 8.22 1.28 1.26 0.636481 A Insertion of catheter vein 6.98 53.44 29.48 3.00 3.00 0.836500 A Insertion of catheter vein 3.51 NA NA 1.35 1.48 0.5

3650F I Eeg ordered rvwd reqstd 0.00 0.00 0.00 0.00 0.00 0.0

36510 A Insertion of catheter vein 1.09 1.52 1.81 0.53 0.50 0.236511 A Apheresis wbc 1.74 NA NA 0.89 0.82 0.236512 A Apheresis rbc 1.74 NA NA 0.87 0.84 0.136513 A Apheresis platelets 1.74 NA NA 0.98 0.91 0.336514 A Apheresis plasma 1.74 12.13 13.33 0.80 0.77 0.236515 A Apheresis adsorp/reinfuse 1.74 50.11 55.17 0.88 0.78 0.236516 A Apheresis selective 1.22 54.14 61.60 0.56 0.53 0.336522 A Photopheresis 1.67 34.80 38.36 1.20 1.19 0.136555 A Insert non-tunnel cv cath 2.68 4.66 5.07 0.66 0.74 0.236556 A Insert non-tunnel cv cath 2.50 3.92 4.13 0.84 0.80 0.3
CMS-1582-PN 273 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

36557 A Insert tunneled cv cath 5.14 22.62 21.59 3.58 3.36 1.036558 A Insert tunneled cv cath 4.84 16.82 18.39 2.80 2.94 0.736560 A Insert tunneled cv cath 6.29 31.86 30.60 4.10 3.82 0.536561 A Insert tunneled cv cath 6.04 26.73 27.95 3.59 3.52 1.136563 A Insert tunneled cv cath 6.24 30.35 29.76 3.87 3.64 1.336565 A Insert tunneled cv cath 6.04 21.50 22.48 3.33 3.31 1.236566 A Insert tunneled cv cath 6.54 140.45 124.76 3.70 3.58 1.236568 A Insert picc cath 1.92 5.85 6.73 0.75 0.76 0.136569 A Insert picc cath 1.82 4.95 5.65 0.73 0.79 0.136570 A Insert picvad cath 5.36 24.17 27.56 2.98 3.20 0.436571 A Insert picvad cath 5.34 30.28 31.38 3.34 3.25 1.036575 A Repair tunneled cv cath 0.67 3.85 4.04 0.30 0.30 0.136576 A Repair tunneled cv cath 3.24 7.11 7.32 2.05 2.06 0.536578 A Replace tunneled cv cath 3.54 10.48 11.13 2.37 2.47 0.536580 A Replace cvad cath 1.31 4.57 5.16 0.54 0.55 0.136581 A Replace tunneled cv cath 3.48 17.51 18.82 1.96 2.12 0.436582 A Replace tunneled cv cath 5.24 25.46 26.57 3.11 3.17 0.836583 A Replace tunneled cv cath 5.29 32.29 30.01 3.66 3.43 1.136584 A Replace picc cath 1.20 4.34 5.05 0.66 0.71 0.136585 A Replace picvad cath 4.84 25.61 27.34 2.86 3.00 0.636589 A Removal tunneled cv cath 2.28 2.27 2.35 1.54 1.57 0.336590 A Removal tunneled cv cath 3.35 4.65 4.52 2.22 2.14 0.636591 T Draw blood off venous device 0.00 0.61 0.67 NA NA 0.036592 T Collect blood from picc 0.00 0.69 0.75 NA NA 0.036593 A Declot vascular device 0.00 0.82 0.84 NA NA 0.036595 A Mech remov tunneled cv cath 3.59 11.87 13.52 1.52 1.68 0.336596 A Mech remov tunneled cv cath 0.75 2.88 3.18 0.48 0.52 0.136597 A Reposition venous catheter 1.21 2.20 2.41 0.48 0.54 0.136598 T Inj w/fluor eval cv device 0.74 2.31 2.55 0.27 0.67 0.036600 A Withdrawal of arterial blood 0.32 0.55 0.55 0.11 0.10 0.0
CMS-1582-PN 274 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

36620 A Insertion catheter artery 1.15 NA NA 0.29 0.25 0.136625 A Insertion catheter artery 2.11 NA NA 0.71 0.70 0.436640 A Insertion catheter artery 2.10 NA NA 1.40 1.29 0.436660 A Insertion catheter artery 1.40 NA NA 0.68 0.53 0.336680 A Insert needle bone cavity 1.20 NA NA 0.34 0.37 0.236800 A Insertion of cannula 2.43 NA NA 2.01 2.00 0.436810 A Insertion of cannula 3.96 NA NA 1.80 1.74 0.736815 A Insertion of cannula 2.62 NA NA 1.46 1.42 0.536818 A Av fuse uppr arm cephalic 11.89 NA NA 6.34 6.26 2.636819 A Av fuse uppr arm basilic 13.29 NA NA 6.49 6.53 2.936820 A Av fusion/forearm vein 14.47 NA NA 7.49 7.24 3.236821 A Av fusion direct any site 12.11 NA NA 6.62 6.43 2.736822 A Insertion of cannula(s) 5.57 NA NA 4.69 4.79 1.236823 A Insertion of cannula(s) 22.98 NA NA 12.41 11.91 5.036825 A Artery-vein autograft 14.17 NA NA 7.24 6.78 3.136830 A Artery-vein nonautograft 12.03 NA NA 5.78 5.68 2.736831 A Open thrombect av fistula 8.04 NA NA 4.43 4.34 1.836832 A Av fistula revision open 10.53 NA NA 5.26 5.15 2.336833 A Av fistula revision 11.98 NA NA 5.83 5.70 2.636835 A Artery to vein shunt 7.51 NA NA 5.92 5.51 1.736838 A Dist revas ligation hemo 21.69 NA NA 9.44 9.52 4.936860 A External cannula declotting 2.01 3.79 3.71 1.04 0.94 0.236861 A Cannula declotting 2.52 NA NA 1.61 1.62 0.436870 A Percut thrombect av fistula 5.20 46.24 49.76 3.10 3.35 0.6

3700F I Psych disorders assessed 0.00 0.00 0.00 0.00 0.00 0.0

37140 A Revision of circulation 40.00 NA NA 19.84 17.69 8.537145 A Revision of circulation 37.00 NA NA 18.52 17.00 8.037160 A Revision of circulation 38.00 NA NA 19.03 16.85 8.137180 A Revision of circulation 36.50 NA NA 18.38 16.57 7.837181 A Splice spleen/kidney veins 40.00 NA NA 19.84 17.93 8.5
CMS-1582-PN 275 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

37182 A Insert hepatic shunt (tips) 16.97 NA NA 6.31 7.31 1.637183 A Remove hepatic shunt (tips) 7.99 151.60 151.60 2.99 3.52 0.737184 A Prim art mech thrombectomy 8.66 54.42 61.00 3.55 3.90 1.537185 A Prim art m-thrombect add-on 3.28 17.42 19.61 1.20 1.32 0.637186 A Sec art m-thrombect add-on 4.92 34.22 40.44 1.80 2.08 0.937187 A Venous mech thrombectomy 8.03 52.07 58.58 3.18 3.57 1.137188 A Venous m-thrombectomy add-on 5.71 44.73 50.73 2.38 2.69 0.637195 C Thrombolytic therapy stroke 0.00 0.00 0.00 0.00 0.00 0.037200 A Transcatheter biopsy 4.55 NA NA 1.63 1.89 0.437201 A Transcatheter therapy infuse 4.99 NA NA 2.48 2.75 0.737202 A Transcatheter therapy infuse 5.67 NA NA 2.96 3.49 1.137203 A Transcatheter retrieval 5.02 31.49 34.36 2.08 2.36 0.637204 A Transcatheter occlusion 18.11 NA NA 6.50 7.32 2.237205 A Transcath iv stent percut 8.27 107.98 118.17 3.04 3.63 1.537206 A Transcath iv stent/perc addl 4.12 65.64 72.04 1.48 1.70 0.837207 A Transcath iv stent open 8.27 NA NA 3.22 3.26 1.837208 A Transcath iv stent/open addl 4.12 NA NA 1.41 1.42 0.937209 A Change iv cath at thromb tx 2.27 NA NA 0.80 0.89 0.3

3720F I Cognit impairment assessed 0.00 0.00 0.00 0.00 0.00 0.0

37210 A Embolization uterine fibroid 10.60 88.25 94.83 3.99 4.66 1.037215 R Transcath stent cca w/eps 19.68 NA NA 8.91 10.47 4.137216 N Transcath stent cca w/o eps 18.95 NA NA 10.06 10.00 1.337220 A Iliac revasc 8.15 83.53 83.53 3.02 3.02 1.637221 A Iliac revasc w/stent 10.00 126.04 126.04 3.73 3.73 1.837222 A Iliac revasc add-on 3.73 22.43 22.43 1.34 1.34 0.737223 A Iliac revasc w/stent add-on 4.25 70.87 70.87 1.53 1.53 0.837224 A Fem/popl revas w/tla 9.00 101.34 101.34 3.33 3.33 1.837225 A Fem/popl revas w/ather 12.00 302.09 302.09 4.53 4.53 2.537226 A Fem/popl revasc w/stent 10.49 253.23 253.23 3.91 3.91 1.237227 A Fem/popl revasc stnt & ather 14.50 410.48 410.48 5.46 5.46 3.0
CMS-1582-PN 276 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

37228 A Tib/per revasc w/tla 11.00 146.38 146.38 4.02 4.02 2.237229 A Tib/per revasc w/ather 14.05 296.88 296.88 5.28 5.28 2.937230 A Tib/per revasc w/stent 13.80 230.22 230.22 5.11 5.11 2.637231 A Tib/per revasc stent & ather 15.00 377.88 377.88 5.55 5.55 2.837232 A Tib/per revasc add-on 4.00 31.04 31.04 1.43 1.43 0.837233 A Tibper revasc w/ather add-on 6.50 35.96 35.96 2.40 2.40 1.337234 A Revsc opn/prq tib/pero stent 5.50 107.58 107.58 1.97 1.97 1.037235 A Tib/per revasc stnt & ather 7.80 112.63 112.63 2.80 2.80 1.537250 A Iv us first vessel add-on 2.10 NA NA 0.74 0.84 0.437251 A Iv us each add vessel add-on 1.60 NA NA 0.53 0.58 0.337500 A Endoscopy ligate perf veins 11.67 NA NA 7.12 7.15 2.637501 C Vascular endoscopy procedure 0.00 0.00 0.00 0.00 0.00 0.037565 A Ligation of neck vein 12.05 NA NA 7.63 7.16 2.537600 A Ligation of neck artery 12.42 NA NA 7.10 6.88 2.537605 A Ligation of neck artery 14.28 NA NA 7.51 7.36 3.337606 A Ligation of neck artery 8.81 NA NA 4.32 4.86 1.837607 A Ligation of a-v fistula 6.25 NA NA 4.09 4.01 1.337609 A Temporal artery procedure 3.05 5.60 5.41 2.66 2.49 0.637615 A Ligation of neck artery 7.80 NA NA 6.95 6.06 1.637616 A Ligation of chest artery 18.97 NA NA 10.36 10.26 4.037617 A Ligation of abdomen artery 23.79 NA NA 11.70 11.05 5.037618 A Ligation of extremity artery 6.03 NA NA 4.50 4.39 1.337620 A Revision of major vein 11.57 NA NA 5.99 6.52 1.737650 A Revision of major vein 8.49 NA NA 4.07 4.72 1.837660 A Revision of major vein 22.28 NA NA 12.20 11.10 4.737700 A Revise leg vein 3.82 NA NA 3.14 3.11 0.837718 A Ligate/strip short leg vein 7.13 NA NA 4.84 4.73 1.537722 A Ligate/strip long leg vein 8.16 NA NA 5.11 4.98 1.837735 A Removal of leg veins/lesion 10.90 NA NA 6.14 6.12 2.437760 A Ligate leg veins radical 10.78 NA NA 7.44 6.71 2.2
CMS-1582-PN 277 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

37761 A Ligate leg veins open 9.13 NA NA 6.18 6.18 1.937765 A Stab phleb veins xtr 10-20 7.71 10.64 10.64 4.66 4.73 1.537766 A Phleb veins - extrem 20+ 9.66 12.06 12.06 5.42 5.49 2.037780 A Revision of leg vein 3.93 NA NA 3.24 3.22 0.837785 A Ligate/divide/excise vein 3.93 5.96 6.01 3.26 3.24 0.837788 A Revascularization penis 23.33 NA NA 12.80 13.68 4.937790 A Penile venous occlusion 8.43 NA NA 4.99 5.26 0.837799 C Vascular surgery procedure 0.00 0.00 0.00 0.00 0.00 0.038100 A Removal of spleen total 19.55 NA NA 10.74 9.63 4.038101 A Removal of spleen partial 19.55 NA NA 11.02 9.81 4.138102 A Removal of spleen total 4.79 NA NA 2.08 1.91 0.938115 A Repair of ruptured spleen 21.88 NA NA 11.78 10.55 4.238120 A Laparoscopy splenectomy 17.07 NA NA 10.70 9.78 3.638129 C Laparoscope proc spleen 0.00 0.00 0.00 0.00 0.00 0.038200 A Injection for spleen x-ray 2.64 NA NA 1.15 1.17 0.638204 B Bl donor search management 2.00 NA NA 0.88 0.85 0.138205 R Harvest allogenic stem cells 1.50 NA NA 0.80 0.77 0.038206 R Harvest auto stem cells 1.50 NA NA 0.81 0.77 0.138207 I Cryopreserve stem cells 0.89 NA NA 0.39 0.46 0.038208 I Thaw preserved stem cells 0.56 NA NA 0.25 0.29 0.038209 I Wash harvest stem cells 0.24 NA NA 0.11 0.13 0.038210 I T-cell depletion of harvest 1.57 NA NA 0.69 0.82 0.138211 I Tumor cell deplete of harvst 1.42 NA NA 0.62 0.74 0.138212 I Rbc depletion of harvest 0.94 NA NA 0.41 0.49 0.038213 I Platelet deplete of harvest 0.24 NA NA 0.11 0.13 0.038214 I Volume deplete of harvest 0.81 NA NA 0.35 0.42 0.038215 I Harvest stem cell concentrte 0.94 NA NA 0.41 0.49 0.038220 A Bone marrow aspiration 1.08 2.92 3.26 0.63 0.62 0.138221 A Bone marrow biopsy 1.37 2.94 3.36 0.79 0.78 0.038230 R Bone marrow collection 4.85 NA NA 4.43 4.15 1.1
CMS-1582-PN 278 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

38240 R Bone marrow/stem transplant 2.24 NA NA 1.35 1.29 0.138241 R Bone marrow/stem transplant 2.24 NA NA 1.33 1.30 0.138242 A Lymphocyte infuse transplant 1.71 NA NA 1.05 1.00 0.138300 A Drainage lymph node lesion 2.36 5.27 5.24 2.69 2.61 0.438305 A Drainage lymph node lesion 6.68 NA NA 5.68 5.47 1.338308 A Incision of lymph channels 6.81 NA NA 5.15 4.81 1.438380 A Thoracic duct procedure 8.46 NA NA 8.05 7.27 1.038381 A Thoracic duct procedure 13.38 NA NA 7.63 7.77 3.138382 A Thoracic duct procedure 10.65 NA NA 7.05 6.93 2.238500 A Biopsy/removal lymph nodes 3.79 5.13 4.86 2.97 2.76 0.738505 A Needle biopsy lymph nodes 1.14 2.32 2.44 0.84 0.89 0.138510 A Biopsy/removal lymph nodes 6.74 7.59 7.16 4.78 4.40 1.238520 A Biopsy/removal lymph nodes 7.03 NA NA 5.50 5.16 1.438525 A Biopsy/removal lymph nodes 6.43 NA NA 5.10 4.69 1.338530 A Biopsy/removal lymph nodes 8.34 NA NA 6.25 5.78 1.838542 A Explore deep node(s) neck 7.95 NA NA 6.49 6.00 1.338550 A Removal neck/armpit lesion 7.11 NA NA 6.36 5.78 1.538555 A Removal neck/armpit lesion 15.59 NA NA 11.07 10.41 3.338562 A Removal pelvic lymph nodes 11.06 NA NA 7.63 7.44 1.938564 A Removal abdomen lymph nodes 11.38 NA NA 7.32 6.92 2.238570 A Laparoscopy lymph node biop 9.34 NA NA 5.12 5.15 1.338571 A Laparoscopy lymphadenectomy 14.76 NA NA 7.04 7.77 1.438572 A Laparoscopy lymphadenectomy 16.94 NA NA 8.88 8.42 2.438589 C Laparoscope proc lymphatic 0.00 0.00 0.00 0.00 0.00 0.038700 A Removal of lymph nodes neck 12.81 NA NA 10.13 9.14 1.738720 A Removal of lymph nodes neck 21.95 NA NA 15.87 14.28 3.338724 A Removal of lymph nodes neck 23.95 NA NA 17.57 15.58 3.338740 A Remove armpit lymph nodes 10.70 NA NA 7.52 6.91 2.238745 A Remove armpit lymph nodes 13.87 NA NA 9.21 8.42 2.938746 A Remove thoracic lymph nodes 4.88 NA NA 1.79 1.86 1.1
CMS-1582-PN 279 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

38747 A Remove abdominal lymph nodes 4.88 NA NA 2.09 1.93 1.038760 A Remove groin lymph nodes 13.62 NA NA 8.70 8.13 2.738765 A Remove groin lymph nodes 21.91 NA NA 12.29 11.59 4.238770 A Remove pelvis lymph nodes 14.06 NA NA 7.83 8.06 1.738780 A Remove abdomen lymph nodes 17.70 NA NA 10.22 10.31 2.538790 A Inject for lymphatic x-ray 1.29 NA NA 0.96 0.95 0.238792 A Identify sentinel node 0.52 NA NA 0.59 0.59 0.038794 A Access thoracic lymph duct 4.62 NA NA 3.42 3.78 0.438900 A Io map of sent lymph node 2.50 1.01 1.01 1.01 1.01 0.538999 C Blood/lymph system procedure 0.00 0.00 0.00 0.00 0.00 0.039000 A Exploration of chest 7.57 NA NA 5.78 5.67 1.639010 A Exploration of chest 13.19 NA NA 7.59 7.86 3.139200 A Removal chest lesion 15.09 NA NA 7.99 8.14 3.539220 A Removal chest lesion 19.55 NA NA 10.45 10.56 4.439400 A Visualization of chest 8.05 NA NA 5.32 5.39 1.839499 C Chest procedure 0.00 0.00 0.00 0.00 0.00 0.039501 A Repair diaphragm laceration 13.98 NA NA 8.44 8.00 2.939503 A Repair of diaphragm hernia 108.91 NA NA 51.96 45.81 23.239540 A Repair of diaphragm hernia 14.57 NA NA 8.40 7.87 3.139541 A Repair of diaphragm hernia 15.75 NA NA 9.20 8.55 3.439545 A Revision of diaphragm 14.67 NA NA 8.75 8.82 3.439560 A Resect diaphragm simple 13.06 NA NA 7.85 7.53 2.739561 A Resect diaphragm complex 19.99 NA NA 12.98 12.38 4.339599 C Diaphragm surgery procedure 0.00 0.00 0.00 0.00 0.00 0.0

4014F I Written discharge instr prvd 0.00 0.00 0.00 0.00 0.00 0.04016F I Anti-inflm/anlgsc agent rx 0.00 0.00 0.00 0.00 0.00 0.04017F I Gi prophylaxis for nsaid rx 0.00 0.00 0.00 0.00 0.00 0.04018F I Therapy exercise joint rx 0.00 0.00 0.00 0.00 0.00 0.04019F I Doc recpt counsl vit d/calc+ 0.00 0.00 0.00 0.00 0.00 0.04030F I Oxygen therapy rx 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 280 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

4033F I Pulmonary rehab rec 0.00 0.00 0.00 0.00 0.00 0.04035F I Influenza imm rec 0.00 0.00 0.00 0.00 0.00 0.0

40490 A Biopsy of lip 1.22 2.39 2.40 0.89 0.82 0.140500 A Partial excision of lip 4.47 10.00 9.65 5.96 5.66 0.640510 A Partial excision of lip 4.82 8.98 8.62 5.38 5.02 0.740520 A Partial excision of lip 4.79 9.18 8.92 5.46 5.13 0.740525 A Reconstruct lip with flap 7.72 NA NA 7.95 7.50 1.240527 A Reconstruct lip with flap 9.32 NA NA 8.62 8.35 1.2

4052F I Hemodialysis via av fistula 0.00 0.00 0.00 0.00 0.00 0.0

40530 A Partial removal of lip 5.54 9.85 9.56 5.99 5.67 0.8

4053F I Hemodialysis via av graft 0.00 0.00 0.00 0.00 0.00 0.04054F I Hemodialysis via catheter 0.00 0.00 0.00 0.00 0.00 0.04055F I Pt rcvng periton dialysis 0.00 0.00 0.00 0.00 0.00 0.04056F I Approp oral rehyd recommd 0.00 0.00 0.00 0.00 0.00 0.04058F I Ped gastro ed given caregvr 0.00 0.00 0.00 0.00 0.00 0.04060F I Psych svcs provided 0.00 0.00 0.00 0.00 0.00 0.04062F I Pt referral psych docd 0.00 0.00 0.00 0.00 0.00 0.04063F I Antidepres rxthxpy not rxd 0.00 0.00 0.00 0.00 0.00 0.04064F I Antidepressant rx 0.00 0.00 0.00 0.00 0.00 0.0

40650 A Repair lip 3.78 8.00 7.76 4.31 4.12 0.640652 A Repair lip 4.43 9.24 9.02 5.50 5.23 0.740654 A Repair lip 5.48 10.58 10.32 6.52 6.21 0.9

4065F I Antipsychotic rx 0.00 0.00 0.00 0.00 0.00 0.04066F I Ect provided 0.00 0.00 0.00 0.00 0.00 0.04067F I Pt referral for ect docd 0.00 0.00 0.00 0.00 0.00 0.0

40700 A Repair cleft lip/nasal 14.17 NA NA 14.32 12.51 1.840701 A Repair cleft lip/nasal 17.23 NA NA 13.83 13.53 2.240702 A Repair cleft lip/nasal 14.27 NA NA 9.10 9.15 1.040720 A Repair cleft lip/nasal 14.72 NA NA 12.06 11.55 2.940761 A Repair cleft lip/nasal 15.84 NA NA 14.86 13.47 3.1
CMS-1582-PN 281 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

4077F I Doc t-pa admin considered 0.00 0.00 0.00 0.00 0.00 0.0

40799 C Lip surgery procedure 0.00 0.00 0.00 0.00 0.00 0.040800 A Drainage of mouth lesion 1.23 4.77 4.59 2.53 2.40 0.140801 A Drainage of mouth lesion 2.63 6.36 6.06 3.74 3.51 0.340804 A Removal foreign body mouth 1.30 4.92 4.69 2.50 2.38 0.140805 A Removal foreign body mouth 2.79 6.53 6.26 3.71 3.51 0.340806 A Incision of lip fold 0.31 2.71 2.73 0.52 0.57 0.040808 A Biopsy of mouth lesion 1.01 4.39 4.24 2.13 2.04 0.140810 A Excision of mouth lesion 1.36 4.60 4.42 2.35 2.22 0.140812 A Excise/repair mouth lesion 2.37 5.89 5.60 3.32 3.10 0.340814 A Excise/repair mouth lesion 3.52 7.55 7.15 5.28 4.96 0.440816 A Excision of mouth lesion 3.77 7.83 7.44 5.40 5.08 0.540818 A Excise oral mucosa for graft 2.83 7.24 7.10 4.86 4.79 0.340819 A Excise lip or cheek fold 2.51 6.29 6.03 4.26 4.04 0.340820 A Treatment of mouth lesion 1.34 6.30 6.20 3.64 3.57 0.140830 A Repair mouth laceration 1.82 5.27 5.06 2.70 2.59 0.340831 A Repair mouth laceration 2.57 6.92 6.57 3.76 3.61 0.440840 R Reconstruction of mouth 9.15 15.68 14.07 9.87 8.71 1.140842 R Reconstruction of mouth 9.15 14.06 13.06 9.42 8.27 1.140843 R Reconstruction of mouth 12.79 17.17 15.94 10.01 9.08 2.540844 R Reconstruction of mouth 16.80 22.30 20.94 15.99 14.35 3.340845 R Reconstruction of mouth 19.36 22.53 21.30 15.86 14.77 2.440899 C Mouth surgery procedure 0.00 0.00 0.00 0.00 0.00 0.041000 A Drainage of mouth lesion 1.35 3.31 3.18 1.88 1.77 0.141005 A Drainage of mouth lesion 1.31 5.08 5.04 2.40 2.30 0.141006 A Drainage of mouth lesion 3.34 7.06 6.74 4.32 3.96 0.441007 A Drainage of mouth lesion 3.20 7.10 6.87 3.95 3.76 0.441008 A Drainage of mouth lesion 3.46 7.35 6.95 4.30 3.99 0.441009 A Drainage of mouth lesion 3.71 7.80 7.36 4.71 4.39 0.441010 A Incision of tongue fold 1.11 4.88 4.75 2.09 2.01 0.1
CMS-1582-PN 282 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

41015 A Drainage of mouth lesion 4.08 8.76 8.07 5.91 5.42 0.541016 A Drainage of mouth lesion 4.19 8.40 7.95 5.92 5.53 0.541017 A Drainage of mouth lesion 4.19 8.51 8.06 5.95 5.57 0.541018 A Drainage of mouth lesion 5.22 8.99 8.56 6.32 5.96 0.641019 A Place needles h&n for rt 8.84 NA NA 4.21 4.27 0.741100 A Biopsy of tongue 1.42 3.44 3.32 1.71 1.62 0.241105 A Biopsy of tongue 1.47 3.47 3.32 1.77 1.65 0.241108 A Biopsy of floor of mouth 1.10 3.20 3.06 1.53 1.44 0.141110 A Excision of tongue lesion 1.56 4.62 4.43 2.28 2.15 0.241112 A Excision of tongue lesion 2.83 6.83 6.51 4.51 4.25 0.341113 A Excision of tongue lesion 3.29 7.24 6.88 4.82 4.52 0.441114 A Excision of tongue lesion 8.82 NA NA 9.60 8.90 1.141115 A Excision of tongue fold 1.79 5.26 5.10 2.60 2.41 0.241116 A Excision of mouth lesion 2.52 7.08 6.74 3.88 3.66 0.341120 A Partial removal of tongue 11.14 NA NA 19.24 18.61 1.441130 A Partial removal of tongue 15.74 NA NA 21.95 20.82 2.041135 A Tongue and neck surgery 30.14 NA NA 31.85 29.76 4.041140 A Removal of tongue 29.15 NA NA 34.01 32.25 3.741145 A Tongue removal neck surgery 37.93 NA NA 41.92 39.24 4.841150 A Tongue mouth jaw surgery 29.86 NA NA 33.03 31.13 3.941153 A Tongue mouth neck surgery 33.59 NA NA 34.94 32.58 4.441155 A Tongue jaw & neck surgery 44.30 NA NA 41.46 37.99 5.941250 A Repair tongue laceration 1.96 5.21 4.73 2.25 2.03 0.341251 A Repair tongue laceration 2.32 5.43 4.73 2.52 2.28 0.341252 A Repair tongue laceration 3.02 5.97 5.62 3.00 2.80 0.4

4133F I Antihist/decong rx/recom 0.00 0.00 0.00 0.00 0.00 0.04134F I No antihist/decong rx/recom 0.00 0.00 0.00 0.00 0.00 0.04135F I Systemic corticosteroids rx 0.00 0.00 0.00 0.00 0.00 0.04136F I Syst corticosteroids not rx 0.00 0.00 0.00 0.00 0.00 0.0

41500 A Fixation of tongue 3.80 NA NA 9.36 9.04 0.4
CMS-1582-PN 283 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

41510 A Tongue to lip surgery 3.51 NA NA 6.58 7.30 0.441512 A Tongue suspension 6.86 NA NA 11.70 11.04 0.441520 A Reconstruction tongue fold 2.83 7.25 6.95 4.57 4.34 0.341530 A Tongue base vol reduction 4.51 90.54 90.03 7.58 7.21 0.3

4155F I Hep a vac series prev recvd 0.00 0.00 0.00 0.00 0.00 0.04157F I Hep b vac series prev recvd 0.00 0.00 0.00 0.00 0.00 0.0

41599 C Tongue and mouth surgery 0.00 0.00 0.00 0.00 0.00 0.0

4163F I Pt couns 4 txmnt opt prost 0.00 0.00 0.00 0.00 0.00 0.04167F I Hd bed tilted 1st day vent 0.00 0.00 0.00 0.00 0.00 0.04168F I Pt care icu&vent w/in 24hrs 0.00 0.00 0.00 0.00 0.00 0.04169F I No pt care icu/vent in 24hrs 0.00 0.00 0.00 0.00 0.00 0.04174F I Couns potent glauc impct 0.00 0.00 0.00 0.00 0.00 0.04176F I Talk re uv light pt/crgvr 0.00 0.00 0.00 0.00 0.00 0.04178F I Antid glbln rcvd w/in 26wks 0.00 0.00 0.00 0.00 0.00 0.0

41800 A Drainage of gum lesion 1.27 6.17 5.66 2.79 2.56 0.241805 A Removal foreign body gum 1.34 5.71 5.49 3.56 3.42 0.141806 A Removal foreign body jawbone 2.79 7.66 7.09 4.78 4.43 0.5

4181F I Conformal radn thxpy rcvd 0.00 0.00 0.00 0.00 0.00 0.0

41820 R Excision gum each quadrant 0.00 0.00 0.00 0.00 0.00 0.041821 R Excision of gum flap 0.00 0.00 0.00 0.00 0.00 0.041822 R Excision of gum lesion 2.41 5.90 5.64 2.87 2.55 0.341823 R Excision of gum lesion 3.77 8.48 8.16 5.57 5.21 0.441825 A Excision of gum lesion 1.41 4.62 4.47 2.10 2.08 0.241826 A Excision of gum lesion 2.41 6.56 6.00 3.71 3.39 0.341827 A Excision of gum lesion 3.83 8.75 8.30 5.06 4.69 0.441828 R Excision of gum lesion 3.14 5.64 5.27 3.03 2.75 0.3

4182F I No conformal radn thxpy 0.00 0.00 0.00 0.00 0.00 0.0

41830 R Removal of gum tissue 3.45 7.79 7.38 4.74 4.36 0.441850 R Treatment of gum lesion 0.00 0.00 0.00 0.00 0.00 0.0

4185F I Continuous ppi or h2ra rcvd 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 284 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

4186F I No cont ppi or h2ra rcvd 0.00 0.00 0.00 0.00 0.00 0.0

41870 R Gum graft 0.00 0.00 0.00 0.00 0.00 0.041872 R Repair gum 3.01 7.37 7.16 4.51 4.30 0.641874 R Repair tooth socket 3.19 7.47 7.10 4.17 3.86 0.3

4188F I Approp ace/arb tstng done 0.00 0.00 0.00 0.00 0.00 0.0

41899 C Dental surgery procedure 0.00 0.00 0.00 0.00 0.00 0.0

4189F I Approp digoxin tstng done 0.00 0.00 0.00 0.00 0.00 0.04190F I Approp diuretic tstng done 0.00 0.00 0.00 0.00 0.00 0.04191F I Approp anticonvuls tstng 0.00 0.00 0.00 0.00 0.00 0.0

42000 A Drainage mouth roof lesion 1.28 3.25 3.15 1.75 1.63 0.142100 A Biopsy roof of mouth 1.36 2.98 2.85 1.81 1.70 0.142104 A Excision lesion mouth roof 1.69 4.57 4.31 2.36 2.19 0.242106 A Excision lesion mouth roof 2.15 5.71 5.39 3.01 2.85 0.242107 A Excision lesion mouth roof 4.56 8.74 8.28 5.45 5.08 0.5

4210F I Ace/arb thxpy for >= 6 mons 0.00 0.00 0.00 0.00 0.00 0.0

42120 A Remove palate/lesion 11.86 NA NA 16.98 15.97 1.542140 A Excision of uvula 1.70 5.75 5.53 2.85 2.72 0.242145 A Repair palate pharynx/uvula 9.78 NA NA 10.74 10.00 1.242160 A Treatment mouth roof lesion 1.85 4.91 4.85 2.43 2.37 0.242180 A Repair palate 2.55 3.99 4.00 2.38 2.39 0.342182 A Repair palate 3.87 5.48 5.21 3.59 3.41 0.442200 A Reconstruct cleft palate 12.53 NA NA 12.21 11.67 1.642205 A Reconstruct cleft palate 13.66 NA NA 14.40 12.84 1.7

4220F I Digoxin thxpy for >= 6 mons 0.00 0.00 0.00 0.00 0.00 0.0

42210 A Reconstruct cleft palate 15.03 NA NA 13.70 13.28 2.942215 A Reconstruct cleft palate 8.99 NA NA 11.47 10.57 1.7

4221F I Diuretic thxpy for >= 6 mons 0.00 0.00 0.00 0.00 0.00 0.0

42220 A Reconstruct cleft palate 7.16 NA NA 8.33 7.93 0.542225 A Reconstruct cleft palate 9.77 NA NA 15.88 16.11 1.242226 A Lengthening of palate 10.35 NA NA 15.73 15.52 1.3
CMS-1582-PN 285 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

42227 A Lengthening of palate 9.90 NA NA 14.55 14.80 1.242235 A Repair palate 8.01 NA NA 13.44 12.97 1.042260 A Repair nose to lip fistula 10.22 13.43 12.71 8.96 8.34 1.342280 A Preparation palate mold 1.59 3.08 2.86 1.57 1.36 0.342281 A Insertion palate prosthesis 1.98 4.01 3.79 2.42 2.29 0.242299 C Palate/uvula surgery 0.00 0.00 0.00 0.00 0.00 0.042300 A Drainage of salivary gland 1.98 4.12 3.92 2.46 2.31 0.242305 A Drainage of salivary gland 6.31 NA NA 6.07 5.68 0.8

4230F I Anticonv thxpy for >= 6 mons 0.00 0.00 0.00 0.00 0.00 0.0

42310 A Drainage of salivary gland 1.61 3.12 2.96 2.03 1.90 0.242320 A Drainage of salivary gland 2.40 4.93 4.68 2.73 2.57 0.342330 A Removal of salivary stone 2.26 4.50 4.30 2.54 2.37 0.342335 A Removal of salivary stone 3.41 7.52 7.16 4.11 3.87 0.442340 A Removal of salivary stone 4.72 8.77 8.36 5.06 4.75 0.642400 A Biopsy of salivary gland 0.78 2.32 2.31 0.82 0.82 0.042405 A Biopsy of salivary gland 3.34 5.24 5.07 3.16 2.98 0.442408 A Excision of salivary cyst 4.66 8.64 8.18 4.91 4.55 0.642409 A Drainage of salivary cyst 2.91 6.88 6.54 3.59 3.39 0.3

4240F I Instr xrcz 4bk pn >12 weeks 0.00 0.00 0.00 0.00 0.00 0.0

42410 A Excise parotid gland/lesion 9.57 NA NA 8.17 7.58 1.442415 A Excise parotid gland/lesion 17.16 NA NA 12.66 12.31 2.242420 A Excise parotid gland/lesion 19.53 NA NA 13.96 13.62 2.642425 A Excise parotid gland/lesion 13.42 NA NA 10.61 9.89 1.842426 A Excise parotid gland/lesion 22.66 NA NA 16.10 14.89 3.1

4242F I Sprvsd xrcz bk pn >12 weeks 0.00 0.00 0.00 0.00 0.00 0.0

42440 A Excise submaxillary gland 7.13 NA NA 6.34 5.88 0.942450 A Excise sublingual gland 4.74 8.40 8.01 5.68 5.35 0.642500 A Repair salivary duct 4.42 8.15 7.77 5.51 5.20 0.642505 A Repair salivary duct 6.32 9.80 9.32 6.85 6.44 0.842507 A Parotid duct diversion 6.25 NA NA 8.74 8.33 0.8
CMS-1582-PN 286 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

42508 A Parotid duct diversion 9.33 NA NA 10.70 10.55 1.242509 A Parotid duct diversion 11.76 NA NA 10.13 10.44 2.342510 A Parotid duct diversion 8.35 NA NA 9.97 9.43 1.042550 A Injection for salivary x-ray 1.25 2.42 2.74 0.47 0.52 0.142600 A Closure of salivary fistula 4.94 9.08 8.72 5.21 4.94 0.6

4260F I Wound srfc culturetech used 0.00 0.00 0.00 0.00 0.00 0.04261F I Tech other than surfc cultr 0.00 0.00 0.00 0.00 0.00 0.0

42650 A Dilation of salivary duct 0.77 1.67 1.59 0.94 0.89 0.1

4265F I Wet-dry dressings rx recmd 0.00 0.00 0.00 0.00 0.00 0.0

42660 A Dilation of salivary duct 1.13 1.97 1.87 1.13 1.05 0.142665 A Ligation of salivary duct 2.63 6.59 6.27 3.42 3.24 0.3

4266F I No wet-dry drssings rx recmd 0.00 0.00 0.00 0.00 0.00 0.04268F I Pt ed re comp thxpy rcvd 0.00 0.00 0.00 0.00 0.00 0.0

42699 C Salivary surgery procedure 0.00 0.00 0.00 0.00 0.00 0.0

4269F I Appropos mthd offloading rxd 0.00 0.00 0.00 0.00 0.00 0.0

42700 A Drainage of tonsil abscess 1.67 3.84 3.69 2.27 2.17 0.242720 A Drainage of throat abscess 6.31 6.84 6.40 5.04 4.65 0.842725 A Drainage of throat abscess 12.41 NA NA 11.08 10.25 1.5

4275F I Hep b vac inj admin/rcvd 0.00 0.00 0.00 0.00 0.00 0.04279F I Pcp prophylaxis rxd 0.00 0.00 0.00 0.00 0.00 0.0

42800 A Biopsy of throat 1.44 3.20 3.06 1.83 1.73 0.242802 A Biopsy of throat 1.59 5.20 5.21 2.29 2.24 0.242804 A Biopsy of upper nose/throat 1.29 4.50 4.46 2.04 1.98 0.142806 A Biopsy of upper nose/throat 1.63 4.85 4.79 2.23 2.16 0.242808 A Excise pharynx lesion 2.35 4.29 4.10 2.37 2.24 0.342809 A Remove pharynx foreign body 1.86 3.04 2.91 1.90 1.77 0.242810 A Excision of neck cyst 3.38 8.02 7.69 5.10 4.80 0.442815 A Excision of neck cyst 7.31 NA NA 8.83 8.32 1.042820 A Remove tonsils and adenoids 4.22 NA NA 4.23 3.96 0.542821 A Remove tonsils and adenoids 4.36 NA NA 4.42 4.15 0.5
CMS-1582-PN 287 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

42825 A Removal of tonsils 3.51 NA NA 4.13 3.91 0.442826 A Removal of tonsils 3.45 NA NA 3.88 3.66 0.442830 A Removal of adenoids 2.65 NA NA 3.41 3.22 0.342831 A Removal of adenoids 2.81 NA NA 3.72 3.53 0.342835 A Removal of adenoids 2.38 NA NA 2.58 2.66 0.342836 A Removal of adenoids 3.26 NA NA 3.76 3.57 0.442842 A Extensive surgery of throat 12.23 NA NA 16.75 15.65 1.542844 A Extensive surgery of throat 17.78 NA NA 21.98 20.73 2.242845 A Extensive surgery of throat 32.56 NA NA 31.77 29.54 4.142860 A Excision of tonsil tags 2.30 NA NA 3.20 3.04 0.342870 A Excision of lingual tonsil 5.52 NA NA 11.41 11.02 0.742890 A Partial removal of pharynx 19.13 NA NA 21.85 20.24 2.542892 A Revision of pharyngeal walls 26.03 NA NA 28.30 25.83 3.442894 A Revision of pharyngeal walls 33.92 NA NA 34.51 31.75 4.442900 A Repair throat wound 5.29 NA NA 4.56 4.24 0.642950 A Reconstruction of throat 8.27 NA NA 14.73 14.28 1.142953 A Repair throat esophagus 9.45 NA NA 18.18 18.03 1.342955 A Surgical opening of throat 8.01 NA NA 13.95 13.29 1.042960 A Control throat bleeding 2.38 NA NA 2.53 2.38 0.342961 A Control throat bleeding 5.77 NA NA 6.49 6.10 0.742962 A Control throat bleeding 7.40 NA NA 7.65 7.19 0.942970 A Control nose/throat bleeding 5.82 NA NA 5.56 5.13 0.842971 A Control nose/throat bleeding 6.60 NA NA 6.72 6.27 0.842972 A Control nose/throat bleeding 7.59 NA NA 7.31 6.78 0.942999 C Throat surgery procedure 0.00 0.00 0.00 0.00 0.00 0.0

4300F I Pt rcvng warf thxpy 0.00 0.00 0.00 0.00 0.00 0.04301F I Pt not rcvng warf thxpy 0.00 0.00 0.00 0.00 0.00 0.0

43020 A Incision of esophagus 8.23 NA NA 7.45 6.60 1.043030 A Throat muscle surgery 7.99 NA NA 6.87 6.44 1.143045 A Incision of esophagus 21.88 NA NA 12.19 12.36 5.1
CMS-1582-PN 288 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

4305F I Pt ed re ft care inspct rcvd 0.00 0.00 0.00 0.00 0.00 0.04306F I Pt tlk psych & rx opd addic 0.00 0.00 0.00 0.00 0.00 0.0

43100 A Excision of esophagus lesion 9.66 NA NA 8.55 7.78 1.243101 A Excision of esophagus lesion 17.07 NA NA 9.25 9.37 4.043107 A Removal of esophagus 44.18 NA NA 22.68 22.09 9.843108 A Removal of esophagus 82.87 NA NA 40.18 34.84 17.643112 A Removal of esophagus 47.48 NA NA 22.60 22.52 10.743113 A Removal of esophagus 80.06 NA NA 40.33 36.45 17.043116 A Partial removal of esophagus 92.99 NA NA 58.31 47.38 11.943117 A Partial removal of esophagus 43.65 NA NA 20.83 20.55 9.843118 A Partial removal of esophagus 67.07 NA NA 33.31 29.22 14.343121 A Partial removal of esophagus 51.43 NA NA 23.09 22.40 12.043122 A Partial removal of esophagus 44.18 NA NA 22.65 21.55 9.643123 A Partial removal of esophagus 83.12 NA NA 41.66 35.76 17.743124 A Removal of esophagus 69.09 NA NA 36.43 32.16 16.143130 A Removal of esophagus pouch 12.53 NA NA 9.62 9.05 1.943135 A Removal of esophagus pouch 26.17 NA NA 13.16 12.63 5.943200 A Esophagus endoscopy 1.59 4.53 4.57 1.38 1.31 0.243201 A Esoph scope w/submucous inj 2.09 6.20 6.34 1.49 1.48 0.343202 A Esophagus endoscopy biopsy 1.89 6.04 6.18 1.32 1.27 0.243204 A Esoph scope w/sclerosis inj 3.76 NA NA 2.28 2.32 0.543205 A Esophagus endoscopy/ligation 3.78 NA NA 2.40 2.39 0.5

4320F I Pt talk psychsoc&rx oh dpnd 0.00 0.00 0.00 0.00 0.00 0.0

43215 A Esophagus endoscopy 2.60 NA NA 1.67 1.62 0.443216 A Esophagus endoscopy/lesion 2.40 3.65 3.38 1.59 1.55 0.343217 A Esophagus endoscopy 2.90 7.64 7.80 1.81 1.74 0.443219 A Esophagus endoscopy 2.80 NA NA 1.87 1.87 0.443220 A Esoph endoscopy dilation 2.10 NA NA 1.44 1.40 0.343226 A Esoph endoscopy dilation 2.34 NA NA 1.55 1.54 0.343227 A Esoph endoscopy repair 3.59 NA NA 2.22 2.18 0.5
CMS-1582-PN 289 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

43228 A Esoph endoscopy ablation 3.76 NA NA 2.38 2.35 0.543231 A Esoph endoscopy w/us exam 3.19 NA NA 2.06 2.05 0.443232 A Esoph endoscopy w/us fn bx 4.47 NA NA 2.73 2.72 0.643234 A Upper gi endoscopy exam 2.01 5.77 5.93 1.32 1.27 0.343235 A Uppr gi endoscopy diagnosis 2.39 5.71 6.01 1.61 1.60 0.343236 A Uppr gi scope w/submuc inj 2.92 7.11 7.53 1.92 1.93 0.443237 A Endoscopic us exam esoph 3.98 NA NA 2.49 2.50 0.643238 A Uppr gi endoscopy w/us fn bx 5.02 NA NA 3.03 3.06 0.743239 A Upper gi endoscopy biopsy 2.87 6.57 6.87 1.87 1.85 0.443240 A Esoph endoscope w/drain cyst 6.85 NA NA 4.07 4.04 1.043241 A Upper gi endoscopy with tube 2.59 NA NA 1.71 1.69 0.343242 A Uppr gi endoscopy w/us fn bx 7.30 NA NA 4.36 4.35 1.043243 A Upper gi endoscopy & inject 4.56 NA NA 2.80 2.80 0.643244 A Upper gi endoscopy/ligation 5.04 NA NA 3.11 3.11 0.743245 A Uppr gi scope dilate strictr 3.18 NA NA 2.00 1.97 0.543246 A Place gastrostomy tube 4.32 NA NA 2.58 2.55 0.643247 A Operative upper gi endoscopy 3.38 NA NA 2.14 2.12 0.543248 A Uppr gi endoscopy/guide wire 3.15 NA NA 2.06 2.06 0.443249 A Esoph endoscopy dilation 2.90 NA NA 1.90 1.90 0.4

4324F I Pt queried prkns complic 0.00 0.00 0.00 0.00 0.00 0.0

43250 A Upper gi endoscopy/tumor 3.20 NA NA 1.99 1.95 0.543251 A Operative upper gi endoscopy 3.69 NA NA 2.32 2.30 0.543255 A Operative upper gi endoscopy 4.81 NA NA 2.97 2.97 0.743256 A Uppr gi endoscopy w/stent 4.34 NA NA 2.63 2.64 0.643257 A Uppr gi scope w/thrml txmnt 5.50 NA NA 3.45 3.26 0.843258 A Operative upper gi endoscopy 4.54 NA NA 2.81 2.80 0.643259 A Endoscopic ultrasound exam 5.19 NA NA 3.19 3.19 0.7

4325F I Med txmnt options rvwd w/pt 0.00 0.00 0.00 0.00 0.00 0.0

43260 A Endo cholangiopancreatograph 5.95 NA NA 3.60 3.60 0.843261 A Endo cholangiopancreatograph 6.26 NA NA 3.78 3.78 0.9
CMS-1582-PN 290 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

43262 A Endo cholangiopancreatograph 7.38 NA NA 4.25 4.25 1.043263 A Endo cholangiopancreatograph 7.28 NA NA 4.27 4.33 1.043264 A Endo cholangiopancreatograph 8.89 NA NA 5.24 5.25 1.343265 A Endo cholangiopancreatograph 10.00 NA NA 5.84 5.85 1.443267 A Endo cholangiopancreatograph 7.38 NA NA 4.35 4.35 1.043268 A Endo cholangiopancreatograph 7.38 NA NA 4.56 4.57 1.043269 A Endo cholangiopancreatograph 8.20 NA NA 4.85 4.85 1.2

4326F I Pt asked re symp auto dysfxn 0.00 0.00 0.00 0.00 0.00 0.0

43271 A Endo cholangiopancreatograph 7.38 NA NA 4.39 4.39 1.043272 A Endo cholangiopancreatograph 7.38 NA NA 4.43 4.40 1.043273 A Endoscopic pancreatoscopy 2.24 NA NA 1.24 1.28 0.343279 A Lap myotomy heller 22.10 NA NA 12.01 10.96 4.743280 A Laparoscopy fundoplasty 18.10 NA NA 10.40 9.52 3.843281 A Lap paraesophag hern repair 26.60 NA NA 14.10 14.10 5.643282 A Lap paraesoph her rpr w/mesh 30.10 NA NA 15.61 15.61 6.343283 A Lap esoph lengthening 2.95 NA NA 1.28 1.28 0.643289 C Laparoscope proc esoph 0.00 0.00 0.00 0.00 0.00 0.0

4328F I Pt asked re sleep disturb 0.00 0.00 0.00 0.00 0.00 0.0

43300 A Repair of esophagus 9.33 NA NA 8.56 7.85 1.243305 A Repair esophagus and fistula 18.10 NA NA 13.55 12.42 2.3

4330F I Cnslng epi spec sfty issues 0.00 0.00 0.00 0.00 0.00 0.0

43310 A Repair of esophagus 26.26 NA NA 12.44 12.78 6.143312 A Repair esophagus and fistula 29.25 NA NA 12.29 13.17 6.843313 A Esophagoplasty congenital 48.45 NA NA 26.00 23.58 11.343314 A Tracheo-esophagoplasty cong 53.43 NA NA 23.14 24.78 6.843320 A Fuse esophagus & stomach 23.31 NA NA 13.36 12.52 4.943325 A Revise esophagus & stomach 22.60 NA NA 12.35 11.55 4.843327 A Esoph fundoplasty lap 13.35 NA NA 8.12 8.12 2.843328 A Esoph fundoplasty thor 19.91 NA NA 10.82 10.82 4.943330 A Esophagomyotomy abdominal 22.19 NA NA 12.41 11.43 4.7
CMS-1582-PN 291 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

43331 A Esophagomyotomy thoracic 23.06 NA NA 12.26 12.36 5.443332 A Transab esoph hiat hern rpr 19.62 NA NA 11.02 11.02 4.143333 A Transab esoph hiat hern rpr 21.46 NA NA 11.80 11.80 4.543334 A Transthor diaphrag hern rpr 22.12 NA NA 11.39 11.39 4.743335 A Transthor diaphrag hern rpr 23.97 NA NA 12.13 12.13 5.043336 A Thorabd diaphr hern repair 25.81 NA NA 13.46 13.46 5.843337 A Thorabd diaphr hern repair 27.65 NA NA 15.33 15.33 6.243338 A Esoph lengthening 2.21 NA NA 1.30 1.30 0.543340 A Fuse esophagus & intestine 22.99 NA NA 13.22 12.17 4.943341 A Fuse esophagus & intestine 24.23 NA NA 14.80 14.11 5.643350 A Surgical opening esophagus 19.49 NA NA 14.42 12.38 4.143351 A Surgical opening esophagus 22.05 NA NA 11.96 12.18 5.143352 A Surgical opening esophagus 17.81 NA NA 10.15 10.27 4.143360 A Gastrointestinal repair 40.11 NA NA 18.71 18.95 9.443361 A Gastrointestinal repair 45.68 NA NA 20.54 20.83 9.743400 A Ligate esophagus veins 25.60 NA NA 14.35 15.61 3.743401 A Esophagus surgery for veins 26.49 NA NA 12.50 12.33 5.643405 A Ligate/staple esophagus 24.73 NA NA 15.88 14.52 5.2

4340F I Cnslng chldbrng women epi 0.00 0.00 0.00 0.00 0.00 0.0

43410 A Repair esophagus wound 16.41 NA NA 11.38 10.61 3.843415 A Repair esophagus wound 44.88 NA NA 22.14 20.23 10.243420 A Repair esophagus opening 16.78 NA NA 12.74 11.20 2.143425 A Repair esophagus opening 25.04 NA NA 15.15 14.40 5.343450 A Dilate esophagus 1.38 2.89 3.04 1.07 1.08 0.243453 A Dilate esophagus 1.51 6.56 6.99 1.14 1.15 0.243456 A Dilate esophagus 2.57 13.78 14.72 1.72 1.70 0.343458 A Dilate esophagus 3.06 7.65 7.94 1.97 1.94 0.443460 A Pressure treatment esophagus 3.79 NA NA 2.43 2.31 0.543496 C Free jejunum flap microvasc 0.00 0.00 0.00 0.00 0.00 0.043499 C Esophagus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 292 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

43500 A Surgical opening of stomach 12.79 NA NA 7.91 7.22 2.743501 A Surgical repair of stomach 22.60 NA NA 12.76 11.55 4.743502 A Surgical repair of stomach 25.69 NA NA 14.34 12.92 5.443510 A Surgical opening of stomach 15.14 NA NA 11.35 10.29 2.243520 A Incision of pyloric muscle 11.29 NA NA 6.80 6.52 2.543605 A Biopsy of stomach 13.72 NA NA 8.63 7.68 2.843610 A Excision of stomach lesion 16.34 NA NA 9.48 8.59 3.443611 A Excision of stomach lesion 20.38 NA NA 11.74 10.67 4.343620 A Removal of stomach 34.04 NA NA 17.55 15.97 7.243621 A Removal of stomach 39.53 NA NA 19.86 17.83 8.443622 A Removal of stomach 40.03 NA NA 20.28 18.12 8.543631 A Removal of stomach partial 24.51 NA NA 13.61 12.36 5.243632 A Removal of stomach partial 35.14 NA NA 18.15 15.96 7.443633 A Removal of stomach partial 33.14 NA NA 17.31 15.31 7.043634 A Removal of stomach partial 36.64 NA NA 19.10 16.89 7.843635 A Removal of stomach partial 2.06 NA NA 0.88 0.80 0.443640 A Vagotomy & pylorus repair 19.56 NA NA 11.52 10.39 4.143641 A Vagotomy & pylorus repair 19.81 NA NA 11.78 10.53 4.243644 A Lap gastric bypass/roux-en-y 29.40 NA NA 16.12 14.69 6.243645 A Lap gastr bypass incl smll i 31.53 NA NA 17.07 15.51 6.743647 C Lap impl electrode antrum 0.00 0.00 0.00 0.00 0.00 0.043648 C Lap revise/remv eltrd antrum 0.00 0.00 0.00 0.00 0.00 0.043651 A Laparoscopy vagus nerve 10.13 NA NA 7.14 6.53 2.143652 A Laparoscopy vagus nerve 12.13 NA NA 8.01 7.30 2.543653 A Laparoscopy gastrostomy 8.48 NA NA 6.63 6.06 1.843659 C Laparoscope proc stom 0.00 0.00 0.00 0.00 0.00 0.043752 A Nasal/orogastric w/stent 0.81 NA NA 0.32 0.33 0.043753 A Tx gastro intub w/asp 0.45 NA NA 0.13 0.13 0.043754 A Dx gastr intub w/asp spec 0.45 1.83 1.83 0.44 0.44 0.043755 A Dx gastr intub w/asp specs 0.94 2.52 2.52 0.68 0.68 0.0
CMS-1582-PN 293 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

43756 A Dx duod intub w/asp spec 0.77 5.60 5.60 0.71 0.71 0.043757 A Dx duod intub w/asp specs 1.26 6.92 6.92 0.87 0.87 0.043760 A Change gastrostomy tube 0.90 12.27 10.85 0.41 0.43 0.143761 A Reposition gastrostomy tube 2.01 1.21 1.30 0.83 0.87 0.243770 A Lap place gastr adj device 18.00 NA NA 11.50 10.49 3.843771 A Lap revise gastr adj device 20.79 NA NA 12.74 11.58 4.443772 A Lap rmvl gastr adj device 15.70 NA NA 9.47 8.67 3.343773 A Lap replace gastr adj device 20.79 NA NA 12.72 11.58 4.443774 A Lap rmvl gastr adj all parts 15.76 NA NA 9.48 8.69 3.343775 N Lap sleeve gastrectomy 21.56 NA NA 12.08 12.08 4.643800 A Reconstruction of pylorus 15.43 NA NA 8.98 8.20 3.343810 A Fusion of stomach and bowel 16.88 NA NA 9.84 8.85 3.543820 A Fusion of stomach and bowel 22.53 NA NA 12.74 11.26 4.743825 A Fusion of stomach and bowel 21.76 NA NA 12.66 11.37 4.643830 A Place gastrostomy tube 10.85 NA NA 7.68 7.04 2.243831 A Place gastrostomy tube 8.49 NA NA 7.29 6.71 1.843832 A Place gastrostomy tube 17.34 NA NA 10.37 9.63 3.543840 A Repair of stomach lesion 22.83 NA NA 12.89 11.42 4.843842 N V-band gastroplasty 21.03 NA NA 11.62 11.21 1.543843 A Gastroplasty w/o v-band 21.21 NA NA 12.44 11.14 4.543845 A Gastroplasty duodenal switch 33.30 NA NA 18.30 16.35 7.043846 A Gastric bypass for obesity 27.41 NA NA 15.51 14.06 5.843847 A Gastric bypass incl small i 30.28 NA NA 17.05 15.17 6.443848 A Revision gastroplasty 32.75 NA NA 18.02 16.27 6.943850 A Revise stomach-bowel fusion 27.58 NA NA 15.16 13.54 5.843855 A Revise stomach-bowel fusion 28.69 NA NA 15.64 14.11 6.143860 A Revise stomach-bowel fusion 27.89 NA NA 15.02 13.64 5.843865 A Revise stomach-bowel fusion 29.05 NA NA 15.80 14.22 6.143870 A Repair stomach opening 11.44 NA NA 7.40 6.72 2.343880 A Repair stomach-bowel fistula 27.18 NA NA 14.78 13.40 5.7
CMS-1582-PN 294 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

43881 C Impl/redo electrd antrum 0.00 0.00 0.00 0.00 0.00 0.043882 C Revise/remove electrd antrum 0.00 0.00 0.00 0.00 0.00 0.043886 A Revise gastric port open 4.64 NA NA 5.04 4.61 0.943887 A Remove gastric port open 4.32 NA NA 4.40 4.06 0.943888 A Change gastric port open 6.44 NA NA 5.79 5.31 1.343999 C Stomach surgery procedure 0.00 0.00 0.00 0.00 0.00 0.044005 A Freeing of bowel adhesion 18.46 NA NA 10.36 9.39 3.8

4400F I Rehab thxpy options w/pt 0.00 0.00 0.00 0.00 0.00 0.0

44010 A Incision of small bowel 14.26 NA NA 8.58 7.79 3.044015 A Insert needle cath bowel 2.62 NA NA 1.10 1.03 0.544020 A Explore small intestine 16.22 NA NA 9.43 8.52 3.444021 A Decompress small bowel 16.31 NA NA 9.55 8.69 3.444025 A Incision of large bowel 16.51 NA NA 9.56 8.65 3.444050 A Reduce bowel obstruction 15.52 NA NA 9.13 8.27 3.244055 A Correct malrotation of bowel 25.63 NA NA 13.63 12.29 5.444100 A Biopsy of bowel 2.01 NA NA 1.08 1.09 0.344110 A Excise intestine lesion(s) 14.04 NA NA 8.38 7.61 2.944111 A Excision of bowel lesion(s) 16.52 NA NA 9.45 8.56 3.444120 A Removal of small intestine 20.82 NA NA 11.39 10.25 4.344121 A Removal of small intestine 4.44 NA NA 1.92 1.75 0.944125 A Removal of small intestine 20.03 NA NA 11.20 10.11 4.044126 A Enterectomy w/o taper cong 42.23 NA NA 22.46 20.01 9.044127 A Enterectomy w/taper cong 49.30 NA NA 25.44 22.71 10.544128 A Enterectomy cong add-on 4.44 NA NA 1.93 1.76 0.944130 A Bowel to bowel fusion 22.11 NA NA 12.57 11.08 4.544132 R Enterectomy cadaver donor 0.00 0.00 0.00 0.00 0.00 0.044133 R Enterectomy live donor 0.00 0.00 0.00 0.00 0.00 0.044135 R Intestine transplnt cadaver 0.00 0.00 0.00 0.00 0.00 0.044136 R Intestine transplant live 0.00 0.00 0.00 0.00 0.00 0.044137 C Remove intestinal allograft 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 295 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

44139 A Mobilization of colon 2.23 NA NA 0.97 0.88 0.444140 A Partial removal of colon 22.59 NA NA 12.83 11.64 4.644141 A Partial removal of colon 29.91 NA NA 18.40 16.41 6.144143 A Partial removal of colon 27.79 NA NA 16.23 14.70 5.744144 A Partial removal of colon 29.91 NA NA 16.86 15.04 6.144145 A Partial removal of colon 28.58 NA NA 15.44 13.98 5.644146 A Partial removal of colon 35.30 NA NA 21.14 18.96 6.844147 A Partial removal of colon 33.69 NA NA 17.71 15.45 6.744150 A Removal of colon 30.18 NA NA 19.56 17.64 6.144151 A Removal of colon/ileostomy 34.92 NA NA 21.61 19.50 7.444155 A Removal of colon/ileostomy 34.42 NA NA 21.36 19.13 6.444156 A Removal of colon/ileostomy 37.42 NA NA 23.53 21.16 7.944157 A Colectomy w/ileoanal anast 35.70 NA NA 21.71 19.62 7.644158 A Colectomy w/neo-rectum pouch 36.70 NA NA 21.99 19.90 7.844160 A Removal of colon 20.89 NA NA 11.98 10.80 4.244180 A Lap enterolysis 15.27 NA NA 9.02 8.25 3.144186 A Lap jejunostomy 10.38 NA NA 6.82 6.33 2.244187 A Lap ileo/jejuno-stomy 17.40 NA NA 12.24 11.17 3.344188 A Lap colostomy 19.35 NA NA 13.36 12.18 3.844202 A Lap enterectomy 23.39 NA NA 13.23 11.99 4.844203 A Lap resect s/intestine addl 4.44 NA NA 1.91 1.73 0.944204 A Laparo partial colectomy 26.42 NA NA 14.49 13.08 5.244205 A Lap colectomy part w/ileum 22.95 NA NA 12.71 11.49 4.544206 A Lap part colectomy w/stoma 29.79 NA NA 16.79 15.17 6.044207 A L colectomy/coloproctostomy 31.92 NA NA 16.79 15.08 6.144208 A L colectomy/coloproctostomy 33.99 NA NA 19.27 17.39 6.444210 A Laparo total proctocolectomy 30.09 NA NA 17.88 16.14 5.844211 A Lap colectomy w/proctectomy 37.08 NA NA 22.36 19.92 7.944212 A Laparo total proctocolectomy 34.58 NA NA 20.70 18.72 6.344213 A Lap mobil splenic fl add-on 3.50 NA NA 1.52 1.37 0.6
CMS-1582-PN 296 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

44227 A Lap close enterostomy 28.62 NA NA 15.58 14.08 5.844238 C Laparoscope proc intestine 0.00 0.00 0.00 0.00 0.00 0.044300 A Open bowel to skin 13.75 NA NA 8.48 7.74 2.944310 A Ileostomy/jejunostomy 17.59 NA NA 10.16 9.20 3.444312 A Revision of ileostomy 9.43 NA NA 6.44 6.04 1.744314 A Revision of ileostomy 16.74 NA NA 10.18 9.35 3.144316 A Devise bowel pouch 23.59 NA NA 13.55 12.17 5.044320 A Colostomy 19.91 NA NA 11.91 10.78 4.044322 A Colostomy with biopsies 13.32 NA NA 13.37 12.23 2.844340 A Revision of colostomy 9.28 NA NA 7.35 6.66 1.844345 A Revision of colostomy 17.22 NA NA 10.80 9.77 3.444346 A Revision of colostomy 19.63 NA NA 11.86 10.67 3.844360 A Small bowel endoscopy 2.59 NA NA 1.75 1.76 0.344361 A Small bowel endoscopy/biopsy 2.87 NA NA 1.91 1.92 0.444363 A Small bowel endoscopy 3.49 NA NA 2.23 2.19 0.544364 A Small bowel endoscopy 3.73 NA NA 2.37 2.37 0.544365 A Small bowel endoscopy 3.31 NA NA 2.14 2.13 0.444366 A Small bowel endoscopy 4.40 NA NA 2.77 2.77 0.644369 A Small bowel endoscopy 4.51 NA NA 2.83 2.82 0.644370 A Small bowel endoscopy/stent 4.79 NA NA 3.17 3.14 0.644372 A Small bowel endoscopy 4.40 NA NA 2.63 2.58 0.644373 A Small bowel endoscopy 3.49 NA NA 2.15 2.15 0.544376 A Small bowel endoscopy 5.25 NA NA 3.09 3.06 0.844377 A Small bowel endoscopy/biopsy 5.52 NA NA 3.32 3.32 0.844378 A Small bowel endoscopy 7.12 NA NA 4.26 4.23 1.044379 A S bowel endoscope w/stent 7.46 NA NA 4.67 4.59 1.044380 A Small bowel endoscopy 1.05 NA NA 0.84 0.85 0.144382 A Small bowel endoscopy 1.27 NA NA 1.00 1.01 0.244383 A Ileoscopy w/stent 2.94 NA NA 1.61 1.78 0.344385 A Endoscopy of bowel pouch 1.82 5.35 5.37 1.11 1.08 0.2
CMS-1582-PN 297 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

44386 A Endoscopy bowel pouch/biop 2.12 7.63 7.81 1.38 1.31 0.344388 A Colonoscopy 2.82 6.94 7.00 1.75 1.69 0.444389 A Colonoscopy with biopsy 3.13 7.89 8.14 1.96 1.92 0.444390 A Colonoscopy for foreign body 3.82 9.15 9.29 2.44 2.31 0.544391 A Colonoscopy for bleeding 4.31 9.51 10.02 2.61 2.58 0.644392 A Colonoscopy & polypectomy 3.81 8.37 8.46 2.20 2.12 0.644393 A Colonoscopy lesion removal 4.83 9.28 9.35 2.84 2.75 0.744394 A Colonoscopy w/snare 4.42 9.49 9.77 2.62 2.57 0.644397 A Colonoscopy w/stent 4.70 NA NA 2.93 2.88 0.644500 A Intro gastrointestinal tube 0.49 NA NA 0.19 0.20 0.044602 A Suture small intestine 24.72 NA NA 12.40 10.85 5.144603 A Suture small intestine 28.16 NA NA 14.53 12.74 5.744604 A Suture large intestine 18.16 NA NA 9.73 8.79 3.744605 A Repair of bowel lesion 22.08 NA NA 12.49 11.30 4.544615 A Intestinal stricturoplasty 18.16 NA NA 10.32 9.35 3.744620 A Repair bowel opening 14.43 NA NA 8.68 7.80 2.844625 A Repair bowel opening 17.28 NA NA 9.91 8.90 3.344626 A Repair bowel opening 27.90 NA NA 14.50 13.09 5.744640 A Repair bowel-skin fistula 24.20 NA NA 12.92 11.68 4.844650 A Repair bowel fistula 25.12 NA NA 13.18 12.03 5.044660 A Repair bowel-bladder fistula 23.91 NA NA 12.10 11.88 3.844661 A Repair bowel-bladder fistula 27.35 NA NA 13.92 12.99 5.144680 A Surgical revision intestine 17.96 NA NA 10.22 9.25 3.844700 A Suspend bowel w/prosthesis 17.48 NA NA 9.94 8.96 3.044701 A Intraop colon lavage add-on 3.10 NA NA 1.33 1.21 0.544715 C Prepare donor intestine 0.00 0.00 0.00 0.00 0.00 0.044720 A Prep donor intestine/venous 5.00 NA NA 2.17 2.12 0.344721 A Prep donor intestine/artery 7.00 NA NA 3.07 2.81 1.544799 C Unlisted procedure intestine 0.00 0.00 0.00 0.00 0.00 0.044800 A Excision of bowel pouch 12.05 NA NA 8.21 7.53 2.4
CMS-1582-PN 298 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

44820 A Excision of mesentery lesion 13.73 NA NA 8.46 7.75 2.844850 A Repair of mesentery 12.11 NA NA 7.73 6.97 2.544899 C Bowel surgery procedure 0.00 0.00 0.00 0.00 0.00 0.044900 A Drain app abscess open 12.57 NA NA 7.87 7.09 2.644901 A Drain app abscess percut 3.37 21.42 24.04 1.25 1.38 0.344950 A Appendectomy 10.60 NA NA 6.32 5.76 2.244955 A Appendectomy add-on 1.53 NA NA 0.67 0.62 0.344960 A Appendectomy 14.50 NA NA 8.51 7.68 3.044970 A Laparoscopy appendectomy 9.45 NA NA 6.42 5.83 1.944979 C Laparoscope proc app 0.00 0.00 0.00 0.00 0.00 0.045000 A Drainage of pelvic abscess 6.30 NA NA 5.12 4.72 1.045005 A Drainage of rectal abscess 2.02 5.29 5.06 2.24 2.09 0.345020 A Drainage of rectal abscess 8.56 NA NA 6.67 5.99 1.645100 A Biopsy of rectum 4.04 NA NA 4.06 3.71 0.745108 A Removal of anorectal lesion 5.12 NA NA 4.68 4.23 1.045110 A Removal of rectum 30.76 NA NA 18.81 16.99 5.845111 A Partial removal of rectum 18.01 NA NA 11.06 9.98 3.545112 A Removal of rectum 33.18 NA NA 17.35 15.54 6.045113 A Partial proctectomy 33.22 NA NA 18.91 17.01 7.045114 A Partial removal of rectum 30.79 NA NA 16.91 15.03 6.545116 A Partial removal of rectum 27.72 NA NA 15.56 13.72 3.945119 A Remove rectum w/reservoir 33.48 NA NA 19.23 17.10 5.845120 A Removal of rectum 26.40 NA NA 15.41 13.85 5.645121 A Removal of rectum and colon 29.08 NA NA 16.57 14.85 6.145123 A Partial proctectomy 18.86 NA NA 11.45 10.12 3.145126 A Pelvic exenteration 49.10 NA NA 26.61 24.86 10.445130 A Excision of rectal prolapse 18.50 NA NA 11.03 9.76 3.145135 A Excision of rectal prolapse 22.36 NA NA 13.89 12.30 4.745136 A Excise ileoanal reservior 30.82 NA NA 18.96 17.10 4.445150 A Excision of rectal stricture 5.85 NA NA 5.14 4.72 0.8
CMS-1582-PN 299 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

45160 A Excision of rectal lesion 16.33 NA NA 10.26 9.32 3.445171 A Exc rect tum transanal part 8.13 NA NA 8.03 8.03 1.545172 A Exc rect tum transanal full 12.13 NA NA 9.76 9.76 2.245190 A Destruction rectal tumor 10.42 NA NA 8.23 7.41 1.845300 A Proctosigmoidoscopy dx 0.80 2.58 2.42 0.68 0.60 0.145303 A Proctosigmoidoscopy dilate 1.50 24.62 24.08 0.99 0.86 0.245305 A Proctosigmoidoscopy w/bx 1.25 4.07 3.88 0.90 0.81 0.245307 A Proctosigmoidoscopy fb 1.70 4.23 3.99 1.07 0.93 0.345308 A Proctosigmoidoscopy removal 1.40 4.35 4.00 0.97 0.85 0.245309 A Proctosigmoidoscopy removal 1.50 4.44 4.26 1.02 0.97 0.245315 A Proctosigmoidoscopy removal 1.80 4.84 4.55 1.14 1.07 0.345317 A Proctosigmoidoscopy bleed 2.00 4.42 4.11 1.23 1.07 0.345320 A Proctosigmoidoscopy ablate 1.78 4.25 4.17 1.14 1.08 0.345321 A Proctosigmoidoscopy volvul 1.75 NA NA 1.16 1.07 0.345327 A Proctosigmoidoscopy w/stent 2.00 NA NA 1.44 1.31 0.445330 A Diagnostic sigmoidoscopy 0.96 2.92 2.95 0.79 0.76 0.145331 A Sigmoidoscopy and biopsy 1.15 3.59 3.63 0.94 0.93 0.145332 A Sigmoidoscopy w/fb removal 1.79 6.22 6.35 1.26 1.22 0.245333 A Sigmoidoscopy & polypectomy 1.79 6.34 6.44 1.24 1.21 0.245334 A Sigmoidoscopy for bleeding 2.73 NA NA 1.80 1.79 0.345335 A Sigmoidoscopy w/submuc inj 1.46 5.79 5.75 1.08 1.06 0.245337 A Sigmoidoscopy & decompress 2.36 NA NA 1.56 1.51 0.345338 A Sigmoidoscopy w/tumr remove 2.34 6.44 6.65 1.56 1.54 0.345339 A Sigmoidoscopy w/ablate tumr 3.14 6.26 6.23 1.99 1.97 0.445340 A Sig w/balloon dilation 1.89 11.28 11.19 1.30 1.27 0.345341 A Sigmoidoscopy w/ultrasound 2.60 NA NA 1.74 1.73 0.345342 A Sigmoidoscopy w/us guide bx 4.05 NA NA 2.56 2.54 0.645345 A Sigmoidoscopy w/stent 2.92 NA NA 1.89 1.87 0.445355 A Surgical colonoscopy 3.51 NA NA 2.09 1.98 0.545378 A Diagnostic colonoscopy 3.69 7.12 7.37 2.26 2.22 0.5
CMS-1582-PN 300 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

45378 53 A Diagnostic colonoscopy 0.96 2.92 2.95 0.79 0.76 0.145379 A Colonoscopy w/fb removal 4.68 9.23 9.46 2.82 2.73 0.745380 A Colonoscopy and biopsy 4.43 8.48 8.82 2.72 2.69 0.645381 A Colonoscopy submucous inj 4.19 8.35 8.73 2.59 2.57 0.645382 A Colonoscopy/control bleeding 5.68 11.11 11.71 3.43 3.42 0.845383 A Lesion removal colonoscopy 5.86 9.75 9.95 3.37 3.28 0.945384 A Lesion remove colonoscopy 4.69 8.16 8.36 2.76 2.70 0.745385 A Lesion removal colonoscopy 5.30 9.23 9.59 3.18 3.14 0.845386 A Colonoscopy dilate stricture 4.57 13.55 14.17 2.73 2.68 0.745387 A Colonoscopy w/stent 5.90 NA NA 3.62 3.57 0.845391 A Colonoscopy w/endoscope us 5.09 NA NA 3.09 3.06 0.745392 A Colonoscopy w/endoscopic fnb 6.54 NA NA 3.89 3.85 1.045395 A Lap removal of rectum 33.00 NA NA 20.59 18.65 5.945397 A Lap remove rectum w/pouch 36.50 NA NA 21.94 19.65 6.045400 A Laparoscopic proc 19.44 NA NA 11.50 10.36 3.545402 A Lap proctopexy w/sig resect 26.51 NA NA 14.58 13.07 4.845499 C Laparoscope proc rectum 0.00 0.00 0.00 0.00 0.00 0.045500 A Repair of rectum 7.73 NA NA 6.60 5.92 1.245505 A Repair of rectum 8.36 NA NA 7.60 6.78 1.545520 A Treatment of rectal prolapse 0.55 3.74 3.42 0.57 0.52 0.045540 A Correct rectal prolapse 18.12 NA NA 10.39 9.33 3.145541 A Correct rectal prolapse 14.85 NA NA 10.27 9.19 2.545550 A Repair rectum/remove sigmoid 24.80 NA NA 14.60 13.03 4.445560 A Repair of rectocele 11.50 NA NA 7.52 7.15 1.845562 A Exploration/repair of rectum 17.98 NA NA 11.84 10.87 3.345563 A Exploration/repair of rectum 26.38 NA NA 16.98 15.24 5.645800 A Repair rect/bladder fistula 20.31 NA NA 11.90 11.49 3.345805 A Repair fistula w/colostomy 23.32 NA NA 15.16 13.63 4.945820 A Repair rectourethral fistula 20.37 NA NA 12.43 11.70 1.945825 A Repair fistula w/colostomy 24.17 NA NA 15.49 14.40 3.4
CMS-1582-PN 301 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

45900 A Reduction of rectal prolapse 2.99 NA NA 2.43 2.22 0.545905 A Dilation of anal sphincter 2.35 NA NA 2.22 2.08 0.445910 A Dilation of rectal narrowing 2.85 NA NA 2.44 2.33 0.445915 A Remove rectal obstruction 3.19 5.71 5.43 2.93 2.72 0.545990 A Surg dx exam anorectal 1.80 NA NA 1.09 1.02 0.345999 C Rectum surgery procedure 0.00 0.00 0.00 0.00 0.00 0.046020 A Placement of seton 3.00 4.50 4.07 3.36 3.03 0.546030 A Removal of rectal marker 1.26 2.55 2.34 1.19 1.08 0.246040 A Incision of rectal abscess 5.37 8.96 8.32 5.71 5.25 1.046045 A Incision of rectal abscess 5.87 NA NA 5.70 5.13 1.146050 A Incision of anal abscess 1.24 4.22 3.94 1.39 1.27 0.246060 A Incision of rectal abscess 6.37 NA NA 6.43 5.78 1.146070 A Incision of anal septum 2.79 NA NA 3.81 3.48 0.246080 A Incision of anal sphincter 2.52 4.20 3.87 1.74 1.58 0.446083 A Incise external hemorrhoid 1.45 3.31 3.31 1.44 1.38 0.246200 A Removal of anal fissure 3.59 8.46 7.69 5.22 4.77 0.646220 A Excise anal ext tag/papilla 1.61 4.03 3.75 1.61 1.47 0.346221 A Ligation of hemorrhoid(s) 2.36 4.98 4.60 2.83 2.60 0.446230 A Removal of anal tags 2.62 4.81 4.48 2.03 1.85 0.446250 A Remove ext hem groups 2+ 4.25 8.22 7.67 4.18 3.82 0.846255 A Remove int/ext hem 1 group 4.96 8.61 8.11 4.48 4.11 0.946257 A Remove in/ex hem grp & fiss 5.76 NA NA 5.59 5.02 1.046258 A Remove in/ex hem grp w/fistu 6.41 NA NA 6.07 5.43 1.346260 A Remove in/ex hem groups 2+ 6.73 NA NA 5.99 5.39 1.246261 A Remove in/ex hem grps & fiss 7.76 NA NA 6.48 5.82 1.346262 A Remove in/ex hem grps w/fist 7.91 NA NA 6.98 6.28 1.446270 A Remove anal fist subq 4.92 8.74 8.05 5.59 5.04 0.946275 A Remove anal fist inter 5.42 9.09 8.30 5.74 5.18 0.946280 A Remove anal fist complex 6.39 NA NA 6.26 5.62 1.146285 A Remove anal fist 2 stage 5.42 9.05 8.11 5.78 5.15 0.9
CMS-1582-PN 302 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

46288 A Repair anal fistula 7.81 NA NA 7.01 6.28 1.346320 A Removal of hemorrhoid clot 1.64 3.34 3.10 1.35 1.22 0.346500 A Injection into hemorrhoid(s) 1.69 4.79 4.37 1.83 1.68 0.246505 A Chemodenervation anal musc 3.18 4.58 4.27 3.31 3.03 0.546600 A Diagnostic anoscopy 0.55 1.86 1.79 0.57 0.51 0.046604 A Anoscopy and dilation 1.03 15.86 14.88 0.77 0.72 0.146606 A Anoscopy and biopsy 1.20 4.93 4.82 0.86 0.78 0.246608 A Anoscopy remove for body 1.30 5.09 4.91 0.86 0.80 0.246610 A Anoscopy remove lesion 1.28 4.95 4.82 0.90 0.83 0.246611 A Anoscopy 1.30 3.55 3.42 0.93 0.85 0.246612 A Anoscopy remove lesions 1.50 5.76 5.67 1.01 0.96 0.346614 A Anoscopy control bleeding 1.00 2.49 2.48 0.77 0.76 0.146615 A Anoscopy 1.50 2.39 2.36 1.01 0.97 0.246700 A Repair of anal stricture 9.81 NA NA 7.93 7.05 1.646705 A Repair of anal stricture 7.43 NA NA 6.20 5.99 0.546706 A Repr of anal fistula w/glue 2.44 NA NA 2.08 1.94 0.446707 A Repair anorectal fist w/plug 6.39 NA NA 6.50 6.50 0.946710 A Repr per/vag pouch sngl proc 17.14 NA NA 11.54 10.77 3.646712 A Repr per/vag pouch dbl proc 36.45 NA NA 22.11 19.91 2.546715 A Rep perf anoper fistu 7.62 NA NA 6.35 5.84 0.546716 A Rep perf anoper/vestib fistu 17.54 NA NA 13.74 14.45 1.246730 A Construction of absent anus 30.65 NA NA 19.17 18.42 2.146735 A Construction of absent anus 36.14 NA NA 21.57 20.71 2.546740 A Construction of absent anus 33.90 NA NA 22.50 20.20 7.246742 A Repair of imperforated anus 40.14 NA NA 25.12 22.89 8.546744 A Repair of cloacal anomaly 58.94 NA NA 35.23 30.46 8.446746 A Repair of cloacal anomaly 65.44 NA NA 34.55 33.54 4.646748 A Repair of cloacal anomaly 71.42 NA NA 33.37 33.62 5.046750 A Repair of anal sphincter 12.15 NA NA 8.60 7.84 1.946751 A Repair of anal sphincter 9.30 NA NA 6.95 6.89 1.5
CMS-1582-PN 303 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

46753 A Reconstruction of anus 8.89 NA NA 6.97 6.28 1.546754 A Removal of suture from anus 3.01 5.20 4.86 3.39 3.01 0.446760 A Repair of anal sphincter 17.45 NA NA 12.49 11.12 2.446761 A Repair of anal sphincter 15.29 NA NA 10.15 9.09 2.446762 A Implant artificial sphincter 14.82 NA NA 10.44 9.42 2.146900 A Destruction anal lesion(s) 1.91 4.74 4.45 1.89 1.76 0.346910 A Destruction anal lesion(s) 1.91 4.88 4.68 1.70 1.59 0.346916 A Cryosurgery anal lesion(s) 1.91 4.54 4.51 2.15 2.04 0.246917 A Laser surgery anal lesions 1.91 10.92 10.84 1.73 1.61 0.346922 A Excision of anal lesion(s) 1.91 5.37 5.06 1.74 1.60 0.346924 A Destruction anal lesion(s) 2.81 11.99 11.68 2.24 2.05 0.446930 A Destroy internal hemorrhoids 1.61 3.92 4.12 2.40 2.48 0.246940 A Treatment of anal fissure 2.35 3.93 3.57 1.65 1.49 0.346942 A Treatment of anal fissure 2.07 3.83 3.48 1.52 1.37 0.346945 A Remove by ligat int hem grp 2.21 6.14 5.73 3.91 3.69 0.346946 A Remove by ligat int hem grps 2.63 5.84 5.60 3.47 3.32 0.446947 A Hemorrhoidopexy by stapling 5.57 NA NA 4.66 4.21 1.046999 C Anus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.047000 A Needle biopsy of liver 1.90 8.17 8.05 0.74 0.81 0.247001 A Needle biopsy liver add-on 1.90 NA NA 0.82 0.75 0.347010 A Open drainage liver lesion 19.40 NA NA 12.14 11.31 3.947011 A Percut drain liver lesion 3.69 NA NA 1.35 1.54 0.347015 A Inject/aspirate liver cyst 18.50 NA NA 12.12 10.94 3.947100 A Wedge biopsy of liver 12.91 NA NA 9.44 8.64 2.647120 A Partial removal of liver 39.01 NA NA 22.08 20.15 8.247122 A Extensive removal of liver 59.48 NA NA 30.18 27.54 12.647125 A Partial removal of liver 53.04 NA NA 27.38 24.99 11.247130 A Partial removal of liver 57.19 NA NA 29.04 26.56 12.047133 X Removal of donor liver 0.00 0.00 0.00 0.00 0.00 0.047135 R Transplantation of liver 83.64 NA NA 44.70 40.62 17.7
CMS-1582-PN 304 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

47136 R Transplantation of liver 70.74 NA NA 37.44 34.72 15.047140 A Partial removal donor liver 59.40 NA NA 34.31 30.99 12.647141 A Partial removal donor liver 71.50 NA NA 38.33 35.51 5.047142 A Partial removal donor liver 79.44 NA NA 43.89 39.70 16.947143 C Prep donor liver whole 0.00 0.00 0.00 0.00 0.00 0.047144 C Prep donor liver 3-segment 0.00 0.00 0.00 0.00 0.00 0.047145 C Prep donor liver lobe split 0.00 0.00 0.00 0.00 0.00 0.047146 A Prep donor liver/venous 6.00 NA NA 2.61 2.37 1.247147 A Prep donor liver/arterial 7.00 NA NA 3.05 2.77 1.447300 A Surgery for liver lesion 18.14 NA NA 11.81 10.67 3.847350 A Repair liver wound 22.49 NA NA 13.66 12.45 4.747360 A Repair liver wound 31.31 NA NA 17.98 16.23 6.647361 A Repair liver wound 52.60 NA NA 26.61 24.32 10.747362 A Repair liver wound 23.54 NA NA 14.60 13.08 4.947370 A Laparo ablate liver tumor rf 20.80 NA NA 11.88 10.86 4.247371 A Laparo ablate liver cryosurg 20.80 NA NA 12.20 11.35 4.447379 C Laparoscope procedure liver 0.00 0.00 0.00 0.00 0.00 0.047380 A Open ablate liver tumor rf 24.56 NA NA 13.32 12.30 4.947381 A Open ablate liver tumor cryo 24.88 NA NA 11.31 11.53 5.347382 A Percut ablate liver rf 15.22 119.61 119.61 6.19 7.14 1.447399 C Liver surgery procedure 0.00 0.00 0.00 0.00 0.00 0.047400 A Incision of liver duct 36.36 NA NA 20.18 18.26 7.747420 A Incision of bile duct 22.03 NA NA 13.28 12.09 4.647425 A Incision of bile duct 22.31 NA NA 13.63 12.30 4.747460 A Incise bile duct sphincter 20.52 NA NA 12.85 12.05 4.347480 A Incision of gallbladder 13.25 NA NA 9.86 8.99 2.747490 A Incision of gallbladder 4.76 NA NA 4.30 5.55 0.447500 A Injection for liver x-rays 1.96 NA NA 0.71 0.81 0.247505 A Injection for liver x-rays 0.76 NA NA 0.28 0.31 0.047510 A Insert catheter bile duct 8.03 NA NA 4.86 5.44 0.8
CMS-1582-PN 305 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

47511 A Insert bile duct drain 10.77 NA NA 5.14 5.86 1.047525 A Change bile duct catheter 1.54 12.30 13.46 0.81 1.22 0.147530 A Revise/reinsert bile tube 6.05 33.50 35.96 3.64 4.08 0.647550 A Bile duct endoscopy add-on 3.02 NA NA 1.31 1.21 0.647552 A Biliary endoscopy thru skin 6.03 NA NA 2.59 2.92 0.647553 A Biliary endoscopy thru skin 6.34 NA NA 2.33 2.62 0.647554 A Biliary endoscopy thru skin 9.05 NA NA 4.05 4.14 1.547555 A Biliary endoscopy thru skin 7.55 NA NA 2.70 3.13 0.747556 A Biliary endoscopy thru skin 8.55 NA NA 3.09 3.56 0.847560 A Laparoscopy w/cholangio 4.88 NA NA 2.12 1.95 1.047561 A Laparo w/cholangio/biopsy 5.17 NA NA 2.54 2.33 1.147562 A Laparoscopic cholecystectomy 11.76 NA NA 8.05 7.29 2.447563 A Laparo cholecystectomy/graph 11.47 NA NA 7.20 6.95 2.447564 A Laparo cholecystectomy/explr 18.00 NA NA 11.01 9.95 3.847570 A Laparo cholecystoenterostomy 12.56 NA NA 7.83 7.15 2.647579 C Laparoscope proc biliary 0.00 0.00 0.00 0.00 0.00 0.047600 A Removal of gallbladder 17.48 NA NA 11.10 9.94 3.747605 A Removal of gallbladder 15.98 NA NA 9.88 8.98 3.447610 A Removal of gallbladder 20.92 NA NA 12.03 10.92 4.447612 A Removal of gallbladder 21.21 NA NA 12.10 10.97 4.547620 A Removal of gallbladder 23.07 NA NA 13.12 11.85 4.947630 A Remove bile duct stone 9.65 NA NA 5.25 5.69 1.247700 A Exploration of bile ducts 16.50 NA NA 11.24 10.30 3.547701 A Bile duct revision 28.73 NA NA 16.84 16.14 6.147711 A Excision of bile duct tumor 25.90 NA NA 15.11 13.72 5.447712 A Excision of bile duct tumor 33.72 NA NA 18.74 16.89 7.247715 A Excision of bile duct cyst 21.55 NA NA 13.45 12.09 4.647720 A Fuse gallbladder & bowel 18.34 NA NA 11.87 10.77 3.847721 A Fuse upper gi structures 21.99 NA NA 13.64 12.28 4.747740 A Fuse gallbladder & bowel 21.23 NA NA 13.31 11.95 4.5
CMS-1582-PN 306 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

47741 A Fuse gallbladder & bowel 24.21 NA NA 14.61 13.16 5.147760 A Fuse bile ducts and bowel 38.32 NA NA 20.91 18.45 8.147765 A Fuse liver ducts & bowel 52.19 NA NA 27.49 23.76 11.147780 A Fuse bile ducts and bowel 42.32 NA NA 22.54 19.83 8.947785 A Fuse bile ducts and bowel 56.19 NA NA 28.80 25.09 11.947800 A Reconstruction of bile ducts 26.17 NA NA 15.43 13.93 5.547801 A Placement bile duct support 17.60 NA NA 9.96 10.36 2.447802 A Fuse liver duct & intestine 24.93 NA NA 15.21 13.74 5.347900 A Suture bile duct injury 22.44 NA NA 13.44 12.24 4.747999 C Bile tract surgery procedure 0.00 0.00 0.00 0.00 0.00 0.048000 A Drainage of abdomen 31.95 NA NA 16.91 15.62 6.148001 A Placement of drain pancreas 39.69 NA NA 20.84 18.80 8.448020 A Removal of pancreatic stone 19.09 NA NA 11.88 10.79 4.048100 A Biopsy of pancreas open 14.46 NA NA 8.97 8.17 2.948102 A Needle biopsy pancreas 4.70 10.21 10.77 1.97 2.24 0.448105 A Resect/debride pancreas 49.26 NA NA 25.74 23.11 10.348120 A Removal of pancreas lesion 18.41 NA NA 10.69 9.69 3.948140 A Partial removal of pancreas 26.32 NA NA 14.71 13.33 5.548145 A Partial removal of pancreas 27.39 NA NA 15.49 13.91 5.848146 A Pancreatectomy 30.60 NA NA 18.84 16.93 6.548148 A Removal of pancreatic duct 20.39 NA NA 12.45 11.18 4.348150 A Partial removal of pancreas 52.84 NA NA 28.42 25.92 11.248152 A Pancreatectomy 48.65 NA NA 27.12 24.53 10.348153 A Pancreatectomy 52.79 NA NA 28.39 25.86 11.248154 A Pancreatectomy 48.88 NA NA 27.22 24.53 10.448155 A Removal of pancreas 29.45 NA NA 18.27 16.62 6.248160 N Pancreas removal/transplant 0.00 0.00 0.00 0.00 0.00 0.048400 A Injection intraop add-on 1.95 NA NA 0.85 0.86 0.248500 A Surgery of pancreatic cyst 18.16 NA NA 12.18 10.98 3.848510 A Drain pancreatic pseudocyst 17.19 NA NA 11.52 10.48 3.5
CMS-1582-PN 307 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

48511 A Drain pancreatic pseudocyst 3.99 21.76 23.36 1.47 1.67 0.348520 A Fuse pancreas cyst and bowel 18.15 NA NA 10.60 9.63 3.848540 A Fuse pancreas cyst and bowel 21.94 NA NA 11.92 10.91 4.648545 A Pancreatorrhaphy 22.23 NA NA 13.13 11.71 4.748547 A Duodenal exclusion 30.38 NA NA 16.67 14.91 6.448548 A Fuse pancreas and bowel 28.09 NA NA 15.58 14.15 5.948550 X Donor pancreatectomy 0.00 0.00 0.00 0.00 0.00 0.048551 C Prep donor pancreas 0.00 0.00 0.00 0.00 0.00 0.048552 A Prep donor pancreas/venous 4.30 NA NA 1.87 1.73 0.948554 R Transpl allograft pancreas 37.80 NA NA 30.03 27.54 7.848556 A Removal allograft pancreas 19.47 NA NA 14.07 12.79 4.148999 C Pancreas surgery procedure 0.00 0.00 0.00 0.00 0.00 0.049000 A Exploration of abdomen 12.54 NA NA 7.81 7.23 2.549002 A Reopening of abdomen 17.63 NA NA 9.92 8.81 3.649010 A Exploration behind abdomen 16.06 NA NA 8.86 8.34 3.249020 A Drain abdominal abscess 26.67 NA NA 15.35 14.00 5.449021 A Drain abdominal abscess 3.37 21.01 22.71 1.24 1.40 0.349040 A Drain open abdom abscess 16.52 NA NA 9.94 9.08 3.349041 A Drain percut abdom abscess 3.99 21.44 22.83 1.46 1.66 0.349060 A Drain open retrop abscess 18.53 NA NA 10.54 9.90 3.649061 A Drain percut retroper absc 3.69 21.09 22.59 1.35 1.54 0.349062 A Drain to peritoneal cavity 12.22 NA NA 7.47 7.05 2.449080 A Puncture peritoneal cavity 1.35 2.96 3.34 0.53 0.58 0.149081 A Removal of abdominal fluid 1.26 3.30 3.39 0.57 0.58 0.149180 A Biopsy abdominal mass 1.73 2.63 2.94 0.64 0.72 0.149203 A Exc abd tum 5 cm or less 20.13 NA NA 11.54 10.70 3.949204 A Exc abd tum over 5 cm 26.13 NA NA 14.14 13.06 5.049205 A Exc abd tum over 10 cm 30.13 NA NA 15.90 14.65 6.049215 A Excise sacral spine tumor 37.81 NA NA 20.70 18.69 7.549220 A Multiple surgery abdomen 15.79 NA NA 9.73 8.93 3.3
CMS-1582-PN 308 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

49250 A Excision of umbilicus 9.01 NA NA 6.50 5.98 1.849255 A Removal of omentum 12.56 NA NA 8.35 7.71 2.549320 A Diag laparo separate proc 5.14 NA NA 3.55 3.34 1.049321 A Laparoscopy biopsy 5.44 NA NA 3.75 3.50 1.149322 A Laparoscopy aspiration 6.01 NA NA 3.87 3.65 1.149323 A Laparo drain lymphocele 10.23 NA NA 6.88 6.36 2.149324 A Lap insert tunnel ip cath 6.32 NA NA 4.11 3.81 1.349325 A Lap revision perm ip cath 6.82 NA NA 4.31 3.98 1.449326 A Lap w/omentopexy add-on 3.50 NA NA 1.46 1.32 0.749327 A Lap ins device for rt 2.38 NA NA 1.03 1.03 0.449329 C Laparo proc abdm/per/oment 0.00 0.00 0.00 0.00 0.00 0.049400 A Air injection into abdomen 1.88 1.80 2.52 0.70 0.77 0.249402 A Remove foreign body adbomen 14.09 NA NA 8.53 7.78 2.949411 A Ins mark abd/pel for rt perq 3.82 11.19 11.19 1.65 1.65 0.349412 A Ins device for rt guide open 1.50 NA NA 0.63 0.63 0.349418 A Insert tun ip cath perc 4.21 39.87 39.87 2.07 2.07 0.649419 A Insert tun ip cath w/port 7.08 NA NA 4.78 4.59 1.249421 A Ins tun ip cath for dial opn 4.21 NA NA 1.90 2.89 0.849422 A Remove tunneled ip cath 6.29 NA NA 3.83 3.61 1.249423 A Exchange drainage catheter 1.46 14.12 15.21 0.56 0.65 0.149424 A Assess cyst contrast inject 0.76 3.33 3.65 0.31 0.35 0.049425 A Insert abdomen-venous drain 12.22 NA NA 7.54 7.18 2.649426 A Revise abdomen-venous shunt 10.41 NA NA 6.44 6.14 2.049427 A Injection abdominal shunt 0.89 NA NA 0.34 0.38 0.149428 A Ligation of shunt 6.87 NA NA 4.51 4.34 1.449429 A Removal of shunt 7.44 NA NA 4.63 4.31 1.549435 A Insert subq exten to ip cath 2.25 NA NA 0.89 0.81 0.449436 A Embedded ip cath exit-site 2.72 NA NA 2.21 2.09 0.549440 A Place gastrostomy tube perc 4.18 25.02 27.42 2.00 2.16 0.449441 A Place duod/jej tube perc 4.77 28.18 30.24 2.29 2.44 0.5
CMS-1582-PN 309 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

49442 A Place cecostomy tube perc 4.00 21.69 25.46 2.01 2.04 0.349446 A Change g-tube to g-j perc 3.31 24.16 26.04 1.22 1.39 0.349450 A Replace g/c tube perc 1.36 17.07 19.67 0.51 0.54 0.149451 A Replace duod/jej tube perc 1.84 18.23 19.39 0.69 0.78 0.249452 A Replace g-j tube perc 2.86 21.85 23.51 1.06 1.21 0.249460 A Fix g/colon tube w/device 0.96 19.46 22.28 0.38 0.40 0.149465 A Fluoro exam of g/colon tube 0.62 4.12 4.42 0.23 0.26 0.049491 A Rpr hern preemie reduc 12.53 NA NA 8.36 7.53 2.649492 A Rpr ing hern premie blocked 15.43 NA NA 9.71 8.82 3.249495 A Rpr ing hernia baby reduc 6.20 NA NA 4.62 4.11 1.349496 A Rpr ing hernia baby blocked 9.42 NA NA 6.77 6.14 2.249500 A Rpr ing hernia init reduce 5.84 NA NA 3.94 3.99 1.249501 A Rpr ing hernia init blocked 9.36 NA NA 6.59 5.99 1.949505 A Prp i/hern init reduc >5 yr 7.96 NA NA 5.80 5.31 1.649507 A Prp i/hern init block >5 yr 9.09 NA NA 6.27 6.05 1.949520 A Rerepair ing hernia reduce 9.99 NA NA 6.67 6.10 2.149521 A Rerepair ing hernia blocked 11.48 NA NA 7.22 6.95 2.449525 A Repair ing hernia sliding 8.93 NA NA 6.20 5.68 1.849540 A Repair lumbar hernia 10.74 NA NA 7.14 6.49 2.249550 A Rpr rem hernia init reduce 8.99 NA NA 6.22 5.69 1.849553 A Rpr fem hernia init blocked 9.92 NA NA 6.73 6.14 2.149555 A Rerepair fem hernia reduce 9.39 NA NA 6.38 5.85 1.949557 A Rerepair fem hernia blocked 11.62 NA NA 7.46 6.81 2.449560 A Rpr ventral hern init reduc 11.92 NA NA 7.53 6.88 2.449561 A Rpr ventral hern init block 15.38 NA NA 9.10 8.26 3.249565 A Rerepair ventrl hern reduce 12.37 NA NA 7.90 7.19 2.649566 A Rerepair ventrl hern block 15.53 NA NA 9.20 8.35 3.249568 A Hernia repair w/mesh 4.88 NA NA 2.12 1.93 1.049570 A Rpr epigastric hern reduce 6.05 NA NA 4.96 4.55 1.249572 A Rpr epigastric hern blocked 7.87 NA NA 5.76 5.22 1.6
CMS-1582-PN 310 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

49580 A Rpr umbil hern reduc < 5 yr 4.47 NA NA 4.37 3.98 0.949582 A Rpr umbil hern block < 5 yr 7.13 NA NA 5.62 5.11 1.549585 A Rpr umbil hern reduc > 5 yr 6.59 NA NA 5.18 4.75 1.349587 A Rpr umbil hern block > 5 yr 7.08 NA NA 5.45 5.25 1.449590 A Repair spigelian hernia 8.90 NA NA 6.21 5.67 1.849600 A Repair umbilical lesion 11.55 NA NA 7.68 7.15 2.449605 A Repair umbilical lesion 87.09 NA NA 42.03 39.02 18.549606 A Repair umbilical lesion 19.00 NA NA 10.70 9.76 4.049610 A Repair umbilical lesion 10.91 NA NA 7.18 6.64 2.349611 A Repair umbilical lesion 9.34 NA NA 6.01 6.12 0.649650 A Lap ing hernia repair init 6.36 NA NA 4.97 4.56 1.349651 A Lap ing hernia repair recur 8.38 NA NA 6.35 5.79 1.749652 A Lap vent/abd hernia repair 11.92 NA NA 7.52 7.25 0.849653 A Lap vent/abd hern proc comp 14.94 NA NA 9.31 8.97 1.049654 A Lap inc hernia repair 13.76 NA NA 8.30 8.01 0.949655 A Lap inc hern repair comp 16.84 NA NA 10.06 9.68 1.149656 A Lap inc hernia repair recur 15.08 NA NA 9.11 8.26 1.049657 A Lap inc hern recur comp 22.11 NA NA 12.65 11.44 1.549659 C Laparo proc hernia repair 0.00 0.00 0.00 0.00 0.00 0.049900 A Repair of abdominal wall 12.41 NA NA 9.26 8.57 2.549904 A Omental flap extra-abdom 22.35 NA NA 15.80 15.78 4.749905 A Omental flap intra-abdom 6.54 NA NA 2.80 2.59 1.249906 C Free omental flap microvasc 0.00 0.00 0.00 0.00 0.00 0.049999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.050010 A Exploration of kidney 12.28 NA NA 7.75 7.91 1.850020 A Renal abscess open drain 18.08 NA NA 10.76 10.77 2.450021 A Renal abscess percut drain 3.37 22.47 24.20 1.23 1.39 0.350040 A Drainage of kidney 16.68 NA NA 8.76 9.77 1.650045 A Exploration of kidney 16.82 NA NA 8.87 9.78 1.6

5005F I Pt counsld on exam for moles 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 311 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

50060 A Removal of kidney stone 20.95 NA NA 10.49 11.72 2.050065 A Incision of kidney 22.32 NA NA 11.02 12.06 2.150070 A Incision of kidney 21.85 NA NA 10.84 12.20 2.150075 A Removal of kidney stone 27.09 NA NA 13.11 14.72 2.650080 A Removal of kidney stone 15.74 NA NA 8.22 9.23 1.550081 A Removal of kidney stone 23.50 NA NA 11.72 13.12 2.350100 A Revise kidney blood vessels 17.45 NA NA 7.23 8.32 3.750120 A Exploration of kidney 17.21 NA NA 8.96 9.90 1.650125 A Explore and drain kidney 17.82 NA NA 11.06 11.06 1.750130 A Removal of kidney stone 18.82 NA NA 9.71 10.83 1.850135 A Exploration of kidney 20.59 NA NA 10.35 11.51 1.950200 A Renal biopsy perq 2.63 14.10 14.10 1.29 1.42 0.350205 A Renal biopsy open 12.29 NA NA 7.61 7.20 2.4

5020F I Txmnts 2 main dr by 1 mon 0.00 0.00 0.00 0.00 0.00 0.0

50220 A Remove kidney open 18.68 NA NA 9.83 10.65 2.250225 A Removal kidney open complex 21.88 NA NA 11.01 12.00 2.350230 A Removal kidney open radical 23.81 NA NA 11.45 12.73 2.450234 A Removal of kidney & ureter 24.05 NA NA 11.80 13.10 2.450236 A Removal of kidney & ureter 26.94 NA NA 13.47 15.08 2.650240 A Partial removal of kidney 24.21 NA NA 12.28 13.66 2.450250 A Cryoablate renal mass open 22.22 NA NA 11.33 12.79 2.150280 A Removal of kidney lesion 17.09 NA NA 9.19 10.03 1.850290 A Removal of kidney lesion 16.15 NA NA 10.34 9.85 1.550300 X Remove cadaver donor kidney 0.00 0.00 0.00 0.00 0.00 0.050320 A Remove kidney living donor 22.43 NA NA 15.42 15.33 3.850323 C Prep cadaver renal allograft 0.00 0.00 0.00 0.00 0.00 0.050325 C Prep donor renal graft 0.00 0.00 0.00 0.00 0.00 0.050327 A Prep renal graft/venous 4.00 NA NA 1.69 1.60 0.750328 A Prep renal graft/arterial 3.50 NA NA 1.48 1.41 0.650329 A Prep renal graft/ureteral 3.34 NA NA 1.37 1.42 0.4
CMS-1582-PN 312 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

50340 A Removal of kidney 14.04 NA NA 11.01 10.06 3.050360 A Transplantation of kidney 40.90 NA NA 27.10 24.82 8.350365 A Transplantation of kidney 46.13 NA NA 29.69 27.41 9.850370 A Remove transplanted kidney 18.88 NA NA 12.95 11.93 3.750380 A Reimplantation of kidney 30.11 NA NA 22.76 21.93 6.450382 A Change ureter stent percut 5.50 27.93 31.69 2.07 2.37 0.550384 A Remove ureter stent percut 5.00 21.93 26.02 1.85 2.14 0.450385 A Change stent via transureth 4.44 28.05 31.98 1.97 2.30 0.450386 A Remove stent via transureth 3.30 18.06 20.40 1.55 1.80 0.350387 A Change ext/int ureter stent 2.00 13.45 15.28 0.72 0.84 0.250389 A Remove renal tube w/fluoro 1.10 7.06 8.52 0.41 0.46 0.150390 A Drainage of kidney lesion 1.96 NA NA 0.71 0.81 0.150391 A Instll rx agnt into rnal tub 1.96 1.43 1.65 0.79 0.88 0.250392 A Insert kidney drain 3.37 NA NA 1.55 1.76 0.350393 A Insert ureteral tube 4.15 NA NA 1.83 2.09 0.350394 A Injection for kidney x-ray 0.76 1.98 2.26 0.60 0.68 0.050395 A Create passage to kidney 3.37 NA NA 1.58 1.80 0.350396 A Measure kidney pressure 2.09 NA NA 1.09 1.25 0.250398 A Change kidney tube 1.46 12.69 14.24 0.57 0.65 0.150400 A Revision of kidney/ureter 21.27 NA NA 10.67 11.80 2.150405 A Revision of kidney/ureter 25.86 NA NA 12.63 14.07 2.550500 A Repair of kidney wound 21.22 NA NA 11.99 11.61 4.550520 A Close kidney-skin fistula 18.88 NA NA 9.68 10.66 1.850525 A Repair renal-abdomen fistula 24.39 NA NA 14.15 13.88 5.250526 A Repair renal-abdomen fistula 26.31 NA NA 14.18 13.71 1.850540 A Revision of horseshoe kidney 21.10 NA NA 10.55 11.44 2.050541 A Laparo ablate renal cyst 16.86 NA NA 8.51 9.46 1.750542 A Laparo ablate renal mass 21.36 NA NA 10.86 12.11 2.150543 A Laparo partial nephrectomy 27.41 NA NA 13.65 15.24 2.750544 A Laparoscopy pyeloplasty 23.37 NA NA 11.03 12.36 2.3
CMS-1582-PN 313 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

50545 A Laparo radical nephrectomy 25.06 NA NA 11.93 13.33 2.550546 A Laparoscopic nephrectomy 21.87 NA NA 11.17 12.36 2.350547 A Laparo removal donor kidney 26.34 NA NA 16.33 15.84 4.850548 A Laparo remove w/ureter 25.36 NA NA 11.84 13.27 2.550549 C Laparoscope proc renal 0.00 0.00 0.00 0.00 0.00 0.050551 A Kidney endoscopy 5.59 4.25 4.92 2.56 2.88 0.550553 A Kidney endoscopy 5.98 4.54 5.11 2.68 2.99 0.650555 A Kidney endoscopy & biopsy 6.52 4.76 5.47 2.93 3.28 0.650557 A Kidney endoscopy & treatment 6.61 4.85 5.60 2.96 3.33 0.650561 A Kidney endoscopy & treatment 7.58 5.44 6.27 3.34 3.76 0.750562 A Renal scope w/tumor resect 10.90 NA NA 5.15 5.84 1.050570 A Kidney endoscopy 9.53 NA NA 4.06 4.60 0.950572 A Kidney endoscopy 10.33 NA NA 4.38 4.96 1.050574 A Kidney endoscopy & biopsy 11.00 NA NA 4.64 5.25 1.050575 A Kidney endoscopy 13.96 NA NA 5.80 6.56 1.350576 A Kidney endoscopy & treatment 10.97 NA NA 4.63 5.24 1.050580 A Kidney endoscopy & treatment 11.84 NA NA 4.97 5.56 1.150590 A Fragmenting of kidney stone 9.77 11.22 15.32 5.80 6.47 0.950592 A Perc rf ablate renal tumor 6.80 76.33 94.06 3.15 3.55 0.650593 A Perc cryo ablate renal tum 9.13 115.17 129.65 4.21 4.30 0.850600 A Exploration of ureter 17.17 NA NA 8.72 9.64 1.650605 A Insert ureteral support 16.79 NA NA 9.37 9.48 2.6

5060F I Fndngs mammo 2pt w/in 3 days 0.00 0.00 0.00 0.00 0.00 0.0

50610 A Removal of ureter stone 17.25 NA NA 8.82 9.85 1.650620 A Removal of ureter stone 16.43 NA NA 8.50 9.49 1.5

5062F I Mammo result com to pt 5 day 0.00 0.00 0.00 0.00 0.00 0.0

50630 A Removal of ureter stone 16.21 NA NA 8.41 9.18 1.550650 A Removal of ureter 18.82 NA NA 9.72 10.78 1.850660 A Removal of ureter 21.02 NA NA 10.52 11.65 2.050684 A Injection for ureter x-ray 0.76 2.14 3.61 0.62 0.68 0.0
CMS-1582-PN 314 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

50686 A Measure ureter pressure 1.51 2.62 2.62 1.03 1.11 0.250688 A Change of ureter tube/stent 1.20 NA NA 0.99 1.11 0.150690 A Injection for ureter x-ray 1.16 1.48 1.70 0.76 0.85 0.150700 A Revision of ureter 16.69 NA NA 8.82 9.76 1.650715 A Release of ureter 20.64 NA NA 11.58 11.27 3.050722 A Release of ureter 17.95 NA NA 10.50 10.02 3.050725 A Release/revise ureter 20.20 NA NA 12.10 11.96 1.950727 A Revise ureter 8.28 NA NA 5.65 6.21 0.850728 A Revise ureter 12.18 NA NA 7.06 7.66 1.150740 A Fusion of ureter & kidney 20.07 NA NA 11.40 11.21 4.250750 A Fusion of ureter & kidney 21.22 NA NA 10.59 11.92 2.050760 A Fusion of ureters 20.07 NA NA 10.57 11.19 2.650770 A Splicing of ureters 21.22 NA NA 10.59 11.25 2.050780 A Reimplant ureter in bladder 19.95 NA NA 10.32 11.21 2.350782 A Reimplant ureter in bladder 19.66 NA NA 9.98 10.83 4.150783 A Reimplant ureter in bladder 20.70 NA NA 12.32 11.93 2.050785 A Reimplant ureter in bladder 22.23 NA NA 11.14 12.31 2.250800 A Implant ureter in bowel 16.41 NA NA 9.07 9.95 1.750810 A Fusion of ureter & bowel 22.61 NA NA 11.81 12.09 4.850815 A Urine shunt to intestine 22.26 NA NA 11.45 12.71 2.150820 A Construct bowel bladder 24.07 NA NA 12.18 13.18 2.650825 A Construct bowel bladder 30.68 NA NA 14.97 16.51 3.150830 A Revise urine flow 33.77 NA NA 15.95 17.42 3.250840 A Replace ureter by bowel 22.39 NA NA 11.50 12.82 2.150845 A Appendico-vesicostomy 22.46 NA NA 11.97 13.31 2.150860 A Transplant ureter to skin 17.08 NA NA 8.97 9.93 1.650900 A Repair of ureter 15.04 NA NA 8.47 9.03 1.450920 A Closure ureter/skin fistula 15.81 NA NA 8.48 9.44 1.550930 A Closure ureter/bowel fistula 20.19 NA NA 10.19 10.69 4.350940 A Release of ureter 15.93 NA NA 8.52 9.38 1.5
CMS-1582-PN 315 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

50945 A Laparoscopy ureterolithotomy 17.97 NA NA 8.88 9.90 1.750947 A Laparo new ureter/bladder 25.78 NA NA 12.38 13.66 2.550948 A Laparo new ureter/bladder 23.82 NA NA 11.36 12.80 2.350949 C Laparoscope proc ureter 0.00 0.00 0.00 0.00 0.00 0.050951 A Endoscopy of ureter 5.83 4.45 5.16 2.66 3.00 0.550953 A Endoscopy of ureter 6.23 4.66 5.38 3.14 3.54 0.650955 A Ureter endoscopy & biopsy 6.74 4.91 5.91 3.35 3.79 0.650957 A Ureter endoscopy & treatment 6.78 4.96 5.71 3.02 3.40 0.650961 A Ureter endoscopy & treatment 6.04 4.53 5.24 2.73 3.09 0.550970 A Ureter endoscopy 7.13 NA NA 3.13 3.53 0.650972 A Ureter endoscopy & catheter 6.88 NA NA 3.03 3.40 0.650974 A Ureter endoscopy & biopsy 9.16 NA NA 3.92 4.44 0.850976 A Ureter endoscopy & treatment 9.03 NA NA 3.87 4.36 0.850980 A Ureter endoscopy & treatment 6.84 NA NA 3.01 3.41 0.6

5100F I Rsk fx ref w/n 24 hrs xray 0.00 0.00 0.00 0.00 0.00 0.0

51020 A Incise & treat bladder 7.69 NA NA 5.19 5.78 0.751030 A Incise & treat bladder 7.81 NA NA 5.14 5.56 0.751040 A Incise & drain bladder 4.49 NA NA 3.46 3.90 0.451045 A Incise bladder/drain ureter 7.81 NA NA 5.56 5.85 1.051050 A Removal of bladder stone 7.97 NA NA 5.04 5.62 0.751060 A Removal of ureter stone 9.95 NA NA 6.05 6.76 0.951065 A Remove ureter calculus 9.95 NA NA 5.97 6.65 0.951080 A Drainage of bladder abscess 6.71 NA NA 4.53 5.01 0.651100 A Drain bladder by needle 0.78 0.95 1.02 0.31 0.33 0.051101 A Drain bladder by trocar/cath 1.02 2.45 2.70 0.44 0.45 0.151102 A Drain bl w/cath insertion 2.70 3.49 4.01 1.31 1.49 0.251500 A Removal of bladder cyst 11.05 NA NA 7.92 7.56 1.051520 A Removal of bladder lesion 10.21 NA NA 6.15 6.70 0.951525 A Removal of bladder lesion 15.42 NA NA 8.23 9.17 1.551530 A Removal of bladder lesion 13.71 NA NA 7.97 8.45 1.6
CMS-1582-PN 316 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

51535 A Repair of ureter lesion 13.90 NA NA 7.58 8.27 1.351550 A Partial removal of bladder 17.23 NA NA 9.18 9.88 2.151555 A Partial removal of bladder 23.18 NA NA 11.68 12.71 2.651565 A Revise bladder & ureter(s) 23.68 NA NA 12.05 13.12 2.451570 A Removal of bladder 27.46 NA NA 13.47 14.60 2.851575 A Removal of bladder & nodes 34.18 NA NA 16.07 17.94 3.351580 A Remove bladder/revise tract 35.37 NA NA 16.93 18.97 3.451585 A Removal of bladder & nodes 39.64 NA NA 18.60 20.85 3.851590 A Remove bladder/revise tract 36.33 NA NA 16.93 18.83 3.651595 A Remove bladder/revise tract 41.32 NA NA 19.09 21.29 4.151596 A Remove bladder/create pouch 44.26 NA NA 20.67 23.09 4.351597 A Removal of pelvic structures 42.86 NA NA 20.33 22.31 4.551600 A Injection for bladder x-ray 0.88 4.21 4.81 0.34 0.38 0.051605 A Preparation for bladder xray 0.64 NA NA 0.42 0.47 0.051610 A Injection for bladder x-ray 1.05 1.87 2.16 0.71 0.78 0.151700 A Irrigation of bladder 0.88 1.39 1.62 0.36 0.39 0.051701 A Insert bladder catheter 0.50 0.99 1.21 0.26 0.28 0.051702 A Insert temp bladder cath 0.50 1.43 1.72 0.33 0.36 0.051703 A Insert bladder cath complex 1.47 2.07 2.50 0.78 0.87 0.151705 A Change of bladder tube 0.90 1.59 1.59 0.51 0.51 0.051710 A Change of bladder tube 1.35 1.21 1.21 0.83 0.83 0.151715 A Endoscopic injection/implant 3.73 4.16 4.72 1.79 1.94 0.351720 A Treatment of bladder lesion 1.50 1.48 1.76 0.72 0.83 0.151725 A Simple cystometrogram 1.51 3.62 4.57 NA NA 0.151725 TC A Simple cystometrogram 0.00 2.99 3.91 NA NA 0.051725 26 A Simple cystometrogram 1.51 0.63 0.66 0.63 0.66 0.151726 A Complex cystometrogram 1.71 5.69 7.19 NA NA 0.151726 TC A Complex cystometrogram 0.00 4.98 6.43 NA NA 0.051726 26 A Complex cystometrogram 1.71 0.71 0.76 0.71 0.76 0.151727 A Cystometrogram w/up 2.11 6.68 6.68 NA NA 0.2
CMS-1582-PN 317 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

51727 TC A Cystometrogram w/up 0.00 5.78 5.78 NA NA 0.051727 26 A Cystometrogram w/up 2.11 0.90 0.90 0.90 0.90 0.251728 A Cystometrogram w/vp 2.11 6.63 6.63 NA NA 0.151728 TC A Cystometrogram w/vp 0.00 5.76 5.76 NA NA 0.051728 26 A Cystometrogram w/vp 2.11 0.87 0.87 0.87 0.87 0.151729 A Cystometrogram w/vp&up 2.51 7.02 7.02 NA NA 0.251729 TC A Cystometrogram w/vp&up 0.00 5.96 5.96 NA NA 0.051729 26 A Cystometrogram w/vp&up 2.51 1.06 1.06 1.06 1.06 0.251736 A Urine flow measurement 0.17 0.66 0.85 NA NA 0.051736 TC A Urine flow measurement 0.00 0.59 0.67 NA NA 0.051736 26 A Urine flow measurement 0.17 0.07 0.18 0.07 0.18 0.051741 A Electro-uroflowmetry first 0.17 0.75 1.08 NA NA 0.051741 TC A Electro-uroflowmetry first 0.00 0.68 0.77 NA NA 0.051741 26 A Electro-uroflowmetry first 0.17 0.07 0.31 0.07 0.31 0.051784 A Anal/urinary muscle study 1.53 3.90 4.40 NA NA 0.151784 TC A Anal/urinary muscle study 0.00 3.26 3.73 NA NA 0.051784 26 A Anal/urinary muscle study 1.53 0.64 0.67 0.64 0.67 0.151785 A Anal/urinary muscle study 1.53 4.50 5.00 NA NA 0.151785 TC A Anal/urinary muscle study 0.00 3.85 4.32 NA NA 0.051785 26 A Anal/urinary muscle study 1.53 0.65 0.68 0.65 0.68 0.151792 A Urinary reflex study 1.10 4.96 5.65 NA NA 0.151792 TC A Urinary reflex study 0.00 4.49 5.16 NA NA 0.051792 26 A Urinary reflex study 1.10 0.47 0.49 0.47 0.49 0.151797 A Intraabdominal pressure test 0.80 2.27 3.12 NA NA 0.051797 TC A Intraabdominal pressure test 0.00 1.94 2.73 NA NA 0.051797 26 A Intraabdominal pressure test 0.80 0.33 0.39 0.33 0.39 0.051798 A Us urine capacity measure 0.00 0.50 0.57 NA NA 0.051800 A Revision of bladder/urethra 18.89 NA NA 9.89 10.94 1.951820 A Revision of urinary tract 19.59 NA NA 10.27 10.89 1.851840 A Attach bladder/urethra 11.36 NA NA 6.78 7.02 1.5
CMS-1582-PN 318 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

51841 A Attach bladder/urethra 13.68 NA NA 7.92 8.14 1.851845 A Repair bladder neck 10.15 NA NA 6.05 6.53 1.251860 A Repair of bladder wound 12.60 NA NA 7.68 7.94 1.851865 A Repair of bladder wound 15.80 NA NA 8.71 9.38 1.951880 A Repair of bladder opening 7.87 NA NA 4.97 5.34 0.951900 A Repair bladder/vagina lesion 14.63 NA NA 8.34 8.84 1.451920 A Close bladder-uterus fistula 13.41 NA NA 7.61 8.18 1.251925 A Hysterectomy/bladder repair 17.53 NA NA 11.65 11.30 2.951940 A Correction of bladder defect 30.66 NA NA 14.62 15.48 2.951960 A Revision of bladder & bowel 25.40 NA NA 12.83 14.25 2.651980 A Construct bladder opening 12.57 NA NA 7.07 7.83 1.251990 A Laparo urethral suspension 13.36 NA NA 7.43 7.64 1.751992 A Laparo sling operation 14.87 NA NA 8.51 8.39 2.251999 C Laparoscope proc bla 0.00 0.00 0.00 0.00 0.00 0.052000 A Cystoscopy 2.23 3.29 3.83 1.25 1.37 0.252001 A Cystoscopy removal of clots 5.44 4.68 5.49 2.51 2.80 0.552005 A Cystoscopy & ureter catheter 2.37 5.14 5.54 1.23 1.31 0.252007 A Cystoscopy and biopsy 3.02 9.47 10.69 1.46 1.57 0.3

5200F I Eval appros surg thxpy epi 0.00 0.00 0.00 0.00 0.00 0.0

52010 A Cystoscopy & duct catheter 3.02 7.18 8.60 1.55 1.65 0.352204 A Cystoscopy w/biopsy(s) 2.59 7.35 9.64 1.32 1.46 0.252214 A Cystoscopy and treatment 3.70 13.84 14.60 1.75 2.31 0.352224 A Cystoscopy and treatment 3.14 13.13 18.84 1.53 1.72 0.352234 A Cystoscopy and treatment 4.62 NA NA 2.18 2.46 0.452235 A Cystoscopy and treatment 5.44 NA NA 2.53 2.85 0.552240 A Cystoscopy and treatment 9.71 NA NA 4.20 4.75 0.952250 A Cystoscopy and radiotracer 4.49 NA NA 2.22 2.48 0.452260 A Cystoscopy and treatment 3.91 NA NA 1.90 2.11 0.352265 A Cystoscopy and treatment 2.94 6.98 8.90 1.57 1.66 0.352270 A Cystoscopy & revise urethra 3.36 6.23 8.00 1.66 1.87 0.3
CMS-1582-PN 319 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

52275 A Cystoscopy & revise urethra 4.69 8.28 10.76 2.18 2.46 0.452276 A Cystoscopy and treatment 4.99 NA NA 2.35 2.64 0.452277 A Cystoscopy and treatment 6.16 NA NA 2.86 3.18 0.652281 A Cystoscopy and treatment 2.60 4.54 5.77 1.39 1.60 0.252282 A Cystoscopy implant stent 6.39 NA NA 2.92 3.25 0.652283 A Cystoscopy and treatment 3.73 3.82 4.41 1.85 2.05 0.352285 A Cystoscopy and treatment 3.60 3.99 4.61 1.81 2.00 0.352290 A Cystoscopy and treatment 4.58 NA NA 2.17 2.45 0.452300 A Cystoscopy and treatment 5.30 NA NA 2.54 2.80 0.552301 A Cystoscopy and treatment 5.50 NA NA 2.59 2.92 0.552305 A Cystoscopy and treatment 5.30 NA NA 2.41 2.70 0.552310 A Cystoscopy and treatment 2.81 3.78 4.08 1.29 1.38 0.252315 A Cystoscopy and treatment 5.20 5.98 6.62 2.22 2.39 0.552317 A Remove bladder stone 6.71 15.10 19.72 2.89 3.27 0.652318 A Remove bladder stone 9.18 NA NA 3.92 4.42 0.852320 A Cystoscopy and treatment 4.69 NA NA 2.13 2.39 0.452325 A Cystoscopy stone removal 6.15 NA NA 2.71 3.05 0.652327 A Cystoscopy inject material 5.18 NA NA 2.05 2.32 0.552330 A Cystoscopy and treatment 5.03 8.33 14.31 2.26 2.54 0.452332 A Cystoscopy and treatment 2.60 10.78 11.89 1.39 1.61 0.252334 A Create passage to kidney 4.82 NA NA 2.26 2.55 0.452341 A Cysto w/ureter stricture tx 5.35 NA NA 2.63 2.99 0.552342 A Cysto w/up stricture tx 5.85 NA NA 2.82 3.22 0.552343 A Cysto w/renal stricture tx 6.55 NA NA 3.10 3.53 0.652344 A Cysto/uretero stricture tx 7.05 NA NA 3.44 3.90 0.652345 A Cysto/uretero w/up stricture 7.55 NA NA 3.64 4.13 0.752346 A Cystouretero w/renal strict 8.58 NA NA 4.03 4.59 0.852351 A Cystouretero & or pyeloscope 5.85 NA NA 2.83 3.18 0.552352 A Cystouretero w/stone remove 6.87 NA NA 3.31 3.73 0.652353 A Cystouretero w/lithotripsy 7.96 NA NA 3.74 4.22 0.7
CMS-1582-PN 320 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

52354 A Cystouretero w/biopsy 7.33 NA NA 3.50 3.94 0.752355 A Cystouretero w/excise tumor 8.81 NA NA 4.08 4.60 0.852400 A Cystouretero w/congen repr 8.69 NA NA 4.49 5.11 0.852402 A Cystourethro cut ejacul duct 5.27 NA NA 2.11 2.39 0.552450 A Incision of prostate 7.78 NA NA 5.16 5.75 0.752500 A Revision of bladder neck 8.14 NA NA 5.30 5.93 0.752601 A Prostatectomy (turp) 15.26 NA NA 8.04 8.68 1.552630 A Remove prostate regrowth 6.55 NA NA 4.32 4.57 0.652640 A Relieve bladder contracture 4.79 NA NA 3.80 3.89 0.452647 A Laser surgery of prostate 11.30 36.89 48.67 6.53 7.27 1.152648 A Laser surgery of prostate 12.15 37.46 49.21 6.86 7.64 1.252649 A Prostate laser enucleation 14.56 NA NA 7.50 8.55 1.452700 A Drainage of prostate abscess 7.49 NA NA 4.65 5.08 0.753000 A Incision of urethra 2.33 NA NA 1.74 1.96 0.253010 A Incision of urethra 4.45 NA NA 3.65 4.08 0.453020 A Incision of urethra 1.77 NA NA 0.91 1.01 0.153025 A Incision of urethra 1.13 NA NA 0.83 0.81 0.053040 A Drainage of urethra abscess 6.55 NA NA 4.26 4.73 0.653060 A Drainage of urethra abscess 2.68 2.39 2.44 1.89 1.85 0.453080 A Drainage of urinary leakage 6.92 NA NA 4.64 5.42 0.653085 A Drainage of urinary leakage 11.18 NA NA 6.69 6.81 1.453200 A Biopsy of urethra 2.59 1.68 1.85 1.32 1.43 0.253210 A Removal of urethra 13.72 NA NA 7.68 8.43 1.353215 A Removal of urethra 16.85 NA NA 8.74 9.81 1.653220 A Treatment of urethra lesion 7.63 NA NA 4.93 5.41 0.753230 A Removal of urethra lesion 10.44 NA NA 6.28 6.87 1.153235 A Removal of urethra lesion 10.99 NA NA 6.44 7.27 1.053240 A Surgery for urethra pouch 7.08 NA NA 4.61 5.21 0.653250 A Removal of urethra gland 6.52 NA NA 4.82 5.14 1.453260 A Treatment of urethra lesion 3.03 2.50 2.73 1.94 2.05 0.3
CMS-1582-PN 321 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

53265 A Treatment of urethra lesion 3.17 2.79 3.17 1.96 2.13 0.353270 A Removal of urethra gland 3.14 2.65 2.78 2.11 2.14 0.553275 A Repair of urethra defect 4.57 NA NA 2.65 3.00 0.453400 A Revise urethra stage 1 14.13 NA NA 7.98 8.84 1.453405 A Revise urethra stage 2 15.66 NA NA 8.41 9.47 1.553410 A Reconstruction of urethra 17.68 NA NA 9.34 10.44 1.753415 A Reconstruction of urethra 20.70 NA NA 10.44 11.65 2.053420 A Reconstruct urethra stage 1 15.17 NA NA 8.01 8.31 1.453425 A Reconstruct urethra stage 2 17.07 NA NA 8.75 9.89 1.653430 A Reconstruction of urethra 17.43 NA NA 9.19 9.84 1.953431 A Reconstruct urethra/bladder 21.18 NA NA 10.65 11.88 2.053440 A Male sling procedure 13.36 NA NA 7.02 7.86 1.353442 A Remove/revise male sling 13.49 NA NA 8.09 8.91 1.353444 A Insert tandem cuff 14.19 NA NA 7.68 8.62 1.353445 A Insert uro/ves nck sphincter 15.39 NA NA 8.77 9.88 1.553446 A Remove uro sphincter 11.02 NA NA 6.67 7.50 1.053447 A Remove/replace ur sphincter 14.28 NA NA 8.01 9.02 1.453448 A Remov/replc ur sphinctr comp 23.44 NA NA 11.86 13.30 2.253449 A Repair uro sphincter 10.56 NA NA 6.29 7.05 1.053450 A Revision of urethra 6.77 NA NA 4.47 5.01 0.653460 A Revision of urethra 7.75 NA NA 4.85 5.44 0.753500 A Urethrlys transvag w/ scope 13.00 NA NA 7.59 8.25 1.553502 A Repair of urethra injury 8.26 NA NA 5.14 5.67 0.853505 A Repair of urethra injury 8.26 NA NA 5.12 5.74 0.853510 A Repair of urethra injury 10.96 NA NA 6.42 7.20 1.053515 A Repair of urethra injury 14.22 NA NA 7.70 8.57 1.353520 A Repair of urethra defect 9.48 NA NA 5.84 6.53 0.953600 A Dilate urethra stricture 1.21 1.07 1.25 0.55 0.62 0.153601 A Dilate urethra stricture 0.98 1.23 1.44 0.50 0.56 0.053605 A Dilate urethra stricture 1.28 NA NA 0.50 0.56 0.1
CMS-1582-PN 322 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

53620 A Dilate urethra stricture 1.62 1.55 1.87 0.79 0.89 0.153621 A Dilate urethra stricture 1.35 1.63 1.97 0.64 0.72 0.153660 A Dilation of urethra 0.71 1.21 1.41 0.44 0.48 0.053661 A Dilation of urethra 0.72 1.17 1.38 0.40 0.44 0.053665 A Dilation of urethra 0.76 NA NA 0.31 0.33 0.053850 A Prostatic microwave thermotx 10.08 43.20 58.11 5.58 6.22 0.953852 A Prostatic rf thermotx 10.83 40.73 54.81 6.31 7.02 1.053855 A Insert prost urethral stent 1.64 19.26 19.26 0.64 0.64 0.153860 A Transurethral rf treatment 3.97 38.32 38.32 2.23 2.23 0.653899 C Urology surgery procedure 0.00 0.00 0.00 0.00 0.00 0.054000 A Slitting of prepuce 1.59 2.44 2.91 1.38 1.53 0.154001 A Slitting of prepuce 2.24 2.80 3.29 1.58 1.75 0.254015 A Drain penis lesion 5.36 NA NA 3.08 3.47 0.554050 A Destruction penis lesion(s) 1.29 2.39 2.42 1.66 1.64 0.154055 A Destruction penis lesion(s) 1.25 2.00 2.15 1.31 1.36 0.154056 A Cryosurgery penis lesion(s) 1.29 2.71 2.68 1.86 1.81 0.154057 A Laser surg penis lesion(s) 1.29 2.45 2.75 1.32 1.42 0.154060 A Excision of penis lesion(s) 1.98 2.92 3.36 1.61 1.74 0.254065 A Destruction penis lesion(s) 2.47 3.64 3.73 2.37 2.31 0.354100 A Biopsy of penis 1.90 3.61 3.77 1.68 1.62 0.254105 A Biopsy of penis 3.54 3.68 4.35 2.33 2.63 0.354110 A Treatment of penis lesion 10.92 NA NA 6.27 7.00 1.054111 A Treat penis lesion graft 14.42 NA NA 7.64 8.59 1.454112 A Treat penis lesion graft 16.98 NA NA 8.87 10.00 1.654115 A Treatment of penis lesion 6.95 5.44 6.12 4.72 5.25 0.654120 A Partial removal of penis 11.01 NA NA 6.39 7.14 1.054125 A Removal of penis 14.56 NA NA 7.83 8.72 1.454130 A Remove penis & nodes 21.84 NA NA 11.06 12.41 2.154135 A Remove penis & nodes 28.17 NA NA 13.54 15.22 2.754150 A Circumcision w/regionl block 1.90 2.33 2.83 0.80 0.86 0.2
CMS-1582-PN 323 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

54160 A Circumcision neonate 2.53 3.44 4.12 1.43 1.61 0.254161 A Circum 28 days or older 3.32 NA NA 2.09 2.34 0.354162 A Lysis penil circumic lesion 3.32 3.71 4.42 2.17 2.38 0.354163 A Repair of circumcision 3.32 NA NA 2.71 3.01 0.354164 A Frenulotomy of penis 2.82 NA NA 2.48 2.77 0.254200 A Treatment of penis lesion 1.11 1.82 2.11 1.20 1.36 0.154205 A Treatment of penis lesion 8.97 NA NA 5.69 6.45 0.854220 A Treatment of penis lesion 2.42 3.05 3.64 1.29 1.43 0.254230 A Prepare penis study 1.34 1.30 1.48 0.86 0.96 0.154231 A Dynamic cavernosometry 2.04 1.79 2.03 1.17 1.32 0.254235 A Penile injection 1.19 1.29 1.44 0.84 0.93 0.154240 A Penis study 1.31 1.43 1.60 NA NA 0.054240 TC A Penis study 0.00 0.92 1.03 NA NA 0.054240 26 A Penis study 1.31 0.51 0.57 0.51 0.57 0.054250 A Penis study 2.22 1.15 1.32 NA NA 0.154250 TC A Penis study 0.00 0.28 0.34 NA NA 0.054250 26 A Penis study 2.22 0.87 0.98 0.87 0.98 0.154300 A Revision of penis 11.20 NA NA 6.49 7.37 1.054304 A Revision of penis 13.28 NA NA 7.39 8.42 1.254308 A Reconstruction of urethra 12.62 NA NA 7.86 8.45 1.254312 A Reconstruction of urethra 14.51 NA NA 8.92 9.62 1.454316 A Reconstruction of urethra 18.05 NA NA 10.51 11.30 1.754318 A Reconstruction of urethra 12.43 NA NA 7.93 8.50 0.854322 A Reconstruction of urethra 13.98 NA NA 7.54 8.59 1.354324 A Reconstruction of urethra 17.55 NA NA 9.16 10.46 1.654326 A Reconstruction of urethra 17.02 NA NA 9.06 9.72 1.654328 A Revise penis/urethra 16.89 NA NA 9.01 10.06 1.654332 A Revise penis/urethra 18.37 NA NA 9.59 10.86 1.754336 A Revise penis/urethra 21.62 NA NA 12.42 12.29 2.154340 A Secondary urethral surgery 9.71 NA NA 5.98 6.61 0.9
CMS-1582-PN 324 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

54344 A Secondary urethral surgery 17.06 NA NA 10.07 10.84 1.654348 A Secondary urethral surgery 18.32 NA NA 16.75 14.62 1.254352 A Reconstruct urethra/penis 26.13 NA NA 22.73 19.75 2.554360 A Penis plastic surgery 12.78 NA NA 7.08 8.06 1.254380 A Repair penis 14.18 NA NA 7.84 8.92 1.354385 A Repair penis 16.56 NA NA 9.02 11.01 2.454390 A Repair penis and bladder 22.77 NA NA 12.73 12.41 2.254400 A Insert semi-rigid prosthesis 9.17 NA NA 5.42 6.12 0.854401 A Insert self-contd prosthesis 10.44 NA NA 7.59 8.52 1.054405 A Insert multi-comp penis pros 14.52 NA NA 7.79 8.73 1.454406 A Remove muti-comp penis pros 12.89 NA NA 7.24 8.11 1.254408 A Repair multi-comp penis pros 13.91 NA NA 7.88 8.79 1.354410 A Remove/replace penis prosth 15.18 NA NA 8.52 9.58 1.454411 A Remov/replc penis pros comp 18.35 NA NA 9.96 11.10 1.754415 A Remove self-contd penis pros 8.88 NA NA 5.66 6.33 0.854416 A Remv/repl penis contain pros 12.08 NA NA 7.49 8.35 1.154417 A Remv/replc penis pros compl 16.10 NA NA 8.67 9.69 1.554420 A Revision of penis 12.39 NA NA 7.03 7.94 1.254430 A Revision of penis 11.06 NA NA 6.57 7.42 1.054435 A Revision of penis 6.81 NA NA 4.66 5.25 0.654440 C Repair of penis 0.00 0.00 0.00 0.00 0.00 0.054450 A Preputial stretching 1.12 0.80 0.95 0.47 0.54 0.154500 A Biopsy of testis 1.31 NA NA 0.75 0.84 0.154505 A Biopsy of testis 3.50 NA NA 2.28 2.59 0.354512 A Excise lesion testis 9.33 NA NA 5.49 6.07 0.954520 A Removal of testis 5.30 NA NA 3.66 4.02 0.654522 A Orchiectomy partial 10.25 NA NA 6.00 6.46 1.054530 A Removal of testis 8.46 NA NA 5.43 6.08 0.854535 A Extensive testis surgery 13.19 NA NA 7.32 7.97 1.254550 A Exploration for testis 8.41 NA NA 5.14 5.68 0.8
CMS-1582-PN 325 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

54560 A Exploration for testis 12.10 NA NA 6.82 7.21 1.154600 A Reduce testis torsion 7.64 NA NA 4.84 5.40 0.754620 A Suspension of testis 5.21 NA NA 3.05 3.45 0.554640 A Suspension of testis 7.73 NA NA 5.45 5.86 0.854650 A Orchiopexy (fowler-stephens) 12.39 NA NA 7.21 7.91 1.254660 A Revision of testis 5.74 NA NA 4.09 4.54 0.554670 A Repair testis injury 6.65 NA NA 4.50 5.01 0.654680 A Relocation of testis(es) 14.04 NA NA 7.65 8.38 1.354690 A Laparoscopy orchiectomy 11.70 NA NA 6.42 6.63 2.454692 A Laparoscopy orchiopexy 13.74 NA NA 7.19 8.09 1.354699 C Laparoscope proc testis 0.00 0.00 0.00 0.00 0.00 0.054700 A Drainage of scrotum 3.47 NA NA 2.39 2.61 0.354800 A Biopsy of epididymis 2.33 NA NA 2.06 1.81 0.354830 A Remove epididymis lesion 6.01 NA NA 4.24 4.68 0.654840 A Remove epididymis lesion 5.27 NA NA 3.57 4.01 0.554860 A Removal of epididymis 6.95 NA NA 4.58 5.11 0.654861 A Removal of epididymis 9.70 NA NA 5.89 6.56 0.954865 A Explore epididymis 5.77 NA NA 4.10 4.55 0.554900 A Fusion of spermatic ducts 14.20 NA NA 7.85 7.99 1.054901 A Fusion of spermatic ducts 19.10 NA NA 11.13 11.82 1.355000 A Drainage of hydrocele 1.43 1.78 2.06 0.91 0.99 0.155040 A Removal of hydrocele 5.45 NA NA 3.83 4.24 0.655041 A Removal of hydroceles 8.54 NA NA 5.49 6.06 0.955060 A Repair of hydrocele 6.15 NA NA 4.31 4.74 0.655100 A Drainage of scrotum abscess 2.45 3.40 3.86 2.11 2.27 0.355110 A Explore scrotum 6.33 NA NA 4.37 4.78 0.655120 A Removal of scrotum lesion 5.72 NA NA 4.08 4.49 0.655150 A Removal of scrotum 8.14 NA NA 5.38 5.91 0.855175 A Revision of scrotum 5.87 NA NA 4.17 4.60 0.655180 A Revision of scrotum 11.78 NA NA 7.28 7.94 1.2
CMS-1582-PN 326 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

55200 A Incision of sperm duct 4.55 7.31 9.18 3.11 3.42 0.455250 A Removal of sperm duct(s) 3.37 7.28 8.94 2.94 3.24 0.355300 A Prepare sperm duct x-ray 3.50 NA NA 1.67 1.72 0.355400 A Repair of sperm duct 8.61 NA NA 5.12 5.79 0.855450 A Ligation of sperm duct 4.43 5.35 6.44 2.66 2.92 0.455500 A Removal of hydrocele 6.22 NA NA 4.65 4.78 0.855520 A Removal of sperm cord lesion 6.66 NA NA 5.36 4.98 1.355530 A Revise spermatic cord veins 5.75 NA NA 3.96 4.39 0.655535 A Revise spermatic cord veins 7.19 NA NA 4.66 5.14 0.655540 A Revise hernia & sperm veins 8.30 NA NA 6.09 5.66 1.655550 A Laparo ligate spermatic vein 7.20 NA NA 4.60 4.99 0.655559 C Laparo proc spermatic cord 0.00 0.00 0.00 0.00 0.00 0.055600 A Incise sperm duct pouch 7.01 NA NA 4.60 5.15 0.655605 A Incise sperm duct pouch 8.76 NA NA 6.18 6.21 0.855650 A Remove sperm duct pouch 12.65 NA NA 7.12 7.84 1.255680 A Remove sperm pouch lesion 5.67 NA NA 3.86 4.15 0.555700 A Biopsy of prostate 2.58 3.35 4.03 1.27 1.38 0.255705 A Biopsy of prostate 4.61 NA NA 2.74 3.09 0.455706 A Prostate saturation sampling 6.28 NA NA 3.99 4.67 0.455720 A Drainage of prostate abscess 7.73 NA NA 4.72 5.26 0.755725 A Drainage of prostate abscess 10.05 NA NA 6.29 6.93 0.955801 A Removal of prostate 19.80 NA NA 10.35 11.43 1.955810 A Extensive prostate surgery 24.29 NA NA 12.00 13.32 2.455812 A Extensive prostate surgery 29.89 NA NA 14.50 16.20 2.955815 A Extensive prostate surgery 32.95 NA NA 15.70 17.59 3.255821 A Removal of prostate 15.76 NA NA 8.35 9.33 1.555831 A Removal of prostate 17.19 NA NA 8.90 9.96 1.655840 A Extensive prostate surgery 24.63 NA NA 12.28 13.74 2.455842 A Extensive prostate surgery 26.49 NA NA 13.01 14.57 2.655845 A Extensive prostate surgery 30.67 NA NA 14.46 16.18 3.0
CMS-1582-PN 327 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

55860 A Surgical exposure prostate 15.84 NA NA 8.27 9.28 1.555862 A Extensive prostate surgery 20.04 NA NA 10.21 11.50 1.955865 A Extensive prostate surgery 24.57 NA NA 12.23 13.76 2.355866 A Laparo radical prostatectomy 32.06 NA NA 15.90 17.57 3.155870 A Electroejaculation 2.58 2.22 2.50 1.34 1.53 0.255873 A Cryoablate prostate 13.60 171.44 171.44 7.46 10.53 1.355875 A Transperi needle place pros 13.46 NA NA 7.57 8.45 1.255876 A Place rt device/marker pros 1.73 1.97 2.26 1.04 1.19 0.155899 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.055920 A Place needles pelvic for rt 8.31 NA NA 4.05 4.11 0.855970 N Sex transformation m to f 0.00 0.00 0.00 0.00 0.00 0.055980 N Sex transformation f to m 0.00 0.00 0.00 0.00 0.00 0.056405 A I & d of vulva/perineum 1.49 1.49 1.49 1.47 1.45 0.256420 A Drainage of gland abscess 1.44 1.87 1.98 1.05 1.05 0.256440 A Surgery for vulva lesion 2.89 NA NA 2.11 2.06 0.456441 A Lysis of labial lesion(s) 2.02 1.92 2.03 1.77 1.83 0.256442 A Hymenotomy 0.68 NA NA 0.63 0.64 0.156501 A Destroy vulva lesions sim 1.58 1.99 2.02 1.56 1.54 0.256515 A Destroy vulva lesion/s compl 3.08 3.09 3.05 2.42 2.31 0.556605 A Biopsy of vulva/perineum 1.10 1.15 1.17 0.56 0.52 0.156606 A Biopsy of vulva/perineum 0.55 0.47 0.48 0.26 0.24 0.056620 A Partial removal of vulva 7.53 NA NA 6.26 6.03 1.256625 A Complete removal of vulva 9.68 NA NA 6.83 6.50 1.656630 A Extensive vulva surgery 14.80 NA NA 9.43 8.79 2.556631 A Extensive vulva surgery 18.99 NA NA 11.73 10.94 3.256632 A Extensive vulva surgery 21.86 NA NA 14.04 12.95 3.756633 A Extensive vulva surgery 19.62 NA NA 11.91 11.05 3.356634 A Extensive vulva surgery 20.66 NA NA 12.73 11.77 3.556637 A Extensive vulva surgery 24.75 NA NA 14.43 13.36 4.156640 A Extensive vulva surgery 24.78 NA NA 13.65 12.74 4.1
CMS-1582-PN 328 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

56700 A Partial removal of hymen 2.84 NA NA 2.28 2.24 0.456740 A Remove vagina gland lesion 4.88 NA NA 3.26 3.12 0.856800 A Repair of vagina 3.93 NA NA 2.66 2.61 0.656805 A Repair clitoris 19.88 NA NA 11.30 10.79 3.356810 A Repair of perineum 4.29 NA NA 2.83 2.74 0.656820 A Exam of vulva w/scope 1.50 1.51 1.51 0.82 0.77 0.256821 A Exam/biopsy of vulva w/scope 2.05 1.94 1.96 1.08 1.01 0.357000 A Exploration of vagina 3.02 NA NA 2.16 2.13 0.557010 A Drainage of pelvic abscess 6.84 NA NA 5.05 4.88 1.157020 A Drainage of pelvic fluid 1.50 1.05 1.03 0.73 0.67 0.257022 A I & d vaginal hematoma pp 2.73 NA NA 1.88 1.80 0.457023 A I & d vag hematoma non-ob 5.18 NA NA 3.33 3.20 0.857061 A Destroy vag lesions simple 1.30 1.80 1.85 1.38 1.38 0.257065 A Destroy vag lesions complex 2.66 2.56 2.57 2.02 1.97 0.457100 A Biopsy of vagina 1.20 1.20 1.20 0.60 0.55 0.257105 A Biopsy of vagina 1.74 1.92 1.97 1.66 1.67 0.257106 A Remove vagina wall partial 7.50 NA NA 5.71 5.52 1.257107 A Remove vagina tissue part 24.56 NA NA 13.86 12.94 4.157109 A Vaginectomy partial w/nodes 28.40 NA NA 15.55 14.40 4.857110 A Remove vagina wall complete 15.48 NA NA 9.08 8.63 2.557111 A Remove vagina tissue compl 28.40 NA NA 15.55 14.69 4.857112 A Vaginectomy w/nodes compl 30.52 NA NA 9.59 11.96 2.457120 A Closure of vagina 8.28 NA NA 5.70 5.55 1.357130 A Remove vagina lesion 2.46 2.38 2.43 1.90 1.88 0.457135 A Remove vagina lesion 2.70 2.52 2.55 2.02 1.98 0.457150 A Treat vagina infection 0.55 0.69 0.78 0.25 0.24 0.057155 A Insert uteri tandems/ovoids 3.37 5.99 5.99 1.66 1.66 0.357156 A Ins vag brachytx device 1.87 2.38 2.38 0.99 0.99 0.157160 A Insert pessary/other device 0.89 1.20 1.24 0.41 0.38 0.157170 A Fitting of diaphragm/cap 0.91 0.75 0.87 0.41 0.38 0.1
CMS-1582-PN 329 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

57180 A Treat vaginal bleeding 1.63 2.19 2.28 1.25 1.25 0.257200 A Repair of vagina 4.42 NA NA 3.76 3.70 0.757210 A Repair vagina/perineum 5.71 NA NA 4.31 4.24 0.957220 A Revision of urethra 4.85 NA NA 3.91 3.86 0.857230 A Repair of urethral lesion 6.30 NA NA 4.52 4.53 1.057240 A Repair bladder & vagina 11.50 NA NA 6.88 6.66 1.657250 A Repair rectum & vagina 11.50 NA NA 7.05 6.50 1.857260 A Repair of vagina 14.44 NA NA 8.39 7.76 2.357265 A Extensive repair of vagina 15.94 NA NA 9.05 8.53 2.557267 A Insert mesh/pelvic flr addon 4.88 NA NA 2.17 2.13 0.757268 A Repair of bowel bulge 7.57 NA NA 5.64 5.51 1.257270 A Repair of bowel pouch 13.67 NA NA 8.18 7.79 2.257280 A Suspension of vagina 16.72 NA NA 9.41 9.15 2.657282 A Colpopexy extraperitoneal 7.97 NA NA 5.77 5.72 1.257283 A Colpopexy intraperitoneal 11.66 NA NA 7.23 6.97 1.957284 A Repair paravag defect open 14.33 NA NA 8.03 7.98 2.157285 A Repair paravag defect vag 11.60 NA NA 6.93 6.75 1.857287 A Revise/remove sling repair 11.15 NA NA 7.21 7.38 1.457288 A Repair bladder defect 12.13 NA NA 7.11 7.23 1.557289 A Repair bladder & vagina 12.80 NA NA 7.28 7.69 1.257291 A Construction of vagina 8.64 NA NA 9.07 7.51 1.457292 A Construct vagina with graft 14.01 NA NA 8.37 8.13 2.357295 A Revise vag graft via vagina 7.82 NA NA 5.30 5.33 1.257296 A Revise vag graft open abd 16.56 NA NA 9.44 8.94 2.757300 A Repair rectum-vagina fistula 8.71 NA NA 6.48 6.01 1.557305 A Repair rectum-vagina fistula 15.35 NA NA 9.60 8.75 2.957307 A Fistula repair & colostomy 17.17 NA NA 10.99 9.90 3.657308 A Fistula repair transperine 10.59 NA NA 7.40 6.81 1.857310 A Repair urethrovaginal lesion 7.65 NA NA 5.02 5.48 0.757311 A Repair urethrovaginal lesion 8.91 NA NA 5.51 6.01 0.8
CMS-1582-PN 330 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

57320 A Repair bladder-vagina lesion 8.88 NA NA 5.76 6.10 1.057330 A Repair bladder-vagina lesion 13.21 NA NA 7.15 7.72 1.257335 A Repair vagina 20.02 NA NA 11.66 11.27 3.357400 A Dilation of vagina 2.27 NA NA 1.36 1.34 0.357410 A Pelvic examination 1.75 NA NA 1.18 1.14 0.257415 A Remove vaginal foreign body 2.49 NA NA 1.89 1.88 0.357420 A Exam of vagina w/scope 1.60 1.56 1.56 0.87 0.81 0.257421 A Exam/biopsy of vag w/scope 2.20 2.04 2.04 1.15 1.07 0.357423 A Repair paravag defect lap 16.08 NA NA 8.92 8.63 2.757425 A Laparoscopy surg colpopexy 17.03 NA NA 9.62 9.17 2.657426 A Revise prosth vag graft lap 14.30 NA NA 8.32 8.32 2.457452 A Exam of cervix w/scope 1.50 1.46 1.47 1.02 0.97 0.257454 A Bx/curett of cervix w/scope 2.33 1.86 1.84 1.40 1.33 0.357455 A Biopsy of cervix w/scope 1.99 1.91 1.91 1.04 0.98 0.357456 A Endocerv curettage w/scope 1.85 1.83 1.84 0.98 0.92 0.357460 A Bx of cervix w/scope leep 2.83 4.89 5.30 1.63 1.55 0.457461 A Conz of cervix w/scope leep 3.43 5.28 5.67 1.71 1.60 0.557500 A Biopsy of cervix 1.20 2.28 2.45 0.88 0.84 0.257505 A Endocervical curettage 1.19 1.58 1.62 1.32 1.32 0.257510 A Cauterization of cervix 1.90 1.69 1.69 1.27 1.22 0.357511 A Cryocautery of cervix 1.95 2.02 2.03 1.67 1.64 0.357513 A Laser surgery of cervix 1.95 1.97 1.98 1.67 1.65 0.357520 A Conization of cervix 4.11 4.21 4.27 3.33 3.28 0.657522 A Conization of cervix 3.67 3.50 3.52 2.97 2.92 0.657530 A Removal of cervix 5.27 NA NA 4.15 4.07 0.857531 A Removal of cervix radical 29.95 NA NA 17.20 15.82 5.057540 A Removal of residual cervix 13.29 NA NA 8.05 7.62 2.257545 A Remove cervix/repair pelvis 14.10 NA NA 8.42 7.97 2.357550 A Removal of residual cervix 6.34 NA NA 4.82 4.71 1.057555 A Remove cervix/repair vagina 9.94 NA NA 6.52 6.23 1.6
CMS-1582-PN 331 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

57556 A Remove cervix repair bowel 9.36 NA NA 6.12 6.03 1.457558 A D&c of cervical stump 1.72 1.69 1.70 1.39 1.36 0.257700 A Revision of cervix 4.35 NA NA 4.16 4.15 0.757720 A Revision of cervix 4.61 NA NA 3.81 3.75 0.757800 A Dilation of cervical canal 0.77 0.88 0.88 0.56 0.54 0.158100 A Biopsy of uterus lining 1.53 1.45 1.46 0.87 0.82 0.258110 A Bx done w/colposcopy add-on 0.77 0.55 0.54 0.36 0.33 0.158120 A Dilation and curettage 3.59 3.43 3.32 2.36 2.26 0.658140 A Myomectomy abdom method 15.79 NA NA 9.24 8.66 2.858145 A Myomectomy vag method 8.91 NA NA 5.97 5.73 1.558146 A Myomectomy abdom complex 20.34 NA NA 11.25 10.61 3.458150 A Total hysterectomy 17.31 NA NA 9.93 9.27 2.958152 A Total hysterectomy 21.86 NA NA 12.19 11.46 3.758180 A Partial hysterectomy 16.60 NA NA 9.56 8.98 2.858200 A Extensive hysterectomy 23.10 NA NA 12.86 11.92 3.858210 A Extensive hysterectomy 30.91 NA NA 17.15 15.82 5.258240 A Removal of pelvis contents 49.33 NA NA 26.84 24.85 8.358260 A Vaginal hysterectomy 14.15 NA NA 8.49 8.05 2.358262 A Vag hyst including t/o 15.94 NA NA 9.30 8.79 2.658263 A Vag hyst w/t/o & vag repair 17.23 NA NA 9.90 9.36 2.958267 A Vag hyst w/urinary repair 18.36 NA NA 10.49 9.90 3.158270 A Vag hyst w/enterocele repair 15.30 NA NA 8.82 8.35 2.558275 A Hysterectomy/revise vagina 17.03 NA NA 9.85 9.32 2.958280 A Hysterectomy/revise vagina 18.33 NA NA 10.50 9.87 3.058285 A Extensive hysterectomy 23.38 NA NA 12.52 11.73 3.958290 A Vag hyst complex 20.27 NA NA 11.22 10.57 3.458291 A Vag hyst incl t/o complex 22.06 NA NA 12.05 11.38 3.758292 A Vag hyst t/o & repair compl 23.35 NA NA 12.64 11.89 3.958293 A Vag hyst w/uro repair compl 24.33 NA NA 13.10 12.27 4.158294 A Vag hyst w/enterocele compl 21.55 NA NA 11.81 11.06 3.6
CMS-1582-PN 332 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

58300 N Insert intrauterine device 1.01 0.94 1.04 0.44 0.44 0.058301 A Remove intrauterine device 1.27 1.32 1.35 0.59 0.54 0.258321 A Artificial insemination 0.92 1.18 1.23 0.42 0.40 0.058322 A Artificial insemination 1.10 1.24 1.28 0.51 0.47 0.158323 A Sperm washing 0.23 0.19 0.25 0.11 0.10 0.058340 A Catheter for hysterography 0.88 2.33 2.62 0.71 0.72 0.158345 A Reopen fallopian tube 4.70 NA NA 2.94 2.84 0.758346 A Insert heyman uteri capsule 7.56 NA NA 4.70 4.73 0.658350 A Reopen fallopian tube 1.06 1.57 1.63 1.09 1.10 0.158353 A Endometr ablate thermal 3.60 23.80 27.59 2.40 2.33 0.658356 A Endometrial cryoablation 6.41 45.11 51.43 3.06 2.85 1.058400 A Suspension of uterus 7.14 NA NA 4.93 4.89 1.058410 A Suspension of uterus 13.80 NA NA 8.22 7.77 2.358520 A Repair of ruptured uterus 13.48 NA NA 8.07 7.58 2.958540 A Revision of uterus 15.71 NA NA 9.17 8.62 2.658541 A Lsh uterus 250 g or less 14.70 NA NA 8.97 8.39 2.458542 A Lsh w/t/o ut 250 g or less 16.56 NA NA 9.84 9.18 2.858543 A Lsh uterus above 250 g 16.87 NA NA 10.00 9.30 2.858544 A Lsh w/t/o uterus above 250 g 18.37 NA NA 10.68 9.89 3.158545 A Laparoscopic myomectomy 15.55 NA NA 8.89 8.37 2.658546 A Laparo-myomectomy complex 19.94 NA NA 10.88 10.23 3.358548 A Lap radical hyst 31.63 NA NA 17.80 16.09 5.358550 A Laparo-asst vag hysterectomy 15.10 NA NA 9.05 8.58 2.558552 A Laparo-vag hyst incl t/o 16.91 NA NA 9.87 9.33 2.858553 A Laparo-vag hyst complex 20.06 NA NA 10.99 10.30 3.458554 A Laparo-vag hyst w/t/o compl 23.11 NA NA 12.84 12.01 3.958555 A Hysteroscopy dx sep proc 3.33 4.95 4.10 1.87 1.76 0.558558 A Hysteroscopy biopsy 4.74 6.06 5.06 2.55 2.41 0.858559 A Hysteroscopy lysis 6.16 NA NA 3.21 3.02 1.058560 A Hysteroscopy resect septum 6.99 NA NA 3.60 3.38 1.1
CMS-1582-PN 333 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

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Implemented 

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2011 

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RVUs2

Ma

Pract

RVU

58561 A Hysteroscopy remove myoma 9.99 NA NA 4.99 4.67 1.658562 A Hysteroscopy remove fb 5.20 5.99 5.01 2.73 2.58 0.858563 A Hysteroscopy ablation 6.16 39.03 44.84 3.21 3.02 1.058565 A Hysteroscopy sterilization 7.12 43.73 48.34 4.75 4.58 1.258570 A Tlh uterus 250 g or less 15.88 NA NA 9.55 8.90 2.658571 A Tlh w/t/o 250 g or less 17.69 NA NA 10.56 9.73 3.058572 A Tlh uterus over 250 g 20.09 NA NA 11.55 10.65 3.458573 A Tlh w/t/o uterus over 250 g 23.11 NA NA 13.10 11.97 3.858578 C Laparo proc uterus 0.00 0.00 0.00 0.00 0.00 0.058579 C Hysteroscope procedure 0.00 0.00 0.00 0.00 0.00 0.058600 A Division of fallopian tube 5.91 NA NA 4.07 3.90 1.058605 A Division of fallopian tube 5.28 NA NA 3.74 3.62 0.858611 A Ligate oviduct(s) add-on 1.45 NA NA 0.67 0.62 0.258615 A Occlude fallopian tube(s) 3.94 NA NA 2.73 2.71 0.658660 A Laparoscopy lysis 11.59 NA NA 6.73 6.33 2.058661 A Laparoscopy remove adnexa 11.35 NA NA 6.21 5.83 1.958662 A Laparoscopy excise lesions 12.15 NA NA 7.10 6.72 2.058670 A Laparoscopy tubal cautery 5.91 NA NA 4.09 3.94 1.058671 A Laparoscopy tubal block 5.91 NA NA 4.08 3.93 1.058672 A Laparoscopy fimbrioplasty 12.91 NA NA 7.23 6.81 2.158673 A Laparoscopy salpingostomy 14.04 NA NA 7.85 7.43 2.358679 C Laparo proc oviduct-ovary 0.00 0.00 0.00 0.00 0.00 0.058700 A Removal of fallopian tube 12.95 NA NA 8.09 7.58 2.458720 A Removal of ovary/tube(s) 12.16 NA NA 7.50 7.08 2.158740 A Adhesiolysis tube ovary 14.90 NA NA 8.90 8.45 2.658750 A Repair oviduct 15.64 NA NA 9.04 8.56 2.658752 A Revise ovarian tube(s) 15.64 NA NA 8.81 8.57 1.158760 A Fimbrioplasty 13.93 NA NA 8.24 7.87 2.358770 A Create new tubal opening 14.77 NA NA 8.57 7.88 2.458800 A Drainage of ovarian cyst(s) 4.62 4.08 4.12 3.55 3.51 0.7
CMS-1582-PN 334 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

58805 A Drainage of ovarian cyst(s) 6.42 NA NA 4.52 4.46 1.058820 A Drain ovary abscess open 4.70 NA NA 4.60 4.19 0.758822 A Drain ovary abscess percut 11.81 NA NA 7.36 7.14 2.558823 A Drain pelvic abscess percut 3.37 21.52 23.12 1.26 1.39 0.358825 A Transposition ovary(s) 11.78 NA NA 7.55 7.05 1.958900 A Biopsy of ovary(s) 6.59 NA NA 5.42 4.95 1.458920 A Partial removal of ovary(s) 11.95 NA NA 7.22 6.81 2.058925 A Removal of ovarian cyst(s) 12.43 NA NA 7.71 7.25 2.258940 A Removal of ovary(s) 8.22 NA NA 5.85 5.47 1.558943 A Removal of ovary(s) 19.52 NA NA 11.19 10.39 3.558950 A Resect ovarian malignancy 18.37 NA NA 11.08 10.32 3.258951 A Resect ovarian malignancy 24.26 NA NA 13.64 12.60 4.158952 A Resect ovarian malignancy 27.29 NA NA 15.46 14.29 4.758953 A Tah rad dissect for debulk 34.13 NA NA 18.76 17.30 5.858954 A Tah rad debulk/lymph remove 37.13 NA NA 20.19 18.63 6.358956 A Bso omentectomy w/tah 22.80 NA NA 13.29 12.38 3.958957 A Resect recurrent gyn mal 26.22 NA NA 14.99 13.65 4.858958 A Resect recur gyn mal w/lym 29.22 NA NA 16.35 14.95 4.958960 A Exploration of abdomen 15.79 NA NA 9.50 8.92 2.758970 A Retrieval of oocyte 3.52 2.56 2.51 1.98 1.83 0.258974 C Transfer of embryo 0.00 0.00 0.00 0.00 0.00 0.058976 A Transfer of embryo 3.82 2.99 3.03 2.07 2.07 0.258999 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.059000 A Amniocentesis diagnostic 1.30 2.01 2.12 0.79 0.76 0.359001 A Amniocentesis therapeutic 3.00 NA NA 1.64 1.63 0.859012 A Fetal cord puncture prenatal 3.44 NA NA 1.79 1.69 0.959015 A Chorion biopsy 2.20 1.85 1.83 1.21 1.15 0.659020 A Fetal contract stress test 0.66 1.22 1.21 NA NA 0.159020 TC A Fetal contract stress test 0.00 0.91 0.93 NA NA 0.059020 26 A Fetal contract stress test 0.66 0.31 0.28 0.31 0.28 0.1
CMS-1582-PN 335 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

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Facility 

PE 

RVUs2

Ma

Pract

RVU

59025 A Fetal non-stress test 0.53 0.75 0.73 NA NA 0.159025 TC A Fetal non-stress test 0.00 0.50 0.50 NA NA 0.059025 26 A Fetal non-stress test 0.53 0.25 0.23 0.25 0.23 0.159030 A Fetal scalp blood sample 1.99 NA NA 0.87 0.82 0.159050 A Fetal monitor w/report 0.89 NA NA 0.41 0.38 0.259051 A Fetal monitor/interpret only 0.74 NA NA 0.34 0.31 0.259070 A Transabdom amnioinfus w/us 5.24 5.72 5.80 2.70 2.64 1.559072 A Umbilical cord occlud w/us 8.99 NA NA 4.34 4.20 2.559074 A Fetal fluid drainage w/us 5.24 5.89 5.56 3.00 2.75 1.559076 A Fetal shunt placement w/us 8.99 NA NA 4.34 4.03 2.559100 A Remove uterus lesion 13.37 NA NA 8.18 7.70 3.859120 A Treat ectopic pregnancy 12.67 NA NA 7.85 7.48 3.659121 A Treat ectopic pregnancy 12.74 NA NA 7.79 7.43 3.659130 A Treat ectopic pregnancy 15.08 NA NA 8.88 8.37 1.059135 A Treat ectopic pregnancy 14.92 NA NA 8.62 8.54 1.059136 A Treat ectopic pregnancy 14.25 NA NA 8.43 7.97 4.159140 A Treat ectopic pregnancy 5.94 NA NA 4.46 4.26 0.459150 A Treat ectopic pregnancy 12.29 NA NA 7.59 7.20 3.559151 A Treat ectopic pregnancy 12.11 NA NA 7.22 6.87 3.459160 A D & c after delivery 2.76 2.55 2.71 1.73 1.76 0.759200 A Insert cervical dilator 0.79 1.10 1.16 0.37 0.34 0.259300 A Episiotomy or vaginal repair 2.41 2.64 2.64 1.44 1.33 0.659320 A Revision of cervix 2.48 NA NA 1.47 1.40 0.659325 A Revision of cervix 4.06 NA NA 2.20 2.08 0.259350 A Repair of uterus 4.94 NA NA 2.29 2.05 1.459400 A Obstetrical care 28.69 NA NA 20.58 19.32 7.959409 A Obstetrical care 12.82 NA NA 6.00 5.63 3.559410 A Obstetrical care 16.07 NA NA 7.99 7.37 4.459412 A Antepartum manipulation 1.53 NA NA 0.88 0.87 0.459414 A Deliver placenta 1.44 NA NA 0.67 0.65 0.4
CMS-1582-PN 336 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

59425 A Antepartum care only 5.63 5.32 5.28 2.61 2.42 1.559426 A Antepartum care only 9.96 9.69 9.62 4.61 4.28 2.659430 A Care after delivery 2.20 2.26 1.84 1.02 0.99 0.659510 A Cesarean delivery 31.80 NA NA 22.58 21.50 9.059514 A Cesarean delivery only 14.39 NA NA 6.74 6.50 4.059515 A Cesarean delivery 19.15 NA NA 10.02 9.21 5.459525 A Remove uterus after cesarean 8.53 NA NA 3.96 3.65 2.459610 A Vbac delivery 30.22 NA NA 21.22 20.09 8.759612 A Vbac delivery only 14.35 NA NA 6.67 6.33 4.159614 A Vbac care after delivery 17.60 NA NA 8.62 7.88 5.059618 A Attempted vbac delivery 32.26 NA NA 22.73 21.98 9.259620 A Attempted vbac delivery only 14.86 NA NA 6.90 6.88 4.259622 A Attempted vbac after care 19.63 NA NA 10.27 9.74 5.659812 A Treatment of miscarriage 4.44 3.85 3.76 3.24 3.12 1.259820 A Care of miscarriage 4.84 5.06 5.09 4.45 4.38 1.359821 A Treatment of miscarriage 5.09 4.86 4.87 4.19 4.10 1.459830 A Treat uterus infection 6.59 NA NA 4.72 4.59 1.859840 R Abortion 3.01 2.66 2.60 2.41 2.37 0.859841 R Abortion 5.65 4.26 4.13 3.68 3.51 1.659850 R Abortion 5.90 NA NA 3.94 3.93 0.459851 R Abortion 5.92 NA NA 4.42 4.32 1.659852 R Abortion 8.23 NA NA 5.99 6.01 0.559855 R Abortion 6.43 NA NA 4.31 4.16 1.859856 R Abortion 7.79 NA NA 4.80 4.61 2.259857 R Abortion 9.33 NA NA 5.42 5.37 0.659866 R Abortion (mpr) 3.99 NA NA 2.15 2.07 0.259870 A Evacuate mole of uterus 6.57 NA NA 5.71 5.69 1.859871 A Remove cerclage suture 2.13 NA NA 1.34 1.28 0.659897 C Fetal invas px w/us 0.00 0.00 0.00 0.00 0.00 0.059898 C Laparo proc ob care/deliver 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 337 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

59899 C Maternity care procedure 0.00 0.00 0.00 0.00 0.00 0.060000 A Drain thyroid/tongue cyst 1.81 2.84 2.73 2.36 2.27 0.2

6005F I Care level rationale doc 0.00 0.00 0.00 0.00 0.00 0.0

60100 A Biopsy of thyroid 1.56 1.48 1.58 0.61 0.65 0.160200 A Remove thyroid lesion 10.02 NA NA 8.22 7.64 1.760210 A Partial thyroid excision 11.23 NA NA 8.10 7.42 2.060212 A Partial thyroid excision 16.43 NA NA 11.36 10.26 3.060220 A Partial removal of thyroid 11.19 NA NA 8.04 7.80 1.960225 A Partial removal of thyroid 14.79 NA NA 10.67 9.78 2.660240 A Removal of thyroid 15.04 NA NA 9.66 9.30 2.760252 A Removal of thyroid 22.01 NA NA 14.08 12.86 3.860254 A Extensive thyroid surgery 28.42 NA NA 18.34 16.76 4.560260 A Repeat thyroid surgery 18.26 NA NA 11.87 10.85 3.160270 A Removal of thyroid 23.20 NA NA 13.98 13.11 4.360271 A Removal of thyroid 17.62 NA NA 11.38 10.50 3.060280 A Remove thyroid duct lesion 6.16 NA NA 6.50 6.07 0.860281 A Remove thyroid duct lesion 8.82 NA NA 8.18 7.46 1.160300 A Aspir/inj thyroid cyst 0.97 2.17 2.18 0.38 0.39 0.1

6040F I Appro rad ds dvcs techs docd 0.00 0.00 0.00 0.00 0.00 0.0

60500 A Explore parathyroid glands 15.60 NA NA 10.06 9.68 3.060502 A Re-explore parathyroids 21.15 NA NA 13.36 12.20 4.160505 A Explore parathyroid glands 23.06 NA NA 14.68 13.56 4.360512 A Autotransplant parathyroid 4.44 NA NA 2.09 1.89 0.860520 A Removal of thymus gland 17.16 NA NA 10.49 9.84 3.460521 A Removal of thymus gland 19.18 NA NA 10.37 10.62 4.560522 A Removal of thymus gland 23.48 NA NA 12.47 12.64 5.460540 A Explore adrenal gland 18.02 NA NA 10.18 10.21 3.060545 A Explore adrenal gland 20.93 NA NA 11.56 11.30 3.660600 A Remove carotid body lesion 25.09 NA NA 12.87 12.44 5.360605 A Remove carotid body lesion 31.96 NA NA 18.71 16.77 4.1
CMS-1582-PN 338 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

60650 A Laparoscopy adrenalectomy 20.73 NA NA 11.09 10.69 3.760659 C Laparo proc endocrine 0.00 0.00 0.00 0.00 0.00 0.060699 C Endocrine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.0

6070F I Pt asked/cnsld aed effects 0.00 0.00 0.00 0.00 0.00 0.06080F I Pt/caregiver queried falls 0.00 0.00 0.00 0.00 0.00 0.06090F I Pt/caregiver counsel safety 0.00 0.00 0.00 0.00 0.00 0.0

61000 A Remove cranial cavity fluid 1.58 NA NA 1.53 1.46 0.161001 A Remove cranial cavity fluid 1.49 NA NA 1.32 1.36 0.561020 A Remove brain cavity fluid 1.51 NA NA 2.08 1.98 0.561026 A Injection into brain canal 1.69 NA NA 1.69 1.67 0.361050 A Remove brain canal fluid 1.51 NA NA 1.37 1.42 0.161055 A Injection into brain canal 2.10 NA NA 1.55 1.61 0.261070 A Brain canal shunt procedure 0.89 NA NA 1.39 1.36 0.261105 A Twist drill hole 5.45 NA NA 6.30 5.88 1.961107 A Drill skull for implantation 4.99 NA NA 2.76 2.66 1.761108 A Drill skull for drainage 11.64 NA NA 11.17 10.51 4.161120 A Burr hole for puncture 9.60 NA NA 9.16 8.60 3.461140 A Pierce skull for biopsy 17.23 NA NA 14.16 13.48 6.161150 A Pierce skull for drainage 18.90 NA NA 14.82 13.98 6.761151 A Pierce skull for drainage 13.49 NA NA 11.33 10.60 4.861154 A Pierce skull & remove clot 17.07 NA NA 14.59 13.80 6.161156 A Pierce skull for drainage 17.45 NA NA 13.44 12.87 6.261210 A Pierce skull implant device 5.83 NA NA 3.22 3.10 2.061215 A Insert brain-fluid device 5.85 NA NA 6.97 6.59 2.061250 A Pierce skull & explore 11.49 NA NA 10.22 9.51 4.161253 A Pierce skull & explore 13.49 NA NA 10.12 9.56 1.761304 A Open skull for exploration 23.41 NA NA 17.52 16.63 8.161305 A Open skull for exploration 28.64 NA NA 21.25 20.15 10.261312 A Open skull for drainage 30.17 NA NA 21.27 20.19 10.761313 A Open skull for drainage 28.09 NA NA 21.13 20.05 10.0
CMS-1582-PN 339 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

61314 A Open skull for drainage 25.90 NA NA 19.46 18.43 9.261315 A Open skull for drainage 29.65 NA NA 21.55 20.56 10.661316 A Implt cran bone flap to abdo 1.39 NA NA 0.77 0.73 0.461320 A Open skull for drainage 27.42 NA NA 19.72 18.89 9.661321 A Open skull for drainage 30.53 NA NA 22.30 20.83 10.961322 A Decompressive craniotomy 34.26 NA NA 24.55 22.94 12.261323 A Decompressive lobectomy 35.06 NA NA 24.23 22.69 12.461330 A Decompress eye socket 25.30 NA NA 19.33 17.48 9.061332 A Explore/biopsy eye socket 28.60 NA NA 20.61 18.89 10.261333 A Explore orbit/remove lesion 29.27 NA NA 23.18 20.44 10.561334 A Explore orbit/remove object 19.60 NA NA 14.21 12.81 7.061340 A Subtemporal decompression 20.11 NA NA 15.88 14.92 7.261343 A Incise skull (press relief) 31.86 NA NA 22.52 21.47 11.361345 A Relieve cranial pressure 29.23 NA NA 21.38 20.32 10.461440 A Incise skull for surgery 28.66 NA NA 21.06 19.93 10.261450 A Incise skull for surgery 27.69 NA NA 19.98 18.85 9.961458 A Incise skull for brain wound 28.84 NA NA 20.96 20.01 10.261460 A Incise skull for surgery 30.24 NA NA 21.94 20.46 10.861470 A Incise skull for surgery 27.62 NA NA 19.94 18.91 9.961480 A Incise skull for surgery 28.05 NA NA 14.41 14.71 1.961490 A Incise skull for surgery 27.22 NA NA 19.72 18.80 9.761500 A Removal of skull lesion 19.18 NA NA 15.26 14.35 5.761501 A Remove infected skull bone 16.35 NA NA 13.65 12.78 4.661510 A Removal of brain lesion 30.83 NA NA 23.35 22.26 11.061512 A Remove brain lining lesion 37.14 NA NA 25.91 24.76 13.261514 A Removal of brain abscess 27.23 NA NA 19.80 18.97 9.761516 A Removal of brain lesion 26.58 NA NA 19.56 18.63 9.261517 A Implt brain chemotx add-on 1.38 NA NA 0.76 0.73 0.461518 A Removal of brain lesion 39.89 NA NA 28.33 26.99 14.361519 A Remove brain lining lesion 43.43 NA NA 29.48 28.12 15.4
CMS-1582-PN 340 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

61520 A Removal of brain lesion 57.09 NA NA 37.72 35.97 17.961521 A Removal of brain lesion 46.99 NA NA 31.73 30.05 16.861522 A Removal of brain abscess 31.54 NA NA 22.66 21.59 11.361524 A Removal of brain lesion 29.89 NA NA 21.74 20.51 10.761526 A Removal of brain lesion 54.08 NA NA 36.11 33.50 19.461530 A Removal of brain lesion 45.56 NA NA 30.47 28.51 16.361531 A Implant brain electrodes 16.41 NA NA 14.13 13.40 5.861533 A Implant brain electrodes 21.46 NA NA 16.43 15.57 7.661534 A Removal of brain lesion 23.01 NA NA 17.91 17.00 8.261535 A Remove brain electrodes 13.15 NA NA 11.88 11.25 4.761536 A Removal of brain lesion 37.72 NA NA 26.11 24.95 13.561537 A Removal of brain tissue 36.45 NA NA 24.52 22.79 13.061538 A Removal of brain tissue 39.45 NA NA 26.53 24.53 14.161539 A Removal of brain tissue 34.28 NA NA 24.19 22.81 12.361540 A Removal of brain tissue 31.43 NA NA 22.70 21.64 11.261541 A Incision of brain tissue 30.94 NA NA 22.33 21.14 11.161542 A Removal of brain tissue 33.16 NA NA 20.39 20.88 11.961543 A Removal of brain tissue 31.31 NA NA 22.54 21.06 11.261544 A Remove & treat brain lesion 27.36 NA NA 19.80 17.16 9.861545 A Excision of brain tumor 46.43 NA NA 32.41 30.64 16.661546 A Removal of pituitary gland 33.44 NA NA 23.72 22.46 11.961548 A Removal of pituitary gland 23.37 NA NA 16.80 15.91 6.661550 A Release of skull seams 15.59 NA NA 10.51 10.57 1.161552 A Release of skull seams 20.40 NA NA 11.39 12.76 1.461556 A Incise skull/sutures 24.09 NA NA 15.82 15.64 8.661557 A Incise skull/sutures 23.31 NA NA 18.54 17.77 8.361558 A Excision of skull/sutures 26.50 NA NA 14.21 16.17 9.561559 A Excision of skull/sutures 34.02 NA NA 25.34 24.32 2.461563 A Excision of skull tumor 28.44 NA NA 20.66 19.67 10.261564 A Excision of skull tumor 34.74 NA NA 24.90 23.76 12.4
CMS-1582-PN 341 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

61566 A Removal of brain tissue 32.45 NA NA 23.27 22.30 11.661567 A Incision of brain tissue 37.00 NA NA 26.52 25.48 13.361570 A Remove foreign body brain 26.51 NA NA 19.86 18.62 9.561571 A Incise skull for brain wound 28.42 NA NA 20.93 19.95 10.161575 A Skull base/brainstem surgery 36.56 NA NA 25.46 23.50 13.161576 A Skull base/brainstem surgery 55.31 NA NA 43.49 42.09 7.161580 A Craniofacial approach skull 34.51 NA NA 34.24 31.81 5.861581 A Craniofacial approach skull 39.13 NA NA 38.38 35.43 5.061582 A Craniofacial approach skull 35.14 NA NA 42.42 39.60 12.661583 A Craniofacial approach skull 38.50 NA NA 34.81 33.29 12.961584 A Orbitocranial approach/skull 37.70 NA NA 34.50 32.92 12.761585 A Orbitocranial approach/skull 42.57 NA NA 38.65 35.04 15.261586 A Resect nasopharynx skull 27.48 NA NA 34.97 31.16 9.861590 A Infratemporal approach/skull 47.04 NA NA 38.39 35.52 8.461591 A Infratemporal approach/skull 47.02 NA NA 38.04 35.53 9.661592 A Orbitocranial approach/skull 43.08 NA NA 36.78 35.27 14.561595 A Transtemporal approach/skull 33.74 NA NA 30.62 28.83 7.161596 A Transcochlear approach/skull 39.43 NA NA 31.43 29.50 5.061597 A Transcondylar approach/skull 40.82 NA NA 31.11 29.89 14.661598 A Transpetrosal approach/skull 36.53 NA NA 34.68 30.82 13.161600 A Resect/excise cranial lesion 30.01 NA NA 28.72 26.70 6.261601 A Resect/excise cranial lesion 31.14 NA NA 29.74 28.27 10.161605 A Resect/excise cranial lesion 32.57 NA NA 29.59 27.47 4.961606 A Resect/excise cranial lesion 42.05 NA NA 33.65 32.50 13.661607 A Resect/excise cranial lesion 40.93 NA NA 31.82 29.85 14.661608 A Resect/excise cranial lesion 45.54 NA NA 35.89 34.28 15.361609 A Transect artery sinus 9.88 NA NA 4.33 4.43 3.561610 A Transect artery sinus 29.63 NA NA 16.50 15.68 10.661611 A Transect artery sinus 7.41 NA NA 3.25 3.55 0.561612 A Transect artery sinus 27.84 NA NA 12.20 12.79 1.9
CMS-1582-PN 342 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

61613 A Remove aneurysm sinus 45.03 NA NA 36.84 34.66 16.161615 A Resect/excise lesion skull 35.77 NA NA 29.44 28.31 4.661616 A Resect/excise lesion skull 46.74 NA NA 38.15 36.19 14.461618 A Repair dura 18.69 NA NA 14.66 13.80 5.761619 A Repair dura 22.10 NA NA 16.55 15.51 6.361623 A Endovasc tempory vessel occl 9.95 NA NA 4.46 4.68 1.861624 A Transcath occlusion cns 20.12 NA NA 8.75 9.10 3.761626 A Transcath occlusion non-cns 16.60 NA NA 6.42 7.07 2.161630 R Intracranial angioplasty 22.07 NA NA 11.18 11.59 4.161635 R Intracran angioplsty w/stent 24.28 NA NA 12.09 12.54 4.061640 N Dilate ic vasospasm init 12.32 NA NA 5.40 5.23 0.861641 N Dilate ic vasospasm add-on 4.33 NA NA 1.90 1.84 0.361642 N Dilate ic vasospasm add-on 8.66 NA NA 3.79 3.67 0.661680 A Intracranial vessel surgery 32.55 NA NA 23.42 22.40 11.661682 A Intracranial vessel surgery 63.41 NA NA 39.62 37.99 22.761684 A Intracranial vessel surgery 41.64 NA NA 28.75 27.01 14.961686 A Intracranial vessel surgery 67.50 NA NA 43.58 41.67 24.261690 A Intracranial vessel surgery 31.34 NA NA 22.88 21.65 11.261692 A Intracranial vessel surgery 54.59 NA NA 35.83 33.97 19.661697 A Brain aneurysm repr complx 63.40 NA NA 41.00 38.60 22.561698 A Brain aneurysm repr complx 69.63 NA NA 44.77 41.53 24.961700 A Brain aneurysm repr simple 50.62 NA NA 33.89 32.61 18.061702 A Inner skull vessel surgery 60.04 NA NA 39.43 36.78 21.561703 A Clamp neck artery 18.80 NA NA 15.03 14.33 6.761705 A Revise circulation to head 38.10 NA NA 26.32 24.49 13.661708 A Revise circulation to head 37.20 NA NA 22.49 20.59 3.061710 A Revise circulation to head 31.29 NA NA 16.07 17.11 6.561711 A Fusion of skull arteries 38.23 NA NA 26.32 24.90 13.761720 A Incise skull/brain surgery 17.62 NA NA 14.00 12.53 6.361735 A Incise skull/brain surgery 22.35 NA NA 14.95 14.10 8.0
CMS-1582-PN 343 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

61750 A Incise skull/brain biopsy 19.83 NA NA 15.13 14.39 7.061751 A Brain biopsy w/ct/mr guide 18.79 NA NA 15.51 14.78 6.761760 A Implant brain electrodes 22.39 NA NA 16.86 15.52 8.061770 A Incise skull for treatment 23.19 NA NA 17.10 15.60 8.161781 A Scan proc cranial intra 3.75 NA NA 2.13 2.13 1.261782 A Scan proc cranial extra 3.18 NA NA 1.80 1.80 0.861783 A Scan proc spinal 3.75 NA NA 2.13 2.13 1.261790 A Treat trigeminal nerve 11.60 NA NA 10.40 9.62 4.061791 A Treat trigeminal tract 15.41 NA NA 12.61 11.88 5.261796 A Srs cranial lesion simple 13.93 NA NA 11.36 9.90 4.661797 A Srs cran les simple addl 3.48 NA NA 1.93 1.79 1.161798 A Srs cranial lesion complex 19.85 NA NA 14.63 11.56 6.661799 A Srs cran les complex addl 4.81 NA NA 2.66 2.47 1.561800 A Apply srs headframe add-on 2.25 NA NA 1.58 1.47 0.761850 A Implant neuroelectrodes 13.34 NA NA 8.19 9.14 4.861860 A Implant neuroelectrodes 22.26 NA NA 16.58 15.80 7.961863 A Implant neuroelectrode 20.71 NA NA 16.62 15.92 7.461864 A Implant neuroelectrde addl 4.49 NA NA 2.50 2.41 1.661867 A Implant neuroelectrode 33.03 NA NA 23.53 22.45 11.861868 A Implant neuroelectrde addl 7.91 NA NA 4.39 4.24 2.861870 A Implant neuroelectrodes 16.34 NA NA 13.13 12.60 5.861875 A Implant neuroelectrodes 16.46 NA NA 13.20 12.49 1.161880 A Revise/remove neuroelectrode 6.95 NA NA 7.41 6.92 2.461885 A Insrt/redo neurostim 1 array 6.05 NA NA 7.19 7.79 2.061886 A Implant neurostim arrays 9.93 NA NA 11.55 10.83 3.561888 A Revise/remove neuroreceiver 5.23 NA NA 4.66 4.52 1.762000 A Treat skull fracture 13.93 NA NA 11.79 10.06 5.062005 A Treat skull fracture 17.63 NA NA 14.00 13.08 6.362010 A Treatment of head injury 21.43 NA NA 16.65 15.65 7.662100 A Repair brain fluid leakage 23.53 NA NA 17.14 16.18 7.5
CMS-1582-PN 344 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

62115 A Reduction of skull defect 22.91 NA NA 12.93 11.57 1.662116 A Reduction of skull defect 25.02 NA NA 19.04 18.12 8.962117 A Reduction of skull defect 28.35 NA NA 20.28 19.42 3.662120 A Repair skull cavity lesion 24.59 NA NA 23.61 22.72 3.162121 A Incise skull repair 23.03 NA NA 19.50 18.71 8.262140 A Repair of skull defect 14.55 NA NA 11.88 11.23 4.762141 A Repair of skull defect 16.07 NA NA 12.80 12.16 5.362142 A Remove skull plate/flap 11.83 NA NA 10.52 9.98 4.062143 A Replace skull plate/flap 14.15 NA NA 11.80 11.17 5.062145 A Repair of skull & brain 20.09 NA NA 14.95 14.29 7.262146 A Repair of skull with graft 17.28 NA NA 13.81 12.84 6.262147 A Repair of skull with graft 20.67 NA NA 15.70 14.78 7.462148 A Retr bone flap to fix skull 2.00 NA NA 1.11 1.05 0.762160 A Neuroendoscopy add-on 3.00 NA NA 1.66 1.61 1.062161 A Dissect brain w/scope 21.23 NA NA 16.48 15.67 7.662162 A Remove colloid cyst w/scope 26.80 NA NA 20.14 19.27 9.662163 A Neuroendoscopy w/fb removal 16.53 NA NA 14.04 13.44 5.962164 A Remove brain tumor w/scope 29.43 NA NA 22.50 20.93 10.562165 A Remove pituit tumor w/scope 23.23 NA NA 17.27 16.38 6.362180 A Establish brain cavity shunt 22.58 NA NA 17.19 16.36 8.162190 A Establish brain cavity shunt 12.17 NA NA 10.96 10.35 4.362192 A Establish brain cavity shunt 13.35 NA NA 11.14 10.51 4.662194 A Replace/irrigate catheter 5.78 NA NA 6.53 5.26 0.462200 A Establish brain cavity shunt 19.29 NA NA 14.93 14.18 6.962201 A Brain cavity shunt w/scope 16.04 NA NA 14.07 13.29 5.762220 A Establish brain cavity shunt 14.10 NA NA 11.46 10.79 4.862223 A Establish brain cavity shunt 14.05 NA NA 12.44 11.84 4.862225 A Replace/irrigate catheter 6.19 NA NA 7.00 6.55 2.262230 A Replace/revise brain shunt 11.43 NA NA 9.65 9.17 3.962252 A Csf shunt reprogram 0.74 1.42 1.71 NA NA 0.2
CMS-1582-PN 345 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

62252 TC A Csf shunt reprogram 0.00 1.01 1.32 NA NA 0.062252 26 A Csf shunt reprogram 0.74 0.41 0.39 0.41 0.39 0.262256 A Remove brain cavity shunt 7.38 NA NA 7.75 7.32 2.662258 A Replace brain cavity shunt 15.64 NA NA 12.38 11.82 5.462263 A Epidural lysis mult sessions 6.54 15.62 13.80 5.75 4.70 0.562264 A Epidural lysis on single day 4.42 8.05 7.37 2.54 2.07 0.362267 A Interdiscal perq aspir dx 3.00 3.80 3.96 1.37 1.39 0.362268 A Drain spinal cord cyst 4.73 2.03 5.19 2.52 2.45 0.462269 A Needle biopsy spinal cord 5.01 1.91 5.59 2.30 2.26 0.562270 A Spinal fluid tap diagnostic 1.37 2.85 2.97 0.71 0.72 0.262272 A Drain cerebro spinal fluid 1.35 4.06 3.99 0.84 0.82 0.362273 A Inject epidural patch 2.15 2.75 2.58 1.08 0.93 0.262280 A Treat spinal cord lesion 2.63 6.72 6.39 1.92 1.64 0.562281 A Treat spinal cord lesion 2.66 4.02 4.70 1.73 1.48 0.262282 A Treat spinal canal lesion 2.33 5.88 6.01 1.69 1.49 0.262284 A Injection for myelogram 1.54 3.93 4.15 0.77 0.80 0.162287 A Percutaneous diskectomy 9.03 NA NA 6.87 6.32 0.862290 A Inject for spine disk x-ray 3.00 6.63 6.47 1.91 1.72 0.362291 A Inject for spine disk x-ray 2.91 6.32 6.04 1.88 1.66 0.262292 A Injection into disk lesion 9.24 NA NA 8.47 6.03 0.762294 A Injection into spinal artery 12.87 NA NA 4.61 6.31 1.062310 A Inject spine c/t 1.91 5.13 4.71 1.19 0.97 0.162311 A Inject spine l/s (cd) 1.54 4.35 4.16 0.99 0.84 0.162318 A Inject spine w/cath c/t 2.04 4.96 4.77 0.83 0.72 0.162319 A Inject spine w/cath l/s (cd) 1.87 2.97 3.53 0.86 0.74 0.162350 A Implant spinal canal cath 6.05 NA NA 4.93 4.37 1.062351 A Implant spinal canal cath 11.66 NA NA 10.84 10.06 3.362355 A Remove spinal canal catheter 4.35 NA NA 4.01 3.58 0.762360 A Insert spine infusion device 4.33 NA NA 4.16 3.65 0.862361 A Implant spine infusion pump 5.65 NA NA 4.93 4.67 1.1
CMS-1582-PN 346 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

62362 A Implant spine infusion pump 6.10 NA NA 5.08 4.65 1.262365 A Remove spine infusion device 4.65 NA NA 4.41 4.01 0.862367 A Analyze spine infusion pump 0.48 0.72 0.65 0.23 0.19 0.062368 A Analyze spine infusion pump 0.75 1.00 0.88 0.37 0.30 0.063001 A Removal of spinal lamina 17.61 NA NA 13.65 12.91 5.663003 A Removal of spinal lamina 17.74 NA NA 13.72 13.00 5.663005 A Removal of spinal lamina 16.43 NA NA 13.66 13.02 5.063011 A Removal of spinal lamina 15.91 NA NA 12.71 11.88 4.063012 A Removal of spinal lamina 16.85 NA NA 13.47 12.90 5.163015 A Removal of spinal lamina 20.85 NA NA 16.41 15.62 7.063016 A Removal of spinal lamina 22.03 NA NA 16.58 15.67 6.763017 A Removal of spinal lamina 17.33 NA NA 14.34 13.65 5.563020 A Neck spine disk surgery 16.20 NA NA 13.56 12.92 5.063030 A Low back disk surgery 13.18 NA NA 11.84 11.25 3.863035 A Spinal disk surgery add-on 3.15 NA NA 1.79 1.73 0.863040 A Laminotomy single cervical 20.31 NA NA 15.40 14.67 6.263042 A Laminotomy single lumbar 18.76 NA NA 14.91 14.21 5.263043 C Laminotomy addl cervical 0.00 0.00 0.00 0.00 0.00 0.063044 C Laminotomy addl lumbar 0.00 0.00 0.00 0.00 0.00 0.063045 A Removal of spinal lamina 17.95 NA NA 14.28 13.60 5.763046 A Removal of spinal lamina 17.25 NA NA 13.77 13.11 5.163047 A Removal of spinal lamina 15.37 NA NA 13.04 12.45 4.463048 A Remove spinal lamina add-on 3.47 NA NA 1.97 1.89 1.063050 A Cervical laminoplasty 22.01 NA NA 17.34 16.20 7.963051 A C-laminoplasty w/graft/plate 25.51 NA NA 18.70 17.68 7.263055 A Decompress spinal cord 23.55 NA NA 17.47 16.67 7.663056 A Decompress spinal cord 21.86 NA NA 16.27 15.46 6.163057 A Decompress spine cord add-on 5.25 NA NA 2.99 2.87 1.563064 A Decompress spinal cord 26.22 NA NA 18.85 17.85 7.963066 A Decompress spine cord add-on 3.26 NA NA 1.82 1.77 1.1
CMS-1582-PN 347 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

63075 A Neck spine disk surgery 19.60 NA NA 15.34 14.72 6.163076 A Neck spine disk surgery 4.04 NA NA 2.28 2.20 1.263077 A Spine disk surgery thorax 22.88 NA NA 16.23 15.43 5.863078 A Spine disk surgery thorax 3.28 NA NA 1.86 1.78 0.763081 A Removal of vertebral body 26.10 NA NA 19.10 18.18 7.863082 A Remove vertebral body add-on 4.36 NA NA 2.47 2.38 1.363085 A Removal of vertebral body 29.47 NA NA 19.44 18.57 7.963086 A Remove vertebral body add-on 3.19 NA NA 1.71 1.67 0.863087 A Removal of vertebral body 37.53 NA NA 24.39 23.34 9.763088 A Remove vertebral body add-on 4.32 NA NA 2.47 2.37 1.063090 A Removal of vertebral body 30.93 NA NA 21.02 19.88 7.263091 A Remove vertebral body add-on 3.03 NA NA 1.69 1.62 0.663101 A Removal of vertebral body 34.10 NA NA 24.88 23.63 10.663102 A Removal of vertebral body 34.10 NA NA 24.52 23.31 8.663103 A Remove vertebral body add-on 4.82 NA NA 2.74 2.66 1.263170 A Incise spinal cord tract(s) 22.21 NA NA 17.42 16.18 7.963172 A Drainage of spinal cyst 19.76 NA NA 15.26 14.44 7.063173 A Drainage of spinal cyst 24.31 NA NA 18.59 17.66 8.763180 A Revise spinal cord ligaments 20.53 NA NA 16.48 14.93 7.363182 A Revise spinal cord ligaments 22.82 NA NA 17.76 15.09 8.163185 A Incise spinal column/nerves 16.49 NA NA 13.29 12.41 5.963190 A Incise spinal column/nerves 18.89 NA NA 14.84 14.06 4.263191 A Incise spinal column/nerves 18.92 NA NA 15.43 12.18 3.763194 A Incise spinal column & cord 22.10 NA NA 16.08 15.35 2.863195 A Incise spinal column & cord 21.64 NA NA 16.56 15.47 7.763196 A Incise spinal column & cord 25.27 NA NA 13.43 15.23 1.863197 A Incise spinal column & cord 24.08 NA NA 18.46 17.46 8.663198 A Incise spinal column & cord 29.90 NA NA 15.68 14.78 2.163199 A Incise spinal column & cord 31.47 NA NA 16.36 17.88 2.263200 A Release of spinal cord 21.44 NA NA 16.53 15.63 7.5
CMS-1582-PN 348 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

63250 A Revise spinal cord vessels 43.86 NA NA 29.53 27.81 15.763251 A Revise spinal cord vessels 44.64 NA NA 30.42 28.87 16.063252 A Revise spinal cord vessels 44.63 NA NA 30.41 28.81 16.063265 A Excise intraspinal lesion 23.82 NA NA 17.97 17.11 8.063266 A Excise intraspinal lesion 24.68 NA NA 18.33 17.41 8.463267 A Excise intraspinal lesion 19.45 NA NA 15.36 14.64 6.263268 A Excise intraspinal lesion 20.02 NA NA 16.25 15.10 7.163270 A Excise intraspinal lesion 29.80 NA NA 21.69 20.47 10.763271 A Excise intraspinal lesion 29.92 NA NA 21.50 20.44 10.563272 A Excise intraspinal lesion 27.50 NA NA 19.95 19.02 9.463273 A Excise intraspinal lesion 26.47 NA NA 19.84 18.21 9.563275 A Biopsy/excise spinal tumor 25.86 NA NA 19.04 18.08 8.863276 A Biopsy/excise spinal tumor 25.69 NA NA 19.02 18.06 8.763277 A Biopsy/excise spinal tumor 22.39 NA NA 17.05 16.18 7.063278 A Biopsy/excise spinal tumor 22.12 NA NA 17.42 16.24 7.963280 A Biopsy/excise spinal tumor 30.29 NA NA 22.05 21.14 10.863281 A Biopsy/excise spinal tumor 29.99 NA NA 22.00 20.99 10.663282 A Biopsy/excise spinal tumor 28.15 NA NA 20.88 19.97 9.963283 A Biopsy/excise spinal tumor 26.76 NA NA 20.46 19.27 9.663285 A Biopsy/excise spinal tumor 38.05 NA NA 26.47 24.99 13.663286 A Biopsy/excise spinal tumor 37.62 NA NA 26.16 24.95 13.263287 A Biopsy/excise spinal tumor 40.08 NA NA 27.88 26.35 14.463290 A Biopsy/excise spinal tumor 40.82 NA NA 27.88 26.53 14.663295 A Repair of laminectomy defect 5.25 NA NA 2.92 2.73 1.863300 A Removal of vertebral body 26.80 NA NA 19.39 18.43 8.663301 A Removal of vertebral body 31.57 NA NA 23.14 20.98 11.363302 A Removal of vertebral body 31.15 NA NA 22.90 20.88 11.163303 A Removal of vertebral body 33.55 NA NA 23.78 21.57 12.063304 A Removal of vertebral body 33.85 NA NA 24.41 22.98 12.163305 A Removal of vertebral body 36.24 NA NA 25.65 23.12 13.0
CMS-1582-PN 349 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

63306 A Removal of vertebral body 35.55 NA NA 15.84 19.22 12.763307 A Removal of vertebral body 34.96 NA NA 24.65 22.97 12.563308 A Remove vertebral body add-on 5.24 NA NA 2.90 2.81 1.563600 A Remove spinal cord lesion 15.12 NA NA 10.44 8.18 1.563610 A Stimulation of spinal cord 8.72 2.03 15.88 2.40 2.32 0.663615 A Remove lesion of spinal cord 17.32 NA NA 13.45 12.20 6.263620 A Srs spinal lesion 15.60 NA NA 12.14 10.29 5.163621 A Srs spinal lesion addl 4.00 NA NA 2.23 2.06 1.363650 A Implant neuroelectrodes 7.20 NA NA 5.25 4.37 0.663655 A Implant neuroelectrodes 10.92 NA NA 10.35 10.00 3.463661 A Remove spine eltrd perq aray 5.08 11.80 11.80 3.93 3.93 0.763662 A Remove spine eltrd plate 11.00 NA NA 8.54 8.54 1.563663 A Revise spine eltrd perq aray 7.75 16.29 16.29 5.27 5.27 1.063664 A Revise spine eltrd plate 11.52 NA NA 8.80 8.80 1.663685 A Insrt/redo spine n generator 6.05 NA NA 5.09 4.52 1.163688 A Revise/remove neuroreceiver 5.30 NA NA 4.73 4.24 1.063700 A Repair of spinal herniation 17.47 NA NA 14.96 13.80 6.263702 A Repair of spinal herniation 19.41 NA NA 16.04 15.19 6.963704 A Repair of spinal herniation 22.43 NA NA 18.71 16.88 8.063706 A Repair of spinal herniation 25.35 NA NA 20.34 19.02 9.163707 A Repair spinal fluid leakage 12.65 NA NA 11.02 10.38 3.563709 A Repair spinal fluid leakage 15.65 NA NA 12.68 12.05 4.563710 A Graft repair of spine defect 15.40 NA NA 12.72 12.08 4.863740 A Install spinal shunt 12.63 NA NA 10.97 10.60 4.263741 A Install spinal shunt 9.12 NA NA 7.57 6.67 2.163744 A Revision of spinal shunt 8.94 NA NA 8.06 7.36 3.063746 A Removal of spinal shunt 7.33 NA NA 7.81 7.17 2.664400 A N block inj trigeminal 1.11 2.17 2.03 0.78 0.67 0.164402 A N block inj facial 1.25 1.99 1.88 0.78 0.71 0.164405 A N block inj occipital 0.94 1.76 1.68 0.70 0.67 0.1
CMS-1582-PN 350 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

64408 A N block inj vagus 1.41 2.20 2.04 1.24 1.10 0.164410 A N block inj phrenic 1.43 2.73 2.60 0.75 0.70 0.364412 A N block inj spinal accessor 1.18 3.25 3.01 0.92 0.80 0.264413 A N block inj cervical plexus 1.40 2.00 1.89 0.83 0.72 0.264415 A N block inj brachial plexus 1.48 1.89 2.01 0.36 0.39 0.164416 A N block cont infuse b plex 1.81 NA NA 0.43 0.44 0.164417 A N block inj axillary 1.44 2.24 2.23 0.56 0.50 0.164418 A N block inj suprascapular 1.32 2.69 2.59 0.83 0.72 0.164420 A N block inj intercost sng 1.18 2.00 2.70 0.76 0.66 0.164421 A N block inj intercost mlt 1.68 2.63 3.87 0.96 0.82 0.264425 A N block inj ilio-ing/hypogi 1.75 2.07 1.89 0.95 0.82 0.264430 A N block inj pudendal 1.46 2.25 2.60 0.78 0.84 0.164435 A N block inj paracervical 1.45 2.35 2.46 0.79 0.77 0.264445 A N block inj sciatic sng 1.48 2.29 2.29 0.54 0.58 0.164446 A N blk inj sciatic cont inf 1.81 NA NA 0.44 0.48 0.164447 A N block inj fem single 1.50 1.89 1.89 0.36 0.33 0.164448 A N block inj fem cont inf 1.63 NA NA 0.39 0.41 0.164449 A N block inj lumbar plexus 1.81 NA NA 0.51 0.52 0.164450 A N block other peripheral 1.27 1.72 1.63 0.67 0.64 0.164455 A N block inj plantar digit 0.75 0.58 0.61 0.24 0.26 0.064479 A Inj foramen epidural c/t 2.29 4.75 5.25 1.54 1.30 0.264480 A Inj foramen epidural add-on 1.20 2.36 2.34 0.63 0.59 0.164483 A Inj foramen epidural l/s 1.75 4.46 5.17 1.27 1.12 0.164484 A Inj foramen epidural add-on 1.00 1.60 2.05 0.52 0.48 0.064490 A Inj paravert f jnt c/t 1 lev 1.82 3.76 3.76 1.26 1.26 0.264491 A Inj paravert f jnt c/t 2 lev 1.16 1.59 1.59 0.58 0.58 0.164492 A Inj paravert f jnt c/t 3 lev 1.16 1.62 1.62 0.61 0.61 0.164493 A Inj paravert f jnt l/s 1 lev 1.52 3.49 3.49 1.10 1.10 0.164494 A Inj paravert f jnt l/s 2 lev 1.00 1.50 1.50 0.49 0.49 0.064495 A Inj paravert f jnt l/s 3 lev 1.00 1.54 1.54 0.51 0.51 0.0
CMS-1582-PN 351 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

64505 A N block spenopalatine gangl 1.36 1.44 1.42 1.01 0.95 0.164508 A N block carotid sinus s/p 1.12 0.50 1.71 0.94 0.84 0.264510 A N block stellate ganglion 1.22 2.48 2.65 0.90 0.73 0.164517 A N block inj hypogas plxs 2.20 2.98 2.72 1.35 1.14 0.164520 A N block lumbar/thoracic 1.35 4.32 4.16 1.01 0.84 0.164530 A N block inj celiac pelus 1.58 4.05 3.97 1.06 0.94 0.164550 A Apply neurostimulator 0.18 0.29 0.27 0.08 0.07 0.064553 A Implant neuroelectrodes 2.36 3.38 3.32 2.00 1.96 0.364555 A Implant neuroelectrodes 2.32 3.00 3.34 1.71 1.79 0.264560 A Implant neuroelectrodes 2.41 4.83 4.17 2.49 2.19 0.164561 A Implant neuroelectrodes 7.15 14.80 20.79 3.86 4.15 0.764565 A Implant neuroelectrodes 1.81 3.30 3.13 1.80 1.61 0.264566 A Neuroeltrd stim post tibial 0.60 3.15 3.15 0.23 0.23 0.064568 A Inc for vagus n elect impl 9.00 NA NA 8.64 8.64 1.264569 A Revise/repl vagus n eltrd 11.00 NA NA 4.49 4.49 3.164570 A Remove vagus n eltrd 9.10 NA NA 4.05 4.05 3.264575 A Implant neuroelectrodes 4.42 NA NA 4.19 3.57 0.464577 A Implant neuroelectrodes 4.69 NA NA 2.74 3.52 1.664580 A Implant neuroelectrodes 4.19 NA NA 3.91 3.81 0.864581 A Implant neuroelectrodes 12.20 NA NA 6.00 7.02 1.564585 A Revise/remove neuroelectrode 2.11 4.73 6.20 1.88 2.09 0.264590 A Insrt/redo pn/gastr stimul 2.45 4.73 5.68 1.95 2.21 0.264595 A Revise/rmv pn/gastr stimul 1.78 4.94 6.35 1.69 1.91 0.264600 A Injection treatment of nerve 3.49 8.21 8.05 2.80 2.45 0.564605 A Injection treatment of nerve 5.65 15.88 12.95 4.82 3.92 0.464610 A Injection treatment of nerve 7.20 12.97 12.07 5.24 4.98 2.164611 A Chemodenerv saliv glands 1.03 1.63 1.63 1.35 1.35 0.264612 A Destroy nerve face muscle 2.01 2.51 2.38 2.18 1.93 0.664613 A Destroy nerve neck muscle 2.01 2.29 2.23 1.92 1.68 0.564614 A Destroy nerve extrem musc 2.20 2.58 2.53 2.08 1.85 0.4
CMS-1582-PN 352 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

64620 A Injection treatment of nerve 2.89 3.06 3.85 2.12 1.81 0.264622 A Destr paravertebrl nerve l/s 3.05 6.94 6.55 2.50 2.07 0.264623 A Destr paravertebral n add-on 0.99 2.76 2.61 0.51 0.40 0.064626 A Destr paravertebrl nerve c/t 3.92 8.13 7.47 3.65 3.03 0.364627 A Destr paravertebral n add-on 1.16 3.95 3.77 0.60 0.47 0.164630 A Injection treatment of nerve 3.05 3.15 3.24 2.16 2.14 0.364632 A N block inj common digit 1.23 1.17 1.17 0.72 0.74 0.164640 A Injection treatment of nerve 2.81 3.26 3.36 1.93 1.90 0.264650 A Chemodenerv eccrine glands 0.70 2.59 1.89 0.42 0.37 0.164653 A Chemodenerv eccrine glands 0.88 2.92 2.11 0.47 0.44 0.264680 A Injection treatment of nerve 2.67 6.45 6.26 2.03 1.83 0.364681 A Injection treatment of nerve 3.78 6.48 6.91 1.70 1.78 0.364702 A Revise finger/toe nerve 6.26 NA NA 7.50 6.77 1.064704 A Revise hand/foot nerve 4.69 NA NA 4.32 4.23 0.564708 A Revise arm/leg nerve 6.36 NA NA 7.07 6.60 1.164712 A Revision of sciatic nerve 8.07 NA NA 7.22 6.69 1.364713 A Revision of arm nerve(s) 11.40 NA NA 9.01 8.52 2.364714 A Revise low back nerve(s) 10.55 NA NA 8.63 7.42 1.764716 A Revision of cranial nerve 6.99 NA NA 7.94 7.46 1.164718 A Revise ulnar nerve at elbow 7.26 NA NA 8.87 8.26 1.464719 A Revise ulnar nerve at wrist 4.97 NA NA 5.96 5.62 0.964721 A Carpal tunnel surgery 4.97 6.71 6.37 6.64 6.31 0.964722 A Relieve pressure on nerve(s) 4.82 NA NA 4.80 4.39 0.864726 A Release foot/toe nerve 4.27 NA NA 3.55 3.45 0.364727 A Internal nerve revision 3.10 NA NA 1.89 1.77 0.664732 A Incision of brow nerve 4.89 NA NA 6.30 5.63 1.764734 A Incision of cheek nerve 5.55 NA NA 7.12 6.15 0.764736 A Incision of chin nerve 5.23 NA NA 5.95 5.56 1.864738 A Incision of jaw nerve 6.36 NA NA 7.57 6.53 2.264740 A Incision of tongue nerve 6.22 NA NA 6.98 6.46 0.8
CMS-1582-PN 353 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

64742 A Incision of facial nerve 6.85 NA NA 7.07 6.27 0.864744 A Incise nerve back of head 5.72 NA NA 6.76 5.75 2.064746 A Incise diaphragm nerve 6.56 NA NA 4.76 4.86 1.564752 A Incision of vagus nerve 7.69 NA NA 6.03 5.65 1.864755 A Incision of stomach nerves 15.05 NA NA 9.08 8.25 3.264760 A Incision of vagus nerve 7.59 NA NA 5.99 5.32 1.664761 A Incision of pelvis nerve 7.04 NA NA 5.41 5.09 1.064763 A Incise hip/thigh nerve 7.56 NA NA 5.88 6.28 1.664766 A Incise hip/thigh nerve 9.47 NA NA 7.05 6.93 0.964771 A Sever cranial nerve 8.15 NA NA 7.51 7.32 1.064772 A Incision of spinal nerve 7.84 NA NA 7.64 7.15 1.864774 A Remove skin nerve lesion 5.80 NA NA 5.61 5.25 1.064776 A Remove digit nerve lesion 5.60 NA NA 5.27 4.94 0.864778 A Digit nerve surgery add-on 3.11 NA NA 2.24 1.93 0.664782 A Remove limb nerve lesion 6.86 NA NA 5.74 5.43 0.964783 A Limb nerve surgery add-on 3.71 NA NA 2.57 2.27 0.464784 A Remove nerve lesion 10.62 NA NA 9.45 8.72 2.064786 A Remove sciatic nerve lesion 16.25 NA NA 13.01 12.05 3.264787 A Implant nerve end 4.29 NA NA 2.27 2.25 0.664788 A Remove skin nerve lesion 5.24 NA NA 5.65 5.24 1.064790 A Removal of nerve lesion 12.10 NA NA 10.28 9.51 2.764792 A Removal of nerve lesion 15.86 NA NA 12.16 11.73 5.664795 A Biopsy of nerve 3.01 NA NA 2.14 1.99 0.864802 A Remove sympathetic nerves 10.37 NA NA 8.81 6.86 0.864804 A Remove sympathetic nerves 15.91 NA NA 6.59 6.80 1.264809 A Remove sympathetic nerves 14.71 NA NA 10.77 9.05 1.164818 A Remove sympathetic nerves 11.34 NA NA 6.74 6.20 2.064820 A Remove sympathetic nerves 10.74 NA NA 10.47 9.62 1.964821 A Remove sympathetic nerves 9.33 NA NA 9.42 8.96 1.864822 A Remove sympathetic nerves 9.33 NA NA 9.42 8.81 1.8
CMS-1582-PN 354 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

64823 A Remove sympathetic nerves 10.94 NA NA 10.38 9.58 2.164831 A Repair of digit nerve 9.16 NA NA 9.76 9.09 1.664832 A Repair nerve add-on 5.65 NA NA 3.70 3.43 1.064834 A Repair of hand or foot nerve 10.81 NA NA 9.76 9.07 1.864835 A Repair of hand or foot nerve 11.73 NA NA 10.32 9.68 2.364836 A Repair of hand or foot nerve 11.73 NA NA 10.32 9.70 2.364837 A Repair nerve add-on 6.25 NA NA 3.73 3.61 0.764840 A Repair of leg nerve 14.02 NA NA 11.17 10.55 1.064856 A Repair/transpose nerve 15.07 NA NA 12.74 11.86 2.864857 A Repair arm/leg nerve 15.82 NA NA 13.11 12.26 2.964858 A Repair sciatic nerve 17.82 NA NA 15.85 14.44 3.564859 A Nerve surgery 4.25 NA NA 3.06 2.71 0.864861 A Repair of arm nerves 20.89 NA NA 12.41 12.89 4.164862 A Repair of low back nerves 21.09 NA NA 16.77 14.47 7.564864 A Repair of facial nerve 13.41 NA NA 11.08 10.31 1.764865 A Repair of facial nerve 16.09 NA NA 16.04 15.42 2.064866 A Fusion of facial/other nerve 16.83 NA NA 14.65 14.74 2.164868 A Fusion of facial/other nerve 14.90 NA NA 14.51 13.79 1.964870 A Fusion of facial/other nerve 17.08 NA NA 12.14 10.94 4.064872 A Subsequent repair of nerve 1.99 NA NA 1.19 1.16 0.264874 A Repair & revise nerve add-on 2.98 NA NA 2.07 1.83 0.364876 A Repair nerve/shorten bone 3.37 NA NA 1.88 1.73 0.664885 A Nerve graft head or neck 17.60 NA NA 13.83 13.03 2.264886 A Nerve graft head or neck 20.82 NA NA 15.77 15.10 2.664890 A Nerve graft hand or foot 16.24 NA NA 13.01 12.40 3.264891 A Nerve graft hand or foot 17.35 NA NA 15.51 13.80 3.464892 A Nerve graft arm or leg 15.74 NA NA 12.71 12.03 3.164893 A Nerve graft arm or leg 16.87 NA NA 14.11 12.85 3.364895 A Nerve graft hand or foot 20.39 NA NA 17.70 15.47 4.064896 A Nerve graft hand or foot 21.96 NA NA 15.88 15.41 7.8
CMS-1582-PN 355 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

64897 A Nerve graft arm or leg 19.38 NA NA 15.51 14.35 3.864898 A Nerve graft arm or leg 20.97 NA NA 16.27 15.43 4.164901 A Nerve graft add-on 10.20 NA NA 7.34 6.38 2.064902 A Nerve graft add-on 11.81 NA NA 8.50 7.32 2.364905 A Nerve pedicle transfer 15.11 NA NA 12.98 12.04 2.964907 A Nerve pedicle transfer 20.03 NA NA 10.97 12.38 1.464910 A Nerve repair w/allograft 11.39 NA NA 11.45 10.66 1.964911 A Neurorraphy w/vein autograft 14.39 NA NA 14.24 12.74 2.864999 C Nervous system surgery 0.00 0.00 0.00 0.00 0.00 0.065091 A Revise eye 7.26 NA NA 10.39 9.65 1.465093 A Revise eye with implant 7.04 NA NA 10.39 9.75 1.365101 A Removal of eye 8.30 NA NA 12.21 11.32 1.665103 A Remove eye/insert implant 8.84 NA NA 12.59 11.63 1.765105 A Remove eye/attach implant 9.93 NA NA 13.71 12.63 1.965110 A Removal of eye 15.70 NA NA 18.29 16.70 2.065112 A Remove eye/revise socket 18.51 NA NA 21.16 19.32 2.365114 A Remove eye/revise socket 19.65 NA NA 21.96 19.94 2.565125 A Revise ocular implant 3.27 9.14 8.98 4.82 4.45 0.665130 A Insert ocular implant 8.42 NA NA 11.94 11.00 1.665135 A Insert ocular implant 8.60 NA NA 12.07 11.14 1.665140 A Attach ocular implant 9.46 NA NA 13.03 12.03 1.265150 A Revise ocular implant 6.43 NA NA 9.61 9.02 0.465155 A Reinsert ocular implant 10.10 NA NA 13.48 12.44 1.965175 A Removal of ocular implant 7.40 NA NA 10.90 10.10 0.965205 A Remove foreign body from eye 0.71 0.82 0.77 0.51 0.45 0.165210 A Remove foreign body from eye 0.84 1.08 1.00 0.67 0.58 0.165220 A Remove foreign body from eye 0.71 0.87 0.81 0.45 0.40 0.165222 A Remove foreign body from eye 0.93 1.18 1.09 0.71 0.62 0.165235 A Remove foreign body from eye 9.01 NA NA 10.91 9.74 1.265260 A Remove foreign body from eye 12.54 NA NA 14.32 12.85 0.8
CMS-1582-PN 356 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

65265 A Remove foreign body from eye 14.34 NA NA 15.91 14.23 3.065270 A Repair of eye wound 1.95 5.30 5.21 1.99 1.78 0.265272 A Repair of eye wound 4.62 9.23 8.75 5.24 4.66 0.365273 A Repair of eye wound 5.16 NA NA 5.55 4.95 0.365275 A Repair of eye wound 6.29 9.78 8.83 6.71 5.84 0.865280 A Repair of eye wound 9.10 NA NA 9.62 8.59 1.865285 A Repair of eye wound 14.71 NA NA 14.44 12.73 2.665286 A Repair of eye wound 6.63 12.80 12.19 7.29 6.47 0.965290 A Repair of eye socket wound 6.53 NA NA 7.25 6.49 1.265400 A Removal of eye lesion 7.50 11.41 10.50 9.38 8.43 1.065410 A Biopsy of cornea 1.47 2.48 2.35 1.46 1.30 0.365420 A Removal of eye lesion 4.36 9.83 9.46 6.16 5.64 0.565426 A Removal of eye lesion 6.05 11.95 11.36 7.36 6.62 0.865430 A Corneal smear 1.47 1.73 1.58 1.44 1.28 0.265435 A Curette/treat cornea 0.92 1.31 1.21 1.04 0.94 0.165436 A Curette/treat cornea 4.82 6.02 5.44 5.60 5.01 0.865450 A Treatment of corneal lesion 3.47 5.57 5.14 5.48 5.04 0.465600 A Revision of cornea 4.20 6.78 6.25 5.45 4.86 0.665710 A Corneal transplant 14.45 NA NA 16.63 14.92 1.965730 A Corneal transplant 16.35 NA NA 18.14 16.21 2.265750 A Corneal transplant 16.90 NA NA 17.81 15.89 2.165755 A Corneal transplant 16.79 NA NA 17.74 15.83 2.265756 A Corneal trnspl endothelial 16.84 NA NA 16.51 14.50 1.265757 C Prep corneal endo allograft 0.00 0.00 0.00 0.00 0.00 0.065760 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.065765 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.065767 N Corneal tissue transplant 0.00 0.00 0.00 0.00 0.00 0.065770 A Revise cornea with implant 19.74 NA NA 19.79 17.60 7.065771 N Radial keratotomy 0.00 0.00 0.00 0.00 0.00 0.065772 A Correction of astigmatism 5.09 7.48 6.88 6.29 5.66 0.6
CMS-1582-PN 357 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

65775 A Correction of astigmatism 6.91 NA NA 8.55 7.73 0.465778 A Cover eye w/membrane 1.19 35.56 35.56 0.84 0.84 0.165779 A Cover eye w/membrane stent 3.92 28.93 28.93 4.07 4.07 0.565780 A Ocular reconst transplant 10.73 NA NA 14.12 12.89 1.365781 A Ocular reconst transplant 18.14 NA NA 19.36 17.39 1.265782 A Ocular reconst transplant 15.43 NA NA 16.92 15.23 3.065800 A Drainage of eye 1.91 2.24 2.06 1.76 1.57 0.265805 A Drainage of eye 1.91 2.63 2.46 1.78 1.57 0.365810 A Drainage of eye 5.82 NA NA 7.43 6.67 0.865815 A Drainage of eye 6.00 11.60 11.04 7.37 6.62 1.065820 A Relieve inner eye pressure 8.91 NA NA 11.98 10.99 0.665850 A Incision of eye 11.39 NA NA 12.20 10.94 1.965855 A Laser surgery of eye 3.99 5.46 5.05 4.37 3.93 0.665860 A Incise inner eye adhesions 3.59 5.04 4.68 3.54 3.17 1.365865 A Incise inner eye adhesions 5.77 NA NA 7.44 6.82 0.365870 A Incise inner eye adhesions 7.39 NA NA 9.16 8.29 1.265875 A Incise inner eye adhesions 7.81 NA NA 9.82 8.89 1.065880 A Incise inner eye adhesions 8.36 NA NA 10.20 9.20 0.665900 A Remove eye lesion 12.51 NA NA 14.52 13.09 0.865920 A Remove implant of eye 9.99 NA NA 12.09 10.88 1.265930 A Remove blood clot from eye 8.39 NA NA 9.48 8.57 1.466020 A Injection treatment of eye 1.64 3.49 3.35 2.04 1.85 0.166030 A Injection treatment of eye 1.30 3.25 3.15 1.80 1.64 0.166130 A Remove eye lesion 7.83 11.53 10.80 8.17 7.31 1.666150 A Glaucoma surgery 10.53 NA NA 13.97 12.63 0.766155 A Glaucoma surgery 10.52 NA NA 13.96 12.62 0.766160 A Glaucoma surgery 12.39 NA NA 15.28 13.75 0.866165 A Glaucoma surgery 10.24 NA NA 13.77 12.45 0.766170 A Glaucoma surgery 15.02 NA NA 18.61 16.71 1.966172 A Incision of eye 18.86 NA NA 23.57 21.13 2.4
CMS-1582-PN 358 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

66174 A Translum dil eye canal 12.85 NA NA 13.79 13.79 2.266175 A Trnslum dil eye canal w/stnt 13.60 NA NA 14.31 14.31 4.866180 A Implant eye shunt 16.30 NA NA 16.48 14.61 2.166185 A Revise eye shunt 9.58 NA NA 11.43 10.24 1.666220 A Repair eye lesion 9.21 NA NA 11.61 10.31 1.266225 A Repair/graft eye lesion 12.63 NA NA 13.54 12.04 2.466250 A Follow-up surgery of eye 7.10 13.58 12.91 8.51 7.62 1.466500 A Incision of iris 3.83 NA NA 6.00 5.57 0.266505 A Incision of iris 4.22 NA NA 6.56 6.08 0.366600 A Remove iris and lesion 10.12 NA NA 13.14 11.79 0.766605 A Removal of iris 14.22 NA NA 15.47 13.73 1.066625 A Removal of iris 5.30 NA NA 6.71 6.09 0.766630 A Removal of iris 7.28 NA NA 8.68 7.78 1.266635 A Removal of iris 7.37 NA NA 8.74 7.84 0.566680 A Repair iris & ciliary body 6.39 NA NA 8.07 7.26 1.366682 A Repair iris & ciliary body 7.33 NA NA 10.42 9.42 1.466700 A Destruction ciliary body 5.14 7.41 6.79 5.89 5.28 0.466710 A Ciliary transsleral therapy 5.14 7.16 6.56 5.89 5.27 1.066711 A Ciliary endoscopic ablation 7.93 NA NA 10.08 9.05 0.566720 A Destruction ciliary body 5.00 8.13 7.46 6.77 6.15 0.666740 A Destruction ciliary body 5.14 7.06 6.47 5.89 5.30 0.366761 A Revision of iris 3.00 5.22 5.82 3.61 4.44 0.466762 A Revision of iris 5.38 7.88 7.22 6.56 5.89 0.666770 A Removal of inner eye lesion 6.13 8.60 7.85 7.40 6.64 0.466820 A Incision secondary cataract 4.01 NA NA 6.88 6.51 0.666821 A After cataract laser surgery 3.42 5.75 5.31 5.23 4.79 0.566825 A Reposition intraocular lens 9.01 NA NA 12.18 11.18 1.166830 A Removal of lens lesion 9.47 NA NA 10.56 9.42 0.666840 A Removal of lens material 9.18 NA NA 10.37 9.24 1.866850 A Removal of lens material 10.55 NA NA 11.71 10.44 1.4
CMS-1582-PN 359 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

66852 A Removal of lens material 11.41 NA NA 12.32 10.98 2.066920 A Extraction of lens 10.13 NA NA 11.06 9.86 0.766930 A Extraction of lens 11.61 NA NA 12.47 11.10 0.866940 A Extraction of lens 10.37 NA NA 11.58 10.33 1.766982 A Cataract surgery complex 15.02 NA NA 14.64 13.01 2.366983 A Cataract surg w/iol 1 stage 10.43 NA NA 10.36 9.25 0.866984 A Cataract surg w/iol 1 stage 10.52 NA NA 10.81 9.68 1.666985 A Insert lens prosthesis 9.98 NA NA 11.63 10.38 1.266986 A Exchange lens prosthesis 12.26 NA NA 13.26 11.94 1.566990 A Ophthalmic endoscope add-on 1.51 NA NA 1.06 0.91 0.166999 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.067005 A Partial removal of eye fluid 5.89 NA NA 7.33 6.60 1.267010 A Partial removal of eye fluid 7.06 NA NA 8.14 7.30 0.967015 A Release of eye fluid 7.14 NA NA 9.08 8.25 0.967025 A Replace eye fluid 8.11 12.09 11.18 9.62 8.61 1.467027 A Implant eye drug system 11.62 NA NA 12.26 10.93 2.067028 A Injection eye drug 1.44 1.42 2.14 1.37 1.52 0.267030 A Incise inner eye strands 6.11 NA NA 8.73 7.92 0.467031 A Laser surgery eye strands 4.47 6.37 5.83 5.52 4.96 0.567036 A Removal of inner eye fluid 13.32 NA NA 13.66 12.15 1.867039 A Laser treatment of retina 16.74 NA NA 17.91 16.01 2.967040 A Laser treatment of retina 19.61 NA NA 20.32 18.09 2.667041 A Vit for macular pucker 19.25 NA NA 18.09 15.81 2.667042 A Vit for macular hole 22.38 NA NA 20.28 17.66 3.067043 A Vit for membrane dissect 23.24 NA NA 21.60 18.87 4.167101 A Repair detached retina 8.80 13.06 11.95 10.12 9.03 1.567105 A Repair detached retina 8.53 11.62 10.58 9.55 8.52 1.167107 A Repair detached retina 16.71 NA NA 17.47 15.50 2.967108 A Repair detached retina 22.89 NA NA 22.31 19.69 3.167110 A Repair detached retina 10.25 14.00 12.82 11.51 10.25 1.3
CMS-1582-PN 360 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

67112 A Rerepair detached retina 18.75 NA NA 18.57 16.40 2.567113 A Repair retinal detach cplx 25.35 NA NA 23.82 20.82 3.467115 A Release encircling material 6.11 NA NA 7.86 7.07 0.767120 A Remove eye implant material 7.10 11.18 10.38 8.55 7.66 1.467121 A Remove eye implant material 12.25 NA NA 13.28 11.80 2.167141 A Treatment of retina 6.15 8.47 7.71 7.51 6.73 1.067145 A Treatment of retina 6.32 8.42 7.64 7.63 6.83 0.867208 A Treatment of retinal lesion 7.65 9.14 8.22 8.57 7.65 0.567210 A Treatment of retinal lesion 9.45 9.91 8.84 9.31 8.21 1.467218 A Treatment of retinal lesion 20.36 NA NA 18.64 16.41 1.467220 A Treatment of choroid lesion 14.39 15.38 13.76 14.04 12.39 2.567221 R Ocular photodynamic ther 3.45 4.56 4.34 2.61 2.28 0.467225 A Eye photodynamic ther add-on 0.47 0.37 0.33 0.33 0.28 0.067227 A Treatment of retinal lesion 7.53 9.55 8.65 8.49 7.58 0.567228 A Treatment of retinal lesion 13.82 18.46 17.42 15.95 14.18 2.167229 A Tr retinal les preterm inf 16.30 NA NA 15.55 13.92 1.167250 A Reinforce eye wall 9.61 NA NA 12.20 11.17 1.667255 A Reinforce/graft eye wall 10.17 NA NA 13.31 12.20 1.967299 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.067311 A Revise eye muscle 7.77 NA NA 9.00 8.08 1.367312 A Revise two eye muscles 9.66 NA NA 10.32 9.19 1.967314 A Revise eye muscle 8.79 NA NA 10.08 9.01 1.467316 A Revise two eye muscles 10.93 NA NA 11.55 10.25 2.167318 A Revise eye muscle(s) 9.12 NA NA 10.66 9.53 0.667320 A Revise eye muscle(s) add-on 5.40 NA NA 3.76 3.17 0.367331 A Eye surgery follow-up add-on 5.13 NA NA 3.54 2.98 0.867332 A Rerevise eye muscles add-on 5.56 NA NA 3.89 3.26 0.967334 A Revise eye muscle w/suture 5.05 NA NA 3.54 2.97 0.367335 A Eye suture during surgery 2.49 NA NA 1.73 1.49 0.467340 A Revise eye muscle add-on 6.00 NA NA 4.21 3.54 0.4
CMS-1582-PN 361 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

67343 A Release eye tissue 8.47 NA NA 9.84 8.82 1.667345 A Destroy nerve of eye muscle 3.01 3.55 3.21 2.92 2.59 0.867346 A Biopsy eye muscle 2.87 NA NA 2.78 2.47 0.667399 C Eye muscle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.067400 A Explore/biopsy eye socket 11.20 NA NA 14.76 13.59 2.067405 A Explore/drain eye socket 9.20 NA NA 12.89 11.95 1.167412 A Explore/treat eye socket 10.30 NA NA 13.44 12.47 1.867413 A Explore/treat eye socket 10.24 NA NA 13.59 12.60 2.067414 A Explr/decompress eye socket 17.94 NA NA 19.25 17.12 2.267415 A Aspiration orbital contents 1.76 NA NA 1.24 1.04 0.267420 A Explore/treat eye socket 21.87 NA NA 23.51 21.29 4.367430 A Explore/treat eye socket 15.29 NA NA 19.53 17.91 1.067440 A Explore/drain eye socket 14.84 NA NA 18.84 17.26 1.967445 A Explr/decompress eye socket 19.12 NA NA 20.21 18.14 3.767450 A Explore/biopsy eye socket 15.41 NA NA 19.61 17.96 1.967500 A Inject/treat eye socket 1.44 0.89 0.83 0.70 0.62 0.167505 A Inject/treat eye socket 1.27 1.24 1.08 1.04 0.85 0.267515 A Inject/treat eye socket 1.40 1.33 1.13 1.13 0.93 0.267550 A Insert eye socket implant 11.77 NA NA 15.18 13.95 2.367560 A Revise eye socket implant 12.18 NA NA 15.50 14.15 1.567570 A Decompress optic nerve 14.40 NA NA 17.39 16.11 5.167599 C Orbit surgery procedure 0.00 0.00 0.00 0.00 0.00 0.067700 A Drainage of eyelid abscess 1.40 5.84 5.82 1.84 1.67 0.267710 A Incision of eyelid 1.07 4.97 5.01 1.64 1.51 0.267715 A Incision of eyelid fold 1.27 5.14 5.13 1.77 1.63 0.267800 A Remove eyelid lesion 1.41 2.13 1.97 1.50 1.35 0.267801 A Remove eyelid lesions 1.91 2.61 2.40 1.85 1.65 0.367805 A Remove eyelid lesions 2.27 3.35 3.10 2.37 2.12 0.467808 A Remove eyelid lesion(s) 4.60 NA NA 5.71 5.15 0.967810 A Biopsy of eyelid 1.48 4.51 4.56 1.08 0.98 0.2
CMS-1582-PN 362 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

67820 A Revise eyelashes 0.71 0.70 0.65 0.79 0.72 0.167825 A Revise eyelashes 1.43 2.14 2.00 1.96 1.80 0.267830 A Revise eyelashes 1.75 5.51 5.44 2.12 1.92 0.367835 A Revise eyelashes 5.70 NA NA 6.61 5.96 1.167840 A Remove eyelid lesion 2.09 5.45 5.37 2.36 2.13 0.367850 A Treat eyelid lesion 1.74 4.24 4.22 2.10 1.99 0.267875 A Closure of eyelid by suture 1.35 3.34 3.28 1.38 1.24 0.267880 A Revision of eyelid 4.60 8.09 7.61 5.72 5.15 0.867882 A Revision of eyelid 6.02 9.63 8.99 7.22 6.49 1.167900 A Repair brow defect 6.82 10.96 10.33 7.48 6.76 1.267901 A Repair eyelid defect 7.59 13.29 11.69 8.57 7.65 1.567902 A Repair eyelid defect 9.82 NA NA 10.54 9.20 1.967903 A Repair eyelid defect 6.51 9.99 9.57 7.09 6.47 1.267904 A Repair eyelid defect 7.97 12.36 11.51 8.81 7.80 1.567906 A Repair eyelid defect 6.93 NA NA 7.36 6.61 0.467908 A Repair eyelid defect 5.30 8.41 7.84 6.59 6.09 1.067909 A Revise eyelid defect 5.57 9.25 8.77 6.69 6.11 1.167911 A Revise eyelid defect 7.50 NA NA 8.29 7.31 1.467912 A Correction eyelid w/implant 6.36 17.97 17.92 7.44 6.82 0.967914 A Repair eyelid defect 3.75 6.96 6.67 4.33 3.92 0.667915 A Repair eyelid defect 3.26 6.26 6.06 3.84 3.51 0.467916 A Repair eyelid defect 5.48 9.43 8.94 6.62 6.03 0.967917 A Repair eyelid defect 6.19 10.06 9.49 7.13 6.46 1.167921 A Repair eyelid defect 3.47 6.74 6.48 4.13 3.73 0.667922 A Repair eyelid defect 3.14 6.07 5.88 3.69 3.38 0.467923 A Repair eyelid defect 6.05 9.70 9.12 7.02 6.35 1.167924 A Repair eyelid defect 5.93 10.28 9.76 6.66 6.01 1.167930 A Repair eyelid wound 3.65 6.45 6.15 3.14 2.79 0.767935 A Repair eyelid wound 6.36 10.14 9.55 6.11 5.48 1.267938 A Remove eyelid foreign body 1.38 5.23 5.20 1.86 1.70 0.2
CMS-1582-PN 363 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

67950 A Revision of eyelid 5.99 9.90 9.39 7.01 6.40 1.167961 A Revision of eyelid 5.86 10.08 9.56 6.90 6.28 1.167966 A Revision of eyelid 8.97 12.45 11.44 9.52 8.39 1.767971 A Reconstruction of eyelid 10.01 NA NA 10.35 9.29 1.967973 A Reconstruction of eyelid 13.13 NA NA 13.11 11.75 2.567974 A Reconstruction of eyelid 13.10 NA NA 13.08 11.70 2.567975 A Reconstruction of eyelid 9.35 NA NA 9.91 8.91 1.867999 C Revision of eyelid 0.00 0.00 0.00 0.00 0.00 0.068020 A Incise/drain eyelid lining 1.42 1.91 1.76 1.68 1.53 0.268040 A Treatment of eyelid lesions 0.85 0.97 0.88 0.65 0.56 0.168100 A Biopsy of eyelid lining 1.35 3.28 3.23 1.40 1.26 0.268110 A Remove eyelid lining lesion 1.82 4.36 4.23 2.34 2.13 0.368115 A Remove eyelid lining lesion 2.41 6.10 5.97 2.75 2.48 0.368130 A Remove eyelid lining lesion 5.10 9.77 9.34 6.44 5.86 0.368135 A Remove eyelid lining lesion 1.89 2.48 2.27 2.33 2.12 0.268200 A Treat eyelid by injection 0.49 0.69 0.64 0.49 0.43 0.068320 A Revise/graft eyelid lining 6.64 13.36 12.70 8.46 7.62 1.268325 A Revise/graft eyelid lining 8.63 NA NA 9.87 8.84 1.668326 A Revise/graft eyelid lining 8.42 NA NA 9.71 8.69 1.668328 A Revise/graft eyelid lining 9.45 NA NA 10.52 9.44 1.868330 A Revise eyelid lining 5.78 10.90 10.36 7.14 6.42 1.168335 A Revise/graft eyelid lining 8.46 NA NA 9.70 8.68 1.668340 A Separate eyelid adhesions 4.97 10.03 9.58 6.21 5.58 0.968360 A Revise eyelid lining 5.17 9.46 8.98 6.32 5.70 1.068362 A Revise eyelid lining 8.61 NA NA 9.82 8.77 1.668371 A Harvest eye tissue alograft 5.09 NA NA 6.47 5.90 0.368399 C Eyelid lining surgery 0.00 0.00 0.00 0.00 0.00 0.068400 A Incise/drain tear gland 1.74 5.94 5.87 1.95 1.83 0.368420 A Incise/drain tear sac 2.35 6.40 6.28 2.38 2.20 0.368440 A Incise tear duct opening 0.99 1.84 1.82 1.76 1.63 0.2
CMS-1582-PN 364 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

68500 A Removal of tear gland 12.77 NA NA 14.60 13.07 2.968505 A Partial removal tear gland 12.69 NA NA 14.54 13.18 2.468510 A Biopsy of tear gland 4.60 7.73 7.43 3.69 3.18 0.968520 A Removal of tear sac 8.78 NA NA 10.45 9.48 1.168525 A Biopsy of tear sac 4.42 NA NA 3.10 2.65 0.868530 A Clearance of tear duct 3.70 8.02 7.87 3.55 3.19 0.768540 A Remove tear gland lesion 12.18 NA NA 13.89 12.48 1.568550 A Remove tear gland lesion 15.16 NA NA 16.82 15.03 1.968700 A Repair tear ducts 7.87 NA NA 9.08 8.14 1.568705 A Revise tear duct opening 2.11 4.38 4.25 2.55 2.31 0.468720 A Create tear sac drain 9.96 NA NA 11.27 10.16 1.668745 A Create tear duct drain 9.90 NA NA 11.42 10.29 1.968750 A Create tear duct drain 10.10 NA NA 11.97 10.80 1.968760 A Close tear duct opening 1.78 3.74 3.62 2.30 2.10 0.368761 A Close tear duct opening 1.41 2.66 2.54 1.91 1.76 0.268770 A Close tear system fistula 8.29 NA NA 9.37 7.92 1.668801 A Dilate tear duct opening 1.00 2.44 2.34 1.99 1.88 0.168810 A Probe nasolacrimal duct 2.15 4.52 4.28 3.07 2.89 0.368811 A Probe nasolacrimal duct 2.45 NA NA 3.32 3.04 0.468815 A Probe nasolacrimal duct 3.30 8.97 8.72 3.92 3.56 0.568816 A Probe nl duct w/balloon 3.06 17.02 16.27 3.98 3.59 0.668840 A Explore/irrigate tear ducts 1.30 2.25 2.08 1.95 1.75 0.268850 A Injection for tear sac x-ray 0.80 0.83 0.89 0.70 0.74 0.068899 C Tear duct system surgery 0.00 0.00 0.00 0.00 0.00 0.069000 A Drain external ear lesion 1.50 3.78 3.65 1.89 1.77 0.269005 A Drain external ear lesion 2.16 3.98 3.83 2.34 2.21 0.269020 A Drain outer ear canal lesion 1.53 5.22 5.10 2.59 2.50 0.269090 N Pierce earlobes 0.00 0.00 0.00 0.00 0.00 0.069100 A Biopsy of external ear 0.81 2.02 2.11 0.59 0.55 0.169105 A Biopsy of external ear canal 0.85 3.24 3.18 0.99 0.94 0.1
CMS-1582-PN 365 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

69110 A Remove external ear partial 3.53 9.56 9.41 5.77 5.64 0.569120 A Removal of external ear 4.14 NA NA 7.49 7.17 0.669140 A Remove ear canal lesion(s) 8.14 NA NA 17.26 16.74 1.069145 A Remove ear canal lesion(s) 2.70 8.84 8.50 4.54 4.33 0.369150 A Extensive ear canal surgery 13.61 NA NA 16.15 15.52 1.969155 A Extensive ear/neck surgery 23.35 NA NA 24.86 23.53 3.069200 A Clear outer ear canal 0.77 2.78 2.73 0.88 0.81 0.169205 A Clear outer ear canal 1.21 NA NA 1.72 1.64 0.169210 A Remove impacted ear wax 0.61 0.85 0.79 0.32 0.28 0.069220 A Clean out mastoid cavity 0.83 3.27 3.19 0.95 0.92 0.169222 A Clean out mastoid cavity 1.45 4.97 4.87 2.53 2.45 0.169300 R Revise external ear 6.69 13.36 12.17 7.06 6.57 0.869310 A Rebuild outer ear canal 10.97 NA NA 20.48 19.83 1.469320 A Rebuild outer ear canal 17.18 NA NA 27.10 26.20 2.269399 C Outer ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.069400 A Inflate middle ear canal 0.83 3.48 3.34 0.96 0.91 0.169401 A Inflate middle ear canal 0.63 1.89 1.79 0.80 0.76 0.069405 A Catheterize middle ear canal 2.68 4.90 4.67 2.89 2.72 0.369420 A Incision of eardrum 1.38 4.20 4.09 2.12 2.02 0.169421 A Incision of eardrum 1.78 NA NA 2.55 2.46 0.269424 A Remove ventilating tube 0.85 2.89 2.84 0.95 0.89 0.169433 A Create eardrum opening 1.57 4.23 4.10 2.20 2.09 0.269436 A Create eardrum opening 2.01 NA NA 2.65 2.56 0.269440 A Exploration of middle ear 7.71 NA NA 12.32 11.70 0.969450 A Eardrum revision 5.69 NA NA 10.16 9.67 0.769501 A Mastoidectomy 9.21 NA NA 12.02 11.35 1.169502 A Mastoidectomy 12.56 NA NA 15.51 14.66 1.669505 A Remove mastoid structures 13.17 NA NA 21.72 20.91 1.769511 A Extensive mastoid surgery 13.70 NA NA 22.03 21.24 1.769530 A Extensive mastoid surgery 20.38 NA NA 27.47 26.27 2.6
CMS-1582-PN 366 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

69535 A Remove part of temporal bone 37.42 NA NA 39.37 37.20 5.269540 A Remove ear lesion 1.25 4.86 4.76 2.45 2.38 0.169550 A Remove ear lesion 11.15 NA NA 19.04 18.36 1.469552 A Remove ear lesion 19.81 NA NA 25.62 24.44 2.569554 A Remove ear lesion 35.97 NA NA 36.94 34.02 4.669601 A Mastoid surgery revision 13.45 NA NA 16.90 15.97 1.769602 A Mastoid surgery revision 13.76 NA NA 17.82 16.86 1.769603 A Mastoid surgery revision 14.20 NA NA 22.33 21.60 1.869604 A Mastoid surgery revision 14.20 NA NA 18.08 17.23 1.869605 A Mastoid surgery revision 18.69 NA NA 26.48 25.40 2.469610 A Repair of eardrum 4.47 6.68 6.46 3.94 3.71 0.569620 A Repair of eardrum 6.03 14.07 13.72 8.09 7.72 0.769631 A Repair eardrum structures 10.05 NA NA 15.64 14.87 1.269632 A Rebuild eardrum structures 12.96 NA NA 18.34 17.42 1.669633 A Rebuild eardrum structures 12.31 NA NA 17.91 17.02 1.569635 A Repair eardrum structures 13.51 NA NA 21.93 21.06 1.769636 A Rebuild eardrum structures 15.43 NA NA 24.57 23.64 1.969637 A Rebuild eardrum structures 15.32 NA NA 24.54 23.60 2.069641 A Revise middle ear & mastoid 12.89 NA NA 17.27 16.39 1.669642 A Revise middle ear & mastoid 17.06 NA NA 21.72 20.58 2.169643 A Revise middle ear & mastoid 15.59 NA NA 19.87 18.81 2.069644 A Revise middle ear & mastoid 17.23 NA NA 25.55 24.59 2.269645 A Revise middle ear & mastoid 16.71 NA NA 25.32 24.34 2.169646 A Revise middle ear & mastoid 18.37 NA NA 26.24 25.14 2.369650 A Release middle ear bone 9.80 NA NA 13.54 12.69 1.269660 A Revise middle ear bone 12.03 NA NA 14.84 14.04 1.569661 A Revise middle ear bone 15.92 NA NA 19.09 18.09 2.069662 A Revise middle ear bone 15.60 NA NA 17.87 16.89 2.069666 A Repair middle ear structures 9.89 NA NA 13.58 12.83 1.269667 A Repair middle ear structures 9.90 NA NA 13.56 12.86 1.2
CMS-1582-PN 367 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

69670 A Remove mastoid air cells 11.73 NA NA 15.66 14.80 1.569676 A Remove middle ear nerve 9.69 NA NA 14.46 13.79 1.269700 A Close mastoid fistula 8.37 NA NA 11.53 11.05 1.069710 N Implant/replace hearing aid 0.00 0.00 0.00 0.00 0.00 0.069711 A Remove/repair hearing aid 10.62 NA NA 14.42 13.74 1.369714 A Implant temple bone w/stimul 14.45 NA NA 16.69 15.76 1.869715 A Temple bne implnt w/stimulat 18.96 NA NA 19.53 18.35 2.469717 A Temple bone implant revision 15.43 NA NA 17.30 16.51 1.969718 A Revise temple bone implant 19.21 NA NA 19.68 18.51 2.469720 A Release facial nerve 14.71 NA NA 19.37 18.35 1.869725 A Release facial nerve 27.64 NA NA 26.81 25.02 3.569740 A Repair facial nerve 16.27 NA NA 17.55 16.53 2.069745 A Repair facial nerve 17.02 NA NA 18.98 17.98 2.169799 C Middle ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.069801 A Incise inner ear 2.06 3.61 3.61 1.57 6.59 0.269802 A Incise inner ear 13.50 NA NA 16.70 15.78 1.769805 A Explore inner ear 14.71 NA NA 15.84 14.84 1.869806 A Explore inner ear 12.63 NA NA 14.73 13.92 1.669820 A Establish inner ear window 10.52 NA NA 14.36 13.71 1.369840 A Revise inner ear window 10.44 NA NA 12.68 13.62 0.769905 A Remove inner ear 11.26 NA NA 15.38 14.64 1.469910 A Remove inner ear & mastoid 13.91 NA NA 15.57 14.71 1.869915 A Incise inner ear nerve 22.77 NA NA 21.76 20.27 2.969930 A Implant cochlear device 17.73 NA NA 17.65 16.73 2.269949 C Inner ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.069950 A Incise inner ear nerve 27.63 NA NA 28.74 25.02 3.569955 A Release facial nerve 29.42 NA NA 27.87 26.04 3.769960 A Release inner ear canal 29.42 NA NA 26.28 24.42 3.769970 A Remove inner ear lesion 32.41 NA NA 29.61 27.67 4.169979 C Temporal bone surgery 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 368 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

69990 R Microsurgery add-on 3.46 NA NA 1.93 1.86 1.170010 A Contrast x-ray of brain 1.19 0.80 2.38 0.80 2.38 0.270010 TC A Contrast x-ray of brain 0.00 0.00 2.69 NA NA 0.070010 26 A Contrast x-ray of brain 1.19 0.00 0.42 0.00 0.42 0.170015 A Contrast x-ray of brain 1.19 3.01 3.09 NA NA 0.070015 TC A Contrast x-ray of brain 0.00 2.56 2.59 NA NA 0.070015 26 A Contrast x-ray of brain 1.19 0.45 0.50 0.45 0.50 0.070030 A X-ray eye for foreign body 0.17 0.63 0.66 NA NA 0.070030 TC A X-ray eye for foreign body 0.00 0.57 0.59 NA NA 0.070030 26 A X-ray eye for foreign body 0.17 0.06 0.07 0.06 0.07 0.070100 A X-ray exam of jaw 0.18 0.80 0.78 NA NA 0.070100 TC A X-ray exam of jaw 0.00 0.72 0.70 NA NA 0.070100 26 A X-ray exam of jaw 0.18 0.08 0.08 0.08 0.08 0.070110 A X-ray exam of jaw 0.25 0.85 0.90 NA NA 0.070110 TC A X-ray exam of jaw 0.00 0.75 0.80 NA NA 0.070110 26 A X-ray exam of jaw 0.25 0.10 0.10 0.10 0.10 0.070120 A X-ray exam of mastoids 0.18 0.84 0.84 NA NA 0.070120 TC A X-ray exam of mastoids 0.00 0.76 0.76 NA NA 0.070120 26 A X-ray exam of mastoids 0.18 0.08 0.08 0.08 0.08 0.070130 A X-ray exam of mastoids 0.34 1.28 1.30 NA NA 0.070130 TC A X-ray exam of mastoids 0.00 1.14 1.16 NA NA 0.070130 26 A X-ray exam of mastoids 0.34 0.14 0.14 0.14 0.14 0.070134 A X-ray exam of middle ear 0.34 0.95 1.01 NA NA 0.070134 TC A X-ray exam of middle ear 0.00 0.82 0.87 NA NA 0.070134 26 A X-ray exam of middle ear 0.34 0.13 0.14 0.13 0.14 0.070140 A X-ray exam of facial bones 0.19 0.66 0.69 NA NA 0.070140 TC A X-ray exam of facial bones 0.00 0.56 0.60 NA NA 0.070140 26 A X-ray exam of facial bones 0.19 0.10 0.09 0.10 0.09 0.070150 A X-ray exam of facial bones 0.26 0.94 0.99 NA NA 0.070150 TC A X-ray exam of facial bones 0.00 0.83 0.88 NA NA 0.0
CMS-1582-PN 369 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

70150 26 A X-ray exam of facial bones 0.26 0.11 0.11 0.11 0.11 0.070160 A X-ray exam of nasal bones 0.17 0.76 0.79 NA NA 0.070150 TC A X-ray exam of nasal bones 0.00 0.69 0.72 NA NA 0.070160 26 A X-ray exam of nasal bones 0.17 0.07 0.07 0.07 0.07 0.070170 C X-ray exam of tear duct 0.00 0.00 0.00 NA NA 0.070170 TC C X-ray exam of tear duct 0.00 0.00 0.00 NA NA 0.070170 26 A X-ray exam of tear duct 0.30 0.11 0.12 0.11 0.12 0.070190 A X-ray exam of eye sockets 0.21 0.80 0.83 NA NA 0.070190 TC A X-ray exam of eye sockets 0.00 0.71 0.74 NA NA 0.070190 26 A X-ray exam of eye sockets 0.21 0.09 0.09 0.09 0.09 0.070200 A X-ray exam of eye sockets 0.28 0.94 1.01 NA NA 0.070200 TC A X-ray exam of eye sockets 0.00 0.83 0.89 NA NA 0.070200 26 A X-ray exam of eye sockets 0.28 0.11 0.12 0.11 0.12 0.0

7020F I Mammo assess cat in dbase 0.00 0.00 0.00 0.00 0.00 0.0

70210 A X-ray exam of sinuses 0.17 0.71 0.73 NA NA 0.070210 TC A X-ray exam of sinuses 0.00 0.63 0.65 NA NA 0.070210 26 A X-ray exam of sinuses 0.17 0.08 0.08 0.08 0.08 0.070220 A X-ray exam of sinuses 0.25 0.85 0.88 NA NA 0.070220 TC A X-ray exam of sinuses 0.00 0.74 0.78 NA NA 0.070220 26 A X-ray exam of sinuses 0.25 0.11 0.10 0.11 0.10 0.070240 A X-ray exam pituitary saddle 0.19 0.64 0.67 NA NA 0.070240 TC A X-ray exam pituitary saddle 0.00 0.56 0.59 NA NA 0.070240 26 A X-ray exam pituitary saddle 0.19 0.08 0.08 0.08 0.08 0.070250 A X-ray exam of skull 0.24 0.81 0.84 NA NA 0.070250 TC A X-ray exam of skull 0.00 0.70 0.73 NA NA 0.070250 26 A X-ray exam of skull 0.24 0.11 0.11 0.11 0.11 0.070260 A X-ray exam of skull 0.34 0.99 1.04 NA NA 0.070260 TC A X-ray exam of skull 0.00 0.84 0.90 NA NA 0.070260 26 A X-ray exam of skull 0.34 0.15 0.14 0.15 0.14 0.070300 A X-ray exam of teeth 0.10 0.31 0.31 NA NA 0.0
CMS-1582-PN 370 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

70300 TC A X-ray exam of teeth 0.00 0.24 0.25 NA NA 0.070300 26 A X-ray exam of teeth 0.10 0.07 0.06 0.07 0.06 0.070310 A X-ray exam of teeth 0.16 0.97 0.93 NA NA 0.070310 TC A X-ray exam of teeth 0.00 0.86 0.84 NA NA 0.070310 26 A X-ray exam of teeth 0.16 0.11 0.09 0.11 0.09 0.070320 A Full mouth x-ray of teeth 0.22 1.25 1.25 NA NA 0.070320 TC A Full mouth x-ray of teeth 0.00 1.12 1.14 NA NA 0.070320 26 A Full mouth x-ray of teeth 0.22 0.13 0.11 0.13 0.11 0.070328 A X-ray exam of jaw joint 0.18 0.69 0.72 NA NA 0.070328 TC A X-ray exam of jaw joint 0.00 0.61 0.64 NA NA 0.070328 26 A X-ray exam of jaw joint 0.18 0.08 0.08 0.08 0.08 0.070330 A X-ray exam of jaw joints 0.24 1.12 1.17 NA NA 0.070330 TC A X-ray exam of jaw joints 0.00 1.01 1.06 NA NA 0.070330 26 A X-ray exam of jaw joints 0.24 0.11 0.11 0.11 0.11 0.070332 A X-ray exam of jaw joint 0.54 1.87 1.95 NA NA 0.070332 TC A X-ray exam of jaw joint 0.00 1.56 1.68 NA NA 0.070332 26 A X-ray exam of jaw joint 0.54 0.31 0.27 0.31 0.27 0.070336 A Magnetic image jaw joint 1.48 8.91 11.75 NA NA 0.070336 TC A Magnetic image jaw joint 0.00 8.37 11.15 NA NA 0.070336 26 A Magnetic image jaw joint 1.48 0.54 0.60 0.54 0.60 0.070350 A X-ray head for orthodontia 0.17 0.44 0.44 NA NA 0.070350 TC A X-ray head for orthodontia 0.00 0.32 0.34 NA NA 0.070350 26 A X-ray head for orthodontia 0.17 0.12 0.10 0.12 0.10 0.070355 A Panoramic x-ray of jaws 0.20 0.39 0.42 NA NA 0.070355 TC A Panoramic x-ray of jaws 0.00 0.27 0.32 NA NA 0.070355 26 A Panoramic x-ray of jaws 0.20 0.12 0.10 0.12 0.10 0.070360 A X-ray exam of neck 0.17 0.60 0.63 NA NA 0.070360 TC A X-ray exam of neck 0.00 0.53 0.56 NA NA 0.070360 26 A X-ray exam of neck 0.17 0.07 0.07 0.07 0.07 0.070370 A Throat x-ray & fluoroscopy 0.32 2.14 2.07 NA NA 0.0
CMS-1582-PN 371 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

70370 TC A Throat x-ray & fluoroscopy 0.00 2.00 1.93 NA NA 0.070370 26 A Throat x-ray & fluoroscopy 0.32 0.14 0.14 0.14 0.14 0.070371 A Speech evaluation complex 0.84 1.76 1.91 NA NA 0.070371 TC A Speech evaluation complex 0.00 1.41 1.57 NA NA 0.070371 26 A Speech evaluation complex 0.84 0.35 0.34 0.35 0.34 0.070373 A Contrast x-ray of larynx 0.44 1.92 1.97 NA NA 0.070373 TC A Contrast x-ray of larynx 0.00 1.74 1.80 NA NA 0.070373 26 A Contrast x-ray of larynx 0.44 0.18 0.17 0.18 0.17 0.070380 A X-ray exam of salivary gland 0.17 1.00 0.98 NA NA 0.070380 TC A X-ray exam of salivary gland 0.00 0.89 0.89 NA NA 0.070380 26 A X-ray exam of salivary gland 0.17 0.11 0.09 0.11 0.09 0.070390 A X-ray exam of salivary duct 0.38 2.47 2.59 NA NA 0.070390 TC A X-ray exam of salivary duct 0.00 2.32 2.43 NA NA 0.070390 26 A X-ray exam of salivary duct 0.38 0.15 0.16 0.15 0.16 0.070450 A Ct head/brain w/o dye 0.85 3.84 4.91 NA NA 0.070450 TC A Ct head/brain w/o dye 0.00 3.52 4.56 NA NA 0.070450 26 A Ct head/brain w/o dye 0.85 0.32 0.35 0.32 0.35 0.070460 A Ct head/brain w/dye 1.13 5.04 6.38 NA NA 0.070460 TC A Ct head/brain w/dye 0.00 4.61 5.91 NA NA 0.070460 26 A Ct head/brain w/dye 1.13 0.43 0.47 0.43 0.47 0.070470 A Ct head/brain w/o & w/dye 1.27 6.15 7.81 NA NA 0.070470 TC A Ct head/brain w/o & w/dye 0.00 5.67 7.28 NA NA 0.070470 26 A Ct head/brain w/o & w/dye 1.27 0.48 0.53 0.48 0.53 0.070480 A Ct orbit/ear/fossa w/o dye 1.28 6.63 7.94 NA NA 0.070480 TC A Ct orbit/ear/fossa w/o dye 0.00 6.14 7.41 NA NA 0.070480 26 A Ct orbit/ear/fossa w/o dye 1.28 0.49 0.53 0.49 0.53 0.070481 A Ct orbit/ear/fossa w/dye 1.38 7.75 9.33 NA NA 0.070481 TC A Ct orbit/ear/fossa w/dye 0.00 7.23 8.76 NA NA 0.070481 26 A Ct orbit/ear/fossa w/dye 1.38 0.52 0.57 0.52 0.57 0.070482 A Ct orbit/ear/fossa w/o&w/dye 1.45 8.68 10.65 NA NA 0.0
CMS-1582-PN 372 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

70482 TC A Ct orbit/ear/fossa w/o&w/dye 0.00 8.14 10.06 NA NA 0.070482 26 A Ct orbit/ear/fossa w/o&w/dye 1.45 0.54 0.59 0.54 0.59 0.070486 A Ct maxillofacial w/o dye 1.14 5.38 6.55 NA NA 0.070486 TC A Ct maxillofacial w/o dye 0.00 4.93 6.07 NA NA 0.070486 26 A Ct maxillofacial w/o dye 1.14 0.45 0.48 0.45 0.48 0.070487 A Ct maxillofacial w/dye 1.30 6.50 7.96 NA NA 0.070487 TC A Ct maxillofacial w/dye 0.00 6.01 7.42 NA NA 0.070487 26 A Ct maxillofacial w/dye 1.30 0.49 0.54 0.49 0.54 0.070488 A Ct maxillofacial w/o & w/dye 1.42 8.00 9.84 NA NA 0.070488 TC A Ct maxillofacial w/o & w/dye 0.00 7.47 9.26 NA NA 0.070488 26 A Ct maxillofacial w/o & w/dye 1.42 0.53 0.58 0.53 0.58 0.070490 A Ct soft tissue neck w/o dye 1.28 5.03 6.24 NA NA 0.070490 TC A Ct soft tissue neck w/o dye 0.00 4.55 5.71 NA NA 0.070490 26 A Ct soft tissue neck w/o dye 1.28 0.48 0.53 0.48 0.53 0.070491 A Ct soft tissue neck w/dye 1.38 6.25 7.69 NA NA 0.070491 TC A Ct soft tissue neck w/dye 0.00 5.72 7.12 NA NA 0.070491 26 A Ct soft tissue neck w/dye 1.38 0.53 0.57 0.53 0.57 0.070492 A Ct sft tsue nck w/o & w/dye 1.45 7.66 9.51 NA NA 0.070492 TC A Ct sft tsue nck w/o & w/dye 0.00 7.12 8.92 NA NA 0.070492 26 A Ct sft tsue nck w/o & w/dye 1.45 0.54 0.59 0.54 0.59 0.070496 A Ct angiography head 1.75 12.53 15.69 NA NA 0.170496 TC A Ct angiography head 0.00 11.88 14.96 NA NA 0.070496 26 A Ct angiography head 1.75 0.65 0.73 0.65 0.73 0.170498 A Ct angiography neck 1.75 13.03 15.99 NA NA 0.170498 TC A Ct angiography neck 0.00 12.38 15.26 NA NA 0.070498 26 A Ct angiography neck 1.75 0.65 0.73 0.65 0.73 0.170540 A Mri orbit/face/neck w/o dye 1.35 10.31 13.33 NA NA 0.070540 TC A Mri orbit/face/neck w/o dye 0.00 9.81 12.78 NA NA 0.070540 26 A Mri orbit/face/neck w/o dye 1.35 0.50 0.55 0.50 0.55 0.070542 A Mri orbit/face/neck w/dye 1.62 11.58 14.78 NA NA 0.1
CMS-1582-PN 373 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

70542 TC A Mri orbit/face/neck w/dye 0.00 10.98 14.12 NA NA 0.070542 26 A Mri orbit/face/neck w/dye 1.62 0.60 0.66 0.60 0.66 0.170543 A Mri orbt/fac/nck w/o & w/dye 2.15 13.89 19.29 NA NA 0.170543 TC A Mri orbt/fac/nck w/o & w/dye 0.00 13.10 18.42 NA NA 0.070543 26 A Mri orbt/fac/nck w/o & w/dye 2.15 0.79 0.87 0.79 0.87 0.170544 A Mr angiography head w/o dye 1.20 11.92 14.87 NA NA 0.070544 TC A Mr angiography head w/o dye 0.00 11.47 14.38 NA NA 0.070544 26 A Mr angiography head w/o dye 1.20 0.45 0.49 0.45 0.49 0.070545 A Mr angiography head w/dye 1.20 11.80 14.77 NA NA 0.070545 TC A Mr angiography head w/dye 0.00 11.36 14.28 NA NA 0.070545 26 A Mr angiography head w/dye 1.20 0.44 0.49 0.44 0.49 0.070546 A Mr angiograph head w/o&w/dye 1.80 18.05 23.36 NA NA 0.170546 TC A Mr angiograph head w/o&w/dye 0.00 17.38 22.62 NA NA 0.070546 26 A Mr angiograph head w/o&w/dye 1.80 0.67 0.74 0.67 0.74 0.170547 A Mr angiography neck w/o dye 1.20 11.91 14.84 NA NA 0.070547 TC A Mr angiography neck w/o dye 0.00 11.46 14.35 NA NA 0.070547 26 A Mr angiography neck w/o dye 1.20 0.45 0.49 0.45 0.49 0.070548 A Mr angiography neck w/dye 1.20 12.72 15.64 NA NA 0.070548 TC A Mr angiography neck w/dye 0.00 12.27 15.15 NA NA 0.070548 26 A Mr angiography neck w/dye 1.20 0.45 0.49 0.45 0.49 0.070549 A Mr angiograph neck w/o&w/dye 1.80 18.06 23.38 NA NA 0.170549 TC A Mr angiograph neck w/o&w/dye 0.00 17.39 22.64 NA NA 0.070549 26 A Mr angiograph neck w/o&w/dye 1.80 0.67 0.74 0.67 0.74 0.170551 A Mri brain w/o dye 1.48 10.79 13.71 NA NA 0.070551 TC A Mri brain w/o dye 0.00 10.24 13.10 NA NA 0.070551 26 A Mri brain w/o dye 1.48 0.55 0.61 0.55 0.61 0.070552 A Mri brain w/dye 1.78 11.92 15.15 NA NA 0.170552 TC A Mri brain w/dye 0.00 11.25 14.41 NA NA 0.070552 26 A Mri brain w/dye 1.78 0.67 0.74 0.67 0.74 0.170553 A Mri brain w/o & w/dye 2.36 13.68 18.91 NA NA 0.1
CMS-1582-PN 374 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

70553 TC A Mri brain w/o & w/dye 0.00 12.80 17.94 NA NA 0.070553 26 A Mri brain w/o & w/dye 2.36 0.88 0.97 0.88 0.97 0.170554 A Fmri brain by tech 2.11 12.01 14.61 NA NA 0.170554 TC A Fmri brain by tech 0.00 11.20 13.72 NA NA 0.070554 26 A Fmri brain by tech 2.11 0.81 0.89 0.81 0.89 0.170555 C Fmri brain by phys/psych 0.00 0.00 0.00 NA NA 0.070555 TC C Fmri brain by phys/psych 0.00 0.00 0.00 NA NA 0.070555 26 A Fmri brain by phys/psych 2.54 0.92 1.06 0.92 1.06 0.270557 C Mri brain w/o dye 0.00 0.00 0.00 NA NA 0.070557 TC C Mri brain w/o dye 0.00 0.00 0.00 NA NA 0.070557 26 A Mri brain w/o dye 2.90 1.62 1.50 1.62 1.50 1.070558 C Mri brain w/dye 0.00 0.00 0.00 NA NA 0.070558 TC C Mri brain w/dye 0.00 0.00 0.00 NA NA 0.070558 26 A Mri brain w/dye 3.20 1.20 1.33 1.20 1.33 0.370559 C Mri brain w/o & w/dye 0.00 0.00 0.00 NA NA 0.070559 TC C Mri brain w/o & w/dye 0.00 0.00 0.00 NA NA 0.070559 26 A Mri brain w/o & w/dye 3.20 1.24 1.38 1.24 1.38 0.371010 A Chest x-ray 0.18 0.46 0.50 NA NA 0.071010 TC A Chest x-ray 0.00 0.39 0.43 NA NA 0.071010 26 A Chest x-ray 0.18 0.07 0.07 0.07 0.07 0.071015 A Chest x-ray 0.21 0.62 0.66 NA NA 0.071015 TC A Chest x-ray 0.00 0.54 0.58 NA NA 0.071015 26 A Chest x-ray 0.21 0.08 0.08 0.08 0.08 0.071020 A Chest x-ray 0.22 0.62 0.68 NA NA 0.071020 TC A Chest x-ray 0.00 0.53 0.59 NA NA 0.071020 26 A Chest x-ray 0.22 0.09 0.09 0.09 0.09 0.071021 A Chest x-ray 0.27 0.79 0.84 NA NA 0.071021 TC A Chest x-ray 0.00 0.67 0.73 NA NA 0.071021 26 A Chest x-ray 0.27 0.12 0.11 0.12 0.11 0.071022 A Chest x-ray 0.31 1.00 1.05 NA NA 0.0
CMS-1582-PN 375 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

71022 TC A Chest x-ray 0.00 0.87 0.92 NA NA 0.071022 26 A Chest x-ray 0.31 0.13 0.13 0.13 0.13 0.071023 A Chest x-ray and fluoroscopy 0.38 1.60 1.65 NA NA 0.071023 TC A Chest x-ray and fluoroscopy 0.00 1.45 1.48 NA NA 0.071023 26 A Chest x-ray and fluoroscopy 0.38 0.15 0.17 0.15 0.17 0.071030 A Chest x-ray 0.31 0.96 1.04 NA NA 0.071030 TC A Chest x-ray 0.00 0.84 0.91 NA NA 0.071030 26 A Chest x-ray 0.31 0.12 0.13 0.12 0.13 0.071034 A Chest x-ray and fluoroscopy 0.46 1.90 2.15 NA NA 0.071034 TC A Chest x-ray and fluoroscopy 0.00 1.72 1.93 NA NA 0.071034 26 A Chest x-ray and fluoroscopy 0.46 0.18 0.22 0.18 0.22 0.071035 A Chest x-ray 0.18 0.81 0.85 NA NA 0.071035 TC A Chest x-ray 0.00 0.74 0.77 NA NA 0.071035 26 A Chest x-ray 0.18 0.07 0.08 0.07 0.08 0.071040 A Contrast x-ray of bronchi 0.58 2.15 2.26 NA NA 0.071040 TC A Contrast x-ray of bronchi 0.00 1.94 2.03 NA NA 0.071040 26 A Contrast x-ray of bronchi 0.58 0.21 0.23 0.21 0.23 0.071060 A Contrast x-ray of bronchi 0.74 3.22 3.39 NA NA 0.071060 TC A Contrast x-ray of bronchi 0.00 2.94 3.09 NA NA 0.071060 26 A Contrast x-ray of bronchi 0.74 0.28 0.30 0.28 0.30 0.071090 C X-ray & pacemaker insertion 0.00 0.00 0.00 NA NA 0.071090 TC C X-ray & pacemaker insertion 0.00 0.00 0.00 NA NA 0.071090 26 A X-ray & pacemaker insertion 0.54 0.21 0.26 0.21 0.26 0.071100 A X-ray exam of ribs 0.22 0.68 0.72 NA NA 0.071100 TC A X-ray exam of ribs 0.00 0.59 0.63 NA NA 0.071100 26 A X-ray exam of ribs 0.22 0.09 0.09 0.09 0.09 0.071101 A X-ray exam of ribs/chest 0.27 0.84 0.88 NA NA 0.071101 TC A X-ray exam of ribs/chest 0.00 0.73 0.77 NA NA 0.071101 26 A X-ray exam of ribs/chest 0.27 0.11 0.11 0.11 0.11 0.071110 A X-ray exam of ribs 0.27 0.88 0.92 NA NA 0.0
CMS-1582-PN 376 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

71110 TC A X-ray exam of ribs 0.00 0.76 0.81 NA NA 0.071110 26 A X-ray exam of ribs 0.27 0.12 0.11 0.12 0.11 0.071111 A X-ray exam of ribs/chest 0.32 1.17 1.22 NA NA 0.071111 TC A X-ray exam of ribs/chest 0.00 1.04 1.09 NA NA 0.071111 26 A X-ray exam of ribs/chest 0.32 0.13 0.13 0.13 0.13 0.071120 A X-ray exam of breastbone 0.20 0.67 0.73 NA NA 0.071120 TC A X-ray exam of breastbone 0.00 0.59 0.65 NA NA 0.071120 26 A X-ray exam of breastbone 0.20 0.08 0.08 0.08 0.08 0.071130 A X-ray exam of breastbone 0.22 0.81 0.87 NA NA 0.071130 TC A X-ray exam of breastbone 0.00 0.72 0.78 NA NA 0.071130 26 A X-ray exam of breastbone 0.22 0.09 0.09 0.09 0.09 0.071250 A Ct thorax w/o dye 1.00 4.94 6.35 NA NA 0.071250 TC A Ct thorax w/o dye 0.00 4.57 5.90 NA NA 0.071250 26 A Ct thorax w/o dye 1.00 0.37 0.45 0.37 0.45 0.071260 A Ct thorax w/dye 1.24 6.21 7.87 NA NA 0.071260 TC A Ct thorax w/dye 0.00 5.74 7.35 NA NA 0.071260 26 A Ct thorax w/dye 1.24 0.47 0.52 0.47 0.52 0.071270 A Ct thorax w/o & w/dye 1.38 7.69 9.82 NA NA 0.071270 TC A Ct thorax w/o & w/dye 0.00 7.18 9.25 NA NA 0.071270 26 A Ct thorax w/o & w/dye 1.38 0.51 0.57 0.51 0.57 0.071275 A Ct angiography chest 1.92 9.41 12.00 NA NA 0.171275 TC A Ct angiography chest 0.00 8.70 11.20 NA NA 0.071275 26 A Ct angiography chest 1.92 0.71 0.80 0.71 0.80 0.171550 A Mri chest w/o dye 1.46 11.97 15.14 NA NA 0.071550 TC A Mri chest w/o dye 0.00 11.43 14.55 NA NA 0.071550 26 A Mri chest w/o dye 1.46 0.54 0.59 0.54 0.59 0.071551 A Mri chest w/dye 1.73 13.53 16.97 NA NA 0.171551 TC A Mri chest w/dye 0.00 12.88 16.27 NA NA 0.071551 26 A Mri chest w/dye 1.73 0.65 0.70 0.65 0.70 0.171552 A Mri chest w/o & w/dye 2.26 16.63 22.39 NA NA 0.1
CMS-1582-PN 377 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

71552 TC A Mri chest w/o & w/dye 0.00 15.79 21.45 NA NA 0.071552 26 A Mri chest w/o & w/dye 2.26 0.84 0.94 0.84 0.94 0.171555 R Mri angio chest w or w/o dye 1.81 11.54 14.47 NA NA 0.171555 TC R Mri angio chest w or w/o dye 0.00 10.86 13.71 NA NA 0.071555 26 R Mri angio chest w or w/o dye 1.81 0.68 0.76 0.68 0.76 0.172010 A X-ray exam of spine 0.45 1.76 1.71 NA NA 0.072010 TC A X-ray exam of spine 0.00 1.55 1.52 NA NA 0.072010 26 A X-ray exam of spine 0.45 0.21 0.19 0.21 0.19 0.072020 A X-ray exam of spine 0.15 0.50 0.54 NA NA 0.072020 TC A X-ray exam of spine 0.00 0.44 0.47 NA NA 0.072020 26 A X-ray exam of spine 0.15 0.06 0.07 0.06 0.07 0.072040 A X-ray exam of neck spine 0.22 0.89 0.90 NA NA 0.072040 TC A X-ray exam of neck spine 0.00 0.79 0.80 NA NA 0.072040 26 A X-ray exam of neck spine 0.22 0.10 0.10 0.10 0.10 0.072050 A X-ray exam of neck spine 0.31 1.16 1.22 NA NA 0.072050 TC A X-ray exam of neck spine 0.00 1.04 1.09 NA NA 0.072050 26 A X-ray exam of neck spine 0.31 0.12 0.13 0.12 0.13 0.072052 A X-ray exam of neck spine 0.36 1.54 1.59 NA NA 0.072052 TC A X-ray exam of neck spine 0.00 1.39 1.44 NA NA 0.072052 26 A X-ray exam of neck spine 0.36 0.15 0.15 0.15 0.15 0.072069 A X-ray exam of trunk spine 0.22 0.85 0.85 NA NA 0.072069 TC A X-ray exam of trunk spine 0.00 0.75 0.75 NA NA 0.072069 26 A X-ray exam of trunk spine 0.22 0.10 0.10 0.10 0.10 0.072070 A X-ray exam of thoracic spine 0.22 0.72 0.77 NA NA 0.072070 TC A X-ray exam of thoracic spine 0.00 0.62 0.67 NA NA 0.072070 26 A X-ray exam of thoracic spine 0.22 0.10 0.10 0.10 0.10 0.072072 A X-ray exam of thoracic spine 0.22 0.81 0.88 NA NA 0.072072 TC A X-ray exam of thoracic spine 0.00 0.73 0.79 NA NA 0.072072 26 A X-ray exam of thoracic spine 0.22 0.08 0.09 0.08 0.09 0.072074 A X-ray exam of thoracic spine 0.22 1.01 1.08 NA NA 0.0
CMS-1582-PN 378 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

72074 TC A X-ray exam of thoracic spine 0.00 0.92 0.99 NA NA 0.072074 26 A X-ray exam of thoracic spine 0.22 0.09 0.09 0.09 0.09 0.072080 A X-ray exam of trunk spine 0.22 0.80 0.83 NA NA 0.072080 TC A X-ray exam of trunk spine 0.00 0.70 0.73 NA NA 0.072080 26 A X-ray exam of trunk spine 0.22 0.10 0.10 0.10 0.10 0.072090 A X-ray exam of trunk spine 0.28 1.14 1.14 NA NA 0.072090 TC A X-ray exam of trunk spine 0.00 1.01 1.01 NA NA 0.072090 26 A X-ray exam of trunk spine 0.28 0.13 0.13 0.13 0.13 0.072100 A X-ray exam of lower spine 0.22 0.94 0.95 NA NA 0.072100 TC A X-ray exam of lower spine 0.00 0.84 0.85 NA NA 0.072100 26 A X-ray exam of lower spine 0.22 0.10 0.10 0.10 0.10 0.072110 A X-ray exam of lower spine 0.31 1.25 1.30 NA NA 0.072110 TC A X-ray exam of lower spine 0.00 1.12 1.17 NA NA 0.072110 26 A X-ray exam of lower spine 0.31 0.13 0.13 0.13 0.13 0.072114 A X-ray exam of lower spine 0.36 1.77 1.80 NA NA 0.072114 TC A X-ray exam of lower spine 0.00 1.61 1.64 NA NA 0.072114 26 A X-ray exam of lower spine 0.36 0.16 0.16 0.16 0.16 0.072120 A X-ray exam of lower spine 0.22 1.28 1.27 NA NA 0.072120 TC A X-ray exam of lower spine 0.00 1.17 1.17 NA NA 0.072120 26 A X-ray exam of lower spine 0.22 0.11 0.10 0.11 0.10 0.072125 A Ct neck spine w/o dye 1.00 4.99 6.39 NA NA 0.072125 TC A Ct neck spine w/o dye 0.00 4.62 5.94 NA NA 0.072125 26 A Ct neck spine w/o dye 1.00 0.37 0.45 0.37 0.45 0.072126 A Ct neck spine w/dye 1.22 6.22 7.87 NA NA 0.072126 TC A Ct neck spine w/dye 0.00 5.77 7.37 NA NA 0.072126 26 A Ct neck spine w/dye 1.22 0.45 0.50 0.45 0.50 0.072127 A Ct neck spine w/o & w/dye 1.27 7.66 9.76 NA NA 0.072127 TC A Ct neck spine w/o & w/dye 0.00 7.19 9.24 NA NA 0.072127 26 A Ct neck spine w/o & w/dye 1.27 0.47 0.52 0.47 0.52 0.072128 A Ct chest spine w/o dye 1.00 4.98 6.38 NA NA 0.0
CMS-1582-PN 379 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

72128 TC A Ct chest spine w/o dye 0.00 4.61 5.93 NA NA 0.072128 26 A Ct chest spine w/o dye 1.00 0.37 0.45 0.37 0.45 0.072129 A Ct chest spine w/dye 1.22 6.25 7.89 NA NA 0.072129 TC A Ct chest spine w/dye 0.00 5.79 7.38 NA NA 0.072129 26 A Ct chest spine w/dye 1.22 0.46 0.51 0.46 0.51 0.072130 A Ct chest spine w/o & w/dye 1.27 7.66 9.77 NA NA 0.072130 TC A Ct chest spine w/o & w/dye 0.00 7.19 9.25 NA NA 0.072130 26 A Ct chest spine w/o & w/dye 1.27 0.47 0.52 0.47 0.52 0.072131 A Ct lumbar spine w/o dye 1.00 4.97 6.36 NA NA 0.072131 TC A Ct lumbar spine w/o dye 0.00 4.59 5.91 NA NA 0.072131 26 A Ct lumbar spine w/o dye 1.00 0.38 0.45 0.38 0.45 0.072132 A Ct lumbar spine w/dye 1.22 6.22 7.87 NA NA 0.072132 TC A Ct lumbar spine w/dye 0.00 5.77 7.36 NA NA 0.072132 26 A Ct lumbar spine w/dye 1.22 0.45 0.51 0.45 0.51 0.072133 A Ct lumbar spine w/o & w/dye 1.27 7.65 9.76 NA NA 0.072133 TC A Ct lumbar spine w/o & w/dye 0.00 7.18 9.24 NA NA 0.072133 26 A Ct lumbar spine w/o & w/dye 1.27 0.47 0.52 0.47 0.52 0.072141 A Mri neck spine w/o dye 1.60 9.32 12.08 NA NA 0.172141 TC A Mri neck spine w/o dye 0.00 8.71 11.42 NA NA 0.072141 26 A Mri neck spine w/o dye 1.60 0.61 0.66 0.61 0.66 0.172142 A Mri neck spine w/dye 1.92 12.02 15.21 NA NA 0.172142 TC A Mri neck spine w/dye 0.00 11.29 14.42 NA NA 0.072142 26 A Mri neck spine w/dye 1.92 0.73 0.79 0.73 0.79 0.172146 A Mri chest spine w/o dye 1.60 9.33 12.28 NA NA 0.172146 TC A Mri chest spine w/o dye 0.00 8.73 11.62 NA NA 0.072146 26 A Mri chest spine w/o dye 1.60 0.60 0.66 0.60 0.66 0.172147 A Mri chest spine w/dye 1.92 10.48 13.52 NA NA 0.172147 TC A Mri chest spine w/dye 0.00 9.75 12.72 NA NA 0.072147 26 A Mri chest spine w/dye 1.92 0.73 0.80 0.73 0.80 0.172148 A Mri lumbar spine w/o dye 1.48 9.26 12.21 NA NA 0.1
CMS-1582-PN 380 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

72148 TC A Mri lumbar spine w/o dye 0.00 8.70 11.60 NA NA 0.072148 26 A Mri lumbar spine w/o dye 1.48 0.56 0.61 0.56 0.61 0.172149 A Mri lumbar spine w/dye 1.78 11.81 15.07 NA NA 0.172149 TC A Mri lumbar spine w/dye 0.00 11.13 14.33 NA NA 0.072149 26 A Mri lumbar spine w/dye 1.78 0.68 0.74 0.68 0.74 0.172156 A Mri neck spine w/o & w/dye 2.57 13.48 18.69 NA NA 0.172156 TC A Mri neck spine w/o & w/dye 0.00 12.52 17.63 NA NA 0.072156 26 A Mri neck spine w/o & w/dye 2.57 0.96 1.06 0.96 1.06 0.172157 A Mri chest spine w/o & w/dye 2.57 12.37 17.42 NA NA 0.172157 TC A Mri chest spine w/o & w/dye 0.00 11.41 16.36 NA NA 0.072157 26 A Mri chest spine w/o & w/dye 2.57 0.96 1.06 0.96 1.06 0.172158 A Mri lumbar spine w/o & w/dye 2.36 13.35 18.56 NA NA 0.172158 TC A Mri lumbar spine w/o & w/dye 0.00 12.46 17.59 NA NA 0.072158 26 A Mri lumbar spine w/o & w/dye 2.36 0.89 0.97 0.89 0.97 0.172159 R Mr angio spine w/o&w/dye 1.80 13.63 16.23 NA NA 0.072159 TC R Mr angio spine w/o&w/dye 0.00 12.84 15.45 NA NA 0.072159 26 R Mr angio spine w/o&w/dye 1.80 0.79 0.78 0.79 0.78 0.072170 A X-ray exam of pelvis 0.17 0.57 0.60 NA NA 0.072170 TC A X-ray exam of pelvis 0.00 0.49 0.52 NA NA 0.072170 26 A X-ray exam of pelvis 0.17 0.08 0.08 0.08 0.08 0.072190 A X-ray exam of pelvis 0.21 0.99 1.00 NA NA 0.072190 TC A X-ray exam of pelvis 0.00 0.89 0.90 NA NA 0.072190 26 A X-ray exam of pelvis 0.21 0.10 0.10 0.10 0.10 0.072191 A Ct angiograph pelv w/o&w/dye 1.81 8.94 11.52 NA NA 0.172191 TC A Ct angiograph pelv w/o&w/dye 0.00 8.27 10.77 NA NA 0.072191 26 A Ct angiograph pelv w/o&w/dye 1.81 0.67 0.75 0.67 0.75 0.172192 A Ct pelvis w/o dye 1.09 4.69 6.03 NA NA 0.072192 TC A Ct pelvis w/o dye 0.00 4.28 5.58 NA NA 0.072192 26 A Ct pelvis w/o dye 1.09 0.41 0.45 0.41 0.45 0.072193 A Ct pelvis w/dye 1.16 5.87 7.46 NA NA 0.0
CMS-1582-PN 381 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

72193 TC A Ct pelvis w/dye 0.00 5.44 6.98 NA NA 0.072193 26 A Ct pelvis w/dye 1.16 0.43 0.48 0.43 0.48 0.072194 A Ct pelvis w/o & w/dye 1.22 7.78 9.84 NA NA 0.072194 TC A Ct pelvis w/o & w/dye 0.00 7.33 9.34 NA NA 0.072194 26 A Ct pelvis w/o & w/dye 1.22 0.45 0.50 0.45 0.50 0.072195 A Mri pelvis w/o dye 1.46 10.67 13.63 NA NA 0.172195 TC A Mri pelvis w/o dye 0.00 10.12 13.03 NA NA 0.072195 26 A Mri pelvis w/o dye 1.46 0.55 0.60 0.55 0.60 0.172196 A Mri pelvis w/dye 1.73 11.76 14.99 NA NA 0.172196 TC A Mri pelvis w/dye 0.00 11.11 14.27 NA NA 0.072196 26 A Mri pelvis w/dye 1.73 0.65 0.72 0.65 0.72 0.172197 A Mri pelvis w/o & w/dye 2.26 14.17 19.54 NA NA 0.172197 TC A Mri pelvis w/o & w/dye 0.00 13.33 18.61 NA NA 0.072197 26 A Mri pelvis w/o & w/dye 2.26 0.84 0.93 0.84 0.93 0.172198 A Mr angio pelvis w/o & w/dye 1.80 11.52 14.41 NA NA 0.172198 TC A Mr angio pelvis w/o & w/dye 0.00 10.86 13.67 NA NA 0.072198 26 A Mr angio pelvis w/o & w/dye 1.80 0.66 0.74 0.66 0.74 0.172200 A X-ray exam sacroiliac joints 0.17 0.65 0.69 NA NA 0.072200 TC A X-ray exam sacroiliac joints 0.00 0.58 0.62 NA NA 0.072200 26 A X-ray exam sacroiliac joints 0.17 0.07 0.07 0.07 0.07 0.072202 A X-ray exam sacroiliac joints 0.19 0.76 0.82 NA NA 0.072202 TC A X-ray exam sacroiliac joints 0.00 0.69 0.74 NA NA 0.072202 26 A X-ray exam sacroiliac joints 0.19 0.07 0.08 0.07 0.08 0.072220 A X-ray exam of tailbone 0.17 0.63 0.68 NA NA 0.072220 TC A X-ray exam of tailbone 0.00 0.56 0.61 NA NA 0.072220 26 A X-ray exam of tailbone 0.17 0.07 0.07 0.07 0.07 0.072240 A Contrast x-ray of neck spine 0.91 2.73 3.31 NA NA 0.072240 TC A Contrast x-ray of neck spine 0.00 2.38 2.93 NA NA 0.072240 26 A Contrast x-ray of neck spine 0.91 0.35 0.38 0.35 0.38 0.072255 A Contrast x-ray thorax spine 0.91 2.65 3.06 NA NA 0.0
CMS-1582-PN 382 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

72255 TC A Contrast x-ray thorax spine 0.00 2.28 2.69 NA NA 0.072255 26 A Contrast x-ray thorax spine 0.91 0.37 0.37 0.37 0.37 0.072265 A Contrast x-ray lower spine 0.83 2.75 3.20 NA NA 0.072265 TC A Contrast x-ray lower spine 0.00 2.42 2.85 NA NA 0.072265 26 A Contrast x-ray lower spine 0.83 0.33 0.35 0.33 0.35 0.072270 A Contrast x-ray spine 1.33 4.24 4.94 NA NA 0.072270 TC A Contrast x-ray spine 0.00 3.73 4.39 NA NA 0.072270 26 A Contrast x-ray spine 1.33 0.51 0.55 0.51 0.55 0.072275 A Epidurography 0.76 2.68 2.49 NA NA 0.072275 TC A Epidurography 0.00 2.30 2.17 NA NA 0.072275 26 A Epidurography 0.76 0.38 0.32 0.38 0.32 0.072285 A X-ray c/t spine disk 1.16 2.26 3.14 NA NA 0.072285 TC A X-ray c/t spine disk 0.00 1.66 2.63 NA NA 0.072285 26 A X-ray c/t spine disk 1.16 0.60 0.51 0.60 0.51 0.072291 C Perq verte/sacroplsty fluor 0.00 0.00 0.00 NA NA 0.072291 TC C Perq verte/sacroplsty fluor 0.00 0.00 0.00 NA NA 0.072291 26 A Perq verte/sacroplsty fluor 1.31 0.60 0.61 0.60 0.61 0.272292 C Perq verte/sacroplsty ct 0.00 0.00 0.00 NA NA 0.072292 TC C Perq verte/sacroplsty ct 0.00 0.00 0.00 NA NA 0.072292 26 A Perq verte/sacroplsty ct 1.38 0.58 0.62 0.58 0.62 0.272295 A X-ray of lower spine disk 0.83 2.12 2.96 NA NA 0.072295 TC A X-ray of lower spine disk 0.00 1.70 2.59 NA NA 0.072295 26 A X-ray of lower spine disk 0.83 0.42 0.37 0.42 0.37 0.073000 A X-ray exam of collar bone 0.16 0.66 0.67 NA NA 0.073000 TC A X-ray exam of collar bone 0.00 0.58 0.60 NA NA 0.073000 26 A X-ray exam of collar bone 0.16 0.08 0.07 0.08 0.07 0.073010 A X-ray exam of shoulder blade 0.17 0.70 0.70 NA NA 0.073010 TC A X-ray exam of shoulder blade 0.00 0.62 0.62 NA NA 0.073010 26 A X-ray exam of shoulder blade 0.17 0.08 0.08 0.08 0.08 0.073020 A X-ray exam of shoulder 0.15 0.52 0.53 NA NA 0.0
CMS-1582-PN 383 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

73020 TC A X-ray exam of shoulder 0.00 0.45 0.47 NA NA 0.073020 26 A X-ray exam of shoulder 0.15 0.07 0.06 0.07 0.06 0.073030 A X-ray exam of shoulder 0.18 0.68 0.70 NA NA 0.073030 TC A X-ray exam of shoulder 0.00 0.59 0.61 NA NA 0.073030 26 A X-ray exam of shoulder 0.18 0.09 0.09 0.09 0.09 0.073040 A Contrast x-ray of shoulder 0.54 2.46 2.60 NA NA 0.073040 TC A Contrast x-ray of shoulder 0.00 2.24 2.37 NA NA 0.073040 26 A Contrast x-ray of shoulder 0.54 0.22 0.23 0.22 0.23 0.073050 A X-ray exam of shoulders 0.20 0.91 0.90 NA NA 0.073050 TC A X-ray exam of shoulders 0.00 0.81 0.80 NA NA 0.073050 26 A X-ray exam of shoulders 0.20 0.10 0.10 0.10 0.10 0.073060 A X-ray exam of humerus 0.17 0.65 0.68 NA NA 0.073060 TC A X-ray exam of humerus 0.00 0.57 0.60 NA NA 0.073060 26 A X-ray exam of humerus 0.17 0.08 0.08 0.08 0.08 0.073070 A X-ray exam of elbow 0.15 0.65 0.67 NA NA 0.073070 TC A X-ray exam of elbow 0.00 0.58 0.60 NA NA 0.073070 26 A X-ray exam of elbow 0.15 0.07 0.07 0.07 0.07 0.073080 A X-ray exam of elbow 0.17 0.77 0.82 NA NA 0.073080 TC A X-ray exam of elbow 0.00 0.70 0.75 NA NA 0.073080 26 A X-ray exam of elbow 0.17 0.07 0.07 0.07 0.07 0.073085 A Contrast x-ray of elbow 0.54 2.21 2.31 NA NA 0.073085 TC A Contrast x-ray of elbow 0.00 1.96 2.07 NA NA 0.073085 26 A Contrast x-ray of elbow 0.54 0.25 0.24 0.25 0.24 0.073090 A X-ray exam of forearm 0.16 0.62 0.65 NA NA 0.073090 TC A X-ray exam of forearm 0.00 0.55 0.58 NA NA 0.073090 26 A X-ray exam of forearm 0.16 0.07 0.07 0.07 0.07 0.073092 A X-ray exam of arm infant 0.16 0.76 0.73 NA NA 0.073092 TC A X-ray exam of arm infant 0.00 0.69 0.66 NA NA 0.073092 26 A X-ray exam of arm infant 0.16 0.07 0.07 0.07 0.07 0.073100 A X-ray exam of wrist 0.16 0.73 0.72 NA NA 0.0
CMS-1582-PN 384 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

73100 TC A X-ray exam of wrist 0.00 0.65 0.64 NA NA 0.073100 26 A X-ray exam of wrist 0.16 0.08 0.08 0.08 0.08 0.073110 A X-ray exam of wrist 0.17 0.89 0.89 NA NA 0.073110 TC A X-ray exam of wrist 0.00 0.81 0.81 NA NA 0.073110 26 A X-ray exam of wrist 0.17 0.08 0.08 0.08 0.08 0.073115 A Contrast x-ray of wrist 0.54 2.66 2.64 NA NA 0.073115 TC A Contrast x-ray of wrist 0.00 2.41 2.39 NA NA 0.073115 26 A Contrast x-ray of wrist 0.54 0.25 0.25 0.25 0.25 0.073120 A X-ray exam of hand 0.16 0.62 0.64 NA NA 0.073120 TC A X-ray exam of hand 0.00 0.55 0.57 NA NA 0.073120 26 A X-ray exam of hand 0.16 0.07 0.07 0.07 0.07 0.073130 A X-ray exam of hand 0.17 0.75 0.76 NA NA 0.073130 TC A X-ray exam of hand 0.00 0.67 0.69 NA NA 0.073130 26 A X-ray exam of hand 0.17 0.08 0.07 0.08 0.07 0.073140 A X-ray exam of finger(s) 0.13 0.81 0.78 NA NA 0.073140 TC A X-ray exam of finger(s) 0.00 0.75 0.72 NA NA 0.073140 26 A X-ray exam of finger(s) 0.13 0.06 0.06 0.06 0.06 0.073200 A Ct upper extremity w/o dye 1.00 4.93 6.17 NA NA 0.073200 TC A Ct upper extremity w/o dye 0.00 4.56 5.74 NA NA 0.073200 26 A Ct upper extremity w/o dye 1.00 0.37 0.43 0.37 0.43 0.073201 A Ct upper extremity w/dye 1.16 6.15 7.61 NA NA 0.073201 TC A Ct upper extremity w/dye 0.00 5.71 7.13 NA NA 0.073201 26 A Ct upper extremity w/dye 1.16 0.44 0.48 0.44 0.48 0.073202 A Ct uppr extremity w/o&w/dye 1.22 8.09 10.02 NA NA 0.073202 TC A Ct uppr extremity w/o&w/dye 0.00 7.63 9.52 NA NA 0.073202 26 A Ct uppr extremity w/o&w/dye 1.22 0.46 0.50 0.46 0.50 0.073206 A Ct angio upr extrm w/o&w/dye 1.81 8.48 10.93 NA NA 0.073206 TC A Ct angio upr extrm w/o&w/dye 0.00 7.81 10.17 NA NA 0.073206 26 A Ct angio upr extrm w/o&w/dye 1.81 0.67 0.76 0.67 0.76 0.073218 A Mri upper extremity w/o dye 1.35 10.93 13.86 NA NA 0.0
CMS-1582-PN 385 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

73218 TC A Mri upper extremity w/o dye 0.00 10.40 13.30 NA NA 0.073218 26 A Mri upper extremity w/o dye 1.35 0.53 0.56 0.53 0.56 0.073219 A Mri upper extremity w/dye 1.62 11.43 14.82 NA NA 0.173219 TC A Mri upper extremity w/dye 0.00 10.82 14.15 NA NA 0.073219 26 A Mri upper extremity w/dye 1.62 0.61 0.67 0.61 0.67 0.173220 A Mri uppr extremity w/o&w/dye 2.15 14.21 19.58 NA NA 0.173220 TC A Mri uppr extremity w/o&w/dye 0.00 13.40 18.69 NA NA 0.073220 26 A Mri uppr extremity w/o&w/dye 2.15 0.81 0.89 0.81 0.89 0.173221 A Mri joint upr extrem w/o dye 1.35 10.12 12.95 NA NA 0.173221 TC A Mri joint upr extrem w/o dye 0.00 9.59 12.38 NA NA 0.073221 26 A Mri joint upr extrem w/o dye 1.35 0.53 0.57 0.53 0.57 0.173222 A Mri joint upr extrem w/dye 1.62 10.75 13.97 NA NA 0.173222 TC A Mri joint upr extrem w/dye 0.00 10.14 13.30 NA NA 0.073222 26 A Mri joint upr extrem w/dye 1.62 0.61 0.67 0.61 0.67 0.173223 A Mri joint upr extr w/o&w/dye 2.15 13.25 18.47 NA NA 0.173223 TC A Mri joint upr extr w/o&w/dye 0.00 12.43 17.59 NA NA 0.073223 26 A Mri joint upr extr w/o&w/dye 2.15 0.82 0.88 0.82 0.88 0.173225 R Mr angio upr extr w/o&w/dye 1.73 13.60 16.01 NA NA 0.073225 TC R Mr angio upr extr w/o&w/dye 0.00 12.84 15.26 NA NA 0.073225 26 R Mr angio upr extr w/o&w/dye 1.73 0.76 0.75 0.76 0.75 0.073500 A X-ray exam of hip 0.17 0.58 0.59 NA NA 0.073500 TC A X-ray exam of hip 0.00 0.50 0.51 NA NA 0.073500 26 A X-ray exam of hip 0.17 0.08 0.08 0.08 0.08 0.073510 A X-ray exam of hip 0.21 0.89 0.90 NA NA 0.073510 TC A X-ray exam of hip 0.00 0.79 0.80 NA NA 0.073510 26 A X-ray exam of hip 0.21 0.10 0.10 0.10 0.10 0.073520 A X-ray exam of hips 0.26 0.89 0.91 NA NA 0.073520 TC A X-ray exam of hips 0.00 0.77 0.80 NA NA 0.073520 26 A X-ray exam of hips 0.26 0.12 0.11 0.12 0.11 0.073525 A Contrast x-ray of hip 0.54 2.37 2.38 NA NA 0.0
CMS-1582-PN 386 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

73525 TC A Contrast x-ray of hip 0.00 2.11 2.13 NA NA 0.073525 26 A Contrast x-ray of hip 0.54 0.26 0.25 0.26 0.25 0.073530 C X-ray exam of hip 0.00 0.00 0.00 NA NA 0.073530 TC C X-ray exam of hip 0.00 0.00 0.00 NA NA 0.073530 26 A X-ray exam of hip 0.29 0.11 0.12 0.11 0.12 0.073540 A X-ray exam of pelvis & hips 0.20 1.03 0.97 NA NA 0.073540 TC A X-ray exam of pelvis & hips 0.00 0.93 0.88 NA NA 0.073540 26 A X-ray exam of pelvis & hips 0.20 0.10 0.09 0.10 0.09 0.073542 A X-ray exam sacroiliac joint 0.59 1.85 1.81 NA NA 0.073542 TC A X-ray exam sacroiliac joint 0.00 1.56 1.56 NA NA 0.073542 26 A X-ray exam sacroiliac joint 0.59 0.29 0.25 0.29 0.25 0.073550 A X-ray exam of thigh 0.17 0.62 0.64 NA NA 0.073550 TC A X-ray exam of thigh 0.00 0.54 0.57 NA NA 0.073550 26 A X-ray exam of thigh 0.17 0.08 0.07 0.08 0.07 0.073560 A X-ray exam of knee 1 or 2 0.17 0.69 0.70 NA NA 0.073560 TC A X-ray exam of knee 1 or 2 0.00 0.61 0.62 NA NA 0.073560 26 A X-ray exam of knee 1 or 2 0.17 0.08 0.08 0.08 0.08 0.073562 A X-ray exam of knee 3 0.18 0.87 0.87 NA NA 0.073562 TC A X-ray exam of knee 3 0.00 0.78 0.78 NA NA 0.073562 26 A X-ray exam of knee 3 0.18 0.09 0.09 0.09 0.09 0.073564 A X-ray exam knee 4 or more 0.22 1.00 0.99 NA NA 0.073564 TC A X-ray exam knee 4 or more 0.00 0.90 0.89 NA NA 0.073564 26 A X-ray exam knee 4 or more 0.22 0.10 0.10 0.10 0.10 0.073565 A X-ray exam of knees 0.17 0.83 0.80 NA NA 0.073565 TC A X-ray exam of knees 0.00 0.74 0.71 NA NA 0.073565 26 A X-ray exam of knees 0.17 0.09 0.09 0.09 0.09 0.073580 A Contrast x-ray of knee joint 0.54 3.42 3.30 NA NA 0.073580 TC A Contrast x-ray of knee joint 0.00 3.13 3.03 NA NA 0.073580 26 A Contrast x-ray of knee joint 0.54 0.29 0.27 0.29 0.27 0.073590 A X-ray exam of lower leg 0.17 0.60 0.63 NA NA 0.0
CMS-1582-PN 387 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

73590 TC A X-ray exam of lower leg 0.00 0.53 0.56 NA NA 0.073590 26 A X-ray exam of lower leg 0.17 0.07 0.07 0.07 0.07 0.073592 A X-ray exam of leg infant 0.16 0.79 0.74 NA NA 0.073592 TC A X-ray exam of leg infant 0.00 0.71 0.67 NA NA 0.073592 26 A X-ray exam of leg infant 0.16 0.08 0.07 0.08 0.07 0.073600 A X-ray exam of ankle 0.16 0.65 0.66 NA NA 0.073600 TC A X-ray exam of ankle 0.00 0.58 0.59 NA NA 0.073600 26 A X-ray exam of ankle 0.16 0.07 0.07 0.07 0.07 0.073610 A X-ray exam of ankle 0.17 0.78 0.77 NA NA 0.073610 TC A X-ray exam of ankle 0.00 0.70 0.70 NA NA 0.073610 26 A X-ray exam of ankle 0.17 0.08 0.07 0.08 0.07 0.073615 A Contrast x-ray of ankle 0.54 2.51 2.49 NA NA 0.073615 TC A Contrast x-ray of ankle 0.00 2.24 2.24 NA NA 0.073615 26 A Contrast x-ray of ankle 0.54 0.27 0.25 0.27 0.25 0.073620 A X-ray exam of foot 0.16 0.63 0.63 NA NA 0.073620 TC A X-ray exam of foot 0.00 0.57 0.57 NA NA 0.073620 26 A X-ray exam of foot 0.16 0.06 0.06 0.06 0.06 0.073630 A X-ray exam of foot 0.17 0.72 0.75 NA NA 0.073630 TC A X-ray exam of foot 0.00 0.65 0.68 NA NA 0.073630 26 A X-ray exam of foot 0.17 0.07 0.07 0.07 0.07 0.073650 A X-ray exam of heel 0.16 0.65 0.65 NA NA 0.073650 TC A X-ray exam of heel 0.00 0.58 0.58 NA NA 0.073650 26 A X-ray exam of heel 0.16 0.07 0.07 0.07 0.07 0.073660 A X-ray exam of toe(s) 0.13 0.73 0.72 NA NA 0.073660 TC A X-ray exam of toe(s) 0.00 0.67 0.67 NA NA 0.073660 26 A X-ray exam of toe(s) 0.13 0.06 0.05 0.06 0.05 0.073700 A Ct lower extremity w/o dye 1.00 4.94 6.18 NA NA 0.073700 TC A Ct lower extremity w/o dye 0.00 4.57 5.75 NA NA 0.073700 26 A Ct lower extremity w/o dye 1.00 0.37 0.43 0.37 0.43 0.073701 A Ct lower extremity w/dye 1.16 6.23 7.69 NA NA 0.0
CMS-1582-PN 388 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

73701 TC A Ct lower extremity w/dye 0.00 5.80 7.21 NA NA 0.073701 26 A Ct lower extremity w/dye 1.16 0.43 0.48 0.43 0.48 0.073702 A Ct lwr extremity w/o&w/dye 1.22 8.16 10.08 NA NA 0.073702 TC A Ct lwr extremity w/o&w/dye 0.00 7.70 9.57 NA NA 0.073702 26 A Ct lwr extremity w/o&w/dye 1.22 0.46 0.51 0.46 0.51 0.073706 A Ct angio lwr extr w/o&w/dye 1.90 9.53 12.10 NA NA 0.173706 TC A Ct angio lwr extr w/o&w/dye 0.00 8.82 11.30 NA NA 0.073706 26 A Ct angio lwr extr w/o&w/dye 1.90 0.71 0.80 0.71 0.80 0.173718 A Mri lower extremity w/o dye 1.35 10.64 13.54 NA NA 0.073718 TC A Mri lower extremity w/o dye 0.00 10.13 12.99 NA NA 0.073718 26 A Mri lower extremity w/o dye 1.35 0.51 0.55 0.51 0.55 0.073719 A Mri lower extremity w/dye 1.62 11.55 14.77 NA NA 0.173719 TC A Mri lower extremity w/dye 0.00 10.95 14.11 NA NA 0.073719 26 A Mri lower extremity w/dye 1.62 0.60 0.66 0.60 0.66 0.173720 A Mri lwr extremity w/o&w/dye 2.15 14.26 19.60 NA NA 0.173720 TC A Mri lwr extremity w/o&w/dye 0.00 13.46 18.72 NA NA 0.073720 26 A Mri lwr extremity w/o&w/dye 2.15 0.80 0.88 0.80 0.88 0.173721 A Mri jnt of lwr extre w/o dye 1.35 10.38 13.22 NA NA 0.173721 TC A Mri jnt of lwr extre w/o dye 0.00 9.85 12.66 NA NA 0.073721 26 A Mri jnt of lwr extre w/o dye 1.35 0.53 0.56 0.53 0.56 0.173722 A Mri joint of lwr extr w/dye 1.62 11.08 14.22 NA NA 0.173722 TC A Mri joint of lwr extr w/dye 0.00 10.46 13.54 NA NA 0.073722 26 A Mri joint of lwr extr w/dye 1.62 0.62 0.68 0.62 0.68 0.173723 A Mri joint lwr extr w/o&w/dye 2.15 13.24 18.43 NA NA 0.173723 TC A Mri joint lwr extr w/o&w/dye 0.00 12.43 17.55 NA NA 0.073723 26 A Mri joint lwr extr w/o&w/dye 2.15 0.81 0.88 0.81 0.88 0.173725 R Mr ang lwr ext w or w/o dye 1.82 11.56 14.43 NA NA 0.173725 TC R Mr ang lwr ext w or w/o dye 0.00 10.89 13.68 NA NA 0.073725 26 R Mr ang lwr ext w or w/o dye 1.82 0.67 0.75 0.67 0.75 0.174000 A X-ray exam of abdomen 0.18 0.49 0.54 NA NA 0.0
CMS-1582-PN 389 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74000 TC A X-ray exam of abdomen 0.00 0.42 0.47 NA NA 0.074000 26 A X-ray exam of abdomen 0.18 0.07 0.07 0.07 0.07 0.074010 A X-ray exam of abdomen 0.23 0.84 0.88 NA NA 0.074010 TC A X-ray exam of abdomen 0.00 0.75 0.79 NA NA 0.074010 26 A X-ray exam of abdomen 0.23 0.09 0.09 0.09 0.09 0.074020 A X-ray exam of abdomen 0.27 0.85 0.90 NA NA 0.074020 TC A X-ray exam of abdomen 0.00 0.75 0.79 NA NA 0.074020 26 A X-ray exam of abdomen 0.27 0.10 0.11 0.10 0.11 0.074022 A X-ray exam series abdomen 0.32 1.02 1.09 NA NA 0.074022 TC A X-ray exam series abdomen 0.00 0.90 0.96 NA NA 0.074022 26 A X-ray exam series abdomen 0.32 0.12 0.13 0.12 0.13 0.074150 A Ct abdomen w/o dye 1.19 4.71 6.03 NA NA 0.074150 TC A Ct abdomen w/o dye 0.00 4.27 5.54 NA NA 0.074150 26 A Ct abdomen w/o dye 1.19 0.44 0.49 0.44 0.49 0.074160 A Ct abdomen w/dye 1.27 6.83 8.52 NA NA 0.074160 TC A Ct abdomen w/dye 0.00 6.35 7.99 NA NA 0.074160 26 A Ct abdomen w/dye 1.27 0.48 0.53 0.48 0.53 0.074170 A Ct abdomen w/o & w/dye 1.40 9.35 11.55 NA NA 0.074170 TC A Ct abdomen w/o & w/dye 0.00 8.82 10.97 NA NA 0.074170 26 A Ct abdomen w/o & w/dye 1.40 0.53 0.58 0.53 0.58 0.074175 A Ct angio abdom w/o & w/dye 1.90 9.56 12.26 NA NA 0.174175 TC A Ct angio abdom w/o & w/dye 0.00 8.86 11.47 NA NA 0.074175 26 A Ct angio abdom w/o & w/dye 1.90 0.70 0.79 0.70 0.79 0.174176 A Ct abd & pelvis w/o contrast 1.74 4.52 4.52 NA NA 0.174176 TC A Ct abd & pelvis w/o contrast 0.00 3.87 3.87 NA NA 0.074176 26 A Ct abd & pelvis w/o contrast 1.74 0.65 0.65 0.65 0.65 0.174177 A Ct abdomen&pelvis w/contrast 1.82 8.08 8.08 NA NA 0.174177 TC A Ct abdomen&pelvis w/contrast 0.00 7.39 7.39 NA NA 0.074177 26 A Ct abdomen&pelvis w/contrast 1.82 0.69 0.69 0.69 0.69 0.174178 A Ct abd&pelv 1+ section/regns 2.01 10.53 10.53 NA NA 0.1
CMS-1582-PN 390 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74178 TC A Ct abd&pelv 1+ section/regns 0.00 9.77 9.77 NA NA 0.074178 26 A Ct abd&pelv 1+ section/regns 2.01 0.76 0.76 0.76 0.76 0.174181 A Mri abdomen w/o dye 1.46 9.29 12.05 NA NA 0.074181 TC A Mri abdomen w/o dye 0.00 8.75 11.45 NA NA 0.074181 26 A Mri abdomen w/o dye 1.46 0.54 0.60 0.54 0.60 0.074182 A Mri abdomen w/dye 1.73 13.12 16.56 NA NA 0.174182 TC A Mri abdomen w/dye 0.00 12.48 15.85 NA NA 0.074182 26 A Mri abdomen w/dye 1.73 0.64 0.71 0.64 0.71 0.174183 A Mri abdomen w/o & w/dye 2.26 14.23 19.57 NA NA 0.174183 TC A Mri abdomen w/o & w/dye 0.00 13.39 18.65 NA NA 0.074183 26 A Mri abdomen w/o & w/dye 2.26 0.84 0.92 0.84 0.92 0.174185 R Mri angio abdom w orw/o dye 1.80 11.51 14.38 NA NA 0.174185 TC R Mri angio abdom w orw/o dye 0.00 10.85 13.64 NA NA 0.074185 26 R Mri angio abdom w orw/o dye 1.80 0.66 0.74 0.66 0.74 0.174190 C X-ray exam of peritoneum 0.00 0.00 0.00 NA NA 0.074190 TC C X-ray exam of peritoneum 0.00 0.00 0.00 NA NA 0.074190 26 A X-ray exam of peritoneum 0.48 0.17 0.20 0.17 0.20 0.074210 A Contrst x-ray exam of throat 0.36 1.84 1.94 NA NA 0.074210 TC A Contrst x-ray exam of throat 0.00 1.71 1.79 NA NA 0.074210 26 A Contrst x-ray exam of throat 0.36 0.13 0.15 0.13 0.15 0.074220 A Contrast x-ray esophagus 0.46 2.09 2.17 NA NA 0.074220 TC A Contrast x-ray esophagus 0.00 1.92 1.98 NA NA 0.074220 26 A Contrast x-ray esophagus 0.46 0.17 0.19 0.17 0.19 0.074230 A Cine/vid x-ray throat/esoph 0.53 2.04 2.14 NA NA 0.074230 TC A Cine/vid x-ray throat/esoph 0.00 1.84 1.92 NA NA 0.074230 26 A Cine/vid x-ray throat/esoph 0.53 0.20 0.22 0.20 0.22 0.074235 C Remove esophagus obstruction 0.00 0.00 0.00 NA NA 0.074235 TC C Remove esophagus obstruction 0.00 0.00 0.00 NA NA 0.074235 26 A Remove esophagus obstruction 1.19 0.66 0.63 0.66 0.63 0.174240 A X-ray exam upper gi tract 0.69 2.52 2.57 NA NA 0.0
CMS-1582-PN 391 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74240 TC A X-ray exam upper gi tract 0.00 2.25 2.28 NA NA 0.074240 26 A X-ray exam upper gi tract 0.69 0.27 0.29 0.27 0.29 0.074241 A X-ray exam upper gi tract 0.69 2.70 2.78 NA NA 0.074241 TC A X-ray exam upper gi tract 0.00 2.44 2.50 NA NA 0.074241 26 A X-ray exam upper gi tract 0.69 0.26 0.28 0.26 0.28 0.074245 A X-ray exam upper gi tract 0.91 4.10 4.27 NA NA 0.074245 TC A X-ray exam upper gi tract 0.00 3.76 3.89 NA NA 0.074245 26 A X-ray exam upper gi tract 0.91 0.34 0.38 0.34 0.38 0.074246 A Contrst x-ray uppr gi tract 0.69 2.91 3.02 NA NA 0.074246 TC A Contrst x-ray uppr gi tract 0.00 2.65 2.73 NA NA 0.074246 26 A Contrst x-ray uppr gi tract 0.69 0.26 0.29 0.26 0.29 0.074247 A Contrst x-ray uppr gi tract 0.69 3.35 3.44 NA NA 0.074247 TC A Contrst x-ray uppr gi tract 0.00 3.09 3.15 NA NA 0.074247 26 A Contrst x-ray uppr gi tract 0.69 0.26 0.29 0.26 0.29 0.074249 A Contrst x-ray uppr gi tract 0.91 4.52 4.68 NA NA 0.074249 TC A Contrst x-ray uppr gi tract 0.00 4.18 4.30 NA NA 0.074249 26 A Contrst x-ray uppr gi tract 0.91 0.34 0.38 0.34 0.38 0.074250 A X-ray exam of small bowel 0.47 2.59 2.64 NA NA 0.074250 TC A X-ray exam of small bowel 0.00 2.41 2.45 NA NA 0.074250 26 A X-ray exam of small bowel 0.47 0.18 0.19 0.18 0.19 0.074251 A X-ray exam of small bowel 0.69 10.56 10.08 NA NA 0.074251 TC A X-ray exam of small bowel 0.00 10.30 9.79 NA NA 0.074251 26 A X-ray exam of small bowel 0.69 0.26 0.29 0.26 0.29 0.074260 A X-ray exam of small bowel 0.50 8.72 8.39 NA NA 0.074260 TC A X-ray exam of small bowel 0.00 8.53 8.19 NA NA 0.074260 26 A X-ray exam of small bowel 0.50 0.19 0.20 0.19 0.20 0.074261 A Ct colonography dx 2.40 12.70 12.70 NA NA 0.174261 TC A Ct colonography dx 0.00 11.80 11.80 NA NA 0.074261 26 A Ct colonography dx 2.40 0.90 0.90 0.90 0.90 0.174262 A Ct colonography dx w/dye 2.50 14.27 14.27 NA NA 0.1
CMS-1582-PN 392 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74262 TC A Ct colonography dx w/dye 0.00 13.33 13.33 NA NA 0.074262 26 A Ct colonography dx w/dye 2.50 0.94 0.94 0.94 0.94 0.174263 N Ct colonography screening 2.28 20.09 20.09 NA NA 0.174263 TC N Ct colonography screening 0.00 19.09 19.09 NA NA 0.074263 26 N Ct colonography screening 2.28 1.00 1.00 1.00 1.00 0.174270 A Contrast x-ray exam of colon 0.69 3.73 3.79 NA NA 0.074270 TC A Contrast x-ray exam of colon 0.00 3.47 3.50 NA NA 0.074270 26 A Contrast x-ray exam of colon 0.69 0.26 0.29 0.26 0.29 0.074280 A Contrast x-ray exam of colon 0.99 5.15 5.23 NA NA 0.074280 TC A Contrast x-ray exam of colon 0.00 4.78 4.82 NA NA 0.074280 26 A Contrast x-ray exam of colon 0.99 0.37 0.41 0.37 0.41 0.074283 A Contrast x-ray exam of colon 2.02 3.75 3.98 NA NA 0.074283 TC A Contrast x-ray exam of colon 0.00 2.97 3.14 NA NA 0.074283 26 A Contrast x-ray exam of colon 2.02 0.78 0.84 0.78 0.84 0.074290 A Contrast x-ray gallbladder 0.32 1.66 1.68 NA NA 0.074290 TC A Contrast x-ray gallbladder 0.00 1.54 1.55 NA NA 0.074290 26 A Contrast x-ray gallbladder 0.32 0.12 0.13 0.12 0.13 0.074291 A Contrast x-rays gallbladder 0.20 1.76 1.67 NA NA 0.074291 TC A Contrast x-rays gallbladder 0.00 1.68 1.59 NA NA 0.074291 26 A Contrast x-rays gallbladder 0.20 0.08 0.08 0.08 0.08 0.074300 C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.074300 TC C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.074300 26 A X-ray bile ducts/pancreas 0.36 0.14 0.15 0.14 0.15 0.074301 C X-rays at surgery add-on 0.00 0.00 0.00 NA NA 0.074301 TC C X-rays at surgery add-on 0.00 0.00 0.00 NA NA 0.074301 26 A X-rays at surgery add-on 0.21 0.08 0.09 0.08 0.09 0.074305 C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.074305 TC C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.074305 26 A X-ray bile ducts/pancreas 0.42 0.15 0.17 0.15 0.17 0.074320 A Contrast x-ray of bile ducts 0.54 2.25 2.62 NA NA 0.0
CMS-1582-PN 393 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74320 TC A Contrast x-ray of bile ducts 0.00 2.05 2.39 NA NA 0.074320 26 A Contrast x-ray of bile ducts 0.54 0.20 0.23 0.20 0.23 0.074327 A X-ray bile stone removal 0.70 3.16 3.25 NA NA 0.174327 TC A X-ray bile stone removal 0.00 2.90 2.96 NA NA 0.074327 26 A X-ray bile stone removal 0.70 0.26 0.29 0.26 0.29 0.174328 C X-ray bile duct endoscopy 0.00 0.00 0.00 NA NA 0.074328 TC C X-ray bile duct endoscopy 0.00 0.00 0.00 NA NA 0.074328 26 A X-ray bile duct endoscopy 0.70 0.29 0.31 0.29 0.31 0.074329 C X-ray for pancreas endoscopy 0.00 0.00 0.00 NA NA 0.074329 TC C X-ray for pancreas endoscopy 0.00 0.00 0.00 NA NA 0.074329 26 A X-ray for pancreas endoscopy 0.70 0.29 0.31 0.29 0.31 0.074330 C X-ray bile/panc endoscopy 0.00 0.00 0.00 NA NA 0.074330 TC C X-ray bile/panc endoscopy 0.00 0.00 0.00 NA NA 0.074330 26 A X-ray bile/panc endoscopy 0.90 0.36 0.39 0.36 0.39 0.074340 C X-ray guide for gi tube 0.00 0.00 0.00 NA NA 0.074340 TC C X-ray guide for gi tube 0.00 0.00 0.00 NA NA 0.074340 26 A X-ray guide for gi tube 0.54 0.21 0.23 0.21 0.23 0.074355 C X-ray guide intestinal tube 0.00 0.00 0.00 NA NA 0.074355 TC C X-ray guide intestinal tube 0.00 0.00 0.00 NA NA 0.074355 26 A X-ray guide intestinal tube 0.76 0.31 0.33 0.31 0.33 0.074360 C X-ray guide gi dilation 0.00 0.00 0.00 NA NA 0.074360 TC C X-ray guide gi dilation 0.00 0.00 0.00 NA NA 0.074360 26 A X-ray guide gi dilation 0.54 0.28 0.28 0.28 0.28 0.074363 C X-ray bile duct dilation 0.00 0.00 0.00 NA NA 0.074363 TC C X-ray bile duct dilation 0.00 0.00 0.00 NA NA 0.074363 26 A X-ray bile duct dilation 0.88 0.32 0.37 0.32 0.37 0.074400 A Contrst x-ray urinary tract 0.49 2.64 2.78 NA NA 0.074400 TC A Contrst x-ray urinary tract 0.00 2.46 2.58 NA NA 0.074400 26 A Contrst x-ray urinary tract 0.49 0.18 0.20 0.18 0.20 0.074410 A Contrst x-ray urinary tract 0.49 2.64 2.88 NA NA 0.0
CMS-1582-PN 394 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74410 TC A Contrst x-ray urinary tract 0.00 2.46 2.67 NA NA 0.074410 26 A Contrst x-ray urinary tract 0.49 0.18 0.21 0.18 0.21 0.074415 A Contrst x-ray urinary tract 0.49 3.34 3.50 NA NA 0.074415 TC A Contrst x-ray urinary tract 0.00 3.16 3.30 NA NA 0.074415 26 A Contrst x-ray urinary tract 0.49 0.18 0.20 0.18 0.20 0.074420 C Contrst x-ray urinary tract 0.00 0.00 0.00 NA NA 0.074420 TC C Contrst x-ray urinary tract 0.00 0.00 0.00 NA NA 0.074420 26 A Contrst x-ray urinary tract 0.36 0.14 0.15 0.14 0.15 0.074425 C Contrst x-ray urinary tract 0.00 0.00 0.00 NA NA 0.074425 TC C Contrst x-ray urinary tract 0.00 0.00 0.00 NA NA 0.074425 26 A Contrst x-ray urinary tract 0.36 0.13 0.15 0.13 0.15 0.074430 A Contrast x-ray bladder 0.32 0.82 1.46 NA NA 0.074430 TC A Contrast x-ray bladder 0.00 0.70 1.33 NA NA 0.074430 26 A Contrast x-ray bladder 0.32 0.12 0.13 0.12 0.13 0.074440 A X-ray male genital tract 0.38 2.02 2.14 NA NA 0.074440 TC A X-ray male genital tract 0.00 1.87 1.98 NA NA 0.074440 26 A X-ray male genital tract 0.38 0.15 0.16 0.15 0.16 0.074445 C X-ray exam of penis 0.00 0.00 0.00 NA NA 0.074445 TC C X-ray exam of penis 0.00 0.00 0.00 NA NA 0.074445 26 A X-ray exam of penis 1.14 0.45 0.50 0.45 0.50 0.174450 C X-ray urethra/bladder 0.00 0.00 0.00 NA NA 0.074450 TC C X-ray urethra/bladder 0.00 0.00 0.00 NA NA 0.074450 26 A X-ray urethra/bladder 0.33 0.12 0.14 0.12 0.14 0.074455 A X-ray urethra/bladder 0.33 2.10 2.30 NA NA 0.074455 TC A X-ray urethra/bladder 0.00 1.97 2.16 NA NA 0.074455 26 A X-ray urethra/bladder 0.33 0.13 0.14 0.13 0.14 0.074470 C X-ray exam of kidney lesion 0.00 0.00 0.00 NA NA 0.074470 TC C X-ray exam of kidney lesion 0.00 0.00 0.00 NA NA 0.074470 26 A X-ray exam of kidney lesion 0.54 0.20 0.23 0.20 0.23 0.074475 A X-ray control cath insert 0.54 2.23 2.73 NA NA 0.0
CMS-1582-PN 395 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

74475 TC A X-ray control cath insert 0.00 2.03 2.50 NA NA 0.074475 26 A X-ray control cath insert 0.54 0.20 0.23 0.20 0.23 0.074480 A X-ray control cath insert 0.54 2.23 2.74 NA NA 0.074480 TC A X-ray control cath insert 0.00 2.03 2.51 NA NA 0.074480 26 A X-ray control cath insert 0.54 0.20 0.23 0.20 0.23 0.074485 A X-ray guide gu dilation 0.54 2.27 2.69 NA NA 0.074485 TC A X-ray guide gu dilation 0.00 2.07 2.46 NA NA 0.074485 26 A X-ray guide gu dilation 0.54 0.20 0.23 0.20 0.23 0.074710 A X-ray measurement of pelvis 0.34 0.68 0.81 NA NA 0.074710 TC A X-ray measurement of pelvis 0.00 0.55 0.67 NA NA 0.074710 26 A X-ray measurement of pelvis 0.34 0.13 0.14 0.13 0.14 0.074740 A X-ray female genital tract 0.38 1.84 1.94 NA NA 0.074740 TC A X-ray female genital tract 0.00 1.69 1.78 NA NA 0.074740 26 A X-ray female genital tract 0.38 0.15 0.16 0.15 0.16 0.074742 C X-ray fallopian tube 0.00 0.00 0.00 NA NA 0.074742 TC C X-ray fallopian tube 0.00 0.00 0.00 NA NA 0.074742 26 A X-ray fallopian tube 0.61 0.24 0.25 0.24 0.25 0.074775 C X-ray exam of perineum 0.00 0.00 0.00 NA NA 0.074775 TC C X-ray exam of perineum 0.00 0.00 0.00 NA NA 0.074775 26 A X-ray exam of perineum 0.62 0.23 0.26 0.23 0.26 0.075557 A Cardiac mri for morph 2.35 8.11 10.76 NA NA 0.175557 TC A Cardiac mri for morph 0.00 7.22 9.71 NA NA 0.075557 26 A Cardiac mri for morph 2.35 0.89 1.05 0.89 1.05 0.175559 A Cardiac mri w/stress img 2.95 11.64 16.04 NA NA 0.175559 TC A Cardiac mri w/stress img 0.00 10.52 14.66 NA NA 0.075559 26 A Cardiac mri w/stress img 2.95 1.12 1.38 1.12 1.38 0.175561 A Cardiac mri for morph w/dye 2.60 11.36 15.18 NA NA 0.175561 TC A Cardiac mri for morph w/dye 0.00 10.37 14.01 NA NA 0.075561 26 A Cardiac mri for morph w/dye 2.60 0.99 1.17 0.99 1.17 0.175563 A Card mri w/stress img & dye 3.00 13.55 18.67 NA NA 0.1
CMS-1582-PN 396 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75563 TC A Card mri w/stress img & dye 0.00 12.38 17.21 NA NA 0.075563 26 A Card mri w/stress img & dye 3.00 1.17 1.46 1.17 1.46 0.175565 A Card mri veloc flow mapping 0.25 1.92 1.92 NA NA 0.075565 TC A Card mri veloc flow mapping 0.00 1.81 1.81 NA NA 0.075565 26 A Card mri veloc flow mapping 0.25 0.11 0.11 0.11 0.11 0.075571 A Ct hrt w/o dye w/ca test 0.58 2.55 2.55 NA NA 0.075571 TC A Ct hrt w/o dye w/ca test 0.00 2.33 2.33 NA NA 0.075571 26 A Ct hrt w/o dye w/ca test 0.58 0.22 0.22 0.22 0.22 0.075572 A Ct hrt w/3d image 1.75 6.82 6.82 NA NA 0.075572 TC A Ct hrt w/3d image 0.00 6.15 6.15 NA NA 0.075572 26 A Ct hrt w/3d image 1.75 0.67 0.67 0.67 0.67 0.075573 A Ct hrt w/3d image congen 2.55 9.10 9.10 NA NA 0.075573 TC A Ct hrt w/3d image congen 0.00 8.11 8.11 NA NA 0.075573 26 A Ct hrt w/3d image congen 2.55 0.99 0.99 0.99 0.99 0.075574 A Ct angio hrt w/3d image 2.40 10.63 10.63 NA NA 0.075574 TC A Ct angio hrt w/3d image 0.00 9.71 9.71 NA NA 0.075574 26 A Ct angio hrt w/3d image 2.40 0.92 0.92 0.92 0.92 0.075600 A Contrast x-ray exam of aorta 0.49 5.43 7.45 NA NA 0.075600 TC A Contrast x-ray exam of aorta 0.00 5.25 7.22 NA NA 0.075600 26 A Contrast x-ray exam of aorta 0.49 0.18 0.23 0.18 0.23 0.075605 A Contrast x-ray exam of aorta 1.14 3.18 5.13 NA NA 0.075605 TC A Contrast x-ray exam of aorta 0.00 2.76 4.63 NA NA 0.075605 26 A Contrast x-ray exam of aorta 1.14 0.42 0.50 0.42 0.50 0.075625 A Contrast x-ray exam of aorta 1.14 3.27 5.11 NA NA 0.175625 TC A Contrast x-ray exam of aorta 0.00 2.86 4.64 NA NA 0.075625 26 A Contrast x-ray exam of aorta 1.14 0.41 0.47 0.41 0.47 0.175630 A X-ray aorta leg arteries 1.79 3.51 5.51 NA NA 0.175630 TC A X-ray aorta leg arteries 0.00 2.85 4.75 NA NA 0.075630 26 A X-ray aorta leg arteries 1.79 0.66 0.76 0.66 0.76 0.175635 A Ct angio abdominal arteries 2.40 10.15 13.46 NA NA 0.1
CMS-1582-PN 397 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75635 TC A Ct angio abdominal arteries 0.00 9.26 12.43 NA NA 0.075635 26 A Ct angio abdominal arteries 2.40 0.89 1.03 0.89 1.03 0.175650 A Artery x-rays head & neck 1.49 3.44 5.30 NA NA 0.175650 TC A Artery x-rays head & neck 0.00 2.89 4.67 NA NA 0.075650 26 A Artery x-rays head & neck 1.49 0.55 0.63 0.55 0.63 0.175658 A Artery x-rays arm 1.31 4.05 5.67 NA NA 0.075658 TC A Artery x-rays arm 0.00 3.59 5.16 NA NA 0.075658 26 A Artery x-rays arm 1.31 0.46 0.51 0.46 0.51 0.075660 A Artery x-rays head & neck 1.31 4.16 5.81 NA NA 0.075660 TC A Artery x-rays head & neck 0.00 3.63 5.24 NA NA 0.075660 26 A Artery x-rays head & neck 1.31 0.53 0.57 0.53 0.57 0.075662 A Artery x-rays head & neck 1.66 5.05 6.77 NA NA 0.175662 TC A Artery x-rays head & neck 0.00 4.38 6.01 NA NA 0.075662 26 A Artery x-rays head & neck 1.66 0.67 0.76 0.67 0.76 0.075665 A Artery x-rays head & neck 1.31 4.39 6.05 NA NA 0.175665 TC A Artery x-rays head & neck 0.00 3.87 5.48 NA NA 0.075665 26 A Artery x-rays head & neck 1.31 0.52 0.57 0.52 0.57 0.175671 A Artery x-rays head & neck 1.66 5.24 6.93 NA NA 0.175671 TC A Artery x-rays head & neck 0.00 4.59 6.21 NA NA 0.075671 26 A Artery x-rays head & neck 1.66 0.65 0.72 0.65 0.72 0.175676 A Artery x-rays neck 1.31 4.03 5.75 NA NA 0.175676 TC A Artery x-rays neck 0.00 3.52 5.19 NA NA 0.075676 26 A Artery x-rays neck 1.31 0.51 0.56 0.51 0.56 0.175680 A Artery x-rays neck 1.66 4.56 6.36 NA NA 0.175680 TC A Artery x-rays neck 0.00 3.92 5.64 NA NA 0.075680 26 A Artery x-rays neck 1.66 0.64 0.72 0.64 0.72 0.175685 A Artery x-rays spine 1.31 4.12 5.81 NA NA 0.075685 TC A Artery x-rays spine 0.00 3.60 5.24 NA NA 0.075685 26 A Artery x-rays spine 1.31 0.52 0.57 0.52 0.57 0.075705 A Artery x-rays spine 2.18 4.44 6.14 NA NA 0.0
CMS-1582-PN 398 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75705 TC A Artery x-rays spine 0.00 3.59 5.20 NA NA 0.075705 26 A Artery x-rays spine 2.18 0.85 0.94 0.85 0.94 0.075710 A Artery x-rays arm/leg 1.14 3.92 5.69 NA NA 0.075710 TC A Artery x-rays arm/leg 0.00 3.50 5.22 NA NA 0.075710 26 A Artery x-rays arm/leg 1.14 0.42 0.47 0.42 0.47 0.075716 A Artery x-rays arms/legs 1.31 4.70 6.53 NA NA 0.175716 TC A Artery x-rays arms/legs 0.00 4.22 5.99 NA NA 0.075716 26 A Artery x-rays arms/legs 1.31 0.48 0.54 0.48 0.54 0.175722 A Artery x-rays kidney 1.14 3.54 5.46 NA NA 0.075722 TC A Artery x-rays kidney 0.00 3.12 4.96 NA NA 0.075722 26 A Artery x-rays kidney 1.14 0.42 0.50 0.42 0.50 0.075724 A Artery x-rays kidneys 1.49 4.21 6.35 NA NA 0.075724 TC A Artery x-rays kidneys 0.00 3.64 5.63 NA NA 0.075724 26 A Artery x-rays kidneys 1.49 0.57 0.72 0.57 0.72 0.075726 A Artery x-rays abdomen 1.14 3.84 5.61 NA NA 0.075726 TC A Artery x-rays abdomen 0.00 3.43 5.14 NA NA 0.075726 26 A Artery x-rays abdomen 1.14 0.41 0.47 0.41 0.47 0.075731 A Artery x-rays adrenal gland 1.14 3.81 5.75 NA NA 0.075731 TC A Artery x-rays adrenal gland 0.00 3.38 5.22 NA NA 0.075731 26 A Artery x-rays adrenal gland 1.14 0.43 0.53 0.43 0.53 0.075733 A Artery x-rays adrenals 1.31 4.45 6.61 NA NA 0.075733 TC A Artery x-rays adrenals 0.00 3.94 5.97 NA NA 0.075733 26 A Artery x-rays adrenals 1.31 0.51 0.64 0.51 0.64 0.075736 A Artery x-rays pelvis 1.14 3.76 5.61 NA NA 0.075736 TC A Artery x-rays pelvis 0.00 3.35 5.13 NA NA 0.075736 26 A Artery x-rays pelvis 1.14 0.41 0.48 0.41 0.48 0.075741 A Artery x-rays lung 1.31 3.26 5.07 NA NA 0.075741 TC A Artery x-rays lung 0.00 2.79 4.52 NA NA 0.075741 26 A Artery x-rays lung 1.31 0.47 0.55 0.47 0.55 0.075743 A Artery x-rays lungs 1.66 3.64 5.47 NA NA 0.1
CMS-1582-PN 399 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75743 TC A Artery x-rays lungs 0.00 3.04 4.77 NA NA 0.075743 26 A Artery x-rays lungs 1.66 0.60 0.70 0.60 0.70 0.175746 A Artery x-rays lung 1.14 3.62 5.40 NA NA 0.075746 TC A Artery x-rays lung 0.00 3.19 4.92 NA NA 0.075746 26 A Artery x-rays lung 1.14 0.43 0.48 0.43 0.48 0.075756 A Artery x-rays chest 1.14 3.80 5.77 NA NA 0.275756 TC A Artery x-rays chest 0.00 3.39 5.23 NA NA 0.075756 26 A Artery x-rays chest 1.14 0.41 0.54 0.41 0.54 0.275774 A Artery x-ray each vessel 0.36 2.50 4.30 NA NA 0.075774 TC A Artery x-ray each vessel 0.00 2.37 4.15 NA NA 0.075774 26 A Artery x-ray each vessel 0.36 0.13 0.15 0.13 0.15 0.075791 A Av dialysis shunt imaging 1.71 7.84 7.84 NA NA 0.175791 TC A Av dialysis shunt imaging 0.00 7.22 7.22 NA NA 0.075791 26 A Av dialysis shunt imaging 1.71 0.62 0.62 0.62 0.62 0.175801 C Lymph vessel x-ray arm/leg 0.00 0.00 0.00 NA NA 0.075801 TC C Lymph vessel x-ray arm/leg 0.00 0.00 0.00 NA NA 0.075801 26 A Lymph vessel x-ray arm/leg 0.81 0.35 0.33 0.35 0.33 0.175803 C Lymph vessel x-ray arms/legs 0.00 0.00 0.00 NA NA 0.075803 TC C Lymph vessel x-ray arms/legs 0.00 0.00 0.00 NA NA 0.075803 26 A Lymph vessel x-ray arms/legs 1.17 0.44 0.49 0.44 0.49 0.175805 C Lymph vessel x-ray trunk 0.00 0.00 0.00 NA NA 0.075805 TC C Lymph vessel x-ray trunk 0.00 0.00 0.00 NA NA 0.075805 26 A Lymph vessel x-ray trunk 0.81 0.30 0.34 0.30 0.34 0.075807 C Lymph vessel x-ray trunk 0.00 0.00 0.00 NA NA 0.075807 TC C Lymph vessel x-ray trunk 0.00 0.00 0.00 NA NA 0.075807 26 A Lymph vessel x-ray trunk 1.17 0.45 0.50 0.45 0.50 0.175809 A Nonvascular shunt x-ray 0.47 2.49 2.38 NA NA 0.075809 TC A Nonvascular shunt x-ray 0.00 2.30 2.18 NA NA 0.075809 26 A Nonvascular shunt x-ray 0.47 0.19 0.20 0.19 0.20 0.075810 C Vein x-ray spleen/liver 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 400 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75810 TC C Vein x-ray spleen/liver 0.00 0.00 0.00 NA NA 0.075810 26 A Vein x-ray spleen/liver 1.14 0.43 0.49 0.43 0.49 0.175820 A Vein x-ray arm/leg 0.70 2.88 2.96 NA NA 0.075820 TC A Vein x-ray arm/leg 0.00 2.62 2.66 NA NA 0.075820 26 A Vein x-ray arm/leg 0.70 0.26 0.30 0.26 0.30 0.075822 A Vein x-ray arms/legs 1.06 3.36 3.41 NA NA 0.075822 TC A Vein x-ray arms/legs 0.00 2.97 2.98 NA NA 0.075822 26 A Vein x-ray arms/legs 1.06 0.39 0.43 0.39 0.43 0.075825 A Vein x-ray trunk 1.14 3.10 4.86 NA NA 0.075825 TC A Vein x-ray trunk 0.00 2.69 4.41 NA NA 0.075825 26 A Vein x-ray trunk 1.14 0.41 0.45 0.41 0.45 0.075827 A Vein x-ray chest 1.14 3.27 4.94 NA NA 0.075827 TC A Vein x-ray chest 0.00 2.86 4.50 NA NA 0.075827 26 A Vein x-ray chest 1.14 0.41 0.44 0.41 0.44 0.075831 A Vein x-ray kidney 1.14 3.20 4.97 NA NA 0.275831 TC A Vein x-ray kidney 0.00 2.80 4.51 NA NA 0.075831 26 A Vein x-ray kidney 1.14 0.40 0.46 0.40 0.46 0.275833 A Vein x-ray kidneys 1.49 3.83 5.56 NA NA 0.075833 TC A Vein x-ray kidneys 0.00 3.32 4.99 NA NA 0.075833 26 A Vein x-ray kidneys 1.49 0.51 0.57 0.51 0.57 0.075840 A Vein x-ray adrenal gland 1.14 3.05 4.85 NA NA 0.275840 TC A Vein x-ray adrenal gland 0.00 2.67 4.42 NA NA 0.075840 26 A Vein x-ray adrenal gland 1.14 0.38 0.43 0.38 0.43 0.275842 A Vein x-ray adrenal glands 1.49 3.80 5.58 NA NA 0.075842 TC A Vein x-ray adrenal glands 0.00 3.24 4.96 NA NA 0.075842 26 A Vein x-ray adrenal glands 1.49 0.56 0.62 0.56 0.62 0.075860 A Vein x-ray neck 1.14 3.18 5.06 NA NA 0.075860 TC A Vein x-ray neck 0.00 2.76 4.56 NA NA 0.075860 26 A Vein x-ray neck 1.14 0.42 0.50 0.42 0.50 0.075870 A Vein x-ray skull 1.14 3.15 4.99 NA NA 0.0
CMS-1582-PN 401 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75870 TC A Vein x-ray skull 0.00 2.72 4.52 NA NA 0.075870 26 A Vein x-ray skull 1.14 0.43 0.47 0.43 0.47 0.075872 A Vein x-ray skull 1.14 6.71 7.16 NA NA 0.075872 TC A Vein x-ray skull 0.00 6.08 6.57 NA NA 0.075872 26 A Vein x-ray skull 1.14 0.63 0.59 0.63 0.59 0.075880 A Vein x-ray eye socket 0.70 5.52 4.32 NA NA 0.075880 TC A Vein x-ray eye socket 0.00 5.18 4.00 NA NA 0.075880 26 A Vein x-ray eye socket 0.70 0.34 0.32 0.34 0.32 0.075885 A Vein x-ray liver 1.44 3.29 5.11 NA NA 0.075885 TC A Vein x-ray liver 0.00 2.77 4.51 NA NA 0.075885 26 A Vein x-ray liver 1.44 0.52 0.60 0.52 0.60 0.075887 A Vein x-ray liver 1.44 3.38 5.19 NA NA 0.075887 TC A Vein x-ray liver 0.00 2.85 4.58 NA NA 0.075887 26 A Vein x-ray liver 1.44 0.53 0.61 0.53 0.61 0.075889 A Vein x-ray liver 1.14 3.21 4.98 NA NA 0.075889 TC A Vein x-ray liver 0.00 2.80 4.51 NA NA 0.075889 26 A Vein x-ray liver 1.14 0.41 0.47 0.41 0.47 0.075891 A Vein x-ray liver 1.14 3.21 4.99 NA NA 0.075891 TC A Vein x-ray liver 0.00 2.80 4.52 NA NA 0.075891 26 A Vein x-ray liver 1.14 0.41 0.47 0.41 0.47 0.075893 A Venous sampling by catheter 0.54 2.94 4.70 NA NA 0.075893 TC A Venous sampling by catheter 0.00 2.74 4.48 NA NA 0.075893 26 A Venous sampling by catheter 0.54 0.20 0.22 0.20 0.22 0.075894 C X-rays transcath therapy 0.00 0.00 0.00 NA NA 0.075894 TC C X-rays transcath therapy 0.00 0.00 0.00 NA NA 0.075894 26 A X-rays transcath therapy 1.31 0.48 0.54 0.48 0.54 0.175896 C X-rays transcath therapy 0.00 0.00 0.00 NA NA 0.075896 TC C X-rays transcath therapy 0.00 0.00 0.00 NA NA 0.075896 26 A X-rays transcath therapy 1.31 0.48 0.56 0.48 0.56 0.175898 C Follow-up angiography 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 402 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75898 TC C Follow-up angiography 0.00 0.00 0.00 NA NA 0.075898 26 A Follow-up angiography 1.65 0.62 0.71 0.62 0.71 0.275900 C Intravascular cath exchange 0.00 0.00 0.00 NA NA 0.075900 TC C Intravascular cath exchange 0.00 0.00 0.00 NA NA 0.075900 26 A Intravascular cath exchange 0.49 0.17 0.20 0.17 0.20 0.075901 A Remove cva device obstruct 0.49 4.56 4.41 NA NA 0.075901 TC A Remove cva device obstruct 0.00 4.38 4.21 NA NA 0.075901 26 A Remove cva device obstruct 0.49 0.18 0.20 0.18 0.20 0.075902 A Remove cva lumen obstruct 0.39 1.76 1.84 NA NA 0.075902 TC A Remove cva lumen obstruct 0.00 1.62 1.69 NA NA 0.075902 26 A Remove cva lumen obstruct 0.39 0.14 0.15 0.14 0.15 0.075940 C X-ray placement vein filter 0.00 0.00 0.00 NA NA 0.075940 TC C X-ray placement vein filter 0.00 0.00 0.00 NA NA 0.075940 26 A X-ray placement vein filter 0.54 0.19 0.21 0.19 0.21 0.075945 C Intravascular us 0.00 0.00 0.00 NA NA 0.075945 TC C Intravascular us 0.00 0.00 0.00 NA NA 0.075945 26 A Intravascular us 0.40 0.14 0.16 0.14 0.16 0.075946 C Intravascular us add-on 0.00 0.00 0.00 NA NA 0.075946 TC C Intravascular us add-on 0.00 0.00 0.00 NA NA 0.075946 26 A Intravascular us add-on 0.40 0.13 0.15 0.13 0.15 0.075952 C Endovasc repair abdom aorta 0.00 0.00 0.00 NA NA 0.075952 TC C Endovasc repair abdom aorta 0.00 0.00 0.00 NA NA 0.075952 26 A Endovasc repair abdom aorta 4.49 1.54 1.64 1.54 1.64 0.875953 C Abdom aneurysm endovas rpr 0.00 0.00 0.00 NA NA 0.075953 TC C Abdom aneurysm endovas rpr 0.00 0.00 0.00 NA NA 0.075953 26 A Abdom aneurysm endovas rpr 1.36 0.47 0.50 0.47 0.50 0.275954 C Iliac aneurysm endovas rpr 0.00 0.00 0.00 NA NA 0.075954 TC C Iliac aneurysm endovas rpr 0.00 0.00 0.00 NA NA 0.075954 26 A Iliac aneurysm endovas rpr 2.25 0.79 0.83 0.79 0.83 0.475956 C Xray endovasc thor ao repr 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 403 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75956 TC C Xray endovasc thor ao repr 0.00 0.00 0.00 NA NA 0.075956 26 A Xray endovasc thor ao repr 7.00 2.34 2.54 2.34 2.54 1.475957 C Xray endovasc thor ao repr 0.00 0.00 0.00 NA NA 0.075957 TC C Xray endovasc thor ao repr 0.00 0.00 0.00 NA NA 0.075957 26 A Xray endovasc thor ao repr 6.00 2.02 2.18 2.02 2.18 1.275958 C Xray place prox ext thor ao 0.00 0.00 0.00 NA NA 0.075958 TC C Xray place prox ext thor ao 0.00 0.00 0.00 NA NA 0.075958 26 A Xray place prox ext thor ao 4.00 1.33 1.42 1.33 1.42 0.875959 C Xray place dist ext thor ao 0.00 0.00 0.00 NA NA 0.075959 TC C Xray place dist ext thor ao 0.00 0.00 0.00 NA NA 0.075959 26 A Xray place dist ext thor ao 3.50 1.05 1.19 1.05 1.19 0.875960 A Transcath iv stent rs&i 0.82 2.69 4.84 NA NA 0.075960 TC A Transcath iv stent rs&i 0.00 2.39 4.50 NA NA 0.075960 26 A Transcath iv stent rs&i 0.82 0.30 0.34 0.30 0.34 0.075961 A Retrieval broken catheter 4.24 4.76 6.38 NA NA 0.275961 TC A Retrieval broken catheter 0.00 3.25 4.65 NA NA 0.075961 26 A Retrieval broken catheter 4.24 1.51 1.73 1.51 1.73 0.275962 A Repair arterial blockage 0.54 3.44 5.69 NA NA 0.075962 TC A Repair arterial blockage 0.00 3.25 5.47 NA NA 0.075962 26 A Repair arterial blockage 0.54 0.19 0.22 0.19 0.22 0.075964 A Repair artery blockage each 0.36 2.34 3.50 NA NA 0.075964 TC A Repair artery blockage each 0.00 2.21 3.36 NA NA 0.075964 26 A Repair artery blockage each 0.36 0.13 0.14 0.13 0.14 0.075966 A Repair arterial blockage 1.31 3.70 6.15 NA NA 0.075966 TC A Repair arterial blockage 0.00 3.22 5.57 NA NA 0.075966 26 A Repair arterial blockage 1.31 0.48 0.58 0.48 0.58 0.075968 A Repair artery blockage each 0.36 2.20 3.45 NA NA 0.075968 TC A Repair artery blockage each 0.00 2.07 3.29 NA NA 0.075968 26 A Repair artery blockage each 0.36 0.13 0.16 0.13 0.16 0.075970 C Vascular biopsy 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 404 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

75970 TC C Vascular biopsy 0.00 0.00 0.00 NA NA 0.075970 26 A Vascular biopsy 0.83 0.30 0.35 0.30 0.35 0.075978 A Repair venous blockage 0.54 3.62 5.70 NA NA 0.075978 TC A Repair venous blockage 0.00 3.42 5.49 NA NA 0.075978 26 A Repair venous blockage 0.54 0.20 0.21 0.20 0.21 0.075980 C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.075980 TC C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.075980 26 A Contrast xray exam bile duct 1.44 0.52 0.60 0.52 0.60 0.175982 C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.075982 TC C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.075982 26 A Contrast xray exam bile duct 1.44 0.52 0.60 0.52 0.60 0.175984 A Xray control catheter change 0.72 2.45 2.63 NA NA 0.075984 TC A Xray control catheter change 0.00 2.19 2.33 NA NA 0.075984 26 A Xray control catheter change 0.72 0.26 0.30 0.26 0.30 0.075989 A Abscess drainage under x-ray 1.19 2.37 2.76 NA NA 0.075989 TC A Abscess drainage under x-ray 0.00 1.93 2.27 NA NA 0.075989 26 A Abscess drainage under x-ray 1.19 0.44 0.49 0.44 0.49 0.076000 A Fluoroscope examination 0.17 1.30 2.10 NA NA 0.076000 TC A Fluoroscope examination 0.00 1.23 2.03 NA NA 0.076000 26 A Fluoroscope examination 0.17 0.07 0.07 0.07 0.07 0.076001 C Fluoroscope exam extensive 0.00 0.00 0.00 NA NA 0.076001 TC C Fluoroscope exam extensive 0.00 0.00 0.00 NA NA 0.076001 26 A Fluoroscope exam extensive 0.67 0.30 0.30 0.30 0.30 0.076010 A X-ray nose to rectum 0.18 0.56 0.62 NA NA 0.076010 TC A X-ray nose to rectum 0.00 0.49 0.54 NA NA 0.076010 26 A X-ray nose to rectum 0.18 0.07 0.08 0.07 0.08 0.076080 A X-ray exam of fistula 0.54 1.15 1.27 NA NA 0.076080 TC A X-ray exam of fistula 0.00 0.95 1.04 NA NA 0.076080 26 A X-ray exam of fistula 0.54 0.20 0.23 0.20 0.23 0.076098 A X-ray exam breast specimen 0.16 0.33 0.39 NA NA 0.0
CMS-1582-PN 405 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76098 TC A X-ray exam breast specimen 0.00 0.27 0.32 NA NA 0.076098 26 A X-ray exam breast specimen 0.16 0.06 0.07 0.06 0.07 0.076100 A X-ray exam of body section 0.58 2.33 2.99 NA NA 0.076100 TC A X-ray exam of body section 0.00 2.02 2.71 NA NA 0.076100 26 A X-ray exam of body section 0.58 0.31 0.28 0.31 0.28 0.076101 A Complex body section x-ray 0.58 3.72 4.55 NA NA 0.076101 TC A Complex body section x-ray 0.00 3.31 4.22 NA NA 0.076101 26 A Complex body section x-ray 0.58 0.41 0.33 0.41 0.33 0.076102 A Complex body section x-rays 0.58 5.19 6.32 NA NA 0.176102 TC A Complex body section x-rays 0.00 4.77 5.99 NA NA 0.076102 26 A Complex body section x-rays 0.58 0.42 0.33 0.42 0.33 0.176120 A Cine/video x-rays 0.38 1.73 1.85 NA NA 0.076120 TC A Cine/video x-rays 0.00 1.58 1.70 NA NA 0.076120 26 A Cine/video x-rays 0.38 0.15 0.15 0.15 0.15 0.076125 C Cine/video x-rays add-on 0.00 0.00 0.00 NA NA 0.076125 TC C Cine/video x-rays add-on 0.00 0.00 0.00 NA NA 0.076125 26 A Cine/video x-rays add-on 0.27 0.11 0.13 0.11 0.13 0.076140 I X-ray consultation 0.00 0.00 0.00 0.00 0.00 0.076376 A 3d render w/o postprocess 0.20 1.45 1.90 NA NA 0.076376 TC A 3d render w/o postprocess 0.00 1.37 1.81 NA NA 0.076376 26 A 3d render w/o postprocess 0.20 0.08 0.09 0.08 0.09 0.076377 A 3d rendering w/postprocess 0.79 1.42 1.92 NA NA 0.076377 TC A 3d rendering w/postprocess 0.00 1.12 1.59 NA NA 0.076377 26 A 3d rendering w/postprocess 0.79 0.30 0.33 0.30 0.33 0.076380 A Cat scan follow-up study 0.98 3.70 4.57 NA NA 0.076380 TC A Cat scan follow-up study 0.00 3.32 4.16 NA NA 0.076380 26 A Cat scan follow-up study 0.98 0.38 0.41 0.38 0.41 0.076390 N Mr spectroscopy 1.40 11.89 12.50 NA NA 0.076390 TC N Mr spectroscopy 0.00 11.28 11.91 NA NA 0.076390 26 N Mr spectroscopy 1.40 0.61 0.59 0.61 0.59 0.0
CMS-1582-PN 406 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76496 C Fluoroscopic procedure 0.00 0.00 0.00 NA NA 0.076496 TC C Fluoroscopic procedure 0.00 0.00 0.00 NA NA 0.076496 26 C Fluoroscopic procedure 0.00 0.00 0.00 0.00 0.00 0.076497 C Ct procedure 0.00 0.00 0.00 NA NA 0.076497 TC C Ct procedure 0.00 0.00 0.00 NA NA 0.076497 26 C Ct procedure 0.00 0.00 0.00 0.00 0.00 0.076498 C Mri procedure 0.00 0.00 0.00 NA NA 0.076498 TC C Mri procedure 0.00 0.00 0.00 NA NA 0.076498 26 C Mri procedure 0.00 0.00 0.00 0.00 0.00 0.076499 C Radiographic procedure 0.00 0.00 0.00 NA NA 0.076499 TC C Radiographic procedure 0.00 0.00 0.00 NA NA 0.076499 26 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.076506 A Echo exam of head 0.63 2.82 2.89 NA NA 0.076506 TC A Echo exam of head 0.00 2.58 2.63 NA NA 0.076506 26 A Echo exam of head 0.63 0.24 0.26 0.24 0.26 0.076510 A Ophth us b & quant a 1.55 3.24 3.11 NA NA 0.276510 TC A Ophth us b & quant a 0.00 2.16 2.18 NA NA 0.076510 26 A Ophth us b & quant a 1.55 1.08 0.93 1.08 0.93 0.276511 A Ophth us quant a only 0.94 1.94 1.97 NA NA 0.076511 TC A Ophth us quant a only 0.00 1.30 1.42 NA NA 0.076511 26 A Ophth us quant a only 0.94 0.64 0.55 0.64 0.55 0.076512 A Ophth us b w/non-quant a 0.94 1.68 1.73 NA NA 0.076512 TC A Ophth us b w/non-quant a 0.00 1.05 1.18 NA NA 0.076512 26 A Ophth us b w/non-quant a 0.94 0.63 0.55 0.63 0.55 0.076513 A Echo exam of eye water bath 0.66 1.94 1.91 NA NA 0.076513 TC A Echo exam of eye water bath 0.00 1.57 1.58 NA NA 0.076513 26 A Echo exam of eye water bath 0.66 0.37 0.33 0.37 0.33 0.076514 A Echo exam of eye thickness 0.17 0.24 0.22 NA NA 0.076514 TC A Echo exam of eye thickness 0.00 0.13 0.12 NA NA 0.076514 26 A Echo exam of eye thickness 0.17 0.11 0.10 0.11 0.10 0.0
CMS-1582-PN 407 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76516 A Echo exam of eye 0.54 1.61 1.56 NA NA 0.076516 TC A Echo exam of eye 0.00 1.25 1.25 NA NA 0.076516 26 A Echo exam of eye 0.54 0.36 0.31 0.36 0.31 0.076519 A Echo exam of eye 0.54 1.77 1.72 NA NA 0.076519 TC A Echo exam of eye 0.00 1.40 1.40 NA NA 0.076519 26 A Echo exam of eye 0.54 0.37 0.32 0.37 0.32 0.076529 A Echo exam of eye 0.57 1.63 1.56 NA NA 0.076529 TC A Echo exam of eye 0.00 1.23 1.22 NA NA 0.076529 26 A Echo exam of eye 0.57 0.40 0.34 0.40 0.34 0.076536 A Us exam of head and neck 0.56 2.88 2.90 NA NA 0.076536 TC A Us exam of head and neck 0.00 2.66 2.67 NA NA 0.076536 26 A Us exam of head and neck 0.56 0.22 0.23 0.22 0.23 0.076604 A Us exam chest 0.55 1.90 2.01 NA NA 0.076604 TC A Us exam chest 0.00 1.70 1.79 NA NA 0.076604 26 A Us exam chest 0.55 0.20 0.22 0.20 0.22 0.076645 A Us exam breast(s) 0.54 2.20 2.25 NA NA 0.076645 TC A Us exam breast(s) 0.00 2.00 2.03 NA NA 0.076645 26 A Us exam breast(s) 0.54 0.20 0.22 0.20 0.22 0.076700 A Us exam abdom complete 0.81 3.16 3.30 NA NA 0.076700 TC A Us exam abdom complete 0.00 2.85 2.97 NA NA 0.076700 26 A Us exam abdom complete 0.81 0.31 0.33 0.31 0.33 0.076705 A Echo exam of abdomen 0.59 2.43 2.53 NA NA 0.076705 TC A Echo exam of abdomen 0.00 2.21 2.29 NA NA 0.076705 26 A Echo exam of abdomen 0.59 0.22 0.24 0.22 0.24 0.076770 A Us exam abdo back wall comp 0.74 2.99 3.16 NA NA 0.076770 TC A Us exam abdo back wall comp 0.00 2.71 2.86 NA NA 0.076770 26 A Us exam abdo back wall comp 0.74 0.28 0.30 0.28 0.30 0.076775 A Us exam abdo back wall lim 0.58 2.45 2.68 NA NA 0.076775 TC A Us exam abdo back wall lim 0.00 2.23 2.43 NA NA 0.076775 26 A Us exam abdo back wall lim 0.58 0.22 0.25 0.22 0.25 0.0
CMS-1582-PN 408 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76776 A Us exam k transpl w/doppler 0.76 3.54 3.67 NA NA 0.076776 TC A Us exam k transpl w/doppler 0.00 3.26 3.36 NA NA 0.076776 26 A Us exam k transpl w/doppler 0.76 0.28 0.31 0.28 0.31 0.076800 A Us exam spinal canal 1.13 2.91 2.76 NA NA 0.076800 TC A Us exam spinal canal 0.00 2.41 2.31 NA NA 0.076800 26 A Us exam spinal canal 1.13 0.50 0.45 0.50 0.45 0.076801 A Ob us < 14 wks single fetus 0.99 2.62 2.82 NA NA 0.076801 TC A Ob us < 14 wks single fetus 0.00 2.21 2.40 NA NA 0.076801 26 A Ob us < 14 wks single fetus 0.99 0.41 0.42 0.41 0.42 0.076802 A Ob us < 14 wks addl fetus 0.83 1.08 1.20 NA NA 0.076802 TC A Ob us < 14 wks addl fetus 0.00 0.73 0.85 NA NA 0.076802 26 A Ob us < 14 wks addl fetus 0.83 0.35 0.35 0.35 0.35 0.076805 A Ob us >/= 14 wks sngl fetus 0.99 3.23 3.38 NA NA 0.076805 TC A Ob us >/= 14 wks sngl fetus 0.00 2.81 2.96 NA NA 0.076805 26 A Ob us >/= 14 wks sngl fetus 0.99 0.42 0.42 0.42 0.42 0.076810 A Ob us >/= 14 wks addl fetus 0.98 1.80 1.87 NA NA 0.076810 TC A Ob us >/= 14 wks addl fetus 0.00 1.38 1.46 NA NA 0.076810 26 A Ob us >/= 14 wks addl fetus 0.98 0.42 0.41 0.42 0.41 0.076811 A Ob us detailed sngl fetus 1.90 3.42 3.75 NA NA 0.076811 TC A Ob us detailed sngl fetus 0.00 2.56 2.94 NA NA 0.076811 26 A Ob us detailed sngl fetus 1.90 0.86 0.81 0.86 0.81 0.076812 A Ob us detailed addl fetus 1.78 4.32 4.21 NA NA 0.076812 TC A Ob us detailed addl fetus 0.00 3.51 3.46 NA NA 0.076812 26 A Ob us detailed addl fetus 1.78 0.81 0.75 0.81 0.75 0.076813 A Ob us nuchal meas 1 gest 1.18 2.40 2.52 NA NA 0.076813 TC A Ob us nuchal meas 1 gest 0.00 1.86 2.03 NA NA 0.076813 26 A Ob us nuchal meas 1 gest 1.18 0.54 0.49 0.54 0.49 0.076814 A Ob us nuchal meas add-on 0.99 1.34 1.36 NA NA 0.076814 TC A Ob us nuchal meas add-on 0.00 0.88 0.95 NA NA 0.076814 26 A Ob us nuchal meas add-on 0.99 0.46 0.41 0.46 0.41 0.0
CMS-1582-PN 409 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76815 A Ob us limited fetus(s) 0.65 1.92 2.03 NA NA 0.076815 TC A Ob us limited fetus(s) 0.00 1.65 1.76 NA NA 0.076815 26 A Ob us limited fetus(s) 0.65 0.27 0.27 0.27 0.27 0.076816 A Ob us follow-up per fetus 0.85 2.55 2.57 NA NA 0.076816 TC A Ob us follow-up per fetus 0.00 2.17 2.21 NA NA 0.076816 26 A Ob us follow-up per fetus 0.85 0.38 0.36 0.38 0.36 0.076817 A Transvaginal us obstetric 0.75 2.15 2.27 NA NA 0.076817 TC A Transvaginal us obstetric 0.00 1.84 1.96 NA NA 0.076817 26 A Transvaginal us obstetric 0.75 0.31 0.31 0.31 0.31 0.076818 A Fetal biophys profile w/nst 1.05 2.45 2.53 NA NA 0.076818 TC A Fetal biophys profile w/nst 0.00 1.97 2.08 NA NA 0.076818 26 A Fetal biophys profile w/nst 1.05 0.48 0.45 0.48 0.45 0.076819 A Fetal biophys profil w/o nst 0.77 1.76 1.91 NA NA 0.076819 TC A Fetal biophys profil w/o nst 0.00 1.42 1.58 NA NA 0.076819 26 A Fetal biophys profil w/o nst 0.77 0.34 0.33 0.34 0.33 0.076820 A Umbilical artery echo 0.50 0.66 0.86 NA NA 0.076820 TC A Umbilical artery echo 0.00 0.43 0.65 NA NA 0.076820 26 A Umbilical artery echo 0.50 0.23 0.21 0.23 0.21 0.076821 A Middle cerebral artery echo 0.70 2.02 2.14 NA NA 0.076821 TC A Middle cerebral artery echo 0.00 1.70 1.84 NA NA 0.076821 26 A Middle cerebral artery echo 0.70 0.32 0.30 0.32 0.30 0.076825 A Echo exam of fetal heart 1.67 4.64 4.70 NA NA 0.076825 TC A Echo exam of fetal heart 0.00 3.91 4.00 NA NA 0.076825 26 A Echo exam of fetal heart 1.67 0.73 0.70 0.73 0.70 0.076826 A Echo exam of fetal heart 0.83 2.90 2.83 NA NA 0.076826 TC A Echo exam of fetal heart 0.00 2.54 2.49 NA NA 0.076826 26 A Echo exam of fetal heart 0.83 0.36 0.34 0.36 0.34 0.076827 A Echo exam of fetal heart 0.58 1.17 1.36 NA NA 0.076827 TC A Echo exam of fetal heart 0.00 0.92 1.12 NA NA 0.076827 26 A Echo exam of fetal heart 0.58 0.25 0.24 0.25 0.24 0.0
CMS-1582-PN 410 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76828 A Echo exam of fetal heart 0.56 0.73 0.86 NA NA 0.076828 TC A Echo exam of fetal heart 0.00 0.48 0.62 NA NA 0.076828 26 A Echo exam of fetal heart 0.56 0.25 0.24 0.25 0.24 0.076830 A Transvaginal us non-ob 0.69 2.88 2.97 NA NA 0.076830 TC A Transvaginal us non-ob 0.00 2.60 2.68 NA NA 0.076830 26 A Transvaginal us non-ob 0.69 0.28 0.29 0.28 0.29 0.076831 A Echo exam uterus 0.72 2.89 2.95 NA NA 0.076831 TC A Echo exam uterus 0.00 2.57 2.65 NA NA 0.076831 26 A Echo exam uterus 0.72 0.32 0.30 0.32 0.30 0.076856 A Us exam pelvic complete 0.69 2.85 2.96 NA NA 0.076856 TC A Us exam pelvic complete 0.00 2.58 2.67 NA NA 0.076856 26 A Us exam pelvic complete 0.69 0.27 0.29 0.27 0.29 0.076857 A Us exam pelvic limited 0.38 2.33 2.58 NA NA 0.076857 TC A Us exam pelvic limited 0.00 2.18 2.41 NA NA 0.076857 26 A Us exam pelvic limited 0.38 0.15 0.17 0.15 0.17 0.076870 A Us exam scrotum 0.64 2.85 2.98 NA NA 0.076870 TC A Us exam scrotum 0.00 2.61 2.71 NA NA 0.076870 26 A Us exam scrotum 0.64 0.24 0.27 0.24 0.27 0.076872 A Us transrectal 0.69 3.04 3.42 NA NA 0.076872 TC A Us transrectal 0.00 2.77 3.11 NA NA 0.076872 26 A Us transrectal 0.69 0.27 0.31 0.27 0.31 0.076873 A Echograp trans r pros study 1.55 3.39 3.63 NA NA 0.076873 TC A Echograp trans r pros study 0.00 2.74 2.96 NA NA 0.076873 26 A Echograp trans r pros study 1.55 0.65 0.67 0.65 0.67 0.076881 A Us xtr non-vasc complete 0.59 2.75 2.75 NA NA 0.076881 TC A Us xtr non-vasc complete 0.00 2.53 2.53 NA NA 0.076881 26 A Us xtr non-vasc complete 0.59 0.22 0.22 0.22 0.22 0.076882 A Us xtr non-vasc lmtd 0.41 0.44 0.44 NA NA 0.076882 TC A Us xtr non-vasc lmtd 0.00 0.29 0.29 NA NA 0.076882 26 A Us xtr non-vasc lmtd 0.41 0.15 0.15 0.15 0.15 0.0
CMS-1582-PN 411 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76885 A Us exam infant hips dynamic 0.74 3.49 3.51 NA NA 0.076885 TC A Us exam infant hips dynamic 0.00 3.20 3.20 NA NA 0.076885 26 A Us exam infant hips dynamic 0.74 0.29 0.31 0.29 0.31 0.076886 A Us exam infant hips static 0.62 3.03 2.77 NA NA 0.076886 TC A Us exam infant hips static 0.00 2.73 2.49 NA NA 0.076886 26 A Us exam infant hips static 0.62 0.30 0.28 0.30 0.28 0.076930 A Echo guide cardiocentesis 0.67 1.63 1.99 NA NA 0.076930 TC A Echo guide cardiocentesis 0.00 1.37 1.67 NA NA 0.076930 26 A Echo guide cardiocentesis 0.67 0.26 0.32 0.26 0.32 0.076932 C Echo guide for heart biopsy 0.00 0.00 0.00 NA NA 0.076932 TC C Echo guide for heart biopsy 0.00 0.00 0.00 NA NA 0.076932 26 A Echo guide for heart biopsy 0.67 0.26 0.33 0.26 0.33 0.076936 A Echo guide for artery repair 1.99 6.26 6.95 NA NA 0.276936 TC A Echo guide for artery repair 0.00 5.55 6.15 NA NA 0.076936 26 A Echo guide for artery repair 1.99 0.71 0.80 0.71 0.80 0.276937 A Us guide vascular access 0.30 0.67 0.69 NA NA 0.076937 TC A Us guide vascular access 0.00 0.56 0.57 NA NA 0.076937 26 A Us guide vascular access 0.30 0.11 0.12 0.11 0.12 0.076940 C Us guide tissue ablation 0.00 0.00 0.00 NA NA 0.076940 TC C Us guide tissue ablation 0.00 0.00 0.00 NA NA 0.076940 26 A Us guide tissue ablation 2.00 0.79 0.82 0.79 0.82 0.276941 C Echo guide for transfusion 0.00 0.00 0.00 NA NA 0.076941 TC C Echo guide for transfusion 0.00 0.00 0.00 NA NA 0.076941 26 A Echo guide for transfusion 1.34 0.62 0.58 0.62 0.58 0.176942 A Echo guide for biopsy 0.67 4.96 5.11 NA NA 0.076942 TC A Echo guide for biopsy 0.00 4.70 4.83 NA NA 0.076942 26 A Echo guide for biopsy 0.67 0.26 0.28 0.26 0.28 0.076945 C Echo guide villus sampling 0.00 0.00 0.00 NA NA 0.076945 TC C Echo guide villus sampling 0.00 0.00 0.00 NA NA 0.076945 26 A Echo guide villus sampling 0.67 0.31 0.29 0.31 0.29 0.0
CMS-1582-PN 412 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

76946 A Echo guide for amniocentesis 0.38 0.52 0.72 NA NA 0.076946 TC A Echo guide for amniocentesis 0.00 0.35 0.56 NA NA 0.076946 26 A Echo guide for amniocentesis 0.38 0.17 0.16 0.17 0.16 0.076948 A Echo guide ova aspiration 0.38 0.53 0.72 NA NA 0.076948 TC A Echo guide ova aspiration 0.00 0.36 0.56 NA NA 0.076948 26 A Echo guide ova aspiration 0.38 0.17 0.16 0.17 0.16 0.076950 A Echo guidance radiotherapy 0.58 1.27 1.42 NA NA 0.076950 TC A Echo guidance radiotherapy 0.00 1.02 1.17 NA NA 0.076950 26 A Echo guidance radiotherapy 0.58 0.25 0.25 0.25 0.25 0.076965 A Echo guidance radiotherapy 1.34 1.18 2.06 NA NA 0.076965 TC A Echo guidance radiotherapy 0.00 0.63 1.47 NA NA 0.076965 26 A Echo guidance radiotherapy 1.34 0.55 0.59 0.55 0.59 0.076970 A Ultrasound exam follow-up 0.40 2.56 2.39 NA NA 0.076970 TC A Ultrasound exam follow-up 0.00 2.39 2.23 NA NA 0.076970 26 A Ultrasound exam follow-up 0.40 0.17 0.16 0.17 0.16 0.076975 C Gi endoscopic ultrasound 0.00 0.00 0.00 NA NA 0.076975 TC C Gi endoscopic ultrasound 0.00 0.00 0.00 NA NA 0.076975 26 A Gi endoscopic ultrasound 0.81 0.40 0.39 0.40 0.39 0.076977 A Us bone density measure 0.05 0.14 0.24 NA NA 0.076977 TC A Us bone density measure 0.00 0.12 0.22 NA NA 0.076977 26 A Us bone density measure 0.05 0.02 0.02 0.02 0.02 0.076998 C Us guide intraop 0.00 0.00 0.00 NA NA 0.076998 TC C Us guide intraop 0.00 0.00 0.00 NA NA 0.076998 26 A Us guide intraop 1.20 0.47 0.47 0.47 0.47 0.276999 C Echo examination procedure 0.00 0.00 0.00 NA NA 0.076999 TC C Echo examination procedure 0.00 0.00 0.00 NA NA 0.076999 26 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.077001 A Fluoroguide for vein device 0.38 2.99 2.96 NA NA 0.077001 TC A Fluoroguide for vein device 0.00 2.85 2.80 NA NA 0.077001 26 A Fluoroguide for vein device 0.38 0.14 0.16 0.14 0.16 0.0
CMS-1582-PN 413 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77002 A Needle localization by xray 0.54 1.65 1.65 NA NA 0.077002 TC A Needle localization by xray 0.00 1.40 1.41 NA NA 0.077002 26 A Needle localization by xray 0.54 0.25 0.24 0.25 0.24 0.077003 A Fluoroguide for spine inject 0.60 1.24 1.20 NA NA 0.077003 TC A Fluoroguide for spine inject 0.00 0.95 0.96 NA NA 0.077003 26 A Fluoroguide for spine inject 0.60 0.29 0.24 0.29 0.24 0.077011 A Ct scan for localization 1.21 5.36 12.98 NA NA 0.077011 TC A Ct scan for localization 0.00 4.82 12.44 NA NA 0.077011 26 A Ct scan for localization 1.21 0.54 0.54 0.54 0.54 0.077012 A Ct scan for needle biopsy 1.16 2.46 3.61 NA NA 0.077012 TC A Ct scan for needle biopsy 0.00 2.03 3.13 NA NA 0.077012 26 A Ct scan for needle biopsy 1.16 0.43 0.48 0.43 0.48 0.077013 C Ct guide for tissue ablation 0.00 0.00 0.00 NA NA 0.077013 TC C Ct guide for tissue ablation 0.00 0.00 0.00 NA NA 0.077013 26 A Ct guide for tissue ablation 3.99 1.45 1.65 1.45 1.65 0.377014 A Ct scan for therapy guide 0.85 4.51 4.75 NA NA 0.077014 TC A Ct scan for therapy guide 0.00 4.14 4.39 NA NA 0.077014 26 A Ct scan for therapy guide 0.85 0.37 0.36 0.37 0.36 0.077021 A Mr guidance for needle place 1.50 9.78 11.16 NA NA 0.177021 TC A Mr guidance for needle place 0.00 9.22 10.54 NA NA 0.077021 26 A Mr guidance for needle place 1.50 0.56 0.62 0.56 0.62 0.177022 C Mri for tissue ablation 0.00 0.00 0.00 NA NA 0.077022 TC C Mri for tissue ablation 0.00 0.00 0.00 NA NA 0.077022 26 A Mri for tissue ablation 4.24 1.64 1.73 1.64 1.73 0.377031 A Stereotact guide for brst bx 1.59 2.02 3.04 NA NA 0.177031 TC A Stereotact guide for brst bx 0.00 1.41 2.39 NA NA 0.077031 26 A Stereotact guide for brst bx 1.59 0.61 0.65 0.61 0.65 0.177032 A Guidance for needle breast 0.56 0.87 1.05 NA NA 0.077032 TC A Guidance for needle breast 0.00 0.66 0.82 NA NA 0.077032 26 A Guidance for needle breast 0.56 0.21 0.23 0.21 0.23 0.0
CMS-1582-PN 414 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77051 A Computer dx mammogram add-on 0.06 0.20 0.26 NA NA 0.077051 TC A Computer dx mammogram add-on 0.00 0.18 0.24 NA NA 0.077051 26 A Computer dx mammogram add-on 0.06 0.02 0.02 0.02 0.02 0.077052 A Comp screen mammogram add-on 0.06 0.20 0.26 NA NA 0.077052 TC A Comp screen mammogram add-on 0.00 0.18 0.24 NA NA 0.077052 26 A Comp screen mammogram add-on 0.06 0.02 0.02 0.02 0.02 0.077053 A X-ray of mammary duct 0.36 1.26 1.62 NA NA 0.077053 TC A X-ray of mammary duct 0.00 1.13 1.47 NA NA 0.077053 26 A X-ray of mammary duct 0.36 0.13 0.15 0.13 0.15 0.077054 A X-ray of mammary ducts 0.45 1.74 2.22 NA NA 0.077054 TC A X-ray of mammary ducts 0.00 1.57 2.03 NA NA 0.077054 26 A X-ray of mammary ducts 0.45 0.17 0.19 0.17 0.19 0.077055 A Mammogram one breast 0.70 1.70 1.80 NA NA 0.077055 TC A Mammogram one breast 0.00 1.44 1.51 NA NA 0.077055 26 A Mammogram one breast 0.70 0.26 0.29 0.26 0.29 0.077056 A Mammogram both breasts 0.87 2.22 2.33 NA NA 0.077056 TC A Mammogram both breasts 0.00 1.89 1.97 NA NA 0.077056 26 A Mammogram both breasts 0.87 0.33 0.36 0.33 0.36 0.077057 A Mammogram screening 0.70 1.50 1.64 NA NA 0.077057 TC A Mammogram screening 0.00 1.24 1.35 NA NA 0.077057 26 A Mammogram screening 0.70 0.26 0.29 0.26 0.29 0.077058 A Mri one breast 1.63 16.03 20.59 NA NA 0.177058 TC A Mri one breast 0.00 15.43 19.92 NA NA 0.077058 26 A Mri one breast 1.63 0.60 0.67 0.60 0.67 0.177059 A Mri both breasts 1.63 15.93 21.43 NA NA 0.177059 TC A Mri both breasts 0.00 15.33 20.76 NA NA 0.077059 26 A Mri both breasts 1.63 0.60 0.67 0.60 0.67 0.177071 A X-ray stress view 0.41 1.03 0.90 1.03 0.90 0.077072 A X-rays for bone age 0.19 0.46 0.49 NA NA 0.077072 TC A X-rays for bone age 0.00 0.38 0.41 NA NA 0.0
CMS-1582-PN 415 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77072 26 A X-rays for bone age 0.19 0.08 0.08 0.08 0.08 0.077073 A X-rays bone length studies 0.27 0.81 0.84 NA NA 0.077073 TC A X-rays bone length studies 0.00 0.67 0.71 NA NA 0.077073 26 A X-rays bone length studies 0.27 0.14 0.13 0.14 0.13 0.077074 A X-rays bone survey limited 0.45 1.48 1.58 NA NA 0.077074 TC A X-rays bone survey limited 0.00 1.31 1.39 NA NA 0.077074 26 A X-rays bone survey limited 0.45 0.17 0.19 0.17 0.19 0.077075 A X-rays bone survey complete 0.54 2.35 2.46 NA NA 0.077075 TC A X-rays bone survey complete 0.00 2.15 2.24 NA NA 0.077075 26 A X-rays bone survey complete 0.54 0.20 0.22 0.20 0.22 0.077076 A X-rays bone survey infant 0.70 2.25 2.22 NA NA 0.077076 TC A X-rays bone survey infant 0.00 1.98 1.95 NA NA 0.077076 26 A X-rays bone survey infant 0.70 0.27 0.27 0.27 0.27 0.077077 A Joint survey single view 0.31 0.82 0.89 NA NA 0.077077 TC A Joint survey single view 0.00 0.67 0.75 NA NA 0.077077 26 A Joint survey single view 0.31 0.15 0.14 0.15 0.14 0.077078 A Ct bone density axial 0.25 3.54 4.38 NA NA 0.077078 TC A Ct bone density axial 0.00 3.44 4.28 NA NA 0.077078 26 A Ct bone density axial 0.25 0.10 0.10 0.10 0.10 0.077079 A Ct bone density peripheral 0.22 0.92 1.26 NA NA 0.077079 TC A Ct bone density peripheral 0.00 0.82 1.17 NA NA 0.077079 26 A Ct bone density peripheral 0.22 0.10 0.09 0.10 0.09 0.077080 A Dxa bone density axial 0.23 2.50 2.50 NA NA 0.177080 TC A Dxa bone density axial 0.00 2.42 2.42 NA NA 0.177080 26 A Dxa bone density axial 0.23 0.08 0.08 0.08 0.08 0.077081 A Dxa bone density/peripheral 0.22 0.55 0.62 NA NA 0.077081 TC A Dxa bone density/peripheral 0.00 0.55 0.55 NA NA 0.077081 26 A Dxa bone density/peripheral 0.22 0.06 0.06 0.06 0.06 0.077082 A Dxa bone density vert fx 0.13 0.64 0.64 NA NA 0.077082 TC A Dxa bone density vert fx 0.00 0.59 0.59 NA NA 0.0
CMS-1582-PN 416 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77082 26 A Dxa bone density vert fx 0.13 0.05 0.05 0.05 0.05 0.077083 A Radiographic absorptiometry 0.20 0.47 0.52 NA NA 0.077083 TC A Radiographic absorptiometry 0.00 0.38 0.44 NA NA 0.077083 26 A Radiographic absorptiometry 0.20 0.09 0.08 0.09 0.08 0.077084 A Magnetic image bone marrow 1.60 10.98 13.88 NA NA 0.177084 TC A Magnetic image bone marrow 0.00 10.38 13.21 NA NA 0.077084 26 A Magnetic image bone marrow 1.60 0.60 0.67 0.60 0.67 0.177261 A Radiation therapy planning 1.39 0.66 0.64 0.66 0.64 0.177262 A Radiation therapy planning 2.11 0.93 0.92 0.93 0.92 0.177263 A Radiation therapy planning 3.14 1.38 1.36 1.38 1.36 0.277280 A Set radiation therapy field 0.70 4.53 4.82 NA NA 0.077280 TC A Set radiation therapy field 0.00 4.22 4.52 NA NA 0.077280 26 A Set radiation therapy field 0.70 0.31 0.30 0.31 0.30 0.077285 A Set radiation therapy field 1.05 8.23 8.64 NA NA 0.077285 TC A Set radiation therapy field 0.00 7.77 8.19 NA NA 0.077285 26 A Set radiation therapy field 1.05 0.46 0.45 0.46 0.45 0.077290 A Set radiation therapy field 1.56 13.68 13.96 NA NA 0.077290 TC A Set radiation therapy field 0.00 12.99 13.29 NA NA 0.077290 26 A Set radiation therapy field 1.56 0.69 0.67 0.69 0.67 0.077295 A Set radiation therapy field 4.56 7.92 11.78 NA NA 0.277295 TC A Set radiation therapy field 0.00 5.91 9.83 NA NA 0.077295 26 A Set radiation therapy field 4.56 2.01 1.95 2.01 1.95 0.277299 C Radiation therapy planning 0.00 0.00 0.00 NA NA 0.077299 TC C Radiation therapy planning 0.00 0.00 0.00 NA NA 0.077299 26 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.077300 A Radiation therapy dose plan 0.62 1.25 1.40 NA NA 0.077300 TC A Radiation therapy dose plan 0.00 0.98 1.13 NA NA 0.077300 26 A Radiation therapy dose plan 0.62 0.27 0.27 0.27 0.27 0.077301 A Radiotherapy dose plan imrt 7.99 44.85 52.84 NA NA 0.677301 TC A Radiotherapy dose plan imrt 0.00 41.34 49.42 NA NA 0.2
CMS-1582-PN 417 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77301 26 A Radiotherapy dose plan imrt 7.99 3.51 3.42 3.51 3.42 0.477305 A Teletx isodose plan simple 0.70 0.98 1.22 NA NA 0.077305 TC A Teletx isodose plan simple 0.00 0.67 0.92 NA NA 0.077305 26 A Teletx isodose plan simple 0.70 0.31 0.30 0.31 0.30 0.077310 A Teletx isodose plan intermed 1.05 1.37 1.66 NA NA 0.077310 TC A Teletx isodose plan intermed 0.00 0.91 1.21 NA NA 0.077310 26 A Teletx isodose plan intermed 1.05 0.46 0.45 0.46 0.45 0.077315 A Teletx isodose plan complex 1.56 2.26 2.56 NA NA 0.077315 TC A Teletx isodose plan complex 0.00 1.57 1.89 NA NA 0.077315 26 A Teletx isodose plan complex 1.56 0.69 0.67 0.69 0.67 0.077321 A Special teletx port plan 0.95 1.62 2.15 NA NA 0.077321 TC A Special teletx port plan 0.00 1.20 1.75 NA NA 0.077321 26 A Special teletx port plan 0.95 0.42 0.40 0.42 0.40 0.077326 A Brachytx isodose calc simp 0.93 3.08 3.27 NA NA 0.077326 TC A Brachytx isodose calc simp 0.00 2.67 2.88 NA NA 0.077326 26 A Brachytx isodose calc simp 0.93 0.41 0.39 0.41 0.39 0.077327 A Brachytx isodose calc interm 1.39 4.23 4.56 NA NA 0.177327 TC A Brachytx isodose calc interm 0.00 3.62 3.97 NA NA 0.077327 26 A Brachytx isodose calc interm 1.39 0.61 0.59 0.61 0.59 0.077328 A Brachytx isodose plan compl 2.09 5.44 5.94 NA NA 0.177328 TC A Brachytx isodose plan compl 0.00 4.52 5.05 NA NA 0.077328 26 A Brachytx isodose plan compl 2.09 0.92 0.89 0.92 0.89 0.177331 A Special radiation dosimetry 0.87 0.90 0.94 NA NA 0.077331 TC A Special radiation dosimetry 0.00 0.52 0.56 NA NA 0.077331 26 A Special radiation dosimetry 0.87 0.38 0.38 0.38 0.38 0.077332 A Radiation treatment aid(s) 0.54 1.62 1.74 NA NA 0.077332 TC A Radiation treatment aid(s) 0.00 1.38 1.51 NA NA 0.077332 26 A Radiation treatment aid(s) 0.54 0.24 0.23 0.24 0.23 0.077333 A Radiation treatment aid(s) 0.84 0.61 0.87 NA NA 0.077333 TC A Radiation treatment aid(s) 0.00 0.24 0.51 NA NA 0.0
CMS-1582-PN 418 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77333 26 A Radiation treatment aid(s) 0.84 0.37 0.36 0.37 0.36 0.077334 A Radiation treatment aid(s) 1.24 2.87 3.22 NA NA 0.077334 TC A Radiation treatment aid(s) 0.00 2.32 2.69 NA NA 0.077334 26 A Radiation treatment aid(s) 1.24 0.55 0.53 0.55 0.53 0.077336 A Radiation physics consult 0.00 1.13 1.53 NA NA 0.077338 A Design mlc device for imrt 4.29 9.55 9.55 NA NA 0.277338 TC A Design mlc device for imrt 0.00 7.66 7.66 NA NA 0.077338 26 A Design mlc device for imrt 4.29 1.89 1.89 1.89 1.89 0.277370 A Radiation physics consult 0.00 3.01 3.39 NA NA 0.077371 C Srs multisource 0.00 0.00 0.00 0.00 0.00 0.077372 A Srs linear based 0.00 22.83 25.02 NA NA 0.077373 A Sbrt delivery 0.00 42.95 46.74 NA NA 0.077399 C External radiation dosimetry 0.00 0.00 0.00 NA NA 0.077399 TC C External radiation dosimetry 0.00 0.00 0.00 NA NA 0.077399 26 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.077401 A Radiation treatment delivery 0.00 0.53 0.74 NA NA 0.077402 A Radiation treatment delivery 0.00 5.86 5.18 NA NA 0.077403 A Radiation treatment delivery 0.00 3.79 3.85 NA NA 0.077404 A Radiation treatment delivery 0.00 4.24 4.28 NA NA 0.077406 A Radiation treatment delivery 0.00 4.28 4.32 NA NA 0.077407 A Radiation treatment delivery 0.00 7.96 7.51 NA NA 0.077408 A Radiation treatment delivery 0.00 5.21 5.24 NA NA 0.077409 A Radiation treatment delivery 0.00 5.84 5.83 NA NA 0.077411 A Radiation treatment delivery 0.00 5.81 5.80 NA NA 0.077412 A Radiation treatment delivery 0.00 6.86 6.84 NA NA 0.077413 A Radiation treatment delivery 0.00 6.90 6.89 NA NA 0.077414 A Radiation treatment delivery 0.00 7.78 7.71 NA NA 0.077416 A Radiation treatment delivery 0.00 7.83 7.75 NA NA 0.077417 A Radiology port film(s) 0.00 0.36 0.43 NA NA 0.077418 A Radiation tx delivery imrt 0.00 13.27 15.29 NA NA 0.0
CMS-1582-PN 419 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77421 A Stereoscopic x-ray guidance 0.39 2.44 2.83 NA NA 0.077421 TC A Stereoscopic x-ray guidance 0.00 2.27 2.66 NA NA 0.077421 26 A Stereoscopic x-ray guidance 0.39 0.17 0.17 0.17 0.17 0.077422 A Neutron beam tx simple 0.00 5.30 5.85 NA NA 0.077423 A Neutron beam tx complex 0.00 7.49 7.44 NA NA 0.077427 A Radiation tx management x5 3.37 1.69 1.67 1.69 1.67 0.277431 A Radiation therapy management 1.81 0.98 0.96 0.98 0.96 0.177432 A Stereotactic radiation trmt 7.92 3.51 3.46 3.51 3.46 0.677435 A Sbrt management 13.00 5.87 5.85 5.87 5.87 1.077470 A Special radiation treatment 2.09 2.15 3.75 NA NA 0.177470 TC A Special radiation treatment 0.00 1.23 2.85 NA NA 0.077470 26 A Special radiation treatment 2.09 0.92 0.90 0.92 0.90 0.177499 C Radiation therapy management 0.00 0.00 0.00 NA NA 0.077499 TC C Radiation therapy management 0.00 0.00 0.00 NA NA 0.077499 26 C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.077520 C Proton trmt simple w/o comp 0.00 0.00 0.00 0.00 0.00 0.077522 C Proton trmt simple w/comp 0.00 0.00 0.00 0.00 0.00 0.077523 C Proton trmt intermediate 0.00 0.00 0.00 0.00 0.00 0.077525 C Proton treatment complex 0.00 0.00 0.00 0.00 0.00 0.077600 R Hyperthermia treatment 1.56 10.37 10.34 NA NA 0.177600 TC R Hyperthermia treatment 0.00 9.68 9.67 NA NA 0.077600 26 R Hyperthermia treatment 1.56 0.69 0.67 0.69 0.67 0.077605 R Hyperthermia treatment 2.09 30.32 24.92 NA NA 0.477605 TC R Hyperthermia treatment 0.00 29.41 24.10 NA NA 0.077605 26 R Hyperthermia treatment 2.09 0.91 0.82 0.91 0.82 0.377610 R Hyperthermia treatment 1.56 27.81 23.31 NA NA 0.177610 TC R Hyperthermia treatment 0.00 27.13 22.68 NA NA 0.077610 26 R Hyperthermia treatment 1.56 0.68 0.63 0.68 0.63 0.077615 R Hyperthermia treatment 2.09 26.22 26.37 NA NA 0.177615 TC R Hyperthermia treatment 0.00 25.29 25.48 NA NA 0.0
CMS-1582-PN 420 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77615 26 R Hyperthermia treatment 2.09 0.93 0.89 0.93 0.89 0.177620 R Hyperthermia treatment 1.56 14.18 12.52 NA NA 0.077620 TC R Hyperthermia treatment 0.00 13.50 11.90 NA NA 0.077620 26 R Hyperthermia treatment 1.56 0.68 0.62 0.68 0.62 0.077750 A Infuse radioactive materials 5.00 5.10 5.09 NA NA 0.277750 TC A Infuse radioactive materials 0.00 2.91 2.96 NA NA 0.077750 26 A Infuse radioactive materials 5.00 2.19 2.13 2.19 2.13 0.277761 A Apply intrcav radiat simple 3.85 6.65 6.75 NA NA 0.277761 TC A Apply intrcav radiat simple 0.00 4.98 5.14 NA NA 0.077761 26 A Apply intrcav radiat simple 3.85 1.67 1.61 1.67 1.61 0.277762 A Apply intrcav radiat interm 5.76 8.25 8.46 NA NA 0.377762 TC A Apply intrcav radiat interm 0.00 5.74 6.01 NA NA 0.077762 26 A Apply intrcav radiat interm 5.76 2.51 2.45 2.51 2.45 0.377763 A Apply intrcav radiat compl 8.66 11.22 11.45 NA NA 0.577763 TC A Apply intrcav radiat compl 0.00 7.45 7.77 NA NA 0.077763 26 A Apply intrcav radiat compl 8.66 3.77 3.68 3.77 3.68 0.477776 A Apply interstit radiat simpl 4.70 7.08 7.36 NA NA 0.377776 TC A Apply interstit radiat simpl 0.00 5.00 5.36 NA NA 0.077776 26 A Apply interstit radiat simpl 4.70 2.08 2.00 2.08 2.00 0.377777 A Apply interstit radiat inter 7.52 8.74 9.15 NA NA 0.577777 TC A Apply interstit radiat inter 0.00 5.43 5.86 NA NA 0.077777 26 A Apply interstit radiat inter 7.52 3.31 3.29 3.31 3.29 0.477778 A Apply interstit radiat compl 11.32 12.47 12.78 NA NA 0.677778 TC A Apply interstit radiat compl 0.00 7.56 7.97 NA NA 0.077778 26 A Apply interstit radiat compl 11.32 4.91 4.81 4.91 4.81 0.677785 A Hdr brachytx 1 channel 1.42 5.55 4.95 NA NA 0.177785 TC A Hdr brachytx 1 channel 0.00 4.93 4.34 NA NA 0.077785 26 A Hdr brachytx 1 channel 1.42 0.62 0.61 0.62 0.61 0.077786 A Hdr brachytx 2-12 channel 3.25 12.34 13.35 NA NA 0.277786 TC A Hdr brachytx 2-12 channel 0.00 10.91 12.00 NA NA 0.0
CMS-1582-PN 421 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

77786 26 A Hdr brachytx 2-12 channel 3.25 1.43 1.35 1.43 1.35 0.177787 A Hdr brachytx over 12 chan 4.89 21.83 21.58 NA NA 0.377787 TC A Hdr brachytx over 12 chan 0.00 19.67 19.45 NA NA 0.077787 26 A Hdr brachytx over 12 chan 4.89 2.16 2.13 2.16 2.13 0.277789 A Apply surface radiation 1.14 2.10 2.07 NA NA 0.077789 TC A Apply surface radiation 0.00 1.58 1.57 NA NA 0.077789 26 A Apply surface radiation 1.14 0.52 0.50 0.52 0.50 0.077790 A Radiation handling 1.05 1.58 1.58 NA NA 0.077790 TC A Radiation handling 0.00 1.12 1.13 NA NA 0.077790 26 A Radiation handling 1.05 0.46 0.45 0.46 0.45 0.077799 C Radium/radioisotope therapy 0.00 0.00 0.00 NA NA 0.077799 TC C Radium/radioisotope therapy 0.00 0.00 0.00 NA NA 0.077799 26 C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.078000 A Thyroid single uptake 0.19 1.79 1.91 NA NA 0.078000 TC A Thyroid single uptake 0.00 1.73 1.83 NA NA 0.078000 26 A Thyroid single uptake 0.19 0.06 0.08 0.06 0.08 0.078001 A Thyroid multiple uptakes 0.26 2.31 2.42 NA NA 0.078001 TC A Thyroid multiple uptakes 0.00 2.22 2.31 NA NA 0.078001 26 A Thyroid multiple uptakes 0.26 0.09 0.11 0.09 0.11 0.078003 A Thyroid suppress/stimul 0.33 1.93 2.01 NA NA 0.078003 TC A Thyroid suppress/stimul 0.00 1.81 1.87 NA NA 0.078003 26 A Thyroid suppress/stimul 0.33 0.12 0.14 0.12 0.14 0.078006 A Thyroid imaging with uptake 0.49 6.30 6.39 NA NA 0.078006 TC A Thyroid imaging with uptake 0.00 6.13 6.19 NA NA 0.078006 26 A Thyroid imaging with uptake 0.49 0.17 0.20 0.17 0.20 0.078007 A Thyroid image mult uptakes 0.50 6.69 5.19 NA NA 0.078007 TC A Thyroid image mult uptakes 0.00 6.51 4.99 NA NA 0.078007 26 A Thyroid image mult uptakes 0.50 0.18 0.20 0.18 0.20 0.078010 A Thyroid imaging 0.39 4.32 4.36 NA NA 0.078010 TC A Thyroid imaging 0.00 4.18 4.21 NA NA 0.0
CMS-1582-PN 422 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78010 26 A Thyroid imaging 0.39 0.14 0.15 0.14 0.15 0.078011 A Thyroid imaging with flow 0.45 4.54 4.78 NA NA 0.078011 TC A Thyroid imaging with flow 0.00 4.37 4.59 NA NA 0.078011 26 A Thyroid imaging with flow 0.45 0.17 0.19 0.17 0.19 0.078015 A Thyroid met imaging 0.67 5.41 5.60 NA NA 0.078015 TC A Thyroid met imaging 0.00 5.19 5.34 NA NA 0.078015 26 A Thyroid met imaging 0.67 0.22 0.26 0.22 0.26 0.078016 A Thyroid met imaging/studies 0.82 7.11 8.09 NA NA 0.078016 TC A Thyroid met imaging/studies 0.00 6.97 7.83 NA NA 0.078016 26 A Thyroid met imaging/studies 0.82 0.14 0.26 0.14 0.26 0.078018 A Thyroid met imaging body 0.86 7.89 8.45 NA NA 0.078018 TC A Thyroid met imaging body 0.00 7.61 8.12 NA NA 0.078018 26 A Thyroid met imaging body 0.86 0.28 0.33 0.28 0.33 0.078020 A Thyroid met uptake 0.60 1.66 1.90 NA NA 0.078020 TC A Thyroid met uptake 0.00 1.49 1.68 NA NA 0.078020 26 A Thyroid met uptake 0.60 0.17 0.22 0.17 0.22 0.078070 A Parathyroid nuclear imaging 0.82 3.39 3.99 NA NA 0.078070 TC A Parathyroid nuclear imaging 0.00 3.11 3.66 NA NA 0.078070 26 A Parathyroid nuclear imaging 0.82 0.28 0.33 0.28 0.33 0.078075 A Adrenal nuclear imaging 0.74 11.16 11.72 NA NA 0.078075 TC A Adrenal nuclear imaging 0.00 10.93 11.44 NA NA 0.078075 26 A Adrenal nuclear imaging 0.74 0.23 0.28 0.23 0.28 0.078099 C Endocrine nuclear procedure 0.00 0.00 0.00 NA NA 0.078099 TC C Endocrine nuclear procedure 0.00 0.00 0.00 NA NA 0.078099 26 C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.078102 A Bone marrow imaging ltd 0.55 4.06 4.29 NA NA 0.078102 TC A Bone marrow imaging ltd 0.00 3.89 4.08 NA NA 0.078102 26 A Bone marrow imaging ltd 0.55 0.17 0.21 0.17 0.21 0.078103 A Bone marrow imaging mult 0.75 5.24 5.64 NA NA 0.078103 TC A Bone marrow imaging mult 0.00 5.02 5.36 NA NA 0.0
CMS-1582-PN 423 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78103 26 A Bone marrow imaging mult 0.75 0.22 0.28 0.22 0.28 0.078104 A Bone marrow imaging body 0.80 5.95 6.47 NA NA 0.078104 TC A Bone marrow imaging body 0.00 5.70 6.16 NA NA 0.078104 26 A Bone marrow imaging body 0.80 0.25 0.31 0.25 0.31 0.078110 A Plasma volume single 0.19 2.17 2.21 NA NA 0.078110 TC A Plasma volume single 0.00 2.10 2.13 NA NA 0.078110 26 A Plasma volume single 0.19 0.07 0.08 0.07 0.08 0.078111 A Plasma volume multiple 0.22 1.80 2.32 NA NA 0.078111 TC A Plasma volume multiple 0.00 1.76 2.24 NA NA 0.078111 26 A Plasma volume multiple 0.22 0.04 0.08 0.04 0.08 0.078120 A Red cell mass single 0.23 2.13 2.32 NA NA 0.078120 TC A Red cell mass single 0.00 2.04 2.22 NA NA 0.078120 26 A Red cell mass single 0.23 0.09 0.10 0.09 0.10 0.078121 A Red cell mass multiple 0.32 2.24 2.61 NA NA 0.078121 TC A Red cell mass multiple 0.00 2.12 2.48 NA NA 0.078121 26 A Red cell mass multiple 0.32 0.12 0.13 0.12 0.13 0.078122 A Blood volume 0.45 2.08 2.82 NA NA 0.078122 TC A Blood volume 0.00 1.95 2.65 NA NA 0.078122 26 A Blood volume 0.45 0.13 0.17 0.13 0.17 0.078130 A Red cell survival study 0.61 3.57 3.88 NA NA 0.078130 TC A Red cell survival study 0.00 3.34 3.62 NA NA 0.078130 26 A Red cell survival study 0.61 0.23 0.26 0.23 0.26 0.078135 A Red cell survival kinetics 0.64 9.25 9.40 NA NA 0.078135 TC A Red cell survival kinetics 0.00 9.00 9.13 NA NA 0.078135 26 A Red cell survival kinetics 0.64 0.25 0.27 0.25 0.27 0.078140 A Red cell sequestration 0.61 2.89 3.42 NA NA 0.078140 TC A Red cell sequestration 0.00 2.67 3.17 NA NA 0.078140 26 A Red cell sequestration 0.61 0.22 0.25 0.22 0.25 0.078185 A Spleen imaging 0.40 5.39 5.48 NA NA 0.078185 TC A Spleen imaging 0.00 5.24 5.31 NA NA 0.0
CMS-1582-PN 424 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78185 26 A Spleen imaging 0.40 0.15 0.17 0.15 0.17 0.078190 A Platelet survival kinetics 1.09 9.52 9.98 NA NA 0.078190 TC A Platelet survival kinetics 0.00 9.09 9.54 NA NA 0.078190 26 A Platelet survival kinetics 1.09 0.43 0.44 0.43 0.44 0.078191 A Platelet survival 0.61 3.59 4.53 NA NA 0.078191 TC A Platelet survival 0.00 3.36 4.28 NA NA 0.078191 26 A Platelet survival 0.61 0.23 0.25 0.23 0.25 0.078195 A Lymph system imaging 1.20 8.83 9.08 NA NA 0.178195 TC A Lymph system imaging 0.00 8.42 8.60 NA NA 0.078195 26 A Lymph system imaging 1.20 0.41 0.48 0.41 0.48 0.078199 C Blood/lymph nuclear exam 0.00 0.00 0.00 NA NA 0.078199 TC C Blood/lymph nuclear exam 0.00 0.00 0.00 NA NA 0.078199 26 C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.078201 A Liver imaging 0.44 4.90 4.96 NA NA 0.078201 TC A Liver imaging 0.00 4.75 4.80 NA NA 0.078201 26 A Liver imaging 0.44 0.15 0.16 0.15 0.16 0.078202 A Liver imaging with flow 0.51 5.02 5.41 NA NA 0.078202 TC A Liver imaging with flow 0.00 4.88 5.23 NA NA 0.078202 26 A Liver imaging with flow 0.51 0.14 0.18 0.14 0.18 0.078205 A Liver imaging (3d) 0.71 5.16 5.92 NA NA 0.078205 TC A Liver imaging (3d) 0.00 4.93 5.64 NA NA 0.078205 26 A Liver imaging (3d) 0.71 0.23 0.28 0.23 0.28 0.078206 A Liver image (3d) with flow 0.96 8.68 9.21 NA NA 0.078206 TC A Liver image (3d) with flow 0.00 8.36 8.83 NA NA 0.078206 26 A Liver image (3d) with flow 0.96 0.32 0.38 0.32 0.38 0.078215 A Liver and spleen imaging 0.49 4.86 5.11 NA NA 0.078215 TC A Liver and spleen imaging 0.00 4.69 4.91 NA NA 0.078215 26 A Liver and spleen imaging 0.49 0.17 0.20 0.17 0.20 0.078216 A Liver & spleen image/flow 0.57 2.72 3.22 NA NA 0.078216 TC A Liver & spleen image/flow 0.00 2.53 3.00 NA NA 0.0
CMS-1582-PN 425 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78216 26 A Liver & spleen image/flow 0.57 0.19 0.22 0.19 0.22 0.078220 A Liver function study 0.49 3.00 3.49 NA NA 0.078220 TC A Liver function study 0.00 2.83 3.30 NA NA 0.078220 26 A Liver function study 0.49 0.17 0.19 0.17 0.19 0.078223 A Hepatobiliary imaging 0.84 8.70 8.83 NA NA 0.078223 TC A Hepatobiliary imaging 0.00 8.40 8.49 NA NA 0.078223 26 A Hepatobiliary imaging 0.84 0.30 0.34 0.30 0.34 0.078230 A Salivary gland imaging 0.45 4.27 4.38 NA NA 0.078230 TC A Salivary gland imaging 0.00 4.10 4.20 NA NA 0.078230 26 A Salivary gland imaging 0.45 0.17 0.18 0.17 0.18 0.078231 A Serial salivary imaging 0.52 2.85 3.23 NA NA 0.078231 TC A Serial salivary imaging 0.00 2.66 3.02 NA NA 0.078231 26 A Serial salivary imaging 0.52 0.19 0.21 0.19 0.21 0.078232 A Salivary gland function exam 0.47 2.13 2.93 NA NA 0.078232 TC A Salivary gland function exam 0.00 2.05 2.78 NA NA 0.078232 26 A Salivary gland function exam 0.47 0.08 0.15 0.08 0.15 0.078258 A Esophageal motility study 0.74 5.67 5.92 NA NA 0.078258 TC A Esophageal motility study 0.00 5.41 5.61 NA NA 0.078258 26 A Esophageal motility study 0.74 0.26 0.31 0.26 0.31 0.078261 A Gastric mucosa imaging 0.69 6.28 6.60 NA NA 0.078261 TC A Gastric mucosa imaging 0.00 6.02 6.31 NA NA 0.078261 26 A Gastric mucosa imaging 0.69 0.26 0.29 0.26 0.29 0.078262 A Gastroesophageal reflux exam 0.68 6.17 6.49 NA NA 0.078262 TC A Gastroesophageal reflux exam 0.00 5.93 6.22 NA NA 0.078262 26 A Gastroesophageal reflux exam 0.68 0.24 0.27 0.24 0.27 0.078264 A Gastric emptying study 0.80 7.60 7.61 NA NA 0.078264 TC A Gastric emptying study 0.00 7.34 7.33 NA NA 0.078264 26 A Gastric emptying study 0.80 0.26 0.28 0.26 0.28 0.078267 X Breath tst attain/anal c-14 0.00 0.00 0.00 0.00 0.00 0.078268 X Breath test analysis c-14 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 426 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78270 A Vit b-12 absorption exam 0.20 2.07 2.17 NA NA 0.078270 TC A Vit b-12 absorption exam 0.00 1.99 2.09 NA NA 0.078270 26 A Vit b-12 absorption exam 0.20 0.08 0.08 0.08 0.08 0.078271 A Vit b-12 absrp exam int fac 0.20 2.29 2.30 NA NA 0.078271 TC A Vit b-12 absrp exam int fac 0.00 2.20 2.22 NA NA 0.078271 26 A Vit b-12 absrp exam int fac 0.20 0.09 0.08 0.09 0.08 0.078272 A Vit b-12 absorp combined 0.27 2.19 2.37 NA NA 0.078272 TC A Vit b-12 absorp combined 0.00 2.09 2.27 NA NA 0.078272 26 A Vit b-12 absorp combined 0.27 0.10 0.10 0.10 0.10 0.078278 A Acute gi blood loss imaging 0.99 8.75 9.10 NA NA 0.078278 TC A Acute gi blood loss imaging 0.00 8.40 8.70 NA NA 0.078278 26 A Acute gi blood loss imaging 0.99 0.35 0.40 0.35 0.40 0.078282 C Gi protein loss exam 0.00 0.00 0.00 NA NA 0.078282 TC C Gi protein loss exam 0.00 0.00 0.00 NA NA 0.078282 26 A Gi protein loss exam 0.38 0.14 0.16 0.14 0.16 0.078290 A Meckels divert exam 0.68 8.66 8.71 NA NA 0.078290 TC A Meckels divert exam 0.00 8.42 8.43 NA NA 0.078290 26 A Meckels divert exam 0.68 0.24 0.28 0.24 0.28 0.078291 A Leveen/shunt patency exam 0.88 6.27 6.48 NA NA 0.078291 TC A Leveen/shunt patency exam 0.00 5.97 6.13 NA NA 0.078291 26 A Leveen/shunt patency exam 0.88 0.30 0.35 0.30 0.35 0.078299 C Gi nuclear procedure 0.00 0.00 0.00 NA NA 0.078299 TC C Gi nuclear procedure 0.00 0.00 0.00 NA NA 0.078299 26 C Gi nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.078300 A Bone imaging limited area 0.62 4.35 4.51 NA NA 0.078300 TC A Bone imaging limited area 0.00 4.12 4.25 NA NA 0.078300 26 A Bone imaging limited area 0.62 0.23 0.26 0.23 0.26 0.078305 A Bone imaging multiple areas 0.83 5.71 5.95 NA NA 0.078305 TC A Bone imaging multiple areas 0.00 5.41 5.62 NA NA 0.078305 26 A Bone imaging multiple areas 0.83 0.30 0.33 0.30 0.33 0.0
CMS-1582-PN 427 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78306 A Bone imaging whole body 0.86 6.12 6.53 NA NA 0.078306 TC A Bone imaging whole body 0.00 5.82 6.18 NA NA 0.078306 26 A Bone imaging whole body 0.86 0.30 0.35 0.30 0.35 0.078315 A Bone imaging 3 phase 1.02 8.70 9.06 NA NA 0.078315 TC A Bone imaging 3 phase 0.00 8.35 8.65 NA NA 0.078315 26 A Bone imaging 3 phase 1.02 0.35 0.41 0.35 0.41 0.078320 A Bone imaging (3d) 1.04 5.30 6.07 NA NA 0.078320 TC A Bone imaging (3d) 0.00 4.96 5.66 NA NA 0.078320 26 A Bone imaging (3d) 1.04 0.34 0.41 0.34 0.41 0.078350 N Bone mineral single photon 0.22 0.68 0.73 NA NA 0.078350 TC N Bone mineral single photon 0.00 0.58 0.64 NA NA 0.078350 26 N Bone mineral single photon 0.22 0.10 0.09 0.10 0.09 0.078351 N Bone mineral dual photon 0.30 0.13 0.13 0.13 0.13 0.078399 C Musculoskeletal nuclear exam 0.00 0.00 0.00 NA NA 0.078399 TC C Musculoskeletal nuclear exam 0.00 0.00 0.00 NA NA 0.078399 26 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.078414 C Non-imaging heart function 0.00 0.00 0.00 NA NA 0.078414 TC C Non-imaging heart function 0.00 0.00 0.00 NA NA 0.078414 26 A Non-imaging heart function 0.45 0.20 0.18 0.20 0.18 0.078428 A Cardiac shunt imaging 0.78 4.37 4.87 NA NA 0.078428 TC A Cardiac shunt imaging 0.00 4.09 4.52 NA NA 0.078428 26 A Cardiac shunt imaging 0.78 0.28 0.35 0.28 0.35 0.078445 A Vascular flow imaging 0.49 4.29 4.51 NA NA 0.078445 TC A Vascular flow imaging 0.00 4.14 4.32 NA NA 0.078445 26 A Vascular flow imaging 0.49 0.15 0.19 0.15 0.19 0.078451 A Ht muscle image spect sing 1.38 8.58 8.58 NA NA 0.078451 TC A Ht muscle image spect sing 0.00 8.07 8.07 NA NA 0.078451 26 A Ht muscle image spect sing 1.38 0.51 0.51 0.51 0.51 0.078452 A Ht muscle image spect mult 1.62 12.35 12.35 NA NA 0.078452 TC A Ht muscle image spect mult 0.00 11.73 11.73 NA NA 0.0
CMS-1582-PN 428 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78452 26 A Ht muscle image spect mult 1.62 0.62 0.62 0.62 0.62 0.078453 A Ht muscle image planar sing 1.00 7.55 7.55 NA NA 0.078453 TC A Ht muscle image planar sing 0.00 7.18 7.18 NA NA 0.078453 26 A Ht muscle image planar sing 1.00 0.37 0.37 0.37 0.37 0.078454 A Ht musc image planar mult 1.34 11.03 11.03 NA NA 0.078454 TC A Ht musc image planar mult 0.00 10.53 10.53 NA NA 0.078454 26 A Ht musc image planar mult 1.34 0.50 0.50 0.50 0.50 0.078456 A Acute venous thrombus image 1.00 8.75 9.36 NA NA 0.078456 TC A Acute venous thrombus image 0.00 8.38 8.89 NA NA 0.078456 26 A Acute venous thrombus image 1.00 0.37 0.47 0.37 0.47 0.078457 A Venous thrombosis imaging 0.77 4.67 4.91 NA NA 0.078457 TC A Venous thrombosis imaging 0.00 4.40 4.60 NA NA 0.078457 26 A Venous thrombosis imaging 0.77 0.27 0.31 0.27 0.31 0.078458 A Ven thrombosis images bilat 0.90 4.07 4.80 NA NA 0.078458 TC A Ven thrombosis images bilat 0.00 3.86 4.49 NA NA 0.078458 26 A Ven thrombosis images bilat 0.90 0.21 0.31 0.21 0.31 0.078459 C Heart muscle imaging (pet) 0.00 0.00 0.00 NA NA 0.078459 TC C Heart muscle imaging (pet) 0.00 0.00 0.00 NA NA 0.078459 26 A Heart muscle imaging (pet) 1.50 0.45 0.62 0.45 0.62 0.178466 A Heart infarct image 0.69 4.17 4.57 NA NA 0.078466 TC A Heart infarct image 0.00 3.91 4.26 NA NA 0.078466 26 A Heart infarct image 0.69 0.26 0.31 0.26 0.31 0.078468 A Heart infarct image (ef) 0.80 4.85 5.59 NA NA 0.078468 TC A Heart infarct image (ef) 0.00 4.54 5.21 NA NA 0.078468 26 A Heart infarct image (ef) 0.80 0.31 0.38 0.31 0.38 0.078469 A Heart infarct image (3d) 0.92 6.07 6.61 NA NA 0.078469 TC A Heart infarct image (3d) 0.00 5.67 6.16 NA NA 0.078469 26 A Heart infarct image (3d) 0.92 0.40 0.45 0.40 0.45 0.078472 A Gated heart planar single 0.98 5.54 6.37 NA NA 0.078472 TC A Gated heart planar single 0.00 5.19 5.94 NA NA 0.0
CMS-1582-PN 429 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78472 26 A Gated heart planar single 0.98 0.35 0.43 0.35 0.43 0.078473 A Gated heart multiple 1.47 6.86 8.25 NA NA 0.078473 TC A Gated heart multiple 0.00 6.31 7.58 NA NA 0.078473 26 A Gated heart multiple 1.47 0.55 0.67 0.55 0.67 0.078481 A Heart first pass single 0.98 4.20 5.17 NA NA 0.078481 TC A Heart first pass single 0.00 3.82 4.69 NA NA 0.078481 26 A Heart first pass single 0.98 0.38 0.48 0.38 0.48 0.078483 A Heart first pass multiple 1.47 5.53 7.04 NA NA 0.078483 TC A Heart first pass multiple 0.00 4.96 6.31 NA NA 0.078483 26 A Heart first pass multiple 1.47 0.57 0.73 0.57 0.73 0.078491 C Heart image (pet) single 0.00 0.00 0.00 NA NA 0.078491 TC C Heart image (pet) single 0.00 0.00 0.00 NA NA 0.078491 26 A Heart image (pet) single 1.50 0.49 0.65 0.49 0.65 0.178492 C Heart image (pet) multiple 0.00 0.00 0.00 NA NA 0.078492 TC C Heart image (pet) multiple 0.00 0.00 0.00 NA NA 0.078492 26 A Heart image (pet) multiple 1.87 0.65 0.86 0.65 0.86 0.178494 A Heart image spect 1.19 5.56 6.64 NA NA 0.078494 TC A Heart image spect 0.00 5.09 6.09 NA NA 0.078494 26 A Heart image spect 1.19 0.47 0.55 0.47 0.55 0.078496 A Heart first pass add-on 0.50 0.74 1.86 NA NA 0.078496 TC A Heart first pass add-on 0.00 0.55 1.63 NA NA 0.078496 26 A Heart first pass add-on 0.50 0.19 0.23 0.19 0.23 0.078499 C Cardiovascular nuclear exam 0.00 0.00 0.00 NA NA 0.078499 TC C Cardiovascular nuclear exam 0.00 0.00 0.00 NA NA 0.078499 26 C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.078580 A Lung perfusion imaging 0.74 5.12 5.46 NA NA 0.078580 TC A Lung perfusion imaging 0.00 4.87 5.16 NA NA 0.078580 26 A Lung perfusion imaging 0.74 0.25 0.30 0.25 0.30 0.078584 A Lung v/q image single breath 0.99 3.01 3.43 NA NA 0.078584 TC A Lung v/q image single breath 0.00 2.65 3.02 NA NA 0.0
CMS-1582-PN 430 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78584 26 A Lung v/q image single breath 0.99 0.36 0.41 0.36 0.41 0.078585 A Lung v/q imaging 1.09 8.75 9.23 NA NA 0.078585 TC A Lung v/q imaging 0.00 8.37 8.79 NA NA 0.078585 26 A Lung v/q imaging 1.09 0.38 0.44 0.38 0.44 0.078586 A Aerosol lung image single 0.40 4.31 4.46 NA NA 0.078586 TC A Aerosol lung image single 0.00 4.16 4.30 NA NA 0.078586 26 A Aerosol lung image single 0.40 0.15 0.16 0.15 0.16 0.078587 A Aerosol lung image multiple 0.49 5.33 5.59 NA NA 0.078587 TC A Aerosol lung image multiple 0.00 5.17 5.40 NA NA 0.078587 26 A Aerosol lung image multiple 0.49 0.16 0.19 0.16 0.19 0.078588 A Perfusion lung image 1.09 8.82 8.91 NA NA 0.078588 TC A Perfusion lung image 0.00 8.44 8.47 NA NA 0.078588 26 A Perfusion lung image 1.09 0.38 0.44 0.38 0.44 0.078591 A Vent image 1 breath 1 proj 0.40 4.34 4.52 NA NA 0.078591 TC A Vent image 1 breath 1 proj 0.00 4.19 4.35 NA NA 0.078591 26 A Vent image 1 breath 1 proj 0.40 0.15 0.17 0.15 0.17 0.078593 A Vent image 1 proj gas 0.49 4.94 5.22 NA NA 0.078593 TC A Vent image 1 proj gas 0.00 4.77 5.02 NA NA 0.078593 26 A Vent image 1 proj gas 0.49 0.17 0.20 0.17 0.20 0.078594 A Vent image mult proj gas 0.53 5.14 5.79 NA NA 0.078594 TC A Vent image mult proj gas 0.00 4.98 5.59 NA NA 0.078594 26 A Vent image mult proj gas 0.53 0.16 0.20 0.16 0.20 0.078596 A Lung differential function 1.27 8.99 9.63 NA NA 0.078596 TC A Lung differential function 0.00 8.56 9.15 NA NA 0.078596 26 A Lung differential function 1.27 0.43 0.48 0.43 0.48 0.078599 C Respiratory nuclear exam 0.00 0.00 0.00 NA NA 0.078599 TC C Respiratory nuclear exam 0.00 0.00 0.00 NA NA 0.078599 26 C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.078600 A Brain image < 4 views 0.44 4.57 4.81 NA NA 0.078600 TC A Brain image < 4 views 0.00 4.41 4.62 NA NA 0.0
CMS-1582-PN 431 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78600 26 A Brain image < 4 views 0.44 0.16 0.19 0.16 0.19 0.078601 A Brain image w/flow < 4 views 0.51 5.42 5.71 NA NA 0.078601 TC A Brain image w/flow < 4 views 0.00 5.24 5.51 NA NA 0.078601 26 A Brain image w/flow < 4 views 0.51 0.18 0.20 0.18 0.20 0.078605 A Brain image 4+ views 0.53 4.89 5.22 NA NA 0.078605 TC A Brain image 4+ views 0.00 4.69 4.99 NA NA 0.078605 26 A Brain image 4+ views 0.53 0.20 0.23 0.20 0.23 0.078606 A Brain image w/flow 4 + views 0.64 8.71 8.85 NA NA 0.078606 TC A Brain image w/flow 4 + views 0.00 8.48 8.59 NA NA 0.078606 26 A Brain image w/flow 4 + views 0.64 0.23 0.26 0.23 0.26 0.078607 A Brain imaging (3d) 1.23 8.66 9.37 NA NA 0.078607 TC A Brain imaging (3d) 0.00 8.27 8.90 NA NA 0.078607 26 A Brain imaging (3d) 1.23 0.39 0.47 0.39 0.47 0.078608 C Brain imaging (pet) 0.00 0.00 0.00 NA NA 0.078608 TC C Brain imaging (pet) 0.00 0.00 0.00 NA NA 0.078608 26 A Brain imaging (pet) 1.50 0.48 0.58 0.48 0.58 0.178609 N Brain imaging (pet) 1.50 0.66 0.63 NA NA 0.178609 TC N Brain imaging (pet) 0.00 0.00 0.00 NA NA 0.078609 26 N Brain imaging (pet) 1.50 0.66 0.63 0.66 0.63 0.178610 A Brain flow imaging only 0.30 4.47 4.88 NA NA 0.078610 TC A Brain flow imaging only 0.00 4.36 4.75 NA NA 0.078610 26 A Brain flow imaging only 0.30 0.11 0.13 0.11 0.13 0.078630 A Cerebrospinal fluid scan 0.68 8.83 9.16 NA NA 0.078630 TC A Cerebrospinal fluid scan 0.00 8.59 8.88 NA NA 0.078630 26 A Cerebrospinal fluid scan 0.68 0.24 0.28 0.24 0.28 0.078635 A Csf ventriculography 0.61 8.84 8.79 NA NA 0.078635 TC A Csf ventriculography 0.00 8.61 8.53 NA NA 0.078635 26 A Csf ventriculography 0.61 0.23 0.26 0.23 0.26 0.078645 A Csf shunt evaluation 0.57 8.49 8.68 NA NA 0.078645 TC A Csf shunt evaluation 0.00 8.30 8.45 NA NA 0.0
CMS-1582-PN 432 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78645 26 A Csf shunt evaluation 0.57 0.19 0.23 0.19 0.23 0.078647 A Cerebrospinal fluid scan 0.90 8.76 9.25 NA NA 0.078647 TC A Cerebrospinal fluid scan 0.00 8.47 8.91 NA NA 0.078647 26 A Cerebrospinal fluid scan 0.90 0.29 0.34 0.29 0.34 0.078650 A Csf leakage imaging 0.61 8.69 9.02 NA NA 0.078650 TC A Csf leakage imaging 0.00 8.49 8.78 NA NA 0.078650 26 A Csf leakage imaging 0.61 0.20 0.24 0.20 0.24 0.078660 A Nuclear exam of tear flow 0.53 4.63 4.62 NA NA 0.078660 TC A Nuclear exam of tear flow 0.00 4.41 4.39 NA NA 0.078660 26 A Nuclear exam of tear flow 0.53 0.22 0.23 0.22 0.23 0.078699 C Nervous system nuclear exam 0.00 0.00 0.00 NA NA 0.078699 TC C Nervous system nuclear exam 0.00 0.00 0.00 NA NA 0.078699 26 C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.078700 A Kidney imaging morphol 0.45 4.39 4.68 NA NA 0.078700 TC A Kidney imaging morphol 0.00 4.23 4.49 NA NA 0.078700 26 A Kidney imaging morphol 0.45 0.16 0.19 0.16 0.19 0.078701 A Kidney imaging with flow 0.49 5.42 5.72 NA NA 0.078701 TC A Kidney imaging with flow 0.00 5.25 5.52 NA NA 0.078701 26 A Kidney imaging with flow 0.49 0.17 0.20 0.17 0.20 0.078707 A K flow/funct image w/o drug 0.96 5.45 5.97 NA NA 0.078707 TC A K flow/funct image w/o drug 0.00 5.13 5.59 NA NA 0.078707 26 A K flow/funct image w/o drug 0.96 0.32 0.38 0.32 0.38 0.078708 A K flow/funct image w/drug 1.21 3.35 4.03 NA NA 0.078708 TC A K flow/funct image w/drug 0.00 2.94 3.54 NA NA 0.078708 26 A K flow/funct image w/drug 1.21 0.41 0.49 0.41 0.49 0.078709 A K flow/funct image multiple 1.41 8.92 9.28 NA NA 0.178709 TC A K flow/funct image multiple 0.00 8.44 8.72 NA NA 0.078709 26 A K flow/funct image multiple 1.41 0.48 0.56 0.48 0.56 0.078710 A Kidney imaging (3d) 0.66 5.03 5.85 NA NA 0.078710 TC A Kidney imaging (3d) 0.00 4.83 5.60 NA NA 0.0
CMS-1582-PN 433 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78710 26 A Kidney imaging (3d) 0.66 0.20 0.25 0.20 0.25 0.078725 A Kidney function study 0.38 2.48 2.60 NA NA 0.078725 TC A Kidney function study 0.00 2.34 2.45 NA NA 0.078725 26 A Kidney function study 0.38 0.14 0.15 0.14 0.15 0.078730 A Urinary bladder retention 0.15 1.80 2.03 NA NA 0.078730 TC A Urinary bladder retention 0.00 1.74 1.95 NA NA 0.078730 26 A Urinary bladder retention 0.15 0.06 0.08 0.06 0.08 0.078740 A Ureteral reflux study 0.57 5.84 5.89 NA NA 0.078740 TC A Ureteral reflux study 0.00 5.62 5.64 NA NA 0.078740 26 A Ureteral reflux study 0.57 0.22 0.25 0.22 0.25 0.078761 A Testicular imaging w/flow 0.71 5.24 5.48 NA NA 0.078761 TC A Testicular imaging w/flow 0.00 4.97 5.18 NA NA 0.078761 26 A Testicular imaging w/flow 0.71 0.27 0.30 0.27 0.30 0.078799 C Genitourinary nuclear exam 0.00 0.00 0.00 NA NA 0.078799 TC C Genitourinary nuclear exam 0.00 0.00 0.00 NA NA 0.078799 26 C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.078800 A Tumor imaging limited area 0.66 4.51 4.78 NA NA 0.078800 TC A Tumor imaging limited area 0.00 4.27 4.52 NA NA 0.078800 26 A Tumor imaging limited area 0.66 0.24 0.26 0.24 0.26 0.078801 A Tumor imaging mult areas 0.79 6.27 6.58 NA NA 0.078801 TC A Tumor imaging mult areas 0.00 5.98 6.26 NA NA 0.078801 26 A Tumor imaging mult areas 0.79 0.29 0.32 0.29 0.32 0.078802 A Tumor imaging whole body 0.86 8.12 8.69 NA NA 0.078802 TC A Tumor imaging whole body 0.00 7.84 8.35 NA NA 0.078802 26 A Tumor imaging whole body 0.86 0.28 0.34 0.28 0.34 0.078803 A Tumor imaging (3d) 1.09 8.34 9.17 NA NA 0.078803 TC A Tumor imaging (3d) 0.00 8.01 8.75 NA NA 0.078803 26 A Tumor imaging (3d) 1.09 0.33 0.42 0.33 0.42 0.078804 A Tumor imaging whole body 1.07 14.79 15.92 NA NA 0.178804 TC A Tumor imaging whole body 0.00 14.44 15.50 NA NA 0.0
CMS-1582-PN 434 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78804 26 A Tumor imaging whole body 1.07 0.35 0.42 0.35 0.42 0.078805 A Abscess imaging ltd area 0.73 4.29 4.63 NA NA 0.078805 TC A Abscess imaging ltd area 0.00 4.04 4.34 NA NA 0.078805 26 A Abscess imaging ltd area 0.73 0.25 0.29 0.25 0.29 0.078806 A Abscess imaging whole body 0.86 8.35 9.03 NA NA 0.078806 TC A Abscess imaging whole body 0.00 8.07 8.69 NA NA 0.078806 26 A Abscess imaging whole body 0.86 0.28 0.34 0.28 0.34 0.078807 A Nuclear localization/abscess 1.09 8.33 9.16 NA NA 0.078807 TC A Nuclear localization/abscess 0.00 8.01 8.75 NA NA 0.078807 26 A Nuclear localization/abscess 1.09 0.32 0.41 0.32 0.41 0.078808 A Iv inj ra drug dx study 0.18 0.89 1.06 NA NA 0.078811 C Pet image ltd area 0.00 0.00 0.00 NA NA 0.078811 TC C Pet image ltd area 0.00 0.00 0.00 NA NA 0.078811 26 A Pet image ltd area 1.54 0.54 0.63 0.54 0.63 0.178812 C Pet image skull-thigh 0.00 0.00 0.00 NA NA 0.078812 TC C Pet image skull-thigh 0.00 0.00 0.00 NA NA 0.078812 26 A Pet image skull-thigh 1.93 0.66 0.78 0.66 0.78 0.178813 C Pet image full body 0.00 0.00 0.00 NA NA 0.078813 TC C Pet image full body 0.00 0.00 0.00 NA NA 0.078813 26 A Pet image full body 2.00 0.72 0.82 0.72 0.82 0.178814 C Pet image w/ct lmtd 0.00 0.00 0.00 NA NA 0.078814 TC C Pet image w/ct lmtd 0.00 0.00 0.00 NA NA 0.078814 26 A Pet image w/ct lmtd 2.20 0.73 0.87 0.73 0.87 0.278815 C Pet image w/ct skull-thigh 0.00 0.00 0.00 NA NA 0.078815 TC C Pet image w/ct skull-thigh 0.00 0.00 0.00 NA NA 0.078815 26 A Pet image w/ct skull-thigh 2.44 0.83 0.98 0.83 0.98 0.278816 C Pet image w/ct full body 0.00 0.00 0.00 NA NA 0.078816 TC C Pet image w/ct full body 0.00 0.00 0.00 NA NA 0.078816 26 A Pet image w/ct full body 2.50 0.80 0.98 0.80 0.98 0.278999 C Nuclear diagnostic exam 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 435 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

78999 TC C Nuclear diagnostic exam 0.00 0.00 0.00 NA NA 0.078999 26 C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.079005 A Nuclear rx oral admin 1.80 1.91 2.32 NA NA 0.079005 TC A Nuclear rx oral admin 0.00 1.26 1.60 NA NA 0.079005 26 A Nuclear rx oral admin 1.80 0.65 0.72 0.65 0.72 0.079101 A Nuclear rx iv admin 1.96 2.24 2.71 NA NA 0.079101 TC A Nuclear rx iv admin 0.00 1.34 1.74 NA NA 0.079101 26 A Nuclear rx iv admin 1.96 0.90 0.97 0.90 0.97 0.079200 A Nuclear rx intracav admin 1.99 2.43 2.82 NA NA 0.179200 TC A Nuclear rx intracav admin 0.00 1.67 1.98 NA NA 0.079200 26 A Nuclear rx intracav admin 1.99 0.76 0.84 0.76 0.84 0.179300 C Nuclr rx interstit colloid 0.00 0.00 0.00 NA NA 0.079300 TC C Nuclr rx interstit colloid 0.00 0.00 0.00 NA NA 0.079300 26 A Nuclr rx interstit colloid 1.60 0.61 0.66 0.61 0.66 0.179403 A Hematopoietic nuclear tx 2.25 2.87 3.61 NA NA 0.179403 TC A Hematopoietic nuclear tx 0.00 2.07 2.68 NA NA 0.079403 26 A Hematopoietic nuclear tx 2.25 0.80 0.93 0.80 0.93 0.179440 A Nuclear rx intra-articular 1.99 2.38 2.58 NA NA 0.079440 TC A Nuclear rx intra-articular 0.00 1.46 1.66 NA NA 0.079440 26 A Nuclear rx intra-articular 1.99 0.92 0.92 0.92 0.92 0.079445 C Nuclear rx intra-arterial 0.00 0.00 0.00 NA NA 0.079445 TC C Nuclear rx intra-arterial 0.00 0.00 0.00 NA NA 0.079445 26 A Nuclear rx intra-arterial 2.40 0.76 0.94 0.76 0.94 0.279999 C Nuclear medicine therapy 0.00 0.00 0.00 NA NA 0.079999 TC C Nuclear medicine therapy 0.00 0.00 0.00 NA NA 0.079999 26 C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.080500 A Lab pathology consultation 0.37 0.18 0.21 0.12 0.14 0.080502 A Lab pathology consultation 1.33 0.46 0.48 0.41 0.43 0.083020 26 A Hemoglobin electrophoresis 0.37 0.18 0.17 0.18 0.17 0.083912 26 A Genetic examination 0.37 0.15 0.14 0.15 0.14 0.0
CMS-1582-PN 436 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

84165 26 A Protein e-phoresis serum 0.37 0.18 0.16 0.18 0.16 0.084166 26 A Protein e-phoresis/urine/csf 0.37 0.18 0.16 0.18 0.16 0.084181 26 A Western blot test 0.37 0.18 0.17 0.18 0.17 0.084182 26 A Protein western blot test 0.37 0.17 0.16 0.17 0.16 0.085060 A Blood smear interpretation 0.45 0.22 0.20 0.22 0.20 0.085097 A Bone marrow interpretation 0.94 1.36 1.53 0.39 0.39 0.085390 26 A Fibrinolysins screen 0.37 0.19 0.18 0.19 0.18 0.085396 A Clotting assay whole blood 0.37 NA NA 0.17 0.16 0.085576 26 A Blood platelet aggregation 0.37 0.18 0.17 0.18 0.17 0.086077 A Physician blood bank service 0.94 0.55 0.51 0.46 0.42 0.086078 A Physician blood bank service 0.94 0.55 0.52 0.46 0.43 0.086079 A Physician blood bank service 0.94 0.54 0.52 0.45 0.43 0.086255 26 A Fluorescent antibody screen 0.37 0.18 0.17 0.18 0.17 0.086256 26 A Fluorescent antibody titer 0.37 0.18 0.17 0.18 0.17 0.086320 26 A Serum immunoelectrophoresis 0.37 0.18 0.17 0.18 0.17 0.086325 26 A Other immunoelectrophoresis 0.37 0.18 0.16 0.18 0.16 0.086327 26 A Immunoelectrophoresis assay 0.42 0.21 0.20 0.21 0.20 0.086334 26 A Immunofix e-phoresis serum 0.37 0.18 0.17 0.18 0.17 0.086335 26 A Immunfix e-phorsis/urine/csf 0.37 0.18 0.16 0.18 0.16 0.086485 C Skin test candida 0.00 0.00 0.00 0.00 0.00 0.086486 A Skin test nos antigen 0.00 0.13 0.14 NA NA 0.086490 A Coccidioidomycosis skin test 0.00 0.17 0.19 NA NA 0.086510 A Histoplasmosis skin test 0.00 0.16 0.18 NA NA 0.086580 A Tb intradermal test 0.00 0.20 0.21 NA NA 0.087164 26 A Dark field examination 0.37 0.18 0.17 0.18 0.17 0.087207 26 A Smear special stain 0.37 0.19 0.17 0.19 0.17 0.088104 A Cytopath fl nongyn smears 0.56 1.36 1.34 NA NA 0.088104 TC A Cytopath fl nongyn smears 0.00 1.11 1.10 NA NA 0.088104 26 A Cytopath fl nongyn smears 0.56 0.25 0.24 0.25 0.24 0.088106 A Cytopath fl nongyn filter 0.56 1.74 1.77 NA NA 0.0
CMS-1582-PN 437 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

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PE 

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2011 

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RVUs2

Ma

Pract

RVU

88106 TC A Cytopath fl nongyn filter 0.00 1.49 1.54 NA NA 0.088106 26 A Cytopath fl nongyn filter 0.56 0.25 0.23 0.25 0.23 0.088107 A Cytopath fl nongyn sm/fltr 0.76 2.07 2.15 NA NA 0.088107 TC A Cytopath fl nongyn sm/fltr 0.00 1.73 1.82 NA NA 0.088107 26 A Cytopath fl nongyn sm/fltr 0.76 0.34 0.33 0.34 0.33 0.088108 A Cytopath concentrate tech 0.56 1.58 1.64 NA NA 0.088108 TC A Cytopath concentrate tech 0.00 1.34 1.41 NA NA 0.088108 26 A Cytopath concentrate tech 0.56 0.24 0.23 0.24 0.23 0.088112 A Cytopath cell enhance tech 1.18 1.67 1.79 NA NA 0.088112 TC A Cytopath cell enhance tech 0.00 1.21 1.35 NA NA 0.088112 26 A Cytopath cell enhance tech 1.18 0.46 0.44 0.46 0.44 0.088120 A Cytp urne 3-5 probes ea spec 1.20 12.17 12.17 NA NA 0.088120 TC A Cytp urne 3-5 probes ea spec 0.00 11.86 11.86 NA NA 0.088120 26 A Cytp urne 3-5 probes ea spec 1.20 0.31 0.31 0.31 0.31 0.088121 A Cytp urine 3-5 probes cmptr 1.00 10.30 10.30 NA NA 0.088121 TC A Cytp urine 3-5 probes cmptr 0.00 9.96 9.96 NA NA 0.088121 26 A Cytp urine 3-5 probes cmptr 1.00 0.34 0.34 0.34 0.34 0.088125 A Forensic cytopathology 0.26 0.35 0.37 NA NA 0.088125 TC A Forensic cytopathology 0.00 0.23 0.25 NA NA 0.088125 26 A Forensic cytopathology 0.26 0.12 0.12 0.12 0.12 0.088141 A Cytopath c/v interpret 0.42 0.42 0.40 0.42 0.40 0.088160 A Cytopath smear other source 0.50 1.08 1.08 NA NA 0.088160 TC A Cytopath smear other source 0.00 0.86 0.87 NA NA 0.088160 26 A Cytopath smear other source 0.50 0.22 0.21 0.22 0.21 0.088161 A Cytopath smear other source 0.50 1.00 1.08 NA NA 0.088161 TC A Cytopath smear other source 0.00 0.81 0.89 NA NA 0.088161 26 A Cytopath smear other source 0.50 0.19 0.19 0.19 0.19 0.088162 A Cytopath smear other source 0.76 1.38 1.50 NA NA 0.088162 TC A Cytopath smear other source 0.00 1.09 1.20 NA NA 0.088162 26 A Cytopath smear other source 0.76 0.29 0.30 0.29 0.30 0.0
CMS-1582-PN 438 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

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PE 

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Fully 

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2011 

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PE 

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Ma

Pract

RVU

88172 A Cytp dx eval fna 1st ea site 0.60 0.74 0.87 NA NA 0.088172 TC A Cytp dx eval fna 1st ea site 0.00 0.46 0.60 NA NA 0.088172 26 A Cytp dx eval fna 1st ea site 0.60 0.28 0.27 0.28 0.27 0.088173 A Cytopath eval fna report 1.39 2.54 2.61 NA NA 0.088173 TC A Cytopath eval fna report 0.00 1.94 2.03 NA NA 0.088173 26 A Cytopath eval fna report 1.39 0.60 0.58 0.60 0.58 0.088177 A Cytp c/v auto thin lyr addl 0.42 0.38 0.38 NA NA 0.088177 TC A Cytp c/v auto thin lyr addl 0.00 0.18 0.18 NA NA 0.088177 26 A Cytp c/v auto thin lyr addl 0.42 0.20 0.20 0.20 0.20 0.088182 A Cell marker study 0.77 2.06 2.23 NA NA 0.088182 TC A Cell marker study 0.00 1.85 2.01 NA NA 0.088182 26 A Cell marker study 0.77 0.21 0.22 0.21 0.22 0.088184 A Flowcytometry/ tc 1 marker 0.00 2.29 2.46 NA NA 0.088185 A Flowcytometry/tc add-on 0.00 1.39 1.47 NA NA 0.088187 A Flowcytometry/read 2-8 1.36 0.59 0.55 0.59 0.55 0.088188 A Flowcytometry/read 9-15 1.69 0.76 0.68 0.76 0.68 0.188189 A Flowcytometry/read 16 & > 2.23 0.70 0.69 0.70 0.69 0.188199 C Cytopathology procedure 0.00 0.00 0.00 NA NA 0.088199 TC C Cytopathology procedure 0.00 0.00 0.00 NA NA 0.088199 26 C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.088291 A Cyto/molecular report 0.52 0.31 0.31 0.31 0.31 0.088299 C Cytogenetic study 0.00 0.00 0.00 0.00 0.00 0.088300 A Surgical path gross 0.08 0.71 0.69 NA NA 0.088300 TC A Surgical path gross 0.00 0.67 0.65 NA NA 0.088300 26 A Surgical path gross 0.08 0.04 0.04 0.04 0.04 0.088302 A Tissue exam by pathologist 0.13 1.40 1.42 NA NA 0.088302 TC A Tissue exam by pathologist 0.00 1.34 1.37 NA NA 0.088302 26 A Tissue exam by pathologist 0.13 0.06 0.05 0.06 0.05 0.088304 A Tissue exam by pathologist 0.22 1.44 1.60 NA NA 0.088304 TC A Tissue exam by pathologist 0.00 1.34 1.51 NA NA 0.0
CMS-1582-PN 439 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

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PE 

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2011 

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Pract

RVU

88304 26 A Tissue exam by pathologist 0.22 0.10 0.09 0.10 0.09 0.088305 A Tissue exam by pathologist 0.75 2.18 2.35 NA NA 0.088305 TC A Tissue exam by pathologist 0.00 1.86 2.04 NA NA 0.088305 26 A Tissue exam by pathologist 0.75 0.32 0.31 0.32 0.31 0.088307 A Tissue exam by pathologist 1.59 5.07 5.02 NA NA 0.088307 TC A Tissue exam by pathologist 0.00 4.32 4.31 NA NA 0.088307 26 A Tissue exam by pathologist 1.59 0.75 0.71 0.75 0.71 0.088309 A Tissue exam by pathologist 2.80 7.35 7.18 NA NA 0.188309 TC A Tissue exam by pathologist 0.00 6.02 5.97 NA NA 0.088309 26 A Tissue exam by pathologist 2.80 1.33 1.21 1.33 1.21 0.088311 A Decalcify tissue 0.24 0.30 0.29 NA NA 0.088311 TC A Decalcify tissue 0.00 0.19 0.19 NA NA 0.088311 26 A Decalcify tissue 0.24 0.11 0.10 0.11 0.10 0.088312 A Special stains group 1 0.54 2.52 2.58 NA NA 0.088312 TC A Special stains group 1 0.00 2.30 2.36 NA NA 0.088312 26 A Special stains group 1 0.54 0.22 0.22 0.22 0.22 0.088313 A Special stains group 2 0.24 1.95 2.03 NA NA 0.088313 TC A Special stains group 2 0.00 1.86 1.94 NA NA 0.088313 26 A Special stains group 2 0.24 0.09 0.09 0.09 0.09 0.088314 A Histochemical stains add-on 0.45 1.99 2.18 NA NA 0.088314 TC A Histochemical stains add-on 0.00 1.78 1.98 NA NA 0.088314 26 A Histochemical stains add-on 0.45 0.21 0.20 0.21 0.20 0.088318 A Chemical histochemistry 0.42 3.18 2.99 NA NA 0.088318 TC A Chemical histochemistry 0.00 2.99 2.81 NA NA 0.088318 26 A Chemical histochemistry 0.42 0.19 0.18 0.19 0.18 0.088319 A Enzyme histochemistry 0.53 3.56 3.74 NA NA 0.088319 TC A Enzyme histochemistry 0.00 3.32 3.52 NA NA 0.088319 26 A Enzyme histochemistry 0.53 0.24 0.22 0.24 0.22 0.088321 A Microslide consultation 1.63 0.96 0.94 0.71 0.66 0.188323 A Microslide consultation 1.83 2.17 2.32 NA NA 0.0
CMS-1582-PN 440 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

88323 TC A Microslide consultation 0.00 1.57 1.72 NA NA 0.088323 26 A Microslide consultation 1.83 0.60 0.60 0.60 0.60 0.088325 A Comprehensive review of data 2.50 3.28 3.25 1.27 1.14 0.188329 A Path consult introp 0.67 0.84 0.82 0.32 0.30 0.088331 A Path consult intraop 1 bloc 1.19 1.52 1.48 NA NA 0.088331 TC A Path consult intraop 1 bloc 0.00 0.93 0.93 NA NA 0.088331 26 A Path consult intraop 1 bloc 1.19 0.59 0.55 0.59 0.55 0.088332 A Path consult intraop addl 0.59 0.59 0.58 NA NA 0.088332 TC A Path consult intraop addl 0.00 0.31 0.32 NA NA 0.088332 26 A Path consult intraop addl 0.59 0.28 0.26 0.28 0.26 0.088333 A Intraop cyto path consult 1 1.20 1.59 1.55 NA NA 0.088333 TC A Intraop cyto path consult 1 0.00 1.03 1.02 NA NA 0.088333 26 A Intraop cyto path consult 1 1.20 0.56 0.53 0.56 0.53 0.088334 A Intraop cyto path consult 2 0.73 1.00 0.96 NA NA 0.088334 TC A Intraop cyto path consult 2 0.00 0.65 0.64 NA NA 0.088334 26 A Intraop cyto path consult 2 0.73 0.35 0.32 0.35 0.32 0.088342 A Immunohistochemistry 0.85 2.11 2.17 NA NA 0.088342 TC A Immunohistochemistry 0.00 1.77 1.84 NA NA 0.088342 26 A Immunohistochemistry 0.85 0.34 0.33 0.34 0.33 0.088346 A Immunofluorescent study 0.86 2.02 2.12 NA NA 0.088346 TC A Immunofluorescent study 0.00 1.67 1.78 NA NA 0.088346 26 A Immunofluorescent study 0.86 0.35 0.34 0.35 0.34 0.088347 A Immunofluorescent study 0.86 1.27 1.39 NA NA 0.088347 TC A Immunofluorescent study 0.00 1.03 1.14 NA NA 0.088347 26 A Immunofluorescent study 0.86 0.24 0.25 0.24 0.25 0.088348 A Electron microscopy 1.51 17.88 18.41 NA NA 0.188348 TC A Electron microscopy 0.00 17.27 17.81 NA NA 0.088348 26 A Electron microscopy 1.51 0.61 0.60 0.61 0.60 0.088349 A Scanning electron microscopy 0.76 10.52 9.74 NA NA 0.088349 TC A Scanning electron microscopy 0.00 10.14 9.39 NA NA 0.0
CMS-1582-PN 441 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

88349 26 A Scanning electron microscopy 0.76 0.38 0.35 0.38 0.35 0.088355 A Analysis skeletal muscle 1.85 3.22 4.38 NA NA 0.088355 TC A Analysis skeletal muscle 0.00 2.68 3.82 NA NA 0.088355 26 A Analysis skeletal muscle 1.85 0.54 0.56 0.54 0.56 0.088356 A Analysis nerve 3.02 4.49 5.13 NA NA 0.188356 TC A Analysis nerve 0.00 3.92 4.43 NA NA 0.088356 26 A Analysis nerve 3.02 0.57 0.70 0.57 0.70 0.188358 A Analysis tumor 0.95 1.16 1.21 NA NA 0.088358 TC A Analysis tumor 0.00 0.91 0.95 NA NA 0.088358 26 A Analysis tumor 0.95 0.25 0.26 0.25 0.26 0.088360 A Tumor immunohistochem/manual 1.10 2.40 2.49 NA NA 0.088360 TC A Tumor immunohistochem/manual 0.00 1.98 2.08 NA NA 0.088360 26 A Tumor immunohistochem/manual 1.10 0.42 0.41 0.42 0.41 0.088361 A Tumor immunohistochem/comput 1.18 3.01 3.23 NA NA 0.088361 TC A Tumor immunohistochem/comput 0.00 2.57 2.81 NA NA 0.088361 26 A Tumor immunohistochem/comput 1.18 0.44 0.42 0.44 0.42 0.088362 A Nerve teasing preparations 2.17 6.03 6.00 NA NA 0.188362 TC A Nerve teasing preparations 0.00 5.10 5.12 NA NA 0.088362 26 A Nerve teasing preparations 2.17 0.93 0.88 0.93 0.88 0.188363 A Xm archive tissue molec anal 0.37 0.72 0.72 0.10 0.10 0.088365 A Insitu hybridization (fish) 1.20 3.56 3.63 NA NA 0.088365 TC A Insitu hybridization (fish) 0.00 3.09 3.18 NA NA 0.088365 26 A Insitu hybridization (fish) 1.20 0.47 0.45 0.47 0.45 0.088367 A Insitu hybridization auto 1.30 6.06 6.18 NA NA 0.088367 TC A Insitu hybridization auto 0.00 5.61 5.74 NA NA 0.088367 26 A Insitu hybridization auto 1.30 0.45 0.44 0.45 0.44 0.088368 A Insitu hybridization manual 1.40 4.81 5.02 NA NA 0.088368 TC A Insitu hybridization manual 0.00 4.45 4.63 NA NA 0.088368 26 A Insitu hybridization manual 1.40 0.36 0.39 0.36 0.39 0.088371 26 A Protein western blot tissue 0.37 0.18 0.16 0.18 0.16 0.0
CMS-1582-PN 442 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

88372 26 A Protein analysis w/probe 0.37 0.18 0.17 0.18 0.17 0.088380 A Microdissection laser 1.56 2.60 3.54 NA NA 0.088380 TC A Microdissection laser 0.00 2.15 3.01 NA NA 0.088380 26 A Microdissection laser 1.56 0.45 0.53 0.45 0.53 0.088381 A Microdissection manual 1.18 2.80 4.20 NA NA 0.088381 TC A Microdissection manual 0.00 2.55 3.84 NA NA 0.088381 26 A Microdissection manual 1.18 0.25 0.36 0.25 0.36 0.088384 C Eval molecular probes 11-50 0.00 0.00 0.00 NA NA 0.088384 TC C Eval molecular probes 11-50 0.00 0.00 0.00 NA NA 0.088384 26 C Eval molecular probes 11-50 0.00 0.00 0.00 0.00 0.00 0.088385 A Eval molecul probes 51-250 1.50 15.08 15.33 NA NA 0.088385 TC A Eval molecul probes 51-250 0.00 14.71 14.94 NA NA 0.088385 26 A Eval molecul probes 51-250 1.50 0.37 0.39 0.37 0.39 0.088386 A Eval molecul probes 251-500 1.88 13.86 16.89 NA NA 0.088386 TC A Eval molecul probes 251-500 0.00 13.51 16.28 NA NA 0.088386 26 A Eval molecul probes 251-500 1.88 0.35 0.61 0.35 0.61 0.088387 A Tiss exam molecular study 0.62 0.55 0.55 NA NA 0.088387 TC A Tiss exam molecular study 0.00 0.25 0.25 NA NA 0.088387 26 A Tiss exam molecular study 0.62 0.30 0.30 0.30 0.30 0.088388 A Tiss ex molecul study add-on 0.45 0.22 0.22 NA NA 0.088388 TC A Tiss ex molecul study add-on 0.00 0.12 0.12 NA NA 0.088388 26 A Tiss ex molecul study add-on 0.45 0.10 0.10 0.10 0.10 0.088399 C Surgical pathology procedure 0.00 0.00 0.00 NA NA 0.088399 TC C Surgical pathology procedure 0.00 0.00 0.00 NA NA 0.088399 26 C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.089049 A Chct for mal hyperthermia 1.40 5.80 6.00 0.40 0.45 0.189060 26 A Exam synovial fluid crystals 0.37 0.18 0.17 0.18 0.17 0.089220 A Sputum specimen collection 0.00 0.44 0.46 NA NA 0.089230 A Collect sweat for test 0.00 0.06 0.08 NA NA 0.089240 C Pathology lab procedure 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 443 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

90281 I Human ig im 0.00 0.00 0.00 0.00 0.00 0.090283 I Human ig iv 0.00 0.00 0.00 0.00 0.00 0.090284 X Human ig sc 0.00 0.00 0.00 0.00 0.00 0.090287 I Botulinum antitoxin 0.00 0.00 0.00 0.00 0.00 0.090288 I Botulism ig iv 0.00 0.00 0.00 0.00 0.00 0.090291 I Cmv ig iv 0.00 0.00 0.00 0.00 0.00 0.090296 E Diphtheria antitoxin 0.00 0.00 0.00 0.00 0.00 0.090371 E Hep b ig im 0.00 0.00 0.00 0.00 0.00 0.090375 E Rabies ig im/sc 0.00 0.00 0.00 0.00 0.00 0.090376 E Rabies ig heat treated 0.00 0.00 0.00 0.00 0.00 0.090378 X Rsv mab im 50mg 0.00 0.00 0.00 0.00 0.00 0.090384 I Rh ig full-dose im 0.00 0.00 0.00 0.00 0.00 0.090385 E Rh ig minidose im 0.00 0.00 0.00 0.00 0.00 0.090386 I Rh ig iv 0.00 0.00 0.00 0.00 0.00 0.090389 I Tetanus ig im 0.00 0.00 0.00 0.00 0.00 0.090393 E Vaccina ig im 0.00 0.00 0.00 0.00 0.00 0.090396 E Varicella-zoster ig im 0.00 0.00 0.00 0.00 0.00 0.090399 I Immune globulin 0.00 0.00 0.00 0.00 0.00 0.090460 A Imadm any route 1st vac/tox 0.17 0.50 0.50 NA NA 0.090461 A Inadm any route addl vac/tox 0.15 0.20 0.18 NA NA 0.090471 A Immunization admin 0.17 0.50 0.50 NA NA 0.090472 A Immunization admin each add 0.15 0.20 0.18 NA NA 0.090473 R Immune admin oral/nasal 0.17 0.50 0.50 NA NA 0.090474 R Immune admin oral/nasal addl 0.15 0.20 0.18 NA NA 0.090476 E Adenovirus vaccine type 4 0.00 0.00 0.00 0.00 0.00 0.090477 E Adenovirus vaccine type 7 0.00 0.00 0.00 0.00 0.00 0.090581 E Anthrax vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090585 E Bcg vaccine percut 0.00 0.00 0.00 0.00 0.00 0.090586 E Bcg vaccine intravesical 0.00 0.00 0.00 0.00 0.00 0.090632 E Hep a vaccine adult im 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 444 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

90633 E Hep a vacc ped/adol 2 dose 0.00 0.00 0.00 0.00 0.00 0.090634 E Hep a vacc ped/adol 3 dose 0.00 0.00 0.00 0.00 0.00 0.090636 E Hep a/hep b vacc adult im 0.00 0.00 0.00 0.00 0.00 0.090644 X Meningoccl hib vac 4 dose im 0.00 0.00 0.00 0.00 0.00 0.090645 E Hib vaccine hboc im 0.00 0.00 0.00 0.00 0.00 0.090646 E Hib vaccine prp-d im 0.00 0.00 0.00 0.00 0.00 0.090647 E Hib vaccine prp-omp im 0.00 0.00 0.00 0.00 0.00 0.090648 E Hib vaccine prp-t im 0.00 0.00 0.00 0.00 0.00 0.090649 E Hpv vaccine 4 valent im 0.00 0.00 0.00 0.00 0.00 0.090650 E Hpv vaccine 2 valent im 0.00 0.00 0.00 0.00 0.00 0.090654 X Flu vaccine no preserv, id 0.00 0.00 0.00 0.00 0.00 0.090655 X Flu vaccine no preserv 6-35m 0.00 0.00 0.00 0.00 0.00 0.090656 X Flu vaccine no preserv 3 & > 0.00 0.00 0.00 0.00 0.00 0.090657 X Flu vaccine 3 yrs im 0.00 0.00 0.00 0.00 0.00 0.090658 I Flu vaccine 3 yrs & > im 0.00 0.00 0.00 0.00 0.00 0.090660 X Flu vaccine nasal 0.00 0.00 0.00 0.00 0.00 0.090661 X Flu vacc cell cult prsv free 0.00 0.00 0.00 0.00 0.00 0.090662 X Flu vacc prsv free inc antig 0.00 0.00 0.00 0.00 0.00 0.090664 X Flu vacc pandemic intranasal 0.00 0.00 0.00 0.00 0.00 0.090665 E Lyme disease vaccine im 0.00 0.00 0.00 0.00 0.00 0.090666 X Flu vac pandem prsrv free im 0.00 0.00 0.00 0.00 0.00 0.090667 X Flu vac pandemic adjuvant im 0.00 0.00 0.00 0.00 0.00 0.090668 X Flu vac pandemic splt im 0.00 0.00 0.00 0.00 0.00 0.090669 X Pneumococcal vacc 7 val im 0.00 0.00 0.00 0.00 0.00 0.090670 X Pneumococcal vacc 13 val im 0.00 0.00 0.00 0.00 0.00 0.090675 E Rabies vaccine im 0.00 0.00 0.00 0.00 0.00 0.090676 E Rabies vaccine id 0.00 0.00 0.00 0.00 0.00 0.090680 E Rotovirus vacc 3 dose oral 0.00 0.00 0.00 0.00 0.00 0.090681 E Rotavirus vacc 2 dose oral 0.00 0.00 0.00 0.00 0.00 0.090690 E Typhoid vaccine oral 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 445 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

90691 E Typhoid vaccine im 0.00 0.00 0.00 0.00 0.00 0.090692 E Typhoid vaccine h-p sc/id 0.00 0.00 0.00 0.00 0.00 0.090693 E Typhoid vaccine akd sc 0.00 0.00 0.00 0.00 0.00 0.090696 E Dtap-ipv vacc 4-6 yr im 0.00 0.00 0.00 0.00 0.00 0.090698 E Dtap-hib-ip vaccine im 0.00 0.00 0.00 0.00 0.00 0.090700 E Dtap vaccine < 7 yrs im 0.00 0.00 0.00 0.00 0.00 0.090701 E Dtp vaccine im 0.00 0.00 0.00 0.00 0.00 0.090702 E Dt vaccine < 7 im 0.00 0.00 0.00 0.00 0.00 0.090703 E Tetanus vaccine im 0.00 0.00 0.00 0.00 0.00 0.090704 E Mumps vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090705 E Measles vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090706 E Rubella vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090707 E Mmr vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090708 E Measles-rubella vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090710 E Mmrv vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090712 E Oral poliovirus vaccine 0.00 0.00 0.00 0.00 0.00 0.090713 E Poliovirus ipv sc/im 0.00 0.00 0.00 0.00 0.00 0.090714 E Td vaccine no prsrv >/= 7 im 0.00 0.00 0.00 0.00 0.00 0.090715 E Tdap vaccine >7 im 0.00 0.00 0.00 0.00 0.00 0.090716 E Chicken pox vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090717 E Yellow fever vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090718 E Td vaccine > 7 im 0.00 0.00 0.00 0.00 0.00 0.090719 E Diphtheria vaccine im 0.00 0.00 0.00 0.00 0.00 0.090720 E Dtp/hib vaccine im 0.00 0.00 0.00 0.00 0.00 0.090721 E Dtap/hib vaccine im 0.00 0.00 0.00 0.00 0.00 0.090723 I Dtap-hep b-ipv vaccine im 0.00 0.00 0.00 0.00 0.00 0.090725 E Cholera vaccine injectable 0.00 0.00 0.00 0.00 0.00 0.090727 E Plague vaccine im 0.00 0.00 0.00 0.00 0.00 0.090732 X Pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.090733 E Meningococcal vaccine sc 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 446 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

90734 E Meningococcal vaccine im 0.00 0.00 0.00 0.00 0.00 0.090735 E Encephalitis vaccine sc 0.00 0.00 0.00 0.00 0.00 0.090736 E Zoster vacc sc 0.00 0.00 0.00 0.00 0.00 0.090738 I Inactivated je vacc im 0.00 0.00 0.00 0.00 0.00 0.090740 X Hepb vacc ill pat 3 dose im 0.00 0.00 0.00 0.00 0.00 0.090743 X Hep b vacc adol 2 dose im 0.00 0.00 0.00 0.00 0.00 0.090744 X Hepb vacc ped/adol 3 dose im 0.00 0.00 0.00 0.00 0.00 0.090746 X Hep b vaccine adult im 0.00 0.00 0.00 0.00 0.00 0.090747 X Hepb vacc ill pat 4 dose im 0.00 0.00 0.00 0.00 0.00 0.090748 I Hep b/hib vaccine im 0.00 0.00 0.00 0.00 0.00 0.090749 E Vaccine toxoid 0.00 0.00 0.00 0.00 0.00 0.090801 A Psy dx interview 2.80 1.55 1.62 0.60 0.72 0.190802 A Intac psy dx interview 3.01 1.82 1.79 0.78 0.84 0.190804 A Psytx office 20-30 min 1.21 0.56 0.61 0.18 0.25 0.090805 A Psytx off 20-30 min w/e&m 1.37 0.70 0.70 0.28 0.32 0.090806 A Psytx off 45-50 min 1.86 0.46 0.57 0.25 0.37 0.090807 A Psytx off 45-50 min w/e&m 2.02 0.83 0.84 0.41 0.47 0.090808 A Psytx office 75-80 min 2.79 0.63 0.79 0.43 0.59 0.190809 A Psytx off 75-80 w/e&m 2.95 1.02 1.06 0.64 0.71 0.190810 A Intac psytx off 20-30 min 1.32 0.47 0.55 0.21 0.27 0.090811 A Intac psytx 20-30 w/e&m 1.48 0.86 0.84 0.32 0.36 0.090812 A Intac psytx off 45-50 min 1.97 0.57 0.70 0.26 0.39 0.090813 A Intac psytx 45-50 min w/e&m 2.13 0.97 0.98 0.43 0.50 0.090814 A Intac psytx off 75-80 min 2.90 0.73 0.94 0.38 0.62 0.190815 A Intac psytx 75-80 w/e&m 3.06 1.35 1.29 0.82 0.81 0.190816 A Psytx hosp 20-30 min 1.25 0.26 0.26 0.26 0.35 0.090817 A Psytx hosp 20-30 min w/e&m 1.41 0.41 0.41 0.41 0.44 0.090818 A Psytx hosp 45-50 min 1.89 0.34 0.34 0.34 0.48 0.090819 A Psytx hosp 45-50 min w/e&m 2.05 0.55 0.55 0.55 0.59 0.090821 A Psytx hosp 75-80 min 2.83 0.48 0.48 0.48 0.67 0.1
CMS-1582-PN 447 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

90822 A Psytx hosp 75-80 min w/e&m 2.99 0.74 0.74 0.74 0.81 0.190823 A Intac psytx hosp 20-30 min 1.36 0.29 0.29 0.29 0.37 0.090824 A Intac psytx hsp 20-30 w/e&m 1.52 0.43 0.43 0.43 0.47 0.090826 A Intac psytx hosp 45-50 min 2.01 0.38 0.38 0.38 0.51 0.090827 A Intac psytx hsp 45-50 w/e&m 2.16 0.56 0.56 0.56 0.61 0.090828 A Intac psytx hosp 75-80 min 2.94 0.51 0.51 0.51 0.71 0.190829 A Intac psytx hsp 75-80 w/e&m 3.10 0.75 0.75 0.75 0.83 0.190845 A Psychoanalysis 1.79 0.43 0.48 0.35 0.41 0.090846 R Family psytx w/o patient 1.83 0.49 0.58 0.40 0.50 0.090847 R Family psytx w/patient 2.21 0.70 0.80 0.43 0.56 0.090849 R Multiple family group psytx 0.59 0.38 0.38 0.22 0.25 0.090853 A Group psychotherapy 0.59 0.32 0.32 0.25 0.25 0.090857 A Intac group psytx 0.63 0.44 0.42 0.30 0.28 0.090862 A Medication management 0.95 0.73 0.71 0.32 0.33 0.090865 A Narcosynthesis 2.84 1.76 1.69 0.70 0.79 0.190867 C Tcranial magn stim tx plan 0.00 0.00 0.00 0.00 0.00 0.090868 C Tcranial magn stim tx deli 0.00 0.00 0.00 0.00 0.00 0.090870 A Electroconvulsive therapy 2.50 2.32 2.30 0.57 0.56 0.190875 N Psychophysiological therapy 1.20 0.83 0.86 0.53 0.52 0.090876 N Psychophysiological therapy 1.90 1.12 1.15 0.83 0.82 0.190880 A Hypnotherapy 2.19 0.52 0.69 0.36 0.47 0.090882 N Environmental manipulation 0.00 0.00 0.00 0.00 0.00 0.090885 B Psy evaluation of records 0.97 0.43 0.42 0.43 0.42 0.090887 B Consultation with family 1.48 0.98 0.98 0.65 0.64 0.190889 B Preparation of report 0.00 0.00 0.00 0.00 0.00 0.090899 C Psychiatric service/therapy 0.00 0.00 0.00 0.00 0.00 0.090901 A Biofeedback train any meth 0.41 0.70 0.66 0.19 0.17 0.090911 A Biofeedback peri/uro/rectal 0.89 1.47 1.61 0.37 0.38 0.090935 A Hemodialysis one evaluation 1.48 NA NA 0.57 0.64 0.090937 A Hemodialysis repeated eval 2.11 NA NA 0.82 0.92 0.1
CMS-1582-PN 448 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

90940 X Hemodialysis access study 0.00 0.00 0.00 0.00 0.00 0.090945 A Dialysis one evaluation 1.56 NA NA 0.86 0.79 0.090947 A Dialysis repeated eval 2.52 NA NA 0.97 1.01 0.190951 A Esrd serv 4 visits p mo <2 18.46 8.00 8.64 8.00 8.64 1.090952 C Esrd serv 2-3 vsts p mo <2 0.00 0.00 0.00 0.00 0.00 0.090953 C Esrd serv 1 visit p mo <2 0.00 0.00 0.00 0.00 0.00 0.090954 A Esrd serv 4 vsts p mo 2-11 15.98 6.92 6.71 6.92 6.71 0.990955 A Esrd srv 2-3 vsts p mo 2-11 8.79 4.07 4.05 4.07 4.05 0.490956 A Esrd srv 1 visit p mo 2-11 5.95 2.97 2.86 2.97 2.86 0.390957 A Esrd srv 4 vsts p mo 12-19 12.52 5.60 5.63 5.60 5.63 0.790958 A Esrd srv 2-3 vsts p mo 12-19 8.34 3.97 3.96 3.97 3.96 0.490959 A Esrd serv 1 vst p mo 12-19 5.50 2.83 2.70 2.83 2.70 0.390960 A Esrd srv 4 visits p mo 20+ 5.18 2.79 2.90 2.79 2.90 0.390961 A Esrd srv 2-3 vsts p mo 20+ 4.26 2.44 2.38 2.44 2.38 0.290962 A Esrd serv 1 visit p mo 20+ 3.15 2.01 1.81 2.01 1.81 0.290963 A Esrd home pt serv p mo <2 10.56 4.76 4.91 4.76 4.91 0.690964 A Esrd home pt serv p mo 2-11 9.14 4.21 3.99 4.21 3.99 0.590965 A Esrd home pt serv p mo 12-19 8.69 4.04 3.83 4.04 3.83 0.490966 A Esrd home pt serv p mo 20+ 4.26 2.43 2.34 2.43 2.34 0.290967 A Esrd home pt serv p day <2 0.35 0.16 0.19 0.16 0.19 0.090968 A Esrd home pt srv p day 2-11 0.30 0.14 0.14 0.14 0.14 0.090969 A Esrd home pt srv p day 12-19 0.29 0.14 0.14 0.14 0.14 0.090970 A Esrd home pt serv p day 20+ 0.14 0.08 0.08 0.08 0.08 0.090989 X Dialysis training complete 0.00 0.00 0.00 0.00 0.00 0.090993 X Dialysis training incompl 0.00 0.00 0.00 0.00 0.00 0.090997 A Hemoperfusion 1.84 NA NA 0.68 0.68 0.190999 C Dialysis procedure 0.00 0.00 0.00 0.00 0.00 0.091010 A Esophagus motility study 1.28 3.72 4.16 NA NA 0.091010 TC A Esophagus motility study 0.00 3.03 3.48 NA NA 0.091010 26 A Esophagus motility study 1.28 0.69 0.68 0.69 0.68 0.0
CMS-1582-PN 449 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

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RVUs2

Year 

2011 

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Facility 

PE 

RVUs2

Ma

Pract

RVU

91013 A Esophgl motil w/stim/perfus 0.18 0.48 0.48 NA NA 0.091013 TC A Esophgl motil w/stim/perfus 0.00 0.38 0.38 NA NA 0.091013 26 A Esophgl motil w/stim/perfus 0.18 0.10 0.10 0.10 0.10 0.091020 A Gastric motility studies 1.44 5.22 5.46 NA NA 0.091020 TC A Gastric motility studies 0.00 4.44 4.70 NA NA 0.091020 26 A Gastric motility studies 1.44 0.78 0.76 0.78 0.76 0.091022 A Duodenal motility study 1.44 3.45 3.89 NA NA 0.091022 TC A Duodenal motility study 0.00 2.65 3.08 NA NA 0.091022 26 A Duodenal motility study 1.44 0.80 0.81 0.80 0.81 0.091030 A Acid perfusion of esophagus 0.91 3.01 3.19 NA NA 0.091030 TC A Acid perfusion of esophagus 0.00 2.50 2.68 NA NA 0.091030 26 A Acid perfusion of esophagus 0.91 0.51 0.51 0.51 0.51 0.091034 A Gastroesophageal reflux test 0.97 4.37 4.80 NA NA 0.091034 TC A Gastroesophageal reflux test 0.00 3.85 4.29 NA NA 0.091034 26 A Gastroesophageal reflux test 0.97 0.52 0.51 0.52 0.51 0.091035 A G-esoph reflx tst w/electrod 1.59 11.97 12.65 NA NA 0.091035 TC A G-esoph reflx tst w/electrod 0.00 11.11 11.80 NA NA 0.091035 26 A G-esoph reflx tst w/electrod 1.59 0.86 0.85 0.86 0.85 0.091037 A Esoph imped function test 0.97 3.58 3.77 NA NA 0.091037 TC A Esoph imped function test 0.00 3.06 3.24 NA NA 0.091037 26 A Esoph imped function test 0.97 0.52 0.53 0.52 0.53 0.091038 A Esoph imped funct test > 1h 1.10 11.95 7.64 NA NA 0.091038 TC A Esoph imped funct test > 1h 0.00 11.35 7.04 NA NA 0.091038 26 A Esoph imped funct test > 1h 1.10 0.60 0.60 0.60 0.60 0.091040 A Esoph balloon distension tst 0.97 7.06 9.08 NA NA 0.091040 TC A Esoph balloon distension tst 0.00 6.68 8.61 NA NA 0.091040 26 A Esoph balloon distension tst 0.97 0.38 0.47 0.38 0.47 0.091065 A Breath hydrogen test 0.20 2.35 2.12 NA NA 0.091065 TC A Breath hydrogen test 0.00 2.24 2.02 NA NA 0.091065 26 A Breath hydrogen test 0.20 0.11 0.10 0.11 0.10 0.0
CMS-1582-PN 450 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

91110 A Gi tract capsule endoscopy 3.64 21.52 23.27 NA NA 0.191110 TC A Gi tract capsule endoscopy 0.00 19.51 21.27 NA NA 0.091110 26 A Gi tract capsule endoscopy 3.64 2.01 2.00 2.01 2.00 0.191111 A Esophageal capsule endoscopy 1.00 19.37 20.63 NA NA 0.091111 TC A Esophageal capsule endoscopy 0.00 18.82 20.07 NA NA 0.091111 26 A Esophageal capsule endoscopy 1.00 0.55 0.56 0.55 0.56 0.091117 A Colon motility 6 hr study 2.45 1.36 1.36 1.63 1.63 0.391120 A Rectal sensation test 0.97 9.06 10.27 NA NA 0.091120 TC A Rectal sensation test 0.00 8.62 9.85 NA NA 0.091120 26 A Rectal sensation test 0.97 0.44 0.42 0.44 0.42 0.091122 A Anal pressure record 1.77 4.43 4.85 NA NA 0.191122 TC A Anal pressure record 0.00 3.65 4.08 NA NA 0.091122 26 A Anal pressure record 1.77 0.78 0.77 0.78 0.77 0.191132 A Electrogastrography 0.52 3.59 3.60 NA NA 0.091132 TC A Electrogastrography 0.00 3.32 3.32 NA NA 0.091132 26 A Electrogastrography 0.52 0.27 0.28 0.27 0.28 0.091133 A Electrogastrography w/test 0.66 4.37 4.37 NA NA 0.091133 TC A Electrogastrography w/test 0.00 4.00 4.00 NA NA 0.091133 26 A Electrogastrography w/test 0.66 0.37 0.37 0.37 0.37 0.091299 C Gastroenterology procedure 0.00 0.00 0.00 NA NA 0.091299 TC C Gastroenterology procedure 0.00 0.00 0.00 NA NA 0.091299 26 C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.092002 A Eye exam new patient 0.88 1.36 1.27 0.49 0.43 0.092004 A Eye exam new patient 1.82 2.36 2.18 1.05 0.91 0.192012 A Eye exam established pat 0.92 1.47 1.36 0.60 0.50 0.092014 A Eye exam & treatment 1.42 2.06 1.89 0.89 0.75 0.192015 N Refraction 0.38 0.18 0.38 0.17 0.16 0.092018 A New eye exam & treatment 2.50 NA NA 1.65 1.42 0.192019 A Eye exam & treatment 1.31 NA NA 0.67 0.59 0.092020 A Special eye evaluation 0.37 0.40 0.37 0.24 0.21 0.0
CMS-1582-PN 451 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92025 A Corneal topography 0.35 0.71 0.66 NA NA 0.092025 TC A Corneal topography 0.00 0.48 0.46 NA NA 0.092025 26 A Corneal topography 0.35 0.23 0.20 0.23 0.20 0.092060 A Special eye evaluation 0.69 1.13 1.05 NA NA 0.092060 TC A Special eye evaluation 0.00 0.70 0.67 NA NA 0.092060 26 A Special eye evaluation 0.69 0.43 0.38 0.43 0.38 0.092065 A Orthoptic/pleoptic training 0.37 1.13 1.04 NA NA 0.092065 TC A Orthoptic/pleoptic training 0.00 0.98 0.90 NA NA 0.092065 26 A Orthoptic/pleoptic training 0.37 0.15 0.14 0.15 0.14 0.092070 A Fitting of contact lens 0.70 1.29 1.23 0.43 0.37 0.092081 A Visual field examination(s) 0.30 1.02 1.09 NA NA 0.092081 TC A Visual field examination(s) 0.00 0.85 0.93 NA NA 0.092081 26 A Visual field examination(s) 0.30 0.17 0.16 0.17 0.16 0.092082 A Visual field examination(s) 0.40 1.50 1.54 NA NA 0.092082 TC A Visual field examination(s) 0.00 1.27 1.33 NA NA 0.092082 26 A Visual field examination(s) 0.40 0.23 0.21 0.23 0.21 0.092083 A Visual field examination(s) 0.50 2.05 1.94 NA NA 0.092083 TC A Visual field examination(s) 0.00 1.73 1.66 NA NA 0.092083 26 A Visual field examination(s) 0.50 0.32 0.28 0.32 0.28 0.092100 A Serial tonometry exam(s) 0.92 1.81 1.70 0.55 0.47 0.092120 A Tonography & eye evaluation 0.81 1.40 1.32 0.47 0.41 0.092130 A Water provocation tonography 0.81 1.66 1.57 0.51 0.45 0.092132 A Cmptr ophth dx img ant segmt 0.35 0.68 0.68 NA NA 0.092132 TC A Cmptr ophth dx img ant segmt 0.00 0.44 0.44 NA NA 0.092132 26 A Cmptr ophth dx img ant segmt 0.35 0.24 0.24 0.24 0.24 0.092133 A Cmptr ophth img optic nerve 0.50 0.77 0.77 NA NA 0.092133 TC A Cmptr ophth img optic nerve 0.00 0.44 0.44 NA NA 0.092133 26 A Cmptr ophth img optic nerve 0.50 0.33 0.33 0.33 0.33 0.092134 A Cptr ophth dx img post segmt 0.50 0.77 0.77 NA NA 0.092134 TC A Cptr ophth dx img post segmt 0.00 0.44 0.44 NA NA 0.0
CMS-1582-PN 452 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92134 26 A Cptr ophth dx img post segmt 0.50 0.33 0.33 0.33 0.33 0.092136 A Ophthalmic biometry 0.54 1.95 1.88 NA NA 0.092136 TC A Ophthalmic biometry 0.00 1.57 1.56 NA NA 0.092136 26 A Ophthalmic biometry 0.54 0.38 0.32 0.38 0.32 0.092140 A Glaucoma provocative tests 0.50 1.26 1.20 0.28 0.24 0.092225 A Special eye exam initial 0.38 0.39 0.34 0.24 0.21 0.092226 A Special eye exam subsequent 0.33 0.38 0.33 0.22 0.19 0.092227 A Remote dx retinal imaging 0.00 0.33 0.33 NA NA 0.092228 A Remote retinal imaging mgmt 0.30 0.56 0.56 NA NA 0.092228 TC A Remote retinal imaging mgmt 0.00 0.36 0.36 NA NA 0.092228 26 A Remote retinal imaging mgmt 0.30 0.20 0.20 0.20 0.20 0.092230 A Eye exam with photos 0.60 1.01 1.05 0.36 0.31 0.092235 A Eye exam with photos 0.81 3.09 2.99 NA NA 0.092235 TC A Eye exam with photos 0.00 2.52 2.50 NA NA 0.092235 26 A Eye exam with photos 0.81 0.57 0.49 0.57 0.49 0.092240 A Icg angiography 1.10 5.85 5.87 NA NA 0.092240 TC A Icg angiography 0.00 5.08 5.21 NA NA 0.092240 26 A Icg angiography 1.10 0.77 0.66 0.77 0.66 0.092250 A Eye exam with photos 0.44 1.73 1.70 NA NA 0.092250 TC A Eye exam with photos 0.00 1.47 1.47 NA NA 0.092250 26 A Eye exam with photos 0.44 0.26 0.23 0.26 0.23 0.092260 A Ophthalmoscopy/dynamometry 0.20 0.33 0.31 0.13 0.11 0.092265 A Eye muscle evaluation 0.81 1.58 1.47 NA NA 0.092265 TC A Eye muscle evaluation 0.00 1.02 1.03 NA NA 0.092265 26 A Eye muscle evaluation 0.81 0.56 0.44 0.56 0.44 0.092270 A Electro-oculography 0.81 1.73 1.72 NA NA 0.092270 TC A Electro-oculography 0.00 1.34 1.36 NA NA 0.092270 26 A Electro-oculography 0.81 0.39 0.36 0.39 0.36 0.092275 A Electroretinography 1.01 3.38 3.11 NA NA 0.092275 TC A Electroretinography 0.00 2.69 2.52 NA NA 0.0
CMS-1582-PN 453 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92275 26 A Electroretinography 1.01 0.69 0.59 0.69 0.59 0.092283 A Color vision examination 0.17 1.31 1.24 NA NA 0.092283 TC A Color vision examination 0.00 1.22 1.16 NA NA 0.092283 26 A Color vision examination 0.17 0.09 0.08 0.09 0.08 0.092284 A Dark adaptation eye exam 0.24 1.40 1.48 NA NA 0.092284 TC A Dark adaptation eye exam 0.00 1.29 1.38 NA NA 0.092284 26 A Dark adaptation eye exam 0.24 0.11 0.10 0.11 0.10 0.092285 A Eye photography 0.05 0.49 0.75 NA NA 0.092285 TC A Eye photography 0.00 0.46 0.69 NA NA 0.092285 26 A Eye photography 0.05 0.03 0.06 0.03 0.06 0.092286 A Internal eye photography 0.66 2.80 2.81 NA NA 0.092286 TC A Internal eye photography 0.00 2.38 2.45 NA NA 0.092286 26 A Internal eye photography 0.66 0.42 0.36 0.42 0.36 0.092287 A Internal eye photography 0.81 2.66 2.57 0.56 0.47 0.092310 N Contact lens fitting 1.17 1.49 1.50 0.51 0.51 0.092311 A Contact lens fitting 1.08 1.81 1.67 0.56 0.49 0.092312 A Contact lens fitting 1.26 2.10 1.90 0.64 0.57 0.092313 A Contact lens fitting 0.92 1.99 1.81 0.58 0.49 0.092314 N Prescription of contact lens 0.69 1.51 1.50 0.30 0.30 0.092315 A Prescription of contact lens 0.45 1.69 1.57 0.22 0.19 0.092316 A Prescription of contact lens 0.68 2.31 2.04 0.48 0.39 0.092317 A Prescription of contact lens 0.45 1.67 1.59 0.18 0.17 0.092325 A Modification of contact lens 0.00 1.07 0.98 NA NA 0.092326 A Replacement of contact lens 0.00 0.92 1.04 NA NA 0.092340 N Fitting of spectacles 0.37 0.60 0.64 0.16 0.16 0.092341 N Fitting of spectacles 0.47 0.65 0.69 0.21 0.20 0.092342 N Fitting of spectacles 0.53 0.67 0.72 0.23 0.23 0.092352 B Special spectacles fitting 0.37 0.75 0.78 0.16 0.16 0.092353 B Special spectacles fitting 0.50 0.81 0.83 0.22 0.21 0.092354 B Special spectacles fitting 0.00 0.35 1.66 NA NA 0.0
CMS-1582-PN 454 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92355 B Special spectacles fitting 0.00 0.55 1.16 NA NA 0.092358 B Eye prosthesis service 0.00 0.29 0.41 NA NA 0.092370 N Repair & adjust spectacles 0.32 0.53 0.56 0.14 0.14 0.092371 B Repair & adjust spectacles 0.00 0.30 0.37 NA NA 0.092499 C Eye service or procedure 0.00 0.00 0.00 NA NA 0.092499 TC C Eye service or procedure 0.00 0.00 0.00 NA NA 0.092499 26 C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.092502 A Ear and throat examination 1.51 NA NA 1.36 1.27 0.092504 A Ear microscopy examination 0.18 0.70 0.70 0.10 0.10 0.092506 A Speech/hearing evaluation 0.86 4.10 4.01 NA NA 0.092507 A Speech/hearing therapy 1.30 0.69 1.05 NA NA 0.092508 A Speech/hearing therapy 0.33 0.24 0.45 NA NA 0.092511 A Nasopharyngoscopy 0.61 3.50 3.55 0.81 0.81 0.092512 A Nasal function studies 0.55 1.22 1.23 0.30 0.27 0.092516 A Facial nerve function test 0.43 1.60 1.54 0.24 0.23 0.092520 A Laryngeal function studies 0.75 1.37 1.20 0.48 0.42 0.092526 A Oral function therapy 1.34 0.77 1.36 NA NA 0.092531 B Spontaneous nystagmus study 0.00 0.00 0.00 0.00 0.00 0.092532 B Positional nystagmus test 0.00 0.00 0.00 0.00 0.00 0.092533 B Caloric vestibular test 0.00 0.00 0.00 0.00 0.00 0.092534 B Optokinetic nystagmus test 0.00 0.00 0.00 0.00 0.00 0.092540 A Basic vestibular evaluation 1.50 1.31 1.31 NA NA 0.092540 TC A Basic vestibular evaluation 0.00 0.54 0.54 NA NA 0.092540 26 A Basic vestibular evaluation 1.50 0.77 0.77 0.77 0.77 0.092541 A Spontaneous nystagmus test 0.40 0.45 0.92 NA NA 0.092541 TC A Spontaneous nystagmus test 0.00 0.25 0.73 NA NA 0.092541 26 A Spontaneous nystagmus test 0.40 0.20 0.19 0.20 0.19 0.092542 A Positional nystagmus test 0.33 0.42 0.98 NA NA 0.092542 TC A Positional nystagmus test 0.00 0.25 0.82 NA NA 0.092542 26 A Positional nystagmus test 0.33 0.17 0.16 0.17 0.16 0.0
CMS-1582-PN 455 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

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Facility 

PE 

RVUs2

Ma

Pract

RVU

92543 A Caloric vestibular test 0.10 0.30 0.54 NA NA 0.092543 TC A Caloric vestibular test 0.00 0.25 0.49 NA NA 0.092543 26 A Caloric vestibular test 0.10 0.05 0.05 0.05 0.05 0.092544 A Optokinetic nystagmus test 0.26 0.37 0.81 NA NA 0.092544 TC A Optokinetic nystagmus test 0.00 0.24 0.69 NA NA 0.092544 26 A Optokinetic nystagmus test 0.26 0.13 0.12 0.13 0.12 0.092545 A Oscillating tracking test 0.23 0.35 0.77 NA NA 0.092545 TC A Oscillating tracking test 0.00 0.23 0.66 NA NA 0.092545 26 A Oscillating tracking test 0.23 0.12 0.11 0.12 0.11 0.092546 A Sinusoidal rotational test 0.29 2.59 2.46 NA NA 0.092546 TC A Sinusoidal rotational test 0.00 2.45 2.33 NA NA 0.092546 26 A Sinusoidal rotational test 0.29 0.14 0.13 0.14 0.13 0.092547 A Supplemental electrical test 0.00 0.15 0.14 0.15 0.14 0.092548 A Posturography 0.50 2.65 2.49 NA NA 0.092548 TC A Posturography 0.00 2.39 2.25 NA NA 0.092548 26 A Posturography 0.50 0.26 0.24 0.26 0.24 0.092550 A Tympanometry & reflex thresh 0.35 0.25 0.25 NA NA 0.092551 N Pure tone hearing test air 0.00 0.31 0.33 NA NA 0.092552 A Pure tone audiometry air 0.00 0.81 0.74 NA NA 0.092553 A Audiometry air & bone 0.00 0.98 0.94 NA NA 0.092555 A Speech threshold audiometry 0.00 0.58 0.54 NA NA 0.092556 A Speech audiometry complete 0.00 0.92 0.84 NA NA 0.092557 A Comprehensive hearing test 0.60 0.46 0.56 0.33 0.44 0.092559 N Group audiometric testing 0.00 0.00 0.00 0.00 0.00 0.092560 N Bekesy audiometry screen 0.00 0.00 0.00 0.00 0.00 0.092561 A Bekesy audiometry diagnosis 0.00 1.03 0.95 NA NA 0.092562 A Loudness balance test 0.00 1.12 0.92 NA NA 0.092563 A Tone decay hearing test 0.00 0.80 0.72 NA NA 0.092564 A Sisi hearing test 0.00 0.69 0.65 NA NA 0.092565 A Stenger test pure tone 0.00 0.37 0.37 NA NA 0.0
CMS-1582-PN 456 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92567 A Tympanometry 0.20 0.20 0.24 0.11 0.16 0.092568 A Acoustic refl threshold tst 0.29 0.16 0.19 0.16 0.18 0.092570 A Acoustic immitance testing 0.55 0.36 0.36 0.30 0.30 0.092571 A Filtered speech hearing test 0.00 0.65 0.58 NA NA 0.092572 A Staggered spondaic word test 0.00 1.27 0.92 NA NA 0.092575 A Sensorineural acuity test 0.00 1.73 1.44 NA NA 0.092576 A Synthetic sentence test 0.00 0.89 0.77 NA NA 0.092577 A Stenger test speech 0.00 0.44 0.47 NA NA 0.092579 A Visual audiometry (vra) 0.70 0.56 0.55 0.41 0.43 0.092582 A Conditioning play audiometry 0.00 1.69 1.50 NA NA 0.092583 A Select picture audiometry 0.00 1.06 1.04 NA NA 0.092584 A Electrocochleography 0.00 1.88 1.95 NA NA 0.092585 A Auditor evoke potent compre 0.50 3.06 2.81 NA NA 0.092585 TC A Auditor evoke potent compre 0.00 2.79 2.57 NA NA 0.092585 26 A Auditor evoke potent compre 0.50 0.27 0.24 0.27 0.24 0.092586 A Auditor evoke potent limit 0.00 2.20 2.06 NA NA 0.092587 A Evoked auditory test 0.13 0.87 0.94 NA NA 0.092587 TC A Evoked auditory test 0.00 0.80 0.87 NA NA 0.092587 26 A Evoked auditory test 0.13 0.07 0.07 0.07 0.07 0.092588 A Evoked auditory test 0.36 1.62 1.57 NA NA 0.092588 TC A Evoked auditory test 0.00 1.42 1.39 NA NA 0.092588 26 A Evoked auditory test 0.36 0.20 0.18 0.20 0.18 0.092590 N Hearing aid exam one ear 0.00 0.00 0.00 0.00 0.00 0.092591 N Hearing aid exam both ears 0.00 0.00 0.00 0.00 0.00 0.092592 N Hearing aid check one ear 0.00 0.00 0.00 0.00 0.00 0.092593 N Hearing aid check both ears 0.00 0.00 0.00 0.00 0.00 0.092594 N Electro hearng aid test one 0.00 0.00 0.00 0.00 0.00 0.092595 N Electro hearng aid tst both 0.00 0.00 0.00 0.00 0.00 0.092596 A Ear protector evaluation 0.00 1.23 1.16 NA NA 0.092597 A Oral speech device eval 1.26 0.80 1.55 NA NA 0.0
CMS-1582-PN 457 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92601 A Cochlear implt f/up exam < 7 2.30 1.51 1.88 1.01 1.40 0.192602 A Reprogram cochlear implt < 7 1.30 1.02 1.28 0.57 0.86 0.092603 A Cochlear implt f/up exam 7 > 2.25 1.86 1.83 1.22 1.30 0.192604 A Reprogram cochlear implt 7 > 1.25 1.21 1.18 0.67 0.75 0.092605 B Eval for nonspeech device rx 0.00 0.00 0.00 0.00 0.00 0.092606 B Non-speech device service 1.40 0.93 0.93 0.61 0.61 0.092607 A Ex for speech device rx 1hr 1.85 1.49 3.24 NA NA 0.192608 A Ex for speech device rx addl 0.70 0.67 0.80 NA NA 0.092609 A Use of speech device service 1.50 1.03 1.84 NA NA 0.092610 A Evaluate swallowing function 1.30 0.92 1.72 0.67 0.67 0.092611 A Motion fluoroscopy/swallow 1.34 1.09 1.92 NA NA 0.092612 A Endoscopy swallow tst (fees) 1.27 3.60 3.57 0.71 0.66 0.092613 A Endoscopy swallow tst (fees) 0.71 0.39 0.38 0.39 0.37 0.092614 A Laryngoscopic sensory test 1.27 3.09 3.03 0.73 0.67 0.092615 A Eval laryngoscopy sense tst 0.63 0.37 0.34 0.37 0.34 0.092616 A Fees w/laryngeal sense test 1.88 3.96 3.94 1.04 0.97 0.192617 A Interprt fees/laryngeal test 0.79 0.44 0.41 0.44 0.41 0.092620 A Auditory function 60 min 1.50 1.16 0.86 0.88 0.71 0.092621 A Auditory function + 15 min 0.35 0.28 0.20 0.18 0.15 0.092625 A Tinnitus assessment 1.15 0.83 0.66 0.62 0.55 0.092626 A Eval aud rehab status 1.40 1.11 1.00 0.74 0.81 0.092627 A Eval aud status rehab add-on 0.33 0.29 0.26 0.17 0.20 0.092630 I Aud rehab pre-ling hear loss 0.00 0.00 0.00 0.00 0.00 0.092633 I Aud rehab postling hear loss 0.00 0.00 0.00 0.00 0.00 0.092640 A Aud brainstem implt programg 1.76 1.22 0.78 0.90 0.62 0.392700 C Ent procedure/service 0.00 0.00 0.00 0.00 0.00 0.092950 A Heart/lung resuscitation cpr 4.00 4.39 4.31 1.08 1.06 0.392953 A Temporary external pacing 0.23 NA NA 0.07 0.09 0.092960 A Cardioversion electric ext 2.25 3.63 4.70 1.13 1.40 0.192961 A Cardioversion electric int 4.59 NA NA 2.03 2.47 0.4
CMS-1582-PN 458 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

92970 A Cardioassist internal 3.51 NA NA 1.36 1.52 0.292971 A Cardioassist external 1.77 NA NA 0.82 1.04 0.192973 A Percut coronary thrombectomy 3.28 NA NA 1.28 1.64 0.792974 A Cath place cardio brachytx 3.00 NA NA 1.17 1.51 0.692975 A Dissolve clot heart vessel 7.24 NA NA 2.87 3.62 1.592977 A Dissolve clot heart vessel 0.00 1.43 2.69 NA NA 0.092978 C Intravasc us heart add-on 0.00 0.00 0.00 NA NA 0.092978 TC C Intravasc us heart add-on 0.00 0.00 0.00 NA NA 0.092978 26 A Intravasc us heart add-on 1.80 0.70 0.90 0.70 0.90 0.192979 C Intravasc us heart add-on 0.00 0.00 0.00 NA NA 0.092979 TC C Intravasc us heart add-on 0.00 0.00 0.00 NA NA 0.092979 26 A Intravasc us heart add-on 1.44 0.56 0.72 0.56 0.72 0.192980 A Insert intracoronary stent 14.82 NA NA 5.96 7.64 3.292981 A Insert intracoronary stent 4.16 NA NA 1.62 2.08 0.992982 A Coronary artery dilation 10.96 NA NA 4.46 5.70 2.392984 A Coronary artery dilation 2.97 NA NA 1.16 1.48 0.692986 A Revision of aortic valve 22.85 NA NA 11.68 14.58 4.992987 A Revision of mitral valve 23.63 NA NA 11.91 15.00 5.192990 A Revision of pulmonary valve 18.27 NA NA 9.72 11.80 3.992992 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.092993 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.092995 A Coronary atherectomy 12.07 NA NA 4.89 6.27 2.692996 A Coronary atherectomy add-on 3.26 NA NA 1.28 1.64 0.792997 A Pul art balloon repr percut 11.98 NA NA 4.81 5.61 2.692998 A Pul art balloon repr percut 5.99 NA NA 2.32 2.86 1.393000 A Electrocardiogram complete 0.17 0.32 0.39 NA NA 0.093005 A Electrocardiogram tracing 0.00 0.25 0.31 NA NA 0.093010 A Electrocardiogram report 0.17 0.07 0.08 0.07 0.08 0.093015 A Cardiovascular stress test 0.75 1.58 1.94 NA NA 0.093016 A Cardiovascular stress test 0.45 0.18 0.22 0.18 0.22 0.0
CMS-1582-PN 459 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93017 A Cardiovascular stress test 0.00 1.28 1.58 NA NA 0.093018 A Cardiovascular stress test 0.30 0.12 0.14 0.12 0.14 0.093024 A Cardiac drug stress test 1.17 1.90 2.22 NA NA 0.093024 TC A Cardiac drug stress test 0.00 1.44 1.66 NA NA 0.093024 26 A Cardiac drug stress test 1.17 0.46 0.56 0.46 0.56 0.093025 A Microvolt t-wave assess 0.75 3.68 4.89 NA NA 0.093025 TC A Microvolt t-wave assess 0.00 3.38 4.52 NA NA 0.093025 26 A Microvolt t-wave assess 0.75 0.30 0.37 0.30 0.37 0.093040 A Rhythm ecg with report 0.15 0.19 0.22 NA NA 0.093041 A Rhythm ecg tracing 0.00 0.14 0.16 NA NA 0.093042 A Rhythm ecg report 0.15 0.05 0.06 0.05 0.06 0.093224 A Ecg monit/reprt up to 48 hrs 0.52 1.98 2.53 NA NA 0.093225 A Ecg monit/reprt up to 48 hrs 0.00 0.72 0.91 NA NA 0.093226 A Ecg monit/reprt up to 48 hrs 0.00 1.02 1.35 NA NA 0.093227 A Ecg monit/reprt up to 48 hrs 0.52 0.24 0.27 0.24 0.27 0.093228 A Remote 30 day ecg rev/report 0.52 0.21 0.21 0.21 0.21 0.093229 A Remote 30 day ecg tech supp 0.00 20.04 20.04 NA NA 0.093268 A Ecg record/review 0.52 5.67 6.83 NA NA 0.093270 A Remote 30 day ecg rev/report 0.00 0.24 0.44 NA NA 0.093271 A Ecg/monitoring and analysis 0.00 5.23 6.16 NA NA 0.093272 A Ecg/review interpret only 0.52 0.20 0.23 0.20 0.23 0.093278 A Ecg/signal-averaged 0.25 0.61 0.76 NA NA 0.093278 TC A Ecg/signal-averaged 0.00 0.50 0.65 NA NA 0.093278 26 A Ecg/signal-averaged 0.25 0.11 0.11 0.11 0.11 0.093279 A Pm device progr eval sngl 0.65 0.71 0.86 NA NA 0.093279 TC A Pm device progr eval sngl 0.00 0.45 0.53 NA NA 0.093279 26 A Pm device progr eval sngl 0.65 0.26 0.33 0.26 0.33 0.093280 A Pm device progr eval dual 0.77 0.80 1.02 NA NA 0.093280 TC A Pm device progr eval dual 0.00 0.50 0.62 NA NA 0.093280 26 A Pm device progr eval dual 0.77 0.30 0.40 0.30 0.40 0.0
CMS-1582-PN 460 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93281 A Pm device progr eval multi 0.90 0.94 1.19 NA NA 0.093281 TC A Pm device progr eval multi 0.00 0.59 0.72 NA NA 0.093281 26 A Pm device progr eval multi 0.90 0.35 0.47 0.35 0.47 0.093282 A Icd device prog eval 1 sngl 0.85 0.85 1.07 NA NA 0.093282 TC A Icd device prog eval 1 sngl 0.00 0.52 0.64 NA NA 0.093282 26 A Icd device prog eval 1 sngl 0.85 0.33 0.43 0.33 0.43 0.093283 A Icd device progr eval dual 1.15 1.05 1.31 NA NA 0.093283 TC A Icd device progr eval dual 0.00 0.60 0.74 NA NA 0.093283 26 A Icd device progr eval dual 1.15 0.45 0.57 0.45 0.57 0.093284 A Icd device progr eval mult 1.25 1.17 1.49 NA NA 0.093284 TC A Icd device progr eval mult 0.00 0.68 0.84 NA NA 0.093284 26 A Icd device progr eval mult 1.25 0.49 0.65 0.49 0.65 0.093285 A Ilr device eval progr 0.52 0.60 0.76 NA NA 0.093285 TC A Ilr device eval progr 0.00 0.40 0.49 NA NA 0.093285 26 A Ilr device eval progr 0.52 0.20 0.27 0.20 0.27 0.093286 A Pre-op pm device eval 0.30 0.41 0.46 NA NA 0.093286 TC A Pre-op pm device eval 0.00 0.29 0.34 NA NA 0.093286 26 A Pre-op pm device eval 0.30 0.12 0.12 0.12 0.12 0.093287 A Pre-op icd device eval 0.45 0.50 0.55 NA NA 0.093287 TC A Pre-op icd device eval 0.00 0.32 0.37 NA NA 0.093287 26 A Pre-op icd device eval 0.45 0.18 0.18 0.18 0.18 0.093288 A Pm device eval in person 0.43 0.58 0.72 NA NA 0.093288 TC A Pm device eval in person 0.00 0.41 0.50 NA NA 0.093288 26 A Pm device eval in person 0.43 0.17 0.22 0.17 0.22 0.093289 A Icd device interrogate 0.92 0.86 1.05 NA NA 0.093289 TC A Icd device interrogate 0.00 0.50 0.62 NA NA 0.093289 26 A Icd device interrogate 0.92 0.36 0.43 0.36 0.43 0.093290 A Icm device eval 0.43 0.41 0.45 NA NA 0.093290 TC A Icm device eval 0.00 0.24 0.28 NA NA 0.093290 26 A Icm device eval 0.43 0.17 0.17 0.17 0.17 0.0
CMS-1582-PN 461 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93291 A Ilr device interrogate 0.43 0.54 0.67 NA NA 0.093291 TC A Ilr device interrogate 0.00 0.37 0.45 NA NA 0.093291 26 A Ilr device interrogate 0.43 0.17 0.22 0.17 0.22 0.093292 A Wcd device interrogate 0.43 0.45 0.56 NA NA 0.093292 TC A Wcd device interrogate 0.00 0.28 0.34 NA NA 0.093292 26 A Wcd device interrogate 0.43 0.17 0.22 0.17 0.22 0.093293 A Pm phone r-strip device eval 0.32 1.14 1.31 NA NA 0.093293 TC A Pm phone r-strip device eval 0.00 1.02 1.17 NA NA 0.093293 26 A Pm phone r-strip device eval 0.32 0.12 0.14 0.12 0.14 0.093294 A Pm device interrogate remote 0.65 0.25 0.33 0.25 0.33 0.093295 A Icd device interrogat remote 1.29 0.50 0.64 0.50 0.64 0.093296 A Pm/icd remote tech serv 0.00 0.69 0.95 NA NA 0.093297 A Icm device interrogat remote 0.52 0.20 0.21 0.20 0.21 0.093298 A Ilr device interrogat remote 0.52 0.20 0.27 0.20 0.27 0.093299 C Icm/ilr remote tech serv 0.00 0.00 0.00 0.00 0.00 0.093303 A Echo transthoracic 1.30 4.23 4.84 NA NA 0.093303 TC A Echo transthoracic 0.00 3.70 4.23 NA NA 0.093303 26 A Echo transthoracic 1.30 0.53 0.61 0.53 0.61 0.093304 A Echo transthoracic 0.75 2.86 3.16 NA NA 0.093304 TC A Echo transthoracic 0.00 2.56 2.82 NA NA 0.093304 26 A Echo transthoracic 0.75 0.30 0.34 0.30 0.34 0.093306 A Tte w/doppler complete 1.30 4.01 5.50 NA NA 0.093306 TC A Tte w/doppler complete 0.00 3.49 4.85 NA NA 0.093306 26 A Tte w/doppler complete 1.30 0.52 0.65 0.52 0.65 0.093307 A Tte w/o doppler complete 0.92 2.27 3.40 NA NA 0.093307 TC A Tte w/o doppler complete 0.00 1.89 2.95 NA NA 0.093307 26 A Tte w/o doppler complete 0.92 0.38 0.45 0.38 0.45 0.093308 A Tte f-up or lmtd 0.53 2.16 2.55 NA NA 0.093308 TC A Tte f-up or lmtd 0.00 1.95 2.29 NA NA 0.093308 26 A Tte f-up or lmtd 0.53 0.21 0.26 0.21 0.26 0.0
CMS-1582-PN 462 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93312 A Echo transesophageal 2.20 6.57 7.23 NA NA 0.193312 TC A Echo transesophageal 0.00 5.78 6.26 NA NA 0.093312 26 A Echo transesophageal 2.20 0.79 0.97 0.79 0.97 0.093313 A Echo transesophageal 0.95 NA NA 0.23 0.20 0.093314 A Echo transesophageal 1.25 6.59 7.08 NA NA 0.093314 TC A Echo transesophageal 0.00 6.12 6.52 NA NA 0.093314 26 A Echo transesophageal 1.25 0.47 0.56 0.47 0.56 0.093315 C Echo transesophageal 0.00 0.00 0.00 NA NA 0.093315 TC C Echo transesophageal 0.00 0.00 0.00 NA NA 0.093315 26 A Echo transesophageal 2.78 1.04 1.28 1.04 1.28 0.293316 A Echo transesophageal 0.95 NA NA 0.28 0.30 0.093317 C Echo transesophageal 0.00 0.00 0.00 NA NA 0.093317 TC C Echo transesophageal 0.00 0.00 0.00 NA NA 0.093317 26 A Echo transesophageal 1.83 0.67 0.73 0.67 0.73 0.293318 C Echo transesophageal intraop 0.00 0.00 0.00 NA NA 0.093318 TC C Echo transesophageal intraop 0.00 0.00 0.00 NA NA 0.093318 26 A Echo transesophageal intraop 2.20 0.77 0.87 0.77 0.87 0.393320 A Doppler echo exam heart 0.38 0.88 1.44 NA NA 0.093320 TC A Doppler echo exam heart 0.00 0.73 1.26 NA NA 0.093320 26 A Doppler echo exam heart 0.38 0.15 0.18 0.15 0.18 0.093321 A Doppler echo exam heart 0.15 0.52 0.61 NA NA 0.093321 TC A Doppler echo exam heart 0.00 0.47 0.55 NA NA 0.093321 26 A Doppler echo exam heart 0.15 0.05 0.06 0.05 0.06 0.093325 A Doppler color flow add-on 0.07 0.47 0.96 NA NA 0.093325 TC A Doppler color flow add-on 0.00 0.44 0.93 NA NA 0.093325 26 A Doppler color flow add-on 0.07 0.03 0.03 0.03 0.03 0.093350 A Stress tte only 1.46 4.18 4.67 NA NA 0.093350 TC A Stress tte only 0.00 3.60 3.94 NA NA 0.093350 26 A Stress tte only 1.46 0.58 0.73 0.58 0.73 0.093351 A Stress tte complete 1.75 4.74 5.46 NA NA 0.0
CMS-1582-PN 463 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93351 TC A Stress tte complete 0.00 4.05 4.56 NA NA 0.093351 26 A Stress tte complete 1.75 0.69 0.90 0.69 0.90 0.093352 A Admin ecg contrast agent 0.19 0.71 0.87 NA NA 0.093451 A Right heart cath 2.72 19.13 19.13 NA NA 0.693451 TC A Right heart cath 0.00 18.07 18.07 NA NA 0.093451 26 A Right heart cath 2.72 1.06 1.06 1.06 1.06 0.593452 A Left hrt cath w/ventrclgrphy 4.75 19.11 19.11 NA NA 1.093452 TC A Left hrt cath w/ventrclgrphy 0.00 17.26 17.26 NA NA 0.093452 26 A Left hrt cath w/ventrclgrphy 4.75 1.85 1.85 1.85 1.85 1.093453 A R&l hrt cath w/ventriclgrphy 6.24 25.00 25.00 NA NA 1.493453 TC A R&l hrt cath w/ventriclgrphy 0.00 22.57 22.57 NA NA 0.093453 26 A R&l hrt cath w/ventriclgrphy 6.24 2.43 2.43 2.43 2.43 1.393454 A Coronary artery angio s&i 4.79 19.85 19.85 NA NA 1.093454 TC A Coronary artery angio s&i 0.00 17.98 17.98 NA NA 0.093454 26 A Coronary artery angio s&i 4.79 1.87 1.87 1.87 1.87 1.093455 A Coronary art/grft angio s&i 5.54 23.23 23.23 NA NA 1.293455 TC A Coronary art/grft angio s&i 0.00 21.07 21.07 NA NA 0.093455 26 A Coronary art/grft angio s&i 5.54 2.16 2.16 2.16 2.16 1.293456 A R hrt coronary artery angio 6.15 24.68 24.68 NA NA 1.393456 TC A R hrt coronary artery angio 0.00 22.28 22.28 NA NA 0.093456 26 A R hrt coronary artery angio 6.15 2.40 2.40 2.40 2.40 1.393457 A R hrt art/grft angio 6.89 28.06 28.06 NA NA 1.593457 TC A R hrt art/grft angio 0.00 25.37 25.37 NA NA 0.093457 26 A R hrt art/grft angio 6.89 2.69 2.69 2.69 2.69 1.593458 A L hrt artery/ventricle angio 5.85 23.87 23.87 NA NA 1.393458 TC A L hrt artery/ventricle angio 0.00 21.59 21.59 NA NA 0.093458 26 A L hrt artery/ventricle angio 5.85 2.28 2.28 2.28 2.28 1.293459 A L hrt art/grft angio 6.60 26.22 26.22 NA NA 1.493459 TC A L hrt art/grft angio 0.00 23.65 23.65 NA NA 0.093459 26 A L hrt art/grft angio 6.60 2.57 2.57 2.57 2.57 1.4
CMS-1582-PN 464 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93460 A R&l hrt art/ventricle angio 7.35 27.72 27.72 NA NA 1.693460 TC A R&l hrt art/ventricle angio 0.00 24.85 24.85 NA NA 0.093460 26 A R&l hrt art/ventricle angio 7.35 2.87 2.87 2.87 2.87 1.593461 A R&l hrt art/ventricle angio 8.10 32.13 32.13 NA NA 1.893461 TC A R&l hrt art/ventricle angio 0.00 28.97 28.97 NA NA 0.093461 26 A R&l hrt art/ventricle angio 8.10 3.16 3.16 3.16 3.16 1.793462 A L hrt cath trnsptl puncture 3.73 1.47 1.47 1.47 1.47 0.893463 A Drug admin & hemodynmic meas 2.00 0.79 0.79 0.79 0.79 0.393464 A Exercise w/hemodynamic meas 1.80 5.26 5.26 NA NA 0.393464 TC A Exercise w/hemodynamic meas 0.00 4.61 4.61 NA NA 0.093464 26 A Exercise w/hemodynamic meas 1.80 0.65 0.65 0.65 0.65 0.393503 A Insert/place heart catheter 2.91 NA NA 0.77 0.77 0.293505 A Biopsy of heart lining 4.37 17.36 18.38 NA NA 0.893505 TC A Biopsy of heart lining 0.00 15.65 16.22 NA NA 0.093505 26 A Biopsy of heart lining 4.37 1.71 2.16 1.71 2.16 0.893530 C Rt heart cath congenital 0.00 NA NA NA NA 0.093530 TC C Rt heart cath congenital 0.00 NA NA NA NA 0.093530 26 A Rt heart cath congenital 4.22 1.67 2.05 1.67 2.05 0.993531 C R & l heart cath congenital 0.00 NA NA NA NA 0.093531 TC C R & l heart cath congenital 0.00 NA NA NA NA 0.093531 26 A R & l heart cath congenital 8.34 3.29 3.96 3.29 3.96 1.893532 C R & l heart cath congenital 0.00 NA NA NA NA 0.093532 TC C R & l heart cath congenital 0.00 NA NA NA NA 0.093532 26 A R & l heart cath congenital 9.99 3.88 4.62 3.88 4.62 2.193533 C R & l heart cath congenital 0.00 NA NA NA NA 0.093533 TC C R & l heart cath congenital 0.00 NA NA NA NA 0.093533 26 A R & l heart cath congenital 6.69 2.59 3.12 2.59 3.12 1.493561 C Cardiac output measurement 0.00 NA NA NA NA 0.093561 TC C Cardiac output measurement 0.00 NA NA NA NA 0.093561 26 A Cardiac output measurement 0.50 0.20 0.19 0.20 0.19 0.0
CMS-1582-PN 465 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93562 C Cardiac output measurement 0.00 NA NA NA NA 0.093562 TC C Cardiac output measurement 0.00 NA NA NA NA 0.093562 26 A Cardiac output measurement 0.16 0.06 0.05 0.06 0.05 0.093563 A Inject congenital card cath 1.11 0.44 0.44 0.44 0.44 0.193564 A Inject hrt congntl art/grft 1.13 0.44 0.44 0.44 0.44 0.193565 A Inject l ventr/atrial angio 0.86 0.33 0.33 0.33 0.33 0.093566 A Inject r ventr/atrial angio 0.86 4.04 4.04 0.33 0.33 0.093567 A Inject suprvlv aortography 0.97 3.06 3.06 0.38 0.38 0.093568 A Inject pulm art hrt cath 0.88 3.54 3.54 0.34 0.34 0.093571 C Heart flow reserve measure 0.00 NA NA NA NA 0.093571 TC C Heart flow reserve measure 0.00 NA NA NA NA 0.093571 26 A Heart flow reserve measure 1.80 0.70 0.89 0.70 0.89 0.193572 C Heart flow reserve measure 0.00 NA NA NA NA 0.093572 TC C Heart flow reserve measure 0.00 NA NA NA NA 0.093572 26 A Heart flow reserve measure 1.44 0.56 0.69 0.56 0.69 0.193580 A Transcath closure of asd 17.97 NA NA 7.38 9.19 3.993581 A Transcath closure of vsd 24.39 NA NA 9.79 11.53 5.393600 C Bundle of his recording 0.00 0.00 0.00 NA NA 0.093600 TC C Bundle of his recording 0.00 0.00 0.00 NA NA 0.093600 26 A Bundle of his recording 2.12 0.83 1.04 0.83 1.04 0.493602 C Intra-atrial recording 0.00 0.00 0.00 NA NA 0.093602 TC C Intra-atrial recording 0.00 0.00 0.00 NA NA 0.093602 26 A Intra-atrial recording 2.12 0.82 1.03 0.82 1.03 0.493603 C Right ventricular recording 0.00 0.00 0.00 NA NA 0.093603 TC C Right ventricular recording 0.00 0.00 0.00 NA NA 0.093603 26 A Right ventricular recording 2.12 0.82 1.03 0.82 1.03 0.493609 C Map tachycardia add-on 0.00 0.00 0.00 NA NA 0.093609 TC C Map tachycardia add-on 0.00 0.00 0.00 NA NA 0.093609 26 A Map tachycardia add-on 4.99 1.95 2.47 1.95 2.47 1.093610 C Intra-atrial pacing 0.00 0.00 0.00 NA NA 0.0
CMS-1582-PN 466 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93610 TC C Intra-atrial pacing 0.00 0.00 0.00 NA NA 0.093610 26 A Intra-atrial pacing 3.02 1.17 1.45 1.17 1.45 0.693612 C Intraventricular pacing 0.00 0.00 0.00 NA NA 0.093612 TC C Intraventricular pacing 0.00 0.00 0.00 NA NA 0.093612 26 A Intraventricular pacing 3.02 1.16 1.43 1.16 1.43 0.693613 A Electrophys map 3d add-on 6.99 NA NA 2.73 3.48 1.593615 C Esophageal recording 0.00 0.00 0.00 NA NA 0.093615 TC C Esophageal recording 0.00 0.00 0.00 NA NA 0.093615 26 A Esophageal recording 0.99 0.39 0.48 0.39 0.48 0.093616 C Esophageal recording 0.00 0.00 0.00 NA NA 0.093616 TC C Esophageal recording 0.00 0.00 0.00 NA NA 0.093616 26 A Esophageal recording 1.49 0.35 0.39 0.35 0.39 0.193618 C Heart rhythm pacing 0.00 0.00 0.00 NA NA 0.093618 TC C Heart rhythm pacing 0.00 0.00 0.00 NA NA 0.093618 26 A Heart rhythm pacing 4.25 1.65 2.13 1.65 2.13 0.993619 C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093619 TC C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093619 26 A Electrophysiology evaluation 7.31 2.85 3.70 2.85 3.70 1.593620 C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093620 TC C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093620 26 A Electrophysiology evaluation 11.57 4.52 5.79 4.52 5.79 2.593621 C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093621 TC C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093621 26 A Electrophysiology evaluation 2.10 0.82 1.04 0.82 1.04 0.493622 C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093622 TC C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093622 26 A Electrophysiology evaluation 3.10 1.21 1.51 1.21 1.51 0.693623 C Stimulation pacing heart 0.00 0.00 0.00 NA NA 0.093623 TC C Stimulation pacing heart 0.00 0.00 0.00 NA NA 0.093623 26 A Stimulation pacing heart 2.85 1.11 1.41 1.11 1.41 0.6
CMS-1582-PN 467 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93624 C Electrophysiologic study 0.00 0.00 0.00 NA NA 0.093624 TC C Electrophysiologic study 0.00 0.00 0.00 NA NA 0.093624 26 A Electrophysiologic study 4.80 1.86 2.43 NA NA 1.093631 C Heart pacing mapping 0.00 0.00 0.00 NA NA 0.093631 TC C Heart pacing mapping 0.00 0.00 0.00 NA NA 0.093631 26 A Heart pacing mapping 7.59 2.76 3.07 2.76 3.07 1.893640 C Evaluation heart device 0.00 0.00 0.00 NA NA 0.093640 TC C Evaluation heart device 0.00 0.00 0.00 NA NA 0.093640 26 A Evaluation heart device 3.51 1.38 1.74 1.38 1.74 0.793641 C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093641 TC C Electrophysiology evaluation 0.00 0.00 0.00 NA NA 0.093641 26 A Electrophysiology evaluation 5.92 2.31 2.94 2.31 2.94 1.293642 A Electrophysiology evaluation 4.88 5.69 7.50 NA NA 0.293642 TC A Electrophysiology evaluation 0.00 3.78 5.02 NA NA 0.093642 26 A Electrophysiology evaluation 4.88 1.91 2.48 1.91 2.48 0.193650 A Ablate heart dysrhythm focus 10.49 NA NA 4.37 5.51 2.293651 A Ablate heart dysrhythm focus 16.23 NA NA 6.34 8.05 3.593652 A Ablate heart dysrhythm focus 17.65 NA NA 6.92 8.78 3.893660 A Tilt table evaluation 1.89 2.36 2.87 NA NA 0.093660 TC A Tilt table evaluation 0.00 1.61 1.93 NA NA 0.093660 26 A Tilt table evaluation 1.89 0.75 0.94 0.75 0.94 0.093662 C Intracardiac ecg (ice) 0.00 0.00 0.00 NA NA 0.093662 TC C Intracardiac ecg (ice) 0.00 0.00 0.00 NA NA 0.093662 26 A Intracardiac ecg (ice) 2.80 1.09 1.38 1.09 1.38 0.293668 N Peripheral vascular rehab 0.00 0.51 0.54 NA NA 0.093701 A Bioimpedance cv analysis 0.00 0.65 0.78 NA NA 0.093720 A Total body plethysmography 0.17 1.22 1.25 NA NA 0.093721 A Plethysmography tracing 0.00 1.16 1.19 NA NA 0.093722 A Plethysmography report 0.17 0.06 0.06 0.06 0.06 0.093724 A Analyze pacemaker system 4.88 2.66 3.77 NA NA 0.1
CMS-1582-PN 468 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93724 TC A Analyze pacemaker system 0.00 0.72 1.35 NA NA 0.093724 26 A Analyze pacemaker system 4.88 1.94 2.42 1.94 2.42 0.193740 B Temperature gradient studies 0.16 0.07 0.07 0.07 0.07 0.093740 TC B Temperature gradient studies 0.00 NA NA NA NA 0.093740 26 B Temperature gradient studies 0.16 0.00 0.05 0.00 0.05 0.093745 C Set-up cardiovert-defibrill 0.00 0.00 0.00 NA NA 0.093745 TC C Set-up cardiovert-defibrill 0.00 0.00 0.00 NA NA 0.093745 26 C Set-up cardiovert-defibrill 0.00 0.00 0.00 0.00 0.00 0.093750 A Interrogation vad in person 0.92 0.54 0.54 0.34 0.34 0.093770 B Measure venous pressure 0.16 0.07 0.07 0.07 0.07 0.093770 TC B Measure venous pressure 0.00 NA NA NA NA 0.093770 26 B Measure venous pressure 0.16 0.00 0.05 0.00 0.05 0.093784 A Ambulatory bp monitoring 0.38 1.12 1.42 NA NA 0.093786 A Ambulatory bp recording 0.00 0.82 0.91 NA NA 0.093788 A Ambulatory bp analysis 0.00 0.14 0.34 NA NA 0.093790 A Review/report bp recording 0.38 0.16 0.17 0.16 0.17 0.093797 A Cardiac rehab 0.18 0.30 0.34 0.08 0.09 0.093798 A Cardiac rehab/monitor 0.28 0.40 0.46 0.12 0.14 0.093799 C Cardiovascular procedure 0.00 0.00 0.00 NA NA 0.093799 TC C Cardiovascular procedure 0.00 0.00 0.00 NA NA 0.093799 26 C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.093875 A Extracranial study 0.22 2.73 2.87 NA NA 0.093875 TC A Extracranial study 0.00 2.64 2.78 NA NA 0.093875 26 A Extracranial study 0.22 0.09 0.09 0.09 0.09 0.093880 A Extracranial study 0.60 6.23 6.72 NA NA 0.093880 TC A Extracranial study 0.00 6.00 6.47 NA NA 0.093880 26 A Extracranial study 0.60 0.23 0.25 0.23 0.25 0.093882 A Extracranial study 0.40 4.56 4.65 NA NA 0.093882 TC A Extracranial study 0.00 4.41 4.50 NA NA 0.093882 26 A Extracranial study 0.40 0.15 0.15 0.15 0.15 0.0
CMS-1582-PN 469 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93886 A Intracranial study 0.94 9.10 8.76 NA NA 0.093886 TC A Intracranial study 0.00 8.68 8.36 NA NA 0.093886 26 A Intracranial study 0.94 0.42 0.40 0.42 0.40 0.093888 A Intracranial study 0.62 5.36 5.54 NA NA 0.093888 TC A Intracranial study 0.00 5.10 5.28 NA NA 0.093888 26 A Intracranial study 0.62 0.26 0.26 0.26 0.26 0.093890 A Tcd vasoreactivity study 1.00 6.74 6.92 NA NA 0.093890 TC A Tcd vasoreactivity study 0.00 6.32 6.51 NA NA 0.093890 26 A Tcd vasoreactivity study 1.00 0.42 0.41 0.42 0.41 0.093892 A Tcd emboli detect w/o inj 1.15 8.61 8.19 NA NA 0.093892 TC A Tcd emboli detect w/o inj 0.00 8.10 7.71 NA NA 0.093892 26 A Tcd emboli detect w/o inj 1.15 0.51 0.48 0.51 0.48 0.093893 A Tcd emboli detect w/inj 1.15 9.45 8.61 NA NA 0.093893 TC A Tcd emboli detect w/inj 0.00 8.93 8.12 NA NA 0.093893 26 A Tcd emboli detect w/inj 1.15 0.52 0.49 0.52 0.49 0.093922 A Upr/l xtremity art 2 levels 0.25 2.38 2.98 NA NA 0.093922 TC A Upr/l xtremity art 2 levels 0.00 2.28 2.88 NA NA 0.093922 26 A Upr/l xtremity art 2 levels 0.25 0.10 0.10 0.10 0.10 0.093923 A Upr/lxtr art stdy 3+ lvls 0.45 3.63 4.53 NA NA 0.093923 TC A Upr/lxtr art stdy 3+ lvls 0.00 3.46 4.35 NA NA 0.093923 26 A Upr/lxtr art stdy 3+ lvls 0.45 0.17 0.18 0.17 0.18 0.093924 A Lwr xtr vasc stdy bilat 0.50 4.70 5.73 NA NA 0.093924 TC A Lwr xtr vasc stdy bilat 0.00 4.51 5.53 NA NA 0.093924 26 A Lwr xtr vasc stdy bilat 0.50 0.19 0.20 0.19 0.20 0.093925 A Lower extremity study 0.58 8.08 8.67 NA NA 0.093925 TC A Lower extremity study 0.00 7.86 8.44 NA NA 0.093925 26 A Lower extremity study 0.58 0.22 0.23 0.22 0.23 0.093926 A Lower extremity study 0.39 5.34 5.61 NA NA 0.093926 TC A Lower extremity study 0.00 5.20 5.46 NA NA 0.093926 26 A Lower extremity study 0.39 0.14 0.15 0.14 0.15 0.0
CMS-1582-PN 470 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93930 A Upper extremity study 0.46 6.46 6.83 NA NA 0.093930 TC A Upper extremity study 0.00 6.29 6.65 NA NA 0.093930 26 A Upper extremity study 0.46 0.17 0.18 0.17 0.18 0.093931 A Upper extremity study 0.31 4.29 4.56 NA NA 0.093931 TC A Upper extremity study 0.00 4.18 4.44 NA NA 0.093931 26 A Upper extremity study 0.31 0.11 0.12 0.11 0.12 0.093965 A Extremity study 0.35 3.11 3.34 NA NA 0.093965 TC A Extremity study 0.00 2.98 3.20 NA NA 0.093965 26 A Extremity study 0.35 0.13 0.14 0.13 0.14 0.093970 A Extremity study 0.68 6.46 6.84 NA NA 0.093970 TC A Extremity study 0.00 6.21 6.57 NA NA 0.093970 26 A Extremity study 0.68 0.25 0.27 0.25 0.27 0.093971 A Extremity study 0.45 4.21 4.49 NA NA 0.093971 TC A Extremity study 0.00 4.04 4.31 NA NA 0.093971 26 A Extremity study 0.45 0.17 0.18 0.17 0.18 0.093975 A Vascular study 1.80 8.52 9.22 NA NA 0.193975 TC A Vascular study 0.00 7.85 8.49 NA NA 0.093975 26 A Vascular study 1.80 0.67 0.73 0.67 0.73 0.193976 A Vascular study 1.21 4.72 5.11 NA NA 0.093976 TC A Vascular study 0.00 4.27 4.61 NA NA 0.093976 26 A Vascular study 1.21 0.45 0.50 0.45 0.50 0.093978 A Vascular study 0.65 6.06 6.42 NA NA 0.093978 TC A Vascular study 0.00 5.82 6.16 NA NA 0.093978 26 A Vascular study 0.65 0.24 0.26 0.24 0.26 0.093979 A Vascular study 0.44 4.21 4.46 NA NA 0.093979 TC A Vascular study 0.00 4.05 4.29 NA NA 0.093979 26 A Vascular study 0.44 0.16 0.17 0.16 0.17 0.093980 A Penile vascular study 1.25 3.51 3.86 NA NA 0.093980 TC A Penile vascular study 0.00 3.02 3.32 NA NA 0.093980 26 A Penile vascular study 1.25 0.49 0.54 0.49 0.54 0.0
CMS-1582-PN 471 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

93981 A Penile vascular study 0.44 2.69 3.07 NA NA 0.093981 TC A Penile vascular study 0.00 2.52 2.89 NA NA 0.093981 26 A Penile vascular study 0.44 0.17 0.18 0.17 0.18 0.093982 R Aneurysm pressure sens study 0.30 0.87 0.92 NA NA 0.093990 A Doppler flow testing 0.25 5.87 5.90 NA NA 0.093990 TC A Doppler flow testing 0.00 5.78 5.81 NA NA 0.093990 26 A Doppler flow testing 0.25 0.09 0.09 0.09 0.09 0.094002 A Vent mgmt inpat init day 1.99 NA NA 0.60 0.52 0.194003 A Vent mgmt inpat subq day 1.37 NA NA 0.49 0.45 0.194004 A Vent mgmt nf per day 1.00 NA NA 0.36 0.33 0.094005 B Home vent mgmt supervision 1.50 1.09 1.09 NA NA 0.194010 A Breathing capacity test 0.17 0.83 0.85 NA NA 0.094010 TC A Breathing capacity test 0.00 0.76 0.78 NA NA 0.094010 26 A Breathing capacity test 0.17 0.07 0.07 0.07 0.07 0.094011 A Spirometry up to 2 yrs old 2.00 NA NA 0.77 0.77 0.194012 A Spirmtry w/brnchdil inf-2 yr 3.10 NA NA 1.16 1.16 0.294013 A Meas lung vol thru 2 yrs 0.66 NA NA 0.22 0.22 0.094014 A Patient recorded spirometry 0.52 0.83 0.90 NA NA 0.094015 A Patient recorded spirometry 0.00 0.64 0.71 NA NA 0.094016 A Review patient spirometry 0.52 0.19 0.19 0.19 0.19 0.094060 A Evaluation of wheezing 0.31 1.43 1.46 NA NA 0.094060 TC A Evaluation of wheezing 0.00 1.31 1.35 NA NA 0.094060 26 A Evaluation of wheezing 0.31 0.12 0.11 0.12 0.11 0.094070 A Evaluation of wheezing 0.60 1.10 1.12 NA NA 0.094070 TC A Evaluation of wheezing 0.00 0.87 0.91 NA NA 0.094070 26 A Evaluation of wheezing 0.60 0.23 0.21 0.23 0.21 0.094150 B Vital capacity test 0.07 0.61 0.62 NA NA 0.094150 TC B Vital capacity test 0.00 0.58 0.59 NA NA 0.094150 26 B Vital capacity test 0.07 0.03 0.03 0.03 0.03 0.094200 A Lung function test (mbc/mvv) 0.11 0.57 0.58 NA NA 0.0
CMS-1582-PN 472 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

94200 TC A Lung function test (mbc/mvv) 0.00 0.53 0.54 NA NA 0.094200 26 A Lung function test (mbc/mvv) 0.11 0.04 0.04 0.04 0.04 0.094240 A Residual lung capacity 0.26 0.86 0.90 NA NA 0.094240 TC A Residual lung capacity 0.00 0.77 0.81 NA NA 0.094240 26 A Residual lung capacity 0.26 0.09 0.09 0.09 0.09 0.094250 A Expired gas collection 0.11 0.57 0.62 NA NA 0.094250 TC A Expired gas collection 0.00 0.53 0.58 NA NA 0.094250 26 A Expired gas collection 0.11 0.04 0.04 0.04 0.04 0.094260 A Thoracic gas volume 0.13 0.78 0.81 NA NA 0.094260 TC A Thoracic gas volume 0.00 0.73 0.77 NA NA 0.094260 26 A Thoracic gas volume 0.13 0.05 0.04 0.05 0.04 0.094350 A Lung nitrogen washout curve 0.26 0.69 0.74 NA NA 0.094350 TC A Lung nitrogen washout curve 0.00 0.59 0.65 NA NA 0.094350 26 A Lung nitrogen washout curve 0.26 0.10 0.09 0.10 0.09 0.094360 A Measure airflow resistance 0.26 0.99 1.03 NA NA 0.094360 TC A Measure airflow resistance 0.00 0.90 0.94 NA NA 0.094360 26 A Measure airflow resistance 0.26 0.09 0.09 0.09 0.09 0.094370 A Breath airway closing volume 0.26 0.69 0.73 NA NA 0.094370 TC A Breath airway closing volume 0.00 0.59 0.64 NA NA 0.094370 26 A Breath airway closing volume 0.26 0.10 0.09 0.10 0.09 0.094375 A Respiratory flow volume loop 0.31 0.78 0.80 NA NA 0.094375 TC A Respiratory flow volume loop 0.00 0.66 0.69 NA NA 0.094375 26 A Respiratory flow volume loop 0.31 0.12 0.11 0.12 0.11 0.094400 A Co2 breathing response curve 0.40 1.13 1.16 NA NA 0.094400 TC A Co2 breathing response curve 0.00 0.99 1.02 NA NA 0.094400 26 A Co2 breathing response curve 0.40 0.14 0.14 0.14 0.14 0.094450 A Hypoxia response curve 0.40 1.47 1.32 NA NA 0.094450 TC A Hypoxia response curve 0.00 1.30 1.17 NA NA 0.094450 26 A Hypoxia response curve 0.40 0.17 0.15 0.17 0.15 0.094452 A Hast w/report 0.31 1.29 1.36 NA NA 0.0
CMS-1582-PN 473 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

94452 TC A Hast w/report 0.00 1.18 1.26 NA NA 0.094452 26 A Hast w/report 0.31 0.11 0.10 0.11 0.10 0.094453 A Hast w/oxygen titrate 0.40 1.77 1.87 NA NA 0.094453 TC A Hast w/oxygen titrate 0.00 1.63 1.73 NA NA 0.094453 26 A Hast w/oxygen titrate 0.40 0.14 0.14 0.14 0.14 0.094610 A Surfactant admin thru tube 1.16 0.56 0.51 0.56 0.51 0.094620 A Pulmonary stress test/simple 0.64 0.88 1.19 NA NA 0.094620 TC A Pulmonary stress test/simple 0.00 0.65 0.96 NA NA 0.094620 26 A Pulmonary stress test/simple 0.64 0.23 0.23 0.23 0.23 0.094621 A Pulm stress test/complex 1.42 3.11 3.31 NA NA 0.094621 TC A Pulm stress test/complex 0.00 2.58 2.76 NA NA 0.094621 26 A Pulm stress test/complex 1.42 0.53 0.55 0.53 0.55 0.094640 A Airway inhalation treatment 0.00 0.49 0.46 NA NA 0.094642 C Aerosol inhalation treatment 0.00 0.00 0.00 0.00 0.00 0.094644 A Cbt 1st hour 0.00 1.21 1.17 NA NA 0.094645 A Cbt each addl hour 0.00 0.40 0.42 NA NA 0.094660 A Pos airway pressure cpap 0.76 0.98 0.96 0.28 0.27 0.094662 A Neg press ventilation cnp 0.76 NA NA 0.26 0.25 0.094664 A Evaluate pt use of inhaler 0.00 0.47 0.46 NA NA 0.094667 A Chest wall manipulation 0.00 0.67 0.65 NA NA 0.094668 A Chest wall manipulation 0.00 0.64 0.63 NA NA 0.094680 A Exhaled air analysis o2 0.26 1.35 1.45 NA NA 0.094680 TC A Exhaled air analysis o2 0.00 1.24 1.35 NA NA 0.094680 26 A Exhaled air analysis o2 0.26 0.11 0.10 0.11 0.10 0.094681 A Exhaled air analysis o2/co2 0.20 1.20 1.46 NA NA 0.094681 TC A Exhaled air analysis o2/co2 0.00 1.12 1.39 NA NA 0.094681 26 A Exhaled air analysis o2/co2 0.20 0.08 0.07 0.08 0.07 0.094690 A Exhaled air analysis 0.07 1.31 1.43 NA NA 0.094690 TC A Exhaled air analysis 0.00 1.28 1.40 NA NA 0.094690 26 A Exhaled air analysis 0.07 0.03 0.03 0.03 0.03 0.0
CMS-1582-PN 474 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

94720 A Monoxide diffusing capacity 0.26 1.18 1.26 NA NA 0.094720 TC A Monoxide diffusing capacity 0.00 1.09 1.17 NA NA 0.094720 26 A Monoxide diffusing capacity 0.26 0.09 0.09 0.09 0.09 0.094725 A Membrane diffusion capacity 0.26 1.16 1.48 NA NA 0.094725 TC A Membrane diffusion capacity 0.00 1.06 1.38 NA NA 0.094725 26 A Membrane diffusion capacity 0.26 0.10 0.10 0.10 0.10 0.094750 A Pulmonary compliance study 0.23 2.04 2.04 NA NA 0.094750 TC A Pulmonary compliance study 0.00 1.95 1.96 NA NA 0.094750 26 A Pulmonary compliance study 0.23 0.09 0.08 0.09 0.08 0.094760 T Measure blood oxygen level 0.00 0.08 0.07 NA NA 0.094761 T Measure blood oxygen level 0.00 0.12 0.12 NA NA 0.094762 A Measure blood oxygen level 0.00 0.29 0.58 NA NA 0.094770 A Exhaled carbon dioxide test 0.15 0.07 0.50 0.07 0.50 0.094770 TC A Exhaled carbon dioxide test 0.00 0.00 0.74 NA NA 0.094770 26 A Exhaled carbon dioxide test 0.15 0.00 0.04 0.00 0.04 0.094772 C Breath recording infant 0.00 0.00 0.00 NA NA 0.094772 TC C Breath recording infant 0.00 0.00 0.00 NA NA 0.094772 26 C Breath recording infant 0.00 0.00 0.00 0.00 0.00 0.094774 C Ped home apnea rec compl 0.00 0.00 0.00 0.00 0.00 0.094775 C Ped home apnea rec hk-up 0.00 0.00 0.00 0.00 0.00 0.094776 C Ped home apnea rec downld 0.00 0.00 0.00 0.00 0.00 0.094777 C Ped home apnea rec report 0.00 0.00 0.00 0.00 0.00 0.094799 C Pulmonary service/procedure 0.00 0.00 0.00 NA NA 0.094799 TC C Pulmonary service/procedure 0.00 0.00 0.00 NA NA 0.094799 26 C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.095004 A Percut allergy skin tests 0.01 0.17 0.17 NA NA 0.095010 A Percut allergy titrate test 0.15 0.38 0.38 NA NA 0.095012 A Exhaled nitric oxide meas 0.00 0.55 0.60 NA NA 0.095015 A Id allergy titrate-drug/bug 0.15 0.29 0.26 0.07 0.07 0.095024 A Id allergy test drug/bug 0.01 0.19 0.20 NA NA 0.0
CMS-1582-PN 475 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95027 A Id allergy titrate-airborne 0.01 0.11 0.12 NA NA 0.095028 A Id allergy test-delayed type 0.00 0.37 0.36 NA NA 0.095044 A Allergy patch tests 0.00 0.15 0.17 NA NA 0.095052 A Photo patch test 0.00 0.17 0.20 NA NA 0.095056 A Photosensitivity tests 0.00 1.23 1.19 NA NA 0.095060 A Eye allergy tests 0.00 0.90 0.83 0.90 0.83 0.095065 A Nose allergy test 0.00 0.72 0.71 0.72 0.71 0.095070 A Bronchial allergy tests 0.00 0.80 1.11 NA NA 0.095071 A Bronchial allergy tests 0.00 1.23 1.49 NA NA 0.095075 A Ingestion challenge test 0.95 0.90 0.90 0.44 0.42 0.095115 A Immunotherapy one injection 0.00 0.26 0.29 NA NA 0.095117 A Immunotherapy injections 0.00 0.31 0.36 NA NA 0.095120 I Immunotherapy one injection 0.00 0.00 0.00 0.00 0.00 0.095125 I Immunotherapy many antigens 0.00 0.00 0.00 0.00 0.00 0.095130 I Immunotherapy insect venom 0.00 0.00 0.00 0.00 0.00 0.095131 I Immunotherapy insect venoms 0.00 0.00 0.00 0.00 0.00 0.095132 I Immunotherapy insect venoms 0.00 0.00 0.00 0.00 0.00 0.095133 I Immunotherapy insect venoms 0.00 0.00 0.00 0.00 0.00 0.095134 I Immunotherapy insect venoms 0.00 0.00 0.00 0.00 0.00 0.095144 A Antigen therapy services 0.06 0.30 0.30 0.03 0.03 0.095145 A Antigen therapy services 0.06 0.55 0.49 0.03 0.03 0.095146 A Antigen therapy services 0.06 1.06 0.91 0.03 0.03 0.095147 A Antigen therapy services 0.06 0.95 0.85 0.03 0.03 0.095148 A Antigen therapy services 0.06 1.45 1.26 0.03 0.03 0.095149 A Antigen therapy services 0.06 1.97 1.70 0.03 0.03 0.095165 A Antigen therapy services 0.06 0.30 0.30 0.03 0.03 0.095170 A Antigen therapy services 0.06 0.21 0.22 0.03 0.03 0.095180 A Rapid desensitization 2.01 1.94 2.07 0.99 1.02 0.095199 C Allergy immunology services 0.00 0.00 0.00 0.00 0.00 0.095250 A Glucose monitoring cont 0.00 4.35 4.35 NA NA 0.0
CMS-1582-PN 476 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95251 A Gluc monitor cont phys i&r 0.85 0.39 0.34 0.39 0.34 0.095800 A Slp stdy unattended 1.05 4.95 4.95 NA NA 0.095800 TC A Slp stdy unattended 0.00 4.33 4.33 NA NA 0.095800 26 A Slp stdy unattended 1.05 0.62 0.62 0.62 0.62 0.095801 A Slp stdy unatnd w/anal 1.00 1.80 1.80 NA NA 0.095801 TC A Slp stdy unatnd w/anal 0.00 1.33 1.33 NA NA 0.095801 26 A Slp stdy unatnd w/anal 1.00 0.47 0.47 0.47 0.47 0.095803 A Actigraphy testing 0.90 3.83 3.83 NA NA 0.095803 TC A Actigraphy testing 0.00 3.39 3.39 NA NA 0.095803 26 A Actigraphy testing 0.90 0.44 0.44 0.44 0.44 0.095805 A Multiple sleep latency test 1.20 10.13 10.80 NA NA 0.095805 TC A Multiple sleep latency test 0.00 9.65 10.22 NA NA 0.095805 26 A Multiple sleep latency test 1.20 0.48 0.58 0.48 0.58 0.095806 A Sleep study unatt&resp efft 1.25 3.49 4.03 NA NA 0.095806 TC A Sleep study unatt&resp efft 0.00 3.00 3.48 NA NA 0.095806 26 A Sleep study unatt&resp efft 1.25 0.49 0.55 0.49 0.55 0.095807 A Sleep study attended 1.28 10.76 12.40 NA NA 0.195807 TC A Sleep study attended 0.00 10.29 11.87 NA NA 0.195807 26 A Sleep study attended 1.28 0.47 0.53 0.47 0.53 0.095808 A Polysomnography 1-3 1.74 16.46 17.21 NA NA 0.195808 TC A Polysomnography 1-3 0.00 15.73 16.37 NA NA 0.195808 26 A Polysomnography 1-3 1.74 0.73 0.84 0.73 0.84 0.095810 A Polysomnography 4 or more 2.50 14.54 17.72 NA NA 0.295810 TC A Polysomnography 4 or more 0.00 13.58 16.63 NA NA 0.195810 26 A Polysomnography 4 or more 2.50 0.96 1.09 0.96 1.09 0.195811 A Polysomnography w/cpap 2.60 15.27 19.22 NA NA 0.295811 TC A Polysomnography w/cpap 0.00 14.28 18.07 NA NA 0.195811 26 A Polysomnography w/cpap 2.60 0.99 1.15 0.99 1.15 0.195812 A Eeg 41-60 minutes 1.08 9.75 8.12 NA NA 0.095812 TC A Eeg 41-60 minutes 0.00 9.23 7.65 NA NA 0.0
CMS-1582-PN 477 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95812 26 A Eeg 41-60 minutes 1.08 0.52 0.47 0.52 0.47 0.095813 A Eeg over 1 hour 1.73 9.75 8.61 NA NA 0.195813 TC A Eeg over 1 hour 0.00 8.95 7.87 NA NA 0.095813 26 A Eeg over 1 hour 1.73 0.80 0.74 0.80 0.74 0.095816 A Eeg awake and drowsy 1.08 8.99 7.43 NA NA 0.095816 TC A Eeg awake and drowsy 0.00 8.47 6.95 NA NA 0.095816 26 A Eeg awake and drowsy 1.08 0.52 0.48 0.52 0.48 0.095819 A Eeg awake and asleep 1.08 10.45 8.43 NA NA 0.095819 TC A Eeg awake and asleep 0.00 9.93 7.95 NA NA 0.095819 26 A Eeg awake and asleep 1.08 0.52 0.48 0.52 0.48 0.095822 A Eeg coma or sleep only 1.08 9.27 7.81 NA NA 0.095822 TC A Eeg coma or sleep only 0.00 8.75 7.33 NA NA 0.095822 26 A Eeg coma or sleep only 1.08 0.52 0.48 0.52 0.48 0.095824 C Eeg cerebral death only 0.00 0.00 0.00 NA NA 0.095824 TC C Eeg cerebral death only 0.00 0.00 0.00 NA NA 0.095824 26 A Eeg cerebral death only 0.74 0.35 0.32 0.35 0.32 0.095827 A Eeg all night recording 1.08 19.27 15.25 NA NA 0.195827 TC A Eeg all night recording 0.00 18.75 14.78 NA NA 0.095827 26 A Eeg all night recording 1.08 0.52 0.47 0.52 0.47 0.095829 A Surgery electrocorticogram 6.20 42.49 37.55 NA NA 0.295829 TC A Surgery electrocorticogram 0.00 39.49 34.81 NA NA 0.095829 26 A Surgery electrocorticogram 6.20 3.00 2.74 3.00 2.74 0.195830 A Insert electrodes for eeg 1.70 3.85 3.77 0.74 0.70 0.195831 A Limb muscle testing manual 0.28 0.57 0.54 0.14 0.13 0.095832 A Hand muscle testing manual 0.29 0.57 0.50 0.17 0.14 0.095833 A Body muscle testing manual 0.47 0.61 0.60 0.16 0.18 0.095834 A Body muscle testing manual 0.60 0.81 0.73 0.26 0.24 0.095851 A Range of motion measurements 0.16 0.34 0.34 0.06 0.06 0.095852 A Range of motion measurements 0.11 0.34 0.31 0.05 0.05 0.095857 A Cholinesterase challenge 0.53 0.92 0.81 0.30 0.27 0.0
CMS-1582-PN 478 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95860 A Muscle test one limb 0.96 1.84 1.66 NA NA 0.095860 TC A Muscle test one limb 0.00 1.34 1.19 NA NA 0.095860 26 A Muscle test one limb 0.96 0.50 0.47 0.50 0.47 0.095861 A Muscle test 2 limbs 1.54 2.58 2.26 NA NA 0.095861 TC A Muscle test 2 limbs 0.00 1.79 1.52 NA NA 0.095861 26 A Muscle test 2 limbs 1.54 0.79 0.74 0.79 0.74 0.095863 A Muscle test 3 limbs 1.87 3.16 2.71 NA NA 0.095863 TC A Muscle test 3 limbs 0.00 2.22 1.85 NA NA 0.095863 26 A Muscle test 3 limbs 1.87 0.94 0.86 0.94 0.86 0.095864 A Muscle test 4 limbs 1.99 3.34 3.05 NA NA 0.095864 TC A Muscle test 4 limbs 0.00 2.34 2.12 NA NA 0.095864 26 A Muscle test 4 limbs 1.99 1.00 0.93 1.00 0.93 0.095865 A Muscle test larynx 1.57 2.06 1.90 NA NA 0.095865 TC A Muscle test larynx 0.00 1.22 1.12 NA NA 0.095865 26 A Muscle test larynx 1.57 0.84 0.78 0.84 0.78 0.095866 A Muscle test hemidiaphragm 1.25 2.01 1.74 NA NA 0.095866 TC A Muscle test hemidiaphragm 0.00 1.41 1.16 NA NA 0.095866 26 A Muscle test hemidiaphragm 1.25 0.60 0.58 0.60 0.58 0.095867 A Muscle test cran nerv unilat 0.79 1.73 1.53 NA NA 0.095867 TC A Muscle test cran nerv unilat 0.00 1.32 1.15 NA NA 0.095867 26 A Muscle test cran nerv unilat 0.79 0.41 0.38 0.41 0.38 0.095868 A Muscle test cran nerve bilat 1.18 2.25 1.97 NA NA 0.095868 TC A Muscle test cran nerve bilat 0.00 1.65 1.42 NA NA 0.095868 26 A Muscle test cran nerve bilat 1.18 0.60 0.55 0.60 0.55 0.095869 A Muscle test thor paraspinal 0.37 1.62 1.33 NA NA 0.095869 TC A Muscle test thor paraspinal 0.00 1.43 1.15 NA NA 0.095869 26 A Muscle test thor paraspinal 0.37 0.19 0.18 0.19 0.18 0.095870 A Muscle test nonparaspinal 0.37 1.60 1.29 NA NA 0.095870 TC A Muscle test nonparaspinal 0.00 1.41 1.12 NA NA 0.095870 26 A Muscle test nonparaspinal 0.37 0.19 0.17 0.19 0.17 0.0
CMS-1582-PN 479 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95872 A Muscle test one fiber 2.88 2.58 2.23 NA NA 0.195872 TC A Muscle test one fiber 0.00 1.20 1.02 NA NA 0.095872 26 A Muscle test one fiber 2.88 1.38 1.21 1.38 1.21 0.195873 A Guide nerv destr elec stim 0.37 1.60 1.32 NA NA 0.095873 TC A Guide nerv destr elec stim 0.00 1.39 1.12 NA NA 0.095873 26 A Guide nerv destr elec stim 0.37 0.21 0.20 0.21 0.20 0.095874 A Guide nerv destr needle emg 0.37 1.53 1.24 NA NA 0.095874 TC A Guide nerv destr needle emg 0.00 1.33 1.06 NA NA 0.095874 26 A Guide nerv destr needle emg 0.37 0.20 0.18 0.20 0.18 0.095875 A Limb exercise test 1.10 2.21 1.93 NA NA 0.095875 TC A Limb exercise test 0.00 1.68 1.44 NA NA 0.095875 26 A Limb exercise test 1.10 0.53 0.49 0.53 0.49 0.095900 A Motor nerve conduction test 0.42 1.44 1.33 NA NA 0.095900 TC A Motor nerve conduction test 0.00 1.22 1.13 NA NA 0.095900 26 A Motor nerve conduction test 0.42 0.22 0.20 0.22 0.20 0.095903 A Motor nerve conduction test 0.60 1.54 1.41 NA NA 0.095903 TC A Motor nerve conduction test 0.00 1.25 1.14 NA NA 0.095903 26 A Motor nerve conduction test 0.60 0.29 0.27 0.29 0.27 0.095904 A Sense nerve conduction test 0.34 1.28 1.20 NA NA 0.095904 TC A Sense nerve conduction test 0.00 1.11 1.04 NA NA 0.095904 26 A Sense nerve conduction test 0.34 0.17 0.16 0.17 0.16 0.095905 A Motor/sens nrve conduct test 0.05 2.41 2.41 NA NA 0.095905 TC A Motor/sens nrve conduct test 0.00 2.38 2.38 NA NA 0.095905 26 A Motor/sens nrve conduct test 0.05 0.03 0.03 0.03 0.03 0.095920 A Intraop nerve test add-on 2.11 2.69 2.46 NA NA 0.095920 TC A Intraop nerve test add-on 0.00 1.66 1.51 NA NA 0.095920 26 A Intraop nerve test add-on 2.11 1.03 0.95 1.03 0.95 0.095921 A Autonomic nerv function test 0.90 1.53 1.41 NA NA 0.095921 TC A Autonomic nerv function test 0.00 1.12 1.03 NA NA 0.095921 26 A Autonomic nerv function test 0.90 0.41 0.38 0.41 0.38 0.0
CMS-1582-PN 480 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95922 A Autonomic nerv function test 0.96 2.09 1.90 NA NA 0.095922 TC A Autonomic nerv function test 0.00 1.66 1.49 NA NA 0.095922 26 A Autonomic nerv function test 0.96 0.43 0.41 0.43 0.41 0.095923 A Autonomic nerv function test 0.90 3.92 3.31 NA NA 0.095923 TC A Autonomic nerv function test 0.00 3.48 2.91 NA NA 0.095923 26 A Autonomic nerv function test 0.90 0.44 0.40 0.44 0.40 0.095925 A Somatosensory testing 0.54 4.92 4.05 NA NA 0.095925 TC A Somatosensory testing 0.00 4.66 3.81 NA NA 0.095925 26 A Somatosensory testing 0.54 0.26 0.24 0.26 0.24 0.095926 A Somatosensory testing 0.54 4.65 3.89 NA NA 0.095926 TC A Somatosensory testing 0.00 4.40 3.65 NA NA 0.095926 26 A Somatosensory testing 0.54 0.25 0.24 0.25 0.24 0.095927 A Somatosensory testing 0.54 4.05 3.63 NA NA 0.095927 TC A Somatosensory testing 0.00 3.79 3.38 NA NA 0.095927 26 A Somatosensory testing 0.54 0.26 0.25 0.26 0.25 0.095928 A C motor evoked uppr limbs 1.50 6.22 5.28 NA NA 0.195928 TC A C motor evoked uppr limbs 0.00 5.49 4.62 NA NA 0.095928 26 A C motor evoked uppr limbs 1.50 0.73 0.66 0.73 0.66 0.095929 A C motor evoked lwr limbs 1.50 6.67 5.69 NA NA 0.195929 TC A C motor evoked lwr limbs 0.00 5.94 5.02 NA NA 0.095929 26 A C motor evoked lwr limbs 1.50 0.73 0.67 0.73 0.67 0.095930 A Visual evoked potential test 0.35 4.08 3.55 NA NA 0.095930 TC A Visual evoked potential test 0.00 3.90 3.39 NA NA 0.095930 26 A Visual evoked potential test 0.35 0.18 0.16 0.18 0.16 0.095933 A Blink reflex test 0.59 1.78 1.55 NA NA 0.095933 TC A Blink reflex test 0.00 1.49 1.28 NA NA 0.095933 26 A Blink reflex test 0.59 0.29 0.27 0.29 0.27 0.095934 A H-reflex test 0.51 1.30 1.12 NA NA 0.095934 TC A H-reflex test 0.00 1.05 0.88 NA NA 0.095934 26 A H-reflex test 0.51 0.25 0.24 0.25 0.24 0.0
CMS-1582-PN 481 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95936 A H-reflex test 0.55 0.90 0.79 NA NA 0.095936 TC A H-reflex test 0.00 0.63 0.54 NA NA 0.095936 26 A H-reflex test 0.55 0.27 0.25 0.27 0.25 0.095937 A Neuromuscular junction test 0.65 1.39 1.20 NA NA 0.095937 TC A Neuromuscular junction test 0.00 1.08 0.91 NA NA 0.095937 26 A Neuromuscular junction test 0.65 0.31 0.29 0.31 0.29 0.095950 A Ambulatory eeg monitoring 1.51 7.11 6.35 NA NA 0.195950 TC A Ambulatory eeg monitoring 0.00 6.38 5.69 NA NA 0.095950 26 A Ambulatory eeg monitoring 1.51 0.73 0.66 0.73 0.66 0.095951 C Eeg monitoring/videorecord 0.00 0.00 0.00 NA NA 0.095951 TC C Eeg monitoring/videorecord 0.00 0.00 0.00 NA NA 0.095951 26 A Eeg monitoring/videorecord 5.99 2.90 2.65 2.90 2.65 0.495953 A Eeg monitoring/computer 3.08 9.01 8.89 NA NA 0.195953 TC A Eeg monitoring/computer 0.00 7.52 7.50 NA NA 0.095953 26 A Eeg monitoring/computer 3.08 1.49 1.39 1.49 1.39 0.195954 A Eeg monitoring/giving drugs 2.45 7.96 6.53 NA NA 0.195954 TC A Eeg monitoring/giving drugs 0.00 7.08 5.74 NA NA 0.095954 26 A Eeg monitoring/giving drugs 2.45 0.88 0.79 0.88 0.79 0.195955 A Eeg during surgery 1.01 4.61 3.88 NA NA 0.095955 TC A Eeg during surgery 0.00 4.13 3.45 NA NA 0.095955 26 A Eeg during surgery 1.01 0.48 0.43 0.48 0.43 0.095956 A Eeg monitor technol attended 3.61 32.06 25.78 NA NA 0.395956 TC A Eeg monitor technol attended 0.00 30.41 24.33 NA NA 0.195956 26 A Eeg monitor technol attended 3.61 1.65 1.45 1.65 1.45 0.195957 A Eeg digital analysis 1.98 9.70 7.88 NA NA 0.195957 TC A Eeg digital analysis 0.00 8.76 7.01 NA NA 0.095957 26 A Eeg digital analysis 1.98 0.94 0.87 0.94 0.87 0.195958 A Eeg monitoring/function test 4.24 10.43 8.85 NA NA 0.295958 TC A Eeg monitoring/function test 0.00 8.47 7.01 NA NA 0.095958 26 A Eeg monitoring/function test 4.24 1.96 1.84 1.96 1.84 0.2
CMS-1582-PN 482 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

95961 A Electrode stimulation brain 2.97 4.97 4.27 NA NA 0.195961 TC A Electrode stimulation brain 0.00 3.50 2.91 NA NA 0.095961 26 A Electrode stimulation brain 2.97 1.47 1.36 1.47 1.36 0.195962 A Electrode stim brain add-on 3.21 3.76 3.29 NA NA 0.195962 TC A Electrode stim brain add-on 0.00 2.19 1.86 NA NA 0.095962 26 A Electrode stim brain add-on 3.21 1.57 1.43 1.57 1.43 0.195965 C Meg spontaneous 0.00 0.00 0.00 NA NA 0.095965 TC C Meg spontaneous 0.00 0.00 0.00 NA NA 0.095965 26 A Meg spontaneous 7.99 3.88 3.69 3.88 3.69 0.695966 C Meg evoked single 0.00 0.00 0.00 NA NA 0.095966 TC C Meg evoked single 0.00 0.00 0.00 NA NA 0.095966 26 A Meg evoked single 3.99 1.94 1.85 1.94 1.85 0.395967 C Meg evoked each addl 0.00 0.00 0.00 NA NA 0.095967 TC C Meg evoked each addl 0.00 0.00 0.00 NA NA 0.095967 26 A Meg evoked each addl 3.49 1.69 1.56 1.69 1.56 0.295970 A Analyze neurostim no prog 0.45 1.40 1.24 0.21 0.19 0.095971 A Analyze neurostim simple 0.78 0.82 0.85 0.34 0.33 0.095972 A Analyze neurostim complex 1.50 1.55 1.49 0.70 0.64 0.195973 A Analyze neurostim complex 0.92 0.86 0.76 0.46 0.39 0.095974 A Cranial neurostim complex 3.00 2.49 2.18 1.41 1.28 0.295975 A Cranial neurostim complex 1.70 1.28 1.12 0.82 0.75 0.195978 A Analyze neurostim brain/1h 3.50 3.10 2.71 1.72 1.56 0.395979 A Analyz neurostim brain addon 1.64 1.24 1.10 0.81 0.73 0.195980 A Io anal gast n-stim init 0.80 NA NA 0.44 0.37 0.195981 A Io anal gast n-stim subsq 0.30 0.60 0.57 0.20 0.17 0.095982 A Io ga n-stim subsq w/reprog 0.65 0.80 0.70 0.36 0.30 0.095990 A Spin/brain pump refil & main 0.00 2.47 2.19 NA NA 0.095991 A Spin/brain pump refil & main 0.77 2.63 2.28 0.36 0.29 0.095992 A Canalith repositioning proc 0.75 0.46 0.45 0.33 0.32 0.095999 C Neurological procedure 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 483 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

96000 A Motion analysis video/3d 1.80 NA NA 0.93 0.77 0.196001 A Motion test w/ft press meas 2.15 NA NA 0.65 0.68 0.196002 A Dynamic surface emg 0.41 NA NA 0.20 0.18 0.096003 A Dynamic fine wire emg 0.37 NA NA 0.18 0.15 0.096004 A Phys review of motion tests 2.14 1.03 1.00 1.03 1.00 0.196020 C Functional brain mapping 0.00 0.00 0.00 NA NA 0.096020 TC C Functional brain mapping 0.00 0.00 0.00 NA NA 0.096020 26 A Functional brain mapping 3.43 1.28 1.45 1.28 1.45 0.396040 B Genetic counseling 30 min 0.00 1.23 1.29 NA NA 0.096101 A Psycho testing by psych/phys 1.86 0.48 0.51 0.28 0.40 0.096102 A Psycho testing by technician 0.50 1.73 1.43 0.17 0.16 0.096103 A Psycho testing admin by comp 0.51 1.30 1.11 0.19 0.18 0.096105 A Assessment of aphasia 1.75 0.84 1.35 NA NA 0.096110 A Developmental test lim 0.00 0.24 0.23 NA NA 0.096111 A Developmental test extend 2.60 0.84 0.93 0.67 0.79 0.196116 A Neurobehavioral status exam 1.86 0.70 0.72 0.55 0.56 0.196118 A Neuropsych tst by psych/phys 1.86 0.69 0.93 0.26 0.38 0.096119 A Neuropsych testing by tec 0.55 1.39 1.51 0.09 0.12 0.096120 A Neuropsych tst admin w/comp 0.51 2.07 1.88 0.18 0.17 0.096125 A Cognitive test by hc pro 1.70 1.04 0.99 NA NA 0.096150 A Assess hlth/behave init 0.50 0.07 0.11 0.07 0.10 0.096151 A Assess hlth/behave subseq 0.48 0.08 0.11 0.07 0.10 0.096152 A Intervene hlth/behave indiv 0.46 0.07 0.10 0.06 0.09 0.096153 A Intervene hlth/behave group 0.10 0.02 0.03 0.02 0.02 0.096154 A Interv hlth/behav fam w/pt 0.45 0.07 0.10 0.06 0.09 0.096155 N Interv hlth/behav fam no pt 0.44 0.19 0.20 0.19 0.19 0.096360 A Hydration iv infusion init 0.17 1.33 1.48 NA NA 0.096361 A Hydrate iv infusion add-on 0.09 0.31 0.35 NA NA 0.096365 A Ther/proph/diag iv inf init 0.21 1.71 1.85 NA NA 0.096366 A Ther/proph/diag iv inf addon 0.18 0.42 0.45 NA NA 0.0
CMS-1582-PN 484 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

96367 A Tx/proph/dg addl seq iv inf 0.19 0.65 0.77 NA NA 0.096368 A Ther/diag concurrent inf 0.17 0.35 0.39 NA NA 0.096369 A Sc ther infusion up to 1 hr 0.21 4.82 4.79 NA NA 0.096370 A Sc ther infusion addl hr 0.18 0.26 0.26 NA NA 0.096371 A Sc ther infusion reset pump 0.00 2.25 2.35 NA NA 0.096372 A Ther/proph/diag inj sc/im 0.17 0.50 0.50 NA NA 0.096373 A Ther/proph/diag inj ia 0.17 0.38 0.38 NA NA 0.096374 A Ther/proph/diag inj iv push 0.18 1.29 1.43 NA NA 0.096375 A Tx/pro/dx inj new drug addon 0.10 0.48 0.56 NA NA 0.096376 X Tx/pro/dx inj same drug adon 0.00 0.00 0.00 0.00 0.00 0.096379 C Ther/prop/diag inj/inf proc 0.00 0.00 0.00 0.00 0.00 0.096401 A Chemo anti-neopl sq/im 0.21 1.76 1.89 NA NA 0.096402 A Chemo hormon antineopl sq/im 0.19 0.67 0.83 NA NA 0.096405 A Chemo intralesional up to 7 0.52 1.78 1.98 0.37 0.34 0.096406 A Chemo intralesional over 7 0.80 2.35 2.64 0.50 0.45 0.096409 A Chemo iv push sngl drug 0.24 2.64 3.03 NA NA 0.096411 A Chemo iv push addl drug 0.20 1.42 1.63 NA NA 0.096413 A Chemo iv infusion 1 hr 0.28 3.42 3.98 NA NA 0.096415 A Chemo iv infusion addl hr 0.19 0.62 0.72 NA NA 0.096416 A Chemo prolong infuse w/pump 0.21 3.85 4.47 NA NA 0.096417 A Chemo iv infus each addl seq 0.21 1.63 1.89 NA NA 0.096420 A Chemo ia push tecnique 0.17 2.57 2.96 NA NA 0.096422 A Chemo ia infusion up to 1 hr 0.17 4.25 4.91 NA NA 0.096423 A Chemo ia infuse each addl hr 0.17 1.89 2.14 NA NA 0.096425 A Chemotherapy infusion method 0.17 4.55 5.02 NA NA 0.196440 A Chemotherapy intracavitary 2.37 19.85 18.54 1.51 1.45 0.596446 A Chemotx admn prtl cavity 0.37 4.77 4.77 0.19 0.19 0.096450 A Chemotherapy into cns 1.53 3.37 4.21 0.75 0.88 0.196521 A Refill/maint portable pump 0.21 3.35 3.66 NA NA 0.096522 A Refill/maint pump/resvr syst 0.21 2.70 3.01 NA NA 0.0
CMS-1582-PN 485 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

96523 T Irrig drug delivery device 0.04 0.61 0.70 NA NA 0.096542 A Chemotherapy injection 0.75 2.37 2.95 0.45 0.50 0.096549 C Chemotherapy unspecified 0.00 0.00 0.00 0.00 0.00 0.096567 A Photodynamic tx skin 0.00 3.76 3.84 NA NA 0.096570 A Photodynmc tx 30 min add-on 1.10 0.44 0.47 0.44 0.47 0.196571 A Photodynamic tx addl 15 min 0.55 0.19 0.21 0.19 0.21 0.096900 A Ultraviolet light therapy 0.00 0.57 0.60 NA NA 0.096902 B Trichogram 0.41 0.20 0.20 0.18 0.18 0.096904 R Whole body photography 0.00 1.82 1.99 NA NA 0.096910 A Photochemotherapy with uv-b 0.00 1.98 2.03 NA NA 0.096912 A Photochemotherapy with uv-a 0.00 2.55 2.61 NA NA 0.096913 A Photochemotherapy uv-a or b 0.00 3.59 3.63 NA NA 0.096920 A Laser tx skin < 250 sq cm 1.15 3.81 3.91 0.85 0.79 0.096921 A Laser tx skin 250-500 sq cm 1.17 3.94 3.90 0.85 0.76 0.096922 A Laser tx skin > 500 sq cm 2.10 5.07 5.17 1.55 1.38 0.096999 C Dermatological procedure 0.00 0.00 0.00 0.00 0.00 0.097001 A Pt evaluation 1.20 0.92 0.88 NA NA 0.097002 A Pt re-evaluation 0.60 0.58 0.55 NA NA 0.097003 A Ot evaluation 1.20 1.23 1.10 NA NA 0.097004 A Ot re-evaluation 0.60 0.89 0.80 NA NA 0.097005 I Athletic train eval 0.00 0.00 0.00 0.00 0.00 0.097006 I Athletic train reeval 0.00 0.00 0.00 0.00 0.00 0.097010 B Hot or cold packs therapy 0.06 0.10 0.09 NA NA 0.097012 A Mechanical traction therapy 0.25 0.20 0.19 NA NA 0.097014 I Electric stimulation therapy 0.18 0.26 0.24 NA NA 0.097016 A Vasopneumatic device therapy 0.18 0.35 0.32 NA NA 0.097018 A Paraffin bath therapy 0.06 0.23 0.21 NA NA 0.097022 A Whirlpool therapy 0.17 0.47 0.42 NA NA 0.097024 A Diathermy eg microwave 0.06 0.12 0.11 NA NA 0.097026 R Infrared therapy 0.06 0.10 0.09 NA NA 0.0
CMS-1582-PN 486 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

97028 A Ultraviolet therapy 0.08 0.12 0.11 NA NA 0.097032 A Electrical stimulation 0.25 0.28 0.26 NA NA 0.097033 A Electric current therapy 0.26 0.63 0.56 NA NA 0.097034 A Contrast bath therapy 0.21 0.29 0.26 NA NA 0.097035 A Ultrasound therapy 0.21 0.14 0.13 NA NA 0.097036 A Hydrotherapy 0.28 0.63 0.57 NA NA 0.097039 C Physical therapy treatment 0.00 0.00 0.00 0.00 0.00 0.097110 A Therapeutic exercises 0.45 0.45 0.41 NA NA 0.097112 A Neuromuscular reeducation 0.45 0.49 0.45 NA NA 0.097113 A Aquatic therapy/exercises 0.44 0.76 0.69 NA NA 0.097116 A Gait training therapy 0.40 0.39 0.36 NA NA 0.097124 A Massage therapy 0.35 0.38 0.35 NA NA 0.097139 C Physical medicine procedure 0.00 0.00 0.00 0.00 0.00 0.097140 A Manual therapy 0.43 0.41 0.38 NA NA 0.097150 A Group therapeutic procedures 0.27 0.31 0.28 NA NA 0.097530 A Therapeutic activities 0.44 0.54 0.50 NA NA 0.097532 A Cognitive skills development 0.44 0.31 0.29 NA NA 0.097533 A Sensory integration 0.44 0.38 0.36 NA NA 0.097535 A Self care mngment training 0.45 0.53 0.49 NA NA 0.097537 A Community/work reintegration 0.45 0.40 0.37 NA NA 0.097542 A Wheelchair mngment training 0.45 0.41 0.38 NA NA 0.097545 R Work hardening 0.00 0.00 0.00 0.00 0.00 0.097546 R Work hardening add-on 0.00 0.00 0.00 0.00 0.00 0.097597 A Rmvl devital tis 20 cm/< 0.51 1.56 1.56 0.15 0.15 0.097598 A Rmvl devital tis addl 20 cm< 0.24 0.44 0.44 0.07 0.07 0.097602 B Wound(s) care non-selective 0.00 0.00 0.00 0.00 0.00 0.097605 A Neg press wound tx < 50 cm 0.55 0.57 0.53 0.16 0.17 0.097606 A Neg press wound tx > 50 cm 0.60 0.59 0.54 0.17 0.18 0.197750 A Physical performance test 0.45 0.47 0.44 NA NA 0.097755 A Assistive technology assess 0.62 0.39 0.36 NA NA 0.0
CMS-1582-PN 487 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

97760 A Orthotic mgmt and training 0.45 0.60 0.55 NA NA 0.097761 A Prosthetic training 0.45 0.46 0.43 NA NA 0.097762 A C/o for orthotic/prosth use 0.25 1.05 0.93 NA NA 0.097799 C Physical medicine procedure 0.00 0.00 0.00 0.00 0.00 0.097802 A Medical nutrition indiv in 0.53 0.42 0.38 0.36 0.32 0.097803 A Med nutrition indiv subseq 0.45 0.37 0.34 0.31 0.28 0.097804 A Medical nutrition group 0.25 0.18 0.15 0.17 0.15 0.097810 N Acupunct w/o stimul 15 min 0.60 0.41 0.41 0.26 0.26 0.097811 N Acupunct w/o stimul addl 15m 0.50 0.27 0.27 0.22 0.21 0.097813 N Acupunct w/stimul 15 min 0.65 0.43 0.44 0.28 0.28 0.097814 N Acupunct w/stimul addl 15m 0.55 0.32 0.32 0.24 0.24 0.098925 A Osteopathic manipulation 0.46 0.43 0.41 0.20 0.18 0.098926 A Osteopathic manipulation 0.71 0.57 0.54 0.29 0.27 0.098927 A Osteopathic manipulation 0.96 0.71 0.67 0.36 0.35 0.098928 A Osteopathic manipulation 1.21 0.82 0.78 0.45 0.43 0.098929 A Osteopathic manipulation 1.46 1.00 0.93 0.54 0.51 0.098940 A Chiropractic manipulation 0.45 0.30 0.29 0.16 0.15 0.098941 A Chiropractic manipulation 0.65 0.39 0.36 0.23 0.23 0.098942 A Chiropractic manipulation 0.87 0.47 0.44 0.31 0.30 0.098943 N Chiropractic manipulation 0.40 0.28 0.28 0.18 0.17 0.098960 B Self-mgmt educ & train 1 pt 0.00 0.73 0.76 NA NA 0.098961 B Self-mgmt educ/train 2-4 pt 0.00 0.35 0.36 NA NA 0.098962 B Self-mgmt educ/train 5-8 pt 0.00 0.25 0.27 NA NA 0.098966 N Hc pro phone call 5-10 min 0.25 0.15 0.15 0.11 0.10 0.098967 N Hc pro phone call 11-20 min 0.50 0.26 0.25 0.22 0.21 0.098968 N Hc pro phone call 21-30 min 0.75 0.36 0.35 0.33 0.32 0.098969 N Online service by hc pro 0.00 0.00 0.00 0.00 0.00 0.099000 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.099001 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.099002 B Device handling 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 488 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99024 B Postop follow-up visit 0.00 0.00 0.00 0.00 0.00 0.099026 N In-hospital on call service 0.00 0.00 0.00 0.00 0.00 0.099027 N Out-of-hosp on call service 0.00 0.00 0.00 0.00 0.00 0.099050 B Medical services after hrs 0.00 0.00 0.00 0.00 0.00 0.099051 B Med serv eve/wkend/holiday 0.00 0.00 0.00 0.00 0.00 0.099053 B Med serv 10pm-8am 24 hr fac 0.00 0.00 0.00 0.00 0.00 0.099056 B Med service out of office 0.00 0.00 0.00 0.00 0.00 0.099058 B Office emergency care 0.00 0.00 0.00 0.00 0.00 0.099060 B Out of office emerg med serv 0.00 0.00 0.00 0.00 0.00 0.099070 B Special supplies 0.00 0.00 0.00 0.00 0.00 0.099071 B Patient education materials 0.00 0.00 0.00 0.00 0.00 0.099075 N Medical testimony 0.00 0.00 0.00 0.00 0.00 0.099078 B Group health education 0.00 0.00 0.00 0.00 0.00 0.099080 B Special reports or forms 0.00 0.00 0.00 0.00 0.00 0.099082 C Unusual physician travel 0.00 0.00 0.00 0.00 0.00 0.099090 B Computer data analysis 0.00 0.00 0.00 0.00 0.00 0.099091 B Collect/review data from pt 1.10 0.48 0.47 NA NA 0.099100 B Special anesthesia service 0.00 0.00 0.00 0.00 0.00 0.099116 B Anesthesia with hypothermia 0.00 0.00 0.00 0.00 0.00 0.099135 B Special anesthesia procedure 0.00 0.00 0.00 0.00 0.00 0.099140 B Emergency anesthesia 0.00 0.00 0.00 0.00 0.00 0.099143 C Mod cs by same phys < 5 yrs 0.00 0.00 0.00 0.00 0.00 0.099144 C Mod cs by same phys 5 yrs + 0.00 0.00 0.00 0.00 0.00 0.099145 C Mod cs by same phys add-on 0.00 0.00 0.00 0.00 0.00 0.099148 C Mod cs diff phys < 5 yrs 0.00 0.00 0.00 0.00 0.00 0.099149 C Mod cs diff phys 5 yrs + 0.00 0.00 0.00 0.00 0.00 0.099150 C Mod cs diff phys add-on 0.00 0.00 0.00 0.00 0.00 0.099170 A Anogenital exam child 1.75 2.18 2.38 0.86 0.91 0.199172 N Ocular function screen 0.00 0.00 0.00 0.00 0.00 0.099173 N Visual acuity screen 0.00 0.07 0.07 NA NA 0.0
CMS-1582-PN 489 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99174 N Ocular photoscreening 0.00 0.78 0.81 NA NA 0.099175 A Induction of vomiting 0.00 0.66 0.71 NA NA 0.099183 A Hyperbaric oxygen therapy 2.34 3.67 3.52 0.99 0.89 0.299190 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.099191 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.099192 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.099195 A Phlebotomy 0.00 2.61 2.49 NA NA 0.099199 C Special service/proc/report 0.00 0.00 0.00 0.00 0.00 0.099201 A Office/outpatient visit new 0.48 0.73 0.69 0.26 0.24 0.099202 A Office/outpatient visit new 0.93 1.16 1.09 0.49 0.44 0.099203 A Office/outpatient visit new 1.42 1.57 1.47 0.72 0.64 0.199204 A Office/outpatient visit new 2.43 2.14 2.00 1.20 1.06 0.299205 A Office/outpatient visit new 3.17 2.51 2.36 1.49 1.34 0.299211 A Office/outpatient visit est 0.18 0.37 0.39 0.08 0.08 0.099212 A Office/outpatient visit est 0.48 0.72 0.70 0.24 0.22 0.099213 A Office/outpatient visit est 0.97 1.05 0.99 0.47 0.41 0.099214 A Office/outpatient visit est 1.50 1.48 1.41 0.71 0.63 0.199215 A Office/outpatient visit est 2.11 1.90 1.80 1.00 0.90 0.199217 A Observation care discharge 1.28 NA NA 0.73 0.68 0.099218 A Initial observation caree 1.28 NA NA 0.54 0.52 0.099219 A Initial observation care 2.14 NA NA 0.92 0.88 0.199220 A Initial observation care 2.99 NA NA 1.26 1.21 0.299221 A Initial hospital care 1.92 NA NA 0.86 0.76 0.199222 A Initial hospital care 2.61 NA NA 1.20 1.06 0.299223 A Initial hospital care 3.86 NA NA 1.77 1.56 0.299224 A Subsequent observation care 0.54 NA NA 0.24 0.24 0.099225 A Subsequent observation care 0.96 NA NA 0.44 0.44 0.099226 A Subsequent observation care 1.44 NA NA 0.65 0.65 0.099231 A Subsequent hospital care 0.76 NA NA 0.34 0.32 0.099232 A Subsequent hospital care 1.39 NA NA 0.63 0.57 0.0
CMS-1582-PN 490 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99233 A Subsequent hospital care 2.00 NA NA 0.90 0.81 0.199234 A Observ/hosp same date 1.92 NA NA 0.81 0.86 0.199235 A Observ/hosp same date 2.78 NA NA 1.19 1.20 0.199236 A Observ/hosp same date 3.63 NA NA 1.52 1.52 0.299238 A Hospital discharge day 1.28 NA NA 0.74 0.68 0.099239 A Hospital discharge day 1.90 NA NA 1.09 0.97 0.199241 I Office consultation 0.64 0.66 0.66 0.24 0.24 0.099242 I Office consultation 1.34 1.10 1.10 0.51 0.51 0.199243 I Office consultation 1.88 1.46 1.46 0.71 0.71 0.199244 I Office consultation 3.02 1.96 1.96 1.14 1.14 0.299245 I Office consultation 3.77 2.30 2.30 1.38 1.38 0.299251 I Inpatient consultation 1.00 NA NA 0.32 0.32 0.099252 I Inpatient consultation 1.50 NA NA 0.52 0.52 0.199253 I Inpatient consultation 2.27 NA NA 0.84 0.84 0.199254 I Inpatient consultation 3.29 NA NA 1.23 1.23 0.199255 I Inpatient consultation 4.00 NA NA 1.44 1.44 0.299281 A Emergency dept visit 0.45 NA NA 0.14 0.13 0.099282 A Emergency dept visit 0.88 NA NA 0.27 0.24 0.099283 A Emergency dept visit 1.34 NA NA 0.39 0.36 0.199284 A Emergency dept visit 2.56 NA NA 0.67 0.62 0.299285 A Emergency dept visit 3.80 NA NA 0.91 0.88 0.399288 B Direct advanced life support 0.00 0.00 0.00 0.00 0.00 0.099291 A Critical care first hour 4.50 3.02 2.94 1.67 1.55 0.399292 A Critical care addl 30 min 2.25 1.12 1.07 0.84 0.78 0.199304 A Nursing facility care init 1.64 0.94 0.81 0.94 0.81 0.199305 A Nursing facility care init 2.35 1.27 1.09 1.27 1.09 0.299306 A Nursing facility care init 3.06 1.58 1.34 1.58 1.34 0.299307 A Nursing fac care subseq 0.76 0.49 0.44 0.49 0.44 0.099308 A Nursing fac care subseq 1.16 0.76 0.68 0.76 0.68 0.099309 A Nursing fac care subseq 1.55 0.99 0.88 0.99 0.88 0.0
CMS-1582-PN 491 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99310 A Nursing fac care subseq 2.35 1.41 1.23 1.41 1.23 0.199315 A Nursing fac discharge day 1.28 0.74 0.68 0.74 0.68 0.099316 A Nursing fac discharge day 1.90 1.01 0.92 1.01 0.92 0.199318 A Annual nursing fac assessmnt 1.71 0.98 0.84 0.98 0.84 0.199324 A Domicil/r-home visit new pat 1.01 0.54 0.54 NA NA 0.099325 A Domicil/r-home visit new pat 1.52 0.72 0.72 NA NA 0.199326 A Domicil/r-home visit new pat 2.63 1.31 1.18 NA NA 0.199327 A Domicil/r-home visit new pat 3.46 1.74 1.54 NA NA 0.299328 A Domicil/r-home visit new pat 4.09 1.99 1.77 NA NA 0.299334 A Domicil/r-home visit est pat 1.07 0.62 0.58 NA NA 0.099335 A Domicil/r-home visit est pat 1.72 0.94 0.84 NA NA 0.199336 A Domicil/r-home visit est pat 2.46 1.31 1.15 NA NA 0.199337 A Domicil/r-home visit est pat 3.58 1.83 1.59 NA NA 0.299339 B Domicil/r-home care supervis 1.25 0.91 0.91 NA NA 0.099340 B Domicil/r-home care supervis 1.80 1.22 1.22 NA NA 0.199341 A Home visit new patient 1.01 0.52 0.53 NA NA 0.099342 A Home visit new patient 1.52 0.70 0.71 NA NA 0.199343 A Home visit new patient 2.53 1.15 1.11 NA NA 0.199344 A Home visit new patient 3.38 1.74 1.53 NA NA 0.299345 A Home visit new patient 4.09 2.05 1.81 NA NA 0.299347 A Home visit est patient 1.00 0.55 0.53 NA NA 0.099348 A Home visit est patient 1.56 0.80 0.76 NA NA 0.199349 A Home visit est patient 2.33 1.26 1.11 NA NA 0.199350 A Home visit est patient 3.28 1.69 1.49 NA NA 0.299354 A Prolonged service office 1.77 1.00 0.93 0.81 0.75 0.199355 A Prolonged service office 1.77 0.96 0.90 0.78 0.72 0.199356 A Prolonged service inpatient 1.71 NA NA 0.85 0.75 0.199357 A Prolonged service inpatient 1.71 NA NA 0.85 0.76 0.199358 B Prolong service w/o contact 2.10 0.96 0.93 0.96 0.93 0.199359 B Prolong serv w/o contact add 1.00 0.47 0.46 0.47 0.46 0.0
CMS-1582-PN 492 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99360 X Physician standby services 1.20 NA NA 0.53 0.51 0.099363 B Anticoag mgmt init 1.65 1.86 1.89 0.72 0.70 0.199364 B Anticoag mgmt subseq 0.63 0.57 0.57 0.28 0.27 0.099366 B Team conf w/pat by hc pro 0.82 0.38 0.37 0.36 0.35 0.099367 B Team conf w/o pat by phys 1.10 NA NA 0.48 0.47 0.099368 B Team conf w/o pat by hc pro 0.72 NA NA 0.32 0.30 0.099374 B Home health care supervision 1.10 0.85 0.85 0.48 0.47 0.099375 I Home health care supervision 1.73 1.19 1.28 0.76 0.88 0.199377 B Hospice care supervision 1.10 0.85 0.85 0.48 0.47 0.099378 I Hospice care supervision 1.73 1.19 1.34 0.76 0.94 0.199379 B Nursing fac care supervision 1.10 0.85 0.85 0.48 0.47 0.099380 B Nursing fac care supervision 1.73 1.19 1.19 0.76 0.75 0.199381 N Init pm e/m new pat inf 1.50 1.56 1.54 0.61 0.58 0.199382 N Init pm e/m new pat 1-4 yrs 1.60 1.6 1.59 0.65 0.63 0.099383 N Prev visit new age 5-11 1.70 1.63 1.61 0.69 0.66 0.199384 N Prev visit new age 12-17 2.00 1.75 1.72 0.81 0.77 0.199385 N Prev visit new age 18-39 1.92 1.72 1.69 0.78 0.74 0.199386 N Prev visit new age 40-64 2.33 1.89 1.86 0.95 0.9 0.199387 N Init pm e/m new pat 65+ yrs 2.50 2.07 2.04 1.02 0.98 0.199391 N Per pm reeval est pat inf 1.37 1.38 1.34 0.56 0.52 0.099392 N Prev visit est age 1-4 1.50 1.43 1.4 0.61 0.58 0.199393 N Prev visit est age 5-11 1.50 1.42 1.39 0.61 0.58 0.199394 N Prev visit est age 12-17 1.70 1.5 1.46 0.69 0.66 0.199395 N Prev visit est age 18-39 1.75 1.53 1.49 0.71 0.67 0.199396 N Prev visit est age 40-64 1.90 1.59 1.55 0.77 0.74 0.199397 N Per pm reeval est pat 65+ yr 2.00 1.76 1.72 0.81 0.79 0.199401 N Preventive counseling indiv 0.48 0.52 0.55 0.21 0.21 0.099402 N Preventive counseling indiv 0.98 0.74 0.78 0.43 0.42 0.099403 N Preventive counseling indiv 1.46 0.95 0.99 0.64 0.63 0.199404 N Preventive counseling indiv 1.95 1.17 1.21 0.85 0.84 0.1
CMS-1582-PN 493 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99406 A Behav chng smoking 3-10 min 0.24 0.16 0.15 0.10 0.10 0.099407 A Behav chng smoking > 10 min 0.50 0.27 0.25 0.22 0.20 0.099408 N Audit/dast 15-30 min 0.65 0.34 0.33 0.28 0.28 0.099409 N Audit/dast over 30 min 1.30 0.62 0.60 0.57 0.55 0.099411 N Preventive counseling group 0.15 0.30 0.30 0.07 0.06 0.099412 N Preventive counseling group 0.25 0.34 0.34 0.11 0.11 0.099420 N Health risk assessment test 0.00 0.28 0.29 NA NA 0.099429 N Unlisted preventive service 0.00 0.00 0.00 0.00 0.00 0.099441 N Phone e/m by phys 5-10 min 0.25 0.15 0.15 0.11 0.10 0.099442 N Phone e/m by phys 11-20 min 0.50 0.26 0.25 0.22 0.21 0.099443 N Phone e/m by phys 21-30 min 0.75 0.36 0.35 0.33 0.32 0.099444 N Online e/m by phys 0.00 0.00 0.00 0.00 0.00 0.099450 N Basic life disability exam 0.00 0.00 0.00 0.00 0.00 0.099455 R Work related disability exam 0.00 0.00 0.00 0.00 0.00 0.099456 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.099460 A Init nb em per day hosp 1.92 NA NA 0.84 0.73 0.099461 A Init nb em per day non-fac 1.26 1.44 1.34 0.55 0.53 0.099462 A Sbsq nb em per day hosp 0.84 NA NA 0.37 0.33 0.099463 A Same day nb discharge 2.13 NA NA 1.09 0.98 0.199464 A Attendance at delivery 1.50 NA NA 0.59 0.54 0.099465 A Nb resuscitation 2.93 NA NA 0.68 0.93 0.299466 A Ped crit care transport 4.79 NA NA 2.23 1.98 1.099467 A Ped crit care transport addl 2.40 NA NA 1.05 0.95 0.199468 A Neonate crit care initial 18.46 NA NA 7.38 6.47 1.599469 A Neonate crit care subsq 7.99 NA NA 3.50 3.11 0.499471 A Ped critical care initial 15.98 NA NA 6.39 5.94 0.899472 A Ped critical care subsq 7.99 NA NA 3.28 3.00 0.499475 A Ped crit care age 2-5 init 11.25 4.51 4.00 4.51 4.00 0.899476 A Ped crit care age 2-5 subsq 6.75 2.89 2.49 2.89 2.49 0.599477 A Init day hosp neonate care 7.00 NA NA 3.07 2.79 0.3
CMS-1582-PN 494 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

99478 A Ic lbw inf < 1500 gm subsq 2.75 NA NA 1.10 1.11 0.199479 A Ic lbw inf 1500-2500 g subsq 2.50 NA NA 1.22 1.05 0.199480 A Ic inf pbw 2501-5000 g subsq 2.40 NA NA 0.96 0.90 0.199499 C Unlisted e&m service 0.00 0.00 0.00 0.00 0.00 0.099500 I Home visit prenatal 0.00 0.00 0.00 0.00 0.00 0.099501 I Home visit postnatal 0.00 0.00 0.00 0.00 0.00 0.099502 I Home visit nb care 0.00 0.00 0.00 0.00 0.00 0.099503 I Home visit resp therapy 0.00 0.00 0.00 0.00 0.00 0.099504 I Home visit mech ventilator 0.00 0.00 0.00 0.00 0.00 0.099505 I Home visit stoma care 0.00 0.00 0.00 0.00 0.00 0.099506 I Home visit im injection 0.00 0.00 0.00 0.00 0.00 0.099507 I Home visit cath maintain 0.00 0.00 0.00 0.00 0.00 0.099509 I Home visit day life activity 0.00 0.00 0.00 0.00 0.00 0.099510 I Home visit sing/m/fam couns 0.00 0.00 0.00 0.00 0.00 0.099511 I Home visit fecal/enema mgmt 0.00 0.00 0.00 0.00 0.00 0.099512 I Home visit for hemodialysis 0.00 0.00 0.00 0.00 0.00 0.099600 I Home visit nos 0.00 0.00 0.00 0.00 0.00 0.099601 I Home infusion/visit 2 hrs 0.00 0.00 0.00 0.00 0.00 0.099602 I Home infusion each addtl hr 0.00 0.00 0.00 0.00 0.00 0.099605 X Mtms by pharm np 15 min 0.00 0.00 0.00 0.00 0.00 0.099606 X Mtms by pharm est 15 min 0.00 0.00 0.00 0.00 0.00 0.099607 X Mtms by pharm addl 15 min 0.00 0.00 0.00 0.00 0.00 0.0

A4641 C Radiopharm dx agent noc 0.00 0.00 0.00 0.00 0.00 0.0A4642 C In111 satumomab 0.00 0.00 0.00 0.00 0.00 0.0A4890 R Repair/maint cont hemo equip 0.00 0.00 0.00 0.00 0.00 0.0A9500 C Tc99m sestamibi 0.00 0.00 0.00 0.00 0.00 0.0A9501 C Technetium tc-99m teboroxime 0.00 0.00 0.00 0.00 0.00 0.0A9502 C Tc99m tetrofosmin 0.00 0.00 0.00 0.00 0.00 0.0A9503 C Tc99m medronate 0.00 0.00 0.00 0.00 0.00 0.0A9504 C Tc99m apcitide 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 495 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

A9505 C Tl201 thallium 0.00 0.00 0.00 0.00 0.00 0.0A9507 C In111 capromab 0.00 0.00 0.00 0.00 0.00 0.0A9508 C I131 iodobenguate, dx 0.00 0.00 0.00 0.00 0.00 0.0A9509 C Iodine i-123 sod iodide mil 0.00 0.00 0.00 0.00 0.00 0.0A9510 C Tc99m disofenin 0.00 0.00 0.00 0.00 0.00 0.0A9512 C Tc99m pertechnetate 0.00 0.00 0.00 0.00 0.00 0.0A9516 C Iodine i-123 sod iodide mic 0.00 0.00 0.00 0.00 0.00 0.0A9517 C I131 iodide cap, rx 0.00 0.00 0.00 0.00 0.00 0.0A9521 C Tc99m exametazime 0.00 0.00 0.00 0.00 0.00 0.0A9524 C I131 serum albumin, dx 0.00 0.00 0.00 0.00 0.00 0.0A9526 C Nitrogen n-13 ammonia 0.00 0.00 0.00 0.00 0.00 0.0A9527 C Iodine i-125 sodium iodide 0.00 0.00 0.00 0.00 0.00 0.0A9528 C Iodine i-131 iodide cap, dx 0.00 0.00 0.00 0.00 0.00 0.0A9529 C I131 iodide sol, dx 0.00 0.00 0.00 0.00 0.00 0.0A9530 C I131 iodide sol, rx 0.00 0.00 0.00 0.00 0.00 0.0A9531 C I131 max 100uci 0.00 0.00 0.00 0.00 0.00 0.0A9532 C I125 serum albumin, dx 0.00 0.00 0.00 0.00 0.00 0.0A9536 C Tc99m depreotide 0.00 0.00 0.00 0.00 0.00 0.0A9537 C Tc99m mebrofenin 0.00 0.00 0.00 0.00 0.00 0.0A9538 C Tc99m pyrophosphate 0.00 0.00 0.00 0.00 0.00 0.0A9539 C Tc99m pentetate 0.00 0.00 0.00 0.00 0.00 0.0A9540 C Tc99m maa 0.00 0.00 0.00 0.00 0.00 0.0A9541 C Tc99m sulfur colloid 0.00 0.00 0.00 0.00 0.00 0.0A9542 C In111 ibritumomab, dx 0.00 0.00 0.00 0.00 0.00 0.0A9543 C Y90 ibritumomab, rx 0.00 0.00 0.00 0.00 0.00 0.0A9544 C I131 tositumomab, dx 0.00 0.00 0.00 0.00 0.00 0.0A9545 C I131 tositumomab, rx 0.00 0.00 0.00 0.00 0.00 0.0A9546 C Co57/58 0.00 0.00 0.00 0.00 0.00 0.0A9547 C In111 oxyquinoline 0.00 0.00 0.00 0.00 0.00 0.0A9548 C In111 pentetate 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 496 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

A9550 C Tc99m gluceptate 0.00 0.00 0.00 0.00 0.00 0.0A9551 C Tc99m succimer 0.00 0.00 0.00 0.00 0.00 0.0A9552 C F18 fdg 0.00 0.00 0.00 0.00 0.00 0.0A9553 C Cr51 chromate 0.00 0.00 0.00 0.00 0.00 0.0A9554 C I125 iothalamate, dx 0.00 0.00 0.00 0.00 0.00 0.0A9555 C Rb82 rubidium 0.00 0.00 0.00 0.00 0.00 0.0A9556 C Ga67 gallium 0.00 0.00 0.00 0.00 0.00 0.0A9557 C Tc99m bicisate 0.00 0.00 0.00 0.00 0.00 0.0A9558 C Xe133 xenon 10mci 0.00 0.00 0.00 0.00 0.00 0.0A9559 C Co57 cyano 0.00 0.00 0.00 0.00 0.00 0.0A9560 C Tc99m labeled rbc 0.00 0.00 0.00 0.00 0.00 0.0A9561 C Tc99m oxidronate 0.00 0.00 0.00 0.00 0.00 0.0A9562 C Tc99m mertiatide 0.00 0.00 0.00 0.00 0.00 0.0A9563 C P32 na phosphate 0.00 0.00 0.00 0.00 0.00 0.0A9564 C P32 chromic phosphate 0.00 0.00 0.00 0.00 0.00 0.0A9566 C Tc99m fanolesomab 0.00 0.00 0.00 0.00 0.00 0.0A9567 C Technetium tc-99m aerosol 0.00 0.00 0.00 0.00 0.00 0.0A9568 C Technetium tc99m arcitumomab 0.00 0.00 0.00 0.00 0.00 0.0A9569 C Technetium tc-99m auto wbc 0.00 0.00 0.00 0.00 0.00 0.0A9570 C Indium in-111 auto wbc 0.00 0.00 0.00 0.00 0.00 0.0A9571 C Indium in-111 auto platelet 0.00 0.00 0.00 0.00 0.00 0.0A9572 C Indium in-111 pentetreotide 0.00 0.00 0.00 0.00 0.00 0.0A9580 C Sodium fluoride f-18 0.00 0.00 0.00 0.00 0.00 0.0A9600 C Sr89 strontium 0.00 0.00 0.00 0.00 0.00 0.0A9699 C Radiopharm rx agent noc 0.00 0.00 0.00 0.00 0.00 0.0

G0008 X Admin influenza virus vac 0.00 0.00 0.00 0.00 0.00 0.0G0009 X Admin pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.0G0010 X Admin hepatitis b vaccine 0.00 0.00 0.00 0.00 0.00 0.0G0027 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.0G0101 A Ca screen;pelvic/breast exam 0.45 0.61 0.60 0.32 0.32 0.0
CMS-1582-PN 497 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0102 A Prostate ca screening; dre 0.17 0.37 0.39 0.08 0.08 0.0G0103 X Psa screening 0.00 0.00 0.00 0.00 0.00 0.0G0104 A Ca screen;flexi sigmoidscope 0.96 2.92 2.95 0.79 0.76 0.1G0105 A Colorectal scrn; hi risk ind 3.69 7.12 7.37 2.26 2.22 0.5G0105 53 A Colorectal scrn; hi risk ind 0.96 2.92 2.95 0.79 0.76 0.1G0106 A Colon ca screen;barium enema 0.99 5.15 5.23 NA NA 0.0G0106 TC A Colon ca screen;barium enema 0.00 4.78 4.82 NA NA 0.0G0106 26 A Colon ca screen;barium enema 0.99 0.37 0.41 0.37 0.41 0.0G0108 A Diab manage trn per indiv 0.90 0.55 0.66 NA NA 0.0G0109 A Diab manage trn ind/group 0.25 0.15 0.29 NA NA 0.0G0117 T Glaucoma scrn hgh risk direc 0.45 1.02 0.97 NA NA 0.0G0118 T Glaucoma scrn hgh risk direc 0.17 0.86 0.82 NA NA 0.0G0120 A Colon ca scrn; barium enema 0.99 5.15 5.23 NA NA 0.0G0120 TC A Colon ca scrn; barium enema 0.00 4.78 4.82 NA NA 0.0G0120 26 A Colon ca scrn; barium enema 0.99 0.37 0.41 0.37 0.41 0.0G0121 A Colon ca scrn not hi rsk ind 3.69 7.12 7.37 2.26 2.22 0.5G0121 53 A Colon ca scrn not hi rsk ind 0.96 2.92 2.95 0.79 0.76 0.1G0122 N Colon ca scrn; barium enema 0.99 7.14 6.87 NA NA 0.0G0122 TC N Colon ca scrn; barium enema 0.00 6.71 6.44 NA NA 0.0G0122 26 N Colon ca scrn; barium enema 0.99 0.43 0.43 0.43 0.43 0.0G0123 X Screen cerv/vag thin layer 0.00 0.00 0.00 0.00 0.00 0.0G0124 A Screen c/v thin layer by md 0.42 0.42 0.40 0.42 0.40 0.0G0127 R Trim nail(s) 0.17 0.47 0.45 0.05 0.06 0.0G0128 R Corf skilled nursing service 0.08 0.20 0.19 NA NA 0.0G0130 A Single energy x-ray study 0.22 0.72 0.74 NA NA 0.0G0130 TC A Single energy x-ray study 0.00 0.62 0.65 NA NA 0.0G0130 26 A Single energy x-ray study 0.22 0.10 0.09 0.10 0.09 0.0G0141 A Scr c/v cyto,autosys and md 0.42 0.42 0.40 0.42 0.40 0.0G0143 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.0G0144 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.0
CMS-1582-PN 498 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0145 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.0G0147 X Scr c/v cyto, automated sys 0.00 0.00 0.00 0.00 0.00 0.0G0148 X Scr c/v cyto, autosys, rescr 0.00 0.00 0.00 0.00 0.00 0.0G0157 E Hhc pt assistant ea 15 0.00 0.00 0.00 0.00 0.00 0.0G0158 E Hhc ot assistant ea 15 0.00 0.00 0.00 0.00 0.00 0.0G0159 E Hhc pt maint ea 15 min 0.00 0.00 0.00 0.00 0.00 0.0G0160 E Hhc occup therapy ea 15 0.00 0.00 0.00 0.00 0.00 0.0G0161 E Hhc slp ea 15 min 0.00 0.00 0.00 0.00 0.00 0.0G0162 E Hhc rn e&m plan svs, 15 min 0.00 0.00 0.00 0.00 0.00 0.0G0163 E Hhc lpn/rn obs/asses ea 15 0.00 0.00 0.00 0.00 0.00 0.0G0164 E Hhc lis nurse train ea 15 0.00 0.00 0.00 0.00 0.00 0.0G0166 A Extrnl counterpulse, per tx 0.07 3.85 4.41 NA NA 0.0G0168 A Wound closure by adhesive 0.45 2.13 2.06 0.30 0.28 0.0G0173 X Linear acc stereo radsur com 0.00 0.00 0.00 0.00 0.00 0.0G0175 X Opps service,sched team conf 0.00 0.00 0.00 0.00 0.00 0.0G0176 X Opps/php;activity therapy 0.00 0.00 0.00 0.00 0.00 0.0G0177 X Opps/php; train & educ serv 0.00 0.00 0.00 0.00 0.00 0.0G0179 A Md recertification hha pt 0.45 0.68 0.71 NA NA 0.0G0180 A Md certification hha patient 0.67 0.80 0.85 NA NA 0.0G0181 A Home health care supervision 1.73 1.27 1.24 NA NA 0.1G0182 A Hospice care supervision 1.73 1.28 1.28 NA NA 0.1G0186 C Dstry eye lesn,fdr vssl tech 0.00 0.00 0.00 0.00 0.00 0.0G0202 A Screeningmammographydigital 0.70 3.33 3.38 NA NA 0.0G0202 TC A Screeningmammographydigital 0.00 3.05 3.09 NA NA 0.0G0202 26 A Screeningmammographydigital 0.70 0.28 0.29 0.28 0.29 0.0G0204 A Diagnosticmammographydigital 0.87 4.04 4.01 NA NA 0.0G0204 TC A Diagnosticmammographydigital 0.00 3.69 3.66 NA NA 0.0G0204 26 A Diagnosticmammographydigital 0.87 0.35 0.35 0.35 0.35 0.0G0206 A Diagnosticmammographydigital 0.70 3.17 3.16 NA NA 0.0G0206 TC A Diagnosticmammographydigital 0.00 2.89 2.87 NA NA 0.0
CMS-1582-PN 499 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0206 26 A Diagnosticmammographydigital 0.70 0.28 0.29 0.28 0.29 0.0G0219 N Pet img wholbod melano nonco 0.00 0.00 0.00 NA NA 0.0G0219 TC N Pet img wholbod melano nonco 0.00 0.00 0.00 NA NA 0.0G0219 26 N Pet img wholbod melano nonco 0.00 0.00 0.00 0.00 0.00 0.0G0235 N Pet not otherwise specified 0.00 0.00 0.00 NA NA 0.0G0235 TC N Pet not otherwise specified 0.00 0.00 0.00 NA NA 0.0G0235 26 N Pet not otherwise specified 0.00 0.00 0.00 0.00 0.00 0.0G0237 A Therapeutic procd strg endur 0.00 0.25 0.29 NA NA 0.0G0238 A Oth resp proc, indiv 0.00 0.26 0.31 NA NA 0.0G0239 A Oth resp proc, group 0.00 0.31 0.34 NA NA 0.0G0245 R Initial foot exam pt lops 0.88 1.16 1.09 0.49 0.44 0.0G0246 R Followup eval of foot pt lop 0.45 0.72 0.70 0.24 0.22 0.0G0247 R Routine footcare pt w lops 0.50 1.56 1.16 0.15 0.18 0.0G0248 R Demonstrate use home inr mon 0.00 3.22 4.11 NA NA 0.0G0249 R Provide inr test mater/equip 0.00 3.01 3.63 NA NA 0.0G0250 R Md inr test revie inter mgmt 0.18 0.07 0.08 NA NA 0.0G0251 E Linear acc based stero radio 0.00 0.00 0.00 0.00 0.00 0.0G0252 N Pet imaging initial dx 0.00 0.00 0.00 NA NA 0.0G0252 TC N Pet imaging initial dx 0.00 0.00 0.00 NA NA 0.0G0252 26 N Pet imaging initial dx 1.50 0.66 0.70 0.66 0.70 0.1G0255 N Current percep threshold tst 0.00 0.00 0.00 NA NA 0.0G0255 TC N Current percep threshold tst 0.00 0.00 0.00 NA NA 0.0G0255 26 N Current percep threshold tst 0.00 0.00 0.00 0.00 0.00 0.0G0257 E Unsched dialysis esrd pt hos 0.00 0.00 0.00 0.00 0.00 0.0G0259 E Inject for sacroiliac joint 0.00 0.00 0.00 0.00 0.00 0.0G0260 E Inj for sacroiliac jt anesth 0.00 0.00 0.00 0.00 0.00 0.0G0268 A Removal of impacted wax md 0.61 0.91 0.86 0.36 0.31 0.0G0269 B Occlusive device in vein art 0.00 0.00 0.00 0.00 0.00 0.0G0270 A Mnt subs tx for change dx 0.45 0.37 0.34 0.31 0.28 0.0G0271 A Group mnt 2 or more 30 mins 0.25 0.18 0.15 0.17 0.15 0.0
CMS-1582-PN 500 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0275 A Renal angio, cardiac cath 0.25 NA NA 0.10 0.13 0.0G0278 A Iliac art angio,cardiac cath 0.25 NA NA 0.10 0.13 0.0G0281 A Elec stim unattend for press 0.18 0.20 0.18 NA NA 0.0G0282 N Elect stim wound care not pd 0.00 0.00 0.00 0.00 0.00 0.0G0283 A Elec stim other than wound 0.18 0.20 0.18 NA NA 0.0G0288 A Recon, cta for surg plan 0.00 0.99 2.55 NA NA 0.0G0289 A Arthro, loose body + chondro 1.48 NA NA 0.88 0.85 0.2G0290 E Drug-eluting stents, single 0.00 0.00 0.00 0.00 0.00 0.0G0291 E Drug-eluting stents,each add 0.00 0.00 0.00 0.00 0.00 0.0G0293 E Non-cov surg proc,clin trial 0.00 0.00 0.00 0.00 0.00 0.0G0294 E Non-cov proc, clinical trial 0.00 0.00 0.00 0.00 0.00 0.0G0295 N Electromagnetic therapy onc 0.00 0.00 0.00 0.00 0.00 0.0G0302 X Pre-op service lvrs complete 0.00 0.00 0.00 0.00 0.00 0.0G0303 X Pre-op service lvrs 10-15dos 0.00 0.00 0.00 0.00 0.00 0.0G0304 X Pre-op service lvrs 1-9 dos 0.00 0.00 0.00 0.00 0.00 0.0G0305 X Post op service lvrs min 6 0.00 0.00 0.00 0.00 0.00 0.0G0306 X Cbc/diffwbc w/o platelet 0.00 0.00 0.00 0.00 0.00 0.0G0307 X Cbc without platelet 0.00 0.00 0.00 0.00 0.00 0.0G0328 X Fecal blood scrn immunoassay 0.00 0.00 0.00 0.00 0.00 0.0G0329 A Electromagntic tx for ulcers 0.06 0.22 0.20 NA NA 0.0G0333 X Dispense fee initial 30 day 0.00 0.00 0.00 0.00 0.00 0.0G0337 X Hospice evaluation preelecti 1.42 0.62 0.62 0.62 0.62 0.1G0339 C Robot lin-radsurg com, first 0.00 0.00 0.00 0.00 0.00 0.0G0340 C Robt lin-radsurg fractx 2-5 0.00 0.00 0.00 0.00 0.00 0.0G0341 A Percutaneous islet celltrans 6.98 53.44 29.48 3.00 3.83 0.4G0342 A Laparoscopy islet cell trans 11.92 NA NA 7.83 7.14 0.8G0343 A Laparotomy islet cell transp 19.85 NA NA 13.28 12.09 1.4G0364 A Bone marrow aspirate &biopsy 0.16 0.19 0.19 0.09 0.09 0.0G0365 A Vessel mapping hemo access 0.25 5.87 5.90 NA NA 0.0G0365 TC A Vessel mapping hemo access 0.00 5.78 5.81 NA NA 0.0
CMS-1582-PN 501 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0365 26 A Vessel mapping hemo access 0.25 0.09 0.09 0.09 0.09 0.0G0372 A Md service required for pmd 0.17 0.08 0.12 0.08 0.07 0.0G0378 X Hospital observation per hr 0.00 0.00 0.00 0.00 0.00 0.0G0379 X Direct refer hospital observ 0.00 0.00 0.00 0.00 0.00 0.0G0389 A Ultrasound exam aaa screen 0.58 2.45 2.68 NA NA 0.0G0389 TC A Ultrasound exam aaa screen 0.00 2.23 2.43 NA NA 0.0G0389 26 A Ultrasound exam aaa screen 0.58 0.22 0.25 0.22 0.25 0.0G0396 A Alcohol/subs interv 15-30mn 0.65 0.32 0.28 0.27 0.23 0.0G0397 A Alcohol/subs interv >30 min 1.30 0.79 0.61 0.74 0.56 0.0G0398 C Home sleep test/type 2 porta 0.00 0.00 0.00 NA NA 0.0G0398 TC C Home sleep test/type 2 porta 0.00 0.00 0.00 NA NA 0.0G0398 26 C Home sleep test/type 2 porta 0.00 0.00 0.00 0.00 0.00 0.0G0399 C Home sleep test/type 3 porta 0.00 0.00 0.00 NA NA 0.0G0399 TC C Home sleep test/type 3 porta 0.00 0.00 0.00 NA NA 0.0G0399 26 C Home sleep test/type 3 porta 0.00 0.00 0.00 0.00 0.00 0.0G0400 C Home sleep test/type 4 porta 0.00 0.00 0.00 NA NA 0.0G0400 TC C Home sleep test/type 4 porta 0.00 0.00 0.00 NA NA 0.0G0400 26 C Home sleep test/type 4 porta 0.00 0.00 0.00 0.00 0.00 0.0G0402 A Initial preventive exam 2.43 2.19 1.80 1.15 1.15 0.1G0403 A Ekg for initial prevent exam 0.17 0.32 0.39 NA NA 0.0G0404 A Ekg tracing for initial prev 0.00 0.25 0.31 NA NA 0.0G0405 A Ekg interpret & report preve 0.17 0.07 0.08 0.07 0.06 0.0G0406 A Telhealth inpt consult 15min 0.76 NA NA 0.34 0.32 0.0G0407 A Telheath inpt consult 25min 1.39 NA NA 0.63 0.57 0.0G0408 A Telhealth inpt consult 35min 2.00 NA NA 0.90 0.81 0.1G0409 A Corf related serv 15 mins ea 0.00 0.29 0.29 NA NA 0.0G0410 X Grp psych partial hosp 45-50 0.00 0.00 0.00 0.00 0.00 0.0G0411 X Inter active grp psych parti 0.00 0.00 0.00 0.00 0.00 0.0G0412 A Open tx iliac spine uni/bil 10.45 NA NA 9.22 8.73 2.0G0413 A Pelvic ring fracture uni/bil 15.73 NA NA 12.75 12.22 3.0
CMS-1582-PN 502 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0414 A Pelvic ring fx treat int fix 14.65 NA NA 12.59 12.00 2.8G0415 A Open tx post pelvic fxcture 20.93 NA NA 16.35 15.34 4.2G0416 A Sat biopsy prostate 1-20 spc 3.09 13.96 13.96 NA NA 0.1G0416 TC A Sat biopsy prostate 1-20 spc 0.00 12.14 12.14 NA NA 0.0G0416 26 A Sat biopsy prostate 1-20 spc 3.09 1.82 1.82 1.82 1.82 0.1G0417 A Sat biopsy prostate 21-40 5.86 27.26 27.26 NA NA 0.2G0417 TC A Sat biopsy prostate 21-40 0.00 23.71 23.71 NA NA 0.0G0417 26 A Sat biopsy prostate 21-40 5.86 3.55 3.55 3.55 3.55 0.2G0418 A Sat biopsy prostate 41-60 10.30 46.56 46.56 NA NA 0.4G0418 TC A Sat biopsy prostate 41-60 0.00 40.50 40.50 NA NA 0.0G0418 26 A Sat biopsy prostate 41-60 10.30 6.06 6.06 6.06 6.06 0.4G0419 A Sat biopsy prostate: >60 11.61 55.86 55.86 NA NA 0.4G0419 TC A Sat biopsy prostate: >60 0.00 48.60 48.60 NA NA 0.0G0419 26 A Sat biopsy prostate: >60 11.61 7.26 7.26 7.26 7.26 0.4G0420 A Ed svc ckd ind per session 2.12 1.02 1.02 NA NA 0.1G0421 A Ed svc ckd grp per session 0.50 0.24 0.24 NA NA 0.0G0422 A Intens cardiac rehab w/exerc 1.06 0.91 0.91 0.91 0.91 0.0G0423 A Intens cardiac rehab no exer 1.06 0.91 0.91 0.91 0.91 0.0G0424 A Pulmonary rehab w exer 0.28 0.59 0.59 0.12 0.12 0.0G0425 A Inpt telehealth consult 30m 1.92 NA NA 0.86 0.86 0.1G0426 A Inpt telehealth consult 50m 2.61 NA NA 1.20 1.20 0.2G0427 A Inpt telehealth con 70/>m 3.86 NA NA 1.77 1.77 0.2G0428 N Collagen meniscus implant 0.00 0.00 0.00 0.00 0.00 0.0G0429 A Dermal filler injection(s) 1.19 1.19 1.19 0.56 0.56 0.2G0431 X Drug screen multip class 0.00 0.00 0.00 0.00 0.00 0.0G0432 X Eia hiv-1/hiv-2 screen 0.00 0.00 0.00 0.00 0.00 0.0G0433 X Elisa hiv-1/hiv-2 screen 0.00 0.00 0.00 0.00 0.00 0.0G0434 X Drug screen multi drug class 0.00 0.00 0.00 0.00 0.00 0.0G0435 X Oral hiv-1/hiv-2 screen 0.00 0.00 0.00 0.00 0.00 0.0G0436 A Tobacco-use counsel 3-10 min 0.24 0.16 0.16 0.10 0.10 0.0
CMS-1582-PN 503 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G0437 A Tobacco-use counsel>10min 0.50 0.30 0.30 0.24 0.24 0.0G0438 A Ppps, initial visit 2.43 2.19 2.19 NA NA 0.1G0439 A Ppps, subseq visit 1.50 1.63 1.63 NA NA 0.0G0440 A Skin/dermal subs init 25or< 2.22 2.71 2.71 1.01 1.01 0.2G0441 A Skin/dermal subs each additi 0.50 0.82 0.82 0.20 0.20 0.0G3001 X Admin + supply, tositumomab 0.00 0.00 0.00 0.00 0.00 0.0G9001 X Mccd, initial rate 0.00 0.00 0.00 0.00 0.00 0.0G9002 X Mccd,maintenance rate 0.00 0.00 0.00 0.00 0.00 0.0G9003 X Mccd, risk adj hi, initial 0.00 0.00 0.00 0.00 0.00 0.0G9004 X Mccd, risk adj lo, initial 0.00 0.00 0.00 0.00 0.00 0.0G9005 X Mccd, risk adj, maintenance 0.00 0.00 0.00 0.00 0.00 0.0G9006 X Mccd, home monitoring 0.00 0.00 0.00 0.00 0.00 0.0G9007 X Mccd, sch team conf 0.00 0.00 0.00 0.00 0.00 0.0G9008 X Mccd,phys coor-care ovrsght 0.00 0.00 0.00 0.00 0.00 0.0G9009 X Mccd, risk adj, level 3 0.00 0.00 0.00 0.00 0.00 0.0G9010 X Mccd, risk adj, level 4 0.00 0.00 0.00 0.00 0.00 0.0G9011 X Mccd, risk adj, level 5 0.00 0.00 0.00 0.00 0.00 0.0G9012 X Other specified case mgmt 0.00 0.00 0.00 0.00 0.00 0.0G9013 N Esrd demo bundle level i 0.00 0.00 0.00 0.00 0.00 0.0G9014 N Esrd demo bundle-level ii 0.00 0.00 0.00 0.00 0.00 0.0G9016 N Demo-smoking cessation coun 0.00 0.00 0.00 0.00 0.00 0.0G9017 X Amantadine hcl 100mg oral 0.00 0.00 0.00 0.00 0.00 0.0G9018 X Zanamivir,inhalation pwd 10m 0.00 0.00 0.00 0.00 0.00 0.0G9019 X Oseltamivir phosphate 75mg 0.00 0.00 0.00 0.00 0.00 0.0G9020 X Rimantadine hcl 100mg oral 0.00 0.00 0.00 0.00 0.00 0.0G9033 X Amantadine hcl oral brand 0.00 0.00 0.00 0.00 0.00 0.0G9034 X Zanamivir, inh pwdr, brand 0.00 0.00 0.00 0.00 0.00 0.0G9035 X Oseltamivir phosp, brand 0.00 0.00 0.00 0.00 0.00 0.0G9036 X Rimantadine hcl, brand 0.00 0.00 0.00 0.00 0.00 0.0G9041 A Low vision rehab occupationa 0.69 0.28 0.28 0.28 0.28 0.0
CMS-1582-PN 504 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented

NonFacility

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

Ma

Pract

RVU

G9042 A Low vision rehab orient/mobi 0.25 0.25 0.25 0.25 0.25 0.0G9043 A Low vision lowvision therapi 0.25 0.25 0.25 0.25 0.25 0.0G9044 A Low vision rehabilate teache 0.24 0.19 0.19 0.19 0.19 0.0G9140 X Frontier extended stay demo 0.00 0.00 0.00 0.00 0.00 0.0G9141 X Influenza a h1n1,admin w cou 0.00 0.00 0.00 0.00 0.00 0.0G9142 X Influenza a h1n1, vaccine 0.00 0.00 0.00 0.00 0.00 0.0G9143 X Warfarin respon genetic test 0.00 0.00 0.00 0.00 0.00 0.0G9147 N Outpt iv insulin tx any mea 0.00 0.00 0.00 0.00 0.00 0.0

M0064 A Visit for drug monitoring 0.37 1.07 0.99 0.08 0.09 0.0

P3001 A Screening pap smear by phys 0.42 0.42 0.40 0.42 0.40 0.0

Q0035 A Cardiokymography 0.17 0.31 0.35 NA NA 0.0Q0035 TC A Cardiokymography 0.00 0.25 0.29 NA NA 0.0Q0035 26 A Cardiokymography 0.17 0.06 0.06 0.06 0.06 0.0Q0091 A Obtaining screen pap smear 0.37 0.87 0.88 0.17 0.15 0.0Q0092 A Set up port xray equipment 0.00 0.64 0.59 0.64 0.59 0.0Q3001 C Brachytherapy radioelements 0.00 0.00 0.00 0.00 0.00 0.0Q3014 X Telehealth facility fee 0.00 0.00 0.00 0.00 0.00 0.0

R0070 C Transport portable x-ray 0.00 0.00 0.00 0.00 0.00 0.0R0075 C Transport port x-ray multipl 0.00 0.00 0.00 0.00 0.00 0.0R0076 B Transport portable ekg 0.00 0.00 0.00 0.00 0.00 0.0

V5299 R Hearing service 0.00 0.00 0.00 0.00 0.00 0.0

1 CPT codes and descriptors only are copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 

2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and 

payment. 
CMS-1582-PN 505 

ADDENDUM C. - CODES WITH PROPOSED RVUS SUBJECT TO COMMENT FOR 

FOURTH FIVE-YEAR REVIEW OF WORK 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented 

NonFacility 

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

MalPractice

RVUs2 Global 

10140 A Drainage of hematoma/fluid 1.58 2.97 2.85 1.69 1.65 0.20 010 

10160 A Puncture drainage of lesion 1.25 2.40 2.32 1.41 1.37 0.16 010 

11732 A Remove nail plate add-on 0.44 0.56 0.57 0.12 0.14 0.03 ZZZ 

11765 A Excision of nail fold toe 1.22 3.51 3.33 1.42 1.34 0.08 010 

12031 A Intmd wnd repair s/tr/ext 2.00 4.66 4.53 2.24 2.16 0.32 010 

12032 A Intmd wnd repair s/tr/ext 2.52 6.02 5.95 2.91 2.83 0.38 010 

12034 A Intmd wnd repair s/tr/ext 2.97 5.67 5.50 2.65 2.55 0.50 010 

12035 A Intmd wnd repair s/tr/ext 3.50 7.03 6.82 2.97 2.87 0.65 010 

12036 A Intmd wnd repair s/tr/ext 4.23 7.26 7.03 3.26 3.14 0.81 010 

12037 A Intmd wnd repair s/tr/ext 5.00 8.02 7.77 3.74 3.62 0.96 010 

12041 A Intmd wnd repair n-hf/genit 2.10 4.69 4.56 2.24 2.17 0.32 010 

12042 A Intmd wnd repair n-hg/genit 2.79 5.30 5.21 2.77 2.67 0.41 010 

12044 A Intmd wnd repair n-hg/genit 3.19 6.76 6.49 2.64 2.54 0.52 010 

12045 A Intmd wnd repair n-hg/genit 3.75 7.24 6.94 3.58 3.32 0.64 010 

12046 A Intmd wnd repair n-hg/genit 4.30 8.55 8.21 4.02 3.77 0.84 010 

12047 A Intmd wnd repair n-hg/genit 4.95 9.57 9.07 4.24 4.01 0.96 010 

12051 A Intmd wnd repair face/mm 2.33 4.94 4.85 2.44 2.38 0.36 010 

12052 A Intmd wnd repair face/mm 2.87 5.38 5.35 2.79 2.78 0.42 010 

12053 A Intmd wnd repair face/mm 3.17 6.48 6.28 2.80 2.70 0.50 010 

12054 A Intmd wnd repair face/mm 3.50 6.71 6.48 2.71 2.62 0.59 010 

12055 A Intmd wnd repair face/mm 4.50 8.49 8.02 3.62 3.34 0.73 010 

12056 A Intmd wnd repair face/mm 5.30 10.36 9.70 5.38 4.85 0.67 010 

12057 A Intmd wnd repair face/mm 6.00 12.09 11.21 5.38 5.00 0.76 010 

13100 A Repair of wound or lesion 3.17 5.53 5.45 3.27 3.20 0.50 010 

13101 A Repair of wound or lesion 3.96 7.13 7.01 3.88 3.79 0.61 010 

15120 A Skn splt a-grft fac/nck/hf/g 10.15 13.51 13.44 9.09 9.07 1.76 090 

15121 A Skn splt a-grft f/n/hf/g add 2.00 3.76 3.90 1.58 1.60 0.37 ZZZ 

15260 A Skin full graft een & lips 11.64 16.71 16.21 12.42 12.08 1.77 090 

15732 A Muscle-skin graft head/neck 16.38 19.29 19.11 14.67 14.45 2.91 090 

17250 A Chemical cautery tissue 0.50 1.74 1.68 0.51 0.49 0.07 000 

17260 A Destruction of skin lesions 0.96 1.69 1.67 0.99 0.95 0.12 010 

17261 A Destruction of skin lesions 1.22 2.84 2.80 1.34 1.31 0.18 010 

17262 A Destruction of skin lesions 1.63 3.30 3.24 1.62 1.58 0.23 010 

17263 A Destruction of skin lesions 1.84 3.53 3.48 1.75 1.71 0.26 010 

17264 A Destruction of skin lesions 1.99 3.76 3.70 1.83 1.78 0.29 010 

17266 A Destruction of skin lesions 2.39 4.09 4.03 2.06 2.00 0.34 010 

17270 A Destruction of skin lesions 1.37 2.87 2.81 1.41 1.37 0.20 010 
CMS-1582-PN 506 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented 

NonFacility 

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

MalPractice

RVUs2 Global 

17271 A Destruction of skin lesions 1.54 3.06 3.01 1.56 1.52 0.23 010 

17272 A Destruction of skin lesions 1.82 3.41 3.37 1.75 1.71 0.26 010 

17273 A Destruction of skin lesions 2.10 3.73 3.67 1.92 1.87 0.30 010 

17274 A Destruction of skin lesions 2.64 4.20 4.14 2.24 2.19 0.37 010 

17276 A Destruction of skin lesions 3.25 4.63 4.55 2.58 2.51 0.48 010 

17280 A Destruction of skin lesions 1.22 2.75 2.70 1.32 1.28 0.18 010 

17281 A Destruction of skin lesions 1.77 3.23 3.17 1.71 1.67 0.26 010 

17282 A Destruction of skin lesions 2.09 3.64 3.59 1.92 1.88 0.30 010 

17283 A Destruction of skin lesions 2.69 4.14 4.09 2.30 2.25 0.38 010 

17284 A Destruction of skin lesions 3.20 4.57 4.53 2.60 2.55 0.44 010 

17286 A Destruction of skin lesions 4.48 5.50 5.39 3.35 3.28 0.67 010 

19302 A P-mastectomy w/ln removal 13.87 NA NA 9.40 8.93 2.95 090 

22520 A Percut vertebroplasty thor 9.22 55.61 55.64 4.57 4.75 1.06 010 

22521 A Percut vertebroplasty lumb 8.01 55.13 55.03 4.24 4.45 0.94 010 

22522 A Percut vertebroplasty addl 4.30 NA NA 1.75 1.81 0.54 ZZZ 

22523 A Percut kyphoplasty thor 8.62 NA NA 5.60 5.72 1.69 010 

22524 A Percut kyphoplasty lumbar 8.22 NA NA 5.44 5.55 1.61 010 

22525 A Percut kyphoplasty add-on 4.47 NA NA 2.17 2.19 0.95 ZZZ 

25600 A Treat fracture radius/ulna 2.64 6.27 5.82 5.76 5.24 0.49 090 

25605 A Treat fracture radius/ulna 6.00 8.67 8.57 7.73 7.64 1.15 090 

27385 A Repair of thigh muscle 6.93 NA NA 8.72 8.54 1.36 090 

27530 A Treat knee fracture 2.65 5.74 5.77 5.10 5.10 0.51 090 

27792 A Treatment of ankle fracture 8.75 NA NA 8.97 8.79 1.66 090 

28002 A Treatment of foot infection 4.00 6.94 7.03 3.19 3.47 0.45 010 

28003 A Treatment of foot infection 9.06 10.94 10.37 6.70 6.43 1.06 090 

28120 A Part removal of ankle/heel 7.31 11.86 11.19 6.46 6.05 1.01 090 

28122 A Partial removal of foot bone 6.76 10.37 10.13 5.58 5.63 0.72 090 

28285 A Repair of hammertoe 4.76 9.32 8.80 4.63 4.46 0.45 090 

28715 A Fusion of foot bones 13.42 NA NA 12.12 11.74 2.28 090 

28820 A Amputation of toe 5.82 10.40 10.02 5.24 4.99 0.85 090 

28825 A Partial amputation of toe 5.37 10.28 9.99 5.08 4.98 0.75 090 

29125 A Apply forearm splint 0.50 1.31 1.27 0.58 0.56 0.08 000 

29126 A Apply forearm splint 0.68 1.49 1.42 0.65 0.63 0.10 000 

29405 A Apply short leg cast 0.80 1.50 1.47 0.86 0.84 0.11 000 

29425 A Apply short leg cast 0.80 1.41 1.42 0.77 0.78 0.10 000 

29515 A Application lower leg splint 0.73 1.25 1.21 0.62 0.60 0.10 000 

32405 A Biopsy lung or mediastinum 1.93 0.66 0.71 0.66 0.71 0.18 000 

32851 A Lung transplant single 59.64 NA NA 25.28 25.80 14.05 090 

32852 A Lung transplant with bypass 65.50 NA NA 27.10 28.13 15.35 090 

32853 A Lung transplant double 84.48 NA NA 33.67 32.99 20.00 090 
CMS-1582-PN 507 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented 

NonFacility 

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

MalPractice

RVUs2 Global 

32854 A Lung transplant with bypass 90.00 NA NA 35.65 35.47 21.21 090 

33030 A Partial removal of heart sac 36.00 NA NA 16.13 14.94 8.55 090 

33031 A Partial removal of heart sac 45.00 NA NA 19.22 17.47 10.83 090 

33120 A Removal of heart lesion 38.45 NA NA 15.81 15.24 9.20 090 

33315 A Exploratory heart surgery 35.00 NA NA 14.60 14.24 8.41 090 

33411 A Replacement of aortic valve 62.07 NA NA 24.85 25.09 14.93 090 

33412 A Replacement of aortic valve 59.00 NA NA 22.90 22.61 14.77 090 

33468 A Revision of tricuspid valve 45.13 NA NA 18.15 17.91 11.30 090 

33645 A Revision of heart veins 31.30 NA NA 13.46 13.55 7.82 090 

33647 A Repair heart septum defects 33.00 NA NA 14.07 14.49 8.25 090 

33692 A Repair of heart defects 36.15 NA NA 16.58 16.19 2.56 090 

33710 A Repair of heart defects 37.50 NA NA 15.48 16.44 8.78 090 

33875 A Thoracic aortic graft 50.72 NA NA 22.33 20.86 12.12 090 

33910 A Remove lung artery emboli 48.21 NA NA 20.26 18.80 12.04 090 

33916 A Surgery of great vessel 78.00 NA NA 29.74 26.33 19.49 090 

33935 R Transplantation heart/lung 91.78 NA NA 36.50 34.78 22.94 090 

33975 A Implant ventricular device 25.00 NA NA 8.47 8.38 5.95 XXX 

33976 A Implant ventricular device 30.75 NA NA 10.16 10.00 7.68 XXX 

33977 A Remove ventricular device 20.86 NA NA 8.16 9.14 4.96 XXX 

33978 A Remove ventricular device 25.00 NA NA 9.60 10.36 6.26 XXX 

33979 A Insert intracorporeal device 37.50 NA NA 12.55 13.82 8.98 XXX 

33980 A Remove intracorporeal device 33.50 NA NA 12.48 16.96 8.08 XXX 

33981 A Replace vad pump ext 16.11 NA NA 6.56 6.56 4.02 XXX 

33982 A Replace vad intra w/o bp 37.86 NA NA 15.43 15.43 9.07 XXX 

33983 A Replace vad intra w/bp 44.54 NA NA 18.15 18.15 10.67 XXX 

35188 A Repair blood vessel lesion 18.00 NA NA 6.46 6.82 3.85 090 

35612 A Artery bypass graft 20.35 NA NA 7.50 7.72 4.84 090 

35800 A Explore neck vessels 12.00 NA NA 7.27 6.71 2.53 090 

35840 A Explore abdominal vessels 20.75 NA NA 10.33 9.24 4.45 090 

35860 A Explore limb vessels 15.25 NA NA 7.42 6.64 3.48 090 

36200 A Place catheter in aorta 3.02 12.93 13.90 0.98 1.05 0.60 000 

36246 A Place catheter in artery 5.27 22.83 25.31 1.78 1.94 0.98 000 

36247 A Place catheter in artery 6.29 41.60 44.68 2.11 2.30 1.18 000 

36470 A Injection therapy of vein 1.10 3.24 3.15 1.25 1.13 0.22 010 

36471 A Injection therapy of veins 1.65 3.18 3.18 1.04 1.03 0.33 010 

36600 A Withdrawal of arterial blood 0.32 0.55 0.55 0.11 0.10 0.03 XXX 

36819 A Av fuse uppr arm basilic 13.29 NA NA 6.49 6.53 2.98 090 

36821 A Av fusion direct any site 12.11 NA NA 6.62 6.43 2.71 090 

36825 A Artery-vein autograft 14.17 NA NA 7.24 6.78 3.17 090 

37140 A Revision of circulation 40.00 NA NA 19.84 17.69 8.53 090 
CMS-1582-PN 508 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented 

NonFacility 

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

MalPractice

RVUs2 Global 

37145 A Revision of circulation 37.00 NA NA 18.52 17.00 8.07 090 

37160 A Revision of circulation 38.00 NA NA 19.03 16.85 8.13 090 

37180 A Revision of circulation 36.50 NA NA 18.38 16.57 7.80 090 

37181 A Splice spleen/kidney veins 40.00 NA NA 19.84 17.93 8.52 090 

42415 A Excise parotid gland/lesion 17.16 NA NA 12.66 12.31 2.29 090 

42420 A Excise parotid gland/lesion 19.53 NA NA 13.96 13.62 2.63 090 

43262 A Endo cholangiopancreatograph 7.38 NA NA 4.25 4.25 1.09 000 

43415 A Repair esophagus wound 44.88 NA NA 22.14 20.23 10.25 090 

45331 A Sigmoidoscopy and biopsy 1.15 3.59 3.63 0.94 0.93 0.18 000 

47563 A Laparo cholecystectomy/graph 11.47 NA NA 7.20 6.95 2.43 090 

47564 A Laparo cholecystectomy/explr 18.00 NA NA 11.01 9.95 3.84 090 

49507 A Prp i/hern init block >5 yr 9.09 NA NA 6.27 6.05 1.92 090 

49521 A Rerepair ing hernia blocked 11.48 NA NA 7.22 6.95 2.41 090 

49587 A Rpr umbil hern block > 5 yr 7.08 NA NA 5.45 5.25 1.49 090 

49652 A Lap vent/abd hernia repair 11.92 NA NA 7.52 7.25 0.83 090 

49653 A Lap vent/abd hern proc comp 14.94 NA NA 9.31 8.97 1.07 090 

49654 A Lap inc hernia repair 13.76 NA NA 8.30 8.01 0.97 090 

49655 A Lap inc hern repair comp 16.84 NA NA 10.06 9.68 1.19 090 

51705 A Change of bladder tube 0.90 1.59 1.59 0.51 0.51 0.09 000 

51710 A Change of bladder tube 1.35 1.21 1.21 0.83 0.83 0.12 000 

52005 A Cystoscopy & ureter catheter 2.37 5.14 5.54 1.23 1.31 0.24 000 

52007 A Cystoscopy and biopsy 3.02 9.47 10.69 1.46 1.57 0.30 000 

52310 A Cystoscopy and treatment 2.81 3.78 4.08 1.29 1.38 0.29 000 

52315 A Cystoscopy and treatment 5.20 5.98 6.62 2.22 2.39 0.50 000 

52630 A Remove prostate regrowth 6.55 NA NA 4.32 4.57 0.64 090 

52640 A Relieve bladder contracture 4.79 NA NA 3.80 3.89 0.45 090 

52649 A Prostate laser enucleation 14.56 NA NA 7.50 8.55 1.41 090 

53440 A Male sling procedure 13.36 NA NA 7.02 7.86 1.31 090 

57287 A Revise/remove sling repair 11.15 NA NA 7.21 7.38 1.47 090 

57288 A Repair bladder defect 12.13 NA NA 7.11 7.23 1.59 090 

60220 A Partial removal of thyroid 11.19 NA NA 8.04 7.80 1.94 090 

60240 A Removal of thyroid 15.04 NA NA 9.66 9.30 2.74 090 

60500 A Explore parathyroid glands 15.60 NA NA 10.06 9.68 3.01 090 

62284 A Injection for myelogram 1.54 3.93 4.15 0.77 0.80 0.18 000 

63655 A Implant neuroelectrodes 10.92 NA NA 10.35 10.00 3.42 090 

64405 A N block inj occipital 0.94 1.76 1.68 0.70 0.67 0.19 000 

69220 A Clean out mastoid cavity 0.83 3.27 3.19 0.95 0.92 0.10 000 

78264 A Gastric emptying study 0.80 7.60 7.61 NA NA 0.07 XXX 

78264 TC A Gastric emptying study 0.00 7.34 7.33 NA NA 0.03 XXX 

78264 26 A Gastric emptying study 0.80 0.26 0.28 0.26 0.28 0.04 XXX 
CMS-1582-PN 509 

CPT1/ 

HCPCS Mod Status Description 

Physician 

Work 

RVUs2

Fully 

Implemented 

NonFacility 

PE 

RVUs2

Year 

2011 

Transitional 

NonFacility 

PE 

RVUs2

Fully 

Implemented 

Facility 

PE 

RVUs2

Year 

2011 

Transitional 

Facility 

PE 

RVUs2

MalPractice

RVUs2 Global 

92511 A Nasopharyngoscopy 0.61 3.50 3.55 0.81 0.81 0.03 000 

92950 A Heart/lung resuscitation cpr 4.00 4.39 4.31 1.08 1.06 0.32 000 

93321 A Doppler echo exam heart 0.15 0.52 0.61 NA NA 0.02 ZZZ 

93321 TC A Doppler echo exam heart 0.00 0.47 0.55 NA NA 0.01 ZZZ 

93321 26 A Doppler echo exam heart 0.15 0.05 0.06 0.05 0.06 0.01 ZZZ 

94660 A Pos airway pressure cpap 0.76 0.98 0.96 0.28 0.27 0.05 XXX 

98925 A Osteopathic manipulation 0.46 0.43 0.41 0.20 0.18 0.03 000 

98926 A Osteopathic manipulation 0.71 0.57 0.54 0.29 0.27 0.03 000 

98927 A Osteopathic manipulation 0.96 0.71 0.67 0.36 0.35 0.04 000 

98928 A Osteopathic manipulation 1.21 0.82 0.78 0.45 0.43 0.06 000 

98929 A Osteopathic manipulation 1.46 1.00 0.93 0.54 0.51 0.09 000 

99218 A Initial observation caree 1.28 NA NA 0.54 0.52 0.08 XXX 

99219 A Initial observation care 2.14 NA NA 0.92 0.88 0.14 XXX 

99220 A Initial observation care 2.99 NA NA 1.26 1.21 0.20 XXX 

99234 A Observ/hosp same date 1.92 NA NA 0.81 0.86 0.17 XXX 

99235 A Observ/hosp same date 2.78 NA NA 1.19 1.20 0.19 XXX 

99236 A Observ/hosp same date 3.63 NA NA 1.52 1.52 0.25 XXX 

99315 A Nursing fac discharge day 1.28 0.74 0.68 0.74 0.68 0.08 XXX 

99316 A Nursing fac discharge day 1.90 1.01 0.92 1.01 0.92 0.10 XXX 

99460 A Init nb em per day hosp 1.92 NA NA 0.84 0.73 0.08 XXX 

99462 A Sbsq nb em per day hosp 0.84 NA NA 0.37 0.33 0.05 XXX 

99463 A Same day nb discharge 2.13 NA NA 1.09 0.98 0.11 XXX 

1

 CPT codes and descriptors only are copyright 2011 American Medical Association. All Rights Reserved. Applicable 

FARS/DFARS apply. 

2

 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to 

the general public and are not used for Medicare payment. 

[FR Doc. 2011-13052 Filed 05/24/2011 at 4:15 pm; Publication Date: 06/06/2011]