Thursday, 

June 29, 2006 

Part II 

Department of 

Health and Human 

Services 

Centers for Medicare & Medicaid Services 

Medicare Program; Five-Year Review of 

Work Relative Value Units Under the 

Physician Fee Schedule and Proposed 

Changes to the Practice Expense 

Methodology; Notice 


jlentini on PROD1PC65 with NOTICES2
37170 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–1512–PN] 

RIN 0938–AO22 

Medicare Program; Five-Year Review 

of Work Relative Value Units Under the 

Physician Fee Schedule and Proposed 

Changes to the Practice Expense 

Methodology 

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) affecting 

payment for physicians’ services. The 

statute requires that we review RVUs no 

less often than every 5 years. This is our 

third 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, 2007. These 

revisions reflect changes in medical 

practice, coding changes, new data on 

relative value components, and the 

addition of new procedures that affect 

the relative amount of physician work 

required to perform each service as 

required by the statute. In addition, we 

are proposing revisions to our 

methodology for calculating practice 

expense (PE) RVUs, including changes 

based on supplemental survey data for 

PE. This revised methodology would be 

used to establish payment for services 

beginning January 1, 2007. 

DATES: To be assured consideration, 

comments must be received at one of 

the addresses provided below, no later 

than 5 p.m. on Monday, August 21, 

2006. 

ADDRESSES: In commenting, please refer 

to file code CMS–1512–PN. Because of 

staff and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 

You may submit comments in one of 

four ways (no duplicates, please): 

1. Electronically. You may submit 

electronic comments on specific issues 

in this regulation to http:// 

www.cms.hhs.gov/eRulemaking. Click 

on the link ‘‘Submit electronic 

comments on CMS regulations with an 

open comment period.’’ (Attachments 

should be in Microsoft Word, 

WordPerfect, or Excel; however, we 

prefer Microsoft Word.) 

2. By regular mail. You may mail 

written comments (one original and two 

copies) to the following address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS–1512– 

PN, P.O. Box 8014, Baltimore, MD 

21244–8014. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By express or overnight mail. You 

may send written comments (one 

original and two copies) to the following 

address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS–1512– 

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 written comments (one original 

and two copies) before the close of the 

comment period to one of the following 

addresses. If you intend to deliver your 

comments to the Baltimore address, 

please call telephone number (410) 786– 

7195 in advance to schedule your 

arrival with one of our staff members. 

Room 445–G, Hubert H. Humphrey 

Building, 200 Independence Avenue, 

SW., Washington, DC 20201; or 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

(Because access to the interior of the 

HHH Building is not readily available to 

persons without Federal Government 

identification, commenters are 

encouraged to leave their comments in 

the CMS drop slots located in the main 

lobby of the building. A stamp-in clock 

is available for persons wishing to retain 

a proof of filing by stamping in and 

retaining an extra copy of the comments 

being filed.) 

Comments mailed to the addresses 

indicated as appropriate for hand or 

courier delivery may be delayed and 

received after the comment period. 

For information on viewing public 

comments, see the beginning of the 

SUPPLEMENTARY INFORMATION section. 

FOR FURTHER INFORMATION CONTACT: 

Diane Milstead, (410) 786–3355, or 

Gaysha Brooks, (410) 786–9649 

SUPPLEMENTARY INFORMATION: 

Submitting Comments: We welcome 

comments from the public on the 

proposed work RVUs set forth in 

Addendum C, the proposed practice 

expense methodology, and other issues 

set forth in this proposed notice to assist 

us in fully considering issues and 

developing policies. You can assist us 

by referencing the file code CMS–1512– 

PN and the specific ‘‘issue identifier’’ 

that precedes the section on which you 

choose to comment. 

Inspection of Public Comments: All 

comments received before the close of 

the comment period are available for 

viewing by the public, including any 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following Web 

site as soon as possible after they are 

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

eRulemaking. Click on the link 

‘‘Electronic Comments on CMS 

Regulations’’ on that Web site to view 

public comments. 

Comments received timely will be 

available for public inspection as they 

are received, generally beginning 

approximately 3 weeks after publication 

of a document, at the headquarters of 

the Centers for Medicare & Medicaid 

Services, 7500 Security Boulevard, 

Baltimore, Maryland 21244, Monday 

through Friday of each week from 8:30 

a.m. to 4 p.m. To schedule an 

appointment to view public comments, 

phone 1–800–743–3951. 

Information on the PFS can be found 

on the CMS homepage. You can access 

this data by using the following 

directions: 

1. Go to the following Web site 

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

PhysicianFeeSched/. 

2. Select ‘‘Physician Fee Schedule 

Federal Regulation Notices.’’ 

To assist readers in referencing 

sections contained in this preamble, we 

are providing the following table of 

contents. 

Table of Contents 

I. Background 

A. Legislative History 

B. Published Changes to the Physician Fee 

Schedule 

C. Current Proposed Notice 

D. The 5-Year Review Process 

II. Discussion of Comments and Decisions 

A. Review of Comments 

B. Discussion of Comments by Clinical 

Area 

1. Dermatology and Plastic Surgery 

2. Orthopedic Surgery 

3. Gynecology, Urology, Pain Medicine, 

and Neurosurgery 

4. Radiology, Pathology, and Other 

Miscellaneous Services 

5. Evaluation and Management Services 

6. Cardiothoracic Surgery 

7. General, Colorectal and Vascular Surgery 

8. Otolaryngology and Ophthalmology 

9. HCPAC Codes 

C. Other Issues Under the 5-Year Review 

1. Anesthesia Services 

2. Discussion of Post-Operative Visits 

Included in the Global Surgical Packages 

3. Codes Referred to CPT Editorial Panel 

from Five-Year Review of Work Relative 

Value Units 

4. Budget Neutrality 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37171 

5. Effect on Practice Expense Inputs 

Stemming From the 5-Year Review 

6. Nature and Format of Comments on 

Work RVUs 

D. Resource-Based Practice Expense (PE) 

RVUs 

1. Current Methodology 

2. PE Proposed Methodology for CY 2006 

3. Modifications to PE Proposals 

III. Collection of Information Requirements 

IV. Response to Comments 

V. Regulatory Impact Analysis 

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 

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 

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 

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] Veterans Affairs 

I. Background 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘BACKGROUND’’ at the 

beginning of your comments.] 

A. Legislative History 

Since January 1, 1992, Medicare has 

paid for physicians’ services under 

section 1848 of the Social Security Act 

(the Act), ‘‘Payment for Physicians’

Services.’’ 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. 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. 

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

provides that adjustments in RVUs may 

not cause total physician fee schedule 

(PFS) payments for the year to differ by 

more than $20 million from the amount 

that would have been paid had the 

adjustments not been made. If this 

tolerance is exceeded, we must make 

adjustments to the conversion factors 

(CFs) to preserve budget neutrality. 

B. Published Changes to the Physician 

Fee Schedule 

On an annual basis, we publish 

regulations relating to updates to the 

RVUs and revisions to the payment 

policies under the PFS. In the Calendar 

Year (CY) 2006 Physician Fee Schedule 

final rule with comment period that 

appeared in the Federal Register on 

November 21, 2005 (70 FR 70116) 

(hereinafter referred to as the CY 2006 

PFS final rule with comment period), 

we finalized the CY 2005 interim 

physician work RVUs, issued new 

interim work RVUs for new and revised 

codes for CY 2006, and finalized several 

other payment policies related to the 

PFS. This final rule with comment also 

discussed the status of the third 5-Year 

Review of work RVUs. 

C. Current Proposed Notice 

This proposed notice sets forth 

proposed revisions to work RVUs 

affecting payment for physicians’

services. 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 5-Year Review of work 

was initiated in December 1994 and was 

effective for services furnished 

beginning January 1, 1997. The second 

5-Year Review of work was initiated in 

November 1999 and was effective for 

services furnished beginning January 1 

2002. The third 5-Year Review of work 

was initiated in November 2004. 


jlentini on PROD1PC65 with NOTICES2
37172 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

Revisions of physician work RVUs 

proposed in this proposed notice 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 revised values 

in our CY 2007 Physician Fee Schedule 

final rule with comment period, 

effective for services furnished 

beginning January 1, 2007. 

D. The 5-Year Review Process 

We initiated the third 5-Year Review 

by soliciting public comments on 

potentially misvalued work RVUs for all 

services in the CY 2005 Physician Fee 

Schedule final rule with comment 

period that appeared in the Federal 

Register on November 15, 2004 (69 FR 

66370) and provided a 60-day comment 

period. 

We received comments from 

approximately 35 specialty groups, 

organizations, and individuals involving 

over 500 Current Procedural 

Terminology (CPT) and Healthcare 

Common Procedure Coding System 

(HCPCS) codes. As explained in the CY 

2006 PFS final rule with comment 

period (70 FR 70283), we shared these 

comments with the American Medical 

Association (AMA) Specialty Society 

Relative Value Update Committee 

(RUC). The RUC was formed in 

November 1991 and grew out of a series 

of discussions between the AMA and 

major national medical specialty 

societies. The work of the RUC is 

supported by the RUC Advisory 

Committee, which is made up of 

representatives of 100 specialty societies 

in the AMA’s House of Delegates. 

The RUC currently makes annual 

recommendations to us on RVUs for 

new and revised CPT codes. The RUC 

also provided recommendations on 

changes to the work RVUs for existing 

codes during the previous 5-Year 

Reviews. We believe that the RUC’s 

participation was beneficial because the 

RUC is experienced in recommending 

RVUs for the codes that have been 

added to or revised by the CPT Editorial 

Panel since we implemented the PFS in 

1992. By virtue of its multispecialty 

membership and consultation with 

specialty societies, the RUC involves the 

medical community in formulating its 

recommendations. For codes used 

primarily by nonphysician practitioners, 

the Health Care Professionals Advisory 

Committee (HCPAC), a companion to 

the RUC, has made recommendations to 

us. 

As we stated in the previous 5-Year 

Reviews, we retain the responsibility for 

analyzing any comments and 

recommendations received, developing 

the proposed rule, evaluating the 

comments on the proposed rule, and 

deciding whether and how to revise the 

work RVUs for any given service. 

After we sent the RUC the comments 

we received on potentially misvalued 

services, as well as a list of 

approximately 160 services that we had 

identified as being potentially 

misvalued, the RUC identified the 

specialty societies that expressed 

interest in making presentations 

concerning those services. To prepare 

for presentations to the RUC, most 

specialty societies compiled data using 

a standard survey instrument whereby 

respondents compared the surveyed 

service with similar ‘‘reference’’ services 

that have established, agreed upon work 

values. Respondents were asked to 

estimate: the work 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 respondent. Each specialty 

society selected the physician sample 

that was surveyed. A minimum of 30 

responses was required by the RUC for 

the survey to be considered adequate. 

For this 5-Year Review, the RUC 

permitted a specialty society to use a 

‘‘minisurvey’’ for some codes if the 

number of codes a specialty society was 

reviewing was extremely high. These 

minisurveys required less information 

from the respondent, but were similar in 

design. In addition, the RUC approved 

the use of information from the National 

Surgical Quality Improvement Program 

(NSQIP) database and the Society of 

Thoracic Surgeons (STS) national 

database in the valuation of some 

services. 

The NSQIP was started by the 

Department of Veterans Affairs (VA) for 

quality improvement purposes in 1991 

with 128 VA medical centers, but now 

includes a large volume of surgical 

procedures from non-VA medical 

centers as well. The total number of 

cases for VA and non-VA medical 

centers is greater than one million. The 

NSQIP database contains pre-, intra-, 

and post-operative data, including intraservice times and length of stay data. 

The STS National database is a 

voluntary reporting system for the 

collection of outcomes data related to 

thoracic surgical services. This database 

currently contains over two million 

patient records collected from more 

than 450 practices (from 1995 through 

2004). Over 70 percent of the hospitals 

currently performing heart surgeries in 

the U.S. reportedly participate in this 

database. 

Some specialty societies used a 

‘‘building-block’’ approach to validate 

the survey results for surgical services. 

In constructing the building blocks, a 

service is divided into pre-, intra-, and 

post-service components. The preservice component consists of all 

services furnished before the physician 

makes the skin incision (for example, 

pre-operative evaluation and scrubbing); 

the intra-service component consists of 

the ‘‘skin-to-skin’’ time; and the postservice component includes immediate 

post-surgery services and subsequent 

hospital and office visits. Each 

component (or building block) is then 

assigned work RVUs. Pre-service and 

intra-service work RVUs are based on 

time and the intensity of the activities, 

and post-service work is based on the 

specified E/M service for each postoperative visit. These three values are 

then summed to compute ‘‘buildingblock’’ work RVUs. 

The results of the surveys were 

reviewed and organized by the specialty 

societies and then presented to the RUC. 

The RUC used eight workgroups, 

comprised of RUC members, to evaluate 

a series of clinically related codes based 

on the survey results and additional 

discussion. The workgroups also 

evaluated the relative work (time and 

intensity) for each service compared to 

other services on the fee schedule. The 

workgroups submitted their 

recommendations to the full RUC, 

which then considered the workgroup 

reports and then sent the final RUC 

recommendations to us. 

II. Discussion of Comments and 

Decisions 

A. Review of Comments 

As previously stated, we sent the RUC 

a list of codes for review. The RUC 

submitted work RVU recommendations 

for these codes, with the exception of 

the codes that were withdrawn or 

referred to the CPT Editorial Panel for 

further review or action, and one CPT 

code (32020) for which no specialty 

society expressed an interest in 

conducting a survey. In the future, we 

will consider an alternative method to 

re-evaluate codes when no specialties 

express an interest in conducting a 

survey and we would appreciate 

suggestions from commenters on what 

alternative methods could be used. 

We analyzed all of the RUC 

recommendations by evaluating the 

methodology used by each workgroup to 

develop the recommendations, the 

recommended work RVUs, and the 

rationale for the recommendations. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37173 

When appropriate and feasible, if we 

had concerns about the application of a 

particular methodology, we assessed 

whether the recommended work RVUs 

were appropriate by using alternative 

methodologies. 

In conducting our review of the RUC 

recommendations we considered 

whether: (1) The code was part of a 

completed survey process; (2) the 

methodology used by the specialty 

society followed the standard RUC 

process; (3) the survey respondents 

stated the work had or had not changed 

in the past 5 years; (4) databases (for 

example, STS, NSQIP, and Medicare 

diagnosis-related group (DRG)) were 

used in lieu of the standard RUC 

methodology or as a supplement to the 

standard methodology; and (5) the intraservice work per unit of time (IWPUT) 

calculation was used to determine work 

RVUs in lieu of the standard RUC 

process. (The IWPUT is derived from 

components of the ‘‘building-block’’

approach, described above, and is used 

as a measure of service intensity.) 

Although CMS recognizes that the work 

values of codes may change over time, 

it is the responsibility of the specialty 

society to present compelling evidence 

that a code is misvalued. 

We have some concerns that many of 

the codes that were reviewed in the 

second 5-Year Review have been 

brought back again for further 

consideration. The main purpose of the 

5-Year Review is to identify those 

services that need to be revalued 

because the work involved in 

performing the service has changed. 

Since there have been three 

opportunities for specialties to have 

services that are believed to be 

undervalued reviewed, we expect that, 

for the most part, only those services 

where there is compelling evidence of a 

change in the work will be considered 

for further review. However, because 

there has been little incentive for 

specialties to bring codes that may be 

overvalued for review, such services 

will still need to be identified for the 

next 5-Year Review. 

Table 1, Five-Year Review of Work 

Relative Value Units, lists the codes 

reviewed during the 5-Year Review. 

This table includes the following 

information: 

• CPT/HCPCS Code. This is the CPT 

or alphanumeric HCPCS code for a 

service. 

• Modifier. A modifier -26 is shown if 

the work RVUs represent the 

professional component of the service. 

• Description. This is an abbreviated 

version of the narrative description of 

the code. 

• 2005 Work RVU. The work RVUs 

that appeared in the CY 2005 Physician 

Fee Schedule final rule with comment 

period are shown for each reviewed 

code. 

• Requested Work RVU. This column 

identifies the work RVUs requested by 

the commenting specialty society or 

individual commenter. If we received 

more than one comment on a code, the 

code is listed more than once with the 

recommended RVUs. If the commenters 

did not recommend specific RVUs, we 

indicate this by ‘‘N/A’’. A ‘‘WD’’

(withdrawal) indicates that the 

commenter withdrew the request for 

review of a code and chose not to 

pursue review of the code under the 5- 

Year Review and that no RUC 

recommendation was received. 

• RUC Recommendation. This 

column identifies the work RVUs 

recommended by the RUC. ‘‘CPT’’

indicates that the RUC referred this code 

to the AMA CPT Editorial Panel for 

review and clarification and 

recommended maintaining the current 

work RVUs. An ‘‘(a)’’ indicates the 

commenting specialty society withdrew 

the proposal, and therefore, the RUC 

recommends maintaining the current 

work RVUs. A ‘‘(b)’’ in this column 

indicates there was no RUC 

recommendation. 

HCPAC Recommendation. This 

column identifies the work RVUs 

recommended by the HCPAC. An ‘‘(a)’’

indicates that the commenting specialty 

society withdrew the proposal; 

therefore, the HCPAC recommends 

maintaining the current work RVUs. A 

‘‘(b)’’ in this column indicates there was 

no HCPAC recommendation. 

• CMS Proposal. This column 

indicates whether we agreed with the 

RUC recommendation (‘‘Agree’’); we are 

instead proposing to maintain the 

present work RVUs (‘‘Disagree’’); we are 

proposing work RVUs higher than the 

RUC recommendation (‘‘Disagree/+’’); or 

we are proposing work RVUs that are 

less than the RUC recommendation 

(‘‘Disagree/-’’). Codes for which we did 

not accept the RUC recommendation are 

discussed in greater detail following 

Table 1. A ‘‘(c)’’ in this column 

indicates that in the absence of a RUC/ 

HCPAC recommendation we are 

proposing to maintain the present work 

RVUs. 

• Proposed base work RVU. This 

column contains the 2007 proposed 

work RVUs. The proposed work RVUs 

for surgical services with a 10- or 90-day 

global period do not include the 

application of the RUC-recommended 

work values for E/M services. However, 

the additional work value attributed to 

the increase for E/M services included 

as part of the global period is reflected 

in the work RVUs contained in 

Addenda B and C of this proposed rule. 

(Note: ** denotes codes that were 

deleted for 2006.) 

The following is a summary of our 

response to the RUC-recommended 

work RVUs for the 5-Year Review of 

work. We sent the RUC approximately 

709 codes to review. The RUC referred 

136 codes to the CPT Editorial Panel for 

review and 151 codes were withdrawn 

by the specialty societies. We accepted 

the RUC’s recommended work RVUs for 

299 of the services reviewed and 

disagreed with the RUC’s recommended 

work RVUs for 123 of the services 

reviewed. Of the 123 services for which 

we did not accept the RUC’s 

recommended work RVUs, we increased 

the work RVUs for 3 services, 

recommended maintaining the current 

work RVUs for 48 services, and 

decreased the work RVUs for 72 

services. (Note: 12 CPT codes for 

nursing facility and rest home services 

that were referred to the AMA CPT 

Editorial Panel were deleted for 2007.) 

Additionally, the HCPAC reviewed a 

total of 7 services as part of the 5-Year 

Review. Of the 7 services reviewed by 

the HCPAC, we accepted the HCPAC 

recommendations for 1 service, 

recommended maintaining the current 

work RVU for 1 service, decreased the 

work RVUs for 4 services, and 1 code 

was withdrawn by the specialty society. 

BILLING CODE 4120–01–P 


jlentini on PROD1PC65 with NOTICES2
37174 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.020</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37175 


jlentini on PROD1PC65 with NOTICES2EN29JN06.021</GPH>
37176 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.022</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37177 


jlentini on PROD1PC65 with NOTICES2EN29JN06.023</GPH>
37178 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.024</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37179 


jlentini on PROD1PC65 with NOTICES2EN29JN06.025</GPH>
37180 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.026</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37181 


jlentini on PROD1PC65 with NOTICES2EN29JN06.027</GPH>
37182 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.028</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37183 


jlentini on PROD1PC65 with NOTICES2EN29JN06.029</GPH>
37184 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.030</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37185 


jlentini on PROD1PC65 with NOTICES2EN29JN06.031</GPH>
37186 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.032</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37187 


jlentini on PROD1PC65 with NOTICES2EN29JN06.033</GPH>
37188 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

BILLING CODE 4120–01–C 


jlentini on PROD1PC65 with NOTICES2EN29JN06.034</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37189 

B. Discussion of Comments by Clinical 

Area 

1. Dermatology and Plastic Surgery 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS–DERMATOLOGY AND 

PLASTIC SURGERY’’ at the beginning 

of your comments.] 

a. Hidradenitis 

The American Society of Plastic 

Surgeons (ASPS) submitted the 

hidradenitis services (CPT codes 11450, 

11451, 11462, 11463, 11470 and 11471) 

as undervalued but, based on the very 

low response rate to the survey they 

conducted the ASPS withdrew these 

codes from the 5-Year Review. 

b. Craniofacial Surgery 

The ASPS originally requested that 10 

craniofacial reconstruction and fracture 

codes be reviewed. ASPS conducted a 

standard RUC survey for these services 

and, based on the low survey response 

rate, withdrew the following six CPT 

codes from the 5-Year Review: 21365, 

21366, 21432, 21435, 21436, and 21470. 

ASPS presented survey data for the 

remaining four CPT codes listed in 

Table 2 to the RUC indicating there is 

compelling evidence that these codes 

had been valued based on an incorrect 

assumption regarding the value of the 

bone graft portion of each service. 

TABLE 2 

CPT code Descriptor 

21145 ..................... Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts). 

21146 ..................... Reconstruction midface, LeFort I; two pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (e.g., ungrafted unilateral alveolar cleft). 

21147 ..................... Reconstruction midface, LeFort I; three or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (e.g., ungrafted bilateral alveolar cleft or multiple osteotomies). 

21395 ..................... Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft). 

RUC Recommendations 

The RUC agreed that the appropriate 

increment of work for the bone graft 

should be 50 percent of CPT code 

20902, Bone graft, any donor area; 

major or large (7.54 work RVUs × 50 

percent = 3.77 work RVUs). The RUC 

recommended that this increment of 

3.77 be used and added to the base code 

for each of these services. 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

21145 = 21.84 work RVUs; 21146 = 

22.55 work RVUs, 21147 = 23.32 work 

RVUs; and 21395 = 13.88 work RVUs. 

CMS Proposed Valuation 

We agree with the RUC 

recommendations for craniofacial 

surgery services. 

c. Other Plastic Surgery Services 

ASPS initially submitted five 

additional services for review (see Table 

3). However, the specialty society was 

unable to obtain an adequate survey 

response rate for these codes and 

withdrew them from the RUC review. In 

addition, the RUC recommended that 

CPT code 15831 should be referred to 

the CPT Editorial Panel for review to 

capture the new population of patients 

using this service. 

TABLE 3 

CPT code Descriptor 

11960 ..................... Insertion of tissue expander(s) for other than breast, including subsequent expansion. 

15831 ..................... Excision, excessive skin and subcutaneous tissue (including lipectomy); abdomen (abdominoplasty). 

19361 ..................... Breast reconstruction with latissimus dorsi flap, with or without prosthetic implant. 

43496 ..................... Free jejunum transfer with microvascular anastomosis. 

49906 ..................... Free omental flap with microvascular anastomosis. 

We submitted four plastic surgery 

services for the 5-Year Review as 

services that had never been reviewed 

by the RUC (see Table 4). In addition, 

CPT code 15732 was submitted as it had 

been valued as an inpatient service and 

it is now performed as an outpatient 

service. 

TABLE 4 

CPT code Descriptor 

15100 ..................... Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or one percent of body area of infants and children (except 15050). 

15240 ..................... Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, 

hands, and/or feet; 20 sq cm or less. 

15732 ..................... Muscle, myocutaneous, or fasciocutaneous flap; head and neck (e.g., temporalis, masseter muscle, sternocleidomastoid, 

levator scapulae). 

15734 ..................... Muscle, myocutaneous, or fasciocutaneous flap; trunk. 


jlentini on PROD1PC65 with NOTICES2
37190 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

RUC Recommendations 

The RUC was convinced that the 

survey data validated the current 

valuation of CPT codes 15100, 15240, 

and 15734. The RUC recommended that 

the current work RVUs be maintained 

for these CPT codes as follows: 15100 = 

9.04 work RVUs; 15240 = 9.03 work 

RVUs; and 15734 = 17.76 work RVUs. 

The RUC reviewed and discussed the 

issue concerning the change in setting 

from inpatient to outpatient for CPT 

code 15732 and determined that this 

code describes two disparate 

procedures; therefore, the RUC 

recommended that this CPT code be 

forwarded to the CPT Editorial Panel for 

review. 

CMS Proposed Valuation 

We agree with the RUC 

recommendations for these plastic 

surgery services. 

d. Other Dermatology Services 

The American Academy of 

Dermatology (AAD) and a 

pharmaceutical company submitted 

CPT code 96567, Photodynamic therapy 

by external application of light to 

destroy premalignant and/or malignant 

lesions of the skin and adjacent mucosa 

(e.g., lip) by activation of photosensitive 

drug(s), each phototherapy exposure 

session, for the 5-Year Review but, 

subsequent to discussions with the RUC 

regarding the need for potential CPT 

revisions, withdrew the code from the 5- 

Year Review. 

We submitted the CPT codes for 

integumentary services in Table 5 for 

review because they had never been 

previously reviewed by the RUC. 

TABLE 5 

CPT code Descriptor 

11100 ..................... Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single 

lesion. 

12052 ..................... Layer closure of wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm.

13121 ..................... Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm. 

14040 ..................... Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less. 

14060 ..................... Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less. 

17003 ..................... Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or 

premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; second 

through 14 lesions, each (List separately in addition to code for first lesion). 

17262 ..................... Destruction, malignant lesion (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, 

arms or legs; lesion diameter 1.1 to 2.0 cm. 

17281 ..................... Destruction, malignant lesion (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, 

ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm. 

We requested that CPT code 17003 be 

reviewed because we believe that 

advances in technology have likely 

resulted in a modification to the 

physician work required to accomplish 

the procedure. In discussions at the 

RUC meeting, we noted that new 

Medicare coverage policies related to 

actinic keratoses (AK) have increased 

the reporting of this service to describe 

cryosurgical destruction of AK. 

Standard RUC surveys were conducted 

for all of these services. 

RUC Recommendations 

Based on a review of the survey data, 

the RUC was convinced that the survey 

data validated the current valuation of 

the following services and 

recommended the work RVUs for these 

CPT codes be maintained as follows: 

11100 = 0.81 work RVUs; 12052 = 2.77 

work RVUs; 13121 = 4.32 work RVUs; 

14040 = 7.86 work RVUs; 14060 = 8.49 

work RVUs; 17262 = 1.58 work RVUs; 

and 17281 = 1.72 work RVUs. 

For CPT code 17003, the RUC 

reviewed previous and current survey 

data and agreed that the application of 

cryosurgery to each lesion requires no 

more than two minutes of physician 

time. Therefore, the RUC recommended 

a work RVU of 0.07 for CPT code 17003. 

The RUC determined that the revision to 

the work RVUs for CPT code 17003 

created a rank order anomaly in this 

family of codes. In addition to referring 

codes in this family to the CPT Editorial 

Panel to clarify the code descriptors, the 

RUC in February 2006 also 

recommended a change to the work 

RVUs for CPT code 17004, Destruction 

(e.g., laser surgery, electrosurgery, 

cryosurgery, chemosurgery, surgical 

curettement), all benign or premalignant 

lesions (e.g., actinic keratoses) other 

than skin tags or cutaneous vascular 

proliferative lesions; 15 or more lesions. 

This was based on the understanding 

that when rank order anomalies were 

identified, the specialty could bring 

these additional codes forward for 

consideration for re-evaluation under 

the 5-Year Review at the next RUC 

meeting (that is, February 2006). 

A standard RUC survey was 

conducted for this code and based on 

the survey responses, the specialty 

society recommended a change in the 

intra-service work descriptions to reflect 

a greater time based on their belief that 

the destruction of premalignant lesions 

requires more time than benign lesions. 

Thus, the intra-service period for CPT 

code 17004 was changed to 20 minutes 

which is twice as much as the time 

associated with the destruction of 

benign lesion in CPT code 17111, 

Destruction (e.g., laser surgery, 

electrosurgery, cryosurgery, 

chemosurgery, surgical curettement), of 

flat warts, molluscum contagiosum, or 

milia; 15 or more lesions, of 10 minutes. 

The RUC agreed to this time change and 

recommended work RVUs of 1.80 for 

CPT code 17004. 

CMS Proposed Valuation 

We are in agreement with the RUCrecommended work RVUs for these 

services with the exception of CPT code 

17004. For CPT code 17004, we believe 

that the work associated with benign 

and premalignant lesions is comparable 

and, therefore, the work RVUs for CPT 

code 17004 should be more similar to 

that of CPT code 17111, which is 0.92. 

Based on our proposed valuation of 

17003 (the code used for 2–14 lesions), 

of 0.07 work RVUs, the 14th lesion 

would equal 0.91 work RVUs (0.07 × 13 

lesions) plus 0.6 work RVUs for the 

initial lesion, that is, base code CPT 

code 17000, which is billed once in 

conjunction with 17003. We are 

proposing to value CPT code 17004, for 

15 or more lesions, at 1.58 work RVUs 

by adding the 0.07 work RVU increment 

of 17003 and the 0.6 work RVUs for the 

base code, CPT code 17000, which is 

not billed in conjunction with CPT code 

17004. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37191 

e. Mohs Surgery 

We referred the Mohs surgery codes 

for review because this family of 

services has never been surveyed and 

reviewed by the RUC (see Table 6). 

TABLE 6 

CPT code Descriptor 

17304 ..................... Chemosurgery (Mohs micrographic technique), including removal of all gross tumor, surgical excision of tissue specimens, 

mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and complete 

histopathologic preparation including the first routine stain (e.g., hematoxylin and eosin, toluidine blue); first stage, fresh

tissue technique, up to 5 specimens. 

17305 ..................... Chemosurgery (Mohs micrographic technique), including removal of all gross tumor, surgical excision of tissue specimens, 

mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and complete 

histopathologic preparation including the first routine stain (e.g., hematoxylin and eosin, toluidine blue); second stage, 

fixed or fresh tissue, up to 5 specimens). 

The specialty society conducted 

surveys to collect data for these two 

codes. The workgroup then reviewed 

the history of these services, including 

the fact that the nomenclature for these 

services is not consistent with other 

integumentary coding conventions in 

CPT and that the RUC had previously 

indicated that the specialty society 

should work with the CPT Editorial 

Panel to redefine these services. 

RUC Recommendations 

The RUC recommended that these 

CPT codes be referred to the CPT 

Editorial Panel. 

CMS Proposed Valuation 

We will maintain the current 

valuation for these services pending the 

results of the review of the CPT 

Editorial Panel. 

f. Excision of Lesions 

We submitted all of the excision of 

lesion codes for review, noting that 

these services should be surveyed and 

reviewed by the RUC (see Table 7—

benign: CPT codes 11400 through 

11446, and malignant: CPT codes 11600 

through 11646). 

The work RVUs for the codes 

predominantly performed by the 

surgical specialties (CPT codes 

representing services to excise larger 

lesions) were all valued, with the 

exception of two CPT codes, by 

acceptable RUC surveys. However, there 

were no acceptable RUC surveys for the 

18 services predominantly performed by 

the dermatologists (CPT codes 

representing services to excise smaller 

lesions) due to incomplete surveys and 

low response rates. 

RUC Recommendations 

The RUC agreed that the primary 

difference in the work between the 

family of codes for excision of benign 

lesions versus those codes for excision 

of malignant lesions (see Table 7) is in 

the pre-evaluation time (that is, 

additional planning, and discussions 

with the patient), the intensity of the 

intra-service time, and the level of postoperative visit. 

The workgroup used the RUC surveys 

to determine the work RVUs for those 

services performed by the surgeons and 

then applied the building-block 

approach using the IWPUT values of the 

codes primarily performed by the 

surgical specialties to derive IWPUT 

values and corresponding work RVUs 

for the CPT codes primarily performed 

by dermatology. (The IWPUT is derived 

by dividing the intra-service work by 

the intra-service time, and is used to 

measure the relative intensity of the 

work between services.) 

As a result of the application of the 

building-block methodology to the 

codes without RUC acceptable surveys, 

the RUC recommended that 24 codes 

retain their current work RVUs, 5 codes 

have decreased work RVUs, and 7 codes 

have increased work RVUs. The specific 

RUC recommendations for these CPT 

codes are presented in Table 7. 


jlentini on PROD1PC65 with NOTICES2
37192 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.035</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37193 


jlentini on PROD1PC65 with NOTICES2EN29JN06.036</GPH>
37194 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.037</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37195 

BILLING CODE 4120–01–C 

CMS Proposed Valuation 

We are in agreement with the RUC 

recommendations for the excision of 

lesions services. 

2. Orthopedic Surgery 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS—ORTHOPEDIC 

SURGERY’’ at the beginning of your 

comments.] 

a. Tumor Procedures 

The American Academy of 

Orthopaedic Surgeons (AAOS) 

submitted CPT codes in the following 

three families of tumor procedures for 

review. (See Table 8, Table 9, and Table 

10.) 

TABLE 8.—FAMILY 1—EXCISION OF DEEP SOFT TISSUE MASS

CPT code Description 

21556 ..................... Excision tumor, soft tissue of neck or thorax; deep, subfascial, intramuscular 

23076 ..................... Excision, soft tissue tumor, shoulder area; deep, subfascial, or intramuscular. 

24076 ..................... Excision, tumor, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular). 

25076 ..................... Excision, tumor, soft tissue of forearm and/or wrist area; deep (subfascial or intramuscular). 

27048 ..................... Excision, tumor, pelvis and hip area; deep, subfascial, intramuscular. 

27328 ..................... Excision, tumor, thigh or knee area, deep, subfascial, or intramuscular. 

27619 ..................... Excision, tumor, leg or ankle area; deep (subfascial or intramuscular). 

28045 ..................... Excision, tumor, foot; deep, subfascial, intramuscular. 

TABLE 9.—FAMILY 2—RADICAL RESECTION OF SOFT TISSUE SARCOMA

CPT code Description 

24077 ..................... Radical resection of tumor (e.g., malignant neoplasm), soft tissue of upper arm or elbow area. 

25077 ..................... Radical resection of tumor (e.g., malignant neoplasm), soft tissue of forearm and/or wrist area. 

27049 ..................... Radical resection of tumor, soft tissue of pelvis and hip area (e.g., malignant neoplasm). 

27329 ..................... Radical resection of tumor (e.g., malignant neoplasm), soft tissue of thigh or knee area. 

27615 ..................... Radical resection of tumor (e.g., malignant neoplasm), soft tissue of leg or ankle area). 

TABLE 10.—FAMILY 3—RADICAL RESECTION OF BONE SARCOMA

CPT code Description 

21935 ..................... Radical resection of tumor (e.g., malignant neoplasm), soft tissue of back or flank. 

23200 ..................... Radical resection for tumor; clavicle. 

23210 ..................... Radical resection for tumor; scapula. 

23220 ..................... Radical resection of bone tumor, proximal humerus. 

24150 ..................... Radical resection for tumor, shaft or distal humerus. 

24151 ..................... Radical resection for tumor, shaft or distal humerus; with autograft (includes obtaining graft). 


jlentini on PROD1PC65 with NOTICES2EN29JN06.038</GPH>
37196 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

TABLE 10.—FAMILY 3—RADICAL RESECTION OF BONE SARCOMA—Continued 

CPT code Description 

24152 ..................... Radical resection for tumor, radial head or neck. 

24153 ..................... Radical resection for tumor, radial head or neck; with autograft (includes obtaining graft). 

25170 ..................... Radical resection for tumor, radius or ulna. 

27076 ..................... Radical resection of tumor or infection; ilium, including acetabulum, both pubic rami, or ischium and acetabulum. 

27078 ..................... Radical resection of tumor or infection; ischial tuberosity and greater trochanter of femur. 

27365 ..................... Radical resection of tumor, bone, femur or knee. 

27645 ..................... Radical resection of tumor, bone; tibia. 

27646 ..................... Radical resection of tumor, bone; fibula. 

27647 ..................... Radical resection of tumor; talus or calcaneus. 

The specialty subsequently withdrew 

CPT codes 21935, 24151, and 24153 

from the 5-Year Review. A minisurvey 

methodology was used for all three 

families of codes. 

RUC Recommendations 

Based on a review of the survey 

results for the codes in Families 1 and 

2, the RUC recommended referring these 

codes to the CPT Editorial Panel for 

clarification. The RUC indicated that the 

survey data from the specialty society 

described a hospitalized patient as the 

typical patient. However, our data 

indicates that the typical patient is not 

hospitalized and that this inconsistency 

could be the result of ambiguous CPT 

descriptors. 

For the services in Family 3, the RUC 

discussion focused on the issue of 

whether there may also be different 

patient populations covered by each of 

these codes. 

The RUC also recommended referring 

the codes in Family 3 to the CPT 

Editorial Panel for clarification. 

CMS Proposed Valuation 

We will maintain the current 

valuation for these services pending the 

results of the review by the CPT 

Editorial Panel. 

b. Trauma Procedures 

The AAOS submitted the following 

trauma procedure codes for review (see 

Table 11). Standard RUC surveys of 

these services were conducted. 

TABLE 11 

CPT code Description 

20680 ..................... Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate). 

20692 ..................... Application of a multiplane (pins or wires in more than one plane), unilateral, external fixation system (e.g., Ilizarov, 

Monticelli type). 

24430 ..................... Repair of nonunion or malunion, humerus; without graft (e.g., compression technique). 

27465 ..................... Osteoplasty, femur; shortening (excluding 64876). 

27470 ..................... Repair, nonunion or malunion, femur, distal to head and neck; without graft (e.g., compression technique). 

27472 ..................... Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogeneous bone graft (includes obtaining graft). 

27709 ..................... Osteotomy; tibia and fibula. 

27720 ..................... Repair of nonunion or malunion, tibia; without graft, (e.g., compression technique). 

RUC Recommendations 

Based on a review of the compelling 

evidence, the RUC made the following 

recommendations. 

For CPT code 20680, the RUC agreed 

that the intra-operative time for this 

code is misvalued based on the 

significant changes in physician work 

for the removal of deep implants due to 

changes in technology. Using the 

survey’s 25th percentile value for the 

work RVUs along with the 25th 

percentile value for intra-service time, 

and adjusting for the fact that this 

procedure is typically performed in an 

outpatient setting, the RUC 

recommended a work RVU of 5.86 for 

this service. 

For CPT code 24430, the workgroup 

did not believe that the current work 

value for CPT code 24430 accounts for 

all the work typically involved with this 

service. This is based on the survey’s 

physician time and visit data and a 

comparison to CPT code 24515, Open 

treatment of humeral shaft fracture with 

plate/screws, with or without cerclage, 

which is a less complex procedure than 

CPT code 24430. The RUC 

recommended a work RVU of 14.00 and 

an intra-service time of 102 minutes for 

this service, which was the 25th 

percentile for work of the survey data. 

Based on a comparison to CPT code 

27506, Open treatment of femoral shaft 

fracture, with or without external 

fixation, with insertion of 

intramedullary implant, with or without 

and/or locking screws, the workgroup 

determined that the current work RVUs 

for CPT code 27465, do not fully 

account for the work typically involved 

in shortening the femur because it 

typically includes the insertion of an 

intermedullary nail. However, the 

workgroup believed that CPT code 

27465 should be valued lower than the 

reference service code, CPT code 27454, 

Osteotomy, multiple, with realignment 

on intramedullary rod, femoral shaft 

(e.g., Sofield type procedure), which has 

a work RVU of 17.53, and is a greater 

intensity procedure. The RUCrecommended work RVU for CPT code 

27645 was 17.50, based on the median 

of the survey data. 

Based on a review of the survey data, 

the workgroup did not believe that there 

was compelling evidence to change the 

work RVU for CPT code 27470. 

Therefore, the RUC recommended that 

the current work RVU of 16.05 be 

maintained for this service. However, 

the workgroup also recommended using 

the new survey times as they believed 

the Harvard times from the original 

Harvard relative value study, which was 

used to establish RVUs at the outset of 

the Medicare PFS, are inflated. 

For CPT code 27709, Osteotomy; tibia 

and fibula, the RUC reviewed the survey 

time and compared this service to CPT 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37197 

code 27705, Osteomy, tibia, which has 

a work RVU of 10.36. The RUC 

recommended a work RVU of 16.50 for 

CPT code 27709 which would place the 

code in proper rank order with CPT 

code 27705. 

The RUC recommended the referral of 

CPT codes 20692, 27472, and 27720 to 

the CPT Editorial Panel to clarify 

whether these 90-day global period 

codes should be exempt from modifier 

51. (Modifier 51 denotes that a multiple 

procedure was performed.) The RUC 

was concerned that attempting to value 

these codes would lead to double 

counting some of the work. 

The RUC-recommended valuation for 

these CPT codes was as follows: 20680 

= 5.86 work RVUs; 24430 = 14.00 work 

RVUs; 27465 = 17.50 work RVUs; 27470 

= 16.05 work RVUs; and 27709 = 16.50 

work RVUs. 

CMS Proposed Valuation 

We are in agreement with the RUCrecommended work values for these 

trauma services. 

c. Total Elbow and General Procedures 

AAOS submitted the following elbow 

athroplasty service for review (see Table 

12). 

TABLE 12 

CPT code Description 

24363 ..................... Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (e.g., total elbow). 

In addition, we submitted the 

following CPT codes, in Table 13, for 

review. 

TABLE 13 

CPT code Description 

20600 ..................... Arthrocentesis, aspiration and/or injection; small joint or bursa (e.g., fingers, toes). 

20610 ..................... Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa). 

29075 ..................... Application, cast; elbow to finger (short arm). 

Standard RUC surveys of these 

services were conducted. 

RUC Recommendations 

The RUC recommended maintaining 

the current work RVUs for CPT codes 

20600, 20610, and 29075 because of the 

low response rate for the surveys and 

the lack of compelling evidence for 

changing the work value. 

Based on a review of the survey data 

and information provided by the 

presenting specialty societies, AAOS 

and the American Society of Shoulder 

and Elbow Surgeons, the RUC 

concluded that the CPT code 24363 

should be valued the same as CPT code 

23472, Arthroplasty, glenohumeral 

joint; total shoulder (glenoid and 

proximal humeral replacement (e.g., 

total shoulder), and recommended a 

work RVU of 21.07 to maintain 

appropriate rank-order alignment with 

this family of codes. The RUCrecommended valuation for these CPT 

codes was as follows: 20600 = 0.66 work 

RVUs; 20610 = 0.79 work RVUs; 24363 

= 21.07 work RVUs; and 29075 = 0.77 

work RVUs. 

CMS Proposed Valuation 

We agree with the RUC-recommended 

work RVUs for these elbow and general 

procedure services. 

d. Wrist, Hand and Finger 

We submitted the CPT codes in Table 

14 for review. 

TABLE 14 

CPT code Description 

25447 ..................... Arthroplasty, interposition, intercarpal or carpometacarpal joints. 

26055 ..................... Tendon sheath incision (e.g., for trigger finger). 

26160 ..................... Excision of lesion of tendon sheath or joint capsule (e.g., cyst, mucous cyst, or ganglion), hand or finger. 

26600 ..................... Closed treatment of metacarpal fracture, single; without manipulation, each bone. 

26951 ..................... Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure. 

64721 ..................... Neuroplasty and/or transposition; median nerve at carpal tunnel. 

CPT code 64702, Neuroplasty; digital, 

one or both, same digit, was submitted 

by the American Society for Surgery of 

the Hand (ASSH) with the rationale that 

this code is based on inaccurate Harvard 

physician times that are low compared 

to other hand surgery codes. Standard 

RUC surveys of these services were 

conducted. 

RUC Recommendations 

Based on a review of the survey data, 

the RUC recommended that the current 

work RVUs be maintained for CPT 

codes 25447, 26055, 26160, and 64721. 

For CPT code 26600, the workgroup 

examined the survey data presented by 

the specialty society and agreed that the 

current work value of 1.96 RVUs may 

not fully reflect the value of all postoperative visits that are the current 

standard of care and that the CPT code 

most frequently cited as a reference 

code (CPT code 26720, Closed treatment 

of phalangeal shaft fracture, proximal 

or middle phalanx, finger or thumb; 

without manipulation, each), also 

understates the number of postoperative visits. The workgroup 

validated the survey median value of 

2.40 work RVUs by performing a 


jlentini on PROD1PC65 with NOTICES2
37198 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

building-block calculation that added 

the value of an additional post-operative 

visit (CPT code 99212 at 0.43 work 

RVUs) to the current work value for CPT 

code 26600 of 1.96 for a total of 2.39 

work RVUs. Since this value was almost 

identical to the median survey value of 

2.40, the RUC recommended accepting 

this median value for the work RVUs for 

CPT code 26600. 

For CPT code 26951, the RUC 

workgroup agreed that the current value 

of 4.58 work RVUs for this code creates 

a rank order anomaly when compared to 

the reference code (CPT code 26185, 

Sesamoidectomy, thumb or finger 

(separate procedure)), which has a work 

RVU of 5.24. Based on a review of 

survey data, the RUC recommended that 

CPT code 26951 should be assigned 

work RVUs of 5.25 (the 25th percentile 

survey value) but that the survey 

median intra-service time of 45 minutes 

should be used since that is equal to the 

reference code. 

For CPT code 64702, the RUC 

workgroup agreed that the current value 

for this service of 4.22 work RVUs does 

not include the number of postoperative days typically associated with 

this procedure. The workgroup believed 

that adding the work RVUs (1.3 work 

RVUs) associated with two additional 

outpatient visits, represented by CPT 

code 99213, produces an appropriate 

work RVU for this service and also 

places CPT code 64702 in the proper 

rank order with the reference service. 

The RUC recommended 5.52 work 

RVUs for CPT code 64702. 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

25447 = 10.35 work RVUs; 26055 = 2.69 

work RVUs; 26160 = 3.15 work RVUs; 

26600 = 2.40 work RVUs; 26951 = 5.25 

work RVUs; 64702 = 5.52 work RVUs; 

and 64721 = 4.28 work RVUs. 

CMS Proposed Valuation 

We are in agreement with the RUCrecommended work values for wrist, 

hand and finger services. 

e. Total Joint and Hip Fracture 

We submitted three CPT codes for 

review (see Table 15). 

TABLE 15 

CPT code Description 

27130 ..................... Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or 

allograft. 

27236 ..................... Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement. 

27447 ..................... Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee 

arthroplasty). 

The specialty society did not submit 

surveys for these codes, which is the 

accepted RUC method, for the RUC’s 

consideration of changes to current 

work RVUs. Instead the specialty 

society developed proposed values for 

these services based on data obtained 

from the VA NSQIP database and the 

Medicare DRG database. The specialty 

society did survey its membership to 

obtain the data, but did not provide the 

workgroup or the RUC with this 

information, stating the vignettes did 

not describe a typical patient for this 

series of codes. Thus, the survey data for 

these codes was not available for the 

RUC workgroup to review at its August 

2005 meeting. 

The RUC requested that the specialty 

society survey its members on these 

three codes so that survey data could be 

used to evaluate the codes at the 

September 2005 RUC meeting. The 

specialty society used survey data, as 

well as NSQIP data and Medicare DRG 

data, to evaluate pre-service and intraservice times for these codes. The 

workgroup, as well as the RUC, was 

uncomfortable with mixing data from 

three separate sources in lieu of the 

established and accepted methodology 

of the RUC. The specialty society 

maintained the NSQIP data was more 

accurate than the survey data. 

RUC Recommendations 

The RUC did not find any compelling 

evidence to change the current work 

RVUs assigned to these services. Based 

on a review of the data, the RUC 

recommended maintaining the current 

work RVUs of 20.09 for CPT code 

27130, 15.58 for CPT code 27236 and 

21.45 for CPT code 27447, but also 

recommended using the new physician 

time data for each of these services. 

CMS Proposed Valuation 

For these three CPT codes (27130, 

27236,and 27447), the specialty society 

used NSQIP and Medicare DRG data 

instead of the standard RUC survey 

methodology to create an intra-service 

time. Medicare DRG data has not been 

used by CMS or the RUC to evaluate 

new or existing CPT codes. CPT code 

27130 has never been reviewed by the 

RUC. It currently has 20.09 work RVUs 

which is based on the following Harvard 

time data: pre-service time of 68 

minutes, intra-service time of 128 

minutes, post-service time of 36 minutes 

and eight hospital days. We believe that 

this service can be compared to CPT 

codes 43641, Vagotomy including 

pyloroplasty, with or without 

gastrostomy; parietal cell (highly 

selective), and 60260, Thyroidectomy, 

removal of all remaining thyroid tissue 

following previous removal of a portion 

of thyroid. Both codes were reviewed by 

the RUC during the second 5-Year 

Review. CPT code 43641 has 60 minutes 

pre-service time, 150 minutes intraservice time, 30 minutes post-service 

time, and 6 hospital days, resulting in 

work RVUs of 17.24. CPT code 60260 

has 60 minutes pre-service time, 145 

minutes intra-service time and 30 

minutes post-service time with 2 

hospital days, resulting in work RVUs of 

17.44. We believe CPT code 27130 is 

similar in work and intensity to CPT 

code 43641, and if one removes 2 

hospital days (code 99231), this would 

result in a work RVU of 15.96. 

Therefore, we recommend a work RVU 

of 15.96 for CPT code 27130. 

CPT code 27236 has never been 

reviewed by the RUC. It has a preservice time of 74 minutes, an intraservice time of 89 minutes, a postservice time of 27 minutes, 100 minutes 

for hospital days, and 57 minutes for 

office visits for a total time of 347 

minutes based on the Harvard time data, 

resulting in work RVUs of 15.58. We 

believe CPT codes 34421, 

Thrombectomy, direct or with catheter; 

vena cava, iliac, femoropopliteal vein, 

by leg incision, and 47600, 

Cholecystectomy, which were included 

in the second 5-Year Review, are similar 

in work intensity and time to CPT code 

27236. CPT code 34421 has a preservice time of 70 minutes, an intraservice time of 95 minutes, a postservice time of 221 minutes, and total 

time of 386 minutes, resulting in work 

RVUs of 11.98. CPT code 47600 has a 

pre-service time of 75 minutes, an intraservice time of 80 minutes, and a postservice time of 194 minutes for a total 

time of 349 minutes, resulting in work 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37199 

RVUs of 13.56. We propose a work RVU 

of 12.77 for CPT code 27236, which is 

the median value for these two codes 

and maintains relativity within this 

family of codes. 

CPT Code 27447 has never been 

reviewed by the RUC. It has 21.45 work 

RVUs, which is based on the following 

Harvard time data: pre-service time of 

60 minutes, intra-service time 139 

minutes, post-service time of 37 

minutes, 118 minutes for hospital days, 

and 54 minutes for office visits for a 

total time of 408 minutes. We believe 

this service is comparable to CPT code 

35671, Bypass graft, with other than 

vein; popliteal-tibial or -peroneal artery, 

which was reviewed during the second 

5-Year Review. This service has a preservice time of 70 minutes, an intraservice time of 135 minutes, and a postservice time of 206 minutes for a total 

time of 411 minutes, resulting in work 

RVUs of 19.30. We believe CPT code 

27447 is similar in work intensity and 

time to CPT code 35671 and propose 

work RVUs of 19.30 for CPT code 

27447. 

f. Additional Fracture Codes 

The AAOS also submitted the 

following CPT codes listed in Table 16 

and the ASSH submitted CPT code 

25620. However, the specialty societies 

believed clarification was needed for the 

CPT descriptor for these services, as 

there was a question whether the 

current valuation for these codes 

includes the application of internal and 

external fixation to a fracture site. 

TABLE 16 

CPT code Description 

23515 ..................... Open treatment of clavicle fracture, with or without internal or external fixation. 

23585 ..................... Open treatment of scapular fracture (body, glenoid or acromion) with or without internal fixation. 

23615 ..................... Open treatment of proximal humeral (surgical or anatomical neck) fracture, with or without internal or external fixation, with 

or without repair of tuberosity(s). 

23616 ..................... Open treatment of proximal humeral (surgical or anatomical neck) fracture, with or without internal or external fixation, with 

or without repair of tuberosity(s); with proximal humeral prosthetic replacement. 

23630 ..................... Open treatment of greater humeral tuberosity fracture, with or without internal or external fixation.

23670 ..................... Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with or without internal or external fixation. 

23680 ..................... Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, with or without internal or external fixation. 

24545 ..................... Open treatment of humeral supracondylar or transcondylar fracture, with or without internal or external fixation; without 

intercondylar extension. 

24546 ..................... Open treatment of humeral supracondylar or transcondylar fracture, with or without internal or external fixation; with 

intercondylar extension. 

24575 ..................... Open treatment of humeral epicondylar fracture, medial of lateral, with or without internal or external fixation. 

24579 ..................... Open treatment of humeral condylar fracture, medial or lateral, with or without internal or external fixation. 

24635 ..................... Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial 

head), with or without internal or external fixation. 

24665 ..................... Open treatment of radial head or neck fracture, with or without internal fixation or radial head excision. 

24685 ..................... Open treatment of ulnar fracture proximal end (olecranon process), with or without internal or external fixation. 

25515 ..................... Open treatment of radial shaft fracture, with or without internal or external fixation. 

25526 ..................... Open treatment of radial shaft fracture, with internal and/or external fixation and open treatment, with or without internal or 

external fixation of distal radioulnar joint (Galeazzi fracture/dislocation), includes repair of triangular fibrocartilage complex. 

25545 ..................... Open treatment of ulnar shaft fracture, with or without internal or external fixation. 

25574 ..................... Open treatment of radial AND ulnar shaft fractures, with internal or external fixation; of radius OR ulna. 

25575 ..................... Open treatment of radial AND ulnar shaft fractures, with internal or external fixation; of radius AND ulna. 

25620 ..................... Open treatment of distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, with or without fracture of 

ulnar styloid, with or without internal or external fixation. 

25628 ..................... Open treatment of carpal scaphoid (navicular) fracture, with or without internal or external fixation. 

26615 ..................... Open treatment of metacarpal fracture, single, with or without internal or external fixation, each bone. 

26665 ..................... Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), with or without internal or external fixation. 

26685 ..................... Open treatment of carpometacarpal dislocation, other than thumb, with or without internal or external fixation, each joint. 

26715 ..................... Open treatment of metacarpophalangeal dislocation, single, with or without internal or external fixation. 

26735 ..................... Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with or without internal or external fixation, each. 

26746 ..................... Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, with or without internal or external fixation, each. 

26765 ..................... Open treatment of distal phalangeal fracture, finger or thumb, with or without internal or external fixation, each. 

26785 ..................... Open treatment of interphalangeal joint dislocation, with or without internal or external fixation, single. 

27248 ..................... Open treatment of greater trochanteric fracture, with or without internal of external fixation. 

27511 ..................... Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, with or without internal 

or external fixation. 

27513 ..................... Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, with or without internal or 

external fixation. 

27514 ..................... Open treatment of femoral fracture, distal end, medial of lateral condyle, with or without internal or external fixation. 

27519 ..................... Open treatment of distal femoral epiphyseal separation, with or without internal or external fixation. 

27535 ..................... Open treatment of tibial fracture, proximal (plateau); unicondylar, with or without internal of external fixation. 

27540 ..................... Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without internal or external fixation. 

27556 ..................... Open treatment of knee dislocation, with or without internal or external fixation; without primary ligamentous repair of augmentation/reconstruction. 

27766 ..................... Open treatment of medial malleolus fracture, with or without internal or external fixation. 

27784 ..................... Open treatment of proximal fibula or shaft fracture, with or without internal or external fixation. 


jlentini on PROD1PC65 with NOTICES2
37200 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

TABLE 16—Continued 

CPT code Description 

27792 ..................... Open treatment of distal fibular fracture (lateral malleolus), with or without internal or external fixation. 

27814 ..................... Open treatment of bimalleolar ankle fracture, with or without internal or external fixation. 

27822 ..................... Open treatment of trimalleolar ankle fracture, with or without internal or external fixation, medial and/or lateral malleolus; 

without fixation of posterior lip. 

27826 ..................... Open treatment of fracture of weight bearing articular surface/portion of distal tibia (e.g., pilon or tibial plafond), with internal or external fixation; of fibula only. 

27827 ..................... Open treatment of fracture of weight bearing articular surface/portion of distal tibia (e.g., pilon or tibial plafond), with internal or external fixation; of tibia only. 

27828 ..................... Open treatment of fracture of weight bearing articular surface/portion of distal tibia (e.g., pilon or tibial plafond), with internal or external fixation; of both tibia and fibula. 

27829 ..................... Open treatment of distal tibiofibular joint (syndesmosis) disruption, with or without internal or external fixation. 

27832 ..................... Open treatment of proximal tibiofibular joint dislocation, with or without internal or external fixation, or with excision of 

proximal fibula. 

28415 ..................... Open treatment of calcaneal fracture, with or without internal or external fixation. 

28445 ..................... Open treatment of talus fracture, with or without internal or external fixation. 

28465 ..................... Open treatment of tarsal bone fracture (except talus and calcaneus), with or without internal or external fixation, each. 

28485 ..................... Open treatment of metatarsal fracture, with or without internal or external fixation, each. 

28505 ..................... Open treatment of fracture of great toe, phalanx or phalanges, with or without internal or external fixation. 

28525 ..................... Open treatment of fracture, phalanx or phalanges, other than great toe, with or without internal or external fixation, each. 

28555 ..................... Open treatment of tarsal bone dislocation, with or without internal or external fixation. 

28585 ..................... Open treatment of talotarsal joint dislocation, with or without internal or external fixation. 

28615 ..................... Open treatment of tarsometatarsal joint dislocation, with or without internal or external fixation. 

28645 ..................... Open treatment of metatarsophalangeal joint dislocation, with or without internal or external fixation. 

28675 ..................... Open treatment of interphalangeal joint dislocation, with or without internal or external fixation. 

RUC Recommendations 

The RUC recommended that these 

CPT codes be referred to the CPT 

Editorial Panel for review and 

clarification. 

CMS Proposed Valuation 

We will maintain the current 

valuation for these services pending the 

results of the review by the CPT 

Editorial Panel. 

3. Gynecology, Urology, Pain Medicine, 

and Neurosurgery 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS—GYNECOLOGY, 

UROLOGY, PAIN MEDICINE, AND 

NEUROSURGERY’’ at the beginning of 

your comments.] 

a. Obstetrics and Gynecology 

The American College of 

Obstetricians and Gynecologists (ACOG) 

submitted the CPT codes in Table 17 for 

review. 

TABLE 17 

CPT code Description 

49200 ..................... Excision or destruction, open, intra-abdominal or retroperitoneal tumors or cysts or endometriomas. 

49201 ..................... Excision or destruction, open, intra-abdominal or retroperitoneal tumors or cysts or endometriomas; extensive. 

56631 ..................... Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy. 

56632 ..................... Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy. 

56634 ..................... Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy. 

56637 ..................... Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy. 

56640 ..................... Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy. 

57160 ..................... Fitting and insertion of pessary or other intravaginal support device. 

57240 ..................... Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele. 

57250 ..................... Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy. 

57260 ..................... Combined anteroposterior colporrhaphy. 

57265 ..................... Combined anteroposterior colporrhaphy; with enterocele repair. 

57550 ..................... Excision of cervical stump, vaginal approach. 

57555 ..................... Excision of cervical stump, vaginal approach; with anterior and/or posterior repair. 

57556 ..................... Excision of cervical stump, vaginal approach; with repair of enterocele. 

However, the specialty society 

subsequently withdrew the following 

CPT codes: 49200, 49201, 56631, 56632, 

56634, 56637, 56640, 57550, 57555, and 

57556. 

We identified five CPT codes for 

review but withdrew one code, CPT 

code 58260 (see Table 18). 

TABLE 18 

CPT code Description 

57500 ..................... Biopsy, single or multiple, or local excision of lesion, with or without fulguration (separate procedure). 

58120 ..................... Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical). 

58150 ..................... Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s). 

58260 ..................... Vaginal hysterectomy, for uterus 250 grams or less. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37201 

TABLE 18—Continued 

CPT code Description 

58720 ..................... Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure). 

A standard RUC survey with over 30 

responses was used for these codes. 

RUC Recommendations 

The RUC recommended maintaining 

the existing RVUs for CPT codes 57160, 

58120 and 58720. The RUC believed 

there was no compelling evidence 

presented to indicate that there had 

been a change in work for CPT code 

57160. The RUC also agreed with the 

specialty society that the survey data 

collected validated the existing times 

and existing RVUs for CPT codes 58120 

and 58720. 

The RUC recommended increasing 

the work value for the remaining CPT 

codes. The RUC agreed with the 

specialty society that these procedures 

were currently undervalued because of 

rank-order anomalies, changes in 

patient population or incorrect 

assumptions made in the previous 

valuation of the service. However, the 

RUC-recommended work values for 

each service were below the level 

presented by the specialty society. The 

RUC recommended the use of the 

surveys’ 25th percentile work RVUs for 

four of the services, CPT codes 57240, 

57250, 57500 and 58150, and the 75th 

percentile for CPT codes 57260 and 

57265. The 75th percentile was used 

because the workgroup believed that 

otherwise there would be a rank order 

anomaly between the more complex 

vagina repair services, CPT codes 57280 

and 57265, and the simpler procedures, 

CPT codes 57240 and 57250. 

The RUC-recommended work values 

for these services are as follows: 57160 

= 0.89 work RVUs; 57240 = 10.56 work 

RVUs; 57250 = 10.56 work RVUs; 57260 

= 13.50 work RVUs; 57265 = 15.00 work 

RVUs; 57500 = 1.20 work RVUs; 58120 

= 3.27 work RVUs; 58150 = 15.98 work 

RVUs; and 58720 = 11.34 work RVUs. 

CMS Proposed Valuation 

We propose to accept the RUC 

recommendations for these obstetrics 

and gynecology services. We initially 

had concerns with the use of the 

surveys’ 75th percentile for the 

recommendation of work RVUs for CPT 

codes 57260 and 57265, but in 

comparison with similar services, we 

believe that the RUC recommendations 

for these services create the correct rank 

order, both within the family of codes 

and with other similar services. 

b. Urology 

The American Urological Association 

(AUA) and the Coalition for the 

Advancement of Prosthetic Urology 

(CAPU) submitted five CPT codes for 

review (see Table 19). However, the 

specialty society subsequently withdrew 

four CPT codes (53445, 54400, 54405, 

and 54411). 

TABLE 19 

CPT code Description 

51798 ..................... Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging. 

53445 ..................... Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff. 

54400 ..................... Insertion of penile prosthesis; non-inflatable (semi-rigid). 

54405 ..................... Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir. 

54411 ..................... Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at 

the same operative session, including irrigation and debridement of infected tissue. 

In addition, we identified seven CPT 

codes for review because of possible 

changes in technology or because the 

service had never been reviewed by the 

RUC (see Table 20). A standard RUC 

survey with over 30 responses was used 

for the following codes. 

TABLE 20 

CPT code Description 

50590 ..................... Lithotripsy, extracorporeal shock wave. 

51720 ..................... Bladder instillation of anticarcinogenic agent (including detention time). 

52000 ..................... Cystourethroscopy (separate procedure). 

52204 ..................... Cystourethroscopy, with biopsy. 

52601 ..................... Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, 

meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included). 

55700 ..................... Biopsy, prostate; needle or punch, single or multiple, any approach. 

57288 ..................... Sling operation for stress incontinence (e.g., fascia or synthetic). 

RUC Recommendations 

Of the eight codes presented with 

survey data, the RUC recommended 

maintaining the existing work RVUs for 

two codes. For CPT code 57288, the 

RUC believed that the survey median 

supported the specialty society’s 

contention that the work currently 

associated with the code is accurate. For 

CPT code 50590, the RUC believed that 

the current work value more accurately 

reflected the work involved in the 

service than did the survey, which 

increased the work RVUs while 

decreasing the physician intra-time 

substantially. 

The RUC recommended decreasing 

the current work RVUs for CPT code 

51720 to reflect the median work RVU 

from the survey. 

The RUC agreed with the specialty 

society’s recommendations for an 

increase to the existing RVUs for CPT 

code 51798. This procedure was 


jlentini on PROD1PC65 with NOTICES2
37202 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

originally reviewed by the RUC in April 

2002 with a recommendation 0.38 work 

RVUs to reflect the physician work 

believed to be typically associated with 

this procedure. However, in the CY 

2002 Physician Fee Schedule final rule 

with comment period (66 FR 55246), we 

contended that there was no physician 

work associated with this service and 

assigned work RVUs of 0.00. This 

decision was upheld by the refinement 

process that is used to address 

comments received on the valuation of 

new and revised CPT codes and that 

was discussed in the CY 2004 Physician 

Fee Schedule final rule with comment 

period (67 FR 63227). However, the 

RUC agreed with the specialty society 

that this procedure is performed by 

physicians and reaffirmed its previous 

recommendation of 0.38 work RVUs for 

this procedure. 

The RUC recommended increasing 

the work RVUs for four codes, but below 

the level requested by the specialty 

society (that is, recommending work 

RVUs equal to the surveys’ 25th 

percentile for CPT codes 52000 and 

55700, equal to the median for CPT code 

52601 and less than the 25th percentile 

for CPT code 52204). The RUC agreed 

with the specialty society that these 

procedures were currently undervalued 

due to changes in technology, changes 

in patient populations and incorrect 

assumptions that were made in the 

previous valuation of the service. 

The RUC-recommended work values 

for these CPT codes for urology services 

are as follows: 50590 = 9.08 work RVUs; 

51720 = 1.50 work RVUs; 51798 = 0.38 

work RVUs; 52000 = 2.23 work RVUs; 

52204 = 2.59 work RVUs; 52601 = 14.00 

work RVUs; 55700 = 2.58 work RVUs; 

and 57288 = 13.00 work RVUs. 

CMS Proposed Valuation 

We accept the RUC recommendations 

for these urology services except for 

CPT code 51798. The RUC 

recommendation for bladder ultrasound 

was based on CPT code 79857 (the 

pelvic ultrasound (nonobstetric) 

procedure) as the reference code. (CPT 

code 76857 should be used if the 

urinary bladder alone is imaged, 

whereas CPT code 51798 should be 

utilized if a bladder volume or post-void 

residual measurement is obtained 

without imaging the bladder.) We 

disagree that this is an appropriate 

reference code because the pelvic 

ultrasound procedure is very different 

from a bladder ultrasound procedure. 

The bladder ultrasound procedure only 

results in a ‘‘numerical reading’’ of 

milliliters of residual urine in the 

bladder and does not produce an image 

on a screen for a physician to interpret 

like many other ultrasound procedures 

(for example, the pelvic ultrasound). 

Therefore, we disagree with the RUC 

recommendation to use the 0.38 

physician work RVUs for the 

professional component of code 76857 

as the work RVUs for CPT code 51798 

because we do not believe this 

procedure involves physician work 

since the machine only produces a 

numerical reading. 

c. Spine Surgery 

We identified the CPT codes in Table 

21 for the 5-Year Review. 

TABLE 21 

CPT code Description 

22520 ..................... Percutaneous vertbroplasty, one vertebral body, unilateral or bilateral, injection; thoracic. 

22554 ..................... Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace (other than for decompression); cervical below C2. 

22612 ..................... Arthrodesis, posterior or posterolateral technique, single level; lumbar (with or without lateral transverse technique). 

22840 ..................... Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle fixation across one interspace, 

atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation). 

63047 ..................... Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/ 

or nerve root(s), (e.g., spinal or lateral recess stenosis)), single vertebral segment; lumbar. 

63048 ..................... Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/ 

or nerve root(s), (e.g., spinal or lateral recess stenosis)), single vertebral segment; each additional segment, cervical, 

thoracic, or lumbar (List separately in addition to code for primary procedure). 

63075 ..................... Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single 

interspace. 

With approval of the RUC, the 

specialty society used a modified RUC 

survey that included surveys of time 

(pre-service, intra-service, immediate 

post-service), post-operative visits and 

estimates of total work. Two reference 

codes were used to survey the estimates 

of intensity and complexity. There were 

well over 100 responses to each survey. 

RUC Recommendations 

The RUC accepted the specialty 

society’s recommendations to decrease 

the existing work RVUs for three 

procedures: CPT codes 22554, 63047 

and 63075. The RUC agreed that these 

procedures were overvalued due to 

decreases in the length of stay and 

physician time. The RUC also accepted 

the specialty society’s recommendation 

to maintain the work associated with 

CPT codes 22520 and 22840. The RUC 

agreed with the specialty society that 

the survey data collected validated the 

existing work RVUs associated with 

these codes. For CPT codes 22612 and 

63048, the RUC recommended increases 

in the work RVUs, but less than the 

increases requested by the specialty 

society. The RUC agreed that these 

procedures were undervalued due to 

increases in length of stay and the 

incorrect assumptions made in the 

previous valuation of the service. 

The specific RUC-recommended work 

RVUs were as follows: 22520 = 8.90 

work RVUs; 22554 = 16.40 work RVUs; 

22612 = 22.00 work RVUs; 22840 = 

12.52 work RVUs; 63047 = 14.08 work 

RVUs; 63048 = 3.55 work RVUs; and 

63075 = 18.58 work RVUs. 

CMS Proposed Valuation 

We accept the work RVUs 

recommended by the RUC for CPT 

codes 22520, 22554, 22840, 63047 and 

63075. However, we have technical 

concerns with the recommendations for 

CPT codes 22612 and 63048. 

The workgroup recommended the 

survey’s 25th percentile for CPT code 

22612 to keep the appropriate rank 

order with the reference service, CPT 

code 22595, which is a more complex 

procedure. However, there was a 

typographical error in the information 

presented by the specialty society that 

listed the work RVUs for the reference 

code as 23.36, rather than the correct 

value of 19.36 work RVUs. Therefore, 

the recommended work value of 22.00 

RVUs is clearly inappropriate and we 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37203 

are proposing to maintain the current 

work RVUs of 20.97 for this service. 

There is an additional typographical 

error in the specialty society survey data 

for CPT code 63048. The summary 

information lists the reference code as 

also being CPT code 63048. Therefore, 

there is no information given that 

compares the respondents’ estimates of 

complexity and intensity between CPT 

code 63048 and the reference code. 

Because we do not have sufficient 

information to decide if the 

recommended work RVUs are 

appropriate, we are proposing to 

maintain the current work RVUs of 3.26 

for CPT code 63048. 

d. Spinal Pump Infusion and 

Stimulators 

The American Academy of Pain 

Medicine (AAPM) and the American 

Society of Anesthesiologists (ASA) 

initially submitted several CPT codes 

that were subsequently withdrawn from 

the 5-Year Review (see Table 22). 

TABLE 22 

CPT code Description 

62350 ..................... Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration 

via an external pump or implantable reservoir/infusion pump; without laminectomy. 

62351 ..................... Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration 

via an external pump or implantable reservoir/infusion pump; with laminectomy. 

62355 ..................... Removal of previously implanted intrathecal or epidural catheter. 

62360 ..................... Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir. 

62361 ..................... Implantation or replacement of device for intrathecal or epidural drug infusion; non-programmable pump. 

62362 ..................... Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation 

of pump, with or without programming. 

62365 ..................... Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion.

63650 ..................... Percutaneous implantation of neurostimulator electrode array, epidural. 

63655 ..................... Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural. 

63660 ..................... Revision or removal of spinal neurostimulator electrode percutaneous array(s) or plate/paddle(s). 

63685 ..................... Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling. 

63688 ..................... Revision or removal of implanted spinal neurostimulator pulse generator or receiver. 

64550 ..................... Application of surface (transcutaneous) neurostimulator. 

64553 ..................... Percutaneous implantation of neurostimulator electrodes; cranial nerve. 

64555 ..................... Percutaneous implantation of neurostimulator electrodes; peripheral nerve (excludes sacral nerve). 

64560 ..................... Percutaneous implantation of neurostimulator electrodes; autonomic nerve. 

64561 ..................... Percutaneous implantation of neurostimulator electrodes; sacral nerve (transforaminal placement). 

64565 ..................... Percutaneous implantation of neurostimulator electrodes; neuromuscular. 

64573 ..................... Incision for implantation of neurostimulator electrodes; cranial nerve. 

64575 ..................... Incision for implantation of neurostimulator electrodes; peripheral nerve (excludes sacral nerve). 

64577 ..................... Incision for implantation of neurostimulator electrodes; autonomic nerve. 

64580 ..................... Incision for implantation of neurostimulator electrodes; neuromuscular. 

64581 ..................... Incision for implantation of neurostimulator electrodes; sacral nerve (transforaminal placement). 

64585 ..................... Revision or removal of peripheral neurostimulator electrodes. 

64590 ..................... Insertion or replacement of peripheral neurostimulator pulse generator or receiver, direct or inductive coupling. 

64595 ..................... Revision or removal of peripheral neurostimulator pulse generator or receiver. 

e. Aneurysm, Epilepsy and Skull 

Procedures 

The American Association of 

Neurological Surgeons (AANS) and 

Congress of Neurological Surgeons 

(CNS) submitted six CPT codes for 

review (see Table 23). 

TABLE 23 

CPT code Description 

61537 ..................... Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery. 

61538 ..................... Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery. 

61697 ..................... Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation. 

61698 ..................... Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation. 

61700 ..................... Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation. 

61702 ..................... Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation). 

We submitted two CPT codes for 

review (see Table 24). 

TABLE 24 

CPT code Description 

61154 ..................... Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural. 

61312 ..................... Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural. 


jlentini on PROD1PC65 with NOTICES2
37204 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

A standard RUC survey with over 30 

responses was used for six of the codes. 

The surveys for CPT codes 61537 and 

61538 had only 12 and 14 responses, 

respectively. 

RUC Recommendations 

The RUC agreed with the specialty 

society that the existing RVUs for CPT 

code 61154 should be maintained 

because there was no compelling 

evidence that the work currently 

associated with this procedure has 

changed. The RUC accepted the 

specialty society’s requested increase to 

the existing work RVUs, as reflected by 

the survey median, for CPT code 61312, 

agreeing with the specialty society that 

the increased use of anticoagulants by 

these patients has increased the 

intensity of the intra-service work. The 

RUC recommended increasing the work 

RVUs for CPT codes 61697, 61698, 

61700 and 61702, but at or below the 

surveys’ 25th percentile. 

While the workgroup recommended 

maintaining the current work RVUs for 

CPT codes 61537 and 61538, at the 

subsequent RUC meeting, the specialty 

society extracted these codes for 

discussion and the RUC recommended 

the 25th percentile from the surveys for 

the work RVU. 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

61154 = 14.97 work RVUs; 61312 = 

27.00 work RVUs; 61537 = 35.00 work 

RVUs; 61538 = 38.00 work RVUs; 61697 

= 57.31 work RVUs; 61698 = 64.03 work 

RVUs; 61700 = 46.01 work RVUs; and 

61702 = 54.28 work RVUs. 

CMS Proposed Valuation 

We accept the RUC-recommended 

work RVUs for these neurosurgery 

services. 

4. Radiology, Pathology, and Other 

Miscellaneous Services 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS-RADIOLOGY, 

PATHOLOGY, and OTHER MISC. 

SERVICES’’ at the beginning of your 

comments.] 

a. Pathology 

The College of American Pathologists 

submitted four CPT codes for review 

using the rationale that there have been 

changes in cancer protocols and the 

content of work (see Table 25). The 

specialty society conducted a full RUC 

survey for these codes. 

TABLE 25 

CPT code Description 

88309 ..................... Level VI—Surgical pathology, gross and microscopic examination; Bone Resection; Breast, Mastectomy—with Regional 

Lymph Nodes; Colon, Segmental Resection for Tumor; Colon, Total Resection; Esophagus, Partial/Total Resection; Extremity, Disarticulation; Fetus, with Dissection; Larynx, Partial/Total Resection—with Regional Lymph Nodes; Lung—

Total/Lobe/Segment Resection; Pancreas, Total/Subtotal Resection; Prostate, Radical Resection; Small Intestine, Resection for Tumor; Soft Tissue Tumor, Extensive Resection; Stomach—Subtotal/Total Resection for Tumor; Testis, 

Tumor; Tongue/Tonsil—Resection for Tumor; Urinary Bladder, Partial/Total Resection; Uterus, with or without Tubes 

and Ovaries, Neoplastic; Vulva, Total/Subtotal Resection. 

88321 ..................... Consultation and report on referred slides prepared elsewhere. 

88323 ..................... Consultation and report on referred material requiring preparation of slides. 

88325 ..................... Consultation, comprehensive, with review of records and specimens, with report on referred material. 

RUC Recommendations 

The RUC reviewed the specialty’s 

survey results for each code and 

believed the specialty society had 

presented compelling evidence to 

change the relative work value for each 

code because all were undervalued for 

the increased physician work now 

involved in the services. The RUC 

believed that the change in work was 

due to the increased number and type 

of slides undergoing review in the 

typical case, and, in particular, the 

number of immunohistochemical slides 

that must undergo review. Based on 

recent literature, the RUC also believed 

that the clinical practice of these 

pathology consultations had changed. In 

addition, the RUC agreed with the 

specialty society that the survey’s 25th 

percentile reflected the true physician 

work for each of the codes. 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

88309 = 2.80 work RVUs, 88321 = 1.63 

work RVUs, 88323 = 1.83 work RVUs, 

and 88325 = 2.50 work RVUs. 

CMS Proposed Valuation 

We are in agreement with all of these 

RUC-recommended work RVUs for 

pathology services. 

b. Radiation Oncology 

We submitted the radiation oncology 

CPT codes in Table 26 for review. 

TABLE 26 

CPT code Description 

77263 ..................... Therapeutic radiology treatment planning; complex. 

77280 ..................... Therapeutic radiology simulation-aided field setting; simple. 

77290 ..................... Therapeutic radiology simulation-aided field setting; complex. 

77300 ..................... Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue 

inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician. 

77315 ..................... Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted Y, tangential ports, the use 

of wedges, compensators, complex blocking, rotational beam, or special beam considerations). 

77331 ..................... Special dosimetry (e.g., TLD, microdosimetry) (specify), only when prescribed by the treating physician. 

77334 ..................... Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or 

casts). 

77470 ..................... Special treatment procedure (e.g., total body irradiation, hemibody radiation, per oral, endocavitary or intraoperative cone 

irradiation). 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37205 

Standard RUC surveys were 

conducted for these services. The survey 

results indicated that the work RVUs for 

each code should be maintained at their 

current level, and the specialty society, 

the American Society for Therapeutic 

Radiology and Oncology (ASTRO), 

recommended no change in the work 

RVU. 

RUC Recommendations 

The RUC agreed with the survey 

results and supported the specialty 

society’s recommendation to maintain 

the work RVUs. The RUC found no 

compelling evidence to change the work 

RVUs for these CPT codes, and 

therefore, recommended maintaining 

the current work values for these CPT 

codes as follows: 77263 = 3.14 work 

RVUs; 77280 = 0.70 work RVUs; 77290 

= 1.56 work RVUs; 77300 = 0.62 work 

RVUs; 77315 = 1.56 work RVUs; 77331 

= 0.87 work RVUs; 77334 = 1.24 work 

RVUs; and 77470 = 2.09 work RVUs. 

CMS Proposed Valuation 

We are in agreement with all of these 

RUC-recommended work RVUs for 

radiology oncology. 

c. Radiology 

We requested that the CPT codes for 

radiology services in Table 27 be 

reviewed. 

TABLE 27 

CPT code Description 

70355 ..................... Orthopantogram. 

71010 ..................... Radiologic examination, chest; single view, frontal. 

71020 ..................... Radiologic examination, chest, two views, frontal and lateral. 

71260 ..................... Computed tomography, thorax; with contrast material(s). 

72192 ..................... Computed tomography, pelvis; without contrast material. 

72193 ..................... Computed tomography, pelvis; with contrast material(s). 

73100 ..................... Radiologic examination, wrist; two views. 

73110 ..................... Radiologic examination, wrist; complete, minimum of three views. 

73120 ..................... Radiologic examination, hand; two views. 

73130 ..................... Radiologic examination, hand; minimum of three views. 

73140 ..................... Radiologic examination, finger(s), minimum of two views. 

74000 ..................... Radiologic examination, abdomen; single anteroposterior view. 

74020 ..................... Radiologic examination, abdomen; complete, including decubitus and/or erect views. 

74022 ..................... Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single 

view chest. 

74150 ..................... Computed tomography, abdomen; without contrast material. 

74160 ..................... Computed tomography, abdomen; with contrast material(s). 

76075 ..................... Dual energy x-ray absorptiometry (DXA), bone density study, one or more sites; axial skeleton (e.g., hips, pelvis, spine). 

76700 ..................... Ultrasound, abdominal, B-scan and/or real time with image documentation; complete. 

76830 ..................... Ultrasound, transvaginal. 

78306 ..................... Bone and/or joint imaging; whole body. 

78315 ..................... Bone and/or joint imaging; three phase study. 

78465 ..................... Myocardial perfusion imaging; tomographic (SPECT), multiple studies (including attenuation correction when performed), 

at rest and/or stress (exercise and/or pharmacologic) and redistribution and/or rest injection, with or without quantification. 

78478 ..................... Myocardial perfusion study with wall motion, qualitative or quantitative study (List separately in addition to code for primary 

procedure). 

78480 ..................... Myocardial perfusion study with ejection fraction (List separately in addition to code for primary procedure). 

In addition, the American College of 

Cardiology (ACC) and American College 

of Radiology (ACR) recommended four 

cardiac imaging codes be sent to the 

CPT Editorial Panel for review and 

clarification so that they may reflect 

current practice patterns (see Table 28). 

The RUC agreed with this 

recommendation. 

TABLE 28 

CPT code Description 

75552 ..................... Cardiac magnetic resonance imaging for morphology; without contrast material. 

75553 ..................... Cardiac magnetic resonance imaging for morphology; with contrast material. 

75554 ..................... Cardiac magnetic resonance imaging for function, with or without morphology; complete study. 

75555 ..................... Cardiac magnetic resonance imaging for function, with or without morphology; limited study). 

The specialty societies conducted 

standard RUC surveys for the remaining 

services. 

RUC Recommendations 

The RUC agreed with the survey 

results and found there was no 

compelling evidence to change the work 

RVUs for CPT codes 70355, 71010, 

71020, 71260, 72192, 72193, 73100, 

73110, 73120, 73130, 73140, 74000, 

74020, 74022, 74150, 74160, 76700, 

76830, 78306, 78315, and 78465. 

The RUC recommended a reduction 

in the work RVU for the DXA service, 

CPT code 76075, because the workgroup 

believed that the actual work is less 

intense and more mechanical than the 

specialty society’s description of the 

work. In addition, the RUC believed that 

the survey results provided insufficient 

evidence to support the current work 

RVU associated with CPT code 78478 

and also believed that the physician 

time was overestimated. The RUC also 

recommended a reduction in the work 

RVUs for CPT code 78480 because it 

was not in the correct rank order and 

was therefore overvalued. 


jlentini on PROD1PC65 with NOTICES2
37206 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

70355 = 0.20 work RVUs; 71010 = 0.18 

work RVUs; 71020 = 0.22 work RVUs; 

71260 = 1.24 work RVUs; 72192 = 1.09 

work RVUs; 72193 = 1.16 work RVUs; 

73100 = 0.16 work RVUs; 73110 = 0.17 

work RVUs; 73120 = 0.16 work RVUs; 

73130 = 0.17 work RVUs; 73140 = 0.13 

work RVUs; 74000 = 0.18 work RVUs; 

74020 = 0.27 work RVUs; 74022 = 0.32 

work RVUs; 74150 = 1.19 work RVUs; 

74160 = 1.27 work RVUs; 76075 = 0.20 

work RVUs; 76700 = 0.81 work RVUs; 

76830 = 0.69 work RVUs; 78306 = 0.86 

work RVUs; 78315 = 1.02 work RVUs; 

78465 = 1.46 work RVUs; 78478 = 0.50 

work RVUs; and 78480 = 0.30 work 

RVUs. 

CMS Proposed Valuation 

We are in agreement with all of these 

RUC-recommended work RVUs for 

radiology services. 

d. Endoscopy Procedures 

We requested the RUC to review five 

endoscopy CPT codes because they had 

never been reviewed by the RUC (see 

Table 29). Standard RUC surveys were 

conducted. 

TABLE 29 

CPT code Description 

43235 ..................... Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; 

diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). 

43246 ..................... Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; 

with directed placement of percutaneous gastrostomy tube. 

43750 ..................... Percutaneous placement of gastrostomy tube. 

45330 ..................... Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). 

45378 ..................... Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or 

washing, with or without colon decompression (separate procedure). 

RUC Recommendations 

The RUC agreed with the survey 

results and found no compelling 

evidence to change the work RVUs for 

any of these services. Therefore, the 

RUC recommended the work values for 

these CPT codes be maintained as 

follows: 43235 = 2.39 work RVUs; 43246 

= 4.32 work RVUs; 43750 = 4.48 work 

RVUs; 45330 = 0.96 work RVUs; and 

45378 = 3.69 work RVUs. 

CMS Proposed Valuation 

We are in agreement with the RUCrecommended work RVUs for 

endoscopic procedure codes. 

e. Neurology, Neuromuscular, and 

Nervous System 

The American Academy of Neurology 

(AAN), American Clinical 

Neurophysiology Society (ACNS), 

American Association of 

Neuromuscular and Electrodiagnostic 

Medicine (AANEM), and the American 

Academy of Physical Medicine and 

Rehabilitation (AAPMR) submitted five 

neurology and neuromuscular CPT 

codes for this 5-Year Review and AAN 

and the American Academy of 

Pediatrics (AAP) jointly submitted CPT 

code 62270 (see Table 30). 

TABLE 30 

CPT code Description 

62270 ..................... Spinal puncture, lumbar, diagnostic. 

95872 ..................... Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied. 

95925 ..................... Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from 

the central nervous system; in upper limbs. 

95926 ..................... Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from 

the central nervous system; in lower limbs. 

95927 ..................... Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from 

the central nervous system; in the trunk or head. 

95953 ..................... Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, 

electroencephalographic (EEG) recording and interpretation, each 24 hours. 

In addition, we requested the RUC to 

review five neurological CPT codes (see 

Table 31). 

TABLE 31 

CPT code Description 

95816 ..................... Electroencephalogram (EEG); including recording awake and drowsy. 

95819 ..................... Electroencephalogram (EEG); including recording awake and asleep. 

95861 ..................... Needle electromyography; two extremities with or without related paraspinal areas. 

95900 ..................... Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study. 

95904 ..................... Nerve conduction, amplitude and latency/velocity study, each nerve; sensory. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37207 

Standard RUC surveys were 

conducted for these services. The 

specialty societies believed the survey 

results indicated that the current work 

RVUs were either correctly valued or 

undervalued. 

RUC Recommendations 

The RUC found no compelling 

evidence to change the work RVUs for 

CPT codes 95816, 95819, 95861, 95900, 

95904, 95925, 95926, and 95927. 

However, the RUC agreed that there was 

compelling evidence that CPT codes 

95872 and 95953 were undervalued and 

recommended increasing their existing 

RVUs. 

The RUC-recommended work RVUs 

for these services are as follows: 95816 

= 1.08 work RVUs; 95819 = 1.08 work 

RVUs; 95861 = 1.54 work RVUs; 95872 

= 3.00 work RVUs; 95900 = 0.42 work 

RVUs; 95904 = 0.34 work RVUs; 95925 

= 0.54 work RVUs; 95926 = 0.54 work 

RVUs; 95927 = 0.54 work RVUs; and 

95953 = 3.30 work RVUs. 

For CPT code 62270, the RUC 

believed that there is a bimodal 

distribution of physician work 

associated with the code because there 

are two different typical patient types, 

infants and young children. The RUC 

and the specialty societies believed that 

the infant population requires less work 

than in the young child population. The 

RUC suggested that it may be reasonable 

for the specialty societies to eventually 

consider splitting the code into the two 

typical patient types to capture any 

differences in physician work. However, 

for the current CPT code 62270, the 

RUC recommended that it should be 

valued higher and recommended a work 

RVU of 1.37. 

CMS Proposed Valuation 

We are in agreement with all of the 

RUC-recommended work RVUs for 

neurology, neuromuscular and nervous 

system services except for the 

recommendation for CPT code 95872. 

We have concerns that the work 

recommendation for this service, which 

was based on the survey’s 75th 

percentile for work, is not the correct 

valuation and is inappropriate for this 

service. We calculated the pre-service 

and post-service work RVU using the 

surveyed physician time data. Then, we 

subtracted the surveyed intra-service 

time from the current time. Next, we 

multiplied this difference in time by the 

calculated IWPUT using the specialty 

recommended total work RVUs to 

determine an intra-service work RVU. 

Adding the calculated work RVUs 

resulted in a work RVU of slightly less 

than 2.0, which is close to the same 

value as the survey median work RVU. 

In accordance with this analysis and the 

survey median, we are recommending a 

work RVU of 2.00. 

f. Pulmonary Medicine 

We requested the RUC to review three 

pulmonary medicine CPT codes (see 

Table 32). 

TABLE 32 

CPT code Description 

31622 ..................... Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; diagnostic, with or without cell washing (separate 

procedure). 

94010 ..................... Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without 

maximal voluntary ventilation. 

94657 ..................... Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; 

subsequent days. 

Standard RUC surveys were 

conducted. The specialty societies 

believed the survey results indicated 

that the current work RVUs were either 

correctly valued or undervalued. 

RUC Recommendations 

The RUC reviewed the survey results 

and recommendations from the 

specialty society for CPT codes 31622 

and 94010 and found no compelling 

reason to change the work RVUs for 

these codes. However, the RUC agreed 

with the specialty society that the time 

data elements from the survey results 

reflected the typical patient encounter. 

The RUC did find compelling 

evidence to support the specialty 

society’s recommendation and survey 

work value results for CPT code 94657. 

However, the RUC determined that a 

rank order anomaly would be created 

with CPT code 94656 if the 

recommended value for CPT code 94657 

was adopted. Therefore, the RUC 

recommended that this code be referred 

to the CPT Editorial Panel. 

The RUC-recommended work RVUs 

for these codes are as follows: 31622 = 

2.78 work RVUs and 94010 = 0.17 work 

RVUs. 

CMS Proposed Valuation 

We are in agreement with these RUCrecommended work RVUs for 

pulmonary medicine services. 

g. Miscellaneous Services 

(i) Anesthesia 

The ASA requested that the RUC 

review code 00797, Anesthesia for 

intraperitoneal procedures in upper 

abdomen including laparoscopy; gastric 

restrictive procedure for morbid obesity. 

The ASA believed that the results of the 

standard RUC survey conducted by the 

specialty society indicated the 

physician work was undervalued for 

this code. 

RUC Recommendations 

The RUC reviewed the survey results 

and specialty society recommendation 

and agreed with its recommended 

median base unit value and physician 

time for the code. The RUC 

recommended base unit valuation for 

this service was 11.00. 

CMS Proposed Valuation 

We are in agreement with the RUC 

recommendation for CPT code 00797. 

(ii) Allergy and Immunology 

The Joint Council of Allergy, Asthma, 

and Immunology (JCAAI) and the 

American Academy of Otolaryngic 

Allergy (AAOA) submitted five codes 

without work relative values for this 5- 

Year Review based on the rationale that 

physician work was inherent in the 

service (see Table 33). The specialties 

subsequently withdrew CPT codes 

95115 and 95117 from consideration. 

TABLE 33 

CPT code Description 

95004 ..................... Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, specify number of tests. 


jlentini on PROD1PC65 with NOTICES2
37208 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

TABLE 33—Continued 

CPT code Description 

95024 ..................... Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, specify number of tests. 

95027 ..................... Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate 

type reaction, specify number of tests. 

95115 ..................... Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection. 

95117 ..................... Professional services for allergen immunotherapy not including provision of allergenic extracts; two or more injections. 

In addition, we requested the RUC to 

review the immunotherapy CPT codes 

in Table 34 because they had never been 

reviewed by the RUC. Standard RUC 

surveys were conducted. 

TABLE 34 

CPT code Description 

95144 ..................... Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose 

vial(s) (specify number of vials). 

95165 ..................... Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or 

multiple antigens (specify number of doses). 

RUC Recommendations 

The RUC reviewed the specialty 

society recommendations, and survey 

results recommended that CPT codes 

95004, 95024, and 95027 be referred to 

the CPT Editorial Panel for clarification 

and possible revision. The RUC 

recommended that the current work 

RVUs be maintained for CPT codes 

95144 and 95165, because there was no 

compelling evidence for a change. The 

RUC-recommended work RVUs for 

these CPT codes are: 95144 = 0.06 work 

RVUs; and 95165 = 0.06 work RVUs. 

CMS Proposed Valuation 

We are in agreement with these RUCrecommended work RVUs for allergy 

and immunology services. 

(iii) Pediatric codes 

The AAP requested that the RUC 

review eight pediatric-related CPT codes 

for this 5-Year Review (see Table 35). 

However, two of these CPT codes 

(90473 and 90474) were subsequently 

withdrawn by AAP. The remaining six 

codes were referred to the CPT Editorial 

Panel for review. 

TABLE 35 

CPT code Descriptor 

54150 ..................... Circumcision, using clamp or other device; newborn. 

54152 ..................... Circumcision, using clamp or other device; except newborn. 

90465 ..................... Immunization administration under 8 years of age (includes percutaneous, intradermal, subcutaneous, or intramuscular injections) when the physician counsels the patient/family; first injection (single or combination vaccine/toxoid), per day. 

90466 ..................... Immunization administration under 8 years of age (includes percutaneous, intradermal, subcutaneous, or intramuscular injections) when the physician counsels the patient/family; each additional injection (single or combination vaccine/toxoid), 

per day (List separately in addition to code for primary procedure). 

90467 ..................... Immunization administration under age 8 years (includes intranasal or oral routes of administration) when the physician 

counsels the patient/family; first administration (single or combination vaccine/toxoid), per day. 

90468 ..................... Immunization administration under age 8 years (includes intranasal or oral routes of administration) when the physician 

counsels the patient/family; each additional administration (single or combination vaccine/toxoid), per day (List separately in addition to code for primary procedure). 

90473 ..................... Immunization administration by intranasal or oral route; one vaccine (single or combination vaccine/toxoid). 

90474 ..................... Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (List 

separately in addition to code for primary procedure). 

(iv) Cardiology-Related Services 

We requested that the RUC review 

five cardiology-related CPT codes (see 

Table 36). The specialty societies 

believed that the standard RUC survey 

results indicated that the work RVUs for 

each code should be either maintained 

or decreased from their current level. 

TABLE 36 

CPT code Description 

33208 ..................... Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular. 

93010 ..................... Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only. 

93015 ..................... Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic 

monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report. 

93018 ..................... Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic 

monitoring, and/or pharmacological stress; interpretation and report only. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37209 

TABLE 36—Continued 

CPT code Description 

93325 ..................... Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography). 

RUC Recommendations 

The RUC reviewed the survey results 

and found no compelling evidence to 

change the work RVUs for CPT codes 

33208, 93010, 93015, and 93018. 

However, CPT code 93325 was referred 

to the CPT Editorial Panel by the RUC 

with the recommendation that this 

service be bundled with CPT code 

93307, Echocardiography, transthoracic, 

real-time with image documentation 

(2D) with or without M-mode recording; 

complete. 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

33208 = 8.12 work RVUs; 93010 = 0.17 

work RVUs; 93015 = 0.75 work RVUs; 

and 93018 = 0.30 work RVUs. 

CMS Proposed Valuation 

We are in agreement with these RUCrecommended work RVUs for 

cardiology related services. 

5. Evaluation and Management (E/M) 

Services 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS—EVALUATION AND 

MANAGEMENT SERVICES’’ at the 

beginning of your comments.] 

A consortium of 27 organizations 

submitted a consensus comment letter 

stating that the work of E/M services has 

changed significantly since the E/M 

codes were reviewed during the first 5- 

Year Review and requested that the 

E/M codes be reviewed (see Table 37). 

In addition, the following specialty 

societies submitted requests that 

individual E/M CPT codes be reviewed: 

The American Academy of Family 

Physicians (AAFP), the American 

Medical Directors Association (AMDA), 

the American Geriatric Society (AGS), 

the American Association for Geriatric 

Psychiatry (AAGP), the ASA, and the 

American Academy of Home Care 

Physicians (AAHCP). 


jlentini on PROD1PC65 with NOTICES2
37210 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.039</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37211 


jlentini on PROD1PC65 with NOTICES2EN29JN06.040</GPH>
37212 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.041</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37213 


jlentini on PROD1PC65 with NOTICES2EN29JN06.042</GPH>
37214 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.043</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37215 


jlentini on PROD1PC65 with NOTICES2EN29JN06.044</GPH>
37216 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.045</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37217 

BILLING CODE 4120–01–C 

Standard RUC surveys of the E/M 

services were conducted by a coalition 

of medical specialty societies. 

Recommendations of the coalition, as 

well as comments from the coalition of 

surgical specialties, were considered by 

the RUC workgroup. 

RUC Recommendations 

The RUC E/M workgroup conferred 

via conference call throughout the 

summer of 2005 and reviewed previous 

studies and methodologies used to 

evaluate the physician work related to 

the E/M services. At the first meeting in 

August of 2005, the workgroup 

considered the recommendations of the 

coalition of medical specialty societies, 

as well as the comments of the coalition 

of surgical specialties that countered the 

arguments presented regarding 

increased physician work. After 

extensive discussion, the workgroup 

agreed that there was evidence that 

incorrect assumptions were made in the 

previous valuation of these services. 

The workgroup reviewed each E/M code 

extensively, reviewing the survey from 

the coalition of medical specialties, 

comparing the codes to reference codes 

and considering comments from the 

surgical coalition and other meeting 

attendees. 

At the RUC meeting in October 2005, 

the RUC agreed that there was 

compelling evidence to review the E/M 

services because of evidence that 

incorrect assumptions were made in the 

previous valuation of the services. The 

RUC approved final recommendations 

for 26 of these codes, interim 

recommendations for six codes (CPT 

codes 99222, 99223, 99232, 99233, 

99291, and 99292) and postponed the 

review of three codes (CPT codes 99213, 

99214, and 99215) to the February 2006 

meeting. 

At the February 2006 meeting, the 

RUC reached consensus on the 

recommended work values for all the 


jlentini on PROD1PC65 with NOTICES2EN29JN06.046</GPH>
37218 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

outstanding E/M codes. As an example 

of the RUC review process, we are 

including the RUC notes on the 

rationale used to recommend a revised 

work value for CPT code 99213, the 

mid-level office visit, which is also the 

most frequently billed code in the PFS: 

‘‘The RUC agreed that the compelling 

evidence to review CPT code 99213 is that 

incorrect assumptions were made in the 

previous valuation of CPT code 99213 (that 

is, the assumptions made by Harvard and 

CMS are flawed). The RUC extensively 

discussed CPT code 99213 (physician time: 

pre- = 3, intra- = 15, and post- = 5) and agreed 

that this code is slightly more work than CPT 

code 99202 (recommended work RVU = 0.88; 

physician time: pre- = 2, intra- = 15, and 

post- = 5). It was noted the content for CPT 

code 99213 represents a higher level of 

intensity as the medical decision making is 

‘‘low’’ for CPT code 99213, versus 

‘‘straightforward’’ for CPT code 99202. CMS 

also provided utilization data that indicated 

that diagnosis and number of diagnosis were 

more significant for CPT code 99213 than 

CPT code 99202. Finally, the survey 

respondents agreed with this relationship, as 

the survey median work RVU for ‘‘all’’ survey 

respondents was 1.10 for CPT code 99213 

and 1.05 for CPT code 99202. Utilizing this 

relationship and the recommended work 

RVU of 0.88 for CPT code 99202, the RUC 

determined that a work RVU of 0.92 for CPT 

code 99213 is appropriate. In addition, the 

RUC agreed that CPT code 99213 is similar 

in work to CPT code 93307 

Echocardiography, transthoracic, real-time 

with image documentation (2D) with or 

without M-mode recording; complete (work 

RVU = 0.92, physician time: pre- = 5, intra- 

= 18, and post- = 5), which is a code included 

on the RUC’s Multi-Specialty Points of 

Comparison (MPC). It was also noted that the 

25th percentile of the ‘all’ survey respondent, 

weighted survey data was 0.95 RVUs. The 

RUC recommends a work RVU of 0.92 for 

CPT code 99213 (physician time: pre- = 3, 

intra- = 15, and post- = 5).’’

The RUC also recommended that the 

full increase for these codes be 

incorporated into the surgical global 

periods for each CPT code with a global 

period of 010 and 090. 

Based on a review of the survey 

information, the RUC recommended 

that the work RVUs for the following 

CPT codes be maintained: 99201 = 0.45 

work RVUs; 99202 = 0.88 work RVUs; 

99203 = 1.34 work RVUs; 99211 = 0.17 

work RVUs; 99212 = 0.45 work RVUs; 

99238 = 1.28 work RVUs; and 99241 = 

0.64 work RVUs. 

The RUC also recommended that the 

work RVUs for the following CPT codes 

be increased: 99204 = 2.30 work RVUs; 

99205 = 3.00 work RVUs; 99213 = 0.92 

work RVUs; 99214 = 1.42 work RVUs; 

99215 = 2.00 work RVUs; 99221 = 1.88 

work RVUs; 99222 = 2.56 work RVUs; 

99223 = 3.78 work RVUs; 99231 = 0.76 

work RVUs; 99232 = 1.39 work RVUs; 

99233 = 2.00 work RVUs; 99239 = 1.90 

work RVUs; 99242 = 1.34 work RVUs; 

99243 = 1.88 work RVUs; 99244 = 3.02 

work RVUs; 99245 = 3.77 work RVUs; 

99251 = 1.00 work RVUs; 99252 = 1.50 

work RVUs; 99253 = 2.27 work RVUs; 

99254 = 3.29 work RVUs; 99255 = 4.00 

work RVUs; 99281 = 0.45 work RVUs; 

99282 = 0.88 work RVUs; 99283 = 1.34 

work RVUs; 99284 = 2.56 work RVUs; 

99285 = 3.80 work RVUs; 99291 = 4.50 

work RVUs; and 99292 = 2.25 work 

RVUs. 

The RUC also noted that twelve E/M 

codes (nursing facility and domiciliary 

care) originally submitted had been 

deleted by CPT and replaced by new 

CPT codes that were reviewed by the 

RUC last year. These new CPT codes 

were included in the CY 2006 PFS final 

rule with comment period (70 FR 

70116) and the associated RVUs were 

considered interim and subject to 

comment. Therefore, these new CPT 

codes were not included as part of the 

5-Year Review. 

CMS Proposed Valuation 

We are in agreement with these RUC 

recommended work RVUs for E/M 

services. We also agree with the 

recommendation that the full increase 

for these codes should be incorporated 

into the surgical global periods for each 

CPT code with a global period of 010 

and 090. 

6. Cardiothoracic Surgery 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS—CARDIOTHORACIC 

SURGERY’’ at the beginning of your 

comments.] 

a. Congenital Codes 

The STS/ American Association for 

Thoracic Surgery (AATS) submitted the 

congenital cardiac surgical CPT codes 

for review (see Table 38). 

TABLE 38 

CPT code Descriptor 

33414 ..................... Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract. 

33416 ..................... Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (e.g., asymmetric septal hypertrophy). 

33505 ..................... Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel 

(Takeuchi procedure). 

33665 ..................... Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair. 

33684 ..................... Closure of ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic). 

33688 ..................... Closure of ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset. 

33771 ..................... Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect. 

33779 ..................... Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (e.g., Jatene type); with removal of pulmonary band. 

33781 ..................... Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (e.g., Jatene type); with repair of subpulmonic obstruction. 

The commenters stated that at the 

second 5-Year Review, many of the 

more common congenital cardiac 

surgical codes were reviewed, and the 

values were adjusted. However, at that 

time, these much less commonly 

performed congenital cardiac surgical 

codes were not surveyed due to resource 

and time constraints. The commenter 

believed that this has created rank order 

anomalies within these families of 

codes. 

Standard RUC surveys were 

conducted for the services in Table 38. 

However, there was a low response rate 

that was attributable to these procedures 

being infrequently performed by a small 

number of surgeons. 

RUC Recommendations 

The RUC believed that the current 

work RVUs for the codes presented 

created rank order anomalies in terms of 

the physician work relative value, but, 

during the review, the RUC agreed that 

a number of the reference procedures 

had inaccurate physician times. When 

the reference code times were compared 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37219 

with the surveyed times for the codes 

under review, the RUC noted 

inconsistencies in all time segments, 

including intra-service time. The RUC 

reviewed the survey data and the data 

for the reference codes, and made 

recommendations for work RVUs to 

place the surveyed codes in proper rank 

order. Recommendations for work RVUs 

reflected the survey’s 25th percentile, 

the median survey value, or the timeadjusted survey data, which was based 

on time adjustments for certain portions 

of the service when compared to the 

reference codes. Due to concern about 

the accuracy of time for some of the 

reference codes, the RUC also 

recommended that the specialty society 

conduct future surveys for physician 

time only for CPT codes 33660, 33670, 

33506, 33770, and 33780. However, the 

RUC agreed that the new 5-Year Review 

values and times could not be used to 

justify changes in the relative values of 

the reference services. 

The RUC-recommended work RVUs 

for these CPT codes are as follows: 

33414 = 36.52 work RVUs; 33416 = 

34.25 work RVUs; 33505 = 36.00 work 

RVUs; 33665 = 32.98 work RVUs; 33684 

= 32.50 work RVUs; 33688 = 32.88 work 

RVUs; 33771 = 38.50 work RVUs; 33779 

= 41.00 work RVUs; and 33781 = 41.00 

work RVUs. 

b. Adult Cardiac and General Thoracic 

Codes 

The STS/ATTS submitted 46 adult 

cardiac CPT codes for review and 27 

general thoracic CPT codes for review 

but subsequently withdrew two CPT 

codes (32095 and 35600). The specialty 

believed many of these CPT codes 

needed to be reviewed due to the rank 

order anomalies that exist in these 

families of CPT codes (see Table 39). 

We submitted two CPT codes for 

review, 32020 and 39400; however, no 

specialty expressed an interest in 

conducting a survey for CPT code 32020 

so there was no RUC recommendation 

forwarded for this service. (See Table 39 

for all codes submitted.) 

BILLING CODE 4120–01–P 


jlentini on PROD1PC65 with NOTICES2
37220 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.047</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37221 


jlentini on PROD1PC65 with NOTICES2EN29JN06.048</GPH>
37222 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.049</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37223 

BILLING CODE 4120–01–C 


jlentini on PROD1PC65 with NOTICES2EN29JN06.050</GPH>
37224 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

The RUC had previously approved a 

building-block methodology based on 

the STS database, which would provide 

a mean intra-service time for the adult 

cardiac and general thoracic codes, as 

well as the procedure-specific length of 

stay. Two intensity surveys were also 

conducted and the final recommended 

intensity was an average of the two 

survey results. The remaining preservice and post-service inputs were 

derived through a panel of cardiac 

surgeons. 

The add-on CPT codes (33141, 33517 

through 33523 and 33530) were 

evaluated by subtracting the time data 

for the base code from the time data for 

the combined base and add-on codes, 

with the results weighted for frequency 

of occurrence. 

RUC Recommendations 

The RUC workgroup reviewed the 

data elements for each code on a codeby-code basis. Most of the discussion 

focused on the number and level of 

post-operative visits, as well as the preservice time. For the adult cardiac and 

general thoracic codes, the RUC agreed 

that the pre-service time was overstated 

and needed to reflect previously 

approved RUC pre-service times. Also, 

the RUC questioned the total times 

allocated to the codes when compared 

to a normal surgical work week. The 

workgroup developed a pre-service time 

standard that was used for a majority of 

the codes. This standard consisted of 60 

minutes for evaluation, 15 minutes for 

positioning, and 20 minutes for scrub 

dress and wait time. For emergent 

procedures, the pre-service times were 

set at 10 minutes for evaluation, 12 

minutes for positioning, and 15 minutes 

for scrub dress and wait time. The 

immediate post-service time was 

examined in conjunction with other 

visits on the same day of surgery. For 

most of the codes, the immediate postservice time was standardized at 40 

minutes. 

The intra-service times were derived 

from the STS database with mean times 

used for the adult cardiac codes and 

median times for the general thoracic 

codes. Because the general thoracic 

codes have a much lower number of 

cases in the database, the STS believed 

that the median was more appropriate. 

The RUC agreed with the specialty 

society that critical care visits should be 

used in the STS building-block 

methodology for all of the adult cardiac 

codes and for 13 of the general thoracic 

codes. 

The assignment of the level of critical 

care services was recommended for each 

code based on the STS panel’s 

knowledge and experience in caring for 

these patients, within the framework of 

the duration of mechanical ventilation 

and the length of intensive care unit 

(ICU) stay provided by appropriate data 

in the STS database. The RUC also made 

changes to the hospital visits on a lineby-line basis, but used the STS length of 

stay data as a guide. Generally, the level 

of hospital visits was reduced so that 

the total number of visits equaled the 

length of stay. On the day of discharge, 

the RUC assigned a discharge day 

management code as the only service 

provided on that day. 

During the review of various 

cardiothoracic surgery procedures, the 

RUC determined that several of the 

reference service codes used in the 

analysis of surveyed codes (specifically, 

CPT codes 33506, 33660, 33670, 33770 

and 33780) had inaccurate physician 

times associated with them. The RUC 

instructed the specialty society to 

conduct a survey of time for these 

reference codes; however, these times 

could not be used to justify new relative 

values. 

The RUC recommended work RVUs 

for these CPT codes were as follows: 

General Thoracic codes: 32141 = 

23.90 work RVUs; 32442 = 51.45 work 

RVUs; 32445 = 57.74 work RVUs; 

32484= 23.25 work RVUs; 32486 = 39.44 

work RVUs; 32488 = 38.95 work RVUs; 

32540 = 26.42 work RVUs; 32651 = 

16.64 work RVUs; 32652 = 26.35 work 

RVUs; 32653 = 16.24 work RVUs; 32654 

= 17.73 work RVUs; 32655 = 14.69 work 

RVUs; 32657 = 11.90 work RVUs; 32662 

= 14.29 work RVUs; 32663 = 23.00 work 

RVUs; 32665 = 19.56 work RVUs; 32815 

= 42.94 work RVUs; 39220 = 18.40 work 

RVUs; 39400 = 7.61 work RVUs; 43108 

= 76.55 work RVUs; 43113 = 73.23 work 

RVUs; 43116 = 87.16 work RVUs; 43118 

= 61.08 work RVUs; 43121 = 46.59 work 

RVUs; 43123 = 76.14 work RVUs; 43124 

= 60.61 work RVUs; 43135 = 24.20 work 

RVUs. As noted above in this section, 

there was no RUC recommendation 

forwarded for CPT code 32020. 

Adult Cardiac codes: 33140 = 25.49 

work RVUs; 33141 = 2.43 work RVUs; 

33300 = 40.03 work RVUs; 33305 = 

70.21 work RVUs; 33400 = 38.33 work 

RVUs; 33405 = 37.82 work RVUs; 33406 

= 49.18 work RVUs; 33410 = 42.91 work 

RVUs; 33411 = 56.91 work RVUs; 33413 

= 56.19 work RVUs; 33415 = 34.58 work 

RVUs; 33425 = 45.97 work RVUs; 33426 

= 39.78 work RVUs; 33427 = 41.82 work 

RVUs; 33430 = 46.45 work RVUs; 33460 

= 40.19 work RVUs; 33463 = 50.93 work 

RVUs; 33464 = 40.30 work RVUs; 33465 

= 45.72 work RVUs; 33474 = 36.39 work 

RVUs; 33475 = 39.39 work RVUs; 33510 

= 31.75 work RVUs; 33511 = 35.22 work 

RVUs; 33512 = 40.26 work RVUs; 33513 

= 41.65 work RVUs; 33514 = 44.36 work 

RVUs; 33516 = 46.04 work RVUs; 33517 

= 3.36 work RVUs; 33518 = 7.41 work 

RVUs; 33519 = 9.91 work RVUs; 33521 

= 12.01 work RVUs; 33522 = 13.53 work 

RVUs; 33523 = 15.39 work RVUs; 33530 

= 9.78 work RVUs; 33533 = 30.85 work 

RVUs; 33534 = 36.98 work RVUs; 33535 

= 41.85 work RVUs; 33536 = 45.53 work 

RVUs; 33542 = 44.20 work RVUs; 33545 

= 52.49 work RVUs; 33641 = 27.71 work 

RVUs; 33860 = 55.45 work RVUs; 33863 

= 55.10 work RVUs; 33945 = 80.84 work 

RVUs; and 35820 = 32.24 work RVUs. 

CMS Proposed Valuation 

We are in agreement with the RUCrecommended work RVUs for the 

congenital cardiac surgery services. 

As mentioned above, the general 

thoracic and adult cardiac surgery codes 

submitted to the RUC for review did not 

undergo the standard RUC survey 

methodology. Rather, the data 

pertaining to these codes were derived 

from the STS database, a voluntary 

registry developed by the STS that has 

reportedly captured data on 

approximately 70 percent of all cardiac 

surgical procedures in the United States. 

We believe that the STS database, 

which also captures outcomes data, is a 

significant tool in the effort to improve 

the quality of patient care and we hope 

that this kind of data collection will be 

emulated by other specialties. We also 

believe that the time and visit data 

contained in this database could be a 

useful adjunct to the RUC’s validation of 

the standard RUC survey results. 

However, we have significant concerns 

with its use as a tool to derive work 

RVUs without reference to a standard 

RUC survey. We have questions 

regarding the representativeness of the 

data in the STS database because it is 

unclear what percentage of the patients 

in the database is derived from 

academic medical centers versus 

community hospitals or whether the 

cases are selectively reported (for 

example, does the case mix contain a 

disproportionate number of complex 

cases?) We also would like information 

regarding the type of hospitals that 

chose not to participate in the database. 

Additionally, while we recognize this 

database has collected large numbers of 

cases for cardiac services, the database 

was not robust for the non-cardiac 

thoracic service. 

In addition, we would also want to 

know the median values, as well as the 

mean values, for the intra-service time 

for the adult cardiac services because 

the RUC’s standard methodology is 

based on median values. Therefore, we 

are concerned about maintaining the 

relativity between these services and 

those where the median values were 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37225 

used to recommend the work RVUs. We 

also believe the median is a better 

estimate of central tendency when more 

extreme cases occur in either direction. 

However, our main concern is not 

with the time data itself, but rather with 

how these data were translated into 

work RVUs because work RVUs are not 

calculated solely on the basis of the time 

it takes to perform a given procedure. 

The other equally important variable is 

the intensity of the procedure, which is 

a measure of the technical skill, mental 

effort, and psychological stress involved 

in performing the procedure. The 

standard RUC survey captures these 

data by comparisons to the key 

reference procedure, asking the 

responders to rate both the surveyed 

and reference codes on the specific 

intensity measures, using a scale of one 

to five. 

The presenting specialties used an 

entirely different methodology to arrive 

at their intensity measures by estimating 

the IWPUT of each service. The 

presenters stated that the IWPUT was 

estimated using two methods: IWPUT 

magnitude estimation and RASCH 

paired analysis for each code. According 

to the presenters, the IWPUT magnitude 

estimation produced direct IWPUT 

values and the RASCH analysis 

produced arbitrary scalar values as 

estimates of CPT code intensity rank 

and dispersion. These values were 

converted to IWPUT values by 

regression of the results to obtain slope, 

and offset of the results was based on 

the median value of the magnitude 

estimation survey. Each RASCH scalar 

was then converted to IWPUT with the 

formula y = mx + b where m is the slope 

and b is the y-intercept. 

Though we appreciate the effort that 

went into such a method, we have 

several concerns with this approach: (1) 

We do not believe that the RASCH 

paired analysis methodology has been 

approved by the RUC, and has certainly 

not yet been accepted by CMS as a 

method for calculating the intensity of 

a service; (2) we also would want to 

know more about the surveys 

themselves, as well as the instructions 

to the surveyees, before agreeing to any 

work RVUs based on this method; and 

(3) we are concerned that the relativity 

of the fee schedule could be 

compromised by using such a different 

method to determine the work relative 

values of a small number of codes 

because current work RVUs for other 

services are not based on this 

methodology. In addition, we have a 

further concern regarding the 

appropriate relativity of the RUC 

recommendations for these thoracic and 

cardiac procedures. If we assume the 

times in the STS database are accurate, 

by comparing the intra-service times in 

the STS database to the median times 

from the surveys done in 2000 for these 

codes, it appears that surgeons might 

often underestimate the time spent in 

the intra-service period. If this is 

actually the case here, then this could 

also be true for other services that 

would not have the benefit of this 

database. The acceptance of the work 

RVUs derived by this methodology 

could then produce rank order 

anomalies with codes done by other 

specialties and the relativity of the fee 

schedule could be compromised by the 

selective use of this database. 

We would not want to see the RUC 

abandon its survey methodology, unless 

a better approach can be found that can 

be applied to all services. We 

understand that the standard RUC 

survey process is not perfect, but it does 

provide an even playing field for all 

specialties and we would be concerned 

if each specialty was allowed to develop 

its own unique method for estimating 

work RVUs. Therefore, we would 

recommend that the RUC review this 

issue again to determine the appropriate 

use of data sources other than the RUC 

survey. 

It is our responsibility to assure all 

medical specialties that we will review 

and evaluate their services using an 

approach that is accepted by the AMA 

and CMS. However, we do not know 

how to use this STS data to compare the 

relativity of these thoracic and cardiac 

surgery services to services of similar 

intensity in other clinical areas. 

Therefore, we are proposing not to 

accept the RUC work RVU 

recommendations for these codes. 

Because the RUC did approve the use of 

the STS database and the specialty 

societies put forth a substantial effort to 

present their data to the RUC, based on 

that approval, we also do not think it 

would be appropriate to propose 

maintaining the current values. 

We believe the standard RUC survey 

process used to evaluate the cardiac 

surgery codes during the second 5-Year 

Review had the correct incremental 

increase in work RVUs between codes, 

as well as the appropriate intensity for 

each code. We have calculated the 

IWPUT for the current values for all of 

the cardiac codes submitted for review 

(excluding the add-on codes discussed 

below) and multiplied the IWPUT of 

each code with the time proposed for 

that code to yield a new RVU for that 

service. We also calculated an IWPUT 

for the thoracic codes using the current 

values. Because we do not have survey 

data, we believe this is a fair way to 

value the proposed codes while 

maintaining the incremental increase 

between codes. We look forward to 

comments on this issue and would be 

willing to consider future RUC 

recommendations if the specialty 

societies wish to submit standard RUC 

surveys for these codes. 

CPT codes 33517, 33518, 33519, 

33521, 33522, and 33523 are coronary 

surgery bypass codes using venous 

grafts and arterial grafts. These are addon codes used in conjunction with the 

primary code, a coronary arterial graft. 

Add-on codes reflect the additional 

intra-service time required to perform 

the additional venous anastomoses. 

These codes do not contain post-service 

time, critical care time, or hospital care. 

When presented to the RUC, this series 

of codes had critical care time and 

inpatient hospital care time added to the 

total value of the code. We will 

maintain the current RVU valuation for 

CPT codes 33517, 33518, 33519, 33521, 

33522, and 33523. 

Therefore, the proposed work RVUs 

for these CPT codes are as follows: 

32141 = 13.98 work RVUs; 32442 = 

32.86 work RVUs; 32445 = 34.95 work 

RVUs; 32484 = 20.66 work RVUs; 32486 

= 28.40 work RVUs; 32488 = 28.87 work 

RVUs; 32540 = 19.94 work RVUs; 32651 

= 14.26 work RVUs; 32652 = 20.75 work 

RVUs; 32653 = 18.05 work RVUs; 32654 

= 15.82 work RVUs; 32655 = 13.59 work 

RVUs; 32657 = 13.63 work RVUs; 32662 

= 16.42 work RVUs; 32663 = 18.44 work 

RVUs; 32665 = 15.52 work RVUs; 32815 

= 31.17 work RVUs; 33140 = 19.97 work 

RVUs; 33141 = 4.83 work RVUs; 33300 

= 25.09 work RVUs; 33305 = 27.05 work 

RVUs; 33400 = 36.23 work RVUs; 33405 

= 36.64 work RVUs; 33406 = 45.54 work 

RVUs; 33410 = 35.36 work RVUs; 33411 

= 52.12 work RVUs; 33413 = 51.76 work 

RVUs; 33414 = 36.52 work RVUs; 33415 

= 27.11 work RVUs; 33416 = 34.25 work 

RVUs; 33425 = 34.55 work RVUs; 33426 

= 37.95 work RVUs; 33427 = 39.94 work 

RVUs; 33430 = 45.57 work RVUs; 33460 

= 23.56 work RVUs; 33463 = 36.59 work 

RVUs; 33464 = 26.78 work RVUs; 33465 

= 28.75 work RVUs; 33474 = 23.01 work 

RVUs; 33475 = 41.97 work RVUs; 33505 

= 36.00 work RVUs; 33510 = 30.37 work 

RVUs; 33511 = 31.51 work RVUs; 33512 

= 35.16 work RVUs; 33513 = 36.12 work 

RVUs; 33514 = 36.93 work RVUs; 33516 

= 38.39 work RVUs; 33517 = 2.57 work 

RVUs; 33518 = 4.84 work RVUs; 33519 

= 7.11 work RVUs; 33521 = 9.39 work 

RVUs; 33522 = 11.65 work RVUs; 33523 

= 13.93 work RVUs; 33530 = 5.85 work 

RVUs; 33533 = 34.63 work RVUs; 33534 

= 36.06 work RVUs; 33535 = 38.73 work 

RVUs; 33536 = 38.04 work RVUs; 33542 

= 28.81 work RVUs; 33545 = 36.72 work 

RVUs; 33641 = 26.70 work RVUs; 33665 

= 32.98 work RVUs; 33684 = 32.50 work 


jlentini on PROD1PC65 with NOTICES2
37226 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

RVUs; 33688 = 32.88 work RVUs; 33771 

= 38.50 work RVUs; 33779 = 41.00 work 

RVUs; 33781 = 41.00 work RVUs; 

33860= 39.29 work RVUs; 33863 = 44.93 

work RVUs; 33945 = 42.04 work RVUs; 

35820 = 25.53 work RVUs; 39220 = 

17.39 work RVUs; 39400 = 5.60 work 

RVUs; 43108 = 57.20 work RVUs; 43113 

= 40.41 work RVUs; 43116 = 65.85 work 

RVUs; 43118 = 46.37 work RVUs; 43121 

= 41.80 work RVUs; 43123 = 57.14 work 

RVUs; 43124 = 56.51 work RVUs; and 

43135 = 20.52 work RVUs. 

For CPT code 32020, Tube 

thoracostomy with or without water seal 

(e.g., for abscess, hemothorax, 

empyema)(separate procedure), 

although there was no RUC 

recommendation provided due to the 

lack of a level interest for surveying this 

code, we continue to believe that this 

service is misvalued. This code was 

presented to the RUC during the two 

previous 5-Year Reviews. Based on a 

lack of compelling evidence, the RUC 

recommended maintaining the work 

RVUs, and we accepted this 

recommendation. However, we believe 

that since valuation of this CPT code 

continues to be based on Harvard time 

data, changes in practice and technology 

have not been incorporated, leading to 

an overvaluation of this service. The 

Harvard time data for this service 

includes: Pre-service time of 46 

minutes, intra-service time of 24 

minutes, post-service time of 25 

minutes, 9 minutes for ICU time, 15 

minutes for hospital days, and 2 

minutes for office visits for a total time 

of 121 minutes. We believe that CPT 

code 32020 is comparable to CPT code 

38300, Drainage of lymph node abscess 

or lymphadenitis; simple, or CPT code 

38500, Biopsy or excision of lymph 

node(s); open, superficial. Both of these 

CPT codes were reviewed by the RUC 

during the second 5-Year Review. The 

RUC times for CPT code 38500 are: preservice time of 35 minutes, intra-service 

time of 30 minutes and post-service 

time of 15 minutes, for a total time of 

80 minutes, this includes one outpatient 

visit resulting in a work RVU of 3.74. If 

the value of the outpatient visit is 

removed from CPT code 38500, this 

results in an RVU of 3.29. We believe 

CPT code 32020 compares favorably to 

38500 and propose a work RVU of 3.29 

for CPT code 32020. 

7. General, Colorectal and Vascular 

Surgery 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS—GENERAL, 

COLORECTAL AND VASCULAR 

SURGERY’’ at the beginning of your 

comments.] 

a. General Surgery 

The American College of Surgeons 

(ACS) submitted the following CPT 

codes in Table 40 for review. 

TABLE 40 

CPT code Descriptor 

38100 ..................... Splenectomy; total (separate procedure). 

38101 ..................... Splenectomy; partial (separate procedure). 

38115 ..................... Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy. 

43620 ..................... Gastrectomy, total; with esophagoenterostomy. 

43621 ..................... Gastrectomy, total; with Roux-en-Y reconstruction. 

43622 ..................... Gastrectomy, total; with formation of intestinal pouch, any type. 

43632 ..................... Gastrectomy, partial, distal; with gastrojejunostomy. 

43633 ..................... Gastrectomy, partial, distal; with Roux-en-Y reconstruction. 

43634 ..................... Gastrectomy, partial, distal; with formation of intestinal pouch. 

43820 ..................... Gastrojejunostomy; without vagotomy. 

43840 ..................... Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury. 

44120 ..................... Enterectomy, resection of small intestine; single resection and anastomosis. 

44130 ..................... Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure). 

44143 ..................... Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure). 

44602 ..................... Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation. 

44603 ..................... Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations. 

44604 ..................... Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy. 

44605 ..................... Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy. 

47480 ..................... Cholecystotomy or cholecystostomy with exploration, drainage, or removal of calculus (separate procedure). 

47490 ..................... Percutaneous cholecystostomy. 

47510 ..................... Introduction of percutaneous transhepatic catheter for biliary drainage. 

47511 ..................... Introduction of percutaneous transhepatic stent for internal and external biliary drainage. 

47525 ..................... Change of percutaneous biliary drainage catheter. 

47530 ..................... Revision and/or reinsertion of transhepatic tube. 

47760 ..................... Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract. 

47765 ..................... Anastomosis, of intrahepatic ducts and gastrointestinal tract. 

47780 ..................... Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract. 

47785 ..................... Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract. 

49000 ..................... Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure). 

49002 ..................... Reopening of recent laparotomy. 

49010 ..................... Exploration, retroperitoneal area with or without biopsy(s) (separate procedure). 

In addition, the American Society of 

Colon and Rectal Surgeons (ASCRS) 

submitted six CPT codes for review (see 

Table 41). 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37227 

TABLE 41 

CPT code Descriptor 

44150 ..................... Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy. 

44151 ..................... Colectomy, total, abdominal, without proctectomy; with continent ileostomy. 

44152 ..................... Colectomy, total, abdominal, without proctectomy; with rectal mucosectomy, ileoanal anastomosis, with or without loop ileostomy. 

44153 ..................... Colectomy, total, abdominal, without proctectomy; with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy. 

44155 ..................... Colectomy, total, abdominal, with proctectomy; with ileostomy. 

44156 ..................... Colectomy, total, abdominal, with proctectomy; with continent ileostomy. 

We submitted the CPT codes in Table 

42 for review. 

TABLE 42 

CPT code Descriptor 

19180 ..................... Mastectomy, simple, complete. 

44140 ..................... Colectomy, partial; with anastomosis. 

47562 ..................... Laparoscopy, surgical; cholecystectomy. 

49505 ..................... Repair initial inguinal hernia, age 5 years or over; reducible. 

47600 ..................... Cholecystectomy. 

However, the following CPT codes 

were subsequently withdrawn from the 

5-Year Review: 44604, 44605, 47480, 

47490, 47510, 47511, 47525 and 47530. 

ASCRS also withdrew CPT codes 44152 

and 44153, and is referring them to the 

CPT Editorial Panel. 

For most codes, a standard RUC 

survey with over 30 responses was used. 

However, the surveys for CPT code 

43622 had 29 responses and CPT code 

43634 had 26 responses. Minisurveys, 

with over 30 responses, were used for 

CPT codes 44151 and 44156. Where 

NSQIP data was available, the specialty 

society also used an alternative 

methodology based on a building-block 

approach that used intra-service times 

and length of stay data from the NSQIP 

database to develop the 

recommendations. A specialty society 

consensus panel then assigned preservice times, immediate post-service 

times, as well as IWPUT estimates, with 

the number and level of office visits 

determined based on comparisons to 

codes requiring similar physician work. 

RUC Recommendations 

The RUC recommended maintaining 

the existing RVUs for CPT codes 44140 

and 49505 because the RUC believed 

there was a lack of compelling evidence 

that the work had changed. 

For those services without NSQIP 

data, where only survey data was used 

as a basis for review, the RUC 

recommended the survey median for 

CPT codes 38100, 38101, 38115, 43620, 

43632, 43634, 44156, 47765. For CPT 

code 49010, the RUC recommended use 

of the survey’s 25th percentile because 

the RUC recommended deleting one 

hospital visit. For CPT code 47760, the 

RUC recommended the 25th percentile 

because the RUC believed that the 25th 

percentile was closer to the reference 

code. The RUC recommended use of the 

surveyed 75th percentile (25 work 

RVUs) for: CPT code 44603, which 

represents the suturing of multiple 

small intestinal perforations, to keep the 

correct rank order with CPT code 44602 

(22.00 recommended work RVUs) that is 

used for the repair of a single 

perforation; CPT code 43622 because 

the RUC believed that the use of the 

median value would create a rank order 

anomaly; and CPT code 44151 because 

the RUC believed that the survey 

underestimated the physician time 

required for the service. 

For CPT codes 47780 and 47785, the 

RUC used a building-block method to 

arrive at a recommendation which 

added 4.00 work RVUs to the 

recommended work RVUs for the 

respective base CPT codes 47760 and 

47765 to account for the Roux-en-Y 

procedure. This resulted in 

recommended RVUs that were lower 

than the survey median for CPT code 

47780 and higher for CPT code 47785. 

For services for which NSQIP data 

were presented along with survey data, 

the RUC recommended the use of the 

surveys 25th percentile for CPT codes 

19180, 47562, and 49002. The RUC used 

the NSQIP data to validate the 

recommendation to use the surveyed 

median work RVUs for CPT codes 

43632, 43633, 43820, 43840, 44143, 

44150, 44155 and 44602. Other RUC 

recommendations used the NSQIP data 

to increase the work RVUs above the 

survey median and, in one instance, 

beyond the survey’s 75th percentile. For 

CPT codes 44120, 44130 and 47600, the 

RUC believed the physicians responding 

to the survey underestimated their intraservice time. Therefore, the RUC 

applied what was believed to be an 

appropriate IWPUT to the additional 

NSQIP time and added the resulting 

work RVUs to the survey median. 

The RUC recommended that CPT 

code 49000 be referred to the CPT 

Editorial Panel because this code is 

currently used for two distinct patient 

populations and needs to be separated 

into two codes to be appropriately 

valued. 

The 5-Year Review process allows 

specialty societies to request that the 

RUC review the work RVUs of 

additional codes where a rank order 

anomaly might have been caused by a 

RUC 5-Year Review recommendation for 

codes in the same family. Upon 

reviewing the workgroup 

recommendations for the partial 

colectomy procedures, CPT codes 44140 

and 44143, the RUC determined that 

other codes in the family, CPT codes 

44141, 44144, 44145, 44146 and 44147, 

needed to be reviewed to avoid rank 

order anomalies. 

The RUC considered these CPT codes 

at their February 2006 meeting. The 

specialty society presented standard 

RUC surveys for all these services. For 

CPT codes 44141, 44144, 44146 and 

44147, the RUC recommended the 

survey median. However, for CPT code 

44145, the RUC recommended to 

maintain the current value of 26.38 


jlentini on PROD1PC65 with NOTICES2
37228 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

work RVUs because the post-operative 

work is slightly less than the CPT code 

44144 for which 27.00 work RVUs are 

recommended. 

The RUC-recommended work RVUs 

for these CPT codes were as follows: 

19180 = 14.67 work RVUs; 38100 = 

18.00 work RVUs; 38101 = 18.00 work 

RVUs; 38115 = 20.00 work RVUs; 43620 

= 31.00 work RVUs; 43621 = 36.00 work 

RVUs; 43622 = 36.50 work RVUs; 43632 

= 32.00 work RVUs; 43633 = 30.00 work 

RVUs; 43634 = 33.50 work RVUs; 43820 

= 20.00 work RVUs; 43840 = 20.00 work 

RVUs; 44120 = 20.11 work RVUs; 44130 

= 20.87 work RVUs; 44140 = 20.97 work 

RVUs; 44141 = 27.00 work RVUs; 44143 

= 25.00 work RVUs; 44144 = 27.00 work 

RVUs; 44145 = 26.38 work RVUs; 44146 

= 33.00 work RVUs; 44147 = 31.00 work 

RVUs; 44150 = 27.50 work RVUs; 44151 

= 32.00 work RVUs; 44155 = 31.50 work 

RVUs; 44156 = 34.50 work RVUs; 44602 

= 22.00 work RVUs; 44603 = 25.00 work 

RVUs; 47562 = 11.07 work RVUs; 47600 

= 15.88 work RVUs; 47760 = 34.75 work 

RVUs; 47765 = 48.50 work RVUs; 47780 

= 38.75 work RVUs; 47785 = 52.50 work 

RVUs; 49002 = 15.75 work RVUs; 49010 

= 15.00 work RVUs; and 49505 = 7.59 

work RVUs. 

CMS Proposed Valuation 

We agree with the RUC-recommended 

work RVUs for CPT codes 19180, 38100, 

38101, 38115, 43620, 43621, 43622, 

43632, 43633, 43634, 43820, 43840, 

44140, 44141, 44143, 44144, 44145, 

44146, 44147, 44150, 44151, 44155, 

44156, 44602, 44603, 47562, 47760, 

47765, 47780, 47785, 49002, 49010 and 

49505. 

We have concerns with the RUC 

recommendations to use the NSQIP data 

to increase the work RVUs for CPT 

codes 44120, 44130 and 47600 above 

the median, and, for 47600 above the 

75th percentile, from the survey. While 

we support the use of such a database 

as validation for survey results, we 

believe that the application of the 

NSQIP IWPUT to the 25-minute 

difference in intra-time between the 

survey and NSQIP is questionable. First, 

it is still not clear whether the NSQIP 

data is truly representative. Second, the 

IWPUT applied to the additional 25 

minutes is higher than the IWPUT for 

the rest of the intra-time. Third, such a 

methodology assumes, without 

evidence, that there is a linear 

relationship between the survey 

respondents’ estimate of time and 

estimate of work RVUs; however, even 

if the survey time estimates had 

matched the NSQIP data, it is not clear 

whether or by how much the 

respondents would have increased their 

work value estimate. Fourth, until we 

have available valid and representative 

data such as the NSQIP for all 

procedures, there is the risk that 

applying the data randomly could 

distort the relativity between services. 

Therefore, we are proposing to use the 

median survey values of 18.00, 20.00 

and 14.00 as the work RVUs for CPT 

codes 44120, 44130 and 47600, 

respectively. 

b. Colon and Rectal Surgery 

The ASCRS submitted several 

colorectal surgery CPT codes (see Table 

43). 

TABLE 43 

CPT code Descriptor 

45020 ..................... Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess. 

45300 ..................... Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). 

45303 ..................... Proctosigmoidoscopy, rigid; with dilation (e.g., balloon, guide wire, bougie). 

45305 ..................... Proctosigmoidoscopy, rigid; with biopsy, single or multiple. 

45307 ..................... Proctosigmoidoscopy, rigid; with removal of foreign body. 

45308 ..................... Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery. 

45309 ..................... Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique. 

45315 ..................... Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery 

or snare technique. 

45317 ..................... Proctosigmoidoscopy, rigid; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, 

stapler, plasma coagulator). 

45320 ..................... Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy 

forceps, bipolar cautery or snare technique (e.g., laser). 

45321 ..................... Proctosigmoidoscopy, rigid; with decompression of volvulus. 

45327 ..................... Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation). 

46040 ..................... Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure). 

46045 ..................... Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia. 

46060 ..................... Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without 

placement of seton. 

46270 ..................... Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous. 

46275 ..................... Surgical treatment of anal fistula (fistulectomy/fistulotomy); submuscular. 

46280 ..................... Surgical treatment of anal fistula (fistulectomy/fistulotomy); complex or multiple, with or without placement of seton. 

46285 ..................... Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage. 

46600 ..................... Anoscopy; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). 

46604 ..................... Anoscopy; with dilation (e.g., balloon, guide wire, bougie). 

46606 ..................... Anoscopy; with biopsy, single or multiple. 

46608 ..................... Anoscopy; with removal of foreign body. 

46610 ..................... Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery. 

46611 ..................... Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique. 

46612 ..................... Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique. 

46614 ..................... Anoscopy; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma 

coagulator). 

46615 ..................... Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar 

cautery or snare technique. 

46760 ..................... Sphincteroplasty, anal, for incontinence, adult; muscle transplant. 

46761 ..................... Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair). 

46762 ..................... Sphincteroplasty, anal, for incontinence, adult; implantation artificial sphincter. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37229 

ASCRS subsequently withdrew CPT 

codes 46760, 46761 and 46762 from the 

5-Year Review. 

For most codes, a standard RUC 

survey with over 30 responses was used. 

A minisurvey was used for a few codes. 

RUC Recommendations 

The RUC agreed with the specialty 

society’s recommendations to maintain 

the current work RVUs for CPT codes 

46040, 46060 and 46280 because the 

survey data supported the existing work 

associated with the code. 

The RUC recommended the increased 

work RVUs at the surveys’ median work 

values, as requested by the specialty 

society, for CPT codes 45020, 46045, 

46270, 46275 and 46285. 

For the proctoscopy-anoscopy family 

of codes, the RUC agreed that the 

surveyed median work RVUs, and often 

even the 25th percentile, were 

inconsistent with the reference code. 

Therefore, the RUC did not reference the 

surveyed RVUs in arriving at the 

recommendations. Rather, the RUC used 

the surveyed times for each service and 

applied what the workgroup considered 

an appropriate IWPUT to these times to 

arrive at the recommended work RVUs 

for this family. 

The specific RUC work RVU 

recommendations for these colon and 

rectal surgery CPT codes were as 

follows: 45020 = 7.75 work RVUs; 45300 

= 0.91 work RVUs; 45303 = 2.22 work 

RVUs; 45305 = 2.01 work RVUs; 45307 

= 2.22 work RVUs; 45308 = 2.01 work 

RVUs; 45309 = 2.22 work RVUs; 45315 

= 2.22 work RVUs; 45317 = 1.08 work 

RVUs; 45320 = 2.43 work RVUs; 45321 

= 2.76 work RVUs; 45327 = 3.63 work 

RVUs; 46040 = 4.95 work RVUs; 46045 

= 5.50 work RVUs; 46060 = 5.68 work 

RVUs; 46270 = 4.50 work RVUs; 46275 

= 5.00 work RVUs; 46280 = 5.97 work 

RVUs; 46285 = 5.00 work RVUs; 46600 

= 0.49 work RVUs; 46604 = 1.08 work 

RVUs; 46606 = 1.76 work RVUs; 46608 

= 1.95 work RVUs; 46610 = 1.95 work 

RVUs; 46611 = 1.08 work RVUs; 46612 

= 2.14 work RVUs; 46614 = 1.08 work 

RVUs; and 46615 = 1.18 work RVUs. 

CMS Proposed Valuation 

We agree with the RUC-recommended 

work RVUs for CPT codes 45020, 46040, 

46045, 46060, 46270, 46275, 46280, and 

46285. 

We are proposing not to accept the 

RUC recommendations for all the 

presented codes in the proctoscopyanoscopy family. We are proposing to 

maintain the current work RVUs for 

CPT codes 45300, 45303, 45305, 45307, 

45308, 45309, 45315, 45317, 45320, 

45321, 45327, 46600, 46604, 46606, 

46608, 46610, 46611, 46612, 46614 and 

46615. 

We believe that the method used by 

the RUC to obtain work values for these 

services was flawed. The calculation of 

the recommended work RVUs depended 

solely on applying a workgroup-derived 

IWPUT to the surveyed physician time 

from surveys that were considered 

otherwise unusable. We do not believe 

that the use of IWPUT, in the absence 

of other supporting data, has been 

previously accepted by the RUC. We 

believe the RUC has established rules 

that state that IWPUT cannot be the sole 

rationale for valuation and it appears 

that this workgroup might not have 

adhered to that standard. We believe 

that this use of IWPUT differs from that 

used by workgroup one, as described 

above. There were acceptable surveys 

that were used as anchors to create the 

correct rank order for the dermatology 

codes without adequate surveys. In 

addition, for the dermatology codes, the 

calculation was generally used to 

validate the current or lower work RVUs 

for the services, while for these scope 

codes, the calculation was not used to 

validate but to support significant 

increases for many of the services. 

However, if the specialty society wishes 

to resurvey these codes and the RUC 

submits work RVU recommendations to 

CMS, we would certainly be willing to 

consider them. 

c. Vascular Surgery 

The Society for Vascular Surgery 

(SVS) submitted the CPT codes in Table 

44 for review. However, the specialty 

society subsequently withdrew CPT 

codes 27603, 35612 and 35642 from 

review. 

TABLE 44 

CPT code Descriptor 

27603 ..................... Incision and drainage, leg or ankle; deep abscess or hematoma. 

27880 ..................... Amputation, leg, through tibia and fibula. 

28805 ..................... Amputation, foot; transmetatarsal. 

33877 ..................... Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass. 

34001 ..................... Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision. 

34201 ..................... Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision. 

34471 ..................... Thrombectomy, direct or with catheter; subclavian vein, by neck incision. 

35081 ..................... Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for 

aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta. 

35102 ..................... Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for 

aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, 

hypogastric, external). 

35216 ..................... Repair blood vessel, direct; intrathoracic, without bypass. 

35381 ..................... Thromboendarterectomy, with or without patch graft; femoral and/or popliteal, and/or tibioperoneal. 

35501 ..................... Bypass graft, with vein; carotid. 

35506 ..................... Bypass graft, with vein; carotid-subclavian. 

35507 ..................... Bypass graft, with vein; subclavian-carotid. 

35508 ..................... Bypass graft, with vein; carotid-vertebral. 

35509 ..................... Bypass graft, with vein; carotid-carotid. 

35515 ..................... Bypass graft, with vein; subclavian-vertebral. 

35516 ..................... Bypass graft, with vein; subclavian-axillary. 

35541 ..................... Bypass graft, with vein; aortoiliac or bi-iliac. 

35546 ..................... Bypass graft, with vein; aortofemoral or bifemoral. 

35556 ..................... Bypass graft, with vein; femoral-popliteal. 

35566 ..................... Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels. 

35583 ..................... In-situ vein bypass; femoral-popliteal. 

35585 ..................... In-situ vein bypass; femoral-anterior tibial, posterior tibial,or peroneal artery. 

35601 ..................... Bypass graft, with other than vein; carotid. 

35606 ..................... Bypass graft, with other than vein; carotid-subclavian. 


jlentini on PROD1PC65 with NOTICES2
37230 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

TABLE 44—Continued 

CPT code Descriptor 

35612 ..................... Bypass graft, with other than vein; subclavian-subclavian. 

35616 ..................... Bypass graft, with other than vein; subclavian-axillary. 

35641 ..................... Bypass graft, with other than vein; aortoiliac or bi-iliac. 

35642 ..................... Bypass graft, with other than vein; carotid-vertebral. 

37720 ..................... Ligation and division and complete stripping of long or short saphenous veins. 

60600 ..................... Excision of carotid body tumor; without excision of carotid artery. 

60605 ..................... Excision of carotid body tumor; with excision of carotid artery. 

For all codes, a standard RUC survey 

was used. All but the following CPT 

codes had 30 or more responses: 34471 

(28 responses), 35508 (23 responses), 

35515 (18 responses), 35516 (29 

responses), 35616 (29 responses), 60600 

(19 responses). The specialty society 

also used the intra-service times and 

length of stay data from the NSQIP 

database to develop some of its 

recommendations. A specialty society 

consensus panel then assigned preservice times, and immediate postservice times, as well as IWPUT 

estimates. 

RUC Recommendations 

The RUC agreed with the specialty 

society that the following CPT codes 

cannot undergo the RUC evaluation 

process before having their descriptors 

revised and recommended referring 

these CPT codes to the CPT Editorial 

panel: 35381, 35501, 35507, 35509, 

35541, 35546, 35601, 35641 and 37720. 

(Note that CPT code 37720 was 

subsequently deleted by CPT for CY 

2006.) For the remaining codes, the RUC 

reviewed both the survey data and the 

NSQIP data, where provided, for each 

procedure. In many instances, where the 

NSQIP time and length of stay data were 

available, the RUC believed that the 

physicians responding to the survey 

underestimated their intra-service time 

and that the NSQIP data more 

accurately reflected the actual intraservice times for these procedures. 

The RUC accepted the specialty 

society’s requested increase in work 

RVUs for 12 CPT codes, agreeing with 

the specialty society that these 

procedures were undervalued due to 

compelling evidence such as changes in 

length of stay, changes in patient 

populations, and incorrect assumptions 

made in the previous valuation of the 

service. For CPT codes 27880, 28805, 

34001, 34471, 35506, 35508, 35515, 

35516, 35606, 60600 and 60605, the 

RUC-recommended work RVUs were at 

the survey median or lower. However, 

for CPT code 33877, the RUC accepted 

a work value greater than the survey’s 

75th percentile that was derived from a 

building-block approach using the 

NSQIP data for the service. The RUC 

increased the work RVUs for nine codes. 

For eight of the codes, the increases 

were at levels below those requested by 

the specialty society, and for one code 

the increase was slightly higher than the 

requested work RVUs. For CPT codes 

35081, 35216, 35583 and 35616, the 

recommended increase was no higher 

than the surveyed median work RVUs. 

For CPT codes 34201, 35102, 35556, 

35566, and 35585, the RUC accepted 

work values greater than the survey’s 

median percentile that were derived 

from a building-block approach using 

the NSQIP data for the service. 

The specific RUC-recommended work 

RVUs for these CPT codes are as 

follows: 27880 = 13.75 work RVUs; 

28805 = 11.25 work RVUs; 33877 = 

64.04 work RVUs; 34001 = 16.25 work 

RVUs; 34201 = 18.31 work RVUs; 34471 

= 20.00 work RVUs; 35081 = 31.00 work 

RVUs; 35102 = 36.28 work RVUs; 35216 

= 34.00 work RVUs; 35506 = 23.75 work 

RVUs; 35508 = 25.00 work RVUs; 35515 

= 25.00 work RVUs; 35516 = 23.00 work 

RVUs; 35556 = 27.25 work RVUs; 35566 

= 32.00 work RVUs; 35583 = 26.00 work 

RVUs; 35585 = 32.00 work RVUs; 35606 

= 21.00 work RVUs; 35616 = 21.00 work 

RVUs; 60600 = 24.00 work RVUs; and 

60605 = 30.50 work RVUs. 

CMS Proposed Valuation 

We accept the RUC-recommended 

work RVUs for CPT codes 27880, 28805, 

34001, 34471, 35216, 35506, 35508, 

35515, 35516, 35606, 60600, 60605, 

35081, 35583, and 35616. 

We disagree with the RUC 

recommendations for CPT codes 33877, 

34201, 35102, 35556, 35566, and 35585. 

For these services, the RUC used the 

NSQIP time data to increase the work 

values above the survey median, and 

even for above several codes the 75th 

percentile. For the reasons discussed 

above, we reject such a use of the NSQIP 

data at this time. Therefore, we are 

proposing to use the survey median 

work RVUs for these CPT codes: 33877 

= 53.00 work RVUs; 34201 = 17.00 work 

RVUs; 35102 = 34.00 work RVUs; 35556 

= 25.00 work RVUs; 35566 = 30.00 work 

RVUs; and 35585 = 30.00 work RVUs. 

8. Otolaryngology and Ophthalmology 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS–OTOLARYNGOLOGY 

AND OPTHALMOLOGY’’ at the 

beginning of your comments.] 

a. Otolaryngology Procedures 

The American Academy of 

Otolaryngology—Head and Neck 

Surgery (AAO-HNS) submitted the CPT 

codes in Table 45 for review. 

TABLE 45 

CPT code Descriptor 

31225 ..................... Maxillectomy; without orbital extenteration. 

31230 ..................... Maxillectomy; with orbital exenteration (en bloc). 

31360 ..................... Laryngectomy; total, without radical neck dissection. 

31365 ..................... Laryngectomy; total, with radical neck dissection. 

31367 ..................... Laryngectomy; subtotal supraglottic, without radical neck dissection. 

31368 ..................... Laryngectomy; subtotal supraglottic, with radical neck dissection. 

31370 ..................... Partial laryngectomy (hemilaryngectomy); horizontal. 

31375 ..................... Partial laryngectomy (hemilaryngectomy); laterovertical. 

31380 ..................... Partial laryngectomy (hemilaryngectomy); anterovertical. 

31382 ..................... Partial laryngectomy (hemilaryngectomy); antero-latero-vertical. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37231 

TABLE 45—Continued 

CPT code Descriptor 

31390 ..................... Pharyngolaryngectomy, with radical neck dissection; without reconstruction. 

31395 ..................... Pharyngolaryngectomy, with radical neck dissection; with reconstruction. 

38700 ..................... Suprahyoid lymphadenectomy. 

38720 ..................... Cervical lymphadenectomy (complete). 

38724 ..................... Cervical lymphadenectomy (modified radical neck dissection). 

41120 ..................... Glossectomy; less than one-half tongue. 

41130 ..................... Glossectomy; hemiglossectomy. 

41135 ..................... Glossectomy; partial, with unilateral radical neck dissection. 

41140 ..................... Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection. 

41145 ..................... Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection. 

41150 ..................... Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection. 

41153 ..................... Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection. 

41155 ..................... Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type). 

42120 ..................... Resection of palate or extensive resection of lesion. 

42842 ..................... Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure. 

42844 ..................... Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (e.g., tongue, buccal). 

42845 ..................... Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap. 

42890 ..................... Limited pharyngectomy. 

42892 ..................... Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal 

walls. 

42894 ..................... Resection of pharyngeal wall requiring closure with myocutaneous flap. 

We initially requested that the RUC 

review five CPT codes but then 

withdrew CPT code 31255 from the 5- 

Year Review (see Table 46). 

TABLE 46 

CPT code Descriptor 

30520 ..................... Septoplasty or submucous resection, with or without cartilage scoring, contouring replacement with graft. 

31255 ..................... Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior). 

31575 ..................... Laryngoscopy, flexible fiberoptic; diagnostic. 

31579 ..................... Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy. 

41100 ..................... Biopsy of tongue; anterior two-thirds. 

69210 ..................... Removal impacted cerumen (separate procedure), one or both ears. 

RUC Recommendations 

For one CPT code 42120, palate 

resection procedure, the RUC, based on 

the data presented by the specialty 

society, agreed that there was increased 

work and intensity involved in 

comparison to other codes with similar 

intensity. The RUC believed the survey 

results reflected the complexity of the 

patient, physician time and work 

necessary in performing this procedure, 

and recommended work RVUs of 11.00 

for CPT code 42120. 

The specialty society presented data 

on two maxillectomy procedures, CPT 

codes 31225 and 31230, which the RUC 

also viewed as undervalued. The RUC 

believed that the re-evaluation of these 

two codes corrects rank order anomalies 

and accounts for the appropriate 

intensity for each procedure. The RUC 

recommended work RVUs of 24.00 for 

CPT code 31225 and 28.00 for CPT code 

31230. 

For three lymphadendectomy 

procedures, CPT codes 38700, 38720, 

and 38724, the specialty society 

presented data with the rationale that 

the previous valuation was flawed 

because the procedures were not 

evaluated by otolaryngologists. The RUC 

believed that the survey results reflected 

the appropriate complexity of the 

patient, physician time and work 

necessary in performing the procedure, 

and justified an increase in physician 

work. The RUC-recommended work 

RVUs for these CPT codes are as 

follows: 38700 = 12.00 work RVUs; 

38720 = 20.00 work RVUs; and 38724 = 

22.00 work RVUs. 

The specialty society presented 

survey data on three pharyngectomy 

procedures, CPT codes 42890, 42892, 

and 42894, which had never been 

reviewed by the RUC. The RUC agreed 

that there was a change in the patient 

population and that the increased 

intensity involved in these procedures 

was comparable to other codes with 

similar intensity. The RUC 

recommended the increase 

demonstrated by the survey median 

which was 17.00 work RVUs for CPT 

code 42890, 23.09 work RVUs for CPT 

code 42892, and 30.00 work RVUs for 

CPT code 42894. 

The specialty society presented 

survey data on three tonsillectomy 

procedures, CPT codes 42842, 42844, 

and 42845, which the RUC agreed were 

undervalued due to a previous flawed 

methodology. The RUC believed that the 

survey results reflected the appropriate 

physician work and time necessary in 

performing this procedure and 

recommended the following work RVUs 

for these CPT codes: 42842 = 11.00 work 

RVUs; 42844 = 16.10 work RVUs; and 

42845 = 32.00 work RVUs. 

For the partial glossectomy 

procedures, CPT codes 41120, 41130, 

and 41135, the RUC believed that there 

was not compelling evidence to increase 

the work for CPT code 41120, and, 

therefore, recommended maintaining 

the current value for this service. The 

RUC also agreed that increasing the 

values for the two remaining procedures 

would correct the existing rank order 

anomalies and that these increases were 


jlentini on PROD1PC65 with NOTICES2
37232 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

justified by survey results. The 

recommendation for the work RVUs for 

these CPT codes is as follows: 41120 = 

9.76 work RVUs; 41130 = 14.00 work 

RVUs; and 41135 = 27.00 work RVUs. 

For complete glossectomy procedures, 

CPT codes 41140 and 41145, the 

specialty society presented survey data 

on these procedures and suggested 

decreasing the work RVU of CPT code 

41140. The RUC believed that the 

survey results did not justify decreasing 

the work RVUs for this service, 

particularly because over half of the 

survey respondents indicated that the 

work of performing CPT code 41140 has 

not changed in the past 5 years. 

Therefore, the RUC recommended 

maintaining the value for this code. The 

RUC believed that the flawed 

methodology previously used for 

valuing CPT code 41145 caused this 

procedure to be misvalued and that an 

increase in work was validated by the 

survey median results. The RUC 

recommended the following work RVUs 

for these CPT codes: 41140 = 25.46 work 

RVUs; and 41145 = 34.00 work RVUs. 

For the composite glossectomy 

procedures, CPT codes 41150, 41153, 

and 41155, the specialty society 

presented survey data on each of these 

procedures, noting that the current work 

RVUs for each of these services create a 

rank order anomaly. The RUC agreed 

that increasing the RVUs would correct 

these rank order anomalies and that 

these increases were justified by the 

survey results. The RUC-recommended 

work RVUs for these CPT codes are as 

follows: 41150 = 26.50 work RVUs; 

41153 = 34.00 work RVUs; and 41155 = 

40.00 work RVUs. 

For the laryngopharyngectomy 

procedures, CPT codes 31360, 31365, 

31390 and 31395, the specialty society 

presented as compelling evidence the 

rationale that the current work RVUs 

create rank order anomalies, and that 

there also has been a change in the 

patient population. The RUC agreed that 

increasing the RVUs of these procedures 

by accepting the 75th percentile of 

survey results corrected the specific 

rank order anomalies and also 

accounted for the change in the patient 

population. The RUC-recommended 

work RVUs for these CPT codes are as 

follows: 31360 = 28.00 work RVUs; 

31365 = 37.00 work RVUs; 31390 = 

40.00 work RVUs; and 31395 = 44.00 

work RVUs. 

For the laryngectomy procedures, CPT 

codes 31367, 31368, 31370, 31375, 

31380 and 31382, the specialty society 

presented survey data with the rationale 

that the current work values are based 

on a flawed methodology that creates 

rank order anomalies, and that there 

also has been a change in patient 

population. The RUC agreed with the 

specialty society and recommended 

increasing the work RVUs for these 

services to maintain rank order between 

the codes in the family and to establish 

the correct intensity of the procedure 

based on the change in patient 

population. The RUC-recommended 

work RVUs for these CPT codes are: 

31367 = 27.36 work RVUs; 31368 = 

36.00 work RVUs; 31370 = 25.00 work 

RVUs; 31375 = 25.00 work RVUs; 31380 

= 25.00 work RVUs; and 31382 = 28.00 

work RVUs. 

For CPT code 30520, based on the 

increase in physician time in the current 

survey data, the RUC believed that the 

service was misvalued and that there 

was additional work involved which 

was not previously captured. Using the 

building-block methodology, the RUC 

recommended a work RVU of 6.27 for 

CPT code 30520. 

For CPT codes 31575 and 31579, the 

RUC agreed with the specialty society 

that the surveys validate the current 

values. The RUC also believed that the 

survey validated the current work value 

for CPT code 41100, particularly 

because 98 percent of survey 

respondents indicated that the work in 

performing this service has not changed 

in the past 5 years. The RUC 

recommended maintaining the original 

work values of 1.10 work RVUs for CPT 

code 31575, 2.26 work RVUs for CPT 

code 31579, and 1.63 work RVUs for 

CPT code 41100. 

The specialty society provided survey 

data for CPT code 69210 using the 

rationale that the patient population had 

become more complex. The RUC did not 

agree with the specialty society that the 

patient population had changed because 

94 percent of the survey respondents 

indicated that the work in performing 

this service has not changed in the past 

5 years. The RUC recommended 

maintaining the current work value of 

0.61 for this service. 

CMS Proposed Valuation 

We are in agreement with the RUCrecommended work RVUs for the 

following otolaryngology CPT codes: 

38700, 38720, 38724, 41120, 41130, 

41135, 41140, 41145, 42120, 42890, 

42892, and 42894. 

For the tonsillectomy procedures, 

CPT codes 42842, 42844, and 42845, the 

number of hospital days decreased by at 

least two days (including critical care 

visits for one code), but the outpatient 

post-operative visits increased by one. 

The median values for intra-service 

times were accepted by the RUC for 

these services, which is an indication 

that a value other than the 75th 

percentile for work also may be 

appropriate. CPT codes 42842 and 

42844 were valued at the median work 

RVU obtained from the surveys. 

However, CPT code 42845 was valued 

by the RUC at the 75th percentile for 

work. Therefore, we are accepting the 

median recommended work values for 

CPT codes 42842 of 11.00 work RVUs 

and 42844 of 16.10 work RVUs and, 

consistent with use of the median, 

proposing work RVUs for CPT code 

42845 of 29.00. 

For the composite glossectomy 

procedures, CPT codes 41150, 41153, 

and 41155, the number of hospital days 

decreased by at least 2 days (including, 

in some instances, critical care visits). 

CPT codes 41153 and 41155 were 

valued by the RUC at the 75th percentile 

for work, but CPT code 41150 was 

valued based on the median work value. 

The median values for intra-service 

times were accepted by the RUC for 

these services, which is an indication 

that a value other than the 75th 

percentile for work also may be 

appropriate. Therefore, we are accepting 

the RUC-recommended work RVUs of 

26.50 for CPT code 41150 which were 

based on the median work value, and 

consistent with use of the median 

proposing work RVUs of 30.00 for CPT 

code 41153 and 36.00 for CPT code 

41155. 

For the laryngopharyngectomy 

procedures, CPT codes 31360, 31365, 

31367, 31368, 31370, 31375, 31380, 

31382, 31390 and 31395, the number of 

hospital days decreased by at least two 

days and the post-operative outpatient 

visits increased by one day. However, in 

one instance the number of outpatient 

visits decreased (CPT code 31395). The 

median values for intra-service times 

were accepted by the RUC for these 

services, which is an indication that a 

value other than the 75th percentile for 

work also may be appropriate. 

Therefore, we are proposing using 

median values for these services 

resulting in the following work RVUs 

for these CPT codes: 31360 = 24.00 work 

RVUs; 31365 = 31.50 work RVUs; 31367 

= 24.00 work RVUs; 31368 = 30.50 work 

RVUs; 31370 = 24.00 work RVUs; 31375 

= 22.50 work RVUs; 31380 = 22.00 work 

RVUs; 31382 = 25.00 work RVUs; 31390 

= 35.00 work RVUs; and 31395 = 39.50 

work RVUs. 

For CPT codes 30520, 31575, 31579, 

41100 and 69210, we are in agreement 

with the RUC-recommended work RVUs 

for these services, except for CPT code 

41100. The RUC recommended 

maintaining the current work RVUs of 

1.63 for this service, which is even 

greater than the 75th percentile for 

work, which is what the specialty 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37233 

society had recommended. We believe 

the more appropriate work RVUs for 

this service is represented by the 

median, which is 1.37, and, therefore, 

we are recommending 1.37 work RVUs 

for CPT code 41100. 

We would note that although we 

accepted the RUC’s recommendation of 

a work RVU of 0.61 for CPT code 69210, 

we are concerned with this valuation for 

the use of this code for routine removal 

of ear wax during a physical 

examination of a patient. This code is 

listed with a ‘‘separate procedure’’

designation in the CPT code book, 

meaning that it is billed most properly 

when it is the only service provided for 

a particular date of service. However, 

Medicare data used for evaluation of 

codes in the current 5-Year Review 

indicate that CPT code 69210 was billed 

with an E/M service 63 percent of the 

time. It is our understanding that CPT 

code 69210 is to be used when there is 

a substantial amount of cerumen in the 

external ear canal that is very difficult 

to remove and that impairs the patient’s 

auditory function. We will continue to 

monitor the use of this code for the 

appropriate circumstances. 

b. Ophthalmology Services 

The American Academy of 

Ophthalmology (AAO), the American 

Optometric Association (AOA) and the 

American Society of Cataract and 

Refractive Surgery submitted 15 codes 

for the 5-Year Review (see Table 47). 

However, the specialty societies 

subsequently withdrew five of these 

codes (CPT codes 65420, 65900, 67917, 

67924 and 68750) from the 5-Year 

Review. 

TABLE 47 

CPT code Descriptor 

65420 ..................... Excision or transposition of pterygium; without graft. 

65426 ..................... Excision or transposition of pterygium; with graft. 

65850 ..................... Trabeculotomy ab externo. 

65900 ..................... Removal of epithelial downgrowth, anterior chamber of eye. 

67414 ..................... Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression. 

67445 ..................... Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of bone for decompression. 

67500 ..................... Retrobulbar injection; medication (separate procedure, does not include supply of medication). 

67505 ..................... Retrobulbar injection; alcohol. 

67515 ..................... Injection of medication or other substance into Tenon’s capsule. 

67904 ..................... Repair of blepharoptosis; (tarso) levator resection or advancement, external approach. 

67911 ..................... Correction of lid retraction. 

67917 ..................... Repair of ectropion; extensive (e.g., tarsal strip operations). 

67924 ..................... Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation). 

67966 ..................... Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation 

for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin. 

68750 ..................... Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent . 

We submitted the following 

ophthalmology CPT codes for review 

(see Table 48). 

TABLE 48 

CPT code Descriptor 

66761 ..................... Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (one or more sessions). 

66821 ..................... Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery 

(e.g., YAG laser) (one or more stages). 

66984 ..................... Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical 

technique (e.g., irrigation and aspiration or phacoemulsification). 

67038 ..................... Vitrectomy, mechanical, pars plana approach; with epiretinal membrane stripping. 

67221 ..................... Destruction of localized lesion of choroid (e.g., choroidal neovascularization); photodynamic therapy (includes intravenous 

infusion). 

67228 ..................... Destruction of extensive or progressive retinopathy (e.g., diabetic retinopathy), one or more sessions; photocoagulation 

(laser or xenon arc). 

67820 ..................... Correction of trichiasis; epilation, by forceps only. 

67840 ..................... Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure. 

68840 ..................... Probing of lacrimal canaliculi, with or without irrigation. 

76519 ..................... Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation. 

92083 ..................... Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (e.g., Goldmann visual 

fields with at least 3 isopters plotted and static determination within the central 30°, or quantitative, automated threshold 

perimetry, Octopus program G–1, 32 or 42, Humphrey visual field analyzer full threshold programs 30–2, 24–2 or 30/ 

60–2. 

92226 ..................... Ophthalmoscopy, extended, with retinal drawing (e.g., for retinal detachment, melanoma), with interpretation and report; 

subsequent. 

92235 ..................... Fluorescein angiography (includes multiframe imaging) with interpretation and report. 

92250 ..................... Fundus photography with interpretation and report. 


jlentini on PROD1PC65 with NOTICES2
37234 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

RUC Recommendations 

The RUC questioned the survey 

results for CPT codes 67038 and 67228 

and indicated that the survey data may 

be flawed because respondents may 

have based their answers on a different 

number of membranes stripped or 

sessions conducted. The RUC 

recommended that these two CPT codes 

be referred to the CPT Editorial Panel 

for clarification. 

Based on a review of the survey data, 

the RUC agreed with the specialty 

society that the survey results 

demonstrated that the work had not 

changed and, thus, that the current work 

RVUs should be retained for the 

following CPT codes: 66761 = 4.06 work 

RVUs; 67840 = 2.04 work RVUs; 68840 

= 1.25 work RVUs; 76519 = 0.54 work 

RVUs; 92226 = 0.33 work RVUs; 92235 

= 0.81 work RVUs; and 92250 = 0.44 

work RVUs. In addition, the RUC 

recommended retaining the work RVU 

of 0.50 for CPT code 92083 because the 

specialty society had not presented 

compelling evidence that the physician 

work had changed. 

For CPT codes 67221, 67820, and 

66984, the RUC recommended 

reductions in the work RVUs. The RUC 

used a building-block approach based 

on the work RVU of 3.24 for the 

reference CPT code 67141, Prophylaxis 

of retinal detachment (e.g., retinal 

break, lattice degeneration) without 

drainage, one or more sessions; 

cryotherapy, diathermy, and the work 

RVUs of 0.21 for the infusion code 

G0347, which contain comparable work. 

The RUC recommended work RVUs of 

3.45 for CPT code 67221. 

The RUC supported the specialty 

society’s recommendation to decrease 

the work value for CPT code 67820 

based on evidence that the previous 

Harvard survey data was flawed. The 

RUC agreed with assigning work RVUs 

of 0.71 to CPT code 67820 based on a 

comparison/crosswalk to the key 

reference service, CPT code 65205, 

Removal of foreign body, external eye; 

conjunctival superficial, which has 

work RVUs of 0.71. 

For CPT code 66984, the RUC did not 

agree with the specialty society 

recommendation that the current work 

RVU of 10.21 should be maintained, 

because changes in technology and 

technique in the last 10 years have led 

to increased efficiencies. The RUC 

concluded that these efficiencies 

resulted in a lower overall time for the 

procedure. The RUC used the previous 

survey pre-service time of 44 minutes 

and subtracted the current survey preservice time of 25 minutes for a 

difference of 19 minutes. These 19 

minutes were then multiplied by an 

IWPUT of 0.0224, resulting in an RVU 

of 0.43, which was subtracted from the 

current value. The RUC agreed that 

although the intra-service physician 

time has decreased from the historical 

50 minutes to the current survey time of 

30 minutes as indicated by the survey 

respondents, the decrease in time 

reflects a decrease of only low intensity 

work (that is, suturing) and no further 

decrease in work RVUs was 

recommended. Therefore, the RUC 

recommended work RVUs of 9.78 for 

CPT code 66984. 

The RUC agreed with the specialty 

society that there was compelling 

evidence to support the increases for 

CPT codes 67414, 67445, 67500, 67515, 

67904, 67911, and 67966, either because 

the current work RVUs caused rank 

order anomalies, the previous Harvard 

survey data was misvalued when 

compared to codes with similar values, 

or there was a change in the technique 

of performing the procedures 

(specifically for CPT codes 67911 and 

67966, in which skin-grafting is bundled 

into these codes). However, for two CPT 

codes, 65426 and 65850, while the RUC 

recognized that there was compelling 

evidence to support increases, the RUC 

did not agree with the specific increases 

recommended by the specialty society. 

For CPT code 65426, the RUC 

believed that evidence suggested a 

change in technique for this procedure, 

and believed that a value close to the 

survey’s 25th percentile was justified by 

using a building-block approach. For 

CPT code 65850, the RUC agreed that 

there is a rank order anomaly between 

CPT codes 65850 and 66170, 

Fistualization of sclera for glaucoma; 

trabeculectomy ab externo in absence of 

previous surgery, as well as a change in 

the patient population. The RUC 

believed an increase in value was 

justified by using a building-block 

approach. The RUC recommended 5.85 

work RVUs for CPT code 65426 and 

11.14 work RVUs for CPT code 65850. 

For CPT code 66821, the RUC agreed 

that the intensity of this procedure was 

misvalued and that an increase in the 

relative value would be appropriate. 

The RUC disagreed with our previous 

intensity crosswalk to CPT code 66984, 

Extracapsular cataract removal with 

insertion of intraocular lens prosthesis 

(one stage procedure), manual or 

mechanical technique (e.g., irrigation 

and aspiration or phacoemulsification), 

specified in the Five-Year Review of 

Work Relative Value Units Under the 

Physician Fee Schedule proposed notice 

(May 3, 1996; 61 FR 20027). The RUC 

believed that the previous survey from 

1995 should stand on its own as an 

acceptable survey due to the 

inappropriate selection by HCFA in 

1995 of intensity for this code. The 

RUC-recommended work RVU for this 

service is 2.78, the same value 

recommended by the RUC in 1995. 

CMS Proposed Valuation 

We are in agreement with the RUC 

recommended work values for these 

ophthalmology services. 

c. Additional Codes 

The American Speech-LanguageHearing Association (ASHA) submitted 

the following speech and audiology CPT 

codes (see Table 49) but subsequently 

withdrew them from the 5-Year Review. 

TABLE 49 

CPT code Descriptor 

92506 ..................... Evaluation of speech, language, voice, communication, and/or auditory processing. 

92507 ..................... Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual.

92508 ..................... Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, two or more individuals. 

92510 ..................... Aural rehabilitation following cochlear implant (includes evaluation of aural rehabilitation status and hearing, therapeutic 

services) with or without speech processor programming 

92516 ..................... Facial nerve function studies (e.g., electroneuronography). 

92520 ..................... Laryngeal function studies (ie, aerodynamic testing and acoustic testing). 

92526 ..................... Treatment of swallowing dysfunction and/or oral function for feeding. 

92541 ..................... Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording. 

92542 ..................... Positional nystagmus test, minimum of 4 positions, with recording. 

92543 ..................... Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four tests), with recording. 

92544 ..................... Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37235 

TABLE 49—Continued 

CPT code Descriptor 

92545 ..................... Oscillating tracking test, with recording. 

92546 ..................... Sinusoidal vertical axis rotational testing. 

92547 ..................... Use of vertical electrodes (List separately in addition to code for primary procedure). 

92548 ..................... Computerized dynamic posturography. 

92551 ..................... Screening test, pure tone, air only. 

92552 ..................... Pure tone audiometry (threshold); air only. 

92553 ..................... Pure tone audiometry (threshold); air and bone. 

92555 ..................... Speech audiometry threshold. 

92556 ..................... Speech audiometry threshold; with speech recognition. 

92557 ..................... Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined). 

92559 ..................... Audiometric testing of groups. 

92560 ..................... Bekesy audiometry; screening. 

92561 ..................... Bekesy audiometry; diagnostic. 

92562 ..................... Loudness balance test, alternate binaural or monaural. 

92563 ..................... Tone decay test. 

92564 ..................... Short increment sensitivity index (SISI). 

92565 ..................... Stenger test, pure tone. 

92567 ..................... Tympanometry (impedance testing). 

92568 ..................... Acoustic reflex testing; threshold. 

92569 ..................... Acoustic reflex testing; decay. 

92571 ..................... Filtered speech test. 

92572 ..................... Staggered spondaic word test. 

92573 ..................... Lombard test. 

92575 ..................... Sensorineural acuity level test. 

92576 ..................... Synthetic sentence identification test. 

92579 ..................... Visual reinforcement audiometry (VRA) 

92582 ..................... Conditioning play audiometry. 

92583 ..................... Select picture audiometry. 

92584 ..................... Electrocochleography. 

92585 ..................... Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive. 

92586 ..................... Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited. 

92587 ..................... Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products). 

92588 ..................... Evoked otoacoustic emissions; comprehensive or diagnostic evaluation (comparison of transient and/or distortion product 

otoacoustic emissions at multiple levels and frequencies). 

92596 ..................... Ear protector attenuation measurements. 

92597 ..................... Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech. 

92601 ..................... Diagnostic analysis of cochlear implant, patient under 7 years of age; with programming. 

92602 ..................... Diagnostic analysis of cochlear implant, patient under 7 years of age; subsequent reprogramming. 

92603 ..................... Diagnostic analysis of cochlear implant, age 7 years or older; with programming. 

92604 ..................... Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming. 

92605 ..................... Evaluation for prescription of non-speech-generating augmentative and alternative communication device. 

92606 ..................... Therapeutic service(s) for the use of non-speech-generating device, including programming and modification. 

92607 ..................... Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with 

the patient; first hour. 

92608 ..................... Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with 

the patient; each additional 30 minutes (List separately in addition to code for primary procedure). 

92609 ..................... Therapeutic services for the use of speech-generating device, including programming and modification 

92610 ..................... Evaluation of oral and pharyngeal swallowing function. 

92611 ..................... Motion fluoroscopic evaluation of swallowing function by cine or video recording. 

92612 ..................... Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording. 

92614 ..................... Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording. 

92616 ..................... Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording. 

92620 ..................... Evaluation of central auditory function, with report; initial 60 minutes. 

92621 ..................... Evaluation of central auditory function, with report; each additional 15 minutes. 

92625 ..................... Assessment of tinnitus (includes pitch, loudness matching, and masking). 

9. HCPAC Codes 

a. Podiatric Services 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DISCUSSION OF 

COMMENTS—HCPAC CODES’’ at the 

beginning of your comments.] 

We submitted the podiatric services 

in Table 50 for review. 

TABLE 50 

CPT code Descriptor 

10060 ..................... Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single. 

11040 ..................... Debridement; skin, partial thickness. 


jlentini on PROD1PC65 with NOTICES2
37236 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

TABLE 50—Continued 

CPT code Descriptor 

11041 ..................... Debridement; skin, full thickness. 

11042 ..................... Debridement; skin, and subcutaneous tissue. 

11730 ..................... Avulsion of nail plate, partial or complete, simple; single. 

29580 ..................... Strapping; Unna boot. 

HCPAC Recommendation 

The HCPAC agreed with the specialty 

society that there was compelling 

evidence that the valuation of these 

services was incorrect due to a flawed 

methodology used in the previous 

Harvard valuation for all six podiatric 

codes. Based on the survey data, the 

specialty society requested that the 

work RVU increase for four codes and 

decrease for two codes. 

For CPT codes 10060 and 29580, the 

HCPAC supported an increase in the 

existing work values for these codes and 

recommended a work RVU of 1.50 for 

CPT code 10060 and 0.60 for CPT code 

29580, which represent the survey 

median of the survey data for these 

services. 

For CPT code 11040, the HCPAC did 

not support the work RVU increase 

recommended by the specialty society, 

but instead recommended a work RVU 

of 0.55, which represented the 25th 

percentile work RVU from the survey 

data. 

For CPT codes 11041 and 11730, the 

HCPAC recommended a decrease in the 

work RVUs and, based on the median 

from the survey data, recommended a 

work RVU of 0.80 for CPT code 11041 

and 1.10 for CPT code 11730. 

For CPT code 11042, the HCPAC did 

not agree with the specialty society that 

the work RVU should be increased to 

1.20 work RVUs. The HCPAC 

recommended maintaining the current 

work RVU of 1.12 for this CPT code, 

which was slightly higher than the 

survey’s 25th percentile work value of 

1.10 work RVUs. 

The HCPAC-recommended work 

values for these services are as follows: 

10060 = 1.50 work RVUs; 11040 = 0.55 

work RVUs; 11041 = 0.80 work RVUs; 

11042 = 1.12 work RVUs; 11730 = 1.10 

work RVUs; and 29580 = 0.60 work 

RVUs. 

CMS Proposed Valuation 

For CPT code 10060, we compared 

the survey times them with the current 

Harvard-based times used to value this 

service. These times are comparable 

and, therefore, we are recommending 

maintaining the current work RVUs of 

1.17 for this code. 

For CPT code 29580, we compared 

the current Harvard-based times with 

the survey times. Due to the small 

reduction in time, the recommended 

increase in work RVUs is not supported. 

Therefore, we are proposing to assign 

0.55 work RVUs to this service, which 

represents the 25th percentile of the 

survey and more accurately represents 

the time associated with this service. 

For CPT code 11730, the current work 

RVUs are slightly more (0.03) than the 

recommended value and the survey 

time is approximately 30 percent greater 

than the current Harvard-based time. 

For these reasons, we agree with the 

HCPAC’s recommendation of 1.10 work 

RVUs for 11730 which represents the 

median survey value. 

For CPT codes 11040, 11041 and 

11042, the survey times all reflect 

significant reductions from current 

Harvard-based times used to value these 

services. Based on this comparison 

which shows decreases in time ranging 

from 47 percent to 68 percent, we 

believe that the low values from the 

surveys more accurately represent the 

valuation of these services. Therefore, 

we are proposing to assign work RVUs 

as follows: 11040 = 0.48 work RVUs; 

11041 = 0.60 work RVUs; and 11042 = 

0.80 work RVUs. In addition, to ensure 

that the other codes in this family are 

properly valued, we recommend the 

RUC should review the valuation of CPT 

codes 11043 and 11044. 

b. Other HCPAC Codes 

The American Dietetic Association 

submitted five CPT and HCPCS codes 

related to medical nutrition services that 

were referred to the CPT Editorial Panel 

(see Table 51). 

TABLE 51 

CPT code Descriptor 

97802 ..................... Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes. 

97803 ..................... Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes. 

97804 ..................... Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes G0270 Medical nutrition therapy; reassessment 

and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or 

treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 

15 minutes. 

G0270 ..................... Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change 

in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), individual, 

face to face with the patient, each 15 minutes. 

G0271 ..................... Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change 

in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or 

more individuals), each 30 minutes. 

Additionally, the ASHA submitted 

CPT code 96105, Assessment of aphasia 

(includes assessment of expressive and 

receptive speech and language function, 

language comprehension, speech 

production ability, reading, spelling, 

writing, e.g., by Boston Diagnostic 

Aphasia Examination) with 

interpretation and report, per hour, for 

review but subsequently withdrew this 

code. 

C. Other Issues Under the 5-Year Review 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘OTHER ISSUES’’ at the 

beginning of your comments.] 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37237 

1. Anesthesia Services 

Although anesthesia services are paid 

under the PFS, they are paid on the 

basis of an anesthesia code-specific base 

unit and time units that vary based on 

the anesthesia time of the case. Since 

anesthesia services do not have a work 

value per code as do other medical and 

surgical services, a work value must be 

imputed for each anesthesia code. For 

the last 5-Year Review, this imputed 

work value was compared to an actual 

work value determined by the RUC and 

the ASA through a building-block 

approach. Under the building-block 

approach, each anesthesia code was 

uniformly divided into five 

components: pre-anesthesia, equipment 

and supply preparation, induction 

period, post-induction anesthesia 

period, and post-anesthesia. The work 

was determined for each of the five 

components and summed to calculate 

total anesthesia work for the anesthesia 

code. 

Although the ASA submitted one 

anesthesia code and several other codes 

for this 5-Year Review, they continue to 

believe the work of anesthesia services 

remain seriously undervalued. The last 

5-Year Review of anesthesia services 

proved to be a very laborious and 

exhaustive process involving several 

different RUC workgroups. The 

valuation of anesthesia work is a very 

complex process as it involves relating 

components of anesthesia services to 

other medical and surgical services of 

similar time and work. The ASA was 

dissatisfied with the recommendations 

made by the RUC for the last 5-Year 

Review for anesthesia work. The major 

points of disagreement were the use and 

extent of extrapolation and the work 

value for the post-induction anesthesia 

period, which is the longest period of 

the anesthesia service. 

For the last 5-Year Review, the ASA 

requested the RUC to extrapolate from 

19 high volume anesthesia services, 

which were studied and accounted for 

over 50 percent of Medicare payments 

for anesthesia services, to all anesthesia 

services. The RUC thought that 

extrapolation should be limited. That is, 

an analysis of a single anesthesia code 

based on a single surgical code was 

insufficient when the anesthesia code 

covers a large number of surgical codes. 

For the last 5-Year Review, the buildingblock approach used a value of 0.025 for 

the IWPUT for the post-induction 

anesthesia period. This was a value that 

the RUC agreed to, which we approved, 

although the ASA thought it was too 

low. 

As a result of its relationship with the 

RUC and the past recommendations, the 

ASA requested that we address the 

valuation of anesthesia services reported 

under CPT codes 00100 through 01999. 

The ASA furnished an analysis that 

builds on the methodology used in the 

last 5-Year Review for the valuation of 

work for anesthesia services. 

Based on comparable physicians’

services, the ASA believes that the more 

appropriate IWPUT for the postinduction period is 0.043. Using this 

IWPUT, the ASA calculated a scaling 

factor and used this to recalculate the 

post-induction work value and an 

adjusted total work RVU for each of the 

19 codes. Based on an extrapolation 

from the 19 surveyed services used in 

the last 5-Year Review, the ASA 

proposed that the anesthesia work value 

should be increased by 37.5 percent. 

The extrapolation proposed by the ASA 

is more far reaching than the 

extrapolation used by the RUC in the 

last 5-Year Review. We do not favor 

using extrapolation other than on the 

limited basis it was used in the last 5- 

Year Review. 

Since the ASA believes that the RUC 

process does not work well for their 

codes, they requested that we directly 

evaluate their recommendations 

independent of any RUC review of 

input. Although there may be some 

merit to the ASA approach, we believe 

this analysis is more appropriately done 

by a multispecialty workgroup within 

the RUC itself. Thus, we are 

recommending the valuation of 

anesthesia services, namely the 

proposed valuation of the postinduction time period, be referred to the 

RUC for their review and consideration. 

For example, the ASA and the RUC 

could review the IWPUT for postinduction time, as currently proposed 

by the ASA and compare this to the 

corresponding IWPUT recognized in the 

last 5-Year Review of anesthesia work 

for the 19 surveyed codes. 

A second issue concerning anesthesia 

services pertains to the impact of the 

revised work values for E/M services 

and their relationship to the valuation of 

pre- and post-anesthesia services, 

components of the building-block 

approach. The pre- and post-anesthesia 

services derive their work values from 

the lower level E/M codes for new 

patients, the subsequent hospital care 

codes and the initial inpatient 

consultation codes. We are proposing to 

substitute the proposed revised work 

values for E/M codes where applicable 

and recompute the anesthesia work 

values and their impact on the increase 

in total anesthesia work. While this 

results in a very minor adjustment to 

anesthesia work (that is, less than 1 

percent), we believe this approach 

provides for the consistent application 

of the proposed work RVUs changes. 

2. Discussion of Post-Operative Visits 

Included in the Global Surgical 

Packages 

We have established a national 

definition for a global surgical package 

so that payment is made consistently for 

the same set of services across all 

contractor jurisdictions. In constructing 

the RVUs for a global surgery service, all 

services that are believed to be typically 

included in the defined global period 

are built into the final resource-based 

RVUs and are not separately billable 

within the defined global period; this is 

reflected in the proposed work RVUs in 

Addenda B and C. This would include 

pre-surgery work, the intra-service time 

of actually performing the surgical 

procedure, and the post-operative 

(follow-up) visits associated with the 

monitoring and recovery of the patient. 

As stated above in this section, we are 

proposing to apply the RUCrecommended new values for the E/M 

services to all surgical services with a 10 

or 90-day global period. However, 

because of variations in the patient 

population and in practice patterns, 

there is some question whether the 

assumptions about the number and level 

of visits within the global period reflect 

the actual post-operative work 

performed. Some surgeons have 

commented to us that they perform 

more visits than are included in the 

global period for their services. It is also 

likely that some patients require fewer 

than the ‘‘typical’’ number of follow-up 

visits included in the global period. 

Although we are not proposing any 

changes to our global policy at this time, 

we would be interested in receiving 

comments concerning our current 

policy of including these post-operative 

visits in the global surgical packages 

and what advantages or disadvantages 

might be associated with proposing a 

change to this policy in the future. 

3. Codes Referred to CPT Editorial Panel 

From Five-Year Review of Work 

Relative Value Units 


jlentini on PROD1PC65 with NOTICES2
37238 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.051</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37239 


jlentini on PROD1PC65 with NOTICES2EN29JN06.052</GPH>
37240 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.053</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37241 

BILLING CODE 4120–01–C 

4. 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. This year, we expect that 

budget-neutrality adjustments will be 

required as a result of changes in RVUs 

resulting from the 5-Year Review. 

Revisions in payment policies, 

including the establishment of interim 

and final RVUs for coding changes that 

will be announced later this year, may 

result in additional budget-neutrality 

adjustments. 

We considered making the statutorily 

required budget-neutrality adjustments 

(under section 1848(c)(2)(B)(ii) of the 

Act) to account for the 5-Year Review of 

physician work by reducing all work 

RVUs. We currently estimate that all 

work RVUs would have to be reduced 

by 10 percent under this option. 

Alternatively, we considered making an 

adjustment to the PFS CF to meet the 

provisions of section 1848(c)(2)(B)(ii). 

This option would require an estimated 

5 percent reduction in the CF. We note 

that the application of the budget 

neutrality adjustment to the CF would 

negatively impact all PFS services; 

whereas the application of the budget 

neutrality adjustment to the work RVUs 

would impact only those services that 

have physician work RVUs. Because the 

need for a budget neutrality adjustment 

would be largely due to changes 

proposed as a result of the 5-Year 

Review of work RVUs, we believe it is 

more equitable to apply the adjustment 

across services that have work RVUs. 

For this third 5-Year Review, we are 

proposing to establish a budget 

neutrality adjustor that would reduce all 

work RVUs by an estimated 10 percent 

to meet the budget neutrality provisions 

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

As we noted in the CY 2005 Physician 

Fee Schedule final rule with comment 

period (69 FR 66371), PE and 

malpractice expense RVUs were not 

subject to comment and will not be 

recalculated (other than changes to PE 

RVUs that result from changes in PE 

inputs due to changes in physician time 

or in the number of post procedure 

visits as part of the 5-Year Review of 

work RVUs). 

5. Effect on Practice Expense Inputs 

Stemming From the 5-Year Review 

The proposed changes for work RVUs 

reflect, in part, the physician’s time 

needed to perform each service, as well 

as the number and level of assumed 

post-operative visits. To the extent that 

the RUC recommended changes in the 

times associated with the intra-service 

portion of the procedure, we are also 

proposing to adjust the clinical labor 

time assigned for assisting the physician 

in the nonfacility setting. In addition, if 

an accepted new work RVU reflects a 

change in the number or level of postoperative visits, we are proposing to 

modify the clinical staff time to reflect 

the change. This adjusted time is also 

applied to the equipment used in the 

post-operative visits. Where the number 

of post-operative visits has changed, the 

number of minimum multi-specialty 

visit (MMSV) packs will also be 

adjusted accordingly. A MMSV pack 

consists of the following supplies: exam 

table paper, 2 pairs of non-sterile gloves, 

a patient gown, a pillow case, and a 

thermometer probe cover. These 

changes in clinical labor and equipment 

time and in the quantity of supplies will 

have a minimal impact on the PE 

component. 

6. Nature and Format of Comments on 

Work RVUs 

We will accept comments on the 

proposed work RVUs for the codes 

identified in the Addendum C of this 

notice. We will also accept comments 

on the anesthesia code, CPT code 00797. 

Comments should discuss how the work 

associated with a given CPT or HCPCS 

code is analogous to the work in other 

services, or discuss the rationale for 

agreeing or disagreeing with the 

proposed work RVU. We are especially 

interested in information or discussions 

that were not presented in earlier 

comments. 

D. Resource-Based Practice Expense 

(PE) RVUs 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘PRACTICE EXPENSE’’ at the 

beginning of your comments.] 

Based on section 1848(c)(1)(B) of the 

Act, 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 wages 

of personnel, but excluding malpractice 

expenses. 


jlentini on PROD1PC65 with NOTICES2EN29JN06.054</GPH>
37242 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

Section 121 of the Social Security 

Amendments of 1994 (Pub. L. 103–432), 

enacted on October 31, 1994, required 

CMS to develop a methodology for a 

resource-based system for determining 

PE RVUs for each physician’s service. 

Until that time, physicians’ PEs were 

based on historical allowed charges. 

This legislation stated that the revised 

PE methodology must consider the staff, 

equipment, and supplies used in the 

provision of various medical and 

surgical services in various settings 

beginning in 1998. The Secretary has 

interpreted this to mean that Medicare 

payments for each service would be 

based on the relative PE resources 

typically involved with performing the 

service. 

The initial implementation of 

resource-based PE RVUs was delayed 

from January 1, 1998, until January 1, 

1999, by section 4505(a) of the Balanced 

Budget Act of 1997 (BBA 97) (Pub. L. 

105–33). In addition, section 4505(b) of 

the BBA 97 required that the new 

payment methodology be phased-in 

over 4 years, effective for services 

furnished in CY 1999, and fully 

effective in CY 2002. The first step 

toward implementation of the statute 

was to adjust the PE values for certain 

services for CY 1998. Section 4505(d) of 

BBA 97 required that, in developing the 

resource-based PE RVUs, the Secretary 

must: 

• Use, to the maximum extent 

possible, generally accepted cost 

accounting principles that recognize all 

staff, equipment, supplies, and 

expenses, not solely those that can be 

linked to specific procedures. 

• Develop a refinement method to be 

used during the transition. 

• Consider, in the course of notice 

and comment rulemaking, impact 

projections that compare new proposed 

payment amounts to data on actual 

physician PEs. 

Beginning in CY 1999, we began the 

four year transition to resource-based PE 

RVUs. In CY 2002, the resource-based 

PE RVUs were fully transitioned. 

1. Current Methodology 

The following sections discuss the 

current PE methodology. 

a. Data Sources 

There are two primary data sources 

used to calculate PE. The AMA’s 

Socioeconomic Monitoring System 

(SMS) survey data are used to develop 

the PE per hour (PE/HR) for each 

specialty. The second source of data 

used to calculate PE was originally 

developed by the Clinical Practice 

Expert Panels (CPEP). The CPEP data 

include the supplies, equipment and 

staff times specific to each procedure. 

The AMA developed the SMS survey 

in 1981 and discontinued it in 1999. 

Beginning in 2002, we incorporated the 

1999 SMS survey data into our 

calculation of the PE RVUs, using a 5- 

year average of SMS survey data. (See 

Revisions to Payment Policies and FiveYear Review of and Adjustments to the 

Relative Value Units Under the 

Physician Fee Schedule for CY 2002 

final rule, published November 1, 2001 

(66 FR 55246).) The SMS PE survey data 

are adjusted to a common year, 1995. 

The SMS data provide the following six 

categories of PE costs: 

• Clinical payroll expenses, which 

are payroll expenses (including fringe 

benefits) for nonphysician personnel. 

• Administrative payroll expenses, 

which are payroll expenses (including 

fringe benefits) for nonphysician 

personnel involved in administrative, 

secretarial or clerical activities. 

• Office expenses, which include 

expenses for rent, mortgage interest, 

depreciation on medical buildings, 

utilities and telephones. 

• Medical material and supply 

expenses, which include expenses for 

drugs, x-ray films, and disposable 

medical products. 

• Medical equipment expenses, 

which include expenses depreciation, 

leases, and rent of medical equipment 

used in the diagnosis or treatment of 

patients. 

• All other expenses, which include 

expenses for legal services, accounting, 

office management, professional 

association memberships, and any 

professional expenses not mentioned 

above. 

In accordance with section 212 of the 

Medicare, Medicaid and State Child 

Health Insurance Program Balanced 

Budget Refinement Act of 1999 (BBRA) 

(Pub. L. 106–113), we established a 

process to supplement the SMS data for 

a specialty with data collected by 

entities and organizations other than the 

AMA (that is, the specialty itself). (See 

the Criteria for Submitting 

Supplemental Practice Expense Survey 

Data interim final rule with comment 

period, published on May 3, 2000 (65 

FR 25664).) Originally, the deadline to 

submit supplementary survey data was 

through August 1, 2001. In the 

Revisions to Payment Policies and FiveYear Review of and Adjustments to the 

Relative Value Units Under the 

Physician Fee Schedule for CY 2002 

final rule (November 1, 2001; 66 FR 

55246), the deadline was extended 

through August 1, 2003. To ensure 

maximum opportunity for specialties to 

submit supplementary survey data, we 

extended the deadline to submit surveys 

until March 1, 2005 in the Revisions to 

Payment Policies Under the Physician 

Fee Schedule for CY 2004 final rule, 

(November 7, 2003; 68 FR 63196) 

(hereinafter referred to as CY 2004 PFS 

final rule). 

The CPEPs consisted of panels of 

physicians, practice administrators, and 

nonphysicians (registered nurses (RNs), 

for example) who were nominated by 

physician specialty societies and other 

groups. There were 15 CPEPs consisting 

of 180 members from more than 61 

specialties and subspecialties. 

Approximately 50 percent of the 

panelists were physicians. 

The CPEPs identified specific inputs 

involved in each physician service 

provided in an office or facility setting. 

The inputs identified were the quantity 

and type of nonphysician labor, medical 

supplies, and medical equipment. 

In 1999, the AMA’s RUC established 

the Practice Expense Advisory 

Committee (PEAC). Since 1999, and 

until March 2004, the PEAC, a multispecialty committee, reviewed the 

original CPEP inputs and provided us 

with recommendations for refining 

these direct PE inputs for existing CPT 

codes. Through its last meeting in 

March 2004, the PEAC provided 

recommendations, which we have 

reviewed and accepted, for over 7,600 

codes. As a result, the current CPEP 

inputs differ markedly from those 

originally recommended by the CPEPs. 

The PEAC has now been replaced by the 

Practice Expense Review Committee 

(PERC), which acts to assist the RUC in 

recommending PE inputs. 

b. Allocation of PEs to Services 

To establish PE RVUs for specific 

services, it is necessary to establish the 

direct and indirect PE associated with 

each service. Our current approach 

allocates aggregate specialty practice 

costs to specific procedures and, thus, is 

often referred to as a ‘‘top-down’’

approach. The specialty PEs are derived 

from the AMA’s SMS survey and 

supplementary survey data. The PEs for 

a given specialty are allocated to the 

services performed by that specialty on 

the basis of the CPEP data and work 

RVUs assigned to each CPT code. The 

specific process is detailed as follows: 

Step 1—Calculation of the SMS Cost 

Pool for Each Specialty 

The six SMS cost categories can be 

described as either direct or indirect 

expenses. The three direct expense 

categories include clinical labor, 

medical supplies and medical 

equipment. Indirect expenses include 

administrative labor, office expense, and 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37243 

all other expenses. We combine these 

indirect expenses into a single category. 

The SMS cost pool for each specialty is 

calculated as follows: 

• The specialty PE/HR for each of the 

three direct and one indirect cost 

categories from the SMS is calculated by 

dividing the aggregate PE per specialty 

by the specialty’s total hours spent in 

patient care activities (also determined 

by the SMS survey). The PE/HR is 

divided by 60 to obtain the PE per 

minute (PE/MIN). 

• Each specialty’s PE pools (for each 

of the three direct and one indirect cost 

categories) are created by multiplying 

the PE/MIN for the specialty by the total 

time the specialty spent treating 

Medicare patients for all procedures 

(determined using Medicare utilization 

data). Physician time on a procedurespecific level is available through RUC 

surveys of new or revised codes and 

through surveys conducted as part of 

the 5-Year Review process. For codes 

that the RUC has not yet reviewed, the 

original data from the Harvard resourcebased RVU system survey are used. 

Physician time includes time spent on 

the case prior to, during, and after the 

procedure. The physician procedure 

time is multiplied by the frequency that 

each procedure is performed on 

Medicare patients by the specialty. 

• The total specialty-specific SMS PE 

for each cost category is the sum, for 

each direct and indirect cost category, of 

all of the procedure-specific total PEs. 

Step 2—Calculation of CPEP Cost Pool 

CPEP data provide expenditure 

amounts for the direct expense 

categories (clinical labor, supplies and 

equipment cost) at the procedure level. 

Multiplying the CPEP procedure-level 

PEs for each of these three categories by 

the number of times the specialty 

provided the procedure, produces a 

total category cost, per procedure, for 

that specialty. The sum of the total 

expenses from each procedure results in 

the total CPEP category cost for the 

specialty. 

Step 3—Calculation and Application of 

Scaling Factors 

This step ensures that the total of the 

CPEP costs across all procedures 

performed by the specialty equates with 

the total direct costs for the specialty as 

reflected by the SMS data. To 

accomplish this, the CPEP data are 

scaled to SMS data by a scaling factor 

so that the total CPEP costs for each 

specialty equals the total SMS cost for 

the specialty. (The scaling factor is 

calculated by dividing the specialty’s 

SMS pool by the specialty’s CPEP pool.) 

The unscaled CPEP cost per 

procedure value, at the direct cost level, 

is then multiplied by the respective 

specialty scalar to yield the scaled CPEP 

procedure value. The sum of the scaled 

CPEP direct cost pool expenditures 

equals the total scaled direct expense for 

the specific procedure at the specialty 

level. 

Step 4—Calculation of Indirect 

Expenses 

Indirect PEs cannot be directly 

attributed to a specific service because 

they are incurred by the practice as a 

whole. Indirect costs include rent, 

utilities, office equipment and supplies, 

and accounting and legal fees. There is 

not a single, universally accepted 

approach for allocating indirect practice 

costs to individual procedure codes. 

Rather allocation involves judgment in 

identifying the base or bases that are the 

best measures of a practice’s indirect 

costs. 

To allocate the indirect PEs to a 

specific service, we use the following 

methodology: 

• The scaled direct expenses and the 

converted work RVU (the work RVU for 

the service is multiplied by $34.5030, 

the 1995 CF) are added together, and 

then multiplied by the number of 

services provided by the specialty to 

Medicare patients; 

• The total indirect PEs per specialty 

are calculated by summing the indirect 

expenses for all other procedures 

provided by that specialty. 

Step 5—Calculation and Application of 

Indirect Scaling Factors 

Similar to the direct costs, the indirect 

costs are scaled to ensure that the total 

across all procedures performed by the 

specialty equates with the total indirect 

costs for the specialty as reflected by the 

SMS data. To accomplish this, the 

indirect costs calculated in Step 4 are 

scaled to SMS data. The calculation of 

the indirect scaling factors is as follows: 

• The specialty’s total SMS indirect 

expense pool is divided by the 

specialty’s total indirect expense pool 

calculated in Step 4, to yield the 

indirect expense scaling factor. 

• The unscaled indirect expense 

amount, at the procedure level, is 

multiplied by the specialty’s scaling 

factor to calculate the procedure’s 

scaled indirect expenses. 

• The sum of the scaled indirect 

expense amount and the procedure’s 

direct expenses yields the total PEs for 

the specialty for this procedure. 

Step 6—Weighted Average of RVUs for 

Procedures Performed by More Than 

One Specialty 

For codes that are performed by more 

than one specialty, a weighted average 

PE is calculated based on Medicare 

frequency data of all specialties 

performing the procedure. 

Step 7—Budget Neutrality and Final 

RVU Calculation 

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

provides that adjustments in RVUs may 

not cause total PFS payments to differ 

by more than $20 million from what 

they would have been if the adjustments 

were not made. If the aggregate 

adjustments to PE RVUs would cause 

PFS expenditures to exceed the $20 

million threshold, the total scaled direct 

and indirect inputs are then adjusted by 

a budget neutrality factor (BNF) to 

calculate RVUs. Budget neutrality for 

the upcoming year is determined 

relative to the sum of PE RVUs for the 

current year. Although the PE RVUs for 

any particular code may vary from yearto-year, the sum of PE RVUs across all 

codes is set equal to the current year. 

The BNF is equal to the sum of the 

current year’s PE RVUs, divided by the 

sum of the direct and indirect inputs 

across all codes for the upcoming year. 

The BNF is applied to (multiplied by) 

the scaled direct and indirect expenses 

for each code to set the PE RVU for the 

upcoming year. 

c. Other Methodological Issues: NonPhysician Work Pool (NPWP) 

As an interim measure, until we could 

further analyze the effect of the topdown methodology on the Medicare 

payment for services with no physician 

work (including the technical 

components (TCs) of radiation oncology, 

radiology and other diagnostic tests), we 

created a separate PE pool for these 

services. However, any specialty society 

could request that its services be 

removed from the non-physician work 

pool (NPWP). We will remove services 

from the NPWP if we find that the 

requesting specialty provides the service 

the majority of the time. 

NPWP Step 1—Calculation of the SMS 

Cost Pool for Each Specialty 

This step parallels the calculations 

described above for the standard ‘‘topdown’’ PE allocation methodology. For 

codes in the NPWP, the direct and 

indirect SMS costs are set equal to the 

weighted average of the PE/HR for the 

specialties that provide the services in 

the pool. Clinical staff time is 

substituted for physician time in the 

calculation. The clinical staff time for 

the code is from CPEP data. Otherwise, 


jlentini on PROD1PC65 with NOTICES2
37244 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

the calculation is similar to the method 

described previously for codes with 

physician time. 

NPWP Step 2—Calculation of Chargebased PE RVU Cost Pool 

The NPWP calculation uses the 1998 

(charge-based) PE RVU value for the 

code, multiplied by the 1995 CF (25.74 

× $34.503 = $888.11). The percentage of 

clinical labor, supplies and equipment 

are the percentage that each PE category 

represents for all physicians relative to 

the total PE for all physicians 

(calculated from the SMS data). 

NPWP Step 3—Calculation and 

Application of Scaling Factors 

After the total cost pools for each 

specialty and code performed by the 

specialty are calculated, the steps to 

ensure the total costs for all of the 

procedures performed by a specialty do 

not exceed the total costs for the 

specialty (scaling) are the same as those 

described previously for codes with 

physician work. 

NPWP Step 4—Calculation of Indirect 

Expenses 

Because codes in the NPWP do not 

have work RVUs, indirect expenses are 

set equal to direct expenses (for codes 

with physician work, indirect expenses 

equal the sum of the scaled direct 

expenses and the converted work RVU). 

This amount is then multiplied by the 

number of times the procedure is 

performed. 

NPWP Step 5—Calculation and 

Application of Indirect Scaling Factors 

Similar to the direct costs, the indirect 

costs are scaled to ensure that the total 

of the charge-based PE RVU costs across 

all procedures equates with the total 

indirect costs as reflected by the SMS 

data for the NPWP. To accomplish this, 

the charge-based data are scaled to SMS 

data so the total charge-based costs 

equal the total SMS costs. 

NPWP Step 6—Budget Neutrality and 

Final RVU Calculation 

Similar to the calculation for codes 

with physician work, when a budget 

neutrality adjustment is necessary, the 

BNF is applied to (multiplied by) the 

scaled direct and indirect expenses for 

each code to set the PE RVU for the 

upcoming year. 

d. Facility/Non-facility Costs 

Procedures that can be performed in 

a physician’s office, as well as in a 

hospital have two PE RVUs: Facility and 

non-facility. The non-facility setting 

includes physicians’ offices, patients’

homes, freestanding imaging centers, 

and independent pathology labs. 

Facility settings include hospitals, 

ambulatory surgical centers (ASCs), and 

skilled nursing facilities (SNFs). The 

methodology for calculating the PE RVU 

is the same for both facility and nonfacility RVUs, but is applied 

independently to yield two separate PE 

RVUs. Because the PEs for services 

provided in a facility setting are 

generally included in the payment to 

the facility (rather than the payment to 

the physician under the fee schedule), 

the PE RVUs are generally lower for 

services provided in the facility setting. 

2. PE Proposals Methodology for CY 

2006 

The following discussions outline the 

specific PE related proposals for CY 

2007. 

We have three major goals for our 

resource-based PE methodology: 

• To ensure that the PE portion of 

PFS payments reflect, to the greatest 

extent possible, the relative resources 

required for each of the services on the 

PFS. This could only be accomplished 

by using the best available data to 

calculate the PE RVUs. 

• To develop a payment system for 

PE that is understandable and at least 

somewhat intuitive, so that specialties 

could better predict the impacts of 

changes in the PE data. 

• To stabilize the PE portion of PFS 

payments so that changes in PE RVUs 

do not produce large fluctuations in the 

payment for given procedures from 

year-to-year. 

These goals have also been supported 

in numerous comments we have 

received from the medical community. 

In the CY 2006 PFS proposed rule (70 

FR 45764), we proposed the following 

changes to the PE methodology that we 

believed would help in achieving our 

three major goals (stated above in this 

section): 

• Using the PE/HR data from seven 

specialty-specific supplementary 

surveys. 

• Calculating the direct PE using a 

bottom-up methodology. 

• Eliminating the NPWP. 

We also proposed an indirect PE 

methodology that was to assign to each 

service the higher of the current indirect 

PE RVUs or the indirect PE RVUs 

calculated using the supplementary 

survey data. 

In the CY 2006 PFS final rule with 

comment period (70 FR 70116), we 

withdrew these proposals primarily 

because a programming error for the 

indirect PE RVU calculation had led to 

the publication of inaccurate proposed 

PE RVUs. On February 15, 2006, we 

sponsored a PE Town Hall Meeting and 

invited the public, including all 

specialty representatives to attend. At 

this meeting, we supplied a detailed 

description of the bottom-up approach 

to the calculation of resource-based PE 

RVUs. Three examples were examined 

in detail that illustrated the impact of 

the various assumptions that could be 

used under a bottom-up approach. We 

specifically requested input from all 

interested parties on possible changes to 

our PE methodology, including the 

move to a bottom-up approach and the 

various methods of calculating indirect 

PE. 

We have reviewed the approximately 

35 comments that we received in 

response to our solicitation. Many of the 

comments were combined efforts from 

related specialty organizations. 

Additionally, the AMA RUC also 

supplied a letter that captured the 

comments of nearly 30 specialty 

organizations. The following is a 

summary of some of the comments we 

received. 

• Delaying Implementation of 

Changes to the Current PE Methodology: 

There were mixed opinions from 

commenters on whether we should 

proceed with a proposal to use a 

bottom-up approach. Some commenters 

emphasized that the CPEP data has been 

refined and is now the best available 

source of data, and asserted that it 

should be used for the calculation of 

resource-based PE RVUs. Other 

comments suggested a delay in changing 

to a bottom-up approach because of the 

other issues that are affecting PFS 

payments this year (such as, the effect 

of imaging payment provisions in the 

Deficit Reduction Act (DRA), the impact 

of the negative update, and the 

uncertainty regarding the impact of the 

5-Year Review of work RVUs). 

• Transition to a Bottom-Up 

Approach: The majority of commenters 

requested a minimum one-year 

transition to a maximum 3-year 

transition period to fully implement any 

change to a bottom-up approach. All of 

the commenters supported a transition 

period whether or not they supported 

the implementation of a bottom-up 

approach. 

• Use of Supplemental Survey Data: 

A large number of commenters stated 

that, irrespective of what we propose for 

2007, the supplemental survey data that 

has already been accepted should be 

used. Other commenters believed that 

the supplemental survey data grossly 

overstated PEs and should not be 

utilized in the development of resource 

based PE RVUs. 

• Multi-Specialty PE Survey: The 

majority of commenters supported the 

construction and use of a multiVerDate Aug<31>2005 17:16 Jun 28, 2006 Jkt 208001 PO 00000 Frm 00076 Fmt 4701 Sfmt 4703 E:\FR\FM\29JNN2.SGM 29JNN2

jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37245 

specialty survey to collect PE data. 

Commenters believed that the 

supplemental survey data is inflated 

and that the SMS survey data are 

outdated. 

• Review Equipment Utilization 

Assumptions and Interest Rates: Many 

commenters supported the review and 

revision of both the current utilization 

assumptions and the interest rates 

associated with high cost equipment. 

Commenters had mixed reactions as to 

whether the utilization rates should be 

higher or lower, and some suggested 

that we review the possibility of 

equipment-specific utilization 

assumptions for the future. Most 

commenters believed that the current 11 

percent interest rate is significantly 

higher then the actual interest rates and 

many commenters suggested a rate of 

approximately prime plus 2 percent. 

• Proxy Work RVUs for No Physician 

Work Services: Commenters were 

divided on the assignment of a proxy 

work RVU to services that contain no 

physician work. Some commenters 

believed that no physician work 

services are unfairly penalized under 

any bottom-up approach, while other 

comments stated that the inclusion of a 

proxy work RVU would double count 

the clinical labor associated with the no 

physician work services. 

After considering the comments we 

received on the CY 2006 PFS proposed 

rule (70 FR 45764) and in response to 

comments received during and 

following the Town Hall meeting, we 

believe that the use of a bottom-up 

methodology for direct costs, use of the 

supplementary survey data and 

elimination of the NPWP would assist 

us in meeting our goal of a PE 

methodology that is equitable, 

understandable and stable. Therefore, 

we are again proposing these changes to 

our PE methodology. We are also 

proposing a change in the methodology 

used to calculate the indirect PE for 

each service that is different than 

previously proposed. The following is a 

summary of our proposals. 

a. Use a Bottom-Up Method to Calculate 

the Direct PEs 

We believe that we have consistently 

made a good faith effort to ensure 

fairness in our PE RVU-setting system 

by using the best data available at any 

one time. The reason we did not adopt 

the bottom-up methodology originally 

proposed in 1997 and instead adopted 

the top-down methodology finalized in 

1998 was because we recognized the 

concerns among the physician 

community that the resource input data 

developed in 1995 by the CPEP were 

less reliable than the aggregate specialty 

cost data derived from the SMS process. 

However, the situation has now 

changed. The PEAC/PERC/RUC has 

completed the refinement of the original 

CPEP data and we believe that the 

refined PE inputs now, in general, 

accurately capture the relative direct 

costs of performing PFS services. 

Conversely, although we have now 

accepted supplementary survey data 

from 13 specialties, we have not 

received updated aggregate cost data 

from most specialties. Thus, we believe 

that, in the aggregate, the refined CPEP 

data represent more reliably the relative 

direct cost PE inputs for physicians’

services. 

Therefore, instead of using the topdown approach to calculate the direct 

PE RVUs, where the aggregate CPEP/ 

RUC costs for each specialty are scaled 

to match the aggregate SMS costs, we 

propose to adopt a bottom-up method of 

determining the relative direct costs for 

each service. Under this method, the 

direct costs would be determined by 

adding the costs of the resources (that is, 

the clinical staff, equipment and 

supplies) typically required to provide 

the service. The costs of the resources, 

in turn, would be calculated from the 

refined CPEP/RUC inputs in our PE 

database. 

We believe that this proposed change, 

which was welcomed by most 

commenters in the CY 2006 PFS 

proposed rule, will lead to greater 

stability and accuracy in the PE portion 

of our payment system. Currently, under 

the top-down methodology, the need to 

scale the CPEP costs to equal the SMS 

costs meant that any changes in the 

direct PE inputs for one service often 

leads to unexpected results for other 

services where the inputs had not been 

altered. In addition, the current PE 

RVUs for a procedure do not necessarily 

change proportionately with changes in 

the direct inputs, creating possible 

anomalous values. We believe that our 

proposed bottom-up methodology 

would resolve these issues, so that 

changes in the PE RVUs would be more 

intuitive and would result in fewer 

surprises. 

b. Use the PE/HR Data From the Seven 

Surveys We Have Previously Accepted 

and, in Addition, Use the PE/HR Data 

From the Survey Submitted by the 

National Coalition of Quality Diagnostic 

Imaging Services (NCQDIS) 

As explained in the CY 2005 PFS final 

rule with comment period (69 FR 

66242), we received surveys from the 

ACC, the ACR, and the ASTRO by 

March 1, 2004. The data submitted by 

the ACC and the ACR met our criteria. 

However, as requested by the ACC and 

the ACR, we deferred using their data 

until issues related to the NPWP could 

be addressed. (The survey data from 

ASTRO did not meet the precision 

criteria established for supplemental 

surveys; therefore, we did not accept or 

use it in the calculation of PE RVUs for 

2005.) 

In March 2005, we also received 

surveys from the Association of 

Freestanding Radiation Oncology 

Centers (AFROC), the AUA, the AAD, 

the JCAAI, the NCQDIS, and a joint 

survey from the American 

Gastroenterological Association (AGA), 

the American Society of Gastrointestinal 

Endoscopy (ASGE) and the American 

College of Gastroenterology (ACG). 

All the surveys, with the exception of 

the survey from NCQDIS, met our 

criteria. Therefore, we proposed in the 

CY 2006 PFS proposed rule (70 FR 

45775) to use the survey data from all 

the surveys meeting our criteria in the 

calculation of PE RVUs for 2006; but, as 

discussed in the CY 2006 PFS final rule 

with comment period (70 FR 70116) and 

above in this section, this proposal was 

not finalized. 

We contracted with the Lewin Group 

(Lewin) to evaluate whether the 

supplemental survey data that were 

submitted met our criteria and to make 

recommendations to us regarding their 

suitability for use in calculating PE 

RVUs. As described in the CY 2006 PFS 

proposed rule (70 FR 45775), Lewin 

recommended blending the radiation 

oncology data from the AFROC survey 

data with the ASTRO survey data 

submitted in 2004 to calculate the PE/ 

HR. According to Lewin, the goal of the 

AFROC survey was to represent the 

population of freestanding radiation 

oncology centers only. To develop an 

overall average for the radiation 

oncology PE pool, the Lewin Group 

recommended we use the AFROC 

survey for freestanding radiation 

oncology centers, and the hospital-based 

subset of last year’s ASTRO survey. We 

agreed that this blending of the AFROC 

and ASTRO data was a reasonable way 

to calculate an average PE/HR that fully 

reflects the practice of radiation 

oncology in all settings. Blending the 

survey data overcame the initial 

problem that the ASTRO data do not 

meet the precision criteria as discussed 

in the CY 2005 PFS final rule (69 FR 

66242). In addition, as discussed in the 

CY 2006 PFS proposed rule (70 FR 

45776), blending of the data allowed for 

a broader base of radiation oncology 

providers to be represented. 

Also, as discussed in the CY 2006 PFS 

proposed rule (70 FR 45764), Lewin 

indicated that the survey data submitted 


jlentini on PROD1PC65 with NOTICES2
37246 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

by the NCQDIS on independent 

diagnostic testing facilities (IDTFs) did 

not meet our precision criterion. 

However, upon further analysis, Lewin 

agreed with NCQDIS’ determination that 

the inclusion of one inaccurate record 

skewed the findings outside the 

acceptable precision range. Lewin 

recalculated the precision level at 8.1 

percent of the mean PE/HR (weighted by 

the number of physicians in the 

practice). Lewin indicated that the level 

of precision for the total PE/HR satisfies 

the level of precision requirement, and 

recommended acceptance of the survey. 

We are now proposing to use the PE/ 

HR data from all of the above surveys, 

including the NCQDIS survey, in the 

calculation of the PE RVUs for 2007. We 

are again proposing for radiation 

oncology to use the new PE/HR derived 

from combining the AFROC and ASTRO 

survey data, as recommended by Lewin. 

We propose to use the PE per 

physician hour figures in Table 52. It 

should be noted that the relatively high 

PE per physician hour values for IDTFs 

result from the fact that there are far 

fewer hours for this specialty than most 

others. IDTFs use relatively few 

physician hours, so the same practice 

expenses in the numerator divided by 

the smaller denominator results in 

considerably higher values for practice 

expenses per hour. Although these 

values of PE/HR appear to be outliers, 

they actually contribute little to the 

overall value for practice expenses per 

hour, because the volume of each of the 

services performed by the IDTFs 

represents a relatively small percentage 

of the total services. 

TABLE 52.—PRACTICE EXPENSE PER PHYSICIAN HOUR FIGURES

Specialty Clinical 

labor Supplies Equipment Administrative expense 

Office 

expense 

Other 

expense 

Allergy/Immunology .................................. 65.9 22 .5 6 .3 56 .3 65.9 31 .1 

Cardiology ................................................ 59.6 25 .9 18 .6 53 .3 52.7 25 

Dermatology ............................................. 40.6 15 .4 11 51 .5 78.8 28 .2 

Gastro-enterology .................................... 30.2 8 .2 5 .9 39 .6 48.4 13 .3 

IDTF ......................................................... 111.6 55 302 .5 155 .5 121.2 189 .5 

Radiology ................................................. 29.1 11 .3 27 .3 37 .8 23.9 44 .8 

Radiation Oncology .................................. 49.7 4 .8 27 .6 26 39.7 28 .1 

Urology ..................................................... 27.9 14 .4 11 .2 42 .3 53.8 23 .4 

Section 303(a)(1)(B) of the Medicare 

Prescription Drug, Improvement, and 

Modernization Act of 2003 (MMA) (Pub. 

L. 108–173) added section 1848(c)(2)(I) 

of the Act to require CMS to use survey 

data submitted by a specialty group 

where at least 40 percent of the 

specialty’s payments for Part B services 

are attributable to the administration of 

drugs in 2002 to adjust PE RVUs for 

drug administration services. The 

statute applies to surveys that include 

expenses for the administration of drugs 

and biologicals, and were received by 

March 1, 2005 for determining the CY 

2006 PE RVUs. Section 303(a)(1)(A)(ii) 

of the MMA also added section 

1848(c)(2)(B)(iv)(II) of the Act to provide 

an exemption from budget neutrality in 

2005 and 2006 for any additional 

expenditures resulting from the use of 

these surveys. In the Changes to 

Medicare Payment for Drugs and 

Physician Fee Schedule Payments for 

CY 2004 interim final rule published 

January 7, 2004 (69 FR 1084), we stated 

that the specialties of urology, 

gynecology, and rheumatology meet the 

above criteria. As described in the CY 

2006 PFS final rule with comment 

period (70 FR 70116), we accepted for 

the purposes of calculating the 2006 PE 

RVUs for drug administration services 

the new survey data from the AUA and 

exempted from the budget neutrality 

adjustment any impacts of accepting 

these data for purposes of calculating PE 

RVUs for drug administration services. 

(Note: Rheumatology and gynecology 

did not submit supplemental survey 

data.) 

c. Eliminate the NPWP and Calculate 

the PE RVUs for All Services Using the 

Same Methodology 

Primarily because of the lack of 

representative SMS data or accurate 

direct cost inputs for specialties such as 

radiology and radiation oncology, the 

adoption of the top-down approach 

necessitated the creation of the NPWP. 

This separate work pool was created to 

allocate PE RVUs for TC codes and 

codes that are not performed by 

physicians and, thus, have no work 

RVUs. In the CY 2000 Physician Fee 

Schedule; Payment Policies and 

Relative Value Unit Adjustment final 

rule, we indicated that ‘‘the purpose of 

this pool was only to protect the (TC) 

services from the substantial decreases’’

caused by inaccurate CPEP data and the 

lack of physician work RVU in the 

allocation of the indirect costs (64 FR 

59406). Unfortunately, the services 

priced by the NPWP methodology have 

proven to be especially vulnerable to 

any change in the work pool’s 

composition. This has led to significant 

fluctuations from year to year in the PE 

RVUs calculated for these services. 

The major specialties comprising the 

NPWP (radiology, radiation oncology 

and cardiology) have now submitted 

supplemental survey data that we have 

accepted and are proposing to use in 

their PE calculations. (See the 

discussion on supplementary surveys 

above in this section.) Now that we have 

representative aggregate PE data for 

these specialties, and with the 

completion of the refinement of the 

direct cost inputs, the continued 

necessity and equity of treating these 

technical services outside the PE 

methodology applied to other services is 

questionable. 

Therefore, we are proposing to 

eliminate the NPWP and to calculate the 

PE RVUs for the services currently in 

the work pool by the same methodology 

used for all other services. This would 

also allow the use of the refined CPEP/ 

RUC data to price the direct costs of 

individual services, rather than utilizing 

the pre-1998 charge-based PE RVUs. In 

addition, this proposal would lead to 

greater stability for the PE RVUs for 

these services and would lead to more 

intuitive results than have occurred 

with the NPWP methodology. 

d. Modify the Current Indirect PE RVUs 

Methodology 

As described previously, the SMS and 

supplementary survey data are the 

source for the specialty-specific 

aggregate indirect costs used in our PE 

calculations. We then allocate the 

indirect costs to particular codes on the 

basis of the direct costs allocated to a 

code and the work RVUs. In the CY 

2006 PFS proposed rule (70 FR 45764), 

we stated that we had no information 

that would indicate that the current 

indirect PE methodology is inaccurate. 

At that time, we also were not aware of 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37247 

any alternative approaches or data 

sources that we could use to calculate 

more appropriately the indirect PE, 

other than the new supplementary 

survey data, which we propose to 

incorporate into our PE calculations. 

Therefore, we proposed to use the 

current indirect PEs in our calculation, 

incorporating the new survey data into 

the codes performed by the specialties 

submitting the surveys. We also 

indicated in that same proposed rule 

that we would welcome any suggestions 

that would assist us in further 

refinement of this indirect PE 

methodology. For example, we were 

considering whether we should 

continue to accept supplementary 

survey data or whether it would be 

preferable and feasible to have an SMStype survey of only indirect costs for all 

specialties, or whether a more formulabased methodology independent of the 

SMS data should be adopted, perhaps 

using the specialty-specific indirect-tototal cost percentage as a basis of the 

calculation. For a prior discussion of 

many of the issues associated with 

allocating indirect costs, please refer to 

the CY 2000 Physician Fee Schedule; 

Payment Policies and Relative Value 

Unit Adjustment proposed rule (63 FR 

30823). 

3. Modifications to PE Proposals 

As a result of collaboration with the 

PFS community and public comments 

on this issue, we are now in a position 

to propose modifications to the indirect 

PE methodology. 

a. Indirect Percentage Factor: Use of the 

Specialty-Specific Percentage That 

Indirect PEs Represent of Total PEs 

Based on the Survey Data 

We currently allocate indirect 

expenses on the sum of the direct 

expenses and the work RVUs (converted 

to dollars by multiplying by the CF). We 

are proposing to allocate indirect 

expenses by applying a specialtyspecific indirect percentage factor to the 

direct expenses in order to recognize the 

varying proportion that indirect costs 

represent of total costs by specialty. 

This would have the effect of relatively 

increasing the indirect expense 

allocation for services that are on 

average performed by specialties with 

higher indirect PE percentages, and 

relatively decreasing the indirect 

expense allocation for services that are 

performed by specialties with lower 

indirect PE percentages. For a given 

service, the specific indirect percentage 

factor to apply to the direct costs for the 

purpose of the indirect allocation would 

be calculated as the weighted average of 

the ratio of the indirect to direct costs 

(based on the survey data) for the 

specialties that perform the code. For 

example, if a service is performed by a 

single specialty with indirect PEs that 

were 75 percent of total PEs, the indirect 

percentage factor to apply to the direct 

costs for the purposes of the indirect 

allocation would be (0.75/0.25) = 3.0. 

b. Continued Use of the SpecialtySpecific Indirect Scaling Factors 

As described earlier, we incorporate 

the indirect PE/HR surveys into the 

methodology through the use of 

specialty-specific indirect scaling 

factors. We would continue to use the 

specialty-specific indirect scaling 

factors; however, to apply them in a 

simpler manner we propose to create an 

index. This index would reflect the 

relationship between each specialty’s 

indirect scaling factor and the overall 

indirect scaling factor for the entire PFS. 

For example, if a specialty had an 

indirect practice cost index of 2.00, this 

specialty would have an indirect scaling 

factor that was twice the overall average 

indirect scaling factor. If a specialty had 

an indirect practice cost index of 0.50, 

this specialty would have an indirect 

scaling factor that was half the overall 

average indirect scaling factor. The 

calculation and application of the 

indirect practice cost index is described 

in more detail below in this section. 

c. Use of the Clinical Labor Costs in the 

Indirect Allocation for a Service When 

the Clinical Labor Costs are Greater 

Than the Physician Work RVU 

We have received numerous 

comments that services with little or no 

physician work RVUs are disadvantaged 

under our current indirect allocation 

methodology based on the direct costs 

and the work RVUs. In response to these 

comments, when the clinical labor 

portion of the direct PE RVU is greater 

than the physician work RVU for a 

particular service, we are proposing to 

allocate on the direct costs and the 

clinical labor costs. For example, if a 

service has no physician work, the 

direct PE RVU is 1.10 and the clinical 

labor portion of the direct PE RVU is 

0.65 RVUs, we would use the 1.10 direct 

PE RVUs and the 0.65 clinical labor 

portion of the direct PE RVUs for the 

indirect PE allocation for that service. 

As another example, if the physician 

work RVUs for a service are 0.25, the 

direct PE RVU is 1.10 and the clinical 

labor portion of the direct PE RVU is 

0.65 RVUs, we would use the 1.10 direct 

PE RVUs and the 0.65 clinical labor 

RVUs for the indirect allocation for that 

service. We would not use the 0.25 

physician work RVUs for the indirect PE 

allocation since the 0.65 clinical labor 

RVUs are greater than the 0.25 

physician work RVUs. 

d. Use of 2005 Utilization Data in the 

Indirect PE RVU Calculation 

Under the current PE methodology, 

we predominately use the 1997–2000 

utilization data in the calculation of the 

indirect PE RVUs when the service 

existed during 1997–2000 or the first 

year of utilization data if the service did 

not exist during that time period. We 

used those years of utilization data 

primarily to increase the year to year 

stability of the PE RVUs. With the 

changes we are proposing to make to PE 

RVUs, in particular the elimination of 

the NPWP, we will increase the year-toyear stability of the PE RVUs. We 

believe it is now appropriate to use 

updated utilization data in the 

calculation of the indirect PEs. We 

believe the other proposed changes in 

the PE methodology will help obtain the 

year-to-year stability we were 

attempting to achieve by continuing to 

use the older utilization data. 

Additionally, the use of more current 

utilization data would reflect the more 

current practice patterns. We are 

proposing to use the 2005 utilization 

data in the calculation of the 2007 

indirect PE RVUs. We are also seeking 

comments on whether the utilization 

data should be updated yearly, which 

would increase the accuracy of the PE 

calculations, or less often, which would 

increase the stability of the PE RVUs. 

e. Elimination of the Special 

Methodologies for Services With 

Technical and Professional Components 

Under the PFS, when services have 

technical, professional, and global 

components that can be billed 

separately, the payment for the global 

component equals the sum of the 

payment for the technical and 

professional components. Under the 

current PE methodology, the different 

mix of specialties that perform the 

global, technical and professional 

components can cause the PE RVUs, 

otherwise created by the methodology, 

to fail to add together properly; that is, 

the global component does not equal the 

sum of the professional and technical 

components. The global component 

might exceed the sum of the technical 

and professional components or it might 

be less than the sum of the technical 

and professional components. We 

ensure that the technical and 

professional components add to the 

global component in one of two ways. 

For services in the NPWP, we set the PE 

RVUs for the global component equal to 

the sum of the professional component 

PE RVU and the technical component 


jlentini on PROD1PC65 with NOTICES2
37248 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

PE RVU. For services outside the NPWP, 

we set the PE RVUs for the technical 

component equal to the difference 

between the global PE RVUs and the 

professional component RVUs. 

With our proposed change to a 

bottom-up methodology for the direct 

PEs, there would be no weighted 

averaging of the direct costs inputs 

necessary to create the direct PE RVUs 

and, therefore, the direct PE RVUs for 

the professional and technical 

components would sum to the global 

component. Under the current 

methodology, as a result of the process 

used to ensure the professional and 

technical components sum to the global, 

RVUs for a service with a global 

component can be either more or less 

than the RVUs that would have been 

calculated for the service if the 

professional and technical components 

did not have to sum to the global. 

Given the proposed change to bottomup methodology and the elimination of 

the NPWP, we believe it is 

inappropriate to have codes for which 

the global, and the technical and 

professional components are assigned 

RVUs that are either less than or greater 

than the methodology would otherwise 

produce, and thus, are paid at a rate that 

is either less than or greater than the 

methodology would otherwise specify. 

(See section II.D.1. of this proposed 

notice for the discussion of the current 

methodology.) Therefore, we are 

proposing that in the calculation of the 

indirect percentage factor described 

earlier in section II.D.3.a., we would use 

a weighted average of the ratio of 

indirect to direct costs across all the 

specialties that perform the global, 

technical, and professional components; 

that is, we would apply the same 

weighted average indirect percentage 

factor to allocate indirect expenses to 

the global, professional, and technical 

components for a service. We also 

propose to utilize a similar weighted 

averaging approach across all the 

specialties that perform the components 

when calculating the indirect PE scaling 

factor. Because the direct PE RVUs for 

the technical and professional 

components sum to the global under the 

bottom-up methodology, and we are 

proposing to calculate the indirect 

percentage factor and the indirect 

scaling factor so that they do not vary 

between the technical, professional, and 

global components, our proposed 

methodology would create technical 

and professional components that sum 

to the global, and no other special 

methodology would need to be 

employed. 

(i) Proposed PE RVU Methodology 

Below is a description of the proposed 

PE RVU methodology. 

(a) 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 survey 

PE per physician hour data. Information 

specific to the creation of the setup file 

can be found at the end of section II.D. 

(b) Calculate the Direct Cost PE RVUs 

Sum the costs of each direct input. 

Step 1: Sum the direct costs of the 

inputs for each service. The direct costs 

consist of the costs of the direct inputs 

for clinical labor, medical supplies, and 

medical equipment. The clinical labor 

cost is the sum of the cost of all the staff 

types associated with the service; it is 

the product of the time for each staff 

type and the wage rate for that staff 

type. The medical supplies cost is the 

sum of the supplies associated with the 

service; it is the product of the quantity 

of each supply and the cost of the 

supply. The medical equipment cost is 

the sum of the cost of the equipment 

associated with the service; it is the 

product of the number of minutes each 

piece of equipment is used in the 

service and the equipment cost per 

minute. The equipment cost per minute 

is calculated as described at the end of 

this section. 

Apply a budget neutrality adjustment 

to the direct inputs. 

Step 2: Calculate the current aggregate 

pool of direct PE costs. To do this, 

multiply the current aggregate pool of 

total direct and indirect PE costs (that is, 

the current aggregate PE RVUs 

multiplied by the CF) by the average 

direct PE percentage from the SMS and 

supplementary specialty survey data. 

Step 3: Calculate the aggregate pool of 

proposed direct costs. To do this, for all 

PFS services, sum 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 budget 

neutrality adjustment so that the 

proposed 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 

Medicare PFS CF. 

(c) Create the Indirect PE RVUs 

Create indirect allocators. 

Step 6: Based on the SMS and 

supplementary specialty 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 perform 

the service. Note that for services with 

technical and professional components 

we are calculating the direct and 

indirect percentages across the global, 

professional and technical components. 

That is, the direct and indirect 

percentages for a given service (for 

example, echocardiogram) do not vary 

by the professional, technical and global 

components. 

Step 8: Calculate the service level 

allocators for the indirect PEs based on 

the percentages calculated in Step 7. 

The indirect PEs are allocated based on 

the three components: the direct PE 

RVU, the clinical PE RVU and the work 

RVU. (Note that the work RVU used in 

the calculation includes the separate 

work budget neutrality adjustment from 

the 5-Year Review of the work RVUs 

discussed elsewhere in this proposed 

notice.) 

For most services the indirect 

allocator is: Indirect percentage * (direct 

PE RVU/direct percentage) + work RVU. 

There are two situations where this 

formula is modified: 

• 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 PERVU/direct percentage) + 

clinical PE RVU + work RVU. 

• If the clinical labor PE RVU exceeds 

the work RVU (and the service is not a 

global service), then the indirect 

allocator is: indirect percentage * (direct 

PERVU/direct percentage) + clinical PE 

RVU. 

Note that for global services the indirect 

allocator is based on both the work RVU and 

the clinical labor PE RVU. We do this to 

recognize that, for the professional service, 

indirect PEs will be allocated using the work 

RVUs, and for the technical component 

service, indirect PEs will be allocated using 

the direct PE RVU and the clinical labor PE 

RVU. This also allows the global component 

RVUs to equal the sum of the professional 

and technical component RVUs.) 

For presentation purposes in the 

examples in the Table 53, the formulas 

are divided into two parts for each 

service. The first part does not vary by 

service and is the indirect percentage * 

(direct PE RVU/direct percentage). The 

second part is either the work RVU, 

clinical PE RVU, or both depending on 

whether the service is a global service 

and whether the clinical PE RVU 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37249 

exceeds the work RVU (as described 

earlier in this step.) 

Apply a budget neutrality 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 physician specialty survey 

data. This is similar to the Step 2 

calculation for the direct PE RVUs. 

Step 10: Calculate an aggregate pool of 

proposed indirect PE RVUs for all PFS 

services by adding the product of the 

indirect PE allocators for a service from 

Step 8 and the utilization data for that 

service. This is similar to the Step 3 

calculation for the direct PE RVUs. 

Step 11: Using the results of Step 9 

and Step 10, calculate an indirect PE 

adjustment so that the proposed 

aggregate indirect allocation does not 

exceed the available aggregate indirect 

PE RVUs and apply it to indirect 

allocators calculated in Step 8. This is 

similar to the Step 4 calculation for the 

direct PE RVUs. 

Calculate the Indirect Practice Cost 

Index. 

Step 12: Using the results of Step 11, 

calculate aggregate pools of specialtyspecific 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 specialtyspecific 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. 

Step 14: Using the results of Step 12 

and Step 13, calculate the specialtyspecific indirect PE scaling factors as 

under the current methodology. 

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 perform the service. 

Note that for services with technical and 

professional components, we calculate 

the indirect practice cost index across 

the global, professional and technical 

components. Under this method, the 

indirect practice cost index for a given 

service (for example, echocardiogram) 

does not vary by the professional, 

technical and global components. 

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 RVU. 

(d) Calculate the Final PE RVUs 

Step 18: Add the direct PE RVUs from 

Step 6 to the indirect PE RVUs from 

Step 17. 

Step 19: Calculate and apply the final 

PE budget neutrality adjustment by 

comparing the results of Step 18 to the 

current pool of PE RVUs. This final 

budget neutrality adjustment is 

primarily required because certain 

specialties are excluded from the PE 

RVU calculation for ratesetting 

purposes, but all specialties are 

included for purposes of calculating the 

final budget neutrality adjustment. (See 

‘‘Specialties excluded from rate-setting 

calculation’’ below in this section.) 

(e) Setup File Information 

• Specialties excluded from ratesetting calculation: For the purposes of 

calculating the PE RVUs, we exclude 

certain specialties such as midlevel 

practitioners paid at a percentage of the 

PFS, audiology, and low volume 

specialties from the calculation. This is 

the same approach used under the 

current methodology. These specialties 

are included for the purposes of 

calculating the budget neutrality 

adjustment. 

• Crosswalk certain low volume 

physician specialties: Crosswalk the 

utilization of certain specialties with 

relatively low PFS utilization to the 

associated specialties. This is the same 

approach used under the current 

methodology. 

• Physical therapy utilization: 

Crosswalk physical therapy utilization 

to the specialty of physical therapy. 

This is the same approach used under 

the current methodology. 

• Identify professional and technical 

services not identified under the usual 

TC and 26 modifier: Flag the services 

that are professional and technical 

component services, but do not use TC 

and 26 modifiers (for example, 

electrocardiograms). This flag associates 

the professional and technical 

component with the associated global 

code for use in creating the indirect PE 

RVU. For example, the professional 

service code 93010 is associated with 

the global code 93000. 

• 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. 

• Proposed work RVUs from the 5- 

Year Review: The setup file contains the 

proposed work RVUs from the 5-Year 

Review. 

The equipment cost per minute is 

calculated as: 

(f) Equipment Cost Per Minute = 

(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); 150,000 

minutes. 

Usage = equipment utilization 

assumption; 0.5. 

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. 


jlentini on PROD1PC65 with NOTICES2
37250 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 


jlentini on PROD1PC65 with NOTICES2EN29JN06.055</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37251 

BILLING CODE 4120–01–C 


jlentini on PROD1PC65 with NOTICES2EN29JN06.056</GPH>
37252 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

(ii) Transition the Resulting Revised PE 

RVUs over a Four-Year Period 

A complete analysis of the impacts of 

these changes is contained in the impact 

analysis in section V. of this proposed 

rule. We are concerned that, when 

combined with a proposed negative 

update factor for CY 2007 and the 

proposed changes to the work RVUs 

under the 5-Year Review, the shifts in 

some of the PE RVUs resulting from the 

immediate implementation of our 

proposals could potentially cause some 

disruption for medical practices. 

Therefore, we are proposing to 

transition the proposed PE changes over 

a 4-year period. This would also give 

ample opportunity for us, as well as the 

medical specialties and the RUC, to 

identify any anomalies in the PE data, 

to make any further appropriate 

revisions, and to collect additional data 

as needed prior to the full 

implementation of the proposed PE 

changes. 

During the transition period, the PE 

RVUs would be calculated on the basis 

of a blend of RVUs calculated using our 

proposed methodology described above 

(weighted by 25 percent during CY 

2007, 50 percent during CY 2008, 75 

percent during CY 2009, and 100 

percent thereinafter), and the current CY 

2006 PE RVUs for each existing code. PE 

RVUs for codes that are new during this 

period would be calculated using only 

the proposed methodology, and paid at 

the fully transitioned rate. We believe 

that implementing all of these proposed 

changes would further our goal of 

producing a more accurate, more 

intuitive and more stable PE 

methodology. 

For example, as stated above in this 

section, now that the direct PE inputs 

have been refined, we believe that the 

proposed CPEP/RUC direct input data 

are superior to the specialty-specific 

SMS PE/HR data for the purposes of 

determining the typical direct PE 

resources required to perform each 

service on the PFS. First, we have 

received recommendations on the 

procedure-specific inputs from the 

multi-specialty PEAC that were based 

on presentations from the relevant 

specialties, after the inputs were closely 

scrutinized by the PEAC using 

standards and packages that were agreed 

upon by all involved specialties. 

Second, the refined CPEP/RUC data are 

more current than the aggregate 

specialty-specific data for the majority 

of specialties. Third, for direct costs, we 

believe that it is reasonable to assume 

that the costs of the clinical staff, 

supplies and equipment are the same for 

a given service, regardless of the 

specialty that is performing it. This does 

not happen under the top-down direct 

cost methodology, where the specialtyspecific scaling factors can create 

differing direct costs for the same 

service. 

We also believe the proposed 

methodology is less confusing and more 

intuitive than the current approach. 

First, the NPWP would be eliminated 

and all services would be priced using 

one methodology, eliminating the 

complicated calculations needed to 

price NPWP services. Second, any 

revisions made to the direct inputs for 

one or more services would now have 

predictable results. Changes in the 

direct practice inputs for a service 

would proportionately change the PE 

RVUs for that service without 

significantly affecting the PE RVUs for 

unrelated services (except, of course, to 

the extent that a budget neutrality 

adjustment is required to be applied by 

the statute). 

The proposed methodology would 

also create a system that would be 

significantly more stable from year-toyear than the current approach. 

Specialties should no longer experience 

the wide fluctuations in payment for a 

given service due to an aberrant direct 

cost scaling factor. Direct PEs should 

only change for a service if the service 

is further refined or when prices are 

updated, while indirect PEs should 

change only when there are changes in 

the mix of specialties furnishing the 

service or if any future new survey data 

for indirect costs are utilized. 

We recognize that there may be some 

outstanding issues that need further 

consideration, and we welcome input 

from the medical community regarding 

those issues. We also believe the 

proposed transition period would give 

us the opportunity to work with the 

affected specialties to collect any 

needed data or to determine whether 

further revisions to our PE methodology 

are needed before payment is based 

entirely on the proposed methodology. 

As we gain experience with the new 

methodology, we will reexamine this 

policy beginning next year and propose 

necessary revisions through future 

rulemaking. 

Therefore, we welcome all comments 

on these proposed changes, particularly 

those concerning additional 

modifications to the indirect PE 

methodology that might help us further 

our intended goals. 

III. 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. 3501 et seq.) 

IV. Response to Comments 

Because of the large number of public 

comments we normally receive on 

Federal Register documents, we are not 

able to acknowledge or respond to them 

individually. We will consider all 

comments received by the date and time 

specified in the DATES section of this 

preamble, and, we will respond to the 

comments in the CY 2007 Physician Fee 

Schedule final rule with comment 

period. 

V. Regulatory Impact Analysis 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘REGULATORY IMPACT 

ANALYSIS’’ at the beginning of your 

comments.] 

A. Overall Impact 

We have examined the impacts of this 

proposed notice as required by 

Executive Order 12866 (September 

1993, Regulatory Planning and Review), 

the Regulatory Flexibility Act (RFA) 

(September 19, 1980, Pub. L. 96–354), 

section 1102(b) of the Social Security 

Act, the Unfunded Mandates Reform 

Act of 1995 (Pub. L. 104–4), and 

Executive Order 13132. 

Executive Order 12866 (as amended 

by Executive Order 13258, which 

merely reassigns responsibilities of 

duties) directs agencies to assess all 

costs and benefits of available regulatory 

alternatives and, 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 

(RIA) must be prepared for major rules 

with economically significant effects 

($100 million or more in any 1 year). As 

indicated in more detail below, we 

estimate that the PFS work RVU 

provisions included in this proposed 

notice will redistribute more than $100 

million in one year. We are considering 

this proposed notice to be economically 

significant because its provisions are 

estimated to result in an increase, 

decrease or aggregate redistribution of 

Medicare spending that will exceed 

$100 million. Therefore, this proposed 

notice is a major rule and we have 

prepared a regulatory impact analysis. 

The RFA requires agencies to analyze 

options for regulatory relief of small 

businesses. For purposes of the RFA, 

small entities include small businesses, 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37253 

nonprofit organizations, and small 

governmental jurisdictions. Most 

hospitals and most other providers and 

suppliers are small entities, either by 

nonprofit status or by having revenues 

of $6 million to $29 million in any one 

year. We prepare a regulatory flexibility 

analysis unless we certify that a rule 

would not have a significant economic 

impact on a substantial number of small 

entities. The analysis must include a 

justification concerning the reason 

action is being taken, the kinds and 

number of small entities the rule affects, 

and an explanation of any meaningful 

options that achieve the objectives with 

less significant adverse economic 

impact on the small entities. 

Section 1102(b) of the Act requires us 

to prepare a regulatory impact analysis 

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 a Metropolitan 

Statistical Area and has fewer than 100 

beds. For purposes of the RFA, 

physicians, nonphysician practitioners, 

and suppliers are considered small 

businesses if they generate revenues of 

$6 million or less. Approximately 95 

percent of physicians are considered to 

be small entities. There are over 980,000 

physicians, other practitioners and 

medical suppliers that receive Medicare 

payment under the PFS. The analysis 

and discussion provided in this section, 

as well as elsewhere in this proposed 

notice, complies with the RFA 

requirements. 

Section 202 of the Unfunded 

Mandates Reform Act of 1995 also 

requires that agencies assess anticipated 

costs and benefits before issuing any 

rule whose mandates require spending 

in any one year of $100 million in 1995 

dollars, updated annually for inflation. 

That threshold level is currently 

approximately $120 million. Medicare 

beneficiaries are considered to be part of 

the private sector for this purpose. A 

discussion concerning the impact of this 

proposed notice on beneficiaries is 

found later in this section. 

Executive Order 13132 establishes 

certain requirements that an agency 

must meet when it issues 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 

significant impact on the rights, roles, or 

responsibilities of State, local, or tribal 

governments. A discussion concerning 

the impact of this proposed notice on 

beneficiaries is found later in this 

section. 

B. Anticipated Effects 

We have prepared the following 

analysis, which, together with the 

information provided in the rest of this 

preamble, meets all assessment 

requirements. It explains the rationale 

for and purposes of the proposed notice; 

details the costs and benefits of the rule; 

analyzes alternatives; and presents the 

measures we propose to use to minimize 

the burden on small entities. 

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

requires that increases or decreases in 

RVUs 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 make 

adjustments to preserve budget 

neutrality. This year, the estimated $4 

billion impact of proposed changes in 

work RVUs resulting from the 5-year 

refinement will require that a budgetneutrality adjustment be made. 

Revisions in payment policies, 

including the establishment of interim 

and final RVUs for coding changes that 

will be announced later this year, may 

result in additional budget-neutrality 

adjustments. 

We considered making the statutorily 

required budget-neutrality adjustment to 

account for the 5-Year Review of 

physician work by reducing all work 

RVUs. We estimate that all work RVUs 

would have to be reduced by 10 percent 

under this option. Alternatively, we 

considered making the budget neutrality 

adjustment to the PFS CF. This option 

would require an estimated 5 percent 

reduction in the CF and would also 

affect services that do not have work 

RVUs, and were thus not part of the 5- 

Year Review. Therefore, to confine the 

impact to services that have physician 

work RVUs, we are proposing to 

establish a budget neutrality adjustor 

that would reduce the work RVUs by an 

estimated 10 percent to meet the 

provisions of section 1848(c)(2)(B)(ii) of 

the Act. 

Table 54 shows the specialty-level 

impact on payment of the work and PE 

changes discussed in this proposed 

notice for the CY 2007 Medicare PFS, 

including the effect of the separate work 

budget neutrality adjustor discussed 

above. Because we have proposed a 

four-year transition for the new PE 

changes, we also show the impact of the 

fully implemented PE changes in 2010. 

Our estimates of changes in Medicare 

revenues for PFS services compare 

payment rates for 2006 with proposed 

payment rates for 2007 and 2010 using 

2005 Medicare utilization for all years. 

These impacts do not include estimates 

of the annual updates to the Medicare 

PFS CF for 2007 through 2010. We are 

using 2005 Medicare claims processed 

and paid through March 30, 2005, that 

we estimate are 98 percent complete. 

Using a single year of utilization, as 

opposed to multiple years, limits the 

estimated changes to the proposed work 

and PE. This approach is consistent 

with the methodology outlined in 

section II.D.3.d. of this proposed notice, 

‘‘Use of 2005 utilization data in the 

indirect PE RVU calculation.’’ To the 

extent that there are year-to-year 

changes in the volume and mix of 

services provided by physicians, the 

actual impact on total Medicare 

revenues will be different than those 

shown here. The payment impacts 

reflect averages for each specialty based 

on Medicare utilization. The payment 

impact for an individual physician 

would be different from the average, 

based on the mix of services the 

physician provides. The average change 

in total revenues would be less than the 

impact displayed here because 

physicians furnish services to both 

Medicare and non-Medicare patients 

and specialties may receive substantial 

Medicare revenues for services that are 

not paid under the PFS. For instance, 

independent laboratories receive 

approximately 80 percent of their 

Medicare revenues from clinical 

laboratory services that are not paid 

under the PFS. 

Table 54 shows only the payment 

impact on PFS services. The following 

is an explanation of the information 

represented in Table 54: 

• Specialty: The physician specialty 

or type of practitioner/supplier. 

• Allowed Charges: Allowed charges 

are the Medicare Fee Schedule amounts 

for covered services and include copayments and deductibles (which are 

the financial responsibility of the 

beneficiary). These amounts have been 

summed across all services provided by 

physicians, practitioners or suppliers 

with a specialty to arrive at the total 

allowed charges for the specialty. 

• Impact of Work RVU Changes: The 

percentage increase or decrease in 

allowed charges attributed to changes in 

the valuation of physician/clinical work 

for the given specialty. 

• Impact of PE RVU Changes: The 

percentage increase or decrease in 

allowed charges attributed to changes in 

the valuation of practice expense for the 

services provided by physicians, 


jlentini on PROD1PC65 with NOTICES2
37254 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

practitioners or suppliers within each 

specialty (shown in the first year of 

phase-in (2007) and at full 

implementation (2010)). 

• Combined impact of Work and PE 

RVU changes: The percentage increase 

or decrease in allowed charges 

attributed to the sum of changes to the 

valuation of physician/clinical work 

and the valuation of practice expense 

for services provided by physicians, 

practitioners or suppliers within each 

specialty (shown in the first year of 

phase-in of PE changes (2007) and at 

full implementation of PE changes 

(2010)). 

BILLING CODE 4120–01–P 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37255 

This is the third 5-Year Review of 

physician work RVUs. The first 5-Year 

Review occurred as part of the 1996 

regulatory process and was effective for 

services furnished on or after January 1, 

1997. The second 5-Year Review of 


jlentini on PROD1PC65 with NOTICES2EN29JN06.057</GPH>
37256 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

physician work RVUs occurred as part 

of the 2001 regulatory process and was 

effective for services furnished on or 

after January 1, 2002. Table 55 compares 

some basic data points from the three 5- 

Year Reviews. 

BILLING CODE 4120–01–C 

We are currently developing the CY 

2007 PFS proposed rule that will 

contain our estimate of all other 

proposed policies and changes that will 

affect payment for PFS services in CY 

2007. We will show the combined 

impact of all policy and other changes 

affecting PFS payments in the final CY 

2007 PFS rule. 

C. Alternatives Considered 

This proposed notice discusses the 

proposed revisions to the work 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. Impact on Beneficiaries 

Overall, we believe these changes 

would improve beneficiary access to 

reasonable and necessary services since 

services would now be more 

appropriately valued. The payment 

changes would also affect beneficiary 

liability. Any changes in aggregate 

beneficiary liability from a particular 

work RVU change will 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 aggregate impact of 

the work RVU changes on the 

calculation of the Medicare Part B 

premium rate (generally, 25 percent of 

the aggregate payment change). 

E. Accounting Statement 

As required by OMB Circular A–4 

(available at http:// 

www.whitehouse.gov/omb/circulars/ 

a004/a-4.pdf), in Table 56, we have 

prepared an accounting statement 

showing the classification of the 

expenditures associated with the 

provisions of this proposed notice. 

Expenditures are classified as 

transfers between Medicare providers/ 

suppliers (that is physicians, other 

practitioners medical suppliers, and 

providers that receive payment under or 

based on the PFS) and the Federal 

government. The ¥$40 million shown 

in Table 56 represents the net impact of 

an increase in FY 2007 payments for 

mammography and a decrease in FY 

2007 payments for physical therapy. 

TABLE 56.—ACCOUNTING STATEMENT—CLASSIFICATION OF ESTIMATED EXPENDITURES, FROM FY 2006 TO FY 2007 (IN

MILLIONS) 

Category Transfers 

Annualized Monetized Transfers ¥$40 

From Whom To Whom? ......................... Providers of physical therapy and mammography services that are paid based on Medicare Physician 

Fee Schedule to the Federal government. 

In accordance with the provisions of 

Executive Order 12866, this proposed 

notice was reviewed by the Office of 

Management and Budget. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: May 4, 2006. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services. 

Approved: June 9, 2006. 

Michael O. Leavitt, 

Secretary. 

Note: These addenda will not appear in the 

Code of Federal Regulations. 

Addendum A: Explanation and Use of 

Addenda B 

The addenda on the following pages 

provide various data pertaining to the 

Medicare fee schedule for physicians’

services furnished in 2007. Addendum B 

contains the RVUs for work, non-facility PE, 

facility PE, and malpractice expense, and 

other information for all services included in 

the PFS. 


jlentini on PROD1PC65 with NOTICES2EN29JN06.058</GPH>
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37257 

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 and most 

alphanumeric codes (Healthcare Common 

Procedure Coding System (HCPCS) codes not 

included in CPT) in Addendum B. 

Addendum B—2007 Relative Value Units 

and Related Information Used in 

Determining Medicare Payments for 2007 

This addendum contains the following 

information for each CPT code and 

alphanumeric HCPCS code, except for: 

alphanumeric codes beginning with B 

(enteral and parenteral therapy), E (durable 

medical equipment), K (temporary codes for 

nonphysicians’ services or items), or L 

(orthotics); and codes for anesthesiology. The 

Addendum B included in this proposed 

notice does not include codes which are 

carrier priced since the RVUs for these 

services are set at 0.00. 

Please also note the following: 

• An ‘‘NA’’ in the ‘‘Non-facility PE RVUs’’

column of Addendum B means that CMS has 

not developed a PE RVU in the non-facility 

setting for the service because it is typically 

performed in the hospital (for example, an 

open heart surgery is generally performed in 

the hospital setting and not a physician’s 

office). 

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

‘‘Facility PE RVUs’’ column of Addendum B 

are typically not paid using the PFS when 

provided in a facility setting. These services 

(which include ‘‘incident to’’ services and 

the technical portion of diagnostic tests) are 

generally paid under either the outpatient 

hospital prospective payment system or 

bundled into the hospital inpatient 

prospective payment system payment. 

1. CPT/HCPCS code. This is the CPT or 

alphanumeric HCPCS number for the service. 

Alphanumeric HCPCS codes are included at 

the end of this addendum. 

2. Modifier. A modifier is shown if there 

is a technical component (modifier TC) and 

a professional component (PC) (modifier -26) 

for the service. If there is a PC and a TC for 

the service, Addendum B contains three 

entries for the code. A code for: the global 

values (both professional and technical); 

modifier -26 (PC); and, modifier TC. The 

global service is not designated by a modifier, 

and physicians must bill using the code 

without a modifier if the physician furnishes 

both the PC and the TC of the service. 

Modifier-53 is shown for a discontinued 

procedure. There will be RVUs for the code 

(CPT code 45378) with this modifier. 

3. Status indicator. This indicator shows 

whether the CPT/HCPCS code is in the PFS 

and whether it is separately payable if the 

service is covered. 

A = Active code. These codes are 

separately payable under the PFS if covered. 

There will be RVUs for codes with this 

status. The presence of an ‘‘A’’ indicator does 

not mean that Medicare has made a national 

coverage determination regarding the service. 

Carriers remain responsible for coverage 

decisions in the absence of a national 

Medicare policy. 

B = Bundled code. Payments for covered 

services are always bundled into payment for 

other services not specified. If RVUs are 

shown, they are not used for Medicare 

payment. If these services are covered, 

payment for them is subsumed by the 

payment for the services to which they are 

incident (an example is a telephone call from 

a hospital nurse regarding care of a patient). 

C = Carrier-priced code. Carriers will 

establish RVUs and payment amounts for 

these services, generally on an individual 

case basis following review of 

documentation, such as an operative report. 

D = Deleted/discontinued code. These 

codes are deleted effective with the 

beginning of the CY and are always subject 

to a 90-day grace period. 

E = Excluded from the PFS by regulation. 

These codes are for items and services that 

CMS excludes from payment under 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. 

F = Deleted/discontinued codes. (Code not 

subject to a 90-day grace period.) These codes 

are deleted effective with the beginning of 

the CY and are never subject to a grace 

period. This indicator is no longer effective 

as of January 1, 2006. 

G = Code not valid for Medicare purposes. 

Medicare does not recognize codes assigned 

this status. Medicare uses another code for 

reporting of, and payment for, these services. 

(Codes subject to a 90-day grace period.) This 

indicator is no longer effective with the 2006 

PFS as of January 1, 2006. 

H = Deleted modifier. For 2000 and later 

years, either the TC or PC component shown 

for the code has been deleted or the deleted 

component is shown in the database with the 

H status indicator. 

I = Not valid for Medicare purposes. 

Medicare uses another code for the reporting 

of, and the payment for these services. (Codes 

not subject to a 90-day grace period.) 

N = Noncovered service. These codes are 

noncovered services. Medicare payment may 

not be made for these codes. If RVUs are 

shown, they are not used for Medicare 

payment. 

P = Bundled or excluded code. There are 

no RVUs for these services. No separate 

payment is made for them under the PFS. 

—If the item or service is covered as incident 

to a physician’s service and is furnished on 

the same day as a physician’s service, 

payment for it is bundled into the payment 

for the physician’s service to which it is 

incident (an example is an elastic bandage 

furnished by a physician incident to a 

physician’s service). 

—If the item or service is covered as other 

than incident to a physician’s service, it is 

excluded from the PFS (for example, 

colostomy supplies) and is paid under the 

other payment provisions of the Act. 

R = Restricted coverage. Special coverage 

instructions apply. If the service is covered 

and no RVUs are shown, it is carrier-priced. 

T = 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 = Exclusion by law. These codes 

represent an item or service that is not within 

the definition of ‘‘physicians’ services’’ for 

PFS payment purposes. No RVUs are shown 

for these codes, and no payment may be 

made under the PFS. (Examples are 

ambulance services and clinical diagnostic 

laboratory services.) 

4. Description of code. This is an 

abbreviated version of the narrative 

description of the code. 

5. Physician work RVUs. These are the 

RVUs for the physician work for this service 

in 2007. The RVUs for codes with a 10- or 

90-day global period reflect the application of 

the RUC-recommended values for the E/M 

services that are included as part of the 

global period for the service. Codes that are 

not used for Medicare payment are identified 

with a ‘‘+.’’ Note: The separate budget 

neutrality adjustor is not reflected in these 

physician work RVUs. 

6. Fully implemented non-facility practice 

expense RVUs. These are the fully 

implemented resource-based PE RVUs for 

non-facility settings. 

7. Transitional Non-facility practice 

expense RVUs. These are the 2007 resourcebased PE RVUs for non-facility settings. 

8. Fully implemented facility practice 

expense RVUs. These are the fully 

implemented resource-based PE RVUs for 

facility settings. 

9. Transitional facility practice expense 

RVUs. These are the 2007 resource-based PE 

RVUs for facility settings. 

10. Malpractice expense RVUs. These are 

the RVUs for the malpractice expense for the 

service for 2006. 

11. Non-facility total. This is the sum of the 

work, fully implemented non-facility PE, and 

malpractice expense RVUs. 

12. Transitional non-facility total. This is 

the sum of the work, 2007 transitional nonfacility PE, and malpractice expense RVUs. 

13. Facility total. This is the sum of the 

work, fully implemented facility PE, and 

malpractice expense RVUs. 

14. Transitional facility total. This is the 

sum of the work, 2007 transitional facility 

PE, and malpractice expense RVUs. 

15. Global period. This indicator shows the 

number of days in the global period for the 

code (0, 10, or 90 days). An explanation of 

the alpha codes follows: 

MMM = Code describes a service furnished 

in uncomplicated maternity cases including 

antepartum care, delivery, and postpartum 

care. The usual global surgical concept does 

not apply. See the 1999 Physicians’ CPT for 

specific definitions. 

XXX = The global concept does not apply. 

YYY = The global period is to be set by the 

carrier (for example, unlisted surgery codes). 

ZZZ = Code related to another service that 

is always included in the global period of the 

other service. (Note: Physician work and PE 

are associated with intra service time and in 

some instances the post service time.) 


jlentini on PROD1PC65 with NOTICES2
37258 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007 

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

0073T ......... ............ A Radiation tx delivery, imrt .............................. 0.00 13.15 16.84 NA NA 0.13 13.28 16.97 NA NA XXX 10021 ......... ............ A Fna w/o image ............................................... 1.27 2.11 2.15 0.35 0.49 0.10 3.48 3.52 1.72 1.86 XXX 10022 ......... ............ A Fna w/image .................................................. 1.27 2.21 2.47 0.40 0.42 0.08 3.56 3.82 1.75 1.77 XXX 10040 ......... ............ A Acne surgery ................................................. 1.18 1.28 1.08 0.95 0.83 0.05 2.51 2.31 2.18 2.06 010 10060 ......... ............ A Drainage of skin abscess .............................. 1.17 1.49 1.28 1.07 0.97 0.12 2.78 2.57 2.36 2.26 010 10061 ......... ............ A Drainage of skin abscess .............................. 2.40 2.05 1.89 1.49 1.50 0.26 4.71 4.55 4.15 4.16 010 10080 ......... ............ A Drainage of pilonidal cyst .............................. 1.17 2.63 2.99 1.08 1.10 0.11 3.91 4.27 2.36 2.38 010 10081 ......... ............ A Drainage of pilonidal cyst .............................. 2.45 3.46 3.93 1.42 1.48 0.24 6.15 6.62 4.11 4.17 010 10120 ......... ............ A Remove foreign body .................................... 1.22 2.09 2.16 0.93 0.96 0.12 3.43 3.50 2.27 2.30 010 10121 ......... ............ A Remove foreign body .................................... 2.69 3.49 3.51 1.62 1.75 0.33 6.51 6.53 4.64 4.77 010 10140 ......... ............ A Drainage of hematoma/fluid .......................... 1.53 2.25 1.90 1.28 1.29 0.19 3.97 3.62 3.00 3.01 010 10160 ......... ............ A Puncture drainage of lesion .......................... 1.20 1.85 1.66 1.07 1.08 0.14 3.19 3.00 2.41 2.42 010 10180 ......... ............ A Complex drainage, wound ............................ 2.25 3.28 3.06 1.81 1.95 0.35 5.88 5.66 4.41 4.55 010 11000 ......... ............ A Debride infected skin ..................................... 0.60 0.72 0.62 0.16 0.21 0.07 1.39 1.29 0.83 0.88 000 11001 ......... ............ A Debride infected skin add-on ........................ 0.30 0.23 0.23 0.08 0.10 0.04 0.57 0.57 0.42 0.44 ZZZ 11004 ......... ............ A Debride genitalia & perineum ........................ 10.31 NA NA 3.00 3.68 0.67 NA NA 13.98 14.66 000 11005 ......... ............ A Debride abdom wall ...................................... 13.75 NA NA 3.98 5.18 0.96 NA NA 18.69 19.89 000 11006 ......... ............ A Debride genit/per/abdom wall ....................... 12.61 NA NA 3.55 4.53 1.28 NA NA 17.44 18.42 00011008 ......... ............ A Remove mesh from abd wall ........................ 5.00 NA NA 1.33 1.86 0.61 NA NA 6.94 7.47 ZZZ 11010 ......... ............ A Debride skin, fx ............................................. 4.19 6.71 6.85 2.29 2.55 0.66 11.56 11.70 7.14 7.40 010 11011 ......... ............ A Debride skin/muscle, fx ................................. 4.94 7.04 7.90 2.01 2.27 0.74 12.72 13.58 7.69 7.95 000 11012 ......... ............ A Debride skin/muscle/bone, fx ........................ 6.87 8.91 11.33 3.05 3.65 1.16 16.94 19.36 11.08 11.68 000 11040 ......... ............ A Debride skin, partial ...................................... 0.50 0.68 0.56 0.16 0.20 0.06 1.24 1.12 0.72 0.76 000 11041 ......... ............ A Debride skin, full ............................................ 0.82 0.77 0.69 0.24 0.31 0.10 1.69 1.61 1.16 1.23 000 11042 ......... ............ A Debride skin/tissue ........................................ 1.12 1.04 0.99 0.33 0.41 0.13 2.29 2.24 1.58 1.66 000 11043 ......... ............ A Debride tissue/muscle ................................... 3.00 3.61 3.45 2.68 2.62 0.32 6.93 6.77 6.00 5.94 010 11044 ......... ............ A Debride tissue/muscle/bone .......................... 4.05 4.91 4.57 3.64 3.73 0.43 9.39 9.05 8.12 8.21 010 11055 ......... ............ R Trim skin lesion ............................................. 0.43 0.81 0.62 0.11 0.16 0.05 1.29 1.10 0.59 0.64 000 11056 ......... ............ R Trim skin lesions, 2 to 4 ................................ 0.61 0.88 0.70 0.15 0.21 0.07 1.56 1.38 0.83 0.89 000 11057 ......... ............ R Trim skin lesions, over 4 ............................... 0.79 0.99 0.80 0.20 0.28 0.10 1.88 1.69 1.09 1.17 000 11100 ......... ............ A Biopsy, skin lesion ......................................... 0.81 1.86 1.40 0.38 0.37 0.03 2.70 2.24 1.22 1.21 000 11101 ......... ............ A Biopsy, skin add-on ....................................... 0.41 0.40 0.35 0.19 0.19 0.02 0.83 0.78 0.62 0.62 ZZZ 11200 ......... ............ A Removal of skin tags ..................................... 0.77 1.21 1.08 0.88 0.79 0.04 2.02 1.89 1.69 1.60 010 11201 ......... ............ A Remove skin tags add-on ............................. 0.29 0.16 0.16 0.11 0.12 0.02 0.47 0.47 0.42 0.43 ZZZ 11300 ......... ............ A Shave skin lesion .......................................... 0.51 1.18 1.04 0.20 0.21 0.03 1.72 1.58 0.74 0.75 000 11301 ......... ............ A Shave skin lesion .......................................... 0.85 1.48 1.20 0.37 0.38 0.04 2.37 2.09 1.26 1.27 000 11302 ......... ............ A Shave skin lesion .......................................... 1.05 1.75 1.41 0.47 0.46 0.05 2.85 2.51 1.57 1.56 000 11303 ......... ............ A Shave skin lesion .......................................... 1.24 1.99 1.68 0.53 0.52 0.07 3.30 2.99 1.84 1.83 000 11305 ......... ............ A Shave skin lesion .......................................... 0.67 1.05 0.90 0.20 0.25 0.07 1.79 1.64 0.94 0.99 000 11306 ......... ............ A Shave skin lesion .......................................... 0.99 1.40 1.18 0.37 0.41 0.07 2.46 2.24 1.43 1.47 000 11307 ......... ............ A Shave skin lesion .......................................... 1.14 1.68 1.39 0.46 0.48 0.07 2.89 2.60 1.67 1.69 000 11308 ......... ............ A Shave skin lesion .......................................... 1.41 1.72 1.52 0.50 0.57 0.13 3.26 3.06 2.04 2.11 000 11310 ......... ............ A Shave skin lesion .......................................... 0.73 1.37 1.18 0.31 0.32 0.04 2.14 1.95 1.08 1.09 000 11311 ......... ............ A Shave skin lesion .......................................... 1.05 1.62 1.33 0.47 0.49 0.05 2.72 2.43 1.57 1.59 000 11312 ......... ............ A Shave skin lesion .......................................... 1.20 1.89 1.54 0.55 0.55 0.06 3.15 2.80 1.81 1.81 000 11313 ......... ............ A Shave skin lesion .......................................... 1.62 2.15 1.90 0.71 0.72 0.10 3.87 3.62 2.43 2.44 000 11400 ......... ............ A Exc tr-ext b9+marg 0.5 < cm ........................ 0.85 1.86 1.97 0.92 0.89 0.06 2.77 2.88 1.83 1.80 010 11401 ......... ............ A Exc tr-ext b9+marg 0.6–1 cm ....................... 1.23 2.15 2.08 1.12 1.05 0.10 3.48 3.41 2.45 2.38 010 11402 ......... ............ A Exc tr-ext b9+marg 1.1–2 cm ....................... 1.40 2.35 2.26 1.18 1.11 0.13 3.88 3.79 2.71 2.64 010 11403 ......... ............ A Exc tr-ext b9+marg 2.1–3 cm ....................... 1.79 2.52 2.43 1.54 1.38 0.17 4.48 4.39 3.50 3.34 010 11404 ......... ............ A Exc tr-ext b9+marg 3.1–4 cm ....................... 2.06 2.83 2.74 1.61 1.45 0.21 5.10 5.01 3.88 3.72 010 11406 ......... ............ A Exc tr-ext b9+marg > 4.0 cm ........................ 3.45 3.37 3.15 1.94 1.72 0.32 7.14 6.92 5.71 5.49 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37259 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

11420 ......... ............ A Exc h-f-nk-sp b9+marg 0.5 < ........................ 0.98 1.81 1.78 0.92 0.93 0.09 2.88 2.85 1.99 2.00 010 11421 ......... ............ A Exc h-f-nk-sp b9+marg 0.6–1 ....................... 1.42 2.18 2.10 1.14 1.12 0.13 3.73 3.65 2.69 2.67 010 11422 ......... ............ A Exc h-f-nk-sp b9+marg 1.1–2 ....................... 1.63 2.38 2.29 1.49 1.37 0.16 4.17 4.08 3.28 3.16 010 11423 ......... ............ A Exc h-f-nk-sp b9+marg 2.1–3 ....................... 2.01 2.62 2.60 1.62 1.49 0.20 4.83 4.81 3.83 3.70 010 11424 ......... ............ A Exc h-f-nk-sp b9+marg 3.1–4 ....................... 2.43 2.93 2.84 1.74 1.64 0.25 5.61 5.52 4.42 4.32 010 11426 ......... ............ A Exc h-f-nk-sp b9+marg > 4 cm ..................... 4.02 3.55 3.51 2.14 2.12 0.44 8.01 7.97 6.60 6.58 010 11440 ......... ............ A Exc face-mm b9+marg 0.5 < cm .................. 1.00 1.98 2.15 1.29 1.31 0.08 3.06 3.23 2.37 2.39 01011441 ......... ............ A Exc face-mm b9+marg 0.6–1 cm .................. 1.48 2.34 2.34 1.52 1.50 0.13 3.95 3.95 3.13 3.11 010 11442 ......... ............ A Exc face-mm b9+marg 1.1–2 cm .................. 1.72 2.58 2.56 1.61 1.58 0.16 4.46 4.44 3.49 3.46 010 11443 ......... ............ A Exc face-mm b9+marg 2.1–3 cm .................. 2.29 2.81 2.89 1.79 1.81 0.22 5.32 5.40 4.30 4.32 010 11444 ......... ............ A Exc face-mm b9+marg 3.1–4 cm .................. 3.14 3.21 3.41 2.03 2.15 0.30 6.65 6.85 5.47 5.59 010 11446 ......... ............ A Exc face-mm b9+marg > 4 cm ..................... 4.73 3.86 4.00 2.47 2.70 0.43 9.02 9.16 7.63 7.86 010 11450 ......... ............ A Removal, sweat gland lesion ........................ 3.10 5.15 5.07 2.41 2.13 0.34 8.59 8.51 5.85 5.57 090 11451 ......... ............ A Removal, sweat gland lesion ........................ 4.31 6.14 6.50 2.77 2.61 0.53 10.98 11.34 7.61 7.45 090 11462 ......... ............ A Removal, sweat gland lesion ........................ 2.88 5.31 5.17 2.45 2.13 0.32 8.51 8.37 5.65 5.33 090 11463 ......... ............ A Removal, sweat gland lesion ........................ 4.31 6.58 6.78 2.94 2.75 0.54 11.43 11.63 7.79 7.60 090 11470 ......... ............ A Removal, sweat gland lesion ........................ 3.62 5.57 5.20 2.67 2.37 0.40 9.59 9.22 6.69 6.39 090 11471 ......... ............ A Removal, sweat gland lesion ........................ 4.77 6.42 6.65 2.95 2.82 0.58 11.77 12.00 8.30 8.17 090 11600 ......... ............ A Exc tr-ext mlg+marg 0.5 < cm ...................... 1.56 2.61 2.63 1.01 0.98 0.10 4.27 4.29 2.67 2.64 010 11601 ......... ............ A Exc tr-ext mlg+marg 0.6–1 cm ...................... 2.00 3.27 2.85 1.35 1.25 0.12 5.39 4.97 3.47 3.37 010 11602 ......... ............ A Exc tr-ext mlg+marg 1.1–2 cm ...................... 2.20 3.65 3.04 1.52 1.33 0.12 5.97 5.36 3.84 3.65 010 11603 ......... ............ A Exc tr-ext mlg+marg 2.1–3 cm ...................... 2.75 3.85 3.27 1.69 1.42 0.16 6.76 6.18 4.60 4.33 010 11604 ......... ............ A Exc tr-ext mlg+marg 3.1–4 cm ...................... 3.10 4.15 3.57 1.76 1.48 0.20 7.45 6.87 5.06 4.78 010 11606 ......... ............ A Exc tr-ext mlg+marg > 4 cm ......................... 4.95 5.28 4.37 2.27 1.87 0.36 10.59 9.68 7.58 7.18 010 11620 ......... ............ A Exc h-f-nk-sp mlg+marg 0.5 < ...................... 1.57 2.70 2.63 1.05 0.98 0.09 4.36 4.29 2.71 2.64 010 11621 ......... ............ A Exc h-f-nk-sp mlg+marg 0.6–1 ...................... 2.01 3.32 2.86 1.38 1.28 0.12 5.45 4.99 3.51 3.41 010 11622 ......... ............ A Exc h-f-nk-sp mlg+marg 1.1–2 ...................... 2.34 3.70 3.15 1.57 1.44 0.14 6.18 5.63 4.05 3.92 010 11623 ......... ............ A Exc h-f-nk-sp mlg+marg 2.1–3 ...................... 3.04 3.92 3.49 1.78 1.63 0.20 7.16 6.73 5.02 4.87 010 11624 ......... ............ A Exc h-f-nk-sp *mlg+marg 3.1–4 .................... 3.55 4.23 3.87 1.90 1.81 0.27 8.05 7.69 5.72 5.63 010 11626 ......... ............ A Exc h-f-nk-sp mlg+mar > 4 cm ..................... 4.54 4.88 4.70 2.26 2.37 0.45 9.87 9.69 7.25 7.36 010 11640 ......... ............ A Exc face-mm malig+marg 0.5 < .................... 1.60 2.89 2.72 1.14 1.12 0.11 4.60 4.43 2.85 2.83 010 11641 ......... ............ A Exc face-mm malig+marg 0.6–1 ................... 2.10 3.44 3.13 1.44 1.51 0.16 5.70 5.39 3.70 3.77 010 11642 ......... ............ A Exc face-mm malig+marg 1.1–2 ................... 2.55 3.82 3.51 1.66 1.70 0.19 6.56 6.25 4.40 4.44 010 11643 ......... ............ A Exc face-mm malig+marg 2.1–3 ................... 3.35 4.06 3.87 1.92 1.96 0.26 7.67 7.48 5.53 5.57 010 11644 ......... ............ A Exc face-mm malig+marg 3.1–4 ................... 4.27 4.82 4.72 2.25 2.41 0.37 9.46 9.36 6.89 7.05 010 11646 ......... ............ A Exc face-mm mlg+marg > 4 cm .................... 6.19 5.73 5.76 3.01 3.36 0.61 12.53 12.56 9.81 10.16 010 11719 ......... ............ R Trim nail(s) .................................................... 0.17 0.38 0.28 0.04 0.06 0.02 0.57 0.47 0.23 0.25 000 11720 ......... ............ A Debride nail, 1–5 ........................................... 0.32 0.47 0.37 0.08 0.11 0.04 0.83 0.73 0.44 0.47 000 11721 ......... ............ A Debride nail, 6 or more ................................. 0.54 0.54 0.47 0.14 0.19 0.07 1.15 1.08 0.75 0.80 000 11730 ......... ............ A Removal of nail plate .................................... 1.13 1.34 1.11 0.29 0.40 0.14 2.61 2.38 1.56 1.67 000 11732 ......... ............ A Remove nail plate, add-on ............................ 0.57 0.54 0.47 0.14 0.20 0.07 1.18 1.11 0.78 0.84 ZZZ 11740 ......... ............ A Drain blood from under nail .......................... 0.37 0.80 0.61 0.43 0.37 0.04 1.21 1.02 0.84 0.78 000 11750 ......... ............ A Removal of nail bed ...................................... 2.36 2.94 2.36 1.86 1.79 0.22 5.52 4.94 4.44 4.37 010 11752 ......... ............ A Remove nail bed/finger tip ............................ 3.42 4.07 3.27 2.77 2.94 0.35 7.84 7.04 6.54 6.71 010 11755 ......... ............ A Biopsy, nail unit ............................................. 1.31 2.01 1.68 0.75 0.77 0.14 3.46 3.13 2.20 2.22 000 11760 ......... ............ A Repair of nail bed .......................................... 1.58 3.41 2.83 1.42 1.70 0.21 5.20 4.62 3.21 3.49 010 11762 ......... ............ A Reconstruction of nail bed ............................ 2.89 3.67 3.09 1.66 2.18 0.36 6.92 6.34 4.91 5.43 010 11765 ......... ............ A Excision of nail fold, toe ................................ 0.69 2.67 2.01 1.00 0.82 0.08 3.44 2.78 1.77 1.59 010 11770 ......... ............ A Removal of pilonidal lesion ........................... 2.61 3.47 3.49 1.52 1.51 0.33 6.41 6.43 4.46 4.45 010 11771 ......... ............ A Removal of pilonidal lesion ........................... 5.91 6.67 5.91 3.70 3.42 0.74 13.32 12.56 10.35 10.07 090 11772 ......... ............ A Removal of pilonidal lesion ........................... 7.15 8.00 7.64 5.51 5.19 0.89 16.04 15.68 13.55 13.23 090 11900 ......... ............ A Injection into skin lesions .............................. 0.52 0.90 0.71 0.24 0.22 0.02 1.44 1.25 0.78 0.76 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37260 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

11901 ......... ............ A Added skin lesions injection .......................... 0.80 1.00 0.75 0.38 0.36 0.03 1.83 1.58 1.21 1.19 000 11920 ......... ............ R Correct skin color defects ............................. 1.61 2.37 3.38 1.10 1.09 0.24 4.22 5.23 2.95 2.94 000 11921 ......... ............ R Correct skin color defects ............................. 1.93 2.63 3.64 1.24 1.26 0.29 4.85 5.86 3.46 3.48 000 11922 ......... ............ R Correct skin color defects ............................. 0.49 0.92 1.09 0.22 0.24 0.07 1.48 1.65 0.78 0.80 ZZZ 11950 ......... ............ R Therapy for contour defects .......................... 0.84 0.86 1.07 0.35 0.38 0.06 1.76 1.97 1.25 1.28 000 11951 ......... ............ R Therapy for contour defects .......................... 1.19 1.17 1.41 0.52 0.51 0.11 2.47 2.71 1.82 1.81 000 11952 ......... ............ R Therapy for contour defects .......................... 1.69 1.69 1.82 0.79 0.71 0.16 3.54 3.67 2.64 2.56 000 11954 ......... ............ R Therapy for contour defects .......................... 1.85 1.78 2.28 0.77 0.87 0.25 3.88 4.38 2.87 2.97 000 11960 ......... ............ A Insert tissue expander(s) ............................... 10.85 NA NA 10.40 10.42 1.31 NA NA 22.56 22.58 090 11970 ......... ............ A Replace tissue expander ............................... 7.80 NA NA 5.94 6.10 1.05 NA NA 14.79 14.95 090 11971 ......... ............ A Remove tissue expander(s) .......................... 3.13 7.33 8.69 3.95 3.84 0.32 10.78 12.14 7.40 7.29 090 11975 ......... ............ N Insert contraceptive cap ................................ 1.48 1.53 1.45 0.33 0.51 0.17 3.18 3.10 1.98 2.16 XXX 11976 ......... ............ R Removal of contraceptive cap ....................... 1.78 1.68 1.71 0.45 0.62 0.21 3.67 3.70 2.44 2.61 000 11977 ......... ............ N Removal/reinsert contra cap ......................... 3.30 1.96 2.20 0.74 1.13 0.37 5.63 5.87 4.41 4.80 XXX 11980 ......... ............ A Implant hormone pellet(s) ............................. 1.48 1.17 1.10 0.55 0.54 0.13 2.78 2.71 2.16 2.15 000 11981 ......... ............ A Insert drug implant device ............................. 1.48 1.96 1.77 0.61 0.66 0.12 3.56 3.37 2.21 2.26 XXX 11982 ......... ............ A Remove drug implant device ........................ 1.78 2.09 1.99 0.73 0.81 0.17 4.04 3.94 2.68 2.76 XXX 11983 ......... ............ A Remove/insert drug implant .......................... 3.30 2.74 2.40 1.38 1.45 0.23 6.27 5.93 4.91 4.98 XXX 12001 ......... ............ A Repair superficial wound(s) ........................... 1.70 1.71 1.92 0.71 0.76 0.15 3.56 3.77 2.56 2.61 010 12002 ......... ............ A Repair superficial wound(s) ........................... 1.86 1.77 1.98 0.82 0.88 0.17 3.80 4.01 2.85 2.91 010 12004 ......... ............ A Repair superficial wound(s) ........................... 2.24 2.05 2.26 0.90 0.98 0.21 4.50 4.71 3.35 3.43 010 12005 ......... ............ A Repair superficial wound(s) ........................... 2.86 2.50 2.75 1.05 1.16 0.27 5.63 5.88 4.18 4.29 010 12006 ......... ............ A Repair superficial wound(s) ........................... 3.66 3.00 3.30 1.27 1.45 0.35 7.01 7.31 5.28 5.46 010 12007 ......... ............ A Repair superficial wound(s) ........................... 4.11 3.37 3.72 1.46 1.73 0.45 7.93 8.28 6.02 6.29 010 12011 ......... ............ A Repair superficial wound(s) ........................... 1.76 1.88 2.08 0.74 0.77 0.16 3.80 4.00 2.66 2.69 010 12013 ......... ............ A Repair superficial wound(s) ........................... 1.99 2.03 2.22 0.87 0.92 0.18 4.20 4.39 3.04 3.09 010 12014 ......... ............ A Repair superficial wound(s) ........................... 2.46 2.25 2.50 0.96 1.04 0.23 4.94 5.19 3.65 3.73 010 12015 ......... ............ A Repair superficial wound(s) ........................... 3.19 2.73 3.04 1.09 1.21 0.29 6.21 6.52 4.57 4.69 010 12016 ......... ............ A Repair superficial wound(s) ........................... 3.92 3.12 3.45 1.26 1.46 0.37 7.41 7.74 5.55 5.75 010 12017 ......... ............ A Repair superficial wound(s) ........................... 4.70 NA NA 1.45 1.79 0.47 NA NA 6.62 6.96 01012018 ......... ............ A Repair superficial wound(s) ........................... 5.52 NA NA 1.94 2.18 0.64 NA NA 8.10 8.34 01012020 ......... ............ A Closure of split wound ................................... 2.62 3.73 3.81 1.76 1.89 0.30 6.65 6.73 4.68 4.81 010 12021 ......... ............ A Closure of split wound ................................... 1.84 1.84 1.83 1.32 1.39 0.24 3.92 3.91 3.40 3.47 010 12031 ......... ............ A Layer closure of wound(s) ............................. 2.15 3.84 2.68 1.74 1.16 0.17 6.16 5.00 4.06 3.48 010 12032 ......... ............ A Layer closure of wound(s) ............................. 2.47 5.13 4.17 2.23 1.91 0.16 7.76 6.80 4.86 4.54 010 12034 ......... ............ A Layer closure of wound(s) ............................. 2.92 4.52 3.53 1.94 1.57 0.25 7.69 6.70 5.11 4.74 010 12035 ......... ............ A Layer closure of wound(s) ............................. 3.42 5.23 5.22 2.07 2.14 0.39 9.04 9.03 5.88 5.95 010 12036 ......... ............ A Layer closure of wound(s) ............................. 4.04 5.35 5.52 2.20 2.46 0.55 9.94 10.11 6.79 7.05 010 12037 ......... ............ A Layer closure of wound(s) ............................. 4.66 5.90 6.06 2.57 2.87 0.66 11.22 11.38 7.89 8.19 010 12041 ......... ............ A Layer closure of wound(s) ............................. 2.37 3.78 2.86 1.72 1.28 0.19 6.34 5.42 4.28 3.84 010 12042 ......... ............ A Layer closure of wound(s) ............................. 2.74 4.40 3.55 2.06 1.61 0.17 7.31 6.46 4.97 4.52 010 12044 ......... ............ A Layer closure of wound(s) ............................. 3.14 5.27 3.73 1.88 1.67 0.27 8.68 7.14 5.29 5.08 010 12045 ......... ............ A Layer closure of wound(s) ............................. 3.63 5.04 5.22 2.04 2.23 0.41 9.08 9.26 6.08 6.27 010 12046 ......... ............ A Layer closure of wound(s) ............................. 4.24 5.60 6.29 2.24 2.63 0.54 10.38 11.07 7.02 7.41 010 12047 ......... ............ A Layer closure of wound(s) ............................. 4.64 6.11 6.30 2.47 2.94 0.58 11.33 11.52 7.69 8.16 010 12051 ......... ............ A Layer closure of wound(s) ............................. 2.47 4.03 3.47 1.87 1.56 0.20 6.70 6.14 4.54 4.23 010 12052 ......... ............ A Layer closure of wound(s) ............................. 2.77 4.34 3.51 2.06 1.59 0.17 7.28 6.45 5.00 4.53 010 12053 ......... ............ A Layer closure of wound(s) ............................. 3.12 5.26 3.75 2.06 1.66 0.23 8.61 7.10 5.41 5.01 010 12054 ......... ............ A Layer closure of wound(s) ............................. 3.45 5.31 4.01 2.00 1.72 0.30 9.06 7.76 5.75 5.47 010 12055 ......... ............ A Layer closure of wound(s) ............................. 4.42 5.98 4.86 2.08 2.12 0.45 10.85 9.73 6.95 6.99 010 12056 ......... ............ A Layer closure of wound(s) ............................. 5.23 6.15 6.62 2.34 2.88 0.59 11.97 12.44 8.16 8.70 010 12057 ......... ............ A Layer closure of wound(s) ............................. 5.95 7.34 6.45 2.74 3.51 0.56 13.85 12.96 9.25 10.02 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37261 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

13100 ......... ............ A Repair of wound or lesion ............................. 3.12 4.34 4.13 2.40 2.33 0.26 7.72 7.51 5.78 5.71 010 13101 ......... ............ A Repair of wound or lesion ............................. 3.91 5.85 4.97 2.91 2.75 0.26 10.02 9.14 7.08 6.92 010 13102 ......... ............ A Repair wound/lesion add-on ......................... 1.24 1.33 1.21 0.52 0.56 0.13 2.70 2.58 1.89 1.93 ZZZ 13120 ......... ............ A Repair of wound or lesion ............................. 3.30 4.48 4.23 2.51 2.39 0.26 8.04 7.79 6.07 5.95 010 13121 ......... ............ A Repair of wound or lesion ............................. 4.32 6.13 5.18 3.10 2.88 0.25 10.70 9.75 7.67 7.45 010 13122 ......... ............ A Repair wound/lesion add-on ......................... 1.44 1.36 1.47 0.57 0.62 0.15 2.95 3.06 2.16 2.21 ZZZ 13131 ......... ............ A Repair of wound or lesion ............................. 3.78 4.90 4.50 2.80 2.72 0.26 8.94 8.54 6.84 6.76 010 13132 ......... ............ A Repair of wound or lesion ............................. 6.44 7.73 6.37 4.83 4.34 0.32 14.49 13.13 11.59 11.10 010 13133 ......... ............ A Repair wound/lesion add-on ......................... 2.19 1.82 1.70 0.94 1.01 0.18 4.19 4.07 3.31 3.38 ZZZ 13150 ......... ............ A Repair of wound or lesion ............................. 3.80 4.60 4.81 2.63 2.74 0.34 8.74 8.95 6.77 6.88 010 13151 ......... ............ A Repair of wound or lesion ............................. 4.44 5.39 4.96 3.13 3.15 0.31 10.14 9.71 7.88 7.90 010 13152 ......... ............ A Repair of wound or lesion ............................. 6.32 7.38 6.38 3.80 3.99 0.40 14.10 13.10 10.52 10.71 010 13153 ......... ............ A Repair wound/lesion add-on ......................... 2.38 1.96 1.95 0.97 1.10 0.24 4.58 4.57 3.59 3.72 ZZZ 13160 ......... ............ A Late closure of wound ................................... 11.76 NA NA 6.98 7.13 1.54 NA NA 20.28 20.43 090 14000 ......... ............ A Skin tissue rearrangement ............................ 6.75 8.78 8.10 5.91 5.59 0.59 16.12 15.44 13.25 12.93 090 14001 ......... ............ A Skin tissue rearrangement ............................ 9.52 10.90 9.81 7.40 7.17 0.82 21.24 20.15 17.74 17.51 090 14020 ......... ............ A Skin tissue rearrangement ............................ 7.58 9.80 8.92 6.70 6.59 0.64 18.02 17.14 14.92 14.81 090 14021 ......... ............ A Skin tissue rearrangement ............................ 11.10 12.18 10.55 8.43 8.33 0.81 24.09 22.46 20.34 20.24 090 14040 ......... ............ A Skin tissue rearrangement ............................ 8.36 10.23 9.18 7.06 7.18 0.62 19.21 18.16 16.04 16.16 090 14041 ......... ............ A Skin tissue rearrangement ............................ 12.59 13.27 11.28 9.10 8.80 0.73 26.59 24.60 22.42 22.12 090 14060 ......... ............ A Skin tissue rearrangement ............................ 8.99 9.94 9.09 7.47 7.46 0.68 19.61 18.76 17.14 17.13 090 14061 ......... ............ A Skin tissue rearrangement ............................ 13.57 14.52 12.35 9.92 9.63 0.76 28.85 26.68 24.25 23.96 090 14300 ......... ............ A Skin tissue rearrangement ............................ 13.16 13.25 11.68 9.22 9.21 1.16 27.57 26.00 23.54 23.53 090 14350 ......... ............ A Skin tissue rearrangement ............................ 10.72 NA NA 6.78 7.07 1.34 NA NA 18.84 19.13 090 15000 ......... ............ A Wound prep, 1st 100 sq cm .......................... 3.99 4.19 3.90 1.70 2.07 0.54 8.72 8.43 6.23 6.60 000 15001 ......... ............ A Wound prep, addl 100 sq cm ........................ 1.00 0.55 1.15 0.34 0.39 0.14 1.69 2.29 1.48 1.53 ZZZ 15040 ......... ............ A Harvest cultured skin graft ............................ 2.00 3.82 4.38 1.01 1.10 0.24 6.06 6.62 3.25 3.34 000 15050 ......... ............ A Skin pinch graft ............................................. 5.29 7.58 7.09 4.97 5.08 0.57 13.44 12.95 10.83 10.94 090 15100 ......... ............ A Skin splt grft, trnk/arm/leg ............................. 9.66 10.25 12.03 7.16 7.67 1.28 21.19 22.97 18.10 18.61 090 15101 ......... ............ A Skin splt grft t/a/l, add-on .............................. 1.72 2.48 3.43 0.85 1.09 0.24 4.44 5.39 2.81 3.05 ZZZ 15110 ......... ............ A Epidrm autogrft trnk/arm/leg .......................... 10.82 8.81 10.23 6.40 6.87 1.31 20.94 22.36 18.53 19.00 090 15111 ......... ............ A Epidrm autogrft t/a/l add-on .......................... 1.85 0.87 1.19 0.63 0.75 0.26 2.98 3.30 2.74 2.86 ZZZ 15115 ......... ............ A Epidrm a-grft face/nck/hf/g ............................ 11.13 9.05 9.20 6.58 7.17 1.15 21.33 21.48 18.86 19.45 090 15116 ......... ............ A Epidrm a-grft f/n/hf/g addl ............................. 2.50 1.20 1.49 0.86 1.06 0.33 4.03 4.32 3.69 3.89 ZZZ 15120 ......... ............ A Skn splt a-grft fac/nck/hf/g ............................ 10.88 11.06 10.83 7.22 7.66 1.16 23.10 22.87 19.26 19.70 090 15121 ......... ............ A Skn splt a-grft f/n/hf/g add ............................. 2.67 3.42 4.24 1.30 1.71 0.36 6.45 7.27 4.33 4.74 ZZZ 15130 ......... ............ A Derm autograft, trnk/arm/leg ......................... 7.33 7.94 9.40 5.56 6.16 0.97 16.24 17.70 13.86 14.46 090 15131 ......... ............ A Derm autograft t/a/l add-on ........................... 1.50 0.68 0.97 0.51 0.61 0.21 2.39 2.68 2.22 2.32 ZZZ 15135 ......... ............ A Derm autograft face/nck/hf/g ......................... 10.83 9.30 9.75 6.89 7.84 1.23 21.36 21.81 18.95 19.90 090 15136 ......... ............ A Derm autograft, f/n/hf/g add .......................... 1.50 0.66 0.83 0.52 0.63 0.20 2.36 2.53 2.22 2.33 ZZZ 15150 ......... ............ A Cult epiderm grft t/arm/leg ............................ 9.24 7.12 8.14 5.83 6.30 1.14 17.50 18.52 16.21 16.68 090 15151 ......... ............ A Cult epiderm grft t/a/l addl ............................. 2.00 0.88 1.20 0.68 0.81 0.28 3.16 3.48 2.96 3.09 ZZZ 15152 ......... ............ A Cult epiderm graft t/a/l +% ............................ 2.50 1.05 1.43 0.85 1.01 0.35 3.90 4.28 3.70 3.86 ZZZ 15155 ......... ............ A Cult epiderm graft, f/n/hf/g ............................ 9.99 7.51 7.76 6.17 6.78 1.05 18.55 18.80 17.21 17.82 090 15156 ......... ............ A Cult epidrm grft f/n/hfg add ........................... 2.75 1.16 1.46 0.95 1.17 0.36 4.27 4.57 4.06 4.28 ZZZ 15157 ......... ............ A Cult epiderm grft f/n/hfg +% .......................... 3.00 1.34 1.67 1.04 1.27 0.39 4.73 5.06 4.43 4.66 ZZZ 15170 ......... ............ A Acell graft trunk/arms/legs ............................. 5.99 3.60 3.78 2.31 2.36 0.55 10.14 10.32 8.85 8.90 090 15171 ......... ............ A Acell graft t/arm/leg add-on ........................... 1.55 0.63 0.67 0.50 0.59 0.19 2.37 2.41 2.24 2.33 ZZZ 15175 ......... ............ A Acellular graft, f/n/hf/g ................................... 7.99 5.17 5.37 3.68 3.93 0.82 13.98 14.18 12.49 12.74 090 15176 ......... ............ A Acell graft, f/n/hf/g add-on ............................. 2.45 1.05 1.10 0.79 0.94 0.29 3.79 3.84 3.53 3.68 ZZZ 15200 ......... ............ A Skin full graft, trunk ....................................... 8.89 9.76 9.51 6.22 6.22 0.98 19.63 19.38 16.09 16.09 090 15201 ......... ............ A Skin full graft trunk add-on ............................ 1.32 2.08 2.45 0.55 0.60 0.19 3.59 3.96 2.06 2.11 ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37262 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

15220 ......... ............ A Skin full graft sclp/arm/leg ............................. 7.86 10.19 9.46 6.48 6.65 0.84 18.89 18.16 15.18 15.35 090 15221 ......... ............ A Skin full graft add-on ..................................... 1.19 1.99 2.25 0.49 0.54 0.16 3.34 3.60 1.84 1.89 ZZZ 15240 ......... ............ A Skin full grft face/genit/hf ............................... 10.03 11.05 10.44 7.96 7.97 0.92 22.00 21.39 18.91 18.92 090 15241 ......... ............ A Skin full graft add-on ..................................... 1.86 2.48 2.46 0.78 0.88 0.23 4.57 4.55 2.87 2.97 ZZZ 15260 ......... ............ A Skin full graft een & lips ................................ 11.29 12.67 10.85 9.05 8.71 0.69 24.65 22.83 21.03 20.69 090 15261 ......... ............ A Skin full graft add-on ..................................... 2.23 2.89 2.75 1.11 1.33 0.21 5.33 5.19 3.55 3.77 ZZZ 15300 ......... ............ A Apply skinallogrft, t/arm/lg ............................. 4.65 3.31 3.24 2.06 2.20 0.49 8.45 8.38 7.20 7.34 090 15301 ......... ............ A Apply sknallogrft t/a/l addl ............................. 1.00 0.47 0.47 0.33 0.38 0.14 1.61 1.61 1.47 1.52 ZZZ 15320 ......... ............ A Apply skin allogrft f/n/hf/g .............................. 5.36 3.69 3.65 2.27 2.47 0.58 9.63 9.59 8.21 8.41 090 15321 ......... ............ A Aply sknallogrft f/n/hfg add ............................ 1.50 0.67 0.69 0.49 0.57 0.21 2.38 2.40 2.20 2.28 ZZZ 15330 ......... ............ A Aply acell alogrft t/arm/leg ............................. 3.99 3.10 3.18 1.86 2.14 0.49 7.58 7.66 6.34 6.62 090 15331 ......... ............ A Aply acell grft t/a/l add-on ............................. 1.00 0.45 0.46 0.33 0.38 0.14 1.59 1.60 1.47 1.52 ZZZ 15335 ......... ............ A Apply acell graft, f/n/hf/g ............................... 4.50 3.35 3.45 2.02 2.34 0.55 8.40 8.50 7.07 7.39 090 15336 ......... ............ A Aply acell grft f/n/hf/g add ............................. 1.43 0.70 0.69 0.47 0.55 0.20 2.33 2.32 2.10 2.18 ZZZ 15340 ......... ............ A Apply cult skin substitute ............................... 3.72 3.74 3.94 2.68 2.74 0.41 7.87 8.07 6.81 6.87 010 15341 ......... ............ A Apply cult skin sub add-on ............................ 0.50 0.72 0.64 0.16 0.19 0.06 1.28 1.20 0.72 0.75 ZZZ 15360 ......... ............ A Apply cult derm sub, t/a/l .............................. 3.87 4.26 4.43 3.07 3.09 0.43 8.56 8.73 7.37 7.39 090 15361 ......... ............ A Aply cult derm sub t/a/l add .......................... 1.15 0.56 0.58 0.37 0.44 0.14 1.85 1.87 1.66 1.73 ZZZ 15365 ......... ............ A Apply cult derm sub f/n/hf/g .......................... 4.15 4.30 4.50 3.14 3.19 0.46 8.91 9.11 7.75 7.80 090 15366 ......... ............ A Apply cult derm f/hf/g add ............................. 1.45 0.67 0.69 0.47 0.55 0.17 2.29 2.31 2.09 2.17 ZZZ 15400 ......... ............ A Apply skin xenograft, t/a/l .............................. 4.32 4.87 4.23 3.66 3.93 0.47 9.66 9.02 8.45 8.72 090 15401 ......... ............ A Apply skn xenogrft t/a/l add .......................... 1.00 1.01 1.68 0.33 0.41 0.14 2.15 2.82 1.47 1.55 ZZZ 15420 ......... ............ A Apply skin xgraft, f/n/hf/g ............................... 4.83 5.01 4.85 3.82 3.81 0.52 10.36 10.20 9.17 9.16 090 15421 ......... ............ A Apply skn xgrft f/n/hf/g add ........................... 1.50 1.18 1.29 0.50 0.59 0.21 2.89 3.00 2.21 2.30 ZZZ 15430 ......... ............ A Apply acellular xenograft ............................... 5.75 6.95 6.93 6.37 6.57 0.66 13.36 13.34 12.78 12.98 090 15570 ......... ............ A Form skin pedicle flap ................................... 9.94 10.21 11.05 6.35 6.67 1.34 21.49 22.33 17.63 17.95 090 15572 ......... ............ A Form skin pedicle flap ................................... 9.88 9.61 9.54 6.51 6.48 1.20 20.69 20.62 17.59 17.56 090 15574 ......... ............ A Form skin pedicle flap ................................... 10.48 10.26 10.60 6.81 7.56 1.20 21.94 22.28 18.49 19.24 090 15576 ......... ............ A Form skin pedicle flap ................................... 9.18 9.42 9.69 6.32 6.76 0.87 19.47 19.74 16.37 16.81 090 15600 ......... ............ A Skin graft ....................................................... 1.91 5.21 7.02 2.67 2.97 0.27 7.39 9.20 4.85 5.15 090 15610 ......... ............ A Skin graft ....................................................... 2.42 5.49 4.90 2.99 3.32 0.35 8.26 7.67 5.76 6.09 090 15620 ......... ............ A Skin graft ....................................................... 3.56 6.26 7.42 3.74 3.85 0.35 10.17 11.33 7.65 7.76 090 15630 ......... ............ A Skin graft ....................................................... 3.89 6.86 7.01 4.16 4.16 0.34 11.09 11.24 8.39 8.39 090 15650 ......... ............ A Transfer skin pedicle flap .............................. 4.58 7.00 7.12 4.19 4.21 0.42 12.00 12.12 9.19 9.21 090 15732 ......... ............ A Muscle-skin graft, head/neck ........................ 19.62 14.42 17.17 10.88 11.91 1.99 36.03 38.78 32.49 33.52 090 15734 ......... ............ A Muscle-skin graft, trunk ................................. 19.52 14.95 17.36 11.12 12.09 2.61 37.08 39.49 33.25 34.22 090 15736 ......... ............ A Muscle-skin graft, arm ................................... 16.86 13.54 17.10 9.75 10.88 2.45 32.85 36.41 29.06 30.19 090 15738 ......... ............ A Muscle-skin graft, leg .................................... 18.86 13.82 16.97 10.22 11.37 2.65 35.33 38.48 31.73 32.88 090 15740 ......... ............ A Island pedicle flap graft ................................. 11.47 13.20 10.92 9.13 8.49 0.63 25.30 23.02 21.23 20.59 090 15750 ......... ............ A Neurovascular pedicle graft .......................... 12.63 NA NA 8.53 8.94 1.42 NA NA 22.58 22.99 090 15756 ......... ............ A Free myo/skin flap microvasc ....................... 36.64 NA NA 17.98 19.96 4.61 NA NA 59.23 61.21 090 15757 ......... ............ A Free skin flap, microvasc .............................. 36.85 NA NA 16.45 20.35 3.89 NA NA 57.19 61.09 090 15758 ......... ............ A Free fascial flap, microvasc .......................... 36.60 NA NA 16.06 20.24 4.23 NA NA 56.89 61.07 090 15760 ......... ............ A Composite skin graft ..................................... 9.60 10.03 10.05 6.74 7.15 0.85 20.48 20.50 17.19 17.60 090 15770 ......... ............ A Derma-fat-fascia graft .................................... 8.63 NA NA 6.43 6.63 1.05 NA NA 16.11 16.31 090 15775 ......... ............ R Hair transplant punch grafts .......................... 3.95 3.51 4.06 1.70 1.40 0.52 7.98 8.53 6.17 5.87 000 15776 ......... ............ R Hair transplant punch grafts .......................... 5.53 3.91 5.01 1.56 2.50 0.72 10.16 11.26 7.81 8.75 000 15780 ......... ............ A Abrasion treatment of skin ............................ 8.40 11.63 11.57 6.71 7.88 0.67 20.70 20.64 15.78 16.95 090 15781 ......... ............ A Abrasion treatment of skin ............................ 4.84 8.47 7.32 5.49 5.41 0.34 13.65 12.50 10.67 10.59 090 15782 ......... ............ A Abrasion treatment of skin ............................ 4.31 9.52 9.79 5.47 6.30 0.34 14.17 14.44 10.12 10.95 090 15783 ......... ............ A Abrasion treatment of skin ............................ 4.28 7.95 7.16 4.97 4.39 0.28 12.51 11.72 9.53 8.95 090 15786 ......... ............ A Abrasion, lesion, single ................................. 2.03 3.77 3.46 1.22 1.30 0.11 5.91 5.60 3.36 3.44 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37263 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

15787 ......... ............ A Abrasion, lesions, add-on .............................. 0.33 0.82 1.02 0.10 0.15 0.04 1.19 1.39 0.47 0.52 ZZZ 15788 ......... ............ R Chemical peel, face, epiderm ....................... 2.09 8.47 7.17 3.67 3.24 0.11 10.67 9.37 5.87 5.44 090 15789 ......... ............ R Chemical peel, face, dermal ......................... 4.91 9.11 8.36 5.63 5.02 0.20 14.22 13.47 10.74 10.13 090 15792 ......... ............ R Chemical peel, nonfacial ............................... 1.86 6.78 7.03 3.43 4.20 0.13 8.77 9.02 5.42 6.19 090 15793 ......... ............ A Chemical peel, nonfacial ............................... 3.73 5.47 6.09 3.22 4.10 0.19 9.39 10.01 7.14 8.02 090 15819 ......... ............ A Plastic surgery, neck ..................................... 10.37 NA NA 6.54 7.04 0.97 NA NA 17.88 18.38 090 15820 ......... ............ A Revision of lower eyelid ................................ 6.01 6.09 6.77 4.94 5.42 0.40 12.50 13.18 11.35 11.83 090 15821 ......... ............ A Revision of lower eyelid ................................ 6.58 6.32 7.11 5.08 5.57 0.45 13.35 14.14 12.11 12.60 090 15822 ......... ............ A Revision of upper eyelid ................................ 4.44 4.97 5.63 3.88 4.35 0.37 9.78 10.44 8.69 9.16 090 15823 ......... ............ A Revision of upper eyelid ................................ 8.04 7.14 7.69 5.91 6.32 0.50 15.68 16.23 14.45 14.86 090 15831 ......... ............ A Excise excessive skin tissue ......................... 13.56 NA NA 8.57 8.28 1.75 NA NA 23.88 23.59 090 15832 ......... ............ A Excise excessive skin tissue ......................... 12.57 NA NA 8.11 8.30 1.66 NA NA 22.34 22.53 090 15833 ......... ............ A Excise excessive skin tissue ......................... 11.62 NA NA 7.11 7.95 1.49 NA NA 20.22 21.06 090 15834 ......... ............ A Excise excessive skin tissue ......................... 11.89 NA NA 7.63 7.69 1.61 NA NA 21.13 21.19 090 15835 ......... ............ A Excise excessive skin tissue ......................... 12.71 NA NA 7.67 7.59 1.60 NA NA 21.98 21.90 090 15836 ......... ............ A Excise excessive skin tissue ......................... 10.33 NA NA 6.78 6.80 1.34 NA NA 18.45 18.47 090 15837 ......... ............ A Excise excessive skin tissue ......................... 9.29 8.63 8.59 5.65 6.96 1.18 19.10 19.06 16.12 17.43 090 15838 ......... ............ A Excise excessive skin tissue ......................... 7.99 NA NA 4.79 5.76 0.58 NA NA 13.36 14.33 090 15839 ......... ............ A Excise excessive skin tissue ......................... 10.24 9.21 8.94 6.05 6.32 1.22 20.67 20.40 17.51 17.78 090 15840 ......... ............ A Graft for face nerve palsy ............................. 14.66 NA NA 8.37 9.59 1.32 NA NA 24.35 25.57 090 15841 ......... ............ A Graft for face nerve palsy ............................. 25.57 NA NA 12.70 14.45 2.54 NA NA 40.81 42.56 090 15842 ......... ............ A Flap for face nerve palsy .............................. 40.54 NA NA 20.48 22.36 4.93 NA NA 65.95 67.83 090 15845 ......... ............ A Skin and muscle repair, face ........................ 13.92 NA NA 8.43 9.11 0.81 NA NA 23.16 23.84 090 15850 ......... ............ B Removal of sutures ....................................... 0.78 1.20 1.47 0.18 0.27 0.05 2.03 2.30 1.01 1.10 XXX 15851 ......... ............ A Removal of sutures ....................................... 0.86 1.32 1.59 0.23 0.29 0.06 2.24 2.51 1.15 1.21 000 15852 ......... ............ A Dressing change not for burn ....................... 0.86 1.61 1.79 0.25 0.31 0.09 2.56 2.74 1.20 1.26 000 15860 ......... ............ A Test for blood flow in graft ............................ 1.95 0.68 0.79 0.68 0.76 0.27 2.90 3.01 2.90 2.98 000 15920 ......... ............ A Removal of tail bone ulcer ............................ 8.06 NA NA 5.74 5.61 1.04 NA NA 14.84 14.71 090 15922 ......... ............ A Removal of tail bone ulcer ............................ 10.13 NA NA 6.89 7.15 1.42 NA NA 18.44 18.70 090 15931 ......... ............ A Remove sacrum pressure sore ..................... 9.89 NA NA 5.50 5.65 1.25 NA NA 16.64 16.79 090 15933 ......... ............ A Remove sacrum pressure sore ..................... 11.49 NA NA 7.27 7.72 1.52 NA NA 20.28 20.73 090 15934 ......... ............ A Remove sacrum pressure sore ..................... 13.45 NA NA 7.50 7.92 1.78 NA NA 22.73 23.15 090 15935 ......... ............ A Remove sacrum pressure sore ..................... 15.45 NA NA 9.93 10.25 2.09 NA NA 27.47 27.79 090 15936 ......... ............ A Remove sacrum pressure sore ..................... 12.96 NA NA 7.38 8.03 1.76 NA NA 22.10 22.75 090 15937 ......... ............ A Remove sacrum pressure sore ..................... 14.91 NA NA 8.81 9.59 2.06 NA NA 25.78 26.56 090 15940 ......... ............ A Remove hip pressure sore ............................ 10.05 NA NA 5.76 6.08 1.31 NA NA 17.12 17.44 090 15941 ......... ............ A Remove hip pressure sore ............................ 12.13 NA NA 8.37 9.20 1.66 NA NA 22.16 22.99 090 15944 ......... ............ A Remove hip pressure sore ............................ 12.16 NA NA 8.10 8.49 1.65 NA NA 21.91 22.30 090 15945 ......... ............ A Remove hip pressure sore ............................ 13.45 NA NA 8.99 9.50 1.84 NA NA 24.28 24.79 090 15946 ......... ............ A Remove hip pressure sore ............................ 23.72 NA NA 13.66 14.22 3.16 NA NA 40.54 41.10 090 15950 ......... ............ A Remove thigh pressure sore ......................... 7.83 NA NA 5.33 5.41 1.04 NA NA 14.20 14.28 090 15951 ......... ............ A Remove thigh pressure sore ......................... 11.30 NA NA 7.84 7.87 1.49 NA NA 20.63 20.66 09015952 ......... ............ A Remove thigh pressure sore ......................... 12.03 NA NA 7.66 7.74 1.60 NA NA 21.29 21.37 09015953 ......... ............ A Remove thigh pressure sore ......................... 13.27 NA NA 8.91 8.99 1.79 NA NA 23.97 24.05 09015956 ......... ............ A Remove thigh pressure sore ......................... 16.46 NA NA 9.51 10.48 2.21 NA NA 28.18 29.15 090 15958 ......... ............ A Remove thigh pressure sore ......................... 16.42 NA NA 10.13 10.84 2.25 NA NA 28.80 29.51 090 16000 ......... ............ A Initial treatment of burn(s) ............................. 0.89 0.72 0.83 0.23 0.25 0.08 1.69 1.80 1.20 1.22 000 16020 ......... ............ A Dress/debrid p-thick burn, s .......................... 0.80 1.10 1.24 0.55 0.57 0.08 1.98 2.12 1.43 1.45 000 16025 ......... ............ A Dress/debrid p-thick burn, m ......................... 1.85 1.59 1.73 0.87 0.94 0.19 3.63 3.77 2.91 2.98 000 16030 ......... ............ A Dress/debrid p-thick burn, l ........................... 2.08 1.95 2.12 0.94 1.08 0.24 4.27 4.44 3.26 3.40 000 16035 ......... ............ A Incision of burn scab, initi ............................. 3.74 NA NA 1.23 1.49 0.46 NA NA 5.43 5.69 090 16036 ......... ............ A Escharotomy; addIl incision .......................... 1.50 NA NA 0.47 0.57 0.20 NA NA 2.17 2.27 ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37264 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

17000 ......... ............ A Destroy benign/premlg lesion ........................ 0.60 1.38 1.07 0.72 0.59 0.03 2.01 1.70 1.35 1.22 010 17003 ......... ............ A Destroy lesions, 2–14 .................................... 0.07 0.10 0.11 0.03 0.06 0.01 0.18 0.19 0.11 0.14 ZZZ 17004 ......... ............ A Destroy lesions, 15 or more .......................... 1.58 1.94 2.22 1.32 1.52 0.11 3.63 3.91 3.01 3.21 010 17106 ......... ............ A Destruction of skin lesions ............................ 4.58 4.58 4.60 3.19 3.30 0.35 9.51 9.53 8.12 8.23 090 17107 ......... ............ A Destruction of skin lesions ............................ 9.15 7.14 7.20 5.05 5.37 0.63 16.92 16.98 14.83 15.15 090 17108 ......... ............ A Destruction of skin lesions ............................ 13.18 9.25 9.28 6.69 7.43 0.54 22.97 23.00 20.41 21.15 090 17110 ......... ............ A Destruct lesion, 1–14 .................................... 0.65 1.74 1.65 0.85 0.74 0.05 2.44 2.35 1.55 1.44 010 17111 ......... ............ A Destruct lesion, 15 or more ........................... 0.92 2.25 1.82 1.10 0.88 0.05 3.22 2.79 2.07 1.85 010 17250 ......... ............ A Chemical cautery, tissue ............................... 0.50 1.31 1.24 0.38 0.35 0.06 1.87 1.80 0.94 0.91 000 17260 ......... ............ A Destruction of skin lesions ............................ 0.91 1.39 1.31 0.69 0.68 0.04 2.34 2.26 1.64 1.63 010 17261 ......... ............ A Destruction of skin lesions ............................ 1.17 2.45 1.82 1.04 0.88 0.05 3.67 3.04 2.26 2.10 010 17262 ......... ............ A Destruction of skin lesions ............................ 1.58 2.79 2.12 1.24 1.08 0.06 4.43 3.76 2.88 2.72 010 17263 ......... ............ A Destruction of skin lesions ............................ 1.79 3.01 2.30 1.33 1.15 0.07 4.87 4.16 3.19 3.01 010 17264 ......... ............ A Destruction of skin lesions ............................ 1.94 3.22 2.48 1.40 1.19 0.08 5.24 4.50 3.42 3.21 010 17266 ......... ............ A Destruction of skin lesions ............................ 2.34 3.47 2.75 1.56 1.31 0.09 5.90 5.18 3.99 3.74 010 17270 ......... ............ A Destruction of skin lesions ............................ 1.32 2.40 1.88 1.07 0.92 0.05 3.77 3.25 2.44 2.29 010 17271 ......... ............ A Destruction of skin lesions ............................ 1.49 2.62 1.99 1.19 1.03 0.06 4.17 3.54 2.74 2.58 010 17272 ......... ............ A Destruction of skin lesions ............................ 1.77 2.92 2.23 1.33 1.17 0.07 4.76 4.07 3.17 3.01 010 17273 ......... ............ A Destruction of skin lesions ............................ 2.05 3.16 2.45 1.46 1.27 0.08 5.29 4.58 3.59 3.40 010 17274 ......... ............ A Destruction of skin lesions ............................ 2.59 3.56 2.82 1.71 1.51 0.10 6.25 5.51 4.40 4.20 010 17276 ......... ............ A Destruction of skin lesions ............................ 3.20 3.83 3.17 1.94 1.75 0.16 7.19 6.53 5.30 5.11 010 17280 ......... ............ A Destruction of skin lesions ............................ 1.17 2.32 1.79 1.01 0.86 0.05 3.54 3.01 2.23 2.08 010 17281 ......... ............ A Destruction of skin lesions ............................ 1.72 2.69 2.11 1.30 1.14 0.07 4.48 3.90 3.09 2.93 010 17282 ......... ............ A Destruction of skin lesions ............................ 2.04 3.09 2.39 1.46 1.30 0.08 5.21 4.51 3.58 3.42 010 17283 ......... ............ A Destruction of skin lesions ............................ 2.64 3.50 2.79 1.73 1.55 0.11 6.25 5.54 4.48 4.30 010 17284 ......... ............ A Destruction of skin lesions ............................ 3.21 3.92 3.18 1.99 1.82 0.13 7.26 6.52 5.33 5.16 010 17286 ......... ............ A Destruction of skin lesions ............................ 4.43 4.31 3.84 2.40 2.44 0.23 8.97 8.50 7.06 7.10 010 17304 ......... ............ A 1 stage mohs, up to 5 spec .......................... 7.59 11.81 9.15 3.65 3.59 0.30 19.70 17.04 11.54 11.48 000 17305 ......... ............ A 2 stage mohs, up to 5 spec .......................... 2.85 6.85 4.64 1.37 1.35 0.11 9.81 7.60 4.33 4.31 000 17306 ......... ............ A 3 stage mohs, up to 5 spec .......................... 2.85 7.09 4.71 1.36 1.35 0.11 10.05 7.67 4.32 4.31 000 17307 ......... ............ A Mohs addl stage up to 5 spec ...................... 2.85 6.84 4.39 1.37 1.36 0.11 9.80 7.35 4.33 4.32 000 17310 ......... ............ A Mohs any stage > 5 spec each .................... 0.95 1.97 1.71 0.46 0.46 0.03 2.95 2.69 1.44 1.44 ZZZ 17340 ......... ............ A Cryotherapy of skin ....................................... 0.76 0.32 0.36 0.36 0.36 0.05 1.13 1.17 1.17 1.17 010 17360 ......... ............ A Skin peel therapy .......................................... 1.43 1.40 1.43 0.97 0.90 0.06 2.89 2.92 2.46 2.39 010 19000 ......... ............ A Drainage of breast lesion .............................. 0.84 1.96 1.98 0.26 0.30 0.08 2.88 2.90 1.18 1.22 000 19001 ......... ............ A Drain breast lesion add-on ............................ 0.42 0.26 0.25 0.13 0.14 0.04 0.72 0.71 0.59 0.60 ZZZ 19020 ......... ............ A Incision of breast lesion ................................ 3.68 6.64 6.42 3.02 2.77 0.45 10.77 10.55 7.15 6.90 090 19030 ......... ............ A Injection for breast x-ray ............................... 1.53 2.76 2.84 0.53 0.51 0.09 4.38 4.46 2.15 2.13 000 19100 ......... ............ A Bx breast percut w/o image .......................... 1.27 2.09 2.09 0.33 0.40 0.16 3.52 3.52 1.76 1.83 000 19101 ......... ............ A Biopsy of breast, open .................................. 3.18 4.34 4.47 1.76 1.88 0.39 7.91 8.04 5.33 5.45 010 19102 ......... ............ A Bx breast percut w/image ............................. 2.00 3.58 3.78 0.66 0.66 0.14 5.72 5.92 2.80 2.80 000 19103 ......... ............ A Bx breast percut w/device ............................. 3.69 10.42 11.25 1.17 1.22 0.30 14.41 15.24 5.16 5.21 000 19110 ......... ............ A Nipple exploration .......................................... 4.29 6.41 5.96 3.25 2.97 0.57 11.27 10.82 8.11 7.83 090 19112 ......... ............ A Excise breast duct fistula .............................. 3.66 6.26 6.13 3.14 2.80 0.48 10.40 10.27 7.28 6.94 090 19120 ......... ............ A Removal of breast lesion .............................. 5.80 5.08 4.68 3.35 3.14 0.73 11.61 11.21 9.88 9.67 090 19125 ......... ............ A Excision, breast lesion .................................. 6.55 5.55 4.98 3.64 3.38 0.80 12.90 12.33 10.99 10.73 090 19126 ......... ............ A Excision, addl breast lesion .......................... 2.93 NA NA 0.74 0.94 0.38 NA NA 4.05 4.25 ZZZ19140 ......... ............ A Removal of breast tissue .............................. 5.13 8.01 7.37 3.81 3.50 0.69 13.83 13.19 9.63 9.32 090 19160 ......... ............ A Partial mastectomy ........................................ 5.98 NA NA 3.60 3.47 0.79 NA NA 10.37 10.24 090 19162 ......... ............ A P-mastectomy w/ln removal .......................... 13.81 NA NA 6.08 6.28 1.79 NA NA 21.68 21.88 09019180 ......... ............ A Removal of breast ......................................... 15.61 NA NA 7.01 5.53 1.18 NA NA 23.80 22.32 090 19182 ......... ............ A Removal of breast ......................................... 7.72 NA NA 4.97 4.81 1.04 NA NA 13.73 13.57 090 19200 ......... ............ A Removal of breast ......................................... 17.13 NA NA 8.11 8.01 1.92 NA NA 27.16 27.06 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37265 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

19220 ......... ............ A Removal of breast ......................................... 17.73 NA NA 8.58 8.33 2.07 NA NA 28.38 28.13 090 19240 ......... ............ A Removal of breast ......................................... 17.83 NA NA 8.74 8.35 2.12 NA NA 28.69 28.30 090 19260 ......... ............ A Removal of chest wall lesion ........................ 17.52 NA NA 10.28 10.96 2.13 NA NA 29.93 30.61 090 19271 ......... ............ A Revision of chest wall ................................... 21.72 NA NA 16.08 17.52 2.62 NA NA 40.42 41.86 090 19272 ......... ............ A Extensive chest wall surgery ......................... 24.68 NA NA 17.30 18.56 2.99 NA NA 44.97 46.23 090 19290 ......... ............ A Place needle wire, breast .............................. 1.27 3.00 2.90 0.44 0.43 0.07 4.34 4.24 1.78 1.77 000 19291 ......... ............ A Place needle wire, breast .............................. 0.63 1.18 1.20 0.22 0.21 0.04 1.85 1.87 0.89 0.88 ZZZ 19295 ......... ............ A Place breast clip, percut ................................ 0.00 2.38 2.62 NA NA 0.01 2.39 2.63 NA NA ZZZ 19296 ......... ............ A Place po breast cath for rad ......................... 3.63 85.16 115.6 1.19 1.45 0.36 89.15 119.6 5.18 5.44 000 19297 ......... ............ A Place breast cath for rad ............................... 1.72 NA NA 0.46 0.60 0.17 NA NA 2.35 2.49 ZZZ 19298 ......... ............ A Place breast rad tube/caths .......................... 6.00 23.02 37.47 1.94 2.30 0.43 29.45 43.90 8.37 8.73 000 19316 ......... ............ A Suspension of breast .................................... 10.92 NA NA 6.94 7.38 1.64 NA NA 19.50 19.94 090 19318 ......... ............ A Reduction of large breast .............................. 15.85 NA NA 9.75 10.84 2.92 NA NA 28.52 29.61 090 19324 ......... ............ A Enlarge breast ............................................... 6.59 NA NA 4.56 4.82 0.84 NA NA 11.99 12.25 090 19325 ......... ............ A Enlarge breast with implant ........................... 8.44 NA NA 6.33 6.49 1.33 NA NA 16.10 16.26 090 19328 ......... ............ A Removal of breast implant ............................ 6.29 NA NA 4.94 5.01 0.91 NA NA 12.14 12.21 090 19330 ......... ............ A Removal of implant material ......................... 8.33 NA NA 5.96 6.03 1.26 NA NA 15.55 15.62 09019340 ......... ............ A Immediate breast prosthesis ......................... 6.32 NA NA 2.78 3.04 1.06 NA NA 10.16 10.42 ZZZ19342 ......... ............ A Delayed breast prosthesis ............................. 12.30 NA NA 8.68 8.88 1.83 NA NA 22.81 23.01 090 19350 ......... ............ A Breast reconstruction .................................... 8.91 9.75 12.85 6.46 7.01 1.41 20.07 23.17 16.78 17.33 090 19355 ......... ............ A Correct inverted nipple(s) .............................. 8.31 7.67 9.63 4.84 4.74 0.92 16.90 18.86 14.07 13.97 090 19357 ......... ............ A Breast reconstruction .................................... 20.33 NA NA 15.17 15.54 2.93 NA NA 38.43 38.80 090 19361 ......... ............ A Breast reconstruction .................................... 20.63 NA NA 12.06 12.37 2.92 NA NA 35.61 35.92 090 19364 ......... ............ A Breast reconstruction .................................... 42.30 NA NA 22.32 23.29 6.22 NA NA 70.84 71.81 090 19366 ......... ............ A Breast reconstruction .................................... 21.62 NA NA 9.92 11.19 3.24 NA NA 34.78 36.05 090 19367 ......... ............ A Breast reconstruction .................................... 26.51 NA NA 14.97 16.30 4.03 NA NA 45.51 46.84 090 19368 ......... ............ A Breast reconstruction .................................... 33.51 NA NA 17.75 18.67 5.52 NA NA 56.78 57.70 090 19369 ......... ............ A Breast reconstruction .................................... 30.92 NA NA 15.55 17.73 4.50 NA NA 50.97 53.15 090 19370 ......... ............ A Surgery of breast capsule ............................. 8.91 NA NA 6.71 6.87 1.29 NA NA 16.91 17.07 090 19371 ......... ............ A Removal of breast capsule ........................... 10.34 NA NA 7.57 7.77 1.62 NA NA 19.53 19.73 090 19380 ......... ............ A Revise breast reconstruction ......................... 10.13 NA NA 7.50 7.67 1.44 NA NA 19.07 19.24 090 19396 ......... ............ A Design custom breast implant ....................... 2.17 4.46 1.93 1.21 1.05 0.30 6.93 4.40 3.68 3.52 000 20000 ......... ............ A Incision of abscess ........................................ 2.12 2.77 2.72 1.51 1.68 0.25 5.14 5.09 3.88 4.05 010 20005 ......... ............ A Incision of deep abscess ............................... 3.53 3.70 3.55 2.02 2.20 0.46 7.69 7.54 6.01 6.19 010 20100 ......... ............ A Explore wound, neck ..................................... 10.31 NA NA 3.56 4.24 1.21 NA NA 15.08 15.76 010 20101 ......... ............ A Explore wound, chest .................................... 3.22 6.46 6.07 1.50 1.59 0.44 10.12 9.73 5.16 5.25 010 20102 ......... ............ A Explore wound, abdomen ............................. 3.93 6.95 7.35 1.83 1.89 0.49 11.37 11.77 6.25 6.31 010 20103 ......... ............ A Explore wound, extremity .............................. 5.29 7.63 8.36 2.68 3.22 0.75 13.67 14.40 8.72 9.26 010 20150 ......... ............ A Excise epiphyseal bar ................................... 14.54 NA NA 7.57 7.18 2.03 NA NA 24.14 23.75 090 20200 ......... ............ A Muscle biopsy ................................................ 1.46 3.16 3.07 0.70 0.74 0.23 4.85 4.76 2.39 2.43 000 20205 ......... ............ A Deep muscle biopsy ...................................... 2.35 3.83 3.88 1.09 1.17 0.33 6.51 6.56 3.77 3.85 000 20206 ......... ............ A Needle biopsy, muscle .................................. 0.99 5.45 6.25 0.57 0.62 0.07 6.51 7.31 1.63 1.68 000 20220 ......... ............ A Bone biopsy, trocar/needle ........................... 1.27 2.81 4.13 0.68 0.76 0.08 4.16 5.48 2.03 2.11 000 20225 ......... ............ A Bone biopsy, trocar/needle ........................... 1.87 13.50 21.77 1.07 1.12 0.22 15.59 23.86 3.16 3.21 000 20240 ......... ............ A Bone biopsy, excisional ................................. 3.23 NA NA 2.06 2.44 0.44 NA NA 5.73 6.11 010 20245 ......... ............ A Bone biopsy, excisional ................................. 8.71 NA NA 5.70 6.37 1.31 NA NA 15.72 16.39 010 20250 ......... ............ A Open bone biopsy ......................................... 5.14 NA NA 3.67 3.55 1.02 NA NA 9.83 9.71 010 20251 ......... ............ A Open bone biopsy ......................................... 5.67 NA NA 3.84 4.09 1.15 NA NA 10.66 10.91 010 20500 ......... ............ A Injection of sinus tract ................................... 1.23 1.33 2.04 0.87 1.37 0.12 2.68 3.39 2.22 2.72 010 20501 ......... ............ A Inject sinus tract for x-ray .............................. 0.76 2.47 2.81 0.27 0.26 0.04 3.27 3.61 1.07 1.06 000 20520 ......... ............ A Removal of foreign body ............................... 1.85 2.57 2.83 1.42 1.68 0.21 4.63 4.89 3.48 3.74 010 20525 ......... ............ A Removal of foreign body ............................... 3.49 7.02 8.63 2.16 2.51 0.51 11.02 12.63 6.16 6.51 010 20526 ......... ............ A Ther injection, carp tunnel ............................. 0.94 0.80 0.93 0.40 0.49 0.13 1.87 2.00 1.47 1.56 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37266 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

20550 ......... ............ A Inj tendon sheath/ligament ............................ 0.75 0.62 0.69 0.28 0.24 0.09 1.46 1.53 1.12 1.08 000 20551 ......... ............ A Inj tendon origin/insertion .............................. 0.75 0.63 0.67 0.28 0.32 0.08 1.46 1.50 1.11 1.15 000 20552 ......... ............ A Inj trigger point, 1/2 muscl ............................. 0.66 0.58 0.69 0.24 0.21 0.05 1.29 1.40 0.95 0.92 000 20553 ......... ............ A Inject trigger points, =/> 3 ............................. 0.75 0.64 0.78 0.26 0.23 0.04 1.43 1.57 1.05 1.02 000 20600 ......... ............ A Drain/inject, joint/bursa .................................. 0.66 0.66 0.65 0.31 0.34 0.08 1.40 1.39 1.05 1.08 000 20605 ......... ............ A Drain/inject, joint/bursa .................................. 0.68 0.73 0.75 0.32 0.35 0.08 1.49 1.51 1.08 1.11 000 20610 ......... ............ A Drain/inject, joint/bursa .................................. 0.79 1.06 0.98 0.39 0.41 0.11 1.96 1.88 1.29 1.31 000 20612 ......... ............ A Aspirate/inj ganglion cyst .............................. 0.70 0.69 0.71 0.31 0.35 0.10 1.49 1.51 1.11 1.15 000 20615 ......... ............ A Treatment of bone cyst ................................. 2.28 2.69 3.31 1.39 1.74 0.20 5.17 5.79 3.87 4.22 010 20650 ......... ............ A Insert and remove bone pin .......................... 2.23 2.47 2.40 1.45 1.53 0.31 5.01 4.94 3.99 4.07 010 20660 ......... ............ A Apply, rem fixation device ............................. 2.51 3.33 3.13 1.46 1.57 0.59 6.43 6.23 4.56 4.67 000 20661 ......... ............ A Application of head brace ............................. 5.06 NA NA 5.87 5.16 1.14 NA NA 12.07 11.36 090 20662 ......... ............ A Application of pelvis brace ............................ 6.18 NA NA 4.96 5.40 0.56 NA NA 11.70 12.14 090 20663 ......... ............ A Application of thigh brace .............................. 5.54 NA NA 5.04 4.89 0.94 NA NA 11.52 11.37 090 20664 ......... ............ A Halo brace application ................................... 9.78 NA NA 7.92 7.28 1.74 NA NA 19.44 18.80 090 20665 ......... ............ A Removal of fixation device ............................ 1.31 1.40 1.97 0.98 1.26 0.19 2.90 3.47 2.48 2.76 010 20670 ......... ............ A Removal of support implant .......................... 1.74 6.63 10.34 1.66 2.00 0.28 8.65 12.36 3.68 4.02 010 20680 ......... ............ A Removal of support implant .......................... 5.86 8.09 8.63 4.02 3.80 0.56 14.51 15.05 10.44 10.22 090 20690 ......... ............ A Apply bone fixation device ............................ 3.63 NA NA 2.22 2.45 0.59 NA NA 6.44 6.67 09020692 ......... ............ A Apply bone fixation device ............................ 6.40 NA NA 3.20 3.64 1.05 NA NA 10.65 11.09 090 20693 ......... ............ A Adjust bone fixation device ........................... 5.91 NA NA 4.45 5.21 0.98 NA NA 11.34 12.10 090 20694 ......... ............ A Remove bone fixation device ........................ 4.15 5.29 6.69 3.50 3.91 0.71 10.15 11.55 8.36 8.77 090 20802 ......... ............ A Replantation, arm, complete ......................... 42.16 NA NA 12.96 19.00 3.81 NA NA 58.93 64.97 090 20805 ......... ............ A Replant forearm, complete ............................ 51.00 NA NA 23.26 31.62 4.84 NA NA 79.10 87.46 090 20808 ......... ............ A Replantation hand, complete ........................ 62.63 NA NA 37.95 41.24 6.86 NA NA 107.4 110.7 090 20816 ......... ............ A Replantation digit, complete .......................... 31.64 NA NA 24.04 34.44 4.52 NA NA 60.20 70.60 090 20822 ......... ............ A Replantation digit, complete .......................... 26.30 NA NA 21.95 31.51 4.18 NA NA 52.43 61.99 090 20824 ......... ............ A Replantation thumb, complete ...................... 31.64 NA NA 25.31 33.82 4.61 NA NA 61.56 70.07 090 20827 ......... ............ A Replantation thumb, complete ...................... 27.12 NA NA 23.48 33.31 3.66 NA NA 54.26 64.09 090 20838 ......... ............ A Replantation foot, complete .......................... 42.42 NA NA 13.13 20.04 1.12 NA NA 56.67 63.58 090 20900 ......... ............ A Removal of bone for graft ............................. 5.69 9.21 8.64 4.87 5.49 0.94 15.84 15.27 11.50 12.12 090 20902 ......... ............ A Removal of bone for graft ............................. 7.90 NA NA 5.74 6.61 1.30 NA NA 14.94 15.81 090 20910 ......... ............ A Remove cartilage for graft ............................. 5.33 NA NA 4.54 5.04 0.71 NA NA 10.58 11.08 090 20912 ......... ............ A Remove cartilage for graft ............................. 6.34 NA NA 4.58 5.50 0.69 NA NA 11.61 12.53 090 20920 ......... ............ A Removal of fascia for graft ............................ 5.36 NA NA 4.33 4.26 0.66 NA NA 10.35 10.28 090 20922 ......... ............ A Removal of fascia for graft ............................ 6.78 7.54 7.56 4.97 4.90 0.70 15.02 15.04 12.45 12.38 090 20924 ......... ............ A Removal of tendon for graft .......................... 6.53 NA NA 4.91 5.65 1.04 NA NA 12.48 13.22 090 20926 ......... ............ A Removal of tissue for graft ............................ 5.64 NA NA 4.33 4.65 0.87 NA NA 10.84 11.16 090 20931 ......... ............ A Spinal bone allograft ..................................... 1.81 NA NA 0.67 0.87 0.43 NA NA 2.91 3.11 ZZZ 20937 ......... ............ A Spinal bone autograft .................................... 2.79 NA NA 1.06 1.35 0.54 NA NA 4.39 4.68 ZZZ 20938 ......... ............ A Spinal bone autograft .................................... 3.02 NA NA 1.13 1.45 0.64 NA NA 4.79 5.11 ZZZ 20950 ......... ............ A Fluid pressure, muscle .................................. 1.26 4.14 6.18 0.87 0.96 0.20 5.60 7.64 2.33 2.42 000 20955 ......... ............ A Fibula bone graft, microvasc ......................... 39.90 NA NA 17.66 22.67 4.89 NA NA 62.45 67.46 090 20956 ......... ............ A Iliac bone graft, microvasc ............................ 40.79 NA NA 20.30 23.68 7.01 NA NA 68.10 71.48 090 20957 ......... ............ A Mt bone graft, microvasc ............................... 42.17 NA NA 18.97 18.99 7.05 NA NA 68.19 68.21 090 20962 ......... ............ A Other bone graft, microvasc .......................... 39.21 NA NA 20.73 25.13 6.55 NA NA 66.49 70.89 090 20969 ......... ............ A Bone/skin graft, microvasc ............................ 44.99 NA NA 19.75 24.97 4.79 NA NA 69.53 74.75 090 20970 ......... ............ A Bone/skin graft, iliac crest ............................. 44.14 NA NA 19.85 24.05 6.60 NA NA 70.59 74.79 090 20972 ......... ............ A Bone/skin graft, metatarsal ........................... 44.07 NA NA 17.15 19.77 5.30 NA NA 66.52 69.14 090 20973 ......... ............ A Bone/skin graft, great toe .............................. 46.83 NA NA 14.61 22.58 5.54 NA NA 66.98 74.95 090 20974 ......... ............ A Electrical bone stimulation ............................ 0.62 1.00 0.77 0.49 0.53 0.11 1.73 1.50 1.22 1.26 000 20975 ......... ............ A Electrical bone stimulation ............................ 2.60 NA NA 1.45 1.65 0.51 NA NA 4.56 4.76 000 20979 ......... ............ A Us bone stimulation ....................................... 0.62 0.61 0.75 0.20 0.31 0.09 1.32 1.46 0.91 1.02 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37267 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

20982 ......... ............ A Ablate, bone tumor(s) perq ........................... 7.27 86.78 104.1 2.87 2.95 0.69 94.74 112.1 10.83 10.91 000 21010 ......... ............ A Incision of jaw joint ........................................ 10.82 NA NA 6.35 6.92 1.11 NA NA 18.28 18.85 090 21015 ......... ............ A Resection of facial tumor .............................. 5.53 NA NA 4.34 4.85 0.70 NA NA 10.57 11.08 090 21025 ......... ............ A Excision of bone, lower jaw .......................... 10.99 12.43 12.32 8.65 9.20 1.32 24.74 24.63 20.96 21.51 090 21026 ......... ............ A Excision of facial bone(s) .............................. 5.46 8.65 8.07 5.79 6.20 0.60 14.71 14.13 11.85 12.26 090 21029 ......... ............ A Contour of face bone lesion .......................... 8.20 9.15 9.34 6.18 6.82 0.94 18.29 18.48 15.32 15.96 090 21030 ......... ............ A Excise max/zygoma b9 tumor ....................... 4.74 7.18 6.56 4.67 4.95 0.54 12.46 11.84 9.95 10.23 090 21031 ......... ............ A Remove exostosis, mandible ........................ 3.24 5.99 5.38 3.51 3.60 0.48 9.71 9.10 7.23 7.32 090 21032 ......... ............ A Remove exostosis, maxilla ............................ 3.24 6.08 5.54 3.38 3.49 0.47 9.79 9.25 7.09 7.20 090 21034 ......... ............ A Excise max/zygoma mlg tumor ..................... 17.09 12.98 15.22 9.35 11.86 1.71 31.78 34.02 28.15 30.66 090 21040 ......... ............ A Excise mandible lesion .................................. 4.74 7.26 6.62 4.67 4.72 0.54 12.54 11.90 9.95 10.00 090 21044 ......... ............ A Removal of jaw bone lesion .......................... 12.53 NA NA 7.38 8.90 1.12 NA NA 21.03 22.55 090 21045 ......... ............ A Extensive jaw surgery ................................... 18.03 NA NA 9.84 11.75 1.52 NA NA 29.39 31.30 090 21046 ......... ............ A Remove mandible cyst complex ................... 13.85 NA NA 11.39 11.80 1.85 NA NA 27.09 27.50 090 21047 ......... ............ A Excise lwr jaw cyst w/repair .......................... 19.71 NA NA 9.62 12.52 2.12 NA NA 31.45 34.35 090 21048 ......... ............ A Remove maxilla cyst complex ....................... 14.35 NA NA 11.34 11.96 1.76 NA NA 27.45 28.07 090 21049 ......... ............ A Excis uppr jaw cyst w/repair ......................... 18.96 NA NA 8.93 12.03 1.59 NA NA 29.48 32.58 090 21050 ......... ............ A Removal of jaw joint ...................................... 11.44 NA NA 8.10 9.13 1.47 NA NA 21.01 22.04 090 21060 ......... ............ A Remove jaw joint cartilage ............................ 10.83 NA NA 7.48 8.34 1.38 NA NA 19.69 20.55 090 21070 ......... ............ A Remove coronoid process ............................ 8.44 NA NA 6.09 6.86 1.27 NA NA 15.80 16.57 090 21076 ......... ............ A Prepare face/oral prosthesis ......................... 13.40 7.88 11.26 4.81 8.73 1.99 23.27 26.65 20.20 24.12 010 21077 ......... ............ A Prepare face/oral prosthesis ......................... 33.70 18.22 28.12 12.26 22.63 4.55 56.47 66.37 50.51 60.88 090 21079 ......... ............ A Prepare face/oral prosthesis ......................... 22.31 13.41 19.52 8.32 14.98 3.15 38.87 44.98 33.78 40.44 090 21080 ......... ............ A Prepare face/oral prosthesis ......................... 25.06 15.49 22.29 9.25 16.88 3.74 44.29 51.09 38.05 45.68 090 21081 ......... ............ A Prepare face/oral prosthesis ......................... 22.85 14.23 20.33 8.51 15.28 3.20 40.28 46.38 34.56 41.33 090 21082 ......... ............ A Prepare face/oral prosthesis ......................... 20.84 14.20 18.10 8.46 13.95 3.11 38.15 42.05 32.41 37.90 090 21083 ......... ............ A Prepare face/oral prosthesis ......................... 19.27 14.14 17.67 7.96 12.84 2.88 36.29 39.82 30.11 34.99 090 21084 ......... ............ A Prepare face/oral prosthesis ......................... 22.48 15.59 20.77 8.82 15.52 2.18 40.25 45.43 33.48 40.18 090 21085 ......... ............ A Prepare face/oral prosthesis ......................... 8.99 6.56 7.87 3.58 6.00 1.27 16.82 18.13 13.84 16.26 010 21086 ......... ............ A Prepare face/oral prosthesis ......................... 24.88 12.72 21.04 8.70 16.79 3.71 41.31 49.63 37.29 45.38 090 21087 ......... ............ A Prepare face/oral prosthesis ......................... 24.88 12.92 20.74 8.87 16.66 3.44 41.24 49.06 37.19 44.98 090 21100 ......... ............ A Maxillofacial fixation ...................................... 4.46 13.92 12.15 5.13 4.85 0.34 18.72 16.95 9.93 9.65 090 21110 ......... ............ A Interdental fixation ......................................... 5.70 13.34 10.53 9.95 8.77 0.72 19.76 16.95 16.37 15.19 090 21116 ......... ............ A Injection, jaw joint x-ray ................................. 0.81 2.47 3.87 0.22 0.30 0.06 3.34 4.74 1.09 1.17 000 21120 ......... ............ A Reconstruction of chin ................................... 4.92 10.08 10.48 6.95 7.37 0.60 15.60 16.00 12.47 12.89 090 21121 ......... ............ A Reconstruction of chin ................................... 7.63 10.47 9.94 7.41 7.73 0.90 19.00 18.47 15.94 16.26 090 21122 ......... ............ A Reconstruction of chin ................................... 8.51 NA NA 7.54 8.37 1.07 NA NA 17.12 17.95 090 21123 ......... ............ A Reconstruction of chin ................................... 11.14 NA NA 10.14 10.66 1.40 NA NA 22.68 23.20 090 21125 ......... ............ A Augmentation, lower jaw bone ...................... 10.60 68.82 58.74 7.01 8.01 0.79 80.21 70.13 18.40 19.40 090 21127 ......... ............ A Augmentation, lower jaw bone ...................... 12.16 87.70 54.12 7.88 9.08 1.52 101.4 67.80 21.56 22.76 090 21137 ......... ............ A Reduction of forehead ................................... 10.06 NA NA 6.18 7.36 1.32 NA NA 17.56 18.74 090 21138 ......... ............ A Reduction of forehead ................................... 12.67 NA NA 8.46 9.29 1.74 NA NA 22.87 23.70 090 21139 ......... ............ A Reduction of forehead ................................... 14.84 NA NA 6.89 10.04 1.18 NA NA 22.91 26.06 090 21141 ......... ............ A Reconstruct midface, lefort ........................... 19.13 NA NA 11.24 13.08 2.35 NA NA 32.72 34.56 090 21142 ......... ............ A Reconstruct midface, lefort ........................... 19.84 NA NA 10.35 12.23 2.38 NA NA 32.57 34.45 090 21143 ......... ............ A Reconstruct midface, lefort ........................... 20.61 NA NA 8.69 12.94 1.66 NA NA 30.96 35.21 090 21145 ......... ............ A Reconstruct midface, lefort ........................... 23.52 NA NA 12.44 13.57 2.84 NA NA 38.80 39.93 090 21146 ......... ............ A Reconstruct midface, lefort ........................... 24.41 NA NA 9.15 13.82 3.09 NA NA 36.65 41.32 090 21147 ......... ............ A Reconstruct midface, lefort ........................... 26.01 NA NA 13.44 14.68 1.84 NA NA 41.29 42.53 090 21150 ......... ............ A Reconstruct midface, lefort ........................... 25.70 NA NA 13.48 15.98 2.55 NA NA 41.73 44.23 090 21151 ......... ............ A Reconstruct midface, lefort ........................... 28.76 NA NA 11.43 20.12 2.30 NA NA 42.49 51.18 090 21154 ......... ............ A Reconstruct midface, lefort ........................... 30.95 NA NA 20.76 22.58 2.48 NA NA 54.19 56.01 090 21155 ......... ............ A Reconstruct midface, lefort ........................... 34.88 NA NA 13.09 21.24 6.64 NA NA 54.61 62.76 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37268 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

21159 ......... ............ A Reconstruct midface, lefort ........................... 42.80 NA NA 14.87 25.59 8.18 NA NA 65.85 76.57 090 21160 ......... ............ A Reconstruct midface, lefort ........................... 46.85 NA NA 23.14 26.45 4.13 NA NA 74.12 77.43 090 21172 ......... ............ A Reconstruct orbit/forehead ............................ 28.01 NA NA 12.81 13.55 3.55 NA NA 44.37 45.11 090 21175 ......... ............ A Reconstruct orbit/forehead ............................ 33.37 NA NA 12.26 16.45 4.83 NA NA 50.46 54.65 090 21179 ......... ............ A Reconstruct entire forehead .......................... 22.47 NA NA 10.75 13.32 2.80 NA NA 36.02 38.59 090 21180 ......... ............ A Reconstruct entire forehead .......................... 25.40 NA NA 12.14 14.60 3.48 NA NA 41.02 43.48 090 21181 ......... ............ A Contour cranial bone lesion .......................... 10.14 NA NA 6.63 7.27 1.32 NA NA 18.09 18.73 090 21182 ......... ............ A Reconstruct cranial bone .............................. 32.39 NA NA 13.71 17.81 2.80 NA NA 48.90 53.00 090 21183 ......... ............ A Reconstruct cranial bone .............................. 35.51 NA NA 15.01 19.42 4.47 NA NA 54.99 59.40 090 21184 ......... ............ A Reconstruct cranial bone .............................. 38.43 NA NA 20.38 21.60 5.70 NA NA 64.51 65.73 090 21188 ......... ............ A Reconstruction of midface ............................. 22.91 NA NA 14.49 17.81 1.69 NA NA 39.09 42.41 090 21193 ......... ............ A Reconst lwr jaw w/o graft .............................. 18.55 NA NA 9.96 12.01 2.23 NA NA 30.74 32.79 090 21194 ......... ............ A Reconst lwr jaw w/graft ................................. 21.42 NA NA 11.23 13.15 2.02 NA NA 34.67 36.59 090 21195 ......... ............ A Reconst lwr jaw w/o fixation .......................... 18.76 NA NA 13.08 14.42 1.64 NA NA 33.48 34.82 090 21196 ......... ............ A Reconst lwr jaw w/fixation ............................. 20.43 NA NA 13.01 15.06 2.07 NA NA 35.51 37.56 090 21198 ......... ............ A Reconstr lwr jaw segment ............................. 15.38 NA NA 10.89 12.28 1.44 NA NA 27.71 29.10 090 21199 ......... ............ A Reconstr lwr jaw w/advance ......................... 16.56 NA NA 6.65 8.52 1.39 NA NA 24.60 26.47 09021206 ......... ............ A Reconstruct upper jaw bone ......................... 15.26 NA NA 11.18 12.30 1.33 NA NA 27.77 28.89 090 21208 ......... ............ A Augmentation of facial bones ........................ 11.03 32.29 24.87 7.65 9.12 1.09 44.41 36.99 19.77 21.24 090 21209 ......... ............ A Reduction of facial bones .............................. 7.46 12.20 11.17 7.33 7.90 0.90 20.56 19.53 15.69 16.26 090 21210 ......... ............ A Face bone graft ............................................. 11.28 44.00 29.71 7.72 8.97 1.30 56.58 42.29 20.30 21.55 090 21215 ......... ............ A Lower jaw bone graft ..................................... 11.82 86.93 53.23 8.01 9.05 1.53 100.3 66.58 21.36 22.40 090 21230 ......... ............ A Rib cartilage graft .......................................... 11.00 NA NA 6.67 7.71 1.29 NA NA 18.96 20.00 090 21235 ......... ............ A Ear cartilage graft .......................................... 7.21 9.63 9.81 5.83 6.28 0.61 17.45 17.63 13.65 14.10 090 21240 ......... ............ A Reconstruction of jaw joint ............................ 15.65 NA NA 10.97 11.80 2.24 NA NA 28.86 29.69 090 21242 ......... ............ A Reconstruction of jaw joint ............................ 14.20 NA NA 10.36 11.25 1.78 NA NA 26.34 27.23 090 21243 ......... ............ A Reconstruction of jaw joint ............................ 23.83 NA NA 15.37 16.95 3.25 NA NA 42.45 44.03 090 21244 ......... ............ A Reconstruction of lower jaw .......................... 13.23 NA NA 10.80 11.80 1.25 NA NA 25.28 26.28 090 21245 ......... ............ A Reconstruction of jaw .................................... 12.78 13.18 14.13 7.85 9.37 1.19 27.15 28.10 21.82 23.34 090 21246 ......... ............ A Reconstruction of jaw .................................... 12.70 NA NA 6.58 8.45 1.35 NA NA 20.63 22.50 090 21247 ......... ............ A Reconstruct lower jaw bone .......................... 23.91 NA NA 13.25 16.36 2.83 NA NA 39.99 43.10 090 21248 ......... ............ A Reconstruction of jaw .................................... 12.46 12.63 12.29 7.52 8.95 1.55 26.64 26.30 21.53 22.96 090 21249 ......... ............ A Reconstruction of jaw .................................... 18.49 16.05 16.59 9.87 12.02 2.48 37.02 37.56 30.84 32.99 090 21255 ......... ............ A Reconstruct lower jaw bone .......................... 18.00 NA NA 13.24 15.45 2.38 NA NA 33.62 35.83 090 21256 ......... ............ A Reconstruction of orbit .................................. 17.32 NA NA 9.67 11.31 1.50 NA NA 28.49 30.13 090 21260 ......... ............ A Revise eye sockets ....................................... 17.66 NA NA 9.32 11.93 0.97 NA NA 27.95 30.56 090 21261 ......... ............ A Revise eye sockets ....................................... 33.66 NA NA 14.53 21.86 3.42 NA NA 51.61 58.94 090 21263 ......... ............ A Revise eye sockets ....................................... 30.60 NA NA 13.85 17.81 2.62 NA NA 47.07 51.03 090 21267 ......... ............ A Revise eye sockets ....................................... 20.35 NA NA 15.78 18.82 1.70 NA NA 37.83 40.87 090 21268 ......... ............ A Revise eye sockets ....................................... 26.66 NA NA 15.47 19.07 3.65 NA NA 45.78 49.38 090 21270 ......... ............ A Augmentation, cheek bone ........................... 10.46 10.98 11.51 5.74 6.89 0.72 22.16 22.69 16.92 18.07 090 21275 ......... ............ A Revision, orbitofacial bones .......................... 11.59 NA NA 7.17 7.93 1.29 NA NA 20.05 20.81 090 21280 ......... ............ A Revision of eyelid .......................................... 6.84 NA NA 5.64 5.87 0.42 NA NA 12.90 13.13 090 21282 ......... ............ A Revision of eyelid .......................................... 4.05 NA NA 4.10 4.39 0.26 NA NA 8.41 8.70 090 21295 ......... ............ A Revision of jaw muscle/bone ........................ 1.78 NA NA 2.58 2.55 0.16 NA NA 4.52 4.49 090 21296 ......... ............ A Revision of jaw muscle/bone ........................ 4.61 NA NA 5.45 5.05 0.34 NA NA 10.40 10.00 090 21300 ......... ............ A Treatment of skull fracture ............................ 0.72 0.27 1.85 0.27 0.26 0.13 1.12 2.70 1.12 1.11 000 21310 ......... ............ A Treatment of nose fracture ............................ 0.58 1.95 2.21 0.10 0.14 0.05 2.58 2.84 0.73 0.77 000 21315 ......... ............ A Treatment of nose fracture ............................ 1.76 4.41 4.28 1.63 1.83 0.14 6.31 6.18 3.53 3.73 010 21320 ......... ............ A Treatment of nose fracture ............................ 1.85 4.00 3.94 1.23 1.52 0.18 6.03 5.97 3.26 3.55 010 21325 ......... ............ A Treatment of nose fracture ............................ 4.01 NA NA 6.67 8.15 0.31 NA NA 10.99 12.47 090 21330 ......... ............ A Treatment of nose fracture ............................ 5.62 NA NA 7.31 9.13 0.56 NA NA 13.49 15.31 090 21335 ......... ............ A Treatment of nose fracture ............................ 8.85 NA NA 7.62 9.14 0.74 NA NA 17.21 18.73 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37269 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

21336 ......... ............ A Treat nasal septal fracture ............................ 6.46 NA NA 8.03 9.24 0.55 NA NA 15.04 16.25 090 21337 ......... ............ A Treat nasal septal fracture ............................ 3.20 5.80 6.06 3.32 3.52 0.28 9.28 9.54 6.80 7.00 090 21338 ......... ............ A Treat nasoethmoid fracture ........................... 6.70 NA NA 9.58 12.94 0.82 NA NA 17.10 20.46 090 21339 ......... ............ A Treat nasoethmoid fracture ........................... 8.33 NA NA 10.51 13.08 0.96 NA NA 19.80 22.37 090 21340 ......... ............ A Treatment of nose fracture ............................ 11.25 NA NA 7.17 8.11 1.15 NA NA 19.57 20.51 090 21343 ......... ............ A Treatment of sinus fracture ........................... 14.01 NA NA 12.29 14.71 1.47 NA NA 27.77 30.19 090 21344 ......... ............ A Treatment of sinus fracture ........................... 21.26 NA NA 12.89 15.64 2.43 NA NA 36.58 39.33 090 21345 ......... ............ A Treat nose/jaw fracture ................................. 8.77 9.60 9.80 5.91 6.87 0.92 19.29 19.49 15.60 16.56 090 21346 ......... ............ A Treat nose/jaw fracture ................................. 11.21 NA NA 10.60 11.83 1.21 NA NA 23.02 24.25 090 21347 ......... ............ A Treat nose/jaw fracture ................................. 13.29 NA NA 11.39 15.03 1.47 NA NA 26.15 29.79 090 21348 ......... ............ A Treat nose/jaw fracture ................................. 17.28 NA NA 6.74 10.04 2.48 NA NA 26.50 29.80 090 21355 ......... ............ A Treat cheek bone fracture ............................. 4.26 5.55 6.08 2.96 3.36 0.34 10.15 10.68 7.56 7.96 010 21356 ......... ............ A Treat cheek bone fracture ............................. 4.64 6.70 7.03 3.86 4.39 0.46 11.80 12.13 8.96 9.49 010 21360 ......... ............ A Treat cheek bone fracture ............................. 6.95 NA NA 5.17 5.76 0.74 NA NA 12.86 13.45 090 21365 ......... ............ A Treat cheek bone fracture ............................. 16.42 NA NA 8.73 10.33 1.69 NA NA 26.84 28.44 090 21366 ......... ............ A Treat cheek bone fracture ............................. 18.36 NA NA 10.04 11.03 2.49 NA NA 30.89 31.88 090 21385 ......... ............ A Treat eye socket fracture .............................. 9.40 NA NA 6.77 7.92 0.97 NA NA 17.14 18.29 090 21386 ......... ............ A Treat eye socket fracture .............................. 9.40 NA NA 5.62 6.72 0.97 NA NA 15.99 17.09 090 21387 ......... ............ A Treat eye socket fracture .............................. 9.94 NA NA 7.14 8.52 1.08 NA NA 18.16 19.54 090 21390 ......... ............ A Treat eye socket fracture .............................. 11.01 NA NA 6.64 7.53 0.90 NA NA 18.55 19.44 090 21395 ......... ............ A Treat eye socket fracture .............................. 14.58 NA NA 7.77 8.73 1.44 NA NA 23.79 24.75 090 21400 ......... ............ A Treat eye socket fracture .............................. 1.40 2.68 2.64 1.94 1.90 0.15 4.23 4.19 3.49 3.45 090 21401 ......... ............ A Treat eye socket fracture .............................. 3.51 7.07 7.78 3.02 3.38 0.38 10.96 11.67 6.91 7.27 090 21406 ......... ............ A Treat eye socket fracture .............................. 7.25 NA NA 4.91 5.80 0.73 NA NA 12.89 13.78 090 21407 ......... ............ A Treat eye socket fracture .............................. 8.85 NA NA 5.68 6.58 0.94 NA NA 15.47 16.37 090 21408 ......... ............ A Treat eye socket fracture .............................. 12.61 NA NA 7.66 8.60 1.44 NA NA 21.71 22.65 090 21421 ......... ............ A Treat mouth roof fracture .............................. 5.70 12.01 10.02 8.89 8.47 0.73 18.44 16.45 15.32 14.90 090 21422 ......... ............ A Treat mouth roof fracture .............................. 8.56 NA NA 6.72 7.76 0.99 NA NA 16.27 17.31 090 21423 ......... ............ A Treat mouth roof fracture .............................. 10.63 NA NA 7.16 8.80 1.27 NA NA 19.06 20.70 090 21431 ......... ............ A Treat craniofacial fracture ............................. 7.66 NA NA 9.33 9.50 0.70 NA NA 17.69 17.86 090 21432 ......... ............ A Treat craniofacial fracture ............................. 8.72 NA NA 7.15 7.85 0.81 NA NA 16.68 17.38 090 21433 ......... ............ A Treat craniofacial fracture ............................. 26.05 NA NA 12.22 15.39 2.78 NA NA 41.05 44.22 090 21435 ......... ............ A Treat craniofacial fracture ............................. 19.92 NA NA 10.63 12.21 1.98 NA NA 32.53 34.11 090 21436 ......... ............ A Treat craniofacial fracture ............................. 29.89 NA NA 14.95 17.44 3.09 NA NA 47.93 50.42 090 21440 ......... ............ A Treat dental ridge fracture ............................. 3.20 10.28 7.91 7.61 6.54 0.38 13.86 11.49 11.19 10.12 090 21445 ......... ............ A Treat dental ridge fracture ............................. 5.94 12.42 10.44 8.55 8.43 0.78 19.14 17.16 15.27 15.15 090 21450 ......... ............ A Treat lower jaw fracture ................................ 3.47 10.39 8.15 7.63 7.08 0.33 14.19 11.95 11.43 10.88 090 21451 ......... ............ A Treat lower jaw fracture ................................ 5.36 12.91 10.26 9.62 8.72 0.63 18.90 16.25 15.61 14.71 090 21452 ......... ............ A Treat lower jaw fracture ................................ 2.23 11.76 12.74 5.88 4.94 0.27 14.26 15.24 8.38 7.44 090 21453 ......... ............ A Treat lower jaw fracture ................................ 6.28 14.68 11.75 11.54 10.96 0.74 21.70 18.77 18.56 17.98 090 21454 ......... ............ A Treat lower jaw fracture ................................ 7.07 NA NA 5.57 6.10 0.82 NA NA 13.46 13.99 090 21461 ......... ............ A Treat lower jaw fracture ................................ 8.95 41.00 28.65 12.50 12.65 0.98 50.93 38.58 22.43 22.58 090 21462 ......... ............ A Treat lower jaw fracture ................................ 10.65 42.32 31.35 13.10 12.84 1.27 54.24 43.27 25.02 24.76 090 21465 ......... ............ A Treat lower jaw fracture ................................ 12.76 NA NA 8.12 9.41 1.50 NA NA 22.38 23.67 090 21470 ......... ............ A Treat lower jaw fracture ................................ 17.12 NA NA 9.90 11.51 1.96 NA NA 28.98 30.59 090 21480 ......... ............ A Reset dislocated jaw ..................................... 0.61 1.50 1.71 0.17 0.19 0.06 2.17 2.38 0.84 0.86 000 21485 ......... ............ A Reset dislocated jaw ..................................... 4.48 12.24 9.24 9.21 8.06 0.51 17.23 14.23 14.20 13.05 090 21490 ......... ............ A Repair dislocated jaw .................................... 12.59 NA NA 7.75 9.23 1.96 NA NA 22.30 23.78 090 21495 ......... ............ A Treat hyoid bone fracture .............................. 6.43 NA NA 9.46 8.70 0.46 NA NA 16.35 15.59 090 21497 ......... ............ A Interdental wiring ........................................... 4.35 11.91 9.33 9.09 8.02 0.50 16.76 14.18 13.94 12.87 090 21501 ......... ............ A Drain neck/chest lesion ................................. 3.80 6.39 6.43 3.41 3.73 0.43 10.62 10.66 7.64 7.96 090 21502 ......... ............ A Drain chest lesion .......................................... 7.35 NA NA 4.75 5.43 0.97 NA NA 13.07 13.75 090 21510 ......... ............ A Drainage of bone lesion ................................ 5.97 NA NA 4.68 5.43 0.80 NA NA 11.45 12.20 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37270 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

21550 ......... ............ A Biopsy of neck/chest ..................................... 2.06 4.36 3.78 1.76 1.73 0.16 6.58 6.00 3.98 3.95 010 21555 ......... ............ A Remove lesion, neck/chest ........................... 4.34 5.72 5.58 3.37 3.24 0.56 10.62 10.48 8.27 8.14 090 21556 ......... ............ A Remove lesion, neck/chest ........................... 5.56 NA NA 3.87 4.05 0.65 NA NA 10.08 10.26 09021557 ......... ............ A Remove tumor, neck/chest ........................... 8.87 NA NA 4.35 5.12 1.08 NA NA 14.30 15.07 090 21600 ......... ............ A Partial removal of rib ..................................... 7.06 NA NA 5.72 5.74 0.99 NA NA 13.77 13.79 090 21610 ......... ............ A Partial removal of rib ..................................... 15.70 NA NA 8.03 8.68 3.07 NA NA 26.80 27.45 090 21615 ......... ............ A Removal of rib ............................................... 10.22 NA NA 5.52 6.41 1.45 NA NA 17.19 18.08 090 21616 ......... ............ A Removal of rib and nerves ............................ 12.44 NA NA 7.22 7.84 1.86 NA NA 21.52 22.14 090 21620 ......... ............ A Partial removal of sternum ............................ 7.08 NA NA 4.86 5.71 0.98 NA NA 12.92 13.77 090 21627 ......... ............ A Sternal debridement ...................................... 7.10 NA NA 5.63 6.15 1.02 NA NA 13.75 14.27 090 21630 ......... ............ A Extensive sternum surgery ............................ 18.89 NA NA 10.40 11.50 2.58 NA NA 31.87 32.97 090 21632 ......... ............ A Extensive sternum surgery ............................ 19.40 NA NA 9.70 10.78 2.65 NA NA 31.75 32.83 090 21685 ......... ............ A Hyoid myotomy & suspension ....................... 14.77 NA NA 7.68 9.42 1.06 NA NA 23.51 25.25 090 21700 ......... ............ A Revision of neck muscle ............................... 6.18 NA NA 3.98 4.33 0.32 NA NA 10.48 10.83 090 21705 ......... ............ A Revision of neck muscle/rib .......................... 9.77 NA NA 4.86 5.42 1.43 NA NA 16.06 16.62 090 21720 ......... ............ A Revision of neck muscle ............................... 5.67 1.94 2.34 4.29 2.93 0.91 8.52 8.92 10.87 9.51 090 21725 ......... ............ A Revision of neck muscle ............................... 7.04 NA NA 4.52 5.23 1.21 NA NA 12.77 13.48 090 21740 ......... ............ A Reconstruction of sternum ............................ 17.43 NA NA 8.70 8.58 2.36 NA NA 28.49 28.37 090 21750 ......... ............ A Repair of sternum separation ........................ 11.33 NA NA 5.50 5.97 1.63 NA NA 18.46 18.93 090 21800 ......... ............ A Treatment of rib fracture ............................... 0.96 NA NA 1.40 1.36 0.09 NA NA 2.45 2.41 090 21805 ......... ............ A Treatment of rib fracture ............................... 2.75 NA NA 3.51 3.29 0.38 NA NA 6.64 6.42 090 21810 ......... ............ A Treatment of rib fracture(s) ........................... 6.85 NA NA 5.28 5.06 0.94 NA NA 13.07 12.85 090 21820 ......... ............ A Treat sternum fracture ................................... 1.28 1.78 1.82 1.84 1.79 0.16 3.22 3.26 3.28 3.23 090 21825 ......... ............ A Treat sternum fracture ................................... 7.58 NA NA 5.46 6.17 1.11 NA NA 14.15 14.86 090 21920 ......... ............ A Biopsy soft tissue of back ............................. 2.06 4.36 3.56 1.83 1.56 0.14 6.56 5.76 4.03 3.76 010 21925 ......... ............ A Biopsy soft tissue of back ............................. 4.48 5.47 5.25 3.43 3.30 0.60 10.55 10.33 8.51 8.38 090 21930 ......... ............ A Remove lesion, back or flank ........................ 4.99 6.01 5.80 3.74 3.49 0.66 11.66 11.45 9.39 9.14 090 21935 ......... ............ A Remove tumor, back ..................................... 18.29 NA NA 8.40 9.34 2.47 NA NA 29.16 30.10 090 22010 ......... ............ A I&d, p-spine, c/t/cerv-thor .............................. 12.49 NA NA 8.06 8.70 1.73 NA NA 22.28 22.92 090 22015 ......... ............ A I&d, p-spine, l/s/ls .......................................... 12.38 NA NA 8.02 8.64 1.71 NA NA 22.11 22.73 090 22100 ......... ............ A Remove part of neck vertebra ...................... 10.72 NA NA 7.85 7.63 2.13 NA NA 20.70 20.48 090 22101 ......... ............ A Remove part, thorax vertebra ....................... 10.80 NA NA 7.79 7.78 1.90 NA NA 20.49 20.48 09022102 ......... ............ A Remove part, lumbar vertebra ...................... 10.80 NA NA 7.08 7.87 1.87 NA NA 19.75 20.54 090 22103 ......... ............ A Remove extra spine segment ....................... 2.34 NA NA 0.86 1.12 0.44 NA NA 3.64 3.90 ZZZ 22110 ......... ............ A Remove part of neck vertebra ...................... 13.72 NA NA 8.88 9.11 2.76 NA NA 25.36 25.59 090 22112 ......... ............ A Remove part, thorax vertebra ....................... 13.79 NA NA 8.76 9.17 2.52 NA NA 25.07 25.48 09022114 ......... ............ A Remove part, lumbar vertebra ...................... 13.79 NA NA 8.84 9.17 2.63 NA NA 25.26 25.59 090 22116 ......... ............ A Remove extra spine segment ....................... 2.32 NA NA 0.84 1.09 0.50 NA NA 3.66 3.91 ZZZ 22210 ......... ............ A Revision of neck spine .................................. 25.03 NA NA 14.35 15.18 5.44 NA NA 44.82 45.65 090 22212 ......... ............ A Revision of thorax spine ................................ 20.64 NA NA 12.20 13.03 3.90 NA NA 36.74 37.57 090 22214 ......... ............ A Revision of lumbar spine ............................... 20.67 NA NA 12.30 13.46 3.91 NA NA 36.88 38.04 090 22216 ......... ............ A Revise, extra spine segment ......................... 6.03 NA NA 2.30 2.93 1.29 NA NA 9.62 10.25 ZZZ 22220 ......... ............ A Revision of neck spine .................................. 22.59 NA NA 13.09 13.52 5.06 NA NA 40.74 41.17 090 22222 ......... ............ A Revision of thorax spine ................................ 22.74 NA NA 12.03 11.38 4.12 NA NA 38.89 38.24 090 22224 ......... ............ A Revision of lumbar spine ............................... 22.74 NA NA 12.88 13.92 4.18 NA NA 39.80 40.84 090 22226 ......... ............ A Revise, extra spine segment ......................... 6.03 NA NA 2.08 2.85 1.29 NA NA 9.40 10.17 ZZZ 22305 ......... ............ A Treat spine process fracture ......................... 2.05 2.12 2.27 1.77 1.89 0.39 4.56 4.71 4.21 4.33 090 22310 ......... ............ A Treat spine fracture ....................................... 3.61 2.94 2.84 2.45 2.38 0.50 7.05 6.95 6.56 6.49 090 22315 ......... ............ A Treat spine fracture ....................................... 9.83 9.62 9.69 7.24 7.32 1.85 21.30 21.37 18.92 19.00 090 22318 ......... ............ A Treat odontoid fx w/o graft ............................ 22.46 NA NA 12.88 13.29 5.28 NA NA 40.62 41.03 090 22319 ......... ............ A Treat odontoid fx w/graft ............................... 25.07 NA NA 13.69 14.49 6.03 NA NA 44.79 45.59 090 22325 ......... ............ A Treat spine fracture ....................................... 19.52 NA NA 11.67 12.00 3.87 NA NA 35.06 35.39 090 22326 ......... ............ A Treat neck spine fracture .............................. 20.56 NA NA 11.71 12.48 4.42 NA NA 36.69 37.46 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37271 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

22327 ......... ............ A Treat thorax spine fracture ............................ 20.42 NA NA 11.94 12.29 3.98 NA NA 36.34 36.69 090 22328 ......... ............ A Treat each add spine fx ................................ 4.60 NA NA 1.75 2.14 0.94 NA NA 7.29 7.68 ZZZ 22505 ......... ............ A Manipulation of spine .................................... 1.87 NA NA 1.04 0.97 0.36 NA NA 3.27 3.20 010 22520 ......... ............ A Percut vertebroplasty thor ............................. 9.15 46.33 57.96 4.66 5.00 1.71 57.19 68.82 15.52 15.86 010 22521 ......... ............ A Percut vertebroplasty lumb ........................... 8.58 47.63 54.01 4.46 4.84 1.60 57.81 64.19 14.64 15.02 010 22522 ......... ............ A Percut vertebroplasty addIl ........................... 4.30 NA NA 1.51 1.64 0.82 NA NA 6.63 6.76 ZZZ22523 ......... ............ A Percut kyphoplasty, thor ................................ 9.19 NA NA 4.74 5.63 1.71 NA NA 15.64 16.53 010 22524 ......... ............ A Percut kyphoplasty, lumbar ........................... 8.79 NA NA 4.59 5.43 1.60 NA NA 14.98 15.82 010 22525 ......... ............ A Percut kyphoplasty, add-on ........................... 4.47 NA NA 1.67 2.13 0.82 NA NA 6.96 7.42 ZZZ 22532 ......... ............ A Lat thorax spine fusion .................................. 25.73 NA NA 13.40 14.50 4.34 NA NA 43.47 44.57 090 22533 ......... ............ A Lat lumbar spine fusion ................................. 24.53 NA NA 13.12 13.50 3.15 NA NA 40.80 41.18 090 22534 ......... ............ A Lat thor/lumb, addIl seg ................................ 5.99 NA NA 2.25 2.84 1.25 NA NA 9.49 10.08 ZZZ 22548 ......... ............ A Neck spine fusion .......................................... 26.78 NA NA 14.66 15.55 5.59 NA NA 47.03 47.92 090 22554 ......... ............ A Neck spine fusion .......................................... 17.48 NA NA 11.21 12.09 4.45 NA NA 33.14 34.02 090 22556 ......... ............ A Thorax spine fusion ....................................... 24.42 NA NA 12.78 14.27 4.34 NA NA 41.54 43.03 090 22558 ......... ............ A Lumbar spine fusion ...................................... 23.25 NA NA 11.36 12.84 3.15 NA NA 37.76 39.24 090 22585 ......... ............ A Additional spinal fusion ................................. 5.52 NA NA 2.02 2.61 1.25 NA NA 8.79 9.38 ZZZ 22590 ......... ............ A Spine & skull spinal fusion ............................ 21.48 NA NA 12.77 13.21 4.78 NA NA 39.03 39.47 090 22595 ......... ............ A Neck spinal fusion ......................................... 20.36 NA NA 12.29 12.73 4.40 NA NA 37.05 37.49 090 22600 ......... ............ A Neck spine fusion .......................................... 17.12 NA NA 11.00 11.17 3.72 NA NA 31.84 32.01 090 22610 ......... ............ A Thorax spine fusion ....................................... 17.00 NA NA 10.63 11.24 3.52 NA NA 31.15 31.76 090 22612 ......... ............ A Lumbar spine fusion ...................................... 22.50 NA NA 12.61 13.83 4.46 NA NA 39.57 40.79 090 22614 ......... ............ A Spine fusion, extra segment ......................... 6.43 NA NA 2.42 3.13 1.38 NA NA 10.23 10.94 ZZZ22630 ......... ............ A Lumbar spine fusion ...................................... 21.81 NA NA 12.31 13.31 4.72 NA NA 38.84 39.84 090 22632 ......... ............ A Spine fusion, extra segment ......................... 5.22 NA NA 1.95 2.49 1.16 NA NA 8.33 8.87 ZZZ 22800 ......... ............ A Fusion of spine .............................................. 19.22 NA NA 10.91 12.34 3.75 NA NA 33.88 35.31 090 22802 ......... ............ A Fusion of spine .............................................. 31.83 NA NA 15.80 18.69 6.15 NA NA 53.78 56.67 090 22804 ......... ............ A Fusion of spine .............................................. 37.22 NA NA 17.76 21.51 6.98 NA NA 61.96 65.71 090 22808 ......... ............ A Fusion of spine .............................................. 27.23 NA NA 13.54 15.65 4.92 NA NA 45.69 47.80 090 22810 ......... ............ A Fusion of spine .............................................. 31.22 NA NA 14.63 17.47 5.13 NA NA 50.98 53.82 090 22812 ......... ............ A Fusion of spine .............................................. 33.90 NA NA 16.45 19.20 5.28 NA NA 55.63 58.38 090 22818 ......... ............ A Kyphectomy, 1-2 segments ........................... 34.12 NA NA 16.28 18.26 6.45 NA NA 56.85 58.83 090 22819 ......... ............ A Kyphectomy, 3 or more ................................. 39.10 NA NA 18.97 19.83 7.65 NA NA 65.72 66.58 090 22830 ......... ............ A Exploration of spinal fusion ........................... 11.07 NA NA 6.95 7.72 2.29 NA NA 20.31 21.08 090 22840 ......... ............ A Insert spine fixation device ............................ 12.52 NA NA 4.70 6.06 2.78 NA NA 20.00 21.36 ZZZ 22842 ......... ............ A Insert spine fixation device ............................ 12.56 NA NA 4.72 6.07 2.74 NA NA 20.02 21.37 ZZZ 22843 ......... ............ A Insert spine fixation device ............................ 13.44 NA NA 5.11 6.24 2.85 NA NA 21.40 22.53 ZZZ 22844 ......... ............ A Insert spine fixation device ............................ 16.42 NA NA 6.29 8.16 3.18 NA NA 25.89 27.76 ZZZ 22845 ......... ............ A Insert spine fixation device ............................ 11.94 NA NA 4.40 5.67 2.85 NA NA 19.19 20.46 ZZZ 22846 ......... ............ A Insert spine fixation device ............................ 12.40 NA NA 4.57 5.91 2.95 NA NA 19.92 21.26 ZZZ 22847 ......... ............ A Insert spine fixation device ............................ 13.78 NA NA 5.17 6.57 2.99 NA NA 21.94 23.34 ZZZ 22848 ......... ............ A Insert pelv fixation device .............................. 5.99 NA NA 2.30 2.97 1.15 NA NA 9.44 10.11 ZZZ 22849 ......... ............ A Reinsert spinal fixation .................................. 19.02 NA NA 9.92 11.30 3.89 NA NA 32.83 34.21 090 22850 ......... ............ A Remove spine fixation device ....................... 9.69 NA NA 6.26 6.82 2.04 NA NA 17.99 18.55 090 22851 ......... ............ A Apply spine prosth device ............................. 6.70 NA NA 2.50 3.15 1.49 NA NA 10.69 11.34 ZZZ 22852 ......... ............ A Remove spine fixation device ....................... 9.24 NA NA 5.99 6.61 1.89 NA NA 17.12 17.74 090 22855 ......... ............ A Remove spine fixation device ....................... 15.71 NA NA 8.93 9.50 3.51 NA NA 28.15 28.72 09022900 ......... ............ A Remove abdominal wall lesion ..................... 6.09 NA NA 3.47 3.29 0.76 NA NA 10.32 10.14 090 23000 ......... ............ A Removal of calcium deposits ........................ 4.35 7.75 8.35 3.63 4.23 0.68 12.78 13.38 8.66 9.26 090 23020 ......... ............ A Release shoulder joint ................................... 9.16 NA NA 6.37 7.28 1.54 NA NA 17.07 17.98 090 23030 ......... ............ A Drain shoulder lesion .................................... 3.42 6.26 7.12 2.38 2.78 0.57 10.25 11.11 6.37 6.77 010 23031 ......... ............ A Drain shoulder bursa ..................................... 2.74 6.44 7.52 2.19 2.60 0.46 9.64 10.72 5.39 5.80 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37272 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

23035 ......... ............ A Drain shoulder bone lesion ........................... 8.96 NA NA 6.91 7.95 1.47 NA NA 17.34 18.38 090 23040 ......... ............ A Exploratory shoulder surgery ........................ 9.55 NA NA 6.65 7.57 1.60 NA NA 17.80 18.72 09023044 ......... ............ A Exploratory shoulder surgery ........................ 7.41 NA NA 5.48 6.21 1.24 NA NA 14.13 14.86 09023065 ......... ............ A Biopsy shoulder tissues ................................ 2.27 2.93 2.60 1.71 1.64 0.20 5.40 5.07 4.18 4.11 010 23066 ......... ............ A Biopsy shoulder tissues ................................ 4.15 7.67 7.69 3.56 3.88 0.63 12.45 12.47 8.34 8.66 090 23075 ......... ............ A Removal of shoulder lesion ........................... 2.39 3.71 3.68 1.72 1.77 0.34 6.44 6.41 4.45 4.50 010 23076 ......... ............ A Removal of shoulder lesion ........................... 7.68 NA NA 5.25 5.49 1.13 NA NA 14.06 14.30 090 23077 ......... ............ A Remove tumor of shoulder ............................ 17.98 NA NA 9.59 10.08 2.33 NA NA 29.90 30.39 090 23100 ......... ............ A Biopsy of shoulder joint ................................. 6.02 NA NA 5.04 5.51 1.04 NA NA 12.10 12.57 090 23101 ......... ............ A Shoulder joint surgery ................................... 5.57 NA NA 4.49 5.14 0.96 NA NA 11.02 11.67 090 23105 ......... ............ A Remove shoulder joint lining ......................... 8.28 NA NA 5.99 6.85 1.42 NA NA 15.69 16.55 090 23106 ......... ............ A Incision of collarbone joint ............................. 5.95 NA NA 4.55 5.43 0.99 NA NA 11.49 12.37 090 23107 ......... ............ A Explore treat shoulder joint ........................... 8.67 NA NA 6.14 7.09 1.49 NA NA 16.30 17.25 090 23120 ......... ............ A Partial removal, collar bone .......................... 7.16 NA NA 5.38 6.21 1.23 NA NA 13.77 14.60 090 23125 ......... ............ A Removal of collar bone ................................. 9.44 NA NA 6.22 7.24 1.62 NA NA 17.28 18.30 090 23130 ......... ............ A Remove shoulder bone, part ......................... 7.54 NA NA 5.98 6.86 1.30 NA NA 14.82 15.70 090 23140 ......... ............ A Removal of bone lesion ................................ 6.94 NA NA 4.73 5.11 1.08 NA NA 12.75 13.13 090 23145 ......... ............ A Removal of bone lesion ................................ 9.20 NA NA 5.70 7.02 1.49 NA NA 16.39 17.71 090 23146 ......... ............ A Removal of bone lesion ................................ 7.88 NA NA 5.86 6.81 1.35 NA NA 15.09 16.04 090 23150 ......... ............ A Removal of humerus lesion .......................... 8.71 NA NA 5.94 6.69 1.32 NA NA 15.97 16.72 090 23155 ......... ............ A Removal of humerus lesion .......................... 10.63 NA NA 7.20 8.06 1.80 NA NA 19.63 20.49 09023156 ......... ............ A Removal of humerus lesion .......................... 8.91 NA NA 6.28 7.12 1.50 NA NA 16.69 17.53 090 23170 ......... ............ A Remove collar bone lesion ............................ 7.03 NA NA 5.01 5.78 1.12 NA NA 13.16 13.93 090 23172 ......... ............ A Remove shoulder blade lesion ...................... 7.13 NA NA 4.90 5.95 1.01 NA NA 13.04 14.09 090 23174 ......... ............ A Remove humerus lesion ............................... 9.80 NA NA 7.15 8.07 1.65 NA NA 18.60 19.52 09023180 ......... ............ A Remove collar bone lesion ............................ 8.76 NA NA 6.96 8.51 1.47 NA NA 17.19 18.74 090 23182 ......... ............ A Remove shoulder blade lesion ...................... 8.38 NA NA 6.80 8.13 1.37 NA NA 16.55 17.88 090 23184 ......... ............ A Remove humerus lesion ............................... 9.67 NA NA 7.41 8.86 1.63 NA NA 18.71 20.16 09023190 ......... ............ A Partial removal of scapula ............................. 7.29 NA NA 5.32 5.97 1.17 NA NA 13.78 14.43 090 23195 ......... ............ A Removal of head of humerus ........................ 10.16 NA NA 6.65 7.48 1.70 NA NA 18.51 19.34 090 23200 ......... ............ A Removal of collar bone ................................. 12.60 NA NA 7.41 8.42 1.93 NA NA 21.94 22.95 090 23210 ......... ............ A Removal of shoulder blade ........................... 13.07 NA NA 8.09 8.79 2.02 NA NA 23.18 23.88 090 23220 ......... ............ A Partial removal of humerus ........................... 15.26 NA NA 8.92 10.37 2.48 NA NA 26.66 28.11 090 23221 ......... ............ A Partial removal of humerus ........................... 18.31 NA NA 6.48 10.43 3.05 NA NA 27.84 31.79 090 23222 ......... ............ A Partial removal of humerus ........................... 25.36 NA NA 13.27 15.19 3.94 NA NA 42.57 44.49 090 23330 ......... ............ A Remove shoulder foreign body ..................... 1.85 3.34 3.60 1.51 1.80 0.24 5.43 5.69 3.60 3.89 010 23331 ......... ............ A Remove shoulder foreign body ..................... 7.43 NA NA 5.77 6.55 1.27 NA NA 14.47 15.25 090 23332 ......... ............ A Remove shoulder foreign body ..................... 12.14 NA NA 7.85 8.98 2.02 NA NA 22.01 23.14 090 23350 ......... ............ A Injection for shoulder x-ray ............................ 1.00 2.83 3.31 0.35 0.34 0.06 3.89 4.37 1.41 1.40 000 23395 ......... ............ A Muscle transfer,shoulder/arm ........................ 18.19 NA NA 11.02 12.43 2.93 NA NA 32.14 33.55 090 23397 ......... ............ A Muscle transfers ............................................ 16.53 NA NA 9.49 10.92 2.73 NA NA 28.75 30.18 090 23400 ......... ............ A Fixation of shoulder blade ............................. 13.64 NA NA 8.38 9.67 2.29 NA NA 24.31 25.60 090 23405 ......... ............ A Incision of tendon & muscle .......................... 8.36 NA NA 5.85 6.67 1.45 NA NA 15.66 16.48 090 23406 ......... ............ A Incise tendon(s) & muscle(s) ........................ 10.83 NA NA 6.80 7.97 1.87 NA NA 19.50 20.67 090 23410 ......... ............ A Repair rotator cuff, acute .............................. 12.55 NA NA 7.66 8.99 2.16 NA NA 22.37 23.70 090 23412 ......... ............ A Repair rotator cuff, chronic ............................ 13.47 NA NA 8.04 9.45 2.31 NA NA 23.82 25.23 090 23415 ......... ............ A Release of shoulder ligament ....................... 10.02 NA NA 6.48 7.63 1.73 NA NA 18.23 19.38 09023420 ......... ............ A Repair of shoulder ......................................... 14.65 NA NA 9.58 10.55 2.31 NA NA 26.54 27.51 090 23430 ......... ............ A Repair biceps tendon .................................... 9.97 NA NA 6.66 7.76 1.73 NA NA 18.36 19.46 090 23440 ......... ............ A Remove/transplant tendon ............................ 10.46 NA NA 6.67 7.88 1.82 NA NA 18.95 20.16 090 23450 ......... ............ A Repair shoulder capsule ............................... 13.50 NA NA 8.02 9.41 2.32 NA NA 23.84 25.23 090 23455 ......... ............ A Repair shoulder capsule ............................... 14.47 NA NA 8.41 9.96 2.49 NA NA 25.37 26.92 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37273 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

23460 ......... ............ A Repair shoulder capsule ............................... 15.59 NA NA 9.17 10.84 2.66 NA NA 27.42 29.09 090 23462 ......... ............ A Repair shoulder capsule ............................... 15.52 NA NA 8.90 10.31 2.59 NA NA 27.01 28.42 090 23465 ......... ............ A Repair shoulder capsule ............................... 16.07 NA NA 9.40 10.76 2.76 NA NA 28.23 29.59 090 23466 ......... ............ A Repair shoulder capsule ............................... 15.45 NA NA 9.89 11.02 2.46 NA NA 27.80 28.93 090 23470 ......... ............ A Reconstruct shoulder joint ............................. 17.66 NA NA 9.99 11.72 2.98 NA NA 30.63 32.36 090 23472 ......... ............ A Reconstruct shoulder joint ............................. 22.39 NA NA 11.99 13.84 3.66 NA NA 38.04 39.89 090 23480 ......... ............ A Revision of collar bone .................................. 11.34 NA NA 7.21 8.40 1.94 NA NA 20.49 21.68 090 23485 ......... ............ A Revision of collar bone .................................. 13.71 NA NA 8.14 9.48 2.33 NA NA 24.18 25.52 090 23490 ......... ............ A Reinforce clavicle .......................................... 11.96 NA NA 6.76 8.23 1.47 NA NA 20.19 21.66 090 23491 ......... ............ A Reinforce shoulder bones ............................. 14.31 NA NA 8.69 10.23 2.46 NA NA 25.46 27.00 090 23500 ......... ............ A Treat clavicle fracture .................................... 2.08 2.61 2.81 2.68 2.57 0.30 4.99 5.19 5.06 4.95 090 23505 ......... ............ A Treat clavicle fracture .................................... 3.68 3.97 4.31 3.57 3.78 0.61 8.26 8.60 7.86 8.07 090 23515 ......... ............ A Treat clavicle fracture .................................... 7.40 NA NA 5.48 6.30 1.28 NA NA 14.16 14.98 090 23520 ......... ............ A Treat clavicle dislocation ............................... 2.16 2.60 2.80 2.67 2.73 0.34 5.10 5.30 5.17 5.23 090 23525 ......... ............ A Treat clavicle dislocation ............................... 3.59 4.45 4.53 3.87 3.93 0.46 8.50 8.58 7.92 7.98 090 23530 ......... ............ A Treat clavicle dislocation ............................... 7.30 NA NA 5.18 5.76 1.20 NA NA 13.68 14.26 090 23532 ......... ............ A Treat clavicle dislocation ............................... 8.00 NA NA 5.97 6.74 1.38 NA NA 15.35 16.12 090 23540 ......... ............ A Treat clavicle dislocation ............................... 2.23 2.59 2.80 2.66 2.44 0.29 5.11 5.32 5.18 4.96 090 23545 ......... ............ A Treat clavicle dislocation ............................... 3.25 3.71 4.08 3.23 3.34 0.35 7.31 7.68 6.83 6.94 090 23550 ......... ............ A Treat clavicle dislocation ............................... 7.41 NA NA 5.43 6.15 1.25 NA NA 14.09 14.81 090 23552 ......... ............ A Treat clavicle dislocation ............................... 8.62 NA NA 6.12 7.04 1.46 NA NA 16.20 17.12 090 23570 ......... ............ A Treat shoulder blade fx ................................. 2.23 2.76 2.96 2.90 2.90 0.36 5.35 5.55 5.49 5.49 090 23575 ......... ............ A Treat shoulder blade fx ................................. 4.05 4.29 4.74 3.80 4.19 0.59 8.93 9.38 8.44 8.83 090 23585 ......... ............ A Treat scapula fracture ................................... 9.07 NA NA 6.38 7.34 1.54 NA NA 16.99 17.95 090 23600 ......... ............ A Treat humerus fracture .................................. 2.93 4.03 4.43 3.61 3.57 0.48 7.44 7.84 7.02 6.98 090 23605 ......... ............ A Treat humerus fracture .................................. 4.86 5.34 5.96 4.55 4.98 0.84 11.04 11.66 10.25 10.68 090 23615 ......... ............ A Treat humerus fracture .................................. 10.83 NA NA 8.16 8.69 1.62 NA NA 20.61 21.14 090 23616 ......... ............ A Treat humerus fracture .................................. 21.60 NA NA 11.29 13.46 3.69 NA NA 36.58 38.75 090 23620 ......... ............ A Treat humerus fracture .................................. 2.40 3.38 3.56 3.11 3.02 0.40 6.18 6.36 5.91 5.82 090 23625 ......... ............ A Treat humerus fracture .................................. 3.92 4.37 4.81 3.85 4.18 0.67 8.96 9.40 8.44 8.77 090 23630 ......... ............ A Treat humerus fracture .................................. 7.40 NA NA 5.57 6.38 1.27 NA NA 14.24 15.05 090 23650 ......... ............ A Treat shoulder dislocation ............................. 3.38 3.24 3.65 2.77 2.77 0.30 6.92 7.33 6.45 6.45 090 23655 ......... ............ A Treat shoulder dislocation ............................. 4.56 NA NA 4.11 4.16 0.69 NA NA 9.36 9.41 090 23660 ......... ............ A Treat shoulder dislocation ............................. 7.48 NA NA 5.52 6.18 1.29 NA NA 14.29 14.95 090 23665 ......... ............ A Treat dislocation/fracture ............................... 4.46 4.77 5.21 4.19 4.60 0.71 9.94 10.38 9.36 9.77 090 23670 ......... ............ A Treat dislocation/fracture ............................... 7.95 NA NA 5.75 6.58 1.36 NA NA 15.06 15.89 090 23675 ......... ............ A Treat dislocation/fracture ............................... 6.04 6.06 6.65 5.08 5.66 1.01 13.11 13.70 12.13 12.71 090 23680 ......... ............ A Treat dislocation/fracture ............................... 10.22 NA NA 6.87 7.82 1.75 NA NA 18.84 19.79 090 23700 ......... ............ A Fixation of shoulder ....................................... 2.52 NA NA 1.88 2.11 0.44 NA NA 4.84 5.07 010 23800 ......... ............ A Fusion of shoulder joint ................................. 14.50 NA NA 7.41 9.68 2.35 NA NA 24.26 26.53 090 23802 ......... ............ A Fusion of shoulder joint ................................. 18.07 NA NA 10.76 10.34 2.70 NA NA 31.53 31.11 090 23900 ......... ............ A Amputation of arm & girdle ........................... 20.47 NA NA 10.49 11.43 3.18 NA NA 34.14 35.08 090 23920 ......... ............ A Amputation at shoulder joint ......................... 15.95 NA NA 9.37 9.81 2.46 NA NA 27.78 28.22 090 23921 ......... ............ A Amputation follow-up surgery ........................ 5.54 NA NA 4.80 5.02 0.78 NA NA 11.12 11.34 09023930 ......... ............ A Drainage of arm lesion .................................. 2.94 4.97 6.00 1.97 2.23 0.43 8.34 9.37 5.34 5.60 010 23931 ......... ............ A Drainage of arm bursa .................................. 1.79 4.30 5.52 1.72 2.07 0.28 6.37 7.59 3.79 4.14 010 23935 ......... ............ A Drain arm/elbow bone lesion ........................ 6.20 NA NA 5.04 5.71 1.05 NA NA 12.29 12.96 090 24000 ......... ............ A Exploratory elbow surgery ............................. 5.93 NA NA 4.69 5.25 0.97 NA NA 11.59 12.15 090 24006 ......... ............ A Release elbow joint ....................................... 9.54 NA NA 6.53 7.46 1.50 NA NA 17.57 18.50 090 24065 ......... ............ A Biopsy arm/elbow soft tissue ........................ 2.08 4.12 3.45 1.89 1.79 0.17 6.37 5.70 4.14 4.04 010 24066 ......... ............ A Biopsy arm/elbow soft tissue ........................ 5.20 8.25 8.78 3.89 4.08 0.80 14.25 14.78 9.89 10.08 090 24075 ......... ............ A Remove arm/elbow lesion ............................. 3.91 7.16 7.32 3.24 3.37 0.56 11.63 11.79 7.71 7.84 090 24076 ......... ............ A Remove arm/elbow lesion ............................. 6.29 NA NA 4.51 4.78 0.95 NA NA 11.75 12.02 090

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37274 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

24077 ......... ............ A Remove tumor of arm/elbow ......................... 11.86 NA NA 6.82 7.53 1.72 NA NA 20.40 21.11 090 24100 ......... ............ A Biopsy elbow joint lining ................................ 4.92 NA NA 4.19 4.45 0.85 NA NA 9.96 10.22 090 24101 ......... ............ A Explore/treat elbow joint ................................ 6.12 NA NA 4.98 5.71 1.03 NA NA 12.13 12.86 090 24102 ......... ............ A Remove elbow joint lining ............................. 8.08 NA NA 5.69 6.58 1.33 NA NA 15.10 15.99 090 24105 ......... ............ A Removal of elbow bursa ............................... 3.60 NA NA 3.96 4.29 0.61 NA NA 8.17 8.50 090 24110 ......... ............ A Remove humerus lesion ............................... 7.38 NA NA 5.55 6.40 1.28 NA NA 14.21 15.06 09024115 ......... ............ A Remove/graft bone lesion ............................. 9.92 NA NA 6.68 7.09 1.67 NA NA 18.27 18.68 090 24116 ......... ............ A Remove/graft bone lesion ............................. 12.03 NA NA 7.50 8.70 2.05 NA NA 21.58 22.78 090 24120 ......... ............ A Remove elbow lesion .................................... 6.64 NA NA 5.12 5.74 1.10 NA NA 12.86 13.48 090 24125 ......... ............ A Remove/graft bone lesion ............................. 7.94 NA NA 5.90 6.11 1.06 NA NA 14.90 15.11 090 24126 ......... ............ A Remove/graft bone lesion ............................. 8.42 NA NA 6.09 6.80 1.16 NA NA 15.67 16.38 090 24130 ......... ............ A Removal of head of radius ............................ 6.24 NA NA 5.02 5.79 1.04 NA NA 12.30 13.07 090 24134 ......... ............ A Removal of arm bone lesion ......................... 10.02 NA NA 7.35 8.50 1.64 NA NA 19.01 20.16 09024136 ......... ............ A Remove radius bone lesion .......................... 8.22 NA NA 5.93 6.91 1.38 NA NA 15.53 16.51 090 24138 ......... ............ A Remove elbow bone lesion ........................... 8.22 NA NA 6.58 7.50 1.34 NA NA 16.14 17.06 090 24140 ......... ............ A Partial removal of arm bone .......................... 9.35 NA NA 7.07 8.62 1.51 NA NA 17.93 19.48 090 24145 ......... ............ A Partial removal of radius ............................... 7.63 NA NA 6.19 7.61 1.25 NA NA 15.07 16.49 090 24147 ......... ............ A Partial removal of elbow ................................ 7.59 NA NA 6.79 8.16 1.30 NA NA 15.68 17.05 090 24149 ......... ............ A Radical resection of elbow ............................ 15.80 NA NA 10.66 11.40 2.34 NA NA 28.80 29.54 090 24150 ......... ............ A Extensive humerus surgery ........................... 13.61 NA NA 8.37 9.61 2.32 NA NA 24.30 25.54 090 24151 ......... ............ A Extensive humerus surgery ........................... 15.98 NA NA 9.58 11.05 2.59 NA NA 28.15 29.62 090 24152 ......... ............ A Extensive radius surgery ............................... 10.16 NA NA 6.17 7.36 1.48 NA NA 17.81 19.00 090 24153 ......... ............ A Extensive radius surgery ............................... 11.64 NA NA 6.32 5.77 0.74 NA NA 18.70 18.15 090 24155 ......... ............ A Removal of elbow joint .................................. 11.89 NA NA 7.46 8.18 1.92 NA NA 21.27 21.99 090 24160 ......... ............ A Remove elbow joint implant .......................... 7.82 NA NA 5.73 6.62 1.30 NA NA 14.85 15.74 09024164 ......... ............ A Remove radius head implant ........................ 6.28 NA NA 4.84 5.55 1.03 NA NA 12.15 12.86 090 24200 ......... ............ A Removal of arm foreign body ........................ 1.76 2.75 3.25 1.36 1.56 0.20 4.71 5.21 3.32 3.52 010 24201 ......... ............ A Removal of arm foreign body ........................ 4.55 7.88 9.35 3.68 4.10 0.72 13.15 14.62 8.95 9.37 090 24220 ......... ............ A Injection for elbow x-ray ................................ 1.31 2.73 3.41 0.45 0.44 0.08 4.12 4.80 1.84 1.83 000 24300 ......... ............ A Manipulate elbow w/anesth ........................... 3.74 NA NA 5.10 5.57 0.65 NA NA 9.49 9.96 090 24301 ......... ............ A Muscle/tendon transfer .................................. 10.18 NA NA 6.72 7.83 1.66 NA NA 18.56 19.67 090 24305 ......... ............ A Arm tendon lengthening ................................ 7.44 NA NA 5.56 6.44 1.15 NA NA 14.15 15.03 090 24310 ......... ............ A Revision of arm tendon ................................. 5.97 NA NA 4.71 5.38 0.96 NA NA 11.64 12.31 090 24320 ......... ............ A Repair of arm tendon .................................... 10.66 NA NA 6.97 7.41 1.73 NA NA 19.36 19.80 090 24330 ......... ............ A Revision of arm muscles ............................... 9.59 NA NA 6.52 7.56 1.60 NA NA 17.71 18.75 090 24331 ......... ............ A Revision of arm muscles ............................... 10.75 NA NA 6.40 8.13 1.77 NA NA 18.92 20.65 090 24332 ......... ............ A Tenolysis, triceps ........................................... 7.69 NA NA 5.69 6.52 1.23 NA NA 14.61 15.44 090 24340 ......... ............ A Repair of biceps tendon ................................ 7.88 NA NA 5.89 6.72 1.36 NA NA 15.13 15.96 090 24341 ......... ............ A Repair arm tendon/muscle ............................ 9.14 NA NA 7.40 7.81 1.36 NA NA 17.90 18.31 09024342 ......... ............ A Repair of ruptured tendon ............................. 10.66 NA NA 6.97 8.15 1.85 NA NA 19.48 20.66 090 24343 ......... ............ A Repr elbow lat ligmnt w/tiss .......................... 8.89 NA NA 6.90 7.85 1.43 NA NA 17.22 18.17 090 24344 ......... ............ A Reconstruct elbow lat ligmnt ......................... 14.85 NA NA 9.86 11.13 2.36 NA NA 27.07 28.34 090 24345 ......... ............ A Repr elbw med ligmnt w/tissu ....................... 8.89 NA NA 6.85 7.74 1.44 NA NA 17.18 18.07 090 24346 ......... ............ A Reconstruct elbow med ligmnt ...................... 14.85 NA NA 9.87 11.00 2.33 NA NA 27.05 28.18 09024350 ......... ............ A Repair of tennis elbow .................................. 5.24 NA NA 4.81 5.40 0.87 NA NA 10.92 11.51 090 24351 ......... ............ A Repair of tennis elbow .................................. 5.90 NA NA 4.92 5.69 1.02 NA NA 11.84 12.61 090 24352 ......... ............ A Repair of tennis elbow .................................. 6.42 NA NA 5.13 5.93 1.10 NA NA 12.65 13.45 090 24354 ......... ............ A Repair of tennis elbow .................................. 6.47 NA NA 5.16 5.92 1.07 NA NA 12.70 13.46 090 24356 ......... ............ A Revision of tennis elbow ............................... 6.67 NA NA 5.23 6.06 1.11 NA NA 13.01 13.84 090 24360 ......... ............ A Reconstruct elbow joint ................................. 12.44 NA NA 7.82 9.08 2.05 NA NA 22.31 23.57 090 24361 ......... ............ A Reconstruct elbow joint ................................. 14.18 NA NA 8.60 10.11 2.18 NA NA 24.96 26.47 090 24362 ......... ............ A Reconstruct elbow joint ................................. 15.09 NA NA 9.11 9.83 2.60 NA NA 26.80 27.52 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37275 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

24363 ......... ............ A Replace elbow joint ....................................... 22.39 NA NA 12.69 13.49 3.01 NA NA 38.09 38.89 090 24365 ......... ............ A Reconstruct head of radius ........................... 8.44 NA NA 5.83 6.87 1.41 NA NA 15.68 16.72 090 24366 ......... ............ A Reconstruct head of radius ........................... 9.18 NA NA 6.19 7.22 1.52 NA NA 16.89 17.92 090 24400 ......... ............ A Revision of humerus ..................................... 11.10 NA NA 7.48 8.53 1.92 NA NA 20.50 21.55 090 24410 ......... ............ A Revision of humerus ..................................... 14.86 NA NA 9.14 10.04 2.57 NA NA 26.57 27.47 090 24420 ......... ............ A Revision of humerus ..................................... 13.48 NA NA 8.65 10.09 2.17 NA NA 24.30 25.74 090 24430 ......... ............ A Repair of humerus ......................................... 14.99 NA NA 8.73 9.51 2.21 NA NA 25.93 26.71 090 24435 ......... ............ A Repair humerus with graft ............................. 14.64 NA NA 9.68 10.60 2.27 NA NA 26.59 27.51 090 24470 ......... ............ A Revision of elbow joint .................................. 8.73 NA NA 6.31 7.38 1.48 NA NA 16.52 17.59 090 24495 ......... ............ A Decompression of forearm ............................ 8.23 NA NA 6.68 8.25 1.18 NA NA 16.09 17.66 09024498 ......... ............ A Reinforce humerus ........................................ 12.08 NA NA 7.59 8.87 2.06 NA NA 21.73 23.01 090 24500 ......... ............ A Treat humerus fracture .................................. 3.21 4.38 4.74 3.75 3.71 0.50 8.09 8.45 7.46 7.42 090 24505 ......... ............ A Treat humerus fracture .................................. 5.16 5.78 6.41 4.82 5.26 0.89 11.83 12.46 10.87 11.31 090 24515 ......... ............ A Treat humerus fracture .................................. 11.87 NA NA 7.94 9.04 2.02 NA NA 21.83 22.93 090 24516 ......... ............ A Treat humerus fracture .................................. 11.99 NA NA 7.56 8.75 2.02 NA NA 21.57 22.76 090 24530 ......... ............ A Treat humerus fracture .................................. 3.49 4.67 5.08 3.94 4.02 0.57 8.73 9.14 8.00 8.08 090 24535 ......... ............ A Treat humerus fracture .................................. 6.86 6.73 7.58 5.77 6.42 1.18 14.77 15.62 13.81 14.46 090 24538 ......... ............ A Treat humerus fracture .................................. 9.54 NA NA 7.12 8.33 1.64 NA NA 18.30 19.51 090 24545 ......... ............ A Treat humerus fracture .................................. 10.80 NA NA 7.10 8.13 1.82 NA NA 19.72 20.75 090 24546 ......... ............ A Treat humerus fracture .................................. 15.91 NA NA 9.12 10.79 2.73 NA NA 27.76 29.43 090 24560 ......... ............ A Treat humerus fracture .................................. 2.80 4.00 4.37 3.33 3.23 0.44 7.24 7.61 6.57 6.47 090 24565 ......... ............ A Treat humerus fracture .................................. 5.55 5.76 6.41 4.88 5.38 0.93 12.24 12.89 11.36 11.86 090 24566 ......... ............ A Treat humerus fracture .................................. 8.78 NA NA 6.86 7.85 1.30 NA NA 16.94 17.93 090 24575 ......... ............ A Treat humerus fracture .................................. 10.94 NA NA 7.15 8.10 1.86 NA NA 19.95 20.90 090 24576 ......... ............ A Treat humerus fracture .................................. 2.86 4.38 4.67 3.68 3.71 0.46 7.70 7.99 7.00 7.03 090 24577 ......... ............ A Treat humerus fracture .................................. 5.78 5.95 6.70 5.01 5.65 0.95 12.68 13.43 11.74 12.38 090 24579 ......... ............ A Treat humerus fracture .................................. 11.88 NA NA 7.53 8.53 2.02 NA NA 21.43 22.43 090 24582 ......... ............ A Treat humerus fracture .................................. 9.79 NA NA 8.07 8.87 1.48 NA NA 19.34 20.14 090 24586 ......... ............ A Treat elbow fracture ...................................... 15.55 NA NA 9.18 10.74 2.64 NA NA 27.37 28.93 090 24587 ......... ............ A Treat elbow fracture ...................................... 15.56 NA NA 9.23 10.60 2.52 NA NA 27.31 28.68 090 24600 ......... ............ A Treat elbow dislocation ................................. 4.22 3.82 4.61 3.24 3.44 0.50 8.54 9.33 7.96 8.16 090 24605 ......... ............ A Treat elbow dislocation ................................. 5.41 NA NA 4.88 5.26 0.89 NA NA 11.18 11.56 090 24615 ......... ............ A Treat elbow dislocation ................................. 9.65 NA NA 6.46 7.50 1.60 NA NA 17.71 18.75 090 24620 ......... ............ A Treat elbow fracture ...................................... 6.97 NA NA 5.38 6.05 1.07 NA NA 13.42 14.09 090 24635 ......... ............ A Treat elbow fracture ...................................... 13.47 NA NA 10.05 13.08 2.28 NA NA 25.80 28.83 090 24640 ......... ............ A Treat elbow dislocation ................................. 1.20 1.46 1.75 0.79 0.80 0.12 2.78 3.07 2.11 2.12 010 24650 ......... ............ A Treat radius fracture ...................................... 2.16 3.39 3.69 2.96 2.81 0.35 5.90 6.20 5.47 5.32 090 24655 ......... ............ A Treat radius fracture ...................................... 4.39 5.13 5.76 4.35 4.69 0.70 10.22 10.85 9.44 9.78 090 24665 ......... ............ A Treat radius fracture ...................................... 8.13 NA NA 6.23 7.21 1.41 NA NA 15.77 16.75 090 24666 ......... ............ A Treat radius fracture ...................................... 9.66 NA NA 6.68 7.74 1.62 NA NA 17.96 19.02 090 24670 ......... ............ A Treat ulnar fracture ........................................ 2.54 3.68 4.01 3.11 3.09 0.41 6.63 6.96 6.06 6.04 090 24675 ......... ............ A Treat ulnar fracture ........................................ 4.71 5.24 5.83 4.44 4.85 0.81 10.76 11.35 9.96 10.37 090 24685 ......... ............ A Treat ulnar fracture ........................................ 8.85 NA NA 6.17 7.20 1.52 NA NA 16.54 17.57 090 24800 ......... ............ A Fusion of elbow joint ..................................... 11.18 NA NA 7.51 8.46 1.63 NA NA 20.32 21.27 090 24802 ......... ............ A Fusion/graft of elbow joint ............................. 14.09 NA NA 8.42 9.91 2.37 NA NA 24.88 26.37 090 24900 ......... ............ A Amputation of upper arm .............................. 9.95 NA NA 6.38 6.91 1.53 NA NA 17.86 18.39 090 24920 ......... ............ A Amputation of upper arm .............................. 9.95 NA NA 6.28 6.79 1.61 NA NA 17.84 18.35 090 24925 ......... ............ A Amputation follow-up surgery ........................ 7.12 NA NA 4.92 5.81 1.14 NA NA 13.18 14.07 09024930 ......... ............ A Amputation follow-up surgery ........................ 10.65 NA NA 5.88 6.92 1.67 NA NA 18.20 19.24 090 24931 ......... ............ A Amputate upper arm & implant ..................... 13.24 NA NA 8.08 6.33 1.89 NA NA 23.21 21.46 090 24935 ......... ............ A Revision of amputation .................................. 16.20 NA NA 7.29 7.85 2.13 NA NA 25.62 26.18 090 25000 ......... ............ A Incision of tendon sheath .............................. 3.37 NA NA 4.99 6.42 0.55 NA NA 8.91 10.34 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37276 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

25001 ......... ............ A Incise flexor carpi radialis .............................. 3.62 NA NA 3.79 4.13 0.55 NA NA 7.96 8.30 090 25020 ......... ............ A Decompress forearm 1 space ....................... 5.91 NA NA 6.81 8.90 0.93 NA NA 13.65 15.74 090 25023 ......... ............ A Decompress forearm 1 space ....................... 13.60 NA NA 11.31 14.06 2.03 NA NA 26.94 29.69 09025024 ......... ............ A Decompress forearm 2 spaces ..................... 10.52 NA NA 7.11 7.40 1.36 NA NA 18.99 19.28 090 25025 ......... ............ A Decompress forearm 2 spaces ..................... 17.67 NA NA 8.92 9.73 1.82 NA NA 28.41 29.22 090 25028 ......... ............ A Drainage of forearm lesion ............................ 5.24 NA NA 6.19 7.68 0.81 NA NA 12.24 13.73 090 25031 ......... ............ A Drainage of forearm bursa ............................ 4.13 NA NA 5.40 7.31 0.63 NA NA 10.16 12.07 090 25035 ......... ............ A Treat forearm bone lesion ............................. 7.47 NA NA 8.75 12.41 1.24 NA NA 17.46 21.12 090 25040 ......... ............ A Explore/treat wrist joint .................................. 7.35 NA NA 5.80 6.94 1.15 NA NA 14.30 15.44 090 25065 ......... ............ A Biopsy forearm soft tissues ........................... 1.99 4.23 3.48 1.92 1.91 0.15 6.37 5.62 4.06 4.05 010 25066 ......... ............ A Biopsy forearm soft tissues ........................... 4.12 NA NA 5.39 6.66 0.64 NA NA 10.15 11.42 090 25075 ......... ............ A Removal forearm lesion subcu ..................... 3.73 NA NA 4.86 5.65 0.55 NA NA 9.14 9.93 090 25076 ......... ............ A Removal forearm lesion deep ....................... 4.91 NA NA 6.83 8.89 0.74 NA NA 12.48 14.54 090 25077 ......... ............ A Remove tumor, forearm/wrist ........................ 9.81 NA NA 8.82 11.30 1.42 NA NA 20.05 22.53 09025085 ......... ............ A Incision of wrist capsule ................................ 5.49 NA NA 5.36 6.70 0.85 NA NA 11.70 13.04 090 25100 ......... ............ A Biopsy of wrist joint ....................................... 3.89 NA NA 4.21 5.02 0.59 NA NA 8.69 9.50 090 25101 ......... ............ A Explore/treat wrist joint .................................. 4.68 NA NA 4.75 5.62 0.75 NA NA 10.18 11.05 090 25105 ......... ............ A Remove wrist joint lining ............................... 5.84 NA NA 5.73 6.92 0.92 NA NA 12.49 13.68 090 25107 ......... ............ A Remove wrist joint cartilage .......................... 7.42 NA NA 7.04 8.03 0.99 NA NA 15.45 16.44 090 25110 ......... ............ A Remove wrist tendon lesion .......................... 3.91 NA NA 5.23 6.61 0.62 NA NA 9.76 11.14 090 25111 ......... ............ A Remove wrist tendon lesion .......................... 3.38 NA NA 4.05 4.55 0.53 NA NA 7.96 8.46 090 25112 ......... ............ A Reremove wrist tendon lesion ....................... 4.52 NA NA 4.47 5.07 0.70 NA NA 9.69 10.29 090 25115 ......... ............ A Remove wrist/forearm lesion ......................... 9.81 NA NA 10.05 13.07 1.31 NA NA 21.17 24.19 090 25116 ......... ............ A Remove wrist/forearm lesion ......................... 7.28 NA NA 8.95 12.12 1.11 NA NA 17.34 20.51 090 25118 ......... ............ A Excise wrist tendon sheath ........................... 4.36 NA NA 4.56 5.46 0.68 NA NA 9.60 10.50 09025119 ......... ............ A Partial removal of ulna .................................. 6.03 NA NA 5.77 7.16 0.96 NA NA 12.76 14.15 090 25120 ......... ............ A Removal of forearm lesion ............................ 6.09 NA NA 7.82 11.05 1.00 NA NA 14.91 18.14 090 25125 ......... ............ A Remove/graft forearm lesion ......................... 7.47 NA NA 8.63 11.82 1.06 NA NA 17.16 20.35 090 25126 ......... ............ A Remove/graft forearm lesion ......................... 7.54 NA NA 8.65 11.95 1.27 NA NA 17.46 20.76 090 25130 ......... ............ A Removal of wrist lesion ................................. 5.25 NA NA 5.13 6.11 0.80 NA NA 11.18 12.16 090 25135 ......... ............ A Remove & graft wrist lesion .......................... 6.88 NA NA 6.02 7.15 1.02 NA NA 13.92 15.05 090 25136 ......... ............ A Remove & graft wrist lesion .......................... 5.96 NA NA 5.44 6.32 1.03 NA NA 12.43 13.31 090 25145 ......... ............ A Remove forearm bone lesion ........................ 6.36 NA NA 8.00 11.07 1.01 NA NA 15.37 18.44 090 25150 ......... ............ A Partial removal of ulna .................................. 7.20 NA NA 6.27 7.74 1.14 NA NA 14.61 16.08 090 25151 ......... ............ A Partial removal of radius ............................... 7.50 NA NA 8.39 11.67 1.18 NA NA 17.07 20.35 090 25170 ......... ............ A Extensive forearm surgery ............................ 11.25 NA NA 10.37 13.99 1.77 NA NA 23.39 27.01 090 25210 ......... ............ A Removal of wrist bone .................................. 5.94 NA NA 5.44 6.47 0.88 NA NA 12.26 13.29 090 25215 ......... ............ A Removal of wrist bones ................................. 7.94 NA NA 6.72 8.27 1.19 NA NA 15.85 17.40 090 25230 ......... ............ A Partial removal of radius ............................... 5.22 NA NA 4.88 5.84 0.79 NA NA 10.89 11.85 090 25240 ......... ............ A Partial removal of ulna .................................. 5.16 NA NA 5.19 6.53 0.81 NA NA 11.16 12.50 090 25246 ......... ............ A Injection for wrist x-ray .................................. 1.45 2.80 3.29 0.51 0.49 0.09 4.34 4.83 2.05 2.03 000 25248 ......... ............ A Remove forearm foreign body ...................... 5.13 NA NA 6.50 8.03 0.72 NA NA 12.35 13.88 090 25250 ......... ............ A Removal of wrist prosthesis .......................... 6.59 NA NA 5.23 5.90 1.01 NA NA 12.83 13.50 090 25251 ......... ............ A Removal of wrist prosthesis .......................... 9.62 NA NA 6.59 7.60 1.26 NA NA 17.47 18.48 090 25259 ......... ............ A Manipulate wrist w/anesthes ......................... 3.74 NA NA 5.06 5.57 0.62 NA NA 9.42 9.93 090 25260 ......... ............ A Repair forearm tendon/muscle ...................... 7.79 NA NA 9.08 12.28 1.19 NA NA 18.06 21.26 090 25263 ......... ............ A Repair forearm tendon/muscle ...................... 7.81 NA NA 8.83 12.18 1.18 NA NA 17.82 21.17 090 25265 ......... ............ A Repair forearm tendon/muscle ...................... 9.87 NA NA 9.85 13.23 1.47 NA NA 21.19 24.57 090 25270 ......... ............ A Repair forearm tendon/muscle ...................... 5.99 NA NA 7.78 10.99 0.95 NA NA 14.72 17.93 090 25272 ......... ............ A Repair forearm tendon/muscle ...................... 7.03 NA NA 8.25 11.69 1.11 NA NA 16.39 19.83 090 25274 ......... ............ A Repair forearm tendon/muscle ...................... 8.74 NA NA 9.06 12.51 1.36 NA NA 19.16 22.61 090 25275 ......... ............ A Repair forearm tendon sheath ...................... 8.74 NA NA 6.38 7.30 1.31 NA NA 16.43 17.35 090 25280 ......... ............ A Revise wrist/forearm tendon ......................... 7.21 NA NA 8.33 11.59 1.08 NA NA 16.62 19.88 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37277 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

25290 ......... ............ A Incise wrist/forearm tendon ........................... 5.28 NA NA 9.05 13.54 0.82 NA NA 15.15 19.64 090 25295 ......... ............ A Release wrist/forearm tendon ....................... 6.54 NA NA 8.02 11.15 1.00 NA NA 15.56 18.69 09025300 ......... ............ A Fusion of tendons at wrist ............................. 8.79 NA NA 7.06 8.12 1.26 NA NA 17.11 18.17 090 25301 ......... ............ A Fusion of tendons at wrist ............................. 8.39 NA NA 6.61 7.71 1.29 NA NA 16.29 17.39 090 25310 ......... ............ A Transplant forearm tendon ............................ 8.19 NA NA 8.68 11.97 1.21 NA NA 18.08 21.37 090 25312 ......... ............ A Transplant forearm tendon ............................ 9.62 NA NA 9.46 12.85 1.41 NA NA 20.49 23.88 090 25315 ......... ............ A Revise palsy hand tendon(s) ........................ 10.48 NA NA 9.82 13.29 1.58 NA NA 21.88 25.35 090 25316 ......... ............ A Revise palsy hand tendon(s) ........................ 12.67 NA NA 10.89 14.93 1.74 NA NA 25.30 29.34 090 25320 ......... ............ A Repair/revise wrist joint ................................. 12.28 NA NA 10.20 11.12 1.61 NA NA 24.09 25.01 090 25332 ......... ............ A Revise wrist joint ........................................... 11.51 NA NA 7.59 8.80 1.83 NA NA 20.93 22.14 090 25335 ......... ............ A Realignment of hand ..................................... 13.16 NA NA 6.87 10.43 1.92 NA NA 21.95 25.51 090 25337 ......... ............ A Reconstruct ulna/radioulnar .......................... 11.36 NA NA 9.24 10.64 1.61 NA NA 22.21 23.61 090 25350 ......... ............ A Revision of radius .......................................... 8.89 NA NA 9.12 12.79 1.46 NA NA 19.47 23.14 090 25355 ......... ............ A Revision of radius .......................................... 10.33 NA NA 9.86 13.45 1.73 NA NA 21.92 25.51 090 25360 ......... ............ A Revision of ulna ............................................. 8.54 NA NA 8.99 12.68 1.41 NA NA 18.94 22.63 090 25365 ......... ............ A Revise radius & ulna ..................................... 12.68 NA NA 10.88 14.49 2.15 NA NA 25.71 29.32 090 25370 ......... ............ A Revise radius or ulna .................................... 13.82 NA NA 11.76 15.03 2.28 NA NA 27.86 31.13 090 25375 ......... ............ A Revise radius & ulna ..................................... 13.32 NA NA 11.14 15.14 2.26 NA NA 26.72 30.72 090 25390 ......... ............ A Shorten radius or ulna ................................... 10.50 NA NA 9.78 13.41 1.65 NA NA 21.93 25.56 090 25391 ......... ............ A Lengthen radius or ulna ................................ 14.05 NA NA 11.46 15.32 2.21 NA NA 27.72 31.58 090 25392 ......... ............ A Shorten radius & ulna ................................... 14.35 NA NA 11.59 14.91 2.10 NA NA 28.04 31.36 090 25393 ......... ............ A Lengthen radius & ulna ................................. 16.33 NA NA 12.90 16.45 2.76 NA NA 31.99 35.54 090 25394 ......... ............ A Repair carpal bone, shorten .......................... 10.63 NA NA 6.67 7.73 1.59 NA NA 18.89 19.95 090 25400 ......... ............ A Repair radius or ulna ..................................... 11.08 NA NA 10.01 13.93 1.82 NA NA 22.91 26.83 090 25405 ......... ............ A Repair/graft radius or ulna ............................ 14.78 NA NA 11.72 15.92 2.32 NA NA 28.82 33.02 090 25415 ......... ............ A Repair radius & ulna ..................................... 13.57 NA NA 10.81 15.12 2.17 NA NA 26.55 30.86 090 25420 ......... ............ A Repair/graft radius & ulna ............................. 16.79 NA NA 12.55 16.88 2.61 NA NA 31.95 36.28 090 25425 ......... ............ A Repair/graft radius or ulna ............................ 13.49 NA NA 13.91 19.57 2.08 NA NA 29.48 35.14 090 25426 ......... ............ A Repair/graft radius & ulna ............................. 16.22 NA NA 12.27 15.52 2.54 NA NA 31.03 34.28 090 25430 ......... ............ A Vasc graft into carpal bone ........................... 9.49 NA NA 6.67 7.19 1.27 NA NA 17.43 17.95 090 25431 ......... ............ A Repair nonunion carpal bone ........................ 10.67 NA NA 7.13 8.10 1.90 NA NA 19.70 20.67 09025440 ......... ............ A Repair/graft wrist bone .................................. 10.48 NA NA 7.36 8.91 1.63 NA NA 19.47 21.02 090 25441 ......... ............ A Reconstruct wrist joint ................................... 13.06 NA NA 8.32 9.60 2.07 NA NA 23.45 24.73 090 25442 ......... ............ A Reconstruct wrist joint ................................... 10.89 NA NA 7.19 8.48 1.53 NA NA 19.61 20.90 090 25443 ......... ............ A Reconstruct wrist joint ................................... 10.43 NA NA 6.54 8.24 1.37 NA NA 18.34 20.04 090 25444 ......... ............ A Reconstruct wrist joint ................................... 11.19 NA NA 7.51 8.67 1.71 NA NA 20.41 21.57 090 25445 ......... ............ A Reconstruct wrist joint ................................... 9.68 NA NA 6.59 7.66 1.55 NA NA 17.82 18.89 090 25446 ......... ............ A Wrist replacement ......................................... 17.07 NA NA 9.68 11.38 2.47 NA NA 29.22 30.92 090 25447 ......... ............ A Repair wrist joint(s) ....................................... 10.85 NA NA 7.30 8.34 1.61 NA NA 19.76 20.80 090 25449 ......... ............ A Remove wrist joint implant ............................ 14.71 NA NA 8.87 10.24 2.21 NA NA 25.79 27.16 090 25450 ......... ............ A Revision of wrist joint .................................... 7.86 NA NA 7.22 9.47 1.36 NA NA 16.44 18.69 090 25455 ......... ............ A Revision of wrist joint .................................... 9.48 NA NA 6.38 9.76 0.96 NA NA 16.82 20.20 090 25490 ......... ............ A Reinforce radius ............................................ 9.53 NA NA 9.32 12.66 1.43 NA NA 20.28 23.62 090 25491 ......... ............ A Reinforce ulna ............................................... 9.95 NA NA 9.57 13.27 1.60 NA NA 21.12 24.82 090 25492 ......... ............ A Reinforce radius and ulna ............................. 12.43 NA NA 10.42 14.11 2.14 NA NA 24.99 28.68 090 25500 ......... ............ A Treat fracture of radius .................................. 2.45 3.29 3.51 2.85 2.75 0.35 6.09 6.31 5.65 5.55 090 25505 ......... ............ A Treat fracture of radius .................................. 5.20 5.78 6.37 4.93 5.31 0.90 11.88 12.47 11.03 11.41 090 25515 ......... ............ A Treat fracture of radius .................................. 9.29 NA NA 6.44 7.22 1.59 NA NA 17.32 18.10 090 25520 ......... ............ A Treat fracture of radius .................................. 6.25 5.89 6.63 5.31 5.89 1.08 13.22 13.96 12.64 13.22 090 25525 ......... ............ A Treat fracture of radius .................................. 12.59 NA NA 8.39 9.61 2.12 NA NA 23.10 24.32 090 25526 ......... ............ A Treat fracture of radius .................................. 13.33 NA NA 10.05 12.67 2.19 NA NA 25.57 28.19 090 25530 ......... ............ A Treat fracture of ulna ..................................... 2.09 3.43 3.69 2.92 2.88 0.34 5.86 6.12 5.35 5.31 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37278 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

25535 ......... ............ A Treat fracture of ulna ..................................... 5.13 5.60 5.92 4.85 5.20 0.89 11.62 11.94 10.87 11.22 090 25545 ......... ............ A Treat fracture of ulna ..................................... 9.01 NA NA 6.33 7.34 1.53 NA NA 16.87 17.88 090 25560 ......... ............ A Treat fracture radius & ulna .......................... 2.44 3.34 3.61 2.83 2.67 0.35 6.13 6.40 5.62 5.46 090 25565 ......... ............ A Treat fracture radius & ulna .......................... 5.62 5.88 6.51 4.90 5.31 0.93 12.43 13.06 11.45 11.86 090 25574 ......... ............ A Treat fracture radius & ulna .......................... 7.37 NA NA 6.34 7.00 1.21 NA NA 14.92 15.58 090 25575 ......... ............ A Treat fracture radius/ulna .............................. 11.92 NA NA 8.65 9.32 1.81 NA NA 22.38 23.05 090 25600 ......... ............ A Treat fracture radius/ulna .............................. 2.63 3.64 3.99 3.13 3.02 0.42 6.69 7.04 6.18 6.07 090 25605 ......... ............ A Treat fracture radius/ulna .............................. 6.92 6.80 7.14 6.08 6.20 1.00 14.72 15.06 14.00 14.12 090 25611 ......... ............ A Treat fracture radius/ulna .............................. 9.13 NA NA 8.01 8.75 1.34 NA NA 18.48 19.22 090 25620 ......... ............ A Treat fracture radius/ulna .............................. 8.54 NA NA 5.98 6.96 1.42 NA NA 15.94 16.92 090 25622 ......... ............ A Treat wrist bone fracture ............................... 2.61 3.85 4.17 3.31 3.16 0.41 6.87 7.19 6.33 6.18 090 25624 ......... ............ A Treat wrist bone fracture ............................... 4.52 5.52 6.12 4.67 4.98 0.76 10.80 11.40 9.95 10.26 090 25628 ......... ............ A Treat wrist bone fracture ............................... 9.42 NA NA 7.02 7.64 1.37 NA NA 17.81 18.43 090 25630 ......... ............ A Treat wrist bone fracture ............................... 2.88 3.71 4.07 3.20 3.01 0.45 7.04 7.40 6.53 6.34 090 25635 ......... ............ A Treat wrist bone fracture ............................... 4.38 5.31 5.80 4.50 4.06 0.74 10.43 10.92 9.62 9.18 090 25645 ......... ............ A Treat wrist bone fracture ............................... 7.24 NA NA 5.52 6.37 1.20 NA NA 13.96 14.81 090 25650 ......... ............ A Treat wrist bone fracture ............................... 3.05 3.80 4.19 3.40 3.24 0.45 7.30 7.69 6.90 6.74 090 25651 ......... ............ A Pin ulnar styloid fracture ............................... 5.60 NA NA 5.04 5.39 0.86 NA NA 11.50 11.85 090 25652 ......... ............ A Treat fracture ulnar styloid ............................ 7.84 NA NA 6.11 6.79 1.21 NA NA 15.16 15.84 090 25660 ......... ............ A Treat wrist dislocation ................................... 4.75 NA NA 4.42 4.65 0.58 NA NA 9.75 9.98 090 25670 ......... ............ A Treat wrist dislocation ................................... 7.91 NA NA 5.70 6.68 1.28 NA NA 14.89 15.87 090 25671 ......... ............ A Pin radioulnar dislocation .............................. 6.24 NA NA 5.44 5.99 1.00 NA NA 12.68 13.23 090 25675 ......... ............ A Treat wrist dislocation ................................... 4.66 4.82 5.46 4.09 4.52 0.62 10.10 10.74 9.37 9.80 090 25676 ......... ............ A Treat wrist dislocation ................................... 8.09 NA NA 6.05 7.00 1.34 NA NA 15.48 16.43 090 25680 ......... ............ A Treat wrist fracture ........................................ 5.98 NA NA 4.29 4.64 0.78 NA NA 11.05 11.40 090 25685 ......... ............ A Treat wrist fracture ........................................ 9.89 NA NA 6.38 7.46 1.60 NA NA 17.87 18.95 090 25690 ......... ............ A Treat wrist dislocation ................................... 5.49 NA NA 4.76 5.33 0.88 NA NA 11.13 11.70 090 25695 ......... ............ A Treat wrist dislocation ................................... 8.33 NA NA 5.90 6.81 1.32 NA NA 15.55 16.46 090 25800 ......... ............ A Fusion of wrist joint ....................................... 9.87 NA NA 7.15 8.63 1.57 NA NA 18.59 20.07 090 25805 ......... ............ A Fusion/graft of wrist joint ............................... 11.50 NA NA 8.02 9.72 1.80 NA NA 21.32 23.02 090 25810 ......... ............ A Fusion/graft of wrist joint ............................... 11.67 NA NA 8.40 9.55 1.67 NA NA 21.74 22.89 090 25820 ......... ............ A Fusion of hand bones ................................... 7.44 NA NA 6.18 7.45 1.22 NA NA 14.84 16.11 090 25825 ......... ............ A Fuse hand bones with graft .......................... 9.44 NA NA 7.43 8.80 1.41 NA NA 18.28 19.65 09025830 ......... ............ A Fusion, radioulnar jnt/ulna ............................. 10.61 NA NA 10.30 13.41 1.55 NA NA 22.46 25.57 090 25900 ......... ............ A Amputation of forearm ................................... 9.36 NA NA 9.16 11.74 1.30 NA NA 19.82 22.40 090 25905 ......... ............ A Amputation of forearm ................................... 9.41 NA NA 8.39 11.35 1.40 NA NA 19.20 22.16 090 25907 ......... ............ A Amputation follow-up surgery ........................ 7.91 NA NA 7.75 10.78 1.10 NA NA 16.76 19.79 090 25909 ......... ............ A Amputation follow-up surgery ........................ 9.13 NA NA 8.90 11.46 1.44 NA NA 19.47 22.03 090 25915 ......... ............ A Amputation of forearm ................................... 17.30 NA NA 8.05 16.21 2.93 NA NA 28.28 36.44 090 25920 ......... ............ A Amputate hand at wrist ................................. 8.85 NA NA 6.61 7.56 1.35 NA NA 16.81 17.76 090 25922 ......... ............ A Amputate hand at wrist ................................. 7.47 NA NA 6.27 6.87 1.12 NA NA 14.86 15.46 090 25924 ......... ............ A Amputation follow-up surgery ........................ 8.63 NA NA 6.58 7.73 1.32 NA NA 16.53 17.68 09025927 ......... ............ A Amputation of hand ....................................... 8.91 NA NA 8.51 10.91 1.27 NA NA 18.69 21.09 090 25929 ......... ............ A Amputation follow-up surgery ........................ 7.64 NA NA 5.30 5.74 1.14 NA NA 14.08 14.52 09025931 ......... ............ A Amputation follow-up surgery ........................ 7.86 NA NA 8.38 10.71 1.15 NA NA 17.39 19.72 090 26010 ......... ............ A Drainage of finger abscess ........................... 1.54 3.98 5.18 1.49 1.60 0.18 5.70 6.90 3.21 3.32 010 26011 ......... ............ A Drainage of finger abscess ........................... 2.19 6.22 8.19 1.95 2.24 0.33 8.74 10.71 4.47 4.76 010 26020 ......... ............ A Drain hand tendon sheath ............................. 4.90 NA NA 4.67 5.20 0.73 NA NA 10.30 10.83 090 26025 ......... ............ A Drainage of palm bursa ................................. 4.93 NA NA 4.38 4.94 0.76 NA NA 10.07 10.63 090 26030 ......... ............ A Drainage of palm bursa(s) ............................ 6.10 NA NA 4.90 5.53 0.92 NA NA 11.92 12.55 090 26034 ......... ............ A Treat hand bone lesion ................................. 6.40 NA NA 5.46 6.14 1.01 NA NA 12.87 13.55 090 26035 ......... ............ A Decompress fingers/hand ............................. 11.04 NA NA 7.85 7.88 1.47 NA NA 20.36 20.39 090 26037 ......... ............ A Decompress fingers/hand ............................. 7.42 NA NA 5.41 6.11 1.13 NA NA 13.96 14.66 090

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37279 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

26040 ......... ............ A Release palm contracture ............................. 3.33 NA NA 3.54 3.93 0.53 NA NA 7.40 7.79 090 26045 ......... ............ A Release palm contracture ............................. 5.55 NA NA 4.80 5.45 0.93 NA NA 11.28 11.93 090 26055 ......... ............ A Incise finger tendon sheath ........................... 2.94 8.65 12.96 3.45 3.83 0.43 12.02 16.33 6.82 7.20 090 26060 ......... ............ A Incision of finger tendon ................................ 2.81 NA NA 3.00 3.39 0.45 NA NA 6.26 6.65 090 26070 ......... ............ A Explore/treat hand joint ................................. 3.68 NA NA 2.99 3.28 0.48 NA NA 7.15 7.44 090 26075 ......... ............ A Explore/treat finger joint ................................ 3.78 NA NA 3.36 3.68 0.53 NA NA 7.67 7.99 090 26080 ......... ............ A Explore/treat finger joint ................................ 4.29 NA NA 4.27 4.71 0.66 NA NA 9.22 9.66 090 26100 ......... ............ A Biopsy hand joint lining ................................. 3.66 NA NA 3.52 3.99 0.54 NA NA 7.72 8.19 090 26105 ......... ............ A Biopsy finger joint lining ................................ 3.70 NA NA 3.68 4.10 0.59 NA NA 7.97 8.39 090 26110 ......... ............ A Biopsy finger joint lining ................................ 3.52 NA NA 3.54 3.92 0.53 NA NA 7.59 7.97 090 26115 ......... ............ A Removal hand lesion subcut ......................... 3.85 9.73 12.28 4.16 4.63 0.59 14.17 16.72 8.60 9.07 090 26116 ......... ............ A Removal hand lesion, deep .......................... 5.52 NA NA 5.21 5.82 0.84 NA NA 11.57 12.18 090 26117 ......... ............ A Remove tumor, hand/finger ........................... 8.54 NA NA 6.09 6.83 1.26 NA NA 15.89 16.63 09026121 ......... ............ A Release palm contracture ............................. 7.53 NA NA 5.83 6.69 1.17 NA NA 14.53 15.39 090 26123 ......... ............ A Release palm contracture ............................. 10.53 NA NA 8.08 8.68 1.43 NA NA 20.04 20.64 090 26125 ......... ............ A Release palm contracture ............................. 4.60 NA NA 1.85 2.30 0.70 NA NA 7.15 7.60 ZZZ 26130 ......... ............ A Remove wrist joint lining ............................... 5.41 NA NA 4.76 5.21 0.94 NA NA 11.11 11.56 090 26135 ......... ............ A Revise finger joint, each ................................ 6.95 NA NA 5.39 6.21 1.07 NA NA 13.41 14.23 090 26140 ......... ............ A Revise finger joint, each ................................ 6.16 NA NA 5.08 5.82 0.92 NA NA 12.16 12.90 090 26145 ......... ............ A Tendon excision, palm/finger ........................ 6.31 NA NA 5.10 5.83 0.97 NA NA 12.38 13.11 09026160 ......... ............ A Remove tendon sheath lesion ...................... 3.40 8.79 11.51 3.73 4.03 0.49 12.68 15.40 7.62 7.92 090 26170 ......... ............ A Removal of palm tendon, each ..................... 4.76 NA NA 4.29 4.79 0.69 NA NA 9.74 10.24 090 26180 ......... ............ A Removal of finger tendon .............................. 5.17 NA NA 4.69 5.25 0.78 NA NA 10.64 11.20 090 26185 ......... ............ A Remove finger bone ...................................... 6.24 NA NA 5.72 5.97 0.81 NA NA 12.77 13.02 090 26200 ......... ............ A Remove hand bone lesion ............................ 5.50 NA NA 4.51 5.16 0.88 NA NA 10.89 11.54 090 26205 ......... ............ A Remove/graft bone lesion ............................. 7.75 NA NA 5.75 6.62 1.20 NA NA 14.70 15.57 090 26210 ......... ............ A Removal of finger lesion ............................... 5.14 NA NA 4.67 5.25 0.79 NA NA 10.60 11.18 090 26215 ......... ............ A Remove/graft finger lesion ............................ 7.09 NA NA 5.46 6.11 0.98 NA NA 13.53 14.18 090 26230 ......... ............ A Partial removal of hand bone ........................ 6.32 NA NA 4.92 5.68 1.01 NA NA 12.25 13.01 09026235 ......... ............ A Partial removal, finger bone .......................... 6.18 NA NA 4.87 5.59 0.95 NA NA 12.00 12.72 090 26236 ......... ............ A Partial removal, finger bone .......................... 5.31 NA NA 4.47 5.12 0.81 NA NA 10.59 11.24 090 26250 ......... ............ A Extensive hand surgery ................................. 7.54 NA NA 5.14 6.12 1.07 NA NA 13.75 14.73 090 26255 ......... ............ A Extensive hand surgery ................................. 12.71 NA NA 8.22 9.11 1.68 NA NA 22.61 23.50 090 26260 ......... ............ A Extensive finger surgery ................................ 7.02 NA NA 5.27 5.97 1.01 NA NA 13.30 14.00 090 26261 ......... ............ A Extensive finger surgery ................................ 9.20 NA NA 6.74 6.33 1.14 NA NA 17.08 16.67 090 26262 ......... ............ A Partial removal of finger ................................ 5.66 NA NA 4.58 5.16 0.88 NA NA 11.12 11.70 090 26320 ......... ............ A Removal of implant from hand ...................... 3.97 NA NA 3.71 4.17 0.59 NA NA 8.27 8.73 090 26340 ......... ............ A Manipulate finger w/anesth ........................... 2.50 NA NA 4.54 4.80 0.39 NA NA 7.43 7.69 090 26350 ......... ............ A Repair finger/hand tendon ............................. 5.98 NA NA 9.32 13.32 0.93 NA NA 16.23 20.23 090 26352 ......... ............ A Repair/graft hand tendon .............................. 7.67 NA NA 9.89 14.02 1.13 NA NA 18.69 22.82 090 26356 ......... ............ A Repair finger/hand tendon ............................. 10.06 NA NA 13.47 17.18 1.21 NA NA 24.74 28.45 090 26357 ......... ............ A Repair finger/hand tendon ............................. 8.57 NA NA 10.13 14.29 1.33 NA NA 20.03 24.19 090 26358 ......... ............ A Repair/graft hand tendon .............................. 9.13 NA NA 10.64 15.18 1.38 NA NA 21.15 25.69 090 26370 ......... ............ A Repair finger/hand tendon ............................. 7.10 NA NA 9.36 13.70 1.12 NA NA 17.58 21.92 090 26372 ......... ............ A Repair/graft hand tendon .............................. 8.81 NA NA 10.32 15.02 1.40 NA NA 20.53 25.23 090 26373 ......... ............ A Repair finger/hand tendon ............................. 8.21 NA NA 10.01 14.57 1.23 NA NA 19.45 24.01 090 26390 ......... ............ A Revise hand/finger tendon ............................ 9.24 NA NA 8.93 12.22 1.40 NA NA 19.57 22.86 090 26392 ......... ............ A Repair/graft hand tendon .............................. 10.30 NA NA 10.84 15.29 1.57 NA NA 22.71 27.16 090 26410 ......... ............ A Repair hand tendon ....................................... 4.62 NA NA 7.46 10.84 0.73 NA NA 12.81 16.19 090 26412 ......... ............ A Repair/graft hand tendon .............................. 6.30 NA NA 8.45 12.10 0.97 NA NA 15.72 19.37 090 26415 ......... ............ A Excision, hand/finger tendon ......................... 8.33 NA NA 6.64 10.52 0.98 NA NA 15.95 19.83 090 26416 ......... ............ A Graft hand or finger tendon ........................... 9.36 NA NA 8.62 13.13 0.79 NA NA 18.77 23.28 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37280 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

26418 ......... ............ A Repair finger tendon ...................................... 4.24 NA NA 7.97 11.26 0.67 NA NA 12.88 16.17 090 26420 ......... ............ A Repair/graft finger tendon ............................. 6.76 NA NA 8.61 12.41 1.07 NA NA 16.44 20.24 090 26426 ......... ............ A Repair finger/hand tendon ............................. 6.14 NA NA 8.40 12.00 0.95 NA NA 15.49 19.09 090 26428 ......... ............ A Repair/graft finger tendon ............................. 7.20 NA NA 9.05 12.69 1.09 NA NA 17.34 20.98 090 26432 ......... ............ A Repair finger tendon ...................................... 4.01 NA NA 6.62 9.37 0.64 NA NA 11.27 14.02 090 26433 ......... ............ A Repair finger tendon ...................................... 4.55 NA NA 6.83 9.82 0.72 NA NA 12.10 15.09 090 26434 ......... ............ A Repair/graft finger tendon ............................. 6.08 NA NA 7.75 10.62 0.93 NA NA 14.76 17.63 090 26437 ......... ............ A Realignment of tendons ................................ 5.81 NA NA 7.61 10.60 0.89 NA NA 14.31 17.30 090 26440 ......... ............ A Release palm/finger tendon .......................... 5.01 NA NA 8.32 12.18 0.75 NA NA 14.08 17.94 090 26442 ......... ............ A Release palm & finger tendon ...................... 9.40 NA NA 11.44 14.85 1.20 NA NA 22.04 25.45 09026445 ......... ............ A Release hand/finger tendon .......................... 4.30 NA NA 8.00 11.89 0.65 NA NA 12.95 16.84 090 26449 ......... ............ A Release forearm/hand tendon ....................... 8.24 NA NA 11.14 14.65 1.06 NA NA 20.44 23.95 09026450 ......... ............ A Incision of palm tendon ................................. 3.66 NA NA 5.04 6.77 0.59 NA NA 9.29 11.02 090 26455 ......... ............ A Incision of finger tendon ................................ 3.63 NA NA 4.99 6.72 0.58 NA NA 9.20 10.93 090 26460 ......... ............ A Incise hand/finger tendon .............................. 3.45 NA NA 4.94 6.61 0.55 NA NA 8.94 10.61 090 26471 ......... ............ A Fusion of finger tendons ............................... 5.72 NA NA 7.55 10.34 0.88 NA NA 14.15 16.94 090 26474 ......... ............ A Fusion of finger tendons ............................... 5.31 NA NA 7.38 10.41 0.76 NA NA 13.45 16.48 090 26476 ......... ............ A Tendon lengthening ...................................... 5.17 NA NA 7.29 10.04 0.79 NA NA 13.25 16.00 090 26477 ......... ............ A Tendon shortening ........................................ 5.14 NA NA 7.37 10.16 0.81 NA NA 13.32 16.11 090 26478 ......... ............ A Lengthening of hand tendon ......................... 5.79 NA NA 7.56 10.79 0.90 NA NA 14.25 17.48 09026479 ......... ............ A Shortening of hand tendon ............................ 5.73 NA NA 7.54 10.58 0.92 NA NA 14.19 17.23 090 26480 ......... ............ A Transplant hand tendon ................................ 6.68 NA NA 9.44 13.67 1.02 NA NA 17.14 21.37 090 26483 ......... ............ A Transplant/graft hand tendon ........................ 8.28 NA NA 10.07 14.17 1.26 NA NA 19.61 23.71 090 26485 ......... ............ A Transplant palm tendon ................................ 7.69 NA NA 9.79 14.00 1.15 NA NA 18.63 22.84 090 26489 ......... ............ A Transplant/graft palm tendon ........................ 9.66 NA NA 10.13 11.60 1.26 NA NA 21.05 22.52 090 26490 ......... ............ A Revise thumb tendon .................................... 8.40 NA NA 8.75 11.83 1.21 NA NA 18.36 21.44 090 26492 ......... ............ A Tendon transfer with graft ............................. 9.61 NA NA 9.61 12.63 1.40 NA NA 20.62 23.64 090 26494 ......... ............ A Hand tendon/muscle transfer ........................ 8.46 NA NA 8.87 11.98 1.28 NA NA 18.61 21.72 09026496 ......... ............ A Revise thumb tendon .................................... 9.58 NA NA 9.30 12.28 1.45 NA NA 20.33 23.31 090 26497 ......... ............ A Finger tendon transfer ................................... 9.56 NA NA 9.27 12.53 1.41 NA NA 20.24 23.50 090 26498 ......... ............ A Finger tendon transfer ................................... 13.98 NA NA 11.28 14.98 2.10 NA NA 27.36 31.06 090 26499 ......... ............ A Revision of finger .......................................... 8.97 NA NA 8.61 11.96 1.35 NA NA 18.93 22.28 090 26500 ......... ............ A Hand tendon reconstruction .......................... 5.95 NA NA 7.62 10.51 0.90 NA NA 14.47 17.36 090 26502 ......... ............ A Hand tendon reconstruction .......................... 7.13 NA NA 8.20 11.09 1.13 NA NA 16.46 19.35 090 26504 ......... ............ A Hand tendon reconstruction .......................... 7.46 NA NA 8.46 11.58 1.24 NA NA 17.16 20.28 090 26508 ......... ............ A Release thumb contracture ........................... 6.00 NA NA 7.64 10.69 0.98 NA NA 14.62 17.67 090 26510 ......... ............ A Thumb tendon transfer .................................. 5.42 NA NA 7.46 10.39 0.79 NA NA 13.67 16.60 090 26516 ......... ............ A Fusion of knuckle joint .................................. 7.14 NA NA 8.11 11.23 1.10 NA NA 16.35 19.47 090 26517 ......... ............ A Fusion of knuckle joints ................................. 8.88 NA NA 9.07 12.42 1.41 NA NA 19.36 22.71 090 26518 ......... ............ A Fusion of knuckle joints ................................. 9.07 NA NA 9.09 12.35 1.35 NA NA 19.51 22.77 090 26520 ......... ............ A Release knuckle contracture ......................... 5.29 NA NA 8.69 12.62 0.80 NA NA 14.78 18.71 090 26525 ......... ............ A Release finger contracture ............................ 5.32 NA NA 8.70 12.68 0.81 NA NA 14.83 18.81 090 26530 ......... ............ A Revise knuckle joint ...................................... 6.68 NA NA 5.33 5.95 1.04 NA NA 13.05 13.67 090 26531 ......... ............ A Revise knuckle with implant .......................... 7.90 NA NA 6.05 6.87 1.17 NA NA 15.12 15.94 090 26535 ......... ............ A Revise finger joint .......................................... 5.23 NA NA 3.97 3.81 0.71 NA NA 9.91 9.75 090 26536 ......... ............ A Revise/implant finger joint ............................. 6.36 NA NA 9.02 9.52 0.96 NA NA 16.34 16.84 090 26540 ......... ............ A Repair hand joint ........................................... 6.42 NA NA 7.86 10.89 0.99 NA NA 15.27 18.30 090 26541 ......... ............ A Repair hand joint with graft ........................... 8.61 NA NA 8.90 12.30 1.28 NA NA 18.79 22.19 090 26542 ......... ............ A Repair hand joint with graft ........................... 6.77 NA NA 8.01 11.05 1.02 NA NA 15.80 18.84 090 26545 ......... ............ A Reconstruct finger joint ................................. 6.91 NA NA 8.19 11.18 1.05 NA NA 16.15 19.14 090 26546 ......... ............ A Repair nonunion hand ................................... 10.41 NA NA 11.25 14.12 1.44 NA NA 23.10 25.97 090 26548 ......... ............ A Reconstruct finger joint ................................. 8.02 NA NA 8.66 11.83 1.20 NA NA 17.88 21.05 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37281 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

26550 ......... ............ A Construct thumb replacement ....................... 21.46 NA NA 15.12 17.00 2.45 NA NA 39.03 40.91 090 26551 ......... ............ A Great toe-hand transfer ................................. 48.09 NA NA 21.34 29.73 7.96 NA NA 77.39 85.78 090 26553 ......... ............ A Single transfer, toe-hand ............................... 47.78 NA NA 19.85 22.03 2.41 NA NA 70.04 72.22 090 26554 ......... ............ A Double transfer, toe-hand ............................. 56.57 NA NA 19.02 32.99 9.41 NA NA 85.00 98.97 090 26555 ......... ............ A Positional change of finger ............................ 16.86 NA NA 13.64 17.08 2.48 NA NA 32.98 36.42 090 26556 ......... ............ A Toe joint transfer ........................................... 49.27 NA NA 17.66 29.48 2.57 NA NA 69.50 81.32 090 26560 ......... ............ A Repair of web finger ...................................... 5.37 NA NA 7.00 9.12 0.85 NA NA 13.22 15.34 090 26561 ......... ............ A Repair of web finger ...................................... 10.90 NA NA 9.09 11.56 1.45 NA NA 21.44 23.91 090 26562 ......... ............ A Repair of web finger ...................................... 16.30 NA NA 13.61 16.30 2.23 NA NA 32.14 34.83 090 26565 ......... ............ A Correct metacarpal flaw ................................ 6.73 NA NA 7.79 10.98 1.00 NA NA 15.52 18.71 090 26567 ......... ............ A Correct finger deformity ................................. 6.81 NA NA 8.02 10.99 1.04 NA NA 15.87 18.84 090 26568 ......... ............ A Lengthen metacarpal/finger ........................... 9.07 NA NA 9.99 14.10 1.49 NA NA 20.55 24.66 090 26580 ......... ............ A Repair hand deformity ................................... 19.40 NA NA 11.48 13.13 2.28 NA NA 33.16 34.81 090 26587 ......... ............ A Reconstruct extra finger ................................ 14.28 NA NA 8.28 9.00 1.53 NA NA 24.09 24.81 090 26590 ......... ............ A Repair finger deformity .................................. 18.43 NA NA 10.51 13.11 2.77 NA NA 31.71 34.31 090 26591 ......... ............ A Repair muscles of hand ................................ 3.25 NA NA 6.09 8.76 0.48 NA NA 9.82 12.49 090 26593 ......... ............ A Release muscles of hand .............................. 5.30 NA NA 7.63 10.28 0.78 NA NA 13.71 16.36 090 26596 ......... ............ A Excision constricting tissue ........................... 8.94 NA NA 7.35 8.48 1.43 NA NA 17.72 18.85 090 26600 ......... ............ A Treat metacarpal fracture .............................. 2.40 3.35 3.55 3.01 2.75 0.30 6.05 6.25 5.71 5.45 090 26605 ......... ............ A Treat metacarpal fracture .............................. 2.85 4.03 4.44 3.45 3.61 0.49 7.37 7.78 6.79 6.95 090 26607 ......... ............ A Treat metacarpal fracture .............................. 5.35 NA NA 4.80 5.92 0.87 NA NA 11.02 12.14 090 26608 ......... ............ A Treat metacarpal fracture .............................. 5.35 NA NA 5.16 5.99 0.88 NA NA 11.39 12.22 090 26615 ......... ............ A Treat metacarpal fracture .............................. 5.32 NA NA 4.49 5.11 0.86 NA NA 10.67 11.29 090 26641 ......... ............ A Treat thumb dislocation ................................. 3.93 4.14 4.47 3.49 3.53 0.39 8.46 8.79 7.81 7.85 090 26645 ......... ............ A Treat thumb fracture ...................................... 4.40 4.56 5.03 3.87 4.12 0.67 9.63 10.10 8.94 9.19 090 26650 ......... ............ A Treat thumb fracture ...................................... 5.71 NA NA 5.53 6.42 0.94 NA NA 12.18 13.07 090 26665 ......... ............ A Treat thumb fracture ...................................... 7.65 NA NA 5.59 6.37 0.90 NA NA 14.14 14.92 090 26670 ......... ............ A Treat hand dislocation ................................... 3.68 3.51 4.08 2.92 2.94 0.39 7.58 8.15 6.99 7.01 090 26675 ......... ............ A Treat hand dislocation ................................... 4.63 4.79 5.32 4.10 4.39 0.77 10.19 10.72 9.50 9.79 090 26676 ......... ............ A Pin hand dislocation ...................................... 5.51 NA NA 5.48 6.40 0.91 NA NA 11.90 12.82 090 26685 ......... ............ A Treat hand dislocation ................................... 7.03 NA NA 5.16 5.91 1.09 NA NA 13.28 14.03 090 26686 ......... ............ A Treat hand dislocation ................................... 7.99 NA NA 5.83 6.65 1.24 NA NA 15.06 15.88 090 26700 ......... ............ A Treat knuckle dislocation ............................... 3.68 3.29 3.65 2.92 2.88 0.35 7.32 7.68 6.95 6.91 090 26705 ......... ............ A Treat knuckle dislocation ............................... 4.18 4.74 5.20 4.03 4.24 0.66 9.58 10.04 8.87 9.08 090 26706 ......... ............ A Pin knuckle dislocation .................................. 5.11 NA NA 4.62 4.98 0.81 NA NA 10.54 10.90 090 26715 ......... ............ A Treat knuckle dislocation ............................... 5.73 NA NA 4.66 5.31 0.91 NA NA 11.30 11.95 090 26720 ......... ............ A Treat finger fracture, each ............................. 1.66 2.55 2.73 2.28 2.12 0.24 4.45 4.63 4.18 4.02 090 26725 ......... ............ A Treat finger fracture, each ............................. 3.33 4.04 4.60 3.37 3.48 0.53 7.90 8.46 7.23 7.34 090 26727 ......... ............ A Treat finger fracture, each ............................. 5.22 NA NA 5.12 5.97 0.84 NA NA 11.18 12.03 090 26735 ......... ............ A Treat finger fracture, each ............................. 5.97 NA NA 4.74 5.36 0.95 NA NA 11.66 12.28 090 26740 ......... ............ A Treat finger fracture, each ............................. 1.94 2.91 3.08 2.62 2.69 0.31 5.16 5.33 4.87 4.94 090 26742 ......... ............ A Treat finger fracture, each ............................. 3.84 4.27 4.82 3.56 3.81 0.58 8.69 9.24 7.98 8.23 090 26746 ......... ............ A Treat finger fracture, each ............................. 5.80 NA NA 4.70 5.36 0.91 NA NA 11.41 12.07 090 26750 ......... ............ A Treat finger fracture, each ............................. 1.70 2.22 2.42 2.23 2.07 0.22 4.14 4.34 4.15 3.99 090 26755 ......... ............ A Treat finger fracture, each ............................. 3.10 3.74 4.26 2.93 2.99 0.42 7.26 7.78 6.45 6.51 090 26756 ......... ............ A Pin finger fracture, each ................................ 4.38 NA NA 4.78 5.50 0.71 NA NA 9.87 10.59 090 26765 ......... ............ A Treat finger fracture, each ............................. 4.16 NA NA 3.77 4.24 0.66 NA NA 8.59 9.06 090 26770 ......... ............ A Treat finger dislocation .................................. 3.02 2.88 3.30 2.50 2.44 0.27 6.17 6.59 5.79 5.73 090 26775 ......... ............ A Treat finger dislocation .................................. 3.70 4.49 5.03 3.76 3.81 0.54 8.73 9.27 8.00 8.05 090 26776 ......... ............ A Pin finger dislocation ..................................... 4.79 NA NA 4.94 5.75 0.77 NA NA 10.50 11.31 090 26785 ......... ............ A Treat finger dislocation .................................. 4.20 NA NA 3.84 4.37 0.68 NA NA 8.72 9.25 090 26820 ......... ............ A Thumb fusion with graft ................................. 8.25 NA NA 8.56 12.11 1.30 NA NA 18.11 21.66 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37282 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

26841 ......... ............ A Fusion of thumb ............................................ 7.12 NA NA 8.56 12.09 1.18 NA NA 16.86 20.39 090 26842 ......... ............ A Thumb fusion with graft ................................. 8.29 NA NA 8.81 12.26 1.32 NA NA 18.42 21.87 090 26843 ......... ............ A Fusion of hand joint ....................................... 7.60 NA NA 8.05 11.31 1.15 NA NA 16.80 20.06 090 26844 ......... ............ A Fusion/graft of hand joint .............................. 8.78 NA NA 9.00 12.30 1.33 NA NA 19.11 22.41 090 26850 ......... ............ A Fusion of knuckle .......................................... 6.96 NA NA 8.07 11.20 1.06 NA NA 16.09 19.22 090 26852 ......... ............ A Fusion of knuckle with graft .......................... 8.51 NA NA 8.89 11.92 1.22 NA NA 18.62 21.65 090 26860 ......... ............ A Fusion of finger joint ...................................... 4.68 NA NA 7.34 10.25 0.73 NA NA 12.75 15.66 090 26861 ......... ............ A Fusion of finger jnt, add-on ........................... 1.74 NA NA 0.69 0.87 0.27 NA NA 2.70 2.88 ZZZ 26862 ......... ............ A Fusion/graft of finger joint ............................. 7.36 NA NA 8.45 11.40 1.10 NA NA 16.91 19.86 090 26863 ......... ............ A Fuse/graft added joint ................................... 3.89 NA NA 1.54 1.98 0.56 NA NA 5.99 6.43 ZZZ 26910 ......... ............ A Amputate metacarpal bone ........................... 7.59 NA NA 8.09 10.46 1.16 NA NA 16.84 19.21 09026951 ......... ............ A Amputation of finger/thumb ........................... 5.75 NA NA 7.34 9.47 0.71 NA NA 13.80 15.93 090 26952 ......... ............ A Amputation of finger/thumb ........................... 6.30 NA NA 7.72 10.70 0.95 NA NA 14.97 17.95 090 26990 ......... ............ A Drainage of pelvis lesion ............................... 7.77 NA NA 6.03 6.93 1.22 NA NA 15.02 15.92 090 26991 ......... ............ A Drainage of pelvis bursa ............................... 6.91 8.49 10.52 4.77 5.28 1.11 16.51 18.54 12.79 13.30 090 26992 ......... ............ A Drainage of bone lesion ................................ 13.30 NA NA 8.29 9.88 2.16 NA NA 23.75 25.34 090 27000 ......... ............ A Incision of hip tendon .................................... 5.61 NA NA 4.46 5.09 0.98 NA NA 11.05 11.68 090 27001 ......... ............ A Incision of hip tendon .................................... 6.99 NA NA 5.12 5.86 1.24 NA NA 13.35 14.09 090 27003 ......... ............ A Incision of hip tendon .................................... 7.63 NA NA 5.70 6.30 1.12 NA NA 14.45 15.05 090 27005 ......... ............ A Incision of hip tendon .................................... 9.89 NA NA 6.67 7.55 1.72 NA NA 18.28 19.16 090 27006 ......... ............ A Incision of hip tendons .................................. 9.91 NA NA 6.69 7.67 1.69 NA NA 18.29 19.27 090 27025 ......... ............ A Incision of hip/thigh fascia ............................. 12.56 NA NA 7.97 8.42 1.84 NA NA 22.37 22.82 090 27030 ......... ............ A Drainage of hip joint ...................................... 13.47 NA NA 7.92 9.23 2.26 NA NA 23.65 24.96 090 27033 ......... ............ A Exploration of hip joint ................................... 13.91 NA NA 8.27 9.53 2.32 NA NA 24.50 25.76 090 27035 ......... ............ A Denervation of hip joint ................................. 17.14 NA NA 9.30 10.77 2.15 NA NA 28.59 30.06 090 27036 ......... ............ A Excision of hip joint/muscle ........................... 14.10 NA NA 8.84 9.73 2.26 NA NA 25.20 26.09 090 27040 ......... ............ A Biopsy of soft tissues .................................... 2.87 5.23 5.25 1.85 1.98 0.27 8.37 8.39 4.99 5.12 010 27041 ......... ............ A Biopsy of soft tissues .................................... 10.00 NA NA 5.81 6.45 1.35 NA NA 17.16 17.80 090 27047 ......... ............ A Remove hip/pelvis lesion .............................. 7.44 7.06 7.11 4.51 4.71 1.03 15.53 15.58 12.98 13.18 090 27048 ......... ............ A Remove hip/pelvis lesion .............................. 6.36 NA NA 4.57 4.75 0.92 NA NA 11.85 12.03 090 27049 ......... ............ A Remove tumor, hip/pelvis .............................. 15.12 NA NA 8.10 8.34 2.06 NA NA 25.28 25.52 090 27050 ......... ............ A Biopsy of sacroiliac joint ................................ 4.59 NA NA 3.81 4.28 0.60 NA NA 9.00 9.47 090 27052 ......... ............ A Biopsy of hip joint .......................................... 7.21 NA NA 5.57 5.82 1.08 NA NA 13.86 14.11 090 27054 ......... ............ A Removal of hip joint lining ............................. 9.01 NA NA 6.35 7.11 1.47 NA NA 16.83 17.59 090 27060 ......... ............ A Removal of ischial bursa ............................... 5.72 NA NA 4.31 4.36 0.80 NA NA 10.83 10.88 090 27062 ......... ............ A Remove femur lesion/bursa .......................... 5.60 NA NA 4.53 5.04 0.93 NA NA 11.06 11.57 090 27065 ......... ............ A Removal of hip bone lesion .......................... 6.37 NA NA 5.03 5.35 1.01 NA NA 12.41 12.73 09027066 ......... ............ A Removal of hip bone lesion .......................... 10.97 NA NA 7.30 8.17 1.79 NA NA 20.06 20.93 090 27067 ......... ............ A Remove/graft hip bone lesion ....................... 14.47 NA NA 8.66 10.18 1.84 NA NA 24.97 26.49 090 27070 ......... ............ A Partial removal of hip bone ........................... 11.36 NA NA 7.62 8.78 1.74 NA NA 20.72 21.88 090 27071 ......... ............ A Partial removal of hip bone ........................... 12.16 NA NA 8.21 9.67 1.92 NA NA 22.29 23.75 090 27075 ......... ............ A Extensive hip surgery .................................... 36.71 NA NA 16.24 18.51 5.64 NA NA 58.59 60.86 090 27076 ......... ............ A Extensive hip surgery .................................... 24.17 NA NA 12.43 14.02 3.70 NA NA 40.30 41.89 090 27077 ......... ............ A Extensive hip surgery .................................... 42.48 NA NA 19.47 21.92 6.12 NA NA 68.07 70.52 090 27078 ......... ............ A Extensive hip surgery .................................... 14.44 NA NA 8.56 9.62 2.22 NA NA 25.22 26.28 090 27079 ......... ............ A Extensive hip surgery .................................... 14.81 NA NA 7.40 9.03 1.94 NA NA 24.15 25.78 090 27080 ......... ............ A Removal of tail bone ..................................... 6.74 NA NA 4.64 4.79 0.93 NA NA 12.31 12.46 090 27086 ......... ............ A Remove hip foreign body .............................. 1.87 3.78 4.37 1.53 1.76 0.25 5.90 6.49 3.65 3.88 010 27087 ......... ............ A Remove hip foreign body .............................. 8.65 NA NA 5.56 6.40 1.35 NA NA 15.56 16.40 090 27090 ......... ............ A Removal of hip prosthesis ............................. 11.49 NA NA 7.30 8.43 1.94 NA NA 20.73 21.86 090 27091 ......... ............ A Removal of hip prosthesis ............................. 24.07 NA NA 12.76 13.71 3.84 NA NA 40.67 41.62 090 27093 ......... ............ A Injection for hip x-ray ..................................... 1.30 3.15 4.14 0.46 0.48 0.13 4.58 5.57 1.89 1.91 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37283 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27095 ......... ............ A Injection for hip x-ray ..................................... 1.50 3.78 5.25 0.51 0.52 0.14 5.42 6.89 2.15 2.16 000 27096 ......... ............ A Inject sacroiliac joint ...................................... 1.40 2.53 3.90 0.33 0.33 0.08 4.01 5.38 1.81 1.81 000 27097 ......... ............ A Revision of hip tendon .................................. 9.09 NA NA 6.23 6.38 1.57 NA NA 16.89 17.04 090 27098 ......... ............ A Transfer tendon to pelvis .............................. 9.12 NA NA 4.73 6.46 0.95 NA NA 14.80 16.53 090 27100 ......... ............ A Transfer of abdominal muscle ....................... 11.12 NA NA 7.24 8.33 1.85 NA NA 20.21 21.30 09027105 ......... ............ A Transfer of spinal muscle .............................. 11.81 NA NA 7.77 8.84 1.72 NA NA 21.30 22.37 090 27110 ......... ............ A Transfer of iliopsoas muscle ......................... 13.54 NA NA 8.45 8.97 2.18 NA NA 24.17 24.69 090 27111 ......... ............ A Transfer of iliopsoas muscle ......................... 12.37 NA NA 7.98 8.87 1.94 NA NA 22.29 23.18 090 27120 ......... ............ A Reconstruction of hip socket ......................... 19.00 NA NA 10.57 11.55 3.08 NA NA 32.65 33.63 090 27122 ......... ............ A Reconstruction of hip socket ......................... 15.86 NA NA 9.29 10.63 2.61 NA NA 27.76 29.10 090 27125 ......... ............ A Partial hip replacement ................................. 16.38 NA NA 9.49 10.36 2.54 NA NA 28.41 29.28 090 27130 ......... ............ A Total hip arthroplasty ..................................... 17.40 NA NA 9.46 12.37 3.50 NA NA 30.36 33.27 090 27132 ......... ............ A Total hip arthroplasty ..................................... 25.41 NA NA 13.28 15.08 4.04 NA NA 42.73 44.53 090 27134 ......... ............ A Revise hip joint replacement ......................... 30.07 NA NA 14.52 17.01 4.94 NA NA 49.53 52.02 090 27137 ......... ............ A Revise hip joint replacement ......................... 22.49 NA NA 11.59 13.38 3.67 NA NA 37.75 39.54 090 27138 ......... ............ A Revise hip joint replacement ......................... 23.49 NA NA 11.97 13.82 3.84 NA NA 39.30 41.15 090 27140 ......... ............ A Transplant femur ridge .................................. 12.58 NA NA 7.67 9.00 2.11 NA NA 22.36 23.69 090 27146 ......... ............ A Incision of hip bone ....................................... 18.64 NA NA 10.51 11.76 2.96 NA NA 32.11 33.36 090 27147 ......... ............ A Revision of hip bone ..................................... 21.79 NA NA 11.73 12.90 3.57 NA NA 37.09 38.26 090 27151 ......... ............ A Incision of hip bones ..................................... 23.84 NA NA 12.10 9.00 3.91 NA NA 39.85 36.75 090 27156 ......... ............ A Revision of hip bones .................................... 25.95 NA NA 13.23 15.39 4.21 NA NA 43.39 45.55 090 27158 ......... ............ A Revision of pelvis .......................................... 20.79 NA NA 6.99 10.00 3.16 NA NA 30.94 33.95 090 27161 ......... ............ A Incision of neck of femur ............................... 17.64 NA NA 10.20 11.66 2.94 NA NA 30.78 32.24 090 27165 ......... ............ A Incision/fixation of femur ............................... 19.96 NA NA 11.48 12.58 3.10 NA NA 34.54 35.64 090 27170 ......... ............ A Repair/graft femur head/neck ........................ 17.40 NA NA 9.61 10.90 2.81 NA NA 29.82 31.11 090 27175 ......... ............ A Treat slipped epiphysis ................................. 9.23 NA NA 5.69 6.44 1.46 NA NA 16.38 17.13 090 27176 ......... ............ A Treat slipped epiphysis ................................. 12.69 NA NA 8.10 8.81 2.22 NA NA 23.01 23.72 090 27177 ......... ............ A Treat slipped epiphysis ................................. 15.84 NA NA 9.50 10.57 2.61 NA NA 27.95 29.02 090 27178 ......... ............ A Treat slipped epiphysis ................................. 12.69 NA NA 8.10 8.36 2.08 NA NA 22.87 23.13 090 27179 ......... ............ A Revise head/neck of femur ........................... 13.74 NA NA 8.38 9.61 2.25 NA NA 24.37 25.60 090 27181 ......... ............ A Treat slipped epiphysis ................................. 15.90 NA NA 9.63 10.08 1.57 NA NA 27.10 27.55 090 27185 ......... ............ A Revision of femur epiphysis .......................... 9.59 NA NA 6.56 7.30 2.39 NA NA 18.54 19.28 090 27187 ......... ............ A Reinforce hip bones ...................................... 14.00 NA NA 8.55 9.90 2.37 NA NA 24.92 26.27 090 27193 ......... ............ A Treat pelvic ring fracture ............................... 5.92 4.56 4.97 4.70 5.00 0.96 11.44 11.85 11.58 11.88 090 27194 ......... ............ A Treat pelvic ring fracture ............................... 10.00 NA NA 6.48 7.37 1.65 NA NA 18.13 19.02 090 27200 ......... ............ A Treat tail bone fracture .................................. 1.84 2.05 2.19 2.20 2.17 0.28 4.17 4.31 4.32 4.29 090 27202 ......... ............ A Treat tail bone fracture .................................. 7.21 NA NA 11.31 15.51 1.06 NA NA 19.58 23.78 090 27215 ......... ............ A Treat pelvic fracture(s) .................................. 10.39 NA NA 6.41 6.93 1.97 NA NA 18.77 19.29 090 27216 ......... ............ A Treat pelvic ring fracture ............................... 15.65 NA NA 9.05 9.48 2.63 NA NA 27.33 27.76 090 27217 ......... ............ A Treat pelvic ring fracture ............................... 14.57 NA NA 8.52 9.76 2.41 NA NA 25.50 26.74 090 27218 ......... ............ A Treat pelvic ring fracture ............................... 20.85 NA NA 11.15 11.36 3.48 NA NA 35.48 35.69 090 27220 ......... ............ A Treat hip socket fracture ............................... 6.65 5.18 5.60 5.09 5.51 1.07 12.90 13.32 12.81 13.23 090 27222 ......... ............ A Treat hip socket fracture ............................... 13.88 NA NA 8.35 9.59 2.19 NA NA 24.42 25.66 090 27226 ......... ............ A Treat hip wall fracture ................................... 15.37 NA NA 8.81 8.08 2.48 NA NA 26.66 25.93 090 27227 ......... ............ A Treat hip fracture(s) ....................................... 25.13 NA NA 13.14 14.87 4.05 NA NA 42.32 44.05 090 27228 ......... ............ A Treat hip fracture(s) ....................................... 29.05 NA NA 14.69 16.93 4.66 NA NA 48.40 50.64 090 27230 ......... ............ A Treat thigh fracture ........................................ 5.61 4.90 5.37 4.83 5.04 0.95 11.46 11.93 11.39 11.60 090 27232 ......... ............ A Treat thigh fracture ........................................ 11.62 NA NA 5.90 6.87 1.85 NA NA 19.37 20.34 090 27235 ......... ............ A Treat thigh fracture ........................................ 12.80 NA NA 7.89 9.08 2.11 NA NA 22.80 23.99 090 27236 ......... ............ A Treat thigh fracture ........................................ 14.54 NA NA 8.53 10.44 2.71 NA NA 25.78 27.69 090 27238 ......... ............ A Treat thigh fracture ........................................ 5.57 NA NA 4.61 5.02 0.89 NA NA 11.07 11.48 090 27240 ......... ............ A Treat thigh fracture ........................................ 13.56 NA NA 7.96 9.12 2.16 NA NA 23.68 24.84 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37284 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27244 ......... ............ A Treat thigh fracture ........................................ 17.00 NA NA 9.50 10.87 2.77 NA NA 29.27 30.64 090 27245 ......... ............ A Treat thigh fracture ........................................ 21.01 NA NA 11.21 13.14 3.52 NA NA 35.74 37.67 090 27246 ......... ............ A Treat thigh fracture ........................................ 4.70 3.87 4.32 3.90 4.30 0.81 9.38 9.83 9.41 9.81 090 27248 ......... ............ A Treat thigh fracture ........................................ 10.73 NA NA 6.87 7.89 1.81 NA NA 19.41 20.43 090 27250 ......... ............ A Treat hip dislocation ...................................... 7.12 NA NA 4.22 4.53 0.62 NA NA 11.96 12.27 090 27252 ......... ............ A Treat hip dislocation ...................................... 10.85 NA NA 6.37 7.18 1.66 NA NA 18.88 19.69 090 27253 ......... ............ A Treat hip dislocation ...................................... 13.38 NA NA 7.71 9.29 2.24 NA NA 23.33 24.91 090 27254 ......... ............ A Treat hip dislocation ...................................... 18.71 NA NA 10.34 11.62 3.17 NA NA 32.22 33.50 090 27256 ......... ............ A Treat hip dislocation ...................................... 4.23 2.40 3.25 1.38 1.91 0.46 7.09 7.94 6.07 6.60 010 27257 ......... ............ A Treat hip dislocation ...................................... 5.33 NA NA 2.48 2.74 0.69 NA NA 8.50 8.76 010 27258 ......... ............ A Treat hip dislocation ...................................... 15.95 NA NA 9.26 10.49 2.64 NA NA 27.85 29.08 090 27259 ......... ............ A Treat hip dislocation ...................................... 22.95 NA NA 12.64 13.78 3.74 NA NA 39.33 40.47 090 27265 ......... ............ A Treat hip dislocation ...................................... 5.04 NA NA 3.93 4.58 0.63 NA NA 9.60 10.25 090 27266 ......... ............ A Treat hip dislocation ...................................... 7.60 NA NA 5.45 6.13 1.29 NA NA 14.34 15.02 090 27275 ......... ............ A Manipulation of hip joint ................................ 2.27 NA NA 1.86 2.05 0.39 NA NA 4.52 4.71 010 27280 ......... ............ A Fusion of sacroiliac joint ................................ 14.39 NA NA 8.87 9.94 2.53 NA NA 25.79 26.86 090 27282 ......... ............ A Fusion of pubic bones ................................... 11.62 NA NA 7.69 7.94 1.86 NA NA 21.17 21.42 090 27284 ......... ............ A Fusion of hip joint .......................................... 24.85 NA NA 12.57 14.24 3.92 NA NA 41.34 43.01 090 27286 ......... ............ A Fusion of hip joint .......................................... 24.89 NA NA 13.18 15.18 3.12 NA NA 41.19 43.19 090 27290 ......... ............ A Amputation of leg at hip ................................ 24.27 NA NA 12.25 13.64 3.43 NA NA 39.95 41.34 090 27295 ......... ............ A Amputation of leg at hip ................................ 19.46 NA NA 9.61 10.91 2.95 NA NA 32.02 33.32 090 27301 ......... ............ A Drain thigh/knee lesion .................................. 6.60 8.17 9.62 4.61 5.02 1.04 15.81 17.26 12.25 12.66 090 27303 ......... ............ A Drainage of bone lesion ................................ 8.45 NA NA 5.96 6.74 1.43 NA NA 15.84 16.62 090 27305 ......... ............ A Incise thigh tendon & fascia .......................... 6.03 NA NA 4.58 5.05 1.01 NA NA 11.62 12.09 090 27306 ......... ............ A Incision of thigh tendon ................................. 4.61 NA NA 4.01 4.55 0.85 NA NA 9.47 10.01 090 27307 ......... ............ A Incision of thigh tendons ............................... 5.91 NA NA 4.73 5.23 1.04 NA NA 11.68 12.18 090 27310 ......... ............ A Exploration of knee joint ................................ 9.80 NA NA 6.59 7.35 1.61 NA NA 18.00 18.76 090 27315 ......... ............ A Partial removal, thigh nerve .......................... 7.02 NA NA 5.20 5.02 1.09 NA NA 13.31 13.13 090 27320 ......... ............ A Partial removal, thigh nerve .......................... 6.29 NA NA 4.54 5.07 1.06 NA NA 11.89 12.42 090 27323 ......... ............ A Biopsy, thigh soft tissues .............................. 2.28 4.11 3.67 1.88 1.89 0.24 6.63 6.19 4.40 4.41 010 27324 ......... ............ A Biopsy, thigh soft tissues .............................. 4.89 NA NA 3.79 4.09 0.75 NA NA 9.43 9.73 090 27327 ......... ............ A Removal of thigh lesion ................................. 4.46 6.04 6.02 3.57 3.69 0.64 11.14 11.12 8.67 8.79 090 27328 ......... ............ A Removal of thigh lesion ................................. 5.56 NA NA 4.00 4.29 0.84 NA NA 10.40 10.69 090 27329 ......... ............ A Remove tumor, thigh/knee ............................ 15.60 NA NA 8.40 8.89 2.14 NA NA 26.14 26.63 090 27330 ......... ............ A Biopsy, knee joint lining ................................ 4.96 NA NA 4.00 4.44 0.86 NA NA 9.82 10.26 090 27331 ......... ............ A Explore/treat knee joint ................................. 5.87 NA NA 4.73 5.34 1.02 NA NA 11.62 12.23 090 27332 ......... ............ A Removal of knee cartilage ............................ 8.26 NA NA 6.01 6.86 1.43 NA NA 15.70 16.55 090 27333 ......... ............ A Removal of knee cartilage ............................ 7.35 NA NA 5.61 6.42 1.26 NA NA 14.22 15.03 090 27334 ......... ............ A Remove knee joint lining ............................... 8.99 NA NA 6.34 7.16 1.51 NA NA 16.84 17.66 090 27335 ......... ............ A Remove knee joint lining ............................... 10.35 NA NA 6.90 7.91 1.74 NA NA 18.99 20.00 090 27340 ......... ............ A Removal of kneecap bursa ........................... 4.17 NA NA 3.96 4.42 0.72 NA NA 8.85 9.31 090 27345 ......... ............ A Removal of knee cyst .................................... 5.91 NA NA 4.79 5.43 1.00 NA NA 11.70 12.34 090 27347 ......... ............ A Remove knee cyst ......................................... 6.52 NA NA 5.14 5.37 0.98 NA NA 12.64 12.87 090 27350 ......... ............ A Removal of kneecap ..................................... 8.46 NA NA 6.15 6.98 1.41 NA NA 16.02 16.85 090 27355 ......... ............ A Remove femur lesion .................................... 7.82 NA NA 5.74 6.53 1.32 NA NA 14.88 15.67 090 27356 ......... ............ A Remove femur lesion/graft ............................ 9.89 NA NA 6.71 7.58 1.65 NA NA 18.25 19.12 090 27357 ......... ............ A Remove femur lesion/graft ............................ 10.93 NA NA 7.38 8.39 1.95 NA NA 20.26 21.27 090 27358 ......... ............ A Remove femur lesion/fixation ........................ 4.73 NA NA 1.85 2.36 0.82 NA NA 7.40 7.91 ZZZ 27360 ......... ............ A Partial removal, leg bone(s) .......................... 11.26 NA NA 7.80 9.14 1.83 NA NA 20.89 22.23 090 27365 ......... ............ A Extensive leg surgery .................................... 17.85 NA NA 10.27 11.35 2.79 NA NA 30.91 31.99 090 27370 ......... ............ A Injection for knee x-ray .................................. 0.96 2.85 3.51 0.33 0.32 0.08 3.89 4.55 1.37 1.36 000 27372 ......... ............ A Removal of foreign body ............................... 5.06 8.27 9.63 4.00 4.53 0.84 14.17 15.53 9.90 10.43 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37285 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27380 ......... ............ A Repair of kneecap tendon ............................. 7.27 NA NA 5.83 6.93 1.24 NA NA 14.34 15.44 090 27381 ......... ............ A Repair/graft kneecap tendon ......................... 10.56 NA NA 7.28 8.66 1.79 NA NA 19.63 21.01 090 27385 ......... ............ A Repair of thigh muscle .................................. 7.93 NA NA 6.10 7.26 1.36 NA NA 15.39 16.55 090 27386 ......... ............ A Repair/graft of thigh muscle .......................... 10.90 NA NA 7.69 9.08 1.85 NA NA 20.44 21.83 090 27390 ......... ............ A Incision of thigh tendon ................................. 5.38 NA NA 4.52 4.97 0.92 NA NA 10.82 11.27 090 27391 ......... ............ A Incision of thigh tendons ............................... 7.31 NA NA 5.42 6.29 1.23 NA NA 13.96 14.83 090 27392 ......... ............ A Incision of thigh tendons ............................... 9.43 NA NA 6.59 7.36 1.57 NA NA 17.59 18.36 090 27393 ......... ............ A Lengthening of thigh tendon ......................... 6.44 NA NA 4.95 5.63 1.10 NA NA 12.49 13.17 09027394 ......... ............ A Lengthening of thigh tendons ........................ 8.61 NA NA 6.08 6.95 1.47 NA NA 16.16 17.03 09027395 ......... ............ A Lengthening of thigh tendons ........................ 12.01 NA NA 7.83 8.97 2.04 NA NA 21.88 23.02 090 27396 ......... ............ A Transplant of thigh tendon ............................ 7.97 NA NA 5.82 6.72 1.34 NA NA 15.13 16.03 090 27397 ......... ............ A Transplants of thigh tendons ......................... 12.38 NA NA 8.25 8.87 1.82 NA NA 22.45 23.07 090 27400 ......... ............ A Revise thigh muscles/tendons ...................... 9.13 NA NA 6.10 6.98 1.31 NA NA 16.54 17.42 090 27403 ......... ............ A Repair of knee cartilage ................................ 8.44 NA NA 5.97 6.89 1.44 NA NA 15.85 16.77 090 27405 ......... ............ A Repair of knee ligament ................................ 8.88 NA NA 6.33 7.22 1.51 NA NA 16.72 17.61 090 27407 ......... ............ A Repair of knee ligament ................................ 10.62 NA NA 6.55 7.89 1.78 NA NA 18.95 20.29 090 27409 ......... ............ A Repair of knee ligaments .............................. 13.48 NA NA 8.27 9.55 2.24 NA NA 23.99 25.27 090 27412 ......... ............ A Autochondrocyte implant knee ...................... 24.43 NA NA 13.45 14.49 4.35 NA NA 42.23 43.27 090 27415 ......... ............ A Osteochondral knee allograft ........................ 19.69 NA NA 11.62 12.35 4.35 NA NA 35.66 36.39 090 27418 ......... ............ A Repair degenerated kneecap ........................ 11.37 NA NA 7.46 8.56 1.88 NA NA 20.71 21.81 090 27420 ......... ............ A Revision of unstable kneecap ....................... 10.06 NA NA 6.82 7.80 1.71 NA NA 18.59 19.57 09027422 ......... ............ A Revision of unstable kneecap ....................... 10.01 NA NA 6.78 7.80 1.70 NA NA 18.49 19.51 09027424 ......... ............ A Revision/removal of kneecap ........................ 10.04 NA NA 6.78 7.78 1.70 NA NA 18.52 19.52 09027425 ......... ............ A Lat retinacular release open ......................... 5.21 NA NA 4.63 5.31 0.90 NA NA 10.74 11.42 090 27427 ......... ............ A Reconstruction, knee ..................................... 9.59 NA NA 6.57 7.51 1.63 NA NA 17.79 18.73 090 27428 ......... ............ A Reconstruction, knee ..................................... 15.23 NA NA 9.93 10.94 2.42 NA NA 27.58 28.59 090 27429 ......... ............ A Reconstruction, knee ..................................... 17.12 NA NA 11.11 12.12 2.70 NA NA 30.93 31.94 090 27430 ......... ............ A Revision of thigh muscles ............................. 9.96 NA NA 6.75 7.70 1.69 NA NA 18.40 19.35 090 27435 ......... ............ A Incision of knee joint ..................................... 10.60 NA NA 7.55 8.26 1.69 NA NA 19.84 20.55 090 27437 ......... ............ A Revise kneecap ............................................. 8.75 NA NA 6.12 6.98 1.49 NA NA 16.36 17.22 090 27438 ......... ............ A Revise kneecap with implant ........................ 11.69 NA NA 7.42 8.28 1.95 NA NA 21.06 21.92 09027440 ......... ............ A Revision of knee joint .................................... 10.89 NA NA 7.03 6.27 1.81 NA NA 19.73 18.97 090 27441 ......... ............ A Revision of knee joint .................................... 11.34 NA NA 7.35 6.89 1.88 NA NA 20.57 20.11 090 27442 ......... ............ A Revision of knee joint .................................... 12.17 NA NA 7.63 8.61 2.09 NA NA 21.89 22.87 090 27443 ......... ............ A Revision of knee joint .................................... 11.21 NA NA 7.26 8.38 1.90 NA NA 20.37 21.49 090 27445 ......... ............ A Revision of knee joint .................................... 18.43 NA NA 10.31 11.87 3.08 NA NA 31.82 33.38 090 27446 ......... ............ A Revision of knee joint .................................... 16.18 NA NA 9.18 10.77 2.80 NA NA 28.16 29.75 090 27447 ......... ............ A Total knee arthroplasty .................................. 20.81 NA NA 11.48 13.85 3.79 NA NA 36.08 38.45 090 27448 ......... ............ A Incision of thigh ............................................. 11.40 NA NA 7.23 8.27 1.94 NA NA 20.57 21.61 090 27450 ......... ............ A Incision of thigh ............................................. 14.38 NA NA 8.64 10.12 2.42 NA NA 25.44 26.92 090 27454 ......... ............ A Realignment of thigh bone ............................ 18.89 NA NA 10.53 12.04 3.12 NA NA 32.54 34.05 090 27455 ......... ............ A Realignment of knee ..................................... 13.16 NA NA 8.16 9.47 2.24 NA NA 23.56 24.87 090 27457 ......... ............ A Realignment of knee ..................................... 13.85 NA NA 8.09 9.49 2.34 NA NA 24.28 25.68 090 27465 ......... ............ A Shortening of thigh bone ............................... 18.36 NA NA 10.09 10.21 2.47 NA NA 30.92 31.04 090 27466 ......... ............ A Lengthening of thigh bone ............................ 17.03 NA NA 9.94 11.38 2.77 NA NA 29.74 31.18 090 27468 ......... ............ A Shorten/lengthen thighs ................................ 19.72 NA NA 11.04 12.05 3.30 NA NA 34.06 35.07 090 27470 ......... ............ A Repair of thigh ............................................... 16.87 NA NA 9.88 11.34 2.79 NA NA 29.54 31.00 090 27472 ......... ............ A Repair/graft of thigh ....................................... 18.47 NA NA 10.50 12.17 3.07 NA NA 32.04 33.71 090 27475 ......... ............ A Surgery to stop leg growth ............................ 8.75 NA NA 6.66 7.09 1.36 NA NA 16.77 17.20 090 27477 ......... ............ A Surgery to stop leg growth ............................ 9.96 NA NA 6.52 7.44 1.73 NA NA 18.21 19.13 090 27479 ......... ............ A Surgery to stop leg growth ............................ 12.96 NA NA 4.98 8.50 2.78 NA NA 20.72 24.24 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37286 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27485 ......... ............ A Surgery to stop leg growth ............................ 8.95 NA NA 6.12 7.10 1.53 NA NA 16.60 17.58 090 27486 ......... ............ A Revise/replace knee joint .............................. 20.84 NA NA 11.49 13.02 3.36 NA NA 35.69 37.22 090 27487 ......... ............ A Revise/replace knee joint .............................. 26.83 NA NA 13.83 15.91 4.39 NA NA 45.05 47.13 090 27488 ......... ............ A Removal of knee prosthesis .......................... 17.32 NA NA 10.13 11.33 2.74 NA NA 30.19 31.39 090 27495 ......... ............ A Reinforce thigh .............................................. 16.31 NA NA 9.50 10.96 2.71 NA NA 28.52 29.98 090 27496 ......... ............ A Decompression of thigh/knee ........................ 6.58 NA NA 4.98 5.46 0.99 NA NA 12.55 13.03 090 27497 ......... ............ A Decompression of thigh/knee ........................ 7.64 NA NA 4.61 5.24 1.15 NA NA 13.40 14.03 090 27498 ......... ............ A Decompression of thigh/knee ........................ 8.46 NA NA 5.36 5.82 1.24 NA NA 15.06 15.52 090 27499 ......... ............ A Decompression of thigh/knee ........................ 9.23 NA NA 5.76 6.57 1.47 NA NA 16.46 17.27 090 27500 ......... ............ A Treatment of thigh fracture ............................ 6.15 5.35 5.94 4.57 4.89 1.02 12.52 13.11 11.74 12.06 090 27501 ......... ............ A Treatment of thigh fracture ............................ 6.28 4.95 5.60 4.86 5.27 1.03 12.26 12.91 12.17 12.58 090 27502 ......... ............ A Treatment of thigh fracture ............................ 11.16 NA NA 6.79 7.80 1.78 NA NA 19.73 20.74 090 27503 ......... ............ A Treatment of thigh fracture ............................ 11.05 NA NA 7.12 8.01 1.84 NA NA 20.01 20.90 090 27506 ......... ............ A Treatment of thigh fracture ............................ 19.32 NA NA 10.98 12.36 3.03 NA NA 33.33 34.71 090 27507 ......... ............ A Treatment of thigh fracture ............................ 14.33 NA NA 8.03 9.41 2.42 NA NA 24.78 26.16 090 27508 ......... ............ A Treatment of thigh fracture ............................ 6.00 5.62 6.27 4.99 5.37 0.97 12.59 13.24 11.96 12.34 090 27509 ......... ............ A Treatment of thigh fracture ............................ 7.94 NA NA 6.36 7.58 1.34 NA NA 15.64 16.86 090 27510 ......... ............ A Treatment of thigh fracture ............................ 9.60 NA NA 6.22 7.07 1.53 NA NA 17.35 18.20 090 27511 ......... ............ A Treatment of thigh fracture ............................ 13.86 NA NA 8.75 10.61 2.37 NA NA 24.98 26.84 090 27513 ......... ............ A Treatment of thigh fracture ............................ 19.37 NA NA 11.43 13.30 3.12 NA NA 33.92 35.79 090 27514 ......... ............ A Treatment of thigh fracture ............................ 18.99 NA NA 11.55 12.93 3.00 NA NA 33.54 34.92 090 27516 ......... ............ A Treat thigh fx growth plate ............................ 5.36 5.60 6.18 4.97 5.39 0.81 11.77 12.35 11.14 11.56 090 27517 ......... ............ A Treat thigh fx growth plate ............................ 8.89 NA NA 5.93 7.09 1.22 NA NA 16.04 17.20 090 27519 ......... ............ A Treat thigh fx growth plate ............................ 15.72 NA NA 9.50 11.09 2.55 NA NA 27.77 29.36 090 27520 ......... ............ A Treat kneecap fracture .................................. 2.86 4.05 4.43 3.48 3.46 0.47 7.38 7.76 6.81 6.79 090 27524 ......... ............ A Treat kneecap fracture .................................. 10.17 NA NA 6.83 7.90 1.74 NA NA 18.74 19.81 090 27530 ......... ............ A Treat knee fracture ........................................ 3.89 4.76 5.19 4.20 4.37 0.65 9.30 9.73 8.74 8.91 090 27532 ......... ............ A Treat knee fracture ........................................ 7.35 6.35 7.12 5.57 6.25 1.26 14.96 15.73 14.18 14.86 090 27535 ......... ............ A Treat knee fracture ........................................ 11.72 NA NA 7.92 9.59 2.00 NA NA 21.64 23.31 090 27536 ......... ............ A Treat knee fracture ........................................ 17.11 NA NA 10.07 11.25 2.73 NA NA 29.91 31.09 090 27538 ......... ............ A Treat knee fracture(s) .................................... 4.86 5.46 5.98 4.84 5.12 0.84 11.16 11.68 10.54 10.82 090 27540 ......... ............ A Treat knee fracture ........................................ 13.38 NA NA 7.84 9.12 2.27 NA NA 23.49 24.77 090 27550 ......... ............ A Treat knee dislocation ................................... 5.75 5.26 5.84 4.55 4.84 0.76 11.77 12.35 11.06 11.35 090 27552 ......... ............ A Treat knee dislocation ................................... 7.95 NA NA 6.01 6.73 1.36 NA NA 15.32 16.04 090 27556 ......... ............ A Treat knee dislocation ................................... 14.87 NA NA 9.06 11.03 2.50 NA NA 26.43 28.40 090 27557 ......... ............ A Treat knee dislocation ................................... 17.22 NA NA 10.31 12.45 2.97 NA NA 30.50 32.64 090 27558 ......... ............ A Treat knee dislocation ................................... 17.93 NA NA 10.33 12.39 3.08 NA NA 31.34 33.40 090 27560 ......... ............ A Treat kneecap dislocation ............................. 3.81 3.89 4.61 3.37 3.24 0.40 8.10 8.82 7.58 7.45 090 27562 ......... ............ A Treat kneecap dislocation ............................. 5.78 NA NA 4.38 4.68 0.94 NA NA 11.10 11.40 090 27566 ......... ............ A Treat kneecap dislocation ............................. 12.51 NA NA 7.68 8.93 2.12 NA NA 22.31 23.56 090 27570 ......... ............ A Fixation of knee joint ..................................... 1.74 NA NA 1.60 1.74 0.30 NA NA 3.64 3.78 010 27580 ......... ............ A Fusion of knee ............................................... 20.82 NA NA 12.03 14.14 3.37 NA NA 36.22 38.33 090 27590 ......... ............ A Amputate leg at thigh .................................... 13.27 NA NA 6.15 6.56 1.74 NA NA 21.16 21.57 090 27591 ......... ............ A Amputate leg at thigh .................................... 13.74 NA NA 7.30 8.33 2.02 NA NA 23.06 24.09 090 27592 ......... ............ A Amputate leg at thigh .................................... 10.78 NA NA 5.51 6.02 1.45 NA NA 17.74 18.25 090 27594 ......... ............ A Amputation follow-up surgery ........................ 7.09 NA NA 4.74 5.07 1.02 NA NA 12.85 13.18 09027596 ......... ............ A Amputation follow-up surgery ........................ 11.06 NA NA 6.03 6.63 1.57 NA NA 18.66 19.26 090 27598 ......... ............ A Amputate lower leg at knee .......................... 10.99 NA NA 6.28 6.85 1.65 NA NA 18.92 19.49 090 27600 ......... ............ A Decompression of lower leg .......................... 5.88 NA NA 3.86 4.37 0.86 NA NA 10.60 11.11 09027601 ......... ............ A Decompression of lower leg .......................... 5.87 NA NA 4.25 4.71 0.80 NA NA 10.92 11.38 09027602 ......... ............ A Decompression of lower leg .......................... 7.64 NA NA 4.43 4.96 1.10 NA NA 13.17 13.70 09027603 ......... ............ A Drain lower leg lesion .................................... 5.05 7.01 7.39 3.86 4.09 0.74 12.80 13.18 9.65 9.88 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37287 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27604 ......... ............ A Drain lower leg bursa .................................... 4.46 6.41 6.18 3.37 3.82 0.69 11.56 11.33 8.52 8.97 090 27605 ......... ............ A Incision of achilles tendon ............................. 2.87 5.24 7.09 1.76 2.19 0.41 8.52 10.37 5.04 5.47 010 27606 ......... ............ A Incision of achilles tendon ............................. 4.13 NA NA 2.62 3.18 0.69 NA NA 7.44 8.00 010 27607 ......... ............ A Treat lower leg bone lesion ........................... 8.44 NA NA 5.64 6.05 1.31 NA NA 15.39 15.80 090 27610 ......... ............ A Explore/treat ankle joint ................................. 8.93 NA NA 6.05 6.78 1.40 NA NA 16.38 17.11 090 27612 ......... ............ A Exploration of ankle joint ............................... 7.92 NA NA 5.23 5.89 1.13 NA NA 14.28 14.94 090 27613 ......... ............ A Biopsy lower leg soft tissue .......................... 2.17 3.82 3.39 1.72 1.79 0.20 6.19 5.76 4.09 4.16 010 27614 ......... ............ A Biopsy lower leg soft tissue .......................... 5.65 7.82 7.32 3.95 4.33 0.78 14.25 13.75 10.38 10.76 090 27615 ......... ............ A Remove tumor, lower leg .............................. 12.84 NA NA 7.90 9.04 1.83 NA NA 22.57 23.71 090 27618 ......... ............ A Remove lower leg lesion ............................... 5.08 6.35 6.11 3.74 3.94 0.72 12.15 11.91 9.54 9.74 090 27619 ......... ............ A Remove lower leg lesion ............................... 8.39 9.97 9.65 5.21 5.78 1.25 19.61 19.29 14.85 15.42 090 27620 ......... ............ A Explore/treat ankle joint ................................. 5.97 NA NA 4.50 5.24 0.97 NA NA 11.44 12.18 090 27625 ......... ............ A Remove ankle joint lining .............................. 8.29 NA NA 5.47 6.23 1.28 NA NA 15.04 15.80 090 27626 ......... ............ A Remove ankle joint lining .............................. 8.90 NA NA 5.82 6.66 1.48 NA NA 16.20 17.04 090 27630 ......... ............ A Removal of tendon lesion ............................. 4.79 7.88 7.66 3.74 4.23 0.74 13.41 13.19 9.27 9.76 090 27635 ......... ............ A Remove lower leg bone lesion ...................... 7.83 NA NA 5.56 6.46 1.31 NA NA 14.70 15.60 090 27637 ......... ............ A Remove/graft leg bone lesion ....................... 10.08 NA NA 7.07 8.00 1.66 NA NA 18.81 19.74 09027638 ......... ............ A Remove/graft leg bone lesion ....................... 10.79 NA NA 6.83 7.94 1.84 NA NA 19.46 20.57 09027640 ......... ............ A Partial removal of tibia .................................. 12.01 NA NA 8.04 9.77 1.88 NA NA 21.93 23.66 090 27641 ......... ............ A Partial removal of fibula ................................ 9.65 NA NA 6.68 7.94 1.46 NA NA 17.79 19.05 090 27645 ......... ............ A Extensive lower leg surgery .......................... 14.69 NA NA 9.36 11.40 2.41 NA NA 26.46 28.50 090 27646 ......... ............ A Extensive lower leg surgery .......................... 13.12 NA NA 8.56 10.44 2.05 NA NA 23.73 25.61 090 27647 ......... ............ A Extensive ankle/heel surgery ........................ 12.76 NA NA 6.48 7.34 1.75 NA NA 20.99 21.85 090 27648 ......... ............ A Injection for ankle x-ray ................................. 0.96 2.77 3.34 0.32 0.33 0.08 3.81 4.38 1.36 1.37 000 27650 ......... ............ A Repair achilles tendon ................................... 9.86 NA NA 6.16 7.19 1.59 NA NA 17.61 18.64 090 27652 ......... ............ A Repair/graft achilles tendon .......................... 10.55 NA NA 6.30 7.61 1.71 NA NA 18.56 19.87 090 27654 ......... ............ A Repair of achilles tendon .............................. 10.24 NA NA 5.84 6.83 1.58 NA NA 17.66 18.65 090 27656 ......... ............ A Repair leg fascia defect ................................ 4.56 8.10 8.44 3.67 3.75 0.69 13.35 13.69 8.92 9.00 090 27658 ......... ............ A Repair of leg tendon, each ............................ 4.97 NA NA 3.84 4.39 0.79 NA NA 9.60 10.15 090 27659 ......... ............ A Repair of leg tendon, each ............................ 6.92 NA NA 4.79 5.44 1.09 NA NA 12.80 13.45 090 27664 ......... ............ A Repair of leg tendon, each ............................ 4.58 NA NA 3.88 4.39 0.76 NA NA 9.22 9.73 09027665 ......... ............ A Repair of leg tendon, each ............................ 5.39 NA NA 4.40 4.84 0.89 NA NA 10.68 11.12 090 27675 ......... ............ A Repair lower leg tendons .............................. 7.17 NA NA 4.64 5.47 1.11 NA NA 12.92 13.75 090 27676 ......... ............ A Repair lower leg tendons .............................. 8.53 NA NA 5.64 6.49 1.37 NA NA 15.54 16.39 090 27680 ......... ............ A Release of lower leg tendon ......................... 5.73 NA NA 4.28 4.91 0.93 NA NA 10.94 11.57 09027681 ......... ............ A Release of lower leg tendons ....................... 6.87 NA NA 4.67 5.62 1.15 NA NA 12.69 13.64 090 27685 ......... ............ A Revision of lower leg tendon ......................... 6.49 8.73 7.67 4.52 5.24 0.97 16.19 15.13 11.98 12.70 090 27686 ......... ............ A Revise lower leg tendons .............................. 7.57 NA NA 5.27 6.20 1.24 NA NA 14.08 15.01 090 27687 ......... ............ A Revision of calf tendon .................................. 6.23 NA NA 4.42 5.10 1.00 NA NA 11.65 12.33 090 27690 ......... ............ A Revise lower leg tendon ................................ 8.88 NA NA 5.34 6.11 1.33 NA NA 15.55 16.32 090 27691 ......... ............ A Revise lower leg tendon ................................ 10.19 NA NA 6.57 7.48 1.64 NA NA 18.40 19.31 090 27692 ......... ............ A Revise additional leg tendon ......................... 1.87 NA NA 0.71 0.88 0.32 NA NA 2.90 3.07 ZZZ 27695 ......... ............ A Repair of ankle ligament ............................... 6.50 NA NA 4.90 5.64 1.05 NA NA 12.45 13.19 090 27696 ......... ............ A Repair of ankle ligaments ............................. 8.38 NA NA 5.29 6.16 1.28 NA NA 14.95 15.82 090 27698 ......... ............ A Repair of ankle ligament ............................... 9.41 NA NA 5.78 6.67 1.47 NA NA 16.66 17.55 090 27700 ......... ............ A Revision of ankle joint ................................... 9.46 NA NA 5.03 5.53 1.30 NA NA 15.79 16.29 090 27702 ......... ............ A Reconstruct ankle joint .................................. 14.19 NA NA 8.56 10.01 2.37 NA NA 25.12 26.57 090 27703 ......... ............ A Reconstruction, ankle joint ............................ 16.69 NA NA 9.69 10.87 2.76 NA NA 29.14 30.32 090 27704 ......... ............ A Removal of ankle implant .............................. 7.61 NA NA 5.60 5.61 1.27 NA NA 14.48 14.49 090 27705 ......... ............ A Incision of tibia .............................................. 10.66 NA NA 6.78 7.84 1.80 NA NA 19.24 20.30 090 27707 ......... ............ A Incision of fibula ............................................ 4.60 NA NA 4.42 4.82 0.76 NA NA 9.78 10.18 090 27709 ......... ............ A Incision of tibia & fibula ................................. 17.24 NA NA 9.47 8.48 1.73 NA NA 28.44 27.45 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37288 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27712 ......... ............ A Realignment of lower leg .............................. 15.59 NA NA 8.98 10.32 2.47 NA NA 27.04 28.38 090 27715 ......... ............ A Revision of lower leg ..................................... 15.27 NA NA 8.83 10.31 2.49 NA NA 26.59 28.07 090 27720 ......... ............ A Repair of tibia ................................................ 12.13 NA NA 7.81 9.03 2.04 NA NA 21.98 23.20 090 27722 ......... ............ A Repair/graft of tibia ........................................ 12.22 NA NA 7.90 8.85 2.05 NA NA 22.17 23.12 090 27724 ......... ............ A Repair/graft of tibia ........................................ 19.12 NA NA 10.10 11.83 3.16 NA NA 32.38 34.11 090 27725 ......... ............ A Repair of lower leg ........................................ 17.07 NA NA 10.41 11.56 2.71 NA NA 30.19 31.34 090 27727 ......... ............ A Repair of lower leg ........................................ 14.59 NA NA 8.40 9.88 2.43 NA NA 25.42 26.90 090 27730 ......... ............ A Repair of tibia epiphysis ................................ 7.52 NA NA 5.21 6.13 1.72 NA NA 14.45 15.37 090 27732 ......... ............ A Repair of fibula epiphysis .............................. 5.31 NA NA 4.60 4.86 0.77 NA NA 10.68 10.94 090 27734 ......... ............ A Repair lower leg epiphyses ........................... 8.65 NA NA 6.08 6.25 1.35 NA NA 16.08 16.25 090 27740 ......... ............ A Repair of leg epiphyses ................................ 9.41 NA NA 6.52 7.64 1.62 NA NA 17.55 18.67 090 27742 ......... ............ A Repair of leg epiphyses ................................ 10.40 3.04 4.95 5.19 5.48 1.79 15.23 17.14 17.38 17.67 090 27745 ......... ............ A Reinforce tibia ............................................... 10.29 NA NA 6.87 7.86 1.75 NA NA 18.91 19.90 090 27750 ......... ............ A Treatment of tibia fracture ............................. 3.19 4.26 4.64 3.68 3.82 0.55 8.00 8.38 7.42 7.56 090 27752 ......... ............ A Treatment of tibia fracture ............................. 6.07 5.89 6.48 5.05 5.53 1.01 12.97 13.56 12.13 12.61 090 27756 ......... ............ A Treatment of tibia fracture ............................. 7.25 NA NA 5.65 6.27 1.17 NA NA 14.07 14.69 090 27758 ......... ............ A Treatment of tibia fracture ............................. 12.31 NA NA 7.90 8.88 2.03 NA NA 22.24 23.22 090 27759 ......... ............ A Treatment of tibia fracture ............................. 14.23 NA NA 8.54 9.89 2.38 NA NA 25.15 26.50 090 27760 ......... ............ A Treatment of ankle fracture ........................... 3.01 4.23 4.58 3.63 3.61 0.48 7.72 8.07 7.12 7.10 090 27762 ......... ............ A Treatment of ankle fracture ........................... 5.24 5.50 6.14 4.67 5.14 0.85 11.59 12.23 10.76 11.23 090 27766 ......... ............ A Treatment of ankle fracture ........................... 8.65 NA NA 6.16 6.97 1.44 NA NA 16.25 17.06 090 27780 ......... ............ A Treatment of fibula fracture ........................... 2.65 3.84 4.10 3.28 3.24 0.41 6.90 7.16 6.34 6.30 090 27781 ......... ............ A Treatment of fibula fracture ........................... 4.39 4.89 5.36 4.27 4.56 0.73 10.01 10.48 9.39 9.68 090 27784 ......... ............ A Treatment of fibula fracture ........................... 7.34 NA NA 5.50 6.24 1.23 NA NA 14.07 14.81 090 27786 ......... ............ A Treatment of ankle fracture ........................... 2.84 4.01 4.36 3.39 3.35 0.46 7.31 7.66 6.69 6.65 090 27788 ......... ............ A Treatment of ankle fracture ........................... 4.44 4.93 5.48 4.20 4.55 0.74 10.11 10.66 9.38 9.73 090 27792 ......... ............ A Treatment of ankle fracture ........................... 7.83 NA NA 5.83 6.69 1.32 NA NA 14.98 15.84 090 27808 ......... ............ A Treatment of ankle fracture ........................... 2.83 4.34 4.69 3.65 3.70 0.46 7.63 7.98 6.94 6.99 090 27810 ......... ............ A Treatment of ankle fracture ........................... 5.12 5.38 6.04 4.53 5.00 0.82 11.32 11.98 10.47 10.94 090 27814 ......... ............ A Treatment of ankle fracture ........................... 11.02 NA NA 7.13 8.22 1.85 NA NA 20.00 21.09 090 27816 ......... ............ A Treatment of ankle fracture ........................... 2.89 3.98 4.29 3.31 3.39 0.43 7.30 7.61 6.63 6.71 090 27818 ......... ............ A Treatment of ankle fracture ........................... 5.49 5.36 6.13 4.40 4.99 0.82 11.67 12.44 10.71 11.30 090 27822 ......... ............ A Treatment of ankle fracture ........................... 12.04 NA NA 8.71 10.19 1.91 NA NA 22.66 24.14 090 27823 ......... ............ A Treatment of ankle fracture ........................... 14.18 NA NA 9.33 10.96 2.25 NA NA 25.76 27.39 090 27824 ......... ............ A Treat lower leg fracture ................................. 3.14 3.69 3.98 3.50 3.55 0.45 7.28 7.57 7.09 7.14 090 27825 ......... ............ A Treat lower leg fracture ................................. 6.54 5.78 6.41 4.75 5.24 1.02 13.34 13.97 12.31 12.80 090 27826 ......... ............ A Treat lower leg fracture ................................. 8.89 NA NA 6.89 8.36 1.47 NA NA 17.25 18.72 090 27827 ......... ............ A Treat lower leg fracture ................................. 15.65 NA NA 10.62 12.26 2.43 NA NA 28.70 30.34 090 27828 ......... ............ A Treat lower leg fracture ................................. 18.07 NA NA 12.12 13.51 2.81 NA NA 33.00 34.39 090 27829 ......... ............ A Treat lower leg joint ....................................... 5.60 NA NA 5.44 6.46 0.95 NA NA 11.99 13.01 090 27830 ......... ............ A Treat lower leg dislocation ............................ 3.78 4.25 4.36 3.70 3.82 0.54 8.57 8.68 8.02 8.14 090 27831 ......... ............ A Treat lower leg dislocation ............................ 4.55 NA NA 3.94 4.34 0.73 NA NA 9.22 9.62 090 27832 ......... ............ A Treat lower leg dislocation ............................ 6.60 NA NA 4.65 5.81 1.03 NA NA 12.28 13.44 090 27840 ......... ............ A Treat ankle dislocation .................................. 4.57 NA NA 3.59 3.73 0.46 NA NA 8.62 8.76 090 27842 ......... ............ A Treat ankle dislocation .................................. 6.26 NA NA 4.81 5.05 1.00 NA NA 12.07 12.31 090 27846 ......... ............ A Treat ankle dislocation .................................. 10.08 NA NA 6.73 7.65 1.70 NA NA 18.51 19.43 090 27848 ......... ............ A Treat ankle dislocation .................................. 11.48 NA NA 7.57 9.20 1.94 NA NA 20.99 22.62 090 27860 ......... ............ A Fixation of ankle joint .................................... 2.34 NA NA 1.67 1.91 0.39 NA NA 4.40 4.64 010 27870 ......... ............ A Fusion of ankle joint, open ............................ 15.13 NA NA 9.00 10.16 2.36 NA NA 26.49 27.65 090 27871 ......... ............ A Fusion of tibiofibular joint .............................. 9.34 NA NA 6.40 7.30 1.59 NA NA 17.33 18.23 090 27880 ......... ............ A Amputation of lower leg ................................ 15.18 NA NA 7.13 7.15 1.75 NA NA 24.06 24.08 090 27881 ......... ............ A Amputation of lower leg ................................ 13.22 NA NA 7.42 8.51 1.98 NA NA 22.62 23.71 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37289 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

27882 ......... ............ A Amputation of lower leg ................................ 9.59 NA NA 5.61 6.28 1.29 NA NA 16.49 17.16 090 27884 ......... ............ A Amputation follow-up surgery ........................ 8.56 NA NA 5.09 5.60 1.22 NA NA 14.87 15.38 09027886 ......... ............ A Amputation follow-up surgery ........................ 9.79 NA NA 5.74 6.33 1.40 NA NA 16.93 17.52 09027888 ......... ............ A Amputation of foot at ankle ........................... 10.14 NA NA 6.19 7.19 1.51 NA NA 17.84 18.84 090 27889 ......... ............ A Amputation of foot at ankle ........................... 10.63 NA NA 5.44 6.23 1.46 NA NA 17.53 18.32 090 27892 ......... ............ A Decompression of leg ................................... 7.74 NA NA 4.86 5.42 1.10 NA NA 13.70 14.26 090 27893 ......... ............ A Decompression of leg ................................... 7.70 NA NA 5.05 5.37 1.10 NA NA 13.85 14.17 090 27894 ......... ............ A Decompression of leg ................................... 12.32 NA NA 7.30 7.67 1.65 NA NA 21.27 21.64 090 28001 ......... ............ A Drainage of bursa of foot .............................. 2.73 3.99 3.24 1.60 1.87 0.33 7.05 6.30 4.66 4.93 010 28002 ......... ............ A Treatment of foot infection ............................ 5.72 6.69 5.42 3.56 3.73 0.61 13.02 11.75 9.89 10.06 010 28003 ......... ............ A Treatment of foot infection ............................ 8.88 7.77 6.63 4.54 5.07 1.12 17.77 16.63 14.54 15.07 090 28005 ......... ............ A Treat foot bone lesion ................................... 9.21 NA NA 5.24 5.86 1.16 NA NA 15.61 16.23 090 28008 ......... ............ A Incision of foot fascia .................................... 4.44 6.15 4.96 2.97 3.15 0.57 11.16 9.97 7.98 8.16 090 28010 ......... ............ A Incision of toe tendon .................................... 2.84 2.83 2.49 2.31 2.36 0.36 6.03 5.69 5.51 5.56 090 28011 ......... ............ A Incision of toe tendons .................................. 4.13 NA NA 3.00 3.23 0.59 NA NA 7.72 7.95 090 28020 ......... ............ A Exploration of foot joint ................................. 5.00 7.48 6.39 3.62 4.01 0.72 13.20 12.11 9.34 9.73 090 28022 ......... ............ A Exploration of foot joint ................................. 4.66 6.85 5.62 3.27 3.71 0.62 12.13 10.90 8.55 8.99 090 28024 ......... ............ A Exploration of toe joint .................................. 4.37 6.62 5.58 3.13 3.73 0.58 11.57 10.53 8.08 8.68 090 28030 ......... ............ A Removal of foot nerve ................................... 6.14 NA NA 3.30 3.57 0.74 NA NA 10.18 10.45 090 28035 ......... ............ A Decompression of tibia nerve ....................... 5.08 7.40 6.25 3.60 3.98 0.70 13.18 12.03 9.38 9.76 090 28043 ......... ............ A Excision of foot lesion ................................... 3.53 4.78 4.06 2.72 3.07 0.46 8.77 8.05 6.71 7.06 090 28045 ......... ............ A Excision of foot lesion ................................... 4.71 7.03 5.80 3.23 3.52 0.63 12.37 11.14 8.57 8.86 090 28046 ......... ............ A Resection of tumor, foot ................................ 10.46 10.35 9.18 5.72 6.30 1.36 22.17 21.00 17.54 18.12 090 28050 ......... ............ A Biopsy of foot joint lining ............................... 4.24 6.83 5.38 3.22 3.51 0.60 11.67 10.22 8.06 8.35 090 28052 ......... ............ A Biopsy of foot joint lining ............................... 3.93 6.40 5.29 2.91 3.31 0.53 10.86 9.75 7.37 7.77 090 28054 ......... ............ A Biopsy of toe joint lining ................................ 3.44 6.18 5.09 2.74 3.12 0.46 10.08 8.99 6.64 7.02 090 28060 ......... ............ A Partial removal, foot fascia ............................ 5.22 7.09 5.89 3.53 3.79 0.70 13.01 11.81 9.45 9.71 090 28062 ......... ............ A Removal of foot fascia .................................. 6.51 7.80 6.85 3.78 3.96 0.83 15.14 14.19 11.12 11.30 090 28070 ......... ............ A Removal of foot joint lining ............................ 5.09 7.18 5.72 3.42 3.72 0.73 13.00 11.54 9.24 9.54 090 28072 ......... ............ A Removal of foot joint lining ............................ 4.57 7.58 6.05 3.59 4.13 0.68 12.83 11.30 8.84 9.38 090 28080 ......... ............ A Removal of foot lesion .................................. 4.57 7.63 5.75 4.16 3.81 0.47 12.67 10.79 9.20 8.85 090 28086 ......... ............ A Excise foot tendon sheath ............................. 4.77 7.76 7.94 3.74 4.45 0.76 13.29 13.47 9.27 9.98 090 28088 ......... ............ A Excise foot tendon sheath ............................. 3.85 6.94 6.06 3.14 3.71 0.61 11.40 10.52 7.60 8.17 090 28090 ......... ............ A Removal of foot lesion .................................. 4.40 6.75 5.55 3.15 3.38 0.59 11.74 10.54 8.14 8.37 090 28092 ......... ............ A Removal of toe lesions .................................. 3.63 6.46 5.54 2.97 3.39 0.49 10.58 9.66 7.09 7.51 090 28100 ......... ............ A Removal of ankle/heel lesion ........................ 5.65 8.18 8.03 4.03 4.53 0.82 14.65 14.50 10.50 11.00 090 28102 ......... ............ A Remove/graft foot lesion ............................... 7.72 NA NA 4.87 5.69 1.14 NA NA 13.73 14.55 090 28103 ......... ............ A Remove/graft foot lesion ............................... 6.49 NA NA 4.10 4.49 0.91 NA NA 11.50 11.89 090 28104 ......... ............ A Removal of foot lesion .................................. 5.11 7.20 5.93 3.43 3.81 0.70 13.01 11.74 9.24 9.62 090 28106 ......... ............ A Remove/graft foot lesion ............................... 7.15 NA NA 4.37 4.42 0.97 NA NA 12.49 12.54 090 28107 ......... ............ A Remove/graft foot lesion ............................... 5.55 7.82 6.86 3.70 4.08 0.74 14.11 13.15 9.99 10.37 090 28108 ......... ............ A Removal of toe lesions .................................. 4.15 6.33 5.03 2.96 3.19 0.53 11.01 9.71 7.64 7.87 090 28110 ......... ............ A Part removal of metatarsal ............................ 4.07 6.93 5.66 3.04 3.18 0.54 11.54 10.27 7.65 7.79 090 28111 ......... ............ A Part removal of metatarsal ............................ 5.00 7.31 6.55 3.28 3.57 0.67 12.98 12.22 8.95 9.24 090 28112 ......... ............ A Part removal of metatarsal ............................ 4.48 7.22 6.17 3.24 3.50 0.61 12.31 11.26 8.33 8.59 090 28113 ......... ............ A Part removal of metatarsal ............................ 5.78 8.38 6.65 4.60 4.39 0.63 14.79 13.06 11.01 10.80 090 28114 ......... ............ A Removal of metatarsal heads ....................... 11.49 13.21 12.04 8.15 8.33 1.42 26.12 24.95 21.06 21.24 090 28116 ......... ............ A Revision of foot ............................................. 8.86 9.42 7.46 5.30 5.21 1.03 19.31 17.35 15.19 15.10 090 28118 ......... ............ A Removal of heel bone ................................... 5.95 7.89 6.67 3.98 4.26 0.84 14.68 13.46 10.77 11.05 090 28119 ......... ............ A Removal of heel spur .................................... 5.38 7.18 5.88 3.54 3.68 0.70 13.26 11.96 9.62 9.76 090 28120 ......... ............ A Part removal of ankle/heel ............................ 5.57 8.04 7.49 3.92 4.30 0.77 14.38 13.83 10.26 10.64 090 28122 ......... ............ A Partial removal of foot bone .......................... 7.46 8.45 7.25 4.74 5.15 0.98 16.89 15.69 13.18 13.59 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37290 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

28124 ......... ............ A Partial removal of toe .................................... 4.80 6.73 5.43 3.41 3.60 0.60 12.13 10.83 8.81 9.00 090 28126 ......... ............ A Partial removal of toe .................................... 3.51 5.92 4.65 2.63 2.91 0.45 9.88 8.61 6.59 6.87 090 28130 ......... ............ A Removal of ankle bone ................................. 9.22 NA NA 5.78 6.49 1.26 NA NA 16.26 16.97 090 28140 ......... ............ A Removal of metatarsal .................................. 6.96 7.84 7.39 4.11 4.61 0.92 15.72 15.27 11.99 12.49 090 28150 ......... ............ A Removal of toe .............................................. 4.08 6.39 5.23 2.98 3.21 0.53 11.00 9.84 7.59 7.82 090 28153 ......... ............ A Partial removal of toe .................................... 3.65 6.15 4.78 2.84 2.73 0.47 10.27 8.90 6.96 6.85 090 28160 ......... ............ A Partial removal of toe .................................... 3.73 6.33 5.01 2.92 3.24 0.49 10.55 9.23 7.14 7.46 090 28171 ......... ............ A Extensive foot surgery ................................... 9.77 NA NA 5.10 5.36 1.33 NA NA 16.20 16.46 090 28173 ......... ............ A Extensive foot surgery ................................... 8.97 8.74 7.89 4.60 5.06 1.12 18.83 17.98 14.69 15.15 090 28175 ......... ............ A Extensive foot surgery ................................... 6.10 7.08 6.06 3.57 3.68 0.73 13.91 12.89 10.40 10.51 090 28190 ......... ............ A Removal of foot foreign body ........................ 1.96 4.00 3.55 1.32 1.44 0.22 6.18 5.73 3.50 3.62 010 28192 ......... ............ A Removal of foot foreign body ........................ 4.63 6.71 5.80 3.17 3.53 0.61 11.95 11.04 8.41 8.77 090 28193 ......... ............ A Removal of foot foreign body ........................ 5.72 7.29 6.04 3.58 3.84 0.73 13.74 12.49 10.03 10.29 090 28200 ......... ............ A Repair of foot tendon .................................... 4.59 6.85 5.54 3.20 3.47 0.61 12.05 10.74 8.40 8.67 090 28202 ......... ............ A Repair/graft of foot tendon ............................ 6.89 7.91 7.40 4.00 4.38 0.91 15.71 15.20 11.80 12.18 090 28208 ......... ............ A Repair of foot tendon .................................... 4.36 6.64 5.28 3.14 3.27 0.58 11.58 10.22 8.08 8.21 090 28210 ......... ............ A Repair/graft of foot tendon ............................ 6.34 7.50 6.55 3.84 3.98 0.81 14.65 13.70 10.99 11.13 090 28220 ......... ............ A Release of foot tendon .................................. 4.52 6.37 5.10 3.03 3.33 0.57 11.46 10.19 8.12 8.42 090 28222 ......... ............ A Release of foot tendons ................................ 5.61 6.84 5.65 3.27 3.92 0.69 13.14 11.95 9.57 10.22 090 28225 ......... ............ A Release of foot tendon .................................. 3.65 5.99 4.72 2.69 2.86 0.46 10.10 8.83 6.80 6.97 090 28226 ......... ............ A Release of foot tendons ................................ 4.52 6.94 5.34 3.27 3.63 0.58 12.04 10.44 8.37 8.73 090 28230 ......... ............ A Incision of foot tendon(s) ............................... 4.23 6.26 5.08 2.85 3.47 0.55 11.04 9.86 7.63 8.25 090 28232 ......... ............ A Incision of toe tendon .................................... 3.38 5.91 4.88 2.65 3.15 0.44 9.73 8.70 6.47 6.97 090 28234 ......... ............ A Incision of foot tendon ................................... 3.36 6.25 5.07 3.01 3.27 0.44 10.05 8.87 6.81 7.07 090 28238 ......... ............ A Revision of foot tendon ................................. 7.78 8.28 7.52 4.28 4.78 1.06 17.12 16.36 13.12 13.62 090 28240 ......... ............ A Release of big toe ......................................... 4.35 6.38 5.08 2.95 3.36 0.58 11.31 10.01 7.88 8.29 090 28250 ......... ............ A Revision of foot fascia ................................... 5.91 7.37 6.07 3.70 4.03 0.82 14.10 12.80 10.43 10.76 090 28260 ......... ............ A Release of midfoot joint ................................ 8.01 8.53 6.89 4.64 4.91 1.14 17.68 16.04 13.79 14.06 090 28261 ......... ............ A Revision of foot tendon ................................. 12.83 10.60 9.12 6.26 7.06 1.57 25.00 23.52 20.66 21.46 090 28262 ......... ............ A Revision of foot and ankle ............................ 16.93 15.42 14.05 9.62 10.61 2.59 34.94 33.57 29.14 30.13 090 28264 ......... ............ A Release of midfoot joint ................................ 10.45 10.30 8.39 5.91 6.95 1.54 22.29 20.38 17.90 18.94 090 28270 ......... ............ A Release of foot contracture ........................... 4.75 6.88 5.40 3.40 3.66 0.62 12.25 10.77 8.77 9.03 090 28272 ......... ............ A Release of toe joint, each ............................. 3.79 5.80 4.59 2.62 2.80 0.46 10.05 8.84 6.87 7.05 090 28280 ......... ............ A Fusion of toes ................................................ 5.18 7.31 6.52 3.53 4.25 0.73 13.22 12.43 9.44 10.16 090 28285 ......... ............ A Repair of hammertoe .................................... 4.58 6.67 5.32 3.31 3.40 0.59 11.84 10.49 8.48 8.57 090 28286 ......... ............ A Repair of hammertoe .................................... 4.55 6.45 5.21 3.00 3.20 0.57 11.57 10.33 8.12 8.32 090 28288 ......... ............ A Partial removal of foot bone .......................... 5.73 8.58 6.61 4.66 4.83 0.65 14.96 12.99 11.04 11.21 090 28289 ......... ............ A Repair hallux rigidus ...................................... 8.03 9.38 8.35 5.29 5.66 1.02 18.43 17.40 14.34 14.71 090 28290 ......... ............ A Correction of bunion ...................................... 5.65 8.13 6.74 3.91 4.53 0.82 14.60 13.21 10.38 11.00 090 28292 ......... ............ A Correction of bunion ...................................... 8.60 10.27 8.18 6.08 5.68 0.91 19.78 17.69 15.59 15.19 090 28293 ......... ............ A Correction of bunion ...................................... 10.96 14.40 11.68 6.84 6.30 1.13 26.49 23.77 18.93 18.39 090 28294 ......... ............ A Correction of bunion ...................................... 8.55 9.03 7.85 4.50 4.67 1.09 18.67 17.49 14.14 14.31 090 28296 ......... ............ A Correction of bunion ...................................... 9.23 9.51 8.51 4.73 5.26 1.19 19.93 18.93 15.15 15.68 090 28297 ......... ............ A Correction of bunion ...................................... 9.23 10.35 9.32 5.24 6.01 1.32 20.90 19.87 15.79 16.56 090 28298 ......... ............ A Correction of bunion ...................................... 7.93 9.16 7.71 4.49 4.88 1.05 18.14 16.69 13.47 13.86 090 28299 ......... ............ A Correction of bunion ...................................... 11.31 10.46 9.21 5.64 5.97 1.37 23.14 21.89 18.32 18.65 090 28300 ......... ............ A Incision of heel bone ..................................... 9.53 NA NA 5.99 6.79 1.54 NA NA 17.06 17.86 090 28302 ......... ............ A Incision of ankle bone ................................... 9.54 NA NA 5.64 6.59 1.42 NA NA 16.60 17.55 090 28304 ......... ............ A Incision of midfoot bones .............................. 9.21 9.46 8.34 5.00 5.56 1.27 19.94 18.82 15.48 16.04 090 28305 ......... ............ A Incise/graft midfoot bones ............................. 10.54 NA NA 5.48 6.43 1.27 NA NA 17.29 18.24 090 28306 ......... ............ A Incision of metatarsal .................................... 5.85 8.28 7.21 3.80 4.09 0.84 14.97 13.90 10.49 10.78 090 28307 ......... ............ A Incision of metatarsal .................................... 6.32 9.45 10.65 4.40 5.08 0.90 16.67 17.87 11.62 12.30 090 28308 ......... ............ A Incision of metatarsal .................................... 5.28 7.84 6.28 3.76 3.71 0.70 13.82 12.26 9.74 9.69 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37291 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

28309 ......... ............ A Incision of metatarsals .................................. 13.88 NA NA 7.63 7.89 2.04 NA NA 23.55 23.81 090 28310 ......... ............ A Revision of big toe ........................................ 5.42 7.45 6.18 3.35 3.51 0.70 13.57 12.30 9.47 9.63 090 28312 ......... ............ A Revision of toe .............................................. 4.54 7.32 5.92 3.19 3.53 0.63 12.49 11.09 8.36 8.70 090 28313 ......... ............ A Repair deformity of toe .................................. 5.00 7.31 5.80 3.61 4.53 0.73 13.04 11.53 9.34 10.26 090 28315 ......... ............ A Removal of sesamoid bone .......................... 4.85 6.65 5.34 3.19 3.30 0.63 12.13 10.82 8.67 8.78 090 28320 ......... ............ A Repair of foot bones ...................................... 9.17 NA NA 5.67 6.47 1.43 NA NA 16.27 17.07 090 28322 ......... ............ A Repair of metatarsals .................................... 8.33 9.92 9.38 5.39 6.11 1.27 19.52 18.98 14.99 15.71 090 28340 ......... ............ A Resect enlarged toe tissue ........................... 6.97 7.96 6.84 3.99 4.19 0.84 15.77 14.65 11.80 12.00 090 28341 ......... ............ A Resect enlarged toe ...................................... 8.52 8.57 7.36 4.38 4.71 1.01 18.10 16.89 13.91 14.24 090 28344 ......... ............ A Repair extra toe(s) ........................................ 4.25 6.74 6.01 3.13 3.51 0.51 11.50 10.77 7.89 8.27 090 28345 ......... ............ A Repair webbed toe(s) .................................... 5.91 7.72 6.59 3.82 4.47 0.80 14.43 13.30 10.53 11.18 090 28360 ......... ............ A Reconstruct cleft foot .................................... 14.57 NA NA 6.24 9.45 2.28 NA NA 23.09 26.30 090 28400 ......... ............ A Treatment of heel fracture ............................. 2.16 3.34 3.57 2.89 3.02 0.35 5.85 6.08 5.40 5.53 090 28405 ......... ............ A Treatment of heel fracture ............................. 4.56 4.47 4.75 3.70 4.40 0.73 9.76 10.04 8.99 9.69 090 28406 ......... ............ A Treatment of heel fracture ............................. 6.36 NA NA 5.47 6.48 1.11 NA NA 12.94 13.95 090 28415 ......... ............ A Treat heel fracture ......................................... 17.44 NA NA 10.70 12.67 2.66 NA NA 30.80 32.77 090 28420 ......... ............ A Treat/graft heel fracture ................................. 16.98 NA NA 9.98 12.21 2.80 NA NA 29.76 31.99 090 28430 ......... ............ A Treatment of ankle fracture ........................... 2.09 3.10 3.33 2.55 2.57 0.31 5.50 5.73 4.95 4.97 090 28435 ......... ............ A Treatment of ankle fracture ........................... 3.39 3.72 3.85 3.04 3.57 0.55 7.66 7.79 6.98 7.51 090 28436 ......... ............ A Treatment of ankle fracture ........................... 4.70 NA NA 4.79 5.65 0.81 NA NA 10.30 11.16 090 28445 ......... ............ A Treat ankle fracture ....................................... 16.99 NA NA 9.53 10.68 2.58 NA NA 29.10 30.25 090 28450 ......... ............ A Treat midfoot fracture, each .......................... 1.90 2.90 3.07 2.40 2.46 0.28 5.08 5.25 4.58 4.64 090 28455 ......... ............ A Treat midfoot fracture, each .......................... 3.09 3.47 3.44 2.84 3.28 0.44 7.00 6.97 6.37 6.81 090 28456 ......... ............ A Treat midfoot fracture .................................... 2.68 NA NA 3.46 3.99 0.44 NA NA 6.58 7.11 090 28465 ......... ............ A Treat midfoot fracture, each .......................... 7.06 NA NA 4.98 5.99 1.10 NA NA 13.14 14.15 090 28470 ......... ............ A Treat metatarsal fracture ............................... 1.99 2.80 3.05 2.36 2.43 0.30 5.09 5.34 4.65 4.72 090 28475 ......... ............ A Treat metatarsal fracture ............................... 2.97 3.14 3.29 2.52 3.05 0.44 6.55 6.70 5.93 6.46 090 28476 ......... ............ A Treat metatarsal fracture ............................... 3.37 NA NA 4.17 4.79 0.54 NA NA 8.08 8.70 090 28485 ......... ............ A Treat metatarsal fracture ............................... 5.70 NA NA 4.49 5.22 0.83 NA NA 11.02 11.75 090 28490 ......... ............ A Treat big toe fracture ..................................... 1.09 2.09 2.04 1.67 1.65 0.14 3.32 3.27 2.90 2.88 090 28495 ......... ............ A Treat big toe fracture ..................................... 1.58 2.45 2.25 1.85 2.02 0.20 4.23 4.03 3.63 3.80 090 28496 ......... ............ A Treat big toe fracture ..................................... 2.33 7.14 7.99 2.86 3.12 0.36 9.83 10.68 5.55 5.81 090 28505 ......... ............ A Treat big toe fracture ..................................... 3.80 7.43 7.95 3.23 3.74 0.56 11.79 12.31 7.59 8.10 090 28510 ......... ............ A Treatment of toe fracture .............................. 1.09 1.66 1.56 1.59 1.55 0.14 2.89 2.79 2.82 2.78 090 28515 ......... ............ A Treatment of toe fracture .............................. 1.46 2.22 1.98 1.82 1.88 0.18 3.86 3.62 3.46 3.52 090 28525 ......... ............ A Treat toe fracture ........................................... 3.32 6.84 7.36 2.87 3.30 0.49 10.65 11.17 6.68 7.11 090 28530 ......... ............ A Treat sesamoid bone fracture ....................... 1.06 1.63 1.49 1.34 1.42 0.14 2.83 2.69 2.54 2.62 090 28531 ......... ............ A Treat sesamoid bone fracture ....................... 2.47 5.77 6.90 2.09 2.08 0.34 8.58 9.71 4.90 4.89 090 28540 ......... ............ A Treat foot dislocation ..................................... 2.04 2.74 2.49 2.30 2.38 0.26 5.04 4.79 4.60 4.68 090 28545 ......... ............ A Treat foot dislocation ..................................... 2.45 3.28 2.58 2.68 2.43 0.37 6.10 5.40 5.50 5.25 090 28546 ......... ............ A Treat foot dislocation ..................................... 3.20 7.66 7.11 3.43 4.15 0.52 11.38 10.83 7.15 7.87 090 28555 ......... ............ A Repair foot dislocation ................................... 6.35 9.73 9.88 4.89 5.49 1.04 17.12 17.27 12.28 12.88 090 28570 ......... ............ A Treat foot dislocation ..................................... 1.66 2.57 2.47 1.98 2.25 0.23 4.46 4.36 3.87 4.14 090 28575 ......... ............ A Treat foot dislocation ..................................... 3.31 4.32 3.88 3.63 3.71 0.56 8.19 7.75 7.50 7.58 090 28576 ......... ............ A Treat foot dislocation ..................................... 4.40 NA NA 3.92 4.12 0.69 NA NA 9.01 9.21 090 28585 ......... ............ A Repair foot dislocation ................................... 8.10 9.83 7.96 5.19 5.69 1.25 19.18 17.31 14.54 15.04 090 28600 ......... ............ A Treat foot dislocation ..................................... 1.89 3.02 2.87 2.37 2.61 0.27 5.18 5.03 4.53 4.77 090 28605 ......... ............ A Treat foot dislocation ..................................... 2.71 3.69 3.27 3.10 3.12 0.40 6.80 6.38 6.21 6.23 090 28606 ......... ............ A Treat foot dislocation ..................................... 4.89 NA NA 4.26 4.59 0.82 NA NA 9.97 10.30 090 28615 ......... ............ A Repair foot dislocation ................................... 8.88 NA NA 6.88 7.77 1.30 NA NA 17.06 17.95 090 28630 ......... ............ A Treat toe dislocation ...................................... 1.70 1.94 1.66 0.93 0.98 0.20 3.84 3.56 2.83 2.88 010 28635 ......... ............ A Treat toe dislocation ...................................... 1.91 2.24 2.08 1.31 1.48 0.26 4.41 4.25 3.48 3.65 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37292 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

28636 ......... ............ A Treat toe dislocation ...................................... 2.77 4.36 4.00 2.03 2.48 0.43 7.56 7.20 5.23 5.68 010 28645 ......... ............ A Repair toe dislocation .................................... 4.21 6.79 5.42 3.14 3.25 0.57 11.57 10.20 7.92 8.03 090 28660 ......... ............ A Treat toe dislocation ...................................... 1.23 1.29 1.27 0.77 0.79 0.13 2.65 2.63 2.13 2.15 010 28665 ......... ............ A Treat toe dislocation ...................................... 1.92 NA NA 1.32 1.40 0.26 NA NA 3.50 3.58 010 28666 ......... ............ A Treat toe dislocation ...................................... 2.66 5.25 5.74 1.89 2.42 0.43 8.34 8.83 4.98 5.51 010 28675 ......... ............ A Repair of toe dislocation ............................... 2.92 6.66 7.04 2.83 3.23 0.45 10.03 10.41 6.20 6.60 090 28705 ......... ............ A Fusion of foot bones ..................................... 20.04 NA NA 10.54 11.99 3.08 NA NA 33.66 35.11 090 28715 ......... ............ A Fusion of foot bones ..................................... 14.32 NA NA 8.34 9.42 2.16 NA NA 24.82 25.90 090 28725 ......... ............ A Fusion of foot bones ..................................... 11.89 NA NA 6.79 7.89 1.86 NA NA 20.54 21.64 090 28730 ......... ............ A Fusion of foot bones ..................................... 12.11 NA NA 7.63 8.28 1.70 NA NA 21.44 22.09 090 28735 ......... ............ A Fusion of foot bones ..................................... 11.95 NA NA 6.81 7.58 1.68 NA NA 20.44 21.21 090 28737 ......... ............ A Revision of foot bones .................................. 10.75 NA NA 5.97 6.61 1.47 NA NA 18.19 18.83 090 28740 ......... ............ A Fusion of foot bones ..................................... 9.01 10.82 10.87 5.94 6.35 1.22 21.05 21.10 16.17 16.58 090 28750 ......... ............ A Fusion of big toe joint .................................... 8.29 10.74 11.64 5.84 6.47 1.13 20.16 21.06 15.26 15.89 090 28755 ......... ............ A Fusion of big toe joint .................................... 4.73 7.21 6.39 3.31 3.65 0.65 12.59 11.77 8.69 9.03 090 28760 ......... ............ A Fusion of big toe joint .................................... 8.86 9.86 8.46 5.24 5.46 1.05 19.77 18.37 15.15 15.37 090 28800 ......... ............ A Amputation of midfoot ................................... 8.56 NA NA 5.05 5.62 1.15 NA NA 14.76 15.33 090 28805 ......... ............ A Amputation thru metatarsal ........................... 12.47 NA NA 6.04 5.76 1.18 NA NA 19.69 19.41 090 28810 ......... ............ A Amputation toe & metatarsal ......................... 6.44 NA NA 4.13 4.39 0.86 NA NA 11.43 11.69 09028820 ......... ............ A Amputation of toe .......................................... 4.82 7.74 7.61 3.58 3.74 0.61 13.17 13.04 9.01 9.17 090 28825 ......... ............ A Partial amputation of toe ............................... 3.64 7.21 7.06 3.15 3.41 0.50 11.35 11.20 7.29 7.55 090 28890 ......... ............ A High energy eswt, plantar f ........................... 3.30 4.59 5.45 2.27 2.14 0.41 8.30 9.16 5.98 5.85 090 29000 ......... ............ A Application of body cast ................................ 2.25 4.67 3.40 1.81 1.76 0.41 7.33 6.06 4.47 4.42 000 29010 ......... ............ A Application of body cast ................................ 2.06 3.33 3.30 1.30 1.66 0.45 5.84 5.81 3.81 4.17 000 29015 ......... ............ A Application of body cast ................................ 2.41 3.32 3.07 1.44 1.56 0.28 6.01 5.76 4.13 4.25 000 29020 ......... ............ A Application of body cast ................................ 2.11 3.74 3.33 1.46 1.42 0.28 6.13 5.72 3.85 3.81 000 29025 ......... ............ A Application of body cast ................................ 2.40 3.58 3.26 1.56 1.79 0.44 6.42 6.10 4.40 4.63 000 29035 ......... ............ A Application of body cast ................................ 1.77 3.66 3.63 1.46 1.55 0.28 5.71 5.68 3.51 3.60 000 29040 ......... ............ A Application of body cast ................................ 2.22 3.59 2.75 1.47 1.50 0.36 6.17 5.33 4.05 4.08 000 29044 ......... ............ A Application of body cast ................................ 2.12 3.93 3.97 1.63 1.84 0.35 6.40 6.44 4.10 4.31 000 29046 ......... ............ A Application of body cast ................................ 2.41 4.16 3.47 1.77 2.02 0.42 6.99 6.30 4.60 4.85 000 29049 ......... ............ A Application of figure eight .............................. 0.89 1.16 1.27 0.61 0.55 0.13 2.18 2.29 1.63 1.57 000 29055 ......... ............ A Application of shoulder cast .......................... 1.78 2.88 2.96 1.29 1.43 0.30 4.96 5.04 3.37 3.51 000 29058 ......... ............ A Application of shoulder cast .......................... 1.31 1.25 1.48 0.68 0.71 0.17 2.73 2.96 2.16 2.19 000 29065 ......... ............ A Application of long arm cast .......................... 0.87 1.27 1.32 0.69 0.74 0.15 2.29 2.34 1.71 1.76 000 29075 ......... ............ A Application of forearm cast ........................... 0.77 1.10 1.22 0.65 0.67 0.13 2.00 2.12 1.55 1.57 000 29085 ......... ............ A Apply hand/wrist cast .................................... 0.87 1.25 1.27 0.68 0.64 0.14 2.26 2.28 1.69 1.65 000 29086 ......... ............ A Apply finger cast ............................................ 0.62 1.03 0.98 0.53 0.50 0.07 1.72 1.67 1.22 1.19 000 29105 ......... ............ A Apply long arm splint ..................................... 0.87 1.08 1.19 0.53 0.52 0.12 2.07 2.18 1.52 1.51 000 29125 ......... ............ A Apply forearm splint ...................................... 0.59 0.96 1.01 0.42 0.40 0.07 1.62 1.67 1.08 1.06 000 29126 ......... ............ A Apply forearm splint ...................................... 0.77 1.00 1.16 0.47 0.46 0.07 1.84 2.00 1.31 1.30 000 29130 ......... ............ A Application of finger splint ............................. 0.50 0.43 0.46 0.18 0.17 0.06 0.99 1.02 0.74 0.73 000 29131 ......... ............ A Application of finger splint ............................. 0.55 0.62 0.71 0.26 0.25 0.03 1.20 1.29 0.84 0.83 000 29200 ......... ............ A Strapping of chest ......................................... 0.65 0.61 0.69 0.35 0.34 0.04 1.30 1.38 1.04 1.03 000 29220 ......... ............ A Strapping of low back .................................... 0.64 0.61 0.69 0.35 0.38 0.04 1.29 1.37 1.03 1.06 000 29240 ......... ............ A Strapping of shoulder .................................... 0.71 0.67 0.81 0.38 0.37 0.06 1.44 1.58 1.15 1.14 000 29260 ......... ............ A Strapping of elbow or wrist ........................... 0.55 0.65 0.72 0.36 0.33 0.05 1.25 1.32 0.96 0.93 000 29280 ......... ............ A Strapping of hand or finger ........................... 0.51 0.66 0.77 0.37 0.33 0.03 1.20 1.31 0.91 0.87 000 29305 ......... ............ A Application of hip cast ................................... 2.03 3.35 3.35 1.58 1.72 0.35 5.73 5.73 3.96 4.10 000 29325 ......... ............ A Application of hip casts ................................. 2.32 3.66 3.57 1.73 1.90 0.40 6.38 6.29 4.45 4.62 000 29345 ......... ............ A Application of long leg cast ........................... 1.40 1.65 1.74 0.93 1.03 0.24 3.29 3.38 2.57 2.67 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37293 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

29355 ......... ............ A Application of long leg cast ........................... 1.53 1.61 1.69 0.93 1.07 0.26 3.40 3.48 2.72 2.86 000 29358 ......... ............ A Apply long leg cast brace .............................. 1.43 2.03 2.06 0.92 1.05 0.25 3.71 3.74 2.60 2.73 000 29365 ......... ............ A Application of long leg cast ........................... 1.18 1.56 1.64 0.84 0.92 0.20 2.94 3.02 2.22 2.30 000 29405 ......... ............ A Apply short leg cast ....................................... 0.86 1.19 1.21 0.65 0.70 0.14 2.19 2.21 1.65 1.70 000 29425 ......... ............ A Apply short leg cast ....................................... 1.01 1.22 1.23 0.65 0.72 0.15 2.38 2.39 1.81 1.88 000 29435 ......... ............ A Apply short leg cast ....................................... 1.18 1.52 1.55 0.80 0.90 0.20 2.90 2.93 2.18 2.28 000 29440 ......... ............ A Addition of walker to cast .............................. 0.57 0.61 0.67 0.25 0.27 0.08 1.26 1.32 0.90 0.92 000 29445 ......... ............ A Apply rigid leg cast ........................................ 1.78 1.60 1.76 0.91 0.95 0.27 3.65 3.81 2.96 3.00 000 29450 ......... ............ A Application of leg cast ................................... 2.08 1.50 1.48 0.84 1.03 0.27 3.85 3.83 3.19 3.38 000 29505 ......... ............ A Application, long leg splint ............................ 0.69 1.05 1.15 0.44 0.45 0.08 1.82 1.92 1.21 1.22 000 29515 ......... ............ A Application lower leg splint ............................ 0.73 0.95 0.89 0.45 0.46 0.09 1.77 1.71 1.27 1.28 000 29520 ......... ............ A Strapping of hip ............................................. 0.54 0.67 0.81 0.38 0.45 0.03 1.24 1.38 0.95 1.02 000 29530 ......... ............ A Strapping of knee .......................................... 0.57 0.65 0.76 0.36 0.34 0.05 1.27 1.38 0.98 0.96 000 29540 ......... ............ A Strapping of ankle and/or ft ........................... 0.51 0.54 0.45 0.31 0.31 0.06 1.11 1.02 0.88 0.88 000 29550 ......... ............ A Strapping of toes ........................................... 0.47 0.56 0.46 0.30 0.29 0.06 1.09 0.99 0.83 0.82 000 29580 ......... ............ A Application of paste boot ............................... 0.57 0.72 0.67 0.34 0.35 0.07 1.36 1.31 0.98 0.99 000 29590 ......... ............ A Application of foot splint ................................ 0.76 0.59 0.53 0.26 0.28 0.09 1.44 1.38 1.11 1.13 000 29700 ......... ............ A Removal/revision of cast ............................... 0.57 0.96 0.91 0.26 0.28 0.08 1.61 1.56 0.91 0.93 000 29705 ......... ............ A Removal/revision of cast ............................... 0.76 0.76 0.81 0.36 0.38 0.13 1.65 1.70 1.25 1.27 000 29710 ......... ............ A Removal/revision of cast ............................... 1.34 1.43 1.51 0.62 0.68 0.20 2.97 3.05 2.16 2.22 000 29715 ......... ............ A Removal/revision of cast ............................... 0.94 1.12 1.16 0.40 0.40 0.09 2.15 2.19 1.43 1.43 000 29720 ......... ............ A Repair of body cast ....................................... 0.68 1.14 1.16 0.34 0.38 0.12 1.94 1.96 1.14 1.18 000 29730 ......... ............ A Windowing of cast ......................................... 0.75 0.75 0.80 0.34 0.35 0.12 1.62 1.67 1.21 1.22 000 29740 ......... ............ A Wedging of cast ............................................ 1.12 1.04 1.12 0.48 0.49 0.18 2.34 2.42 1.78 1.79 000 29750 ......... ............ A Wedging of clubfoot cast ............................... 1.26 0.90 1.02 0.43 0.54 0.21 2.37 2.49 1.90 2.01 000 29800 ......... ............ A Jaw arthroscopy/surgery ............................... 6.67 NA NA 5.64 6.65 0.99 NA NA 13.30 14.31 090 29804 ......... ............ A Jaw arthroscopy/surgery ............................... 8.63 NA NA 7.33 7.56 1.38 NA NA 17.34 17.57 090 29805 ......... ............ A Shoulder arthroscopy, dx .............................. 5.88 NA NA 4.66 5.43 1.02 NA NA 11.56 12.33 090 29806 ......... ............ A Shoulder arthroscopy/surgery ....................... 14.85 NA NA 9.22 10.70 2.49 NA NA 26.56 28.04 090 29807 ......... ............ A Shoulder arthroscopy/surgery ....................... 14.38 NA NA 9.10 10.54 2.41 NA NA 25.89 27.33 090 29819 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.61 NA NA 5.56 6.50 1.32 NA NA 14.49 15.43 090 29820 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.06 NA NA 5.12 5.96 1.22 NA NA 13.40 14.24 090 29821 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.71 NA NA 5.58 6.51 1.33 NA NA 14.62 15.55 090 29822 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.42 NA NA 5.51 6.41 1.28 NA NA 14.21 15.11 090 29823 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.16 NA NA 5.96 6.92 1.41 NA NA 15.53 16.49 090 29824 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.74 NA NA 6.45 7.28 1.42 NA NA 16.61 17.44 090 29825 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.61 NA NA 5.57 6.48 1.32 NA NA 14.50 15.41 090 29826 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.98 NA NA 6.11 7.19 1.55 NA NA 16.64 17.72 090 29827 ......... ............ A Arthroscop rotator cuff repr ........................... 15.34 NA NA 9.19 10.97 2.66 NA NA 27.19 28.97 090 29830 ......... ............ A Elbow arthroscopy ......................................... 5.75 NA NA 4.44 5.13 0.99 NA NA 11.18 11.87 090 29834 ......... ............ A Elbow arthroscopy/surgery ............................ 6.27 NA NA 4.79 5.59 1.08 NA NA 12.14 12.94 090 29835 ......... ............ A Elbow arthroscopy/surgery ............................ 6.47 NA NA 4.90 5.65 1.13 NA NA 12.50 13.25 090 29836 ......... ............ A Elbow arthroscopy/surgery ............................ 7.54 NA NA 5.48 6.48 1.22 NA NA 14.24 15.24 090 29837 ......... ............ A Elbow arthroscopy/surgery ............................ 6.86 NA NA 5.06 5.88 1.19 NA NA 13.11 13.93 090 29838 ......... ............ A Elbow arthroscopy/surgery ............................ 7.70 NA NA 5.59 6.58 1.30 NA NA 14.59 15.58 090 29840 ......... ............ A Wrist arthroscopy .......................................... 5.53 NA NA 4.54 5.14 0.84 NA NA 10.91 11.51 090 29843 ......... ............ A Wrist arthroscopy/surgery ............................. 6.00 NA NA 4.83 5.44 0.92 NA NA 11.75 12.36 090 29844 ......... ............ A Wrist arthroscopy/surgery ............................. 6.36 NA NA 4.87 5.60 1.04 NA NA 12.27 13.00 090 29845 ......... ............ A Wrist arthroscopy/surgery ............................. 7.51 NA NA 5.41 6.22 0.99 NA NA 13.91 14.72 090 29846 ......... ............ A Wrist arthroscopy/surgery ............................. 6.74 NA NA 5.01 5.81 1.07 NA NA 12.82 13.62 090 29847 ......... ............ A Wrist arthroscopy/surgery ............................. 7.07 NA NA 5.08 5.93 1.08 NA NA 13.23 14.08 090 29848 ......... ............ A Wrist endoscopy/surgery ............................... 6.18 NA NA 5.20 5.52 0.86 NA NA 12.24 12.56 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37294 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

29850 ......... ............ A Knee arthroscopy/surgery ............................. 8.18 NA NA 5.13 5.07 1.25 NA NA 14.56 14.50 090 29851 ......... ............ A Knee arthroscopy/surgery ............................. 13.08 NA NA 8.16 9.41 2.34 NA NA 23.58 24.83 090 29855 ......... ............ A Tibial arthroscopy/surgery ............................. 10.60 NA NA 7.25 8.41 1.84 NA NA 19.69 20.85 090 29856 ......... ............ A Tibial arthroscopy/surgery ............................. 14.12 NA NA 8.58 10.17 2.39 NA NA 25.09 26.68 090 29860 ......... ............ A Hip arthroscopy, dx ....................................... 8.79 NA NA 6.11 6.76 1.36 NA NA 16.26 16.91 090 29861 ......... ............ A Hip arthroscopy/surgery ................................ 9.89 NA NA 6.51 7.15 1.59 NA NA 17.99 18.63 090 29862 ......... ............ A Hip arthroscopy/surgery ................................ 10.89 NA NA 7.48 8.31 1.62 NA NA 19.99 20.82 090 29863 ......... ............ A Hip arthroscopy/surgery ................................ 10.89 NA NA 7.40 8.25 1.42 NA NA 19.71 20.56 090 29866 ......... ............ A Autgrft implnt, knee w/scope ......................... 14.38 NA NA 9.36 10.88 2.39 NA NA 26.13 27.65 090 29867 ......... ............ A Allgrft implnt, knee w/scope .......................... 18.08 NA NA 11.02 12.70 2.78 NA NA 31.88 33.56 090 29868 ......... ............ A Meniscal trnspl, knee w/scpe ........................ 24.79 NA NA 13.64 16.04 4.35 NA NA 42.78 45.18 090 29870 ......... ............ A Knee arthroscopy, dx .................................... 5.06 NA NA 4.11 4.70 0.85 NA NA 10.02 10.61 090 29871 ......... ............ A Knee arthroscopy/drainage ........................... 6.54 NA NA 4.94 5.65 1.14 NA NA 12.62 13.33 09029873 ......... ............ A Knee arthroscopy/surgery ............................. 5.99 NA NA 5.52 6.32 1.04 NA NA 12.55 13.35 090 29874 ......... ............ A Knee arthroscopy/surgery ............................. 7.04 NA NA 5.08 5.84 1.11 NA NA 13.23 13.99 090 29875 ......... ............ A Knee arthroscopy/surgery ............................. 6.30 NA NA 4.83 5.61 1.09 NA NA 12.22 13.00 090 29876 ......... ............ A Knee arthroscopy/surgery ............................. 8.66 NA NA 6.12 6.81 1.37 NA NA 16.15 16.84 090 29877 ......... ............ A Knee arthroscopy/surgery ............................. 8.09 NA NA 5.88 6.54 1.28 NA NA 15.25 15.91 090 29879 ......... ............ A Knee arthroscopy/surgery ............................. 8.78 NA NA 6.16 6.90 1.39 NA NA 16.33 17.07 090 29880 ......... ............ A Knee arthroscopy/surgery ............................. 9.24 NA NA 6.36 7.13 1.47 NA NA 17.07 17.84 090 29881 ......... ............ A Knee arthroscopy/surgery ............................. 8.50 NA NA 6.07 6.75 1.34 NA NA 15.91 16.59 090 29882 ......... ............ A Knee arthroscopy/surgery ............................. 9.39 NA NA 6.39 7.04 1.50 NA NA 17.28 17.93 090 29883 ......... ............ A Knee arthroscopy/surgery ............................. 11.53 NA NA 7.50 8.69 1.92 NA NA 20.95 22.14 090 29884 ......... ............ A Knee arthroscopy/surgery ............................. 8.07 NA NA 5.90 6.52 1.27 NA NA 15.24 15.86 090 29885 ......... ............ A Knee arthroscopy/surgery ............................. 9.95 NA NA 6.92 7.72 1.58 NA NA 18.45 19.25 090 29886 ......... ............ A Knee arthroscopy/surgery ............................. 8.28 NA NA 5.97 6.65 1.30 NA NA 15.55 16.23 090 29887 ......... ............ A Knee arthroscopy/surgery ............................. 9.90 NA NA 6.91 7.69 1.57 NA NA 18.38 19.16 090 29888 ......... ............ A Knee arthroscopy/surgery ............................. 14.06 NA NA 8.17 9.72 2.41 NA NA 24.64 26.19 090 29889 ......... ............ A Knee arthroscopy/surgery ............................. 17.05 NA NA 10.53 11.99 2.78 NA NA 30.36 31.82 090 29891 ......... ............ A Ankle arthroscopy/surgery ............................. 9.39 NA NA 6.57 7.29 1.39 NA NA 17.35 18.07 090 29892 ......... ............ A Ankle arthroscopy/surgery ............................. 9.99 NA NA 6.45 7.43 1.41 NA NA 17.85 18.83 090 29893 ......... ............ A Scope, plantar fasciotomy ............................. 5.96 8.75 6.91 4.59 4.15 0.63 15.34 13.50 11.18 10.74 090 29894 ......... ............ A Ankle arthroscopy/surgery ............................. 7.20 NA NA 4.61 5.27 1.15 NA NA 12.96 13.62 090 29895 ......... ............ A Ankle arthroscopy/surgery ............................. 6.98 NA NA 4.45 5.23 1.11 NA NA 12.54 13.32 090 29897 ......... ............ A Ankle arthroscopy/surgery ............................. 7.17 NA NA 4.88 5.65 1.17 NA NA 13.22 13.99 090 29898 ......... ............ A Ankle arthroscopy/surgery ............................. 8.31 NA NA 5.19 5.96 1.28 NA NA 14.78 15.55 090 29899 ......... ............ A Ankle arthroscopy/surgery ............................. 15.13 NA NA 9.12 10.21 2.40 NA NA 26.65 27.74 090 29900 ......... ............ A Mcp joint arthroscopy, dx .............................. 5.66 NA NA 4.65 5.57 0.94 NA NA 11.25 12.17 090 29901 ......... ............ A Mcp joint arthroscopy, surg ........................... 6.37 NA NA 5.45 6.07 1.06 NA NA 12.88 13.50 090 29902 ......... ............ A Mcp joint arthroscopy, surg ........................... 6.94 NA NA 3.61 5.82 1.12 NA NA 11.67 13.88 090 30000 ......... ............ A Drainage of nose lesion ................................ 1.43 3.70 3.99 1.21 1.35 0.12 5.25 5.54 2.76 2.90 010 30020 ......... ............ A Drainage of nose lesion ................................ 1.43 3.82 3.42 1.24 1.41 0.12 5.37 4.97 2.79 2.96 010 30100 ......... ............ A Intranasal biopsy ........................................... 0.94 2.39 2.08 0.68 0.79 0.07 3.40 3.09 1.69 1.80 000 30110 ......... ............ A Removal of nose polyp(s) ............................. 1.63 3.59 3.34 1.30 1.50 0.14 5.36 5.11 3.07 3.27 010 30115 ......... ............ A Removal of nose polyp(s) ............................. 4.34 NA NA 5.40 5.69 0.41 NA NA 10.15 10.44 090 30117 ......... ............ A Removal of intranasal lesion ......................... 3.16 16.76 14.08 4.46 4.60 0.26 20.18 17.50 7.88 8.02 090 30118 ......... ............ A Removal of intranasal lesion ......................... 9.74 NA NA 7.61 8.82 0.78 NA NA 18.13 19.34 090 30120 ......... ............ A Revision of nose ............................................ 5.26 6.74 6.57 4.81 5.72 0.52 12.52 12.35 10.59 11.50 090 30124 ......... ............ A Removal of nose lesion ................................. 3.10 NA NA 3.59 3.61 0.25 NA NA 6.94 6.96 090 30125 ......... ............ A Removal of nose lesion ................................. 7.15 NA NA 6.91 7.98 0.63 NA NA 14.69 15.76 090 30130 ......... ............ A Excise inferior turbinate ................................. 3.37 NA NA 5.21 5.51 0.31 NA NA 8.89 9.19 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37295 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

30140 ......... ............ A Resect inferior turbinate ................................ 3.42 NA NA 6.47 6.28 0.35 NA NA 10.24 10.05 090 30150 ......... ............ A Partial removal of nose ................................. 9.37 NA NA 8.38 10.38 0.93 NA NA 18.68 20.68 090 30160 ......... ............ A Removal of nose ........................................... 9.81 NA NA 7.99 9.68 0.88 NA NA 18.68 20.37 090 30200 ......... ............ A Injection treatment of nose ............................ 0.78 1.86 1.68 0.60 0.71 0.06 2.70 2.52 1.44 1.55 000 30210 ......... ............ A Nasal sinus therapy ....................................... 1.08 2.29 2.16 1.14 1.27 0.09 3.46 3.33 2.31 2.44 010 30220 ......... ............ A Insert nasal septal button .............................. 1.54 5.36 4.52 1.27 1.47 0.12 7.02 6.18 2.93 3.13 010 30300 ......... ............ A Remove nasal foreign body .......................... 1.04 4.09 4.50 1.76 1.88 0.08 5.21 5.62 2.88 3.00 010 30310 ......... ............ A Remove nasal foreign body .......................... 1.96 NA NA 2.68 3.00 0.16 NA NA 4.80 5.12 010 30320 ......... ............ A Remove nasal foreign body .......................... 4.51 NA NA 5.85 6.76 0.39 NA NA 10.75 11.66 090 30400 ......... ............ R Reconstruction of nose ................................. 10.46 NA NA 13.49 15.02 1.04 NA NA 24.99 26.52 090 30410 ......... ............ R Reconstruction of nose ................................. 13.60 NA NA 14.12 17.35 1.42 NA NA 29.14 32.37 090 30420 ......... ............ R Reconstruction of nose ................................. 16.50 NA NA 14.47 17.09 1.46 NA NA 32.43 35.05 090 30430 ......... ............ R Revision of nose ............................................ 7.84 NA NA 12.60 15.20 0.77 NA NA 21.21 23.81 090 30435 ......... ............ R Revision of nose ............................................ 12.33 NA NA 14.29 18.13 1.22 NA NA 27.84 31.68 090 30450 ......... ............ R Revision of nose ............................................ 19.26 NA NA 15.82 20.42 1.96 NA NA 37.04 41.64 090 30460 ......... ............ A Revision of nose ............................................ 10.20 NA NA 7.05 9.24 1.03 NA NA 18.28 20.47 090 30462 ......... ............ A Revision of nose ............................................ 20.04 NA NA 14.04 18.74 2.53 NA NA 36.61 41.31 090 30465 ......... ............ A Repair nasal stenosis .................................... 12.12 NA NA 10.08 11.52 1.06 NA NA 23.26 24.70 090 30520 ......... ............ A Repair of nasal septum ................................. 7.63 NA NA 6.88 6.73 0.46 NA NA 14.97 14.82 090 30540 ......... ............ A Repair nasal defect ....................................... 7.74 NA NA 6.92 8.71 0.67 NA NA 15.33 17.12 090 30545 ......... ............ A Repair nasal defect ....................................... 11.42 NA NA 9.88 11.42 1.70 NA NA 23.00 24.54 090 30560 ......... ............ A Release of nasal adhesions .......................... 1.26 4.88 4.81 1.84 2.07 0.10 6.24 6.17 3.20 3.43 010 30580 ......... ............ A Repair upper jaw fistula ................................ 6.68 8.13 7.88 4.66 5.52 0.89 15.70 15.45 12.23 13.09 090 30600 ......... ............ A Repair mouth/nose fistula ............................. 6.01 7.43 7.51 4.00 4.77 0.70 14.14 14.22 10.71 11.48 090 30620 ......... ............ A Intranasal reconstruction ............................... 5.96 NA NA 7.98 8.64 0.57 NA NA 14.51 15.17 090 30630 ......... ............ A Repair nasal septum defect .......................... 7.11 NA NA 6.96 7.72 0.61 NA NA 14.68 15.44 09030801 ......... ............ A Ablate inf turbinate, superf ............................ 1.09 3.98 4.10 1.94 1.93 0.09 5.16 5.28 3.12 3.11 010 30802 ......... ............ A Cauterization, inner nose .............................. 2.03 4.55 4.60 2.27 2.35 0.16 6.74 6.79 4.46 4.54 010 30901 ......... ............ A Control of nosebleed ..................................... 1.21 1.19 1.32 0.27 0.31 0.11 2.51 2.64 1.59 1.63 000 30903 ......... ............ A Control of nosebleed ..................................... 1.54 3.04 2.80 0.37 0.47 0.13 4.71 4.47 2.04 2.14 000 30905 ......... ............ A Control of nosebleed ..................................... 1.97 3.69 3.56 0.45 0.68 0.17 5.83 5.70 2.59 2.82 000 30906 ......... ............ A Repeat control of nosebleed ......................... 2.45 3.92 3.91 0.64 1.06 0.20 6.57 6.56 3.29 3.71 000 30915 ......... ............ A Ligation, nasal sinus artery ........................... 7.31 NA NA 5.71 6.46 0.58 NA NA 13.60 14.35 090 30920 ......... ............ A Ligation, upper jaw artery .............................. 10.97 NA NA 7.97 8.74 0.80 NA NA 19.74 20.51 090 30930 ......... ............ A Ther fx, nasal inf turbinate ............................ 1.26 NA NA 1.50 1.59 0.12 NA NA 2.88 2.97 010 31000 ......... ............ A Irrigation, maxillary sinus ............................... 1.15 2.98 2.88 1.22 1.36 0.09 4.22 4.12 2.46 2.60 010 31002 ......... ............ A Irrigation, sphenoid sinus .............................. 1.91 NA NA 2.49 3.06 0.15 NA NA 4.55 5.12 010 31020 ......... ............ A Exploration, maxillary sinus ........................... 2.94 7.98 8.41 5.11 5.18 0.29 11.21 11.64 8.34 8.41 090 31030 ......... ............ A Exploration, maxillary sinus ........................... 5.91 9.65 11.06 5.93 6.49 0.60 16.16 17.57 12.44 13.00 090 31032 ......... ............ A Explore sinus, remove polyps ....................... 6.56 NA NA 6.38 7.03 0.59 NA NA 13.53 14.18 090 31040 ......... ............ A Exploration behind upper jaw ........................ 9.59 NA NA 7.13 9.17 0.87 NA NA 17.59 19.63 09031050 ......... ............ A Exploration, sphenoid sinus .......................... 5.27 NA NA 6.03 6.29 0.49 NA NA 11.79 12.05 090 31051 ......... ............ A Sphenoid sinus surgery ................................. 7.10 NA NA 7.58 8.09 0.62 NA NA 15.30 15.81 090 31070 ......... ............ A Exploration of frontal sinus ............................ 4.27 NA NA 5.61 5.87 0.38 NA NA 10.26 10.52 090 31075 ......... ............ A Exploration of frontal sinus ............................ 9.33 NA NA 8.36 9.41 0.75 NA NA 18.44 19.49 090 31080 ......... ............ A Removal of frontal sinus ............................... 12.46 NA NA 10.25 12.74 1.23 NA NA 23.94 26.43 090 31081 ......... ............ A Removal of frontal sinus ............................... 13.91 NA NA 14.48 14.15 2.46 NA NA 30.85 30.52 090 31084 ......... ............ A Removal of frontal sinus ............................... 14.67 NA NA 11.64 13.07 1.19 NA NA 27.50 28.93 090 31085 ......... ............ A Removal of frontal sinus ............................... 15.36 NA NA 12.67 13.67 1.72 NA NA 29.75 30.75 090 31086 ......... ............ A Removal of frontal sinus ............................... 14.08 NA NA 11.48 12.86 1.07 NA NA 26.63 28.01 090 31087 ......... ............ A Removal of frontal sinus ............................... 14.31 NA NA 10.51 12.06 1.44 NA NA 26.26 27.81 090 31090 ......... ............ A Exploration of sinuses ................................... 10.78 NA NA 12.11 12.47 0.94 NA NA 23.83 24.19 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37296 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

31200 ......... ............ A Removal of ethmoid sinus ............................. 4.96 NA NA 7.32 8.76 0.29 NA NA 12.57 14.01 090 31201 ......... ............ A Removal of ethmoid sinus ............................. 8.42 NA NA 8.11 8.93 0.82 NA NA 17.35 18.17 090 31205 ......... ............ A Removal of ethmoid sinus ............................. 10.40 NA NA 9.33 11.27 0.67 NA NA 20.40 22.34 090 31225 ......... ............ A Removal of upper jaw ................................... 26.34 NA NA 16.42 17.51 1.59 NA NA 44.35 45.44 090 31230 ......... ............ A Removal of upper jaw ................................... 30.46 NA NA 17.08 18.84 1.77 NA NA 49.31 51.07 090 31231 ......... ............ A Nasal endoscopy, dx ..................................... 1.10 3.30 3.37 0.68 0.83 0.09 4.49 4.56 1.87 2.02 000 31233 ......... ............ A Nasal/sinus endoscopy, dx ........................... 2.18 3.89 4.21 0.97 1.35 0.20 6.27 6.59 3.35 3.73 000 31235 ......... ............ A Nasal/sinus endoscopy, dx ........................... 2.64 4.24 4.75 1.10 1.57 0.26 7.14 7.65 4.00 4.47 000 31237 ......... ............ A Nasal/sinus endoscopy, surg ........................ 2.98 4.46 5.02 1.20 1.72 0.28 7.72 8.28 4.46 4.98 000 31238 ......... ............ A Nasal/sinus endoscopy, surg ........................ 3.26 4.38 5.03 1.27 1.89 0.27 7.91 8.56 4.80 5.42 000 31239 ......... ............ A Nasal/sinus endoscopy, surg ........................ 9.19 NA NA 6.14 7.55 0.62 NA NA 15.95 17.36 010 31240 ......... ............ A Nasal/sinus endoscopy, surg ........................ 2.61 NA NA 1.10 1.58 0.24 NA NA 3.95 4.43 000 31254 ......... ............ A Revision of ethmoid sinus ............................. 4.64 NA NA 1.66 2.56 0.45 NA NA 6.75 7.65 00031255 ......... ............ A Removal of ethmoid sinus ............................. 6.95 NA NA 2.29 3.66 0.73 NA NA 9.97 11.34 00031256 ......... ............ A Exploration maxillary sinus ............................ 3.29 NA NA 1.28 1.91 0.33 NA NA 4.90 5.53 000 31267 ......... ............ A Endoscopy, maxillary sinus ........................... 5.45 NA NA 1.88 2.95 0.55 NA NA 7.88 8.95 000 31276 ......... ............ A Sinus endoscopy, surgical ............................ 8.84 NA NA 2.80 4.55 0.92 NA NA 12.56 14.31 000 31287 ......... ............ A Nasal/sinus endoscopy, surg ........................ 3.91 NA NA 1.45 2.21 0.39 NA NA 5.75 6.51 000 31288 ......... ............ A Nasal/sinus endoscopy, surg ........................ 4.57 NA NA 1.63 2.52 0.46 NA NA 6.66 7.55 000 31290 ......... ............ A Nasal/sinus endoscopy, surg ........................ 18.46 NA NA 7.82 11.02 1.40 NA NA 27.68 30.88 010 31291 ......... ............ A Nasal/sinus endoscopy, surg ........................ 19.41 NA NA 8.42 11.49 1.68 NA NA 29.51 32.58 010 31292 ......... ............ A Nasal/sinus endoscopy, surg ........................ 15.75 NA NA 7.06 9.75 1.21 NA NA 24.02 26.71 01031293 ......... ............ A Nasal/sinus endoscopy, surg ........................ 17.32 NA NA 7.66 10.47 1.28 NA NA 26.26 29.07 010 31294 ......... ............ A Nasal/sinus endoscopy, surg ........................ 20.16 NA NA 8.52 11.81 1.53 NA NA 30.21 33.50 010 31300 ......... ............ A Removal of larynx lesion ............................... 15.63 NA NA 13.25 14.58 1.17 NA NA 30.05 31.38 090 31320 ......... ............ A Diagnostic incision, larynx ............................. 5.55 NA NA 9.07 10.02 0.46 NA NA 15.08 16.03 090 31360 ......... ............ A Removal of larynx ......................................... 27.23 NA NA 16.41 16.68 1.38 NA NA 45.02 45.29 090 31365 ......... ............ A Removal of larynx ......................................... 34.85 NA NA 18.52 19.95 1.97 NA NA 55.34 56.77 090 31367 ......... ............ A Partial removal of larynx ............................... 27.11 NA NA 19.04 21.22 1.78 NA NA 47.93 50.11 090 31368 ......... ............ A Partial removal of larynx ............................... 33.73 NA NA 22.36 24.76 2.20 NA NA 58.29 60.69 090 31370 ......... ............ A Partial removal of larynx ............................... 27.11 NA NA 19.92 21.72 1.74 NA NA 48.77 50.57 090 31375 ......... ............ A Partial removal of larynx ............................... 25.61 NA NA 18.36 19.92 1.63 NA NA 45.60 47.16 090 31380 ......... ............ A Partial removal of larynx ............................... 25.11 NA NA 18.05 20.01 1.70 NA NA 44.86 46.82 090 31382 ......... ............ A Partial removal of larynx ............................... 28.11 NA NA 20.22 21.31 1.67 NA NA 50.00 51.09 090 31390 ......... ............ A Removal of larynx & pharynx ........................ 38.72 NA NA 22.23 23.90 2.23 NA NA 63.18 64.85 090 31395 ......... ............ A Reconstruct larynx & pharynx ....................... 43.34 NA NA 26.33 27.87 2.48 NA NA 72.15 73.69 090 31400 ......... ............ A Revision of larynx .......................................... 11.40 NA NA 11.27 13.18 0.83 NA NA 23.50 25.41 090 31420 ......... ............ A Removal of epiglottis ..................................... 11.25 NA NA 7.70 9.10 0.83 NA NA 19.78 21.18 090 31500 ......... ............ A Insert emergency airway ............................... 2.33 NA NA 0.42 0.52 0.17 NA NA 2.92 3.02 00031502 ......... ............ A Change of windpipe airway ........................... 0.65 0.16 0.27 0.20 0.26 0.05 0.86 0.97 0.90 0.96 000 31505 ......... ............ A Diagnostic laryngoscopy ............................... 0.61 1.32 1.42 0.54 0.59 0.05 1.98 2.08 1.20 1.25 000 31510 ......... ............ A Laryngoscopy with biopsy ............................. 1.92 2.95 3.22 0.89 1.16 0.16 5.03 5.30 2.97 3.24 000 31511 ......... ............ A Remove foreign body, larynx ........................ 2.16 2.72 3.03 0.91 1.02 0.19 5.07 5.38 3.26 3.37 000 31512 ......... ............ A Removal of larynx lesion ............................... 2.07 2.69 3.08 0.93 1.25 0.18 4.94 5.33 3.18 3.50 000 31513 ......... ............ A Injection into vocal cord ................................ 2.10 NA NA 0.95 1.33 0.17 NA NA 3.22 3.60 000 31515 ......... ............ A Laryngoscopy for aspiration .......................... 1.80 3.04 3.42 0.82 1.00 0.14 4.98 5.36 2.76 2.94 000 31520 ......... ............ A Dx laryngoscopy, newborn ............................ 2.56 NA NA 1.07 1.44 0.20 NA NA 3.83 4.20 000 31525 ......... ............ A Dx laryngoscopy excl nb ............................... 2.63 3.18 3.53 1.08 1.52 0.21 6.02 6.37 3.92 4.36 000 31526 ......... ............ A Dx laryngoscopy w/oper scope ..................... 2.57 NA NA 1.08 1.56 0.21 NA NA 3.86 4.34 000 31527 ......... ............ A Laryngoscopy for treatment .......................... 3.27 NA NA 1.26 1.73 0.26 NA NA 4.79 5.26 000 31528 ......... ............ A Laryngoscopy and dilation ............................ 2.37 NA NA 0.95 1.33 0.19 NA NA 3.51 3.89 000 31529 ......... ............ A Laryngoscopy and dilation ............................ 2.68 NA NA 1.07 1.55 0.22 NA NA 3.97 4.45 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37297 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

31530 ......... ............ A Laryngoscopy w/fb removal .......................... 3.38 NA NA 1.26 1.79 0.29 NA NA 4.93 5.46 000 31531 ......... ............ A Laryngoscopy w/fb & op scope ..................... 3.58 NA NA 1.36 2.05 0.29 NA NA 5.23 5.92 000 31535 ......... ............ A Laryngoscopy w/biopsy ................................. 3.16 NA NA 1.24 1.81 0.26 NA NA 4.66 5.23 00031536 ......... ............ A Laryngoscopy w/bx & op scope .................... 3.55 NA NA 1.35 2.03 0.29 NA NA 5.19 5.87 000 31540 ......... ............ A Laryngoscopy w/exc of tumor ....................... 4.12 NA NA 1.51 2.29 0.33 NA NA 5.96 6.74 000 31541 ......... ............ A Larynscop w/tumr exc + scope ..................... 4.52 NA NA 1.62 2.50 0.37 NA NA 6.51 7.39 000 31545 ......... ............ A Remove vc lesion w/scope ........................... 6.30 NA NA 2.14 3.15 0.37 NA NA 8.81 9.82 000 31546 ......... ............ A Remove vc lesion scope/graft ....................... 9.73 NA NA 3.62 4.64 0.78 NA NA 14.13 15.15 000 31560 ......... ............ A Laryngoscop w/arytenoidectom ..................... 5.45 NA NA 1.83 2.83 0.43 NA NA 7.71 8.71 000 31561 ......... ............ A Larynscop, remve cart + scop ...................... 5.99 NA NA 1.97 3.03 0.49 NA NA 8.45 9.51 000 31570 ......... ............ A Laryngoscope w/vc inj ................................... 3.86 3.88 5.24 1.43 2.15 0.31 8.05 9.41 5.60 6.32 000 31571 ......... ............ A Laryngoscop w/vc inj + scope ....................... 4.26 NA NA 1.55 2.35 0.35 NA NA 6.16 6.96 000 31575 ......... ............ A Diagnostic laryngoscopy ............................... 1.10 1.54 1.82 0.68 0.84 0.09 2.73 3.01 1.87 2.03 000 31576 ......... ............ A Laryngoscopy with biopsy ............................. 1.97 3.24 3.56 0.92 1.20 0.14 5.35 5.67 3.03 3.31 000 31577 ......... ............ A Remove foreign body, larynx ........................ 2.47 3.19 3.63 1.07 1.42 0.21 5.87 6.31 3.75 4.10 000 31578 ......... ............ A Removal of larynx lesion ............................... 2.84 3.61 4.12 1.16 1.43 0.23 6.68 7.19 4.23 4.50 000 31579 ......... ............ A Diagnostic laryngoscopy ............................... 2.26 2.59 3.49 1.00 1.36 0.18 5.03 5.93 3.44 3.80 000 31580 ......... ............ A Revision of larynx .......................................... 14.38 NA NA 13.18 15.27 1.00 NA NA 28.56 30.65 090 31582 ......... ............ A Revision of larynx .......................................... 22.73 NA NA 19.99 24.40 1.75 NA NA 44.47 48.88 090 31584 ......... ............ A Treat larynx fracture ...................................... 20.27 NA NA 13.86 17.12 1.71 NA NA 35.84 39.10 090 31587 ......... ............ A Revision of larynx .......................................... 15.06 NA NA 7.74 8.90 0.97 NA NA 23.77 24.93 090 31588 ......... ............ A Revision of larynx .......................................... 14.48 NA NA 11.11 13.02 1.06 NA NA 26.65 28.56 090 31590 ......... ............ A Reinnervate larynx ........................................ 7.53 NA NA 11.97 14.68 0.84 NA NA 20.34 23.05 090 31595 ......... ............ A Larynx nerve surgery .................................... 8.69 NA NA 8.77 10.13 0.68 NA NA 18.14 19.50 090 31600 ......... ............ A Incision of windpipe ....................................... 7.17 NA NA 2.16 2.94 0.80 NA NA 10.13 10.91 000 31601 ......... ............ A Incision of windpipe ....................................... 4.44 NA NA 1.58 2.20 0.40 NA NA 6.42 7.04 000 31603 ......... ............ A Incision of windpipe ....................................... 4.14 NA NA 1.09 1.56 0.44 NA NA 5.67 6.14 000 31605 ......... ............ A Incision of windpipe ....................................... 3.57 NA NA 0.81 1.10 0.40 NA NA 4.78 5.07 000 31610 ......... ............ A Incision of windpipe ....................................... 9.23 NA NA 7.02 7.97 0.79 NA NA 17.04 17.99 090 31611 ......... ............ A Surgery/speech prosthesis ............................ 5.87 NA NA 6.36 6.90 0.46 NA NA 12.69 13.23 090 31612 ......... ............ A Puncture/clear windpipe ................................ 0.91 1.06 1.09 0.24 0.32 0.08 2.05 2.08 1.23 1.31 000 31613 ......... ............ A Repair windpipe opening ............................... 4.58 NA NA 5.73 5.94 0.42 NA NA 10.73 10.94 090 31614 ......... ............ A Repair windpipe opening ............................... 8.39 NA NA 8.70 8.73 0.58 NA NA 17.67 17.70 090 31615 ......... ............ A Visualization of windpipe ............................... 2.09 2.18 2.50 0.93 1.13 0.16 4.43 4.75 3.18 3.38 000 31620 ......... ............ A Endobronchial us add-on .............................. 1.40 5.98 5.74 0.33 0.50 0.11 7.49 7.25 1.84 2.01 ZZZ 31622 ......... ............ A Dx bronchoscope/wash ................................. 2.78 5.21 5.56 0.88 1.02 0.18 8.17 8.52 3.84 3.98 000 31623 ......... ............ A Dx bronchoscope/brush ................................ 2.88 5.96 6.32 0.88 1.01 0.13 8.97 9.33 3.89 4.02 000 31624 ......... ............ A Dx bronchoscope/lavage ............................... 2.88 5.32 5.67 0.88 1.01 0.13 8.33 8.68 3.89 4.02 000 31625 ......... ............ A Bronchoscopy w/biopsy(s) ............................ 3.36 5.46 5.74 1.00 1.16 0.18 9.00 9.28 4.54 4.70 000 31628 ......... ............ A Bronchoscopy/lung bx, each ......................... 3.80 6.93 7.01 1.08 1.25 0.18 10.91 10.99 5.06 5.23 000 31629 ......... ............ A Bronchoscopy/needle bx, each ..................... 4.09 11.96 13.71 1.15 1.34 0.16 16.21 17.96 5.40 5.59 000 31630 ......... ............ A Bronchoscopy dilate/fx repr ........................... 3.81 NA NA 1.23 1.60 0.32 NA NA 5.36 5.73 00031631 ......... ............ A Bronchoscopy, dilate w/stent ........................ 4.36 NA NA 1.38 1.67 0.34 NA NA 6.08 6.37 000 31632 ......... ............ A Bronchoscopy/lung bx, addIl ......................... 1.03 0.85 0.82 0.23 0.29 0.18 2.06 2.03 1.44 1.50 ZZZ 31633 ......... ............ A Bronchoscopy/needle bx addIl ...................... 1.32 0.98 0.94 0.30 0.38 0.16 2.46 2.42 1.78 1.86 ZZZ 31635 ......... ............ A Bronchoscopy w/fb removal .......................... 3.67 5.16 5.89 1.11 1.35 0.24 9.07 9.80 5.02 5.26 000 31636 ......... ............ A Bronchoscopy, bronch stents ........................ 4.30 NA NA 1.35 1.67 0.31 NA NA 5.96 6.28 000 31637 ......... ............ A Bronchoscopy, stent add-on ......................... 1.58 NA NA 0.41 0.52 0.13 NA NA 2.12 2.23 ZZZ 31638 ......... ............ A Bronchoscopy, revise stent ........................... 4.88 NA NA 1.53 1.87 0.22 NA NA 6.63 6.97 000 31640 ......... ............ A Bronchoscopy w/tumor excise ...................... 4.93 NA NA 1.50 1.94 0.46 NA NA 6.89 7.33 000 31641 ......... ............ A Bronchoscopy, treat blockage ....................... 5.02 NA NA 1.46 1.78 0.35 NA NA 6.83 7.15 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37298 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

31643 ......... ............ A Diag bronchoscope/catheter ......................... 3.49 NA NA 1.03 1.18 0.20 NA NA 4.72 4.87 000 31645 ......... ............ A Bronchoscopy, clear airways ........................ 3.16 4.71 5.04 0.95 1.08 0.16 8.03 8.36 4.27 4.40 000 31646 ......... ............ A Bronchoscopy, reclear airway ....................... 2.72 4.43 4.76 0.84 0.96 0.14 7.29 7.62 3.70 3.82 000 31656 ......... ............ A Bronchoscopy, inj for x-ray ........................... 2.17 5.29 6.81 0.64 0.78 0.15 7.61 9.13 2.96 3.10 000 31700 ......... ............ A Insertion of airway catheter ........................... 1.34 2.29 2.19 0.67 0.68 0.08 3.71 3.61 2.09 2.10 000 31708 ......... ............ A Instill airway contrast dye .............................. 1.41 1.27 1.85 0.42 0.45 0.07 2.75 3.33 1.90 1.93 000 31710 ......... ............ A Insertion of airway catheter ........................... 1.30 NA NA 0.45 0.42 0.12 NA NA 1.87 1.84 000 31715 ......... ............ A Injection for bronchus x-ray ........................... 1.11 NA NA 0.29 0.33 0.07 NA NA 1.47 1.51 000 31717 ......... ............ A Bronchial brush biopsy .................................. 2.12 5.81 7.66 0.74 0.78 0.14 8.07 9.92 3.00 3.04 000 31720 ......... ............ A Clearance of airways ..................................... 1.06 0.25 0.31 0.25 0.31 0.07 1.38 1.44 1.38 1.44 000 31725 ......... ............ A Clearance of airways ..................................... 1.96 0.44 0.60 0.44 0.55 0.14 2.54 2.70 2.54 2.65 000 31730 ......... ............ A Intro, windpipe wire/tube ............................... 2.85 25.49 8.02 0.71 0.93 0.21 28.55 11.08 3.77 3.99 000 31750 ......... ............ A Repair of windpipe ........................................ 15.11 NA NA 15.93 17.18 1.05 NA NA 32.09 33.34 090 31755 ......... ............ A Repair of windpipe ........................................ 17.05 NA NA 21.88 23.91 1.29 NA NA 40.22 42.25 090 31760 ......... ............ A Repair of windpipe ........................................ 23.28 NA NA 9.87 10.52 2.94 NA NA 36.09 36.74 090 31766 ......... ............ A Reconstruction of windpipe ........................... 31.52 NA NA 11.44 13.13 4.52 NA NA 47.48 49.17 090 31770 ......... ............ A Repair/graft of bronchus ................................ 23.44 NA NA 9.02 9.96 2.83 NA NA 35.29 36.23 090 31775 ......... ............ A Reconstruct bronchus ................................... 24.46 NA NA 8.87 11.08 3.01 NA NA 36.34 38.55 090 31780 ......... ............ A Reconstruct windpipe .................................... 19.62 NA NA 7.96 10.30 1.65 NA NA 29.23 31.57 090 31781 ......... ............ A Reconstruct windpipe .................................... 24.72 NA NA 9.17 11.41 2.24 NA NA 36.13 38.37 090 31785 ......... ............ A Remove windpipe lesion ............................... 18.25 NA NA 6.80 9.36 1.59 NA NA 26.64 29.20 090 31786 ......... ............ A Remove windpipe lesion ............................... 25.29 NA NA 9.81 12.30 3.29 NA NA 38.39 40.88 090 31800 ......... ............ A Repair of windpipe injury ............................... 8.05 NA NA 8.31 9.03 0.79 NA NA 17.15 17.87 090 31805 ......... ............ A Repair of windpipe injury ............................... 13.29 NA NA 6.45 7.04 1.82 NA NA 21.56 22.15 090 31820 ......... ............ A Closure of windpipe lesion ............................ 4.54 5.37 5.60 2.94 3.48 0.38 10.29 10.52 7.86 8.40 090 31825 ......... ............ A Repair of windpipe defect ............................. 6.92 6.69 7.43 3.93 5.03 0.53 14.14 14.88 11.38 12.48 090 31830 ......... ............ A Revise windpipe scar .................................... 4.49 5.54 5.72 3.29 3.82 0.44 10.47 10.65 8.22 8.75 090 32000 ......... ............ A Drainage of chest .......................................... 1.54 2.46 2.91 0.46 0.48 0.08 4.08 4.53 2.08 2.10 000 32002 ......... ............ A Treatment of collapsed lung .......................... 2.19 2.94 3.15 1.03 1.05 0.12 5.25 5.46 3.34 3.36 000 32005 ......... ............ A Treat lung lining chemically ........................... 2.19 5.12 6.13 0.59 0.67 0.23 7.54 8.55 3.01 3.09 000 32019 ......... ............ A Insert pleural catheter ................................... 4.17 15.73 18.95 1.47 1.61 0.42 20.32 23.54 6.06 6.20 000 32020 ......... ............ A Insertion of chest tube ................................... 3.97 NA NA 1.15 1.30 0.43 NA NA 5.55 5.70 000 32035 ......... ............ A Exploration of chest ....................................... 11.13 NA NA 5.99 5.90 1.26 NA NA 18.38 18.29 090 32036 ......... ............ A Exploration of chest ....................................... 12.14 NA NA 6.31 6.42 1.43 NA NA 19.88 19.99 090 32095 ......... ............ A Biopsy through chest wall ............................. 10.03 NA NA 5.31 5.36 1.22 NA NA 16.56 16.61 090 32100 ......... ............ A Exploration/biopsy of chest ........................... 16.04 NA NA 7.19 7.68 2.23 NA NA 25.46 25.95 090 32110 ......... ............ A Explore/repair chest ...................................... 25.11 NA NA 10.13 10.60 3.21 NA NA 38.45 38.92 090 32120 ......... ............ A Re-exploration of chest ................................. 14.23 NA NA 7.02 7.07 1.63 NA NA 22.88 22.93 090 32124 ......... ............ A Explore chest free adhesions ........................ 15.29 NA NA 7.20 7.22 1.89 NA NA 24.38 24.40 090 32140 ......... ............ A Removal of lung lesion(s) ............................. 16.50 NA NA 7.58 7.67 1.96 NA NA 26.04 26.13 090 32141 ......... ............ A Remove/treat lung lesions ............................. 17.14 NA NA 7.80 7.63 2.00 NA NA 26.94 26.77 090 32150 ......... ............ A Removal of lung lesion(s) ............................. 16.66 NA NA 7.64 7.63 2.00 NA NA 26.30 26.29 090 32151 ......... ............ A Remove lung foreign body ............................ 16.78 NA NA 9.04 8.28 2.03 NA NA 27.85 27.09 090 32160 ......... ............ A Open chest heart massage ........................... 13.00 NA NA 5.96 5.45 1.31 NA NA 20.27 19.76 09032200 ......... ............ A Drain, open, lung lesion ................................ 18.42 NA NA 9.10 8.75 2.13 NA NA 29.65 29.30 090 32201 ......... ............ A Drain, percut, lung lesion .............................. 3.99 20.79 20.77 1.40 1.33 0.24 25.02 25.00 5.63 5.56 000 32215 ......... ............ A Treat chest lining ........................................... 12.90 NA NA 6.48 6.81 1.68 NA NA 21.06 21.39 090 32220 ......... ............ A Release of lung ............................................. 26.31 NA NA 12.24 12.80 3.56 NA NA 42.11 42.67 090 32225 ......... ............ A Partial release of lung ................................... 16.59 NA NA 7.61 7.66 2.06 NA NA 26.26 26.31 090 32310 ......... ............ A Removal of chest lining ................................. 15.13 NA NA 7.05 7.32 1.99 NA NA 24.17 24.44 090 32320 ......... ............ A Free/remove chest lining ............................... 26.96 NA NA 11.73 12.08 3.51 NA NA 42.20 42.55 090 32400 ......... ............ A Needle biopsy chest lining ............................ 1.76 2.21 2.15 0.55 0.55 0.10 4.07 4.01 2.41 2.41 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37299 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

32402 ......... ............ A Open biopsy chest lining ............................... 8.85 NA NA 4.84 5.05 1.07 NA NA 14.76 14.97 090 32405 ......... ............ A Biopsy, lung or mediastinum ......................... 1.93 0.68 0.67 0.68 0.64 0.11 2.72 2.71 2.72 2.68 000 32420 ......... ............ A Puncture/clear lung ....................................... 2.18 NA NA 0.74 0.70 0.12 NA NA 3.04 3.00 000 32440 ......... ............ A Removal of lung ............................................ 27.11 NA NA 11.21 12.50 3.68 NA NA 42.00 43.29 090 32442 ......... ............ A Sleeve pneumonectomy ................................ 37.74 NA NA 14.53 14.73 3.84 NA NA 56.11 56.31 090 32445 ......... ............ A Removal of lung ............................................ 40.73 NA NA 16.04 14.59 3.71 NA NA 60.48 59.03 090 32480 ......... ............ A Partial removal of lung .................................. 25.65 NA NA 10.46 11.68 3.49 NA NA 39.60 40.82 090 32482 ......... ............ A Bilobectomy ................................................... 27.22 NA NA 11.30 12.54 3.66 NA NA 42.18 43.42 090 32484 ......... ............ A Segmentectomy ............................................ 22.67 NA NA 9.74 10.99 3.03 NA NA 35.44 36.69 090 32486 ......... ............ A Sleeve lobectomy .......................................... 31.72 NA NA 12.98 13.21 3.51 NA NA 48.21 48.44 090 32488 ......... ............ A Completion pneumonectomy ......................... 32.69 NA NA 13.02 13.62 3.80 NA NA 49.51 50.11 09032491 ......... ............ R Lung volume reduction .................................. 25.03 NA NA 10.81 12.20 2.98 NA NA 38.82 40.21 090 32500 ......... ............ A Partial removal of lung .................................. 24.42 NA NA 10.53 11.93 3.25 NA NA 38.20 39.60 090 32501 ......... ............ A Repair bronchus add-on ................................ 4.68 NA NA 1.38 1.50 0.65 NA NA 6.71 6.83 ZZZ32503 ......... ............ A Resect apical lung tumor .............................. 31.55 NA NA 12.41 14.44 4.37 NA NA 48.33 50.36 090 32504 ......... ............ A Resect apical lung tum/chest ........................ 36.35 NA NA 13.85 16.00 5.07 NA NA 55.27 57.42 090 32540 ......... ............ A Removal of lung lesion .................................. 23.68 NA NA 10.38 9.84 2.07 NA NA 36.13 35.59 090 32601 ......... ............ A Thoracoscopy, diagnostic .............................. 5.45 NA NA 2.13 2.30 0.80 NA NA 8.38 8.55 00032602 ......... ............ A Thoracoscopy, diagnostic .............................. 5.95 NA NA 2.27 2.47 0.87 NA NA 9.09 9.29 00032603 ......... ............ A Thoracoscopy, diagnostic .............................. 7.80 NA NA 3.01 3.03 1.14 NA NA 11.95 11.97 000 32604 ......... ............ A Thoracoscopy, diagnostic .............................. 8.77 NA NA 3.10 3.37 1.25 NA NA 13.12 13.39 000 32605 ......... ............ A Thoracoscopy, diagnostic .............................. 6.92 NA NA 2.59 2.83 1.00 NA NA 10.51 10.75 000 32606 ......... ............ A Thoracoscopy, diagnostic .............................. 8.39 NA NA 3.05 3.27 1.22 NA NA 12.66 12.88 000 32650 ......... ............ A Thoracoscopy, surgical ................................. 10.73 NA NA 5.36 6.43 1.58 NA NA 17.67 18.74 090 32651 ......... ............ A Thoracoscopy, surgical ................................. 16.28 NA NA 6.99 7.19 1.86 NA NA 25.13 25.33 090 32652 ......... ............ A Thoracoscopy, surgical ................................. 23.34 NA NA 9.43 9.99 2.72 NA NA 35.49 36.05 090 32653 ......... ............ A Thoracoscopy, surgical ................................. 19.86 NA NA 7.60 7.14 1.88 NA NA 29.34 28.88 090 32654 ......... ............ A Thoracoscopy, surgical ................................. 18.49 NA NA 7.37 7.51 1.63 NA NA 27.49 27.63 090 32655 ......... ............ A Thoracoscopy, surgical ................................. 14.95 NA NA 6.64 7.11 1.89 NA NA 23.48 23.95 090 32656 ......... ............ A Thoracoscopy, surgical ................................. 13.14 NA NA 6.07 7.49 1.89 NA NA 21.10 22.52 090 32657 ......... ............ A Thoracoscopy, surgical ................................. 14.54 NA NA 6.52 7.41 1.99 NA NA 23.05 23.94 090 32658 ......... ............ A Thoracoscopy, surgical ................................. 11.61 NA NA 5.68 6.95 1.69 NA NA 18.98 20.25 090 32659 ......... ............ A Thoracoscopy, surgical ................................. 11.82 NA NA 6.01 7.11 1.62 NA NA 19.45 20.55 090 32660 ......... ............ A Thoracoscopy, surgical ................................. 17.65 NA NA 7.59 9.03 2.08 NA NA 27.32 28.76 090 32661 ......... ............ A Thoracoscopy, surgical ................................. 13.23 NA NA 6.30 7.43 1.92 NA NA 21.45 22.58 090 32662 ......... ............ A Thoracoscopy, surgical ................................. 17.00 NA NA 7.28 8.46 2.17 NA NA 26.45 27.63 090 32663 ......... ............ A Thoracoscopy, surgical ................................. 19.96 NA NA 8.99 10.34 2.72 NA NA 31.67 33.02 090 32664 ......... ............ A Thoracoscopy, surgical ................................. 14.18 NA NA 6.48 7.36 2.32 NA NA 22.98 23.86 090 32665 ......... ............ A Thoracoscopy, surgical ................................. 17.37 NA NA 7.66 8.03 2.15 NA NA 27.18 27.55 090 32800 ......... ............ A Repair lung hernia ......................................... 15.56 NA NA 7.14 7.36 1.98 NA NA 24.68 24.90 090 32810 ......... ............ A Close chest after drainage ............................ 14.80 NA NA 7.16 7.45 1.93 NA NA 23.89 24.18 090 32815 ......... ............ A Close bronchial fistula ................................... 37.94 NA NA 14.13 11.78 3.27 NA NA 55.34 52.99 090 32820 ......... ............ A Reconstruct injured chest .............................. 22.27 NA NA 11.58 12.05 2.52 NA NA 36.37 36.84 090 32851 ......... ............ A Lung transplant, single .................................. 40.72 NA NA 21.07 26.07 5.56 NA NA 67.35 72.35 090 32852 ......... ............ A Lung transplant with bypass ......................... 44.37 NA NA 24.10 30.97 6.00 NA NA 74.47 81.34 090 32853 ......... ............ A Lung transplant, double ................................. 49.89 NA NA 23.44 29.74 7.05 NA NA 80.38 86.68 090 32854 ......... ............ A Lung transplant with bypass ......................... 53.60 NA NA 26.89 32.85 7.20 NA NA 87.69 93.65 090 32900 ......... ............ A Removal of rib(s) ........................................... 23.66 NA NA 9.89 9.91 2.93 NA NA 36.48 36.50 090 32905 ......... ............ A Revise & repair chest wall ............................ 23.13 NA NA 9.72 10.05 3.15 NA NA 36.00 36.33 090 32906 ......... ............ A Revise & repair chest wall ............................ 29.14 NA NA 11.47 11.94 3.97 NA NA 44.58 45.05 090 32940 ......... ............ A Revision of lung ............................................. 21.18 NA NA 8.72 9.31 2.88 NA NA 32.78 33.37 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37300 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

32960 ......... ............ A Therapeutic pneumothorax ........................... 1.84 1.65 1.72 0.70 0.60 0.16 3.65 3.72 2.70 2.60 000 32997 ......... ............ A Total lung lavage ........................................... 5.99 NA NA 1.50 1.82 0.55 NA NA 8.04 8.36 000 33010 ......... ............ A Drainage of heart sac .................................... 2.24 NA NA 1.05 0.85 0.14 NA NA 3.43 3.23 000 33011 ......... ............ A Repeat drainage of heart sac ....................... 2.24 NA NA 1.13 0.89 0.15 NA NA 3.52 3.28 000 33015 ......... ............ A Incision of heart sac ...................................... 8.41 NA NA 5.15 5.01 0.65 NA NA 14.21 14.07 090 33020 ......... ............ A Incision of heart sac ...................................... 14.84 NA NA 6.59 6.75 1.79 NA NA 23.22 23.38 090 33025 ......... ............ A Incision of heart sac ...................................... 13.62 NA NA 6.04 6.29 1.80 NA NA 21.46 21.71 090 33030 ......... ............ A Partial removal of heart sac .......................... 22.23 NA NA 9.35 9.50 2.83 NA NA 34.41 34.56 090 33031 ......... ............ A Partial removal of heart sac .......................... 25.27 NA NA 10.10 10.07 3.13 NA NA 38.50 38.47 090 33050 ......... ............ A Removal of heart sac lesion ......................... 16.81 NA NA 7.70 7.82 2.14 NA NA 26.65 26.77 090 33120 ......... ............ A Removal of heart lesion ................................ 27.29 NA NA 10.90 11.43 3.69 NA NA 41.88 42.41 090 33130 ......... ............ A Removal of heart lesion ................................ 24.01 NA NA 9.50 9.98 3.00 NA NA 36.51 36.99 090 33140 ......... ............ A Heart revascularize (tmr) ............................... 22.72 NA NA 10.19 10.73 2.85 NA NA 35.76 36.30 090 33141 ......... ............ A Heart tmr w/other procedure ......................... 4.83 NA NA 1.53 1.57 0.69 NA NA 7.05 7.09 ZZZ 33200 ......... ............ A Insertion of heart pacemaker ........................ 14.69 NA NA 7.55 7.03 1.70 NA NA 23.94 23.42 090 33201 ......... ............ A Insertion of heart pacemaker ........................ 12.08 NA NA 6.47 6.57 1.36 NA NA 19.91 20.01 090 33206 ......... ............ A Insertion of heart pacemaker ........................ 7.27 NA NA 5.24 4.66 0.52 NA NA 13.03 12.45 09033207 ......... ............ A Insertion of heart pacemaker ........................ 9.03 NA NA 5.89 4.98 0.59 NA NA 15.51 14.60 09033208 ......... ............ A Insertion of heart pacemaker ........................ 8.12 NA NA 5.54 4.97 0.56 NA NA 14.22 13.65 09033210 ......... ............ A Insertion of heart electrode ........................... 3.30 NA NA 1.73 1.37 0.18 NA NA 5.21 4.85 000 33211 ......... ............ A Insertion of heart electrode ........................... 3.39 NA NA 1.71 1.41 0.21 NA NA 5.31 5.01 000 33212 ......... ............ A Insertion of pulse generator .......................... 5.51 NA NA 3.82 3.48 0.43 NA NA 9.76 9.42 09033213 ......... ............ A Insertion of pulse generator .......................... 6.36 NA NA 4.35 3.89 0.45 NA NA 11.16 10.70 090 33214 ......... ............ A Upgrade of pacemaker system ..................... 7.74 NA NA 5.48 5.05 0.58 NA NA 13.80 13.37 090 33215 ......... ............ A Reposition pacing-defib lead ......................... 4.87 NA NA 3.58 3.29 0.37 NA NA 8.82 8.53 090 33216 ......... ............ A Insert lead pace-defib, one ........................... 5.77 NA NA 4.67 4.33 0.36 NA NA 10.80 10.46 090 33217 ......... ............ A Insert lead pace-defib, dual ........................... 5.74 NA NA 4.58 4.33 0.39 NA NA 10.71 10.46 090 33218 ......... ............ A Repair lead pace-defib, one .......................... 5.93 NA NA 4.92 4.46 0.37 NA NA 11.22 10.76 090 33220 ......... ............ A Repair lead pace-defib, dual ......................... 6.01 NA NA 4.99 4.46 0.37 NA NA 11.37 10.84 090 33222 ......... ............ A Revise pocket, pacemaker ............................ 4.95 NA NA 4.40 4.33 0.42 NA NA 9.77 9.70 090 33223 ......... ............ A Revise pocket, pacing-defib .......................... 6.45 NA NA 5.07 4.72 0.45 NA NA 11.97 11.62 090 33224 ......... ............ A Insert pacing lead & connect ........................ 9.04 NA NA 5.15 4.30 0.54 NA NA 14.73 13.88 00033225 ......... ............ A L ventric pacing lead add-on ......................... 8.33 NA NA 4.55 3.58 0.45 NA NA 13.33 12.36 ZZZ 33226 ......... ............ A Reposition l ventric lead ................................ 8.68 NA NA 4.97 4.12 0.59 NA NA 14.24 13.39 000 33233 ......... ............ A Removal of pacemaker system ..................... 3.29 NA NA 3.35 3.30 0.22 NA NA 6.86 6.81 090 33234 ......... ............ A Removal of pacemaker system ..................... 7.81 NA NA 5.63 5.10 0.56 NA NA 14.00 13.47 090 33235 ......... ............ A Removal pacemaker electrode ..................... 9.85 NA NA 7.47 6.99 0.73 NA NA 18.05 17.57 090 33236 ......... ............ A Remove electrode/thoracotomy .................... 12.58 NA NA 6.76 7.28 1.68 NA NA 21.02 21.54 090 33237 ......... ............ A Remove electrode/thoracotomy .................... 13.69 NA NA 7.78 7.80 1.59 NA NA 23.06 23.08 090 33238 ......... ............ A Remove electrode/thoracotomy .................... 15.20 NA NA 8.40 8.27 2.02 NA NA 25.62 25.49 090 33240 ......... ............ A Insert pulse generator ................................... 7.59 NA NA 5.46 4.81 0.41 NA NA 13.46 12.81 090 33241 ......... ............ A Remove pulse generator ............................... 3.24 NA NA 3.10 3.00 0.18 NA NA 6.52 6.42 090 33243 ......... ............ A Remove eltrd/thoracotomy ............................ 23.36 NA NA 10.96 11.36 2.09 NA NA 36.41 36.81 090 33244 ......... ............ A Remove eltrd, transven ................................. 13.74 NA NA 9.73 9.12 0.99 NA NA 24.46 23.85 090 33245 ......... ............ A Insert epic eltrd pace-defib ............................ 16.81 NA NA 8.05 7.95 2.01 NA NA 26.87 26.77 090 33246 ......... ............ A Insert epic eltrd/generator ............................. 23.11 NA NA 10.89 10.46 2.63 NA NA 36.63 36.20 090 33249 ......... ............ A Eltrd/insert pace-defib ................................... 14.96 NA NA 10.55 8.92 0.77 NA NA 26.28 24.65 090 33250 ......... ............ A Ablate heart dysrhythm focus ....................... 25.75 NA NA 10.24 10.85 3.18 NA NA 39.17 39.78 090 33251 ......... ............ A Ablate heart dysrhythm focus ....................... 28.77 NA NA 11.25 11.58 3.59 NA NA 43.61 43.94 090 33253 ......... ............ A Reconstruct atria ........................................... 31.33 NA NA 12.28 13.47 4.52 NA NA 48.13 49.32 090 33261 ......... ............ A Ablate heart dysrhythm focus ....................... 28.77 NA NA 11.49 11.72 3.45 NA NA 43.71 43.94 090 33282 ......... ............ A Implant pat-active ht record .......................... 4.66 NA NA 4.37 4.12 0.23 NA NA 9.26 9.01 090

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37301 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

33284 ......... ............ A Remove pat-active ht record ......................... 3.00 NA NA 3.46 3.52 0.14 NA NA 6.60 6.66 090 33300 ......... ............ A Repair of heart wound ................................... 29.93 NA NA 11.69 9.87 2.65 NA NA 44.27 42.45 090 33305 ......... ............ A Repair of heart wound ................................... 33.67 NA NA 12.81 11.18 3.12 NA NA 49.60 47.97 090 33310 ......... ............ A Exploratory heart surgery .............................. 20.19 NA NA 8.93 9.44 2.58 NA NA 31.70 32.21 090 33315 ......... ............ A Exploratory heart surgery .............................. 26.01 NA NA 10.51 10.81 3.27 NA NA 39.79 40.09 090 33320 ......... ............ A Repair major blood vessel(s) ........................ 18.42 NA NA 8.81 8.38 2.07 NA NA 29.30 28.87 090 33321 ......... ............ A Repair major vessel ...................................... 20.67 NA NA 10.44 9.97 2.90 NA NA 34.01 33.54 090 33322 ......... ............ A Repair major blood vessel(s) ........................ 24.26 NA NA 9.95 10.28 2.85 NA NA 37.06 37.39 090 33330 ......... ............ A Insert major vessel graft ................................ 25.13 NA NA 9.94 10.20 2.81 NA NA 37.88 38.14 090 33332 ......... ............ A Insert major vessel graft ................................ 24.42 NA NA 9.72 10.34 3.02 NA NA 37.16 37.78 090 33335 ......... ............ A Insert major vessel graft ................................ 33.75 NA NA 13.13 13.31 4.27 NA NA 51.15 51.33 090 33400 ......... ............ A Repair of aortic valve .................................... 39.23 NA NA 15.49 15.66 4.10 NA NA 58.82 58.99 090 33401 ......... ............ A Valvuloplasty, open ....................................... 24.33 NA NA 10.03 12.66 3.56 NA NA 37.92 40.55 090 33403 ......... ............ A Valvuloplasty, w/cp bypass ........................... 25.31 NA NA 10.70 13.43 3.54 NA NA 39.55 42.28 090 33404 ......... ............ A Prepare heart-aorta conduit .......................... 31.21 NA NA 12.40 14.04 4.32 NA NA 47.93 49.57 090 33405 ......... ............ A Replacement of aortic valve .......................... 39.97 NA NA 16.02 17.76 5.31 NA NA 61.30 63.04 090 33406 ......... ............ A Replacement of aortic valve .......................... 48.87 NA NA 18.67 19.05 5.43 NA NA 72.97 73.35 090 33410 ......... ............ A Replacement of aortic valve .......................... 38.69 NA NA 15.15 16.26 4.68 NA NA 58.52 59.63 090 33411 ......... ............ A Replacement of aortic valve .......................... 57.11 NA NA 21.08 19.36 5.46 NA NA 83.65 81.93 090 33412 ......... ............ A Replacement of aortic valve .......................... 43.71 NA NA 16.71 19.52 6.37 NA NA 66.79 69.60 090 33413 ......... ............ A Replacement of aortic valve .......................... 55.27 NA NA 20.25 20.72 6.51 NA NA 82.03 82.50 090 33414 ......... ............ A Repair of aortic valve .................................... 39.27 NA NA 16.30 14.70 4.56 NA NA 60.13 58.53 090 33415 ......... ............ A Revision, subvalvular tissue .......................... 29.70 NA NA 11.18 11.83 4.13 NA NA 45.01 45.66 090 33416 ......... ............ A Revise ventricle muscle ................................ 36.39 NA NA 13.60 13.56 4.56 NA NA 54.55 54.51 090 33417 ......... ............ A Repair of aortic valve .................................... 29.13 NA NA 12.30 13.31 4.09 NA NA 45.52 46.53 090 33420 ......... ............ A Revision of mitral valve ................................. 25.64 NA NA 8.74 9.38 1.81 NA NA 36.19 36.83 090 33422 ......... ............ A Revision of mitral valve ................................. 29.57 NA NA 12.61 13.42 3.93 NA NA 46.11 46.92 090 33425 ......... ............ A Repair of mitral valve .................................... 38.37 NA NA 14.13 13.35 4.06 NA NA 56.56 55.78 090 33426 ......... ............ A Repair of mitral valve .................................... 41.28 NA NA 16.14 16.92 5.01 NA NA 62.43 63.21 090 33427 ......... ............ A Repair of mitral valve .................................... 42.78 NA NA 16.52 18.70 6.07 NA NA 65.37 67.55 090 33430 ......... ............ A Replacement of mitral valve .......................... 49.81 NA NA 18.82 17.71 5.08 NA NA 73.71 72.60 090 33460 ......... ............ A Revision of tricuspid valve ............................ 27.97 NA NA 11.09 11.27 3.44 NA NA 42.50 42.68 090 33463 ......... ............ A Valvuloplasty, tricuspid .................................. 42.57 NA NA 16.20 13.76 3.86 NA NA 62.63 60.19 090 33464 ......... ............ A Valvuloplasty, tricuspid .................................. 30.93 NA NA 12.84 13.38 4.14 NA NA 47.91 48.45 090 33465 ......... ............ A Replace tricuspid valve ................................. 33.58 NA NA 12.72 12.93 4.38 NA NA 50.68 50.89 090 33468 ......... ............ A Revision of tricuspid valve ............................ 32.78 NA NA 15.74 14.20 4.06 NA NA 52.58 51.04 090 33470 ......... ............ A Revision of pulmonary valve ......................... 21.24 NA NA 8.84 10.25 1.03 NA NA 31.11 32.52 090 33471 ......... ............ A Valvotomy, pulmonary valve ......................... 22.79 NA NA 8.23 9.39 3.38 NA NA 34.40 35.56 09033472 ......... ............ A Revision of pulmonary valve ......................... 22.86 NA NA 7.07 10.69 3.54 NA NA 33.47 37.09 090 33474 ......... ............ A Revision of pulmonary valve ......................... 25.85 NA NA 12.31 11.26 3.21 NA NA 41.37 40.32 090 33475 ......... ............ A Replacement, pulmonary valve ..................... 44.81 NA NA 16.89 15.78 4.92 NA NA 66.62 65.51 09033476 ......... ............ A Revision of heart chamber ............................ 26.37 NA NA 11.49 11.87 2.41 NA NA 40.27 40.65 090 33478 ......... ............ A Revision of heart chamber ............................ 27.34 NA NA 11.15 12.61 3.88 NA NA 42.37 43.83 090 33496 ......... ............ A Repair, prosth valve clot ............................... 29.67 NA NA 11.64 12.50 4.12 NA NA 45.43 46.29 090 33500 ......... ............ A Repair heart vessel fistula ............................. 27.79 NA NA 11.18 11.41 3.86 NA NA 42.83 43.06 090 33501 ......... ............ A Repair heart vessel fistula ............................. 19.39 NA NA 8.28 8.30 1.90 NA NA 29.57 29.59 090 33502 ......... ............ A Coronary artery correction ............................ 21.65 NA NA 9.42 10.68 2.99 NA NA 34.06 35.32 090 33503 ......... ............ A Coronary artery graft ..................................... 22.21 NA NA 10.80 10.02 1.77 NA NA 34.78 34.00 090 33504 ......... ............ A Coronary artery graft ..................................... 25.26 NA NA 10.37 11.47 3.35 NA NA 38.98 40.08 090 33505 ......... ............ A Repair artery w/tunnel ................................... 38.33 NA NA 13.26 13.02 2.18 NA NA 53.77 53.53 090 33506 ......... ............ A Repair artery, translocation ........................... 37.78 NA NA 16.92 15.18 4.65 NA NA 59.35 57.61 090 33507 ......... ............ A Repair art, intramural .................................... 31.33 NA NA 11.93 13.24 4.05 NA NA 47.31 48.62 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37302 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

33508 ......... ............ A Endoscopic vein harvest ............................... 0.31 NA NA 0.10 0.10 0.04 NA NA 0.45 0.45 ZZZ33510 ......... ............ A CABG, vein, single ........................................ 33.45 NA NA 14.10 15.81 4.40 NA NA 51.95 53.66 090 33511 ......... ............ A CABG, vein, two ............................................ 34.59 NA NA 14.66 16.51 4.55 NA NA 53.80 55.65 090 33512 ......... ............ A CABG, vein, three ......................................... 38.73 NA NA 15.96 17.23 4.66 NA NA 59.35 60.62 090 33513 ......... ............ A CABG, vein, four ........................................... 39.69 NA NA 16.45 17.49 4.87 NA NA 61.01 62.05 090 33514 ......... ............ A CABG, vein, five ............................................ 40.50 NA NA 16.68 17.75 4.76 NA NA 61.94 63.01 090 33516 ......... ............ A Cabg, vein, six or more ................................. 41.96 NA NA 17.58 18.53 5.11 NA NA 64.65 65.60 090 33517 ......... ............ A CABG, artery-vein, single .............................. 2.57 NA NA 0.80 0.83 0.39 NA NA 3.76 3.79 ZZZ 33518 ......... ............ A CABG, artery-vein, two ................................. 4.84 NA NA 1.50 1.56 0.73 NA NA 7.07 7.13 ZZZ 33519 ......... ............ A CABG, artery-vein, three ............................... 7.11 NA NA 2.20 2.30 1.04 NA NA 10.35 10.45 ZZZ 33521 ......... ............ A CABG, artery-vein, four ................................. 9.39 NA NA 2.93 3.04 1.37 NA NA 13.69 13.80 ZZZ 33522 ......... ............ A CABG, artery-vein, five ................................. 11.65 NA NA 3.60 3.77 1.77 NA NA 17.02 17.19 ZZZ 33523 ......... ............ A Cabg, art-vein, six or more ........................... 13.93 NA NA 4.35 4.49 2.12 NA NA 20.40 20.54 ZZZ 33530 ......... ............ A Coronary artery, bypass/reop ........................ 5.85 NA NA 1.81 1.89 0.88 NA NA 8.54 8.62 ZZZ 33533 ......... ............ A CABG, arterial, single .................................... 37.38 NA NA 15.18 16.18 4.55 NA NA 57.11 58.11 090 33534 ......... ............ A CABG, arterial, two ....................................... 38.81 NA NA 15.92 17.30 4.69 NA NA 59.42 60.80 090 33535 ......... ............ A CABG, arterial, three ..................................... 41.48 NA NA 16.88 17.86 5.01 NA NA 63.37 64.35 090 33536 ......... ............ A Cabg, arterial, four or more ........................... 40.79 NA NA 16.50 17.88 5.42 NA NA 62.71 64.09 090 33542 ......... ............ A Removal of heart lesion ................................ 32.65 NA NA 12.79 12.97 4.37 NA NA 49.81 49.99 090 33545 ......... ............ A Repair of heart damage ................................ 41.12 NA NA 15.63 15.66 5.19 NA NA 61.94 61.97 090 33548 ......... ............ A Restore/remodel, ventricle ............................ 42.46 NA NA 16.72 18.69 5.51 NA NA 64.69 66.66 090 33572 ......... ............ A Open coronary endarterectomy .................... 4.44 NA NA 1.36 1.43 0.65 NA NA 6.45 6.52 ZZZ 33600 ......... ............ A Closure of valve ............................................ 30.11 NA NA 12.61 12.57 4.41 NA NA 47.13 47.09 090 33602 ......... ............ A Closure of valve ............................................ 29.14 NA NA 13.58 12.76 3.81 NA NA 46.53 45.71 090 33606 ......... ............ A Anastomosis/artery-aorta .............................. 31.33 NA NA 12.36 13.37 4.40 NA NA 48.09 49.10 090 33608 ......... ............ A Repair anomaly w/conduit ............................. 31.68 NA NA 13.61 14.01 4.73 NA NA 50.02 50.42 090 33610 ......... ............ A Repair by enlargement .................................. 31.20 NA NA 11.17 13.02 4.55 NA NA 46.92 48.77 090 33611 ......... ............ A Repair double ventricle ................................. 35.47 NA NA 12.05 13.64 4.36 NA NA 51.88 53.47 090 33612 ......... ............ A Repair double ventricle ................................. 36.47 NA NA 13.15 14.68 5.28 NA NA 54.90 56.43 090 33615 ......... ............ A Repair, modified fontan ................................. 35.72 NA NA 12.53 13.02 4.31 NA NA 52.56 53.05 090 33617 ......... ............ A Repair single ventricle ................................... 38.92 NA NA 16.71 16.21 5.64 NA NA 61.27 60.77 090 33619 ......... ............ A Repair single ventricle ................................... 48.56 NA NA 18.62 20.30 6.44 NA NA 73.62 75.30 090 33641 ......... ............ A Repair heart septum defect ........................... 28.47 NA NA 10.55 9.84 3.22 NA NA 42.24 41.53 090 33645 ......... ............ A Revision of heart veins .................................. 27.94 NA NA 11.08 11.62 3.78 NA NA 42.80 43.34 090 33647 ......... ............ A Repair heart septum defects ......................... 29.33 NA NA 12.54 13.49 3.31 NA NA 45.18 46.13 090 33660 ......... ............ A Repair of heart defects .................................. 31.73 NA NA 12.27 13.21 4.48 NA NA 48.48 49.42 090 33665 ......... ............ A Repair of heart defects .................................. 34.75 NA NA 13.51 13.78 3.99 NA NA 52.25 52.52 090 33670 ......... ............ A Repair of heart chambers ............................. 36.56 NA NA 13.08 13.18 4.64 NA NA 54.28 54.38 090 33681 ......... ............ A Repair heart septum defect ........................... 32.10 NA NA 13.46 14.41 4.44 NA NA 50.00 50.95 090 33684 ......... ............ A Repair heart septum defect ........................... 34.27 NA NA 20.80 15.45 3.38 NA NA 58.45 53.10 090 33688 ......... ............ A Repair heart septum defect ........................... 34.65 NA NA 9.78 10.32 4.72 NA NA 49.15 49.69 090 33690 ......... ............ A Reinforce pulmonary artery ........................... 20.16 NA NA 8.74 9.83 1.96 NA NA 30.86 31.95 090 33692 ......... ............ A Repair of heart defects .................................. 31.34 NA NA 9.04 12.73 4.57 NA NA 44.95 48.64 090 33694 ......... ............ A Repair of heart defects .................................. 35.47 NA NA 9.87 13.16 5.26 NA NA 50.60 53.89 090 33697 ......... ............ A Repair of heart defects .................................. 37.47 NA NA 22.18 16.73 4.08 NA NA 63.73 58.28 090 33702 ......... ............ A Repair of heart defects .................................. 27.07 NA NA 11.76 12.39 3.67 NA NA 42.50 43.13 090 33710 ......... ............ A Repair of heart defects .................................. 30.24 NA NA 11.89 13.47 4.42 NA NA 46.55 48.13 090 33720 ......... ............ A Repair of heart defect ................................... 27.09 NA NA 11.35 12.08 3.83 NA NA 42.27 43.00 090 33722 ......... ............ A Repair of heart defect ................................... 29.01 NA NA 8.51 12.55 1.30 NA NA 38.82 42.86 090 33730 ......... ............ A Repair heart-vein defect(s) ............................ 35.97 NA NA 13.47 13.99 5.01 NA NA 54.45 54.97 090 33732 ......... ............ A Repair heart-vein defect ................................ 28.76 NA NA 14.99 13.81 3.67 NA NA 47.42 46.24 090 33735 ......... ............ A Revision of heart chamber ............................ 22.00 NA NA 9.66 9.15 1.91 NA NA 33.57 33.06 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37303 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

33736 ......... ............ A Revision of heart chamber ............................ 24.12 NA NA 10.93 11.64 3.08 NA NA 38.13 38.84 090 33737 ......... ............ A Revision of heart chamber ............................ 22.30 NA NA 7.44 10.08 3.24 NA NA 32.98 35.62 090 33750 ......... ............ A Major vessel shunt ........................................ 22.02 NA NA 11.54 10.57 1.16 NA NA 34.72 33.75 090 33755 ......... ............ A Major vessel shunt ........................................ 22.40 NA NA 7.69 8.55 3.25 NA NA 33.34 34.20 090 33762 ......... ............ A Major vessel shunt ........................................ 22.40 NA NA 7.03 9.39 3.13 NA NA 32.56 34.92 090 33764 ......... ............ A Major vessel shunt & graft ............................ 22.40 NA NA 9.26 10.00 3.00 NA NA 34.66 35.40 090 33766 ......... ............ A Major vessel shunt ........................................ 23.37 NA NA 8.48 10.90 3.69 NA NA 35.54 37.96 090 33767 ......... ............ A Major vessel shunt ........................................ 25.10 NA NA 9.53 11.20 3.81 NA NA 38.44 40.11 090 33768 ......... ............ A Cavopulmonary shunting ............................... 8.00 NA NA 2.21 2.56 1.19 NA NA 11.40 11.75 ZZZ 33770 ......... ............ A Repair great vessels defect .......................... 39.00 NA NA 11.10 13.82 5.72 NA NA 55.82 58.54 090 33771 ......... ............ A Repair great vessels defect .......................... 40.56 NA NA 11.05 12.08 5.66 NA NA 57.27 58.30 090 33774 ......... ............ A Repair great vessels defect .......................... 31.48 NA NA 12.58 14.17 4.80 NA NA 48.86 50.45 090 33775 ......... ............ A Repair great vessels defect .......................... 32.79 NA NA 9.94 13.76 4.98 NA NA 47.71 51.53 090 33776 ......... ............ A Repair great vessels defect .......................... 34.45 NA NA 13.53 15.27 5.07 NA NA 53.05 54.79 090 33777 ......... ............ A Repair great vessels defect .......................... 33.87 NA NA 9.74 14.18 5.47 NA NA 49.08 53.52 090 33778 ......... ............ A Repair great vessels defect .......................... 42.58 NA NA 15.44 16.57 6.18 NA NA 64.20 65.33 090 33779 ......... ............ A Repair great vessels defect .......................... 43.13 NA NA 11.88 14.53 2.91 NA NA 57.92 60.57 090 33780 ......... ............ A Repair great vessels defect .......................... 43.83 NA NA 12.19 17.40 3.67 NA NA 59.69 64.90 090 33781 ......... ............ A Repair great vessels defect .......................... 43.14 NA NA 15.46 13.89 5.95 NA NA 64.55 62.98 090 33786 ......... ............ A Repair arterial trunk ....................................... 41.70 NA NA 11.19 15.37 5.69 NA NA 58.58 62.76 090 33788 ......... ............ A Revision of pulmonary artery ........................ 27.22 NA NA 9.71 11.41 4.02 NA NA 40.95 42.65 090 33800 ......... ............ A Aortic suspension .......................................... 17.20 NA NA 7.45 7.96 2.45 NA NA 27.10 27.61 090 33802 ......... ............ A Repair vessel defect ...................................... 18.20 NA NA 7.47 8.81 2.26 NA NA 27.93 29.27 090 33803 ......... ............ A Repair vessel defect ...................................... 20.14 NA NA 6.30 8.92 3.19 NA NA 29.63 32.25 090 33813 ......... ............ A Repair septal defect ...................................... 21.19 NA NA 9.15 10.49 3.12 NA NA 33.46 34.80 090 33814 ......... ............ A Repair septal defect ...................................... 26.37 NA NA 10.67 12.18 3.84 NA NA 40.88 42.39 090 33820 ......... ............ A Revise major vessel ...................................... 16.59 NA NA 8.53 8.42 2.34 NA NA 27.46 27.35 090 33822 ......... ............ A Revise major vessel ...................................... 17.61 NA NA 5.87 8.20 2.67 NA NA 26.15 28.48 090 33824 ......... ............ A Revise major vessel ...................................... 20.06 NA NA 8.70 9.68 2.88 NA NA 31.64 32.62 090 33840 ......... ............ A Remove aorta constriction ............................ 21.17 NA NA 9.06 10.01 2.15 NA NA 32.38 33.33 090 33845 ......... ............ A Remove aorta constriction ............................ 22.73 NA NA 9.76 10.98 3.21 NA NA 35.70 36.92 090 33851 ......... ............ A Remove aorta constriction ............................ 21.81 NA NA 9.30 10.36 3.17 NA NA 34.28 35.34 090 33852 ......... ............ A Repair septal defect ...................................... 24.24 NA NA 10.04 11.05 2.15 NA NA 36.43 37.44 090 33853 ......... ............ A Repair septal defect ...................................... 32.31 NA NA 13.28 14.47 4.47 NA NA 50.06 51.25 090 33860 ......... ............ A Ascending aortic graft ................................... 43.13 NA NA 16.08 16.40 5.74 NA NA 64.95 65.27 090 33861 ......... ............ A Ascending aortic graft ................................... 43.88 NA NA 16.31 17.40 6.35 NA NA 66.54 67.63 090 33863 ......... ............ A Ascending aortic graft ................................... 48.52 NA NA 17.87 18.52 6.57 NA NA 72.96 73.61 090 33870 ......... ............ A Transverse aortic arch graft .......................... 45.87 NA NA 16.88 18.04 6.60 NA NA 69.35 70.51 090 33875 ......... ............ A Thoracic aortic graft ...................................... 35.64 NA NA 13.37 13.94 4.88 NA NA 53.89 54.46 090 33877 ......... ............ A Thoracoabdominal graft ................................ 57.75 NA NA 18.74 16.96 5.92 NA NA 82.41 80.63 090 33880 ......... ............ A Endovasc taa repr incl subcl ......................... 34.44 NA NA 11.00 12.88 2.74 NA NA 48.18 50.06 090 33881 ......... ............ A Endovasc taa repr w/o subcl ......................... 29.44 NA NA 9.71 11.42 2.32 NA NA 41.47 43.18 090 33883 ......... ............ A Insert endovasc prosth, taa ........................... 20.95 NA NA 7.31 8.74 2.10 NA NA 30.36 31.79 090 33884 ......... ............ A Endovasc prosth, taa, add-on ....................... 8.20 NA NA 2.09 2.46 0.86 NA NA 11.15 11.52 ZZZ 33886 ......... ............ A Endovasc prosth, delayed ............................. 17.95 NA NA 6.51 7.82 1.79 NA NA 26.25 27.56 090 33889 ......... ............ A Artery transpose/endovas taa ....................... 15.92 NA NA 4.32 4.97 2.17 NA NA 22.41 23.06 00033891 ......... ............ A Car-car bp grft/endovas taa .......................... 20.00 NA NA 6.73 6.92 2.72 NA NA 29.45 29.64 000 33910 ......... ............ A Remove lung artery emboli ........................... 29.56 NA NA 11.45 11.46 3.69 NA NA 44.70 44.71 090 33915 ......... ............ A Remove lung artery emboli ........................... 24.80 NA NA 10.57 9.89 1.44 NA NA 36.81 36.13 090 33916 ......... ............ A Surgery of great vessel ................................. 28.26 NA NA 10.99 11.28 3.66 NA NA 42.91 43.20 090 33917 ......... ............ A Repair pulmonary artery ................................ 25.10 NA NA 10.43 11.77 3.69 NA NA 39.22 40.56 090 33920 ......... ............ A Repair pulmonary atresia .............................. 32.54 NA NA 11.37 13.24 4.37 NA NA 48.28 50.15 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37304 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

33922 ......... ............ A Transect pulmonary artery ............................ 24.05 NA NA 11.61 11.10 3.09 NA NA 38.75 38.24 090 33924 ......... ............ A Remove pulmonary shunt ............................. 5.49 NA NA 2.16 1.93 0.82 NA NA 8.47 8.24 ZZZ 33925 ......... ............ A Rpr pul art unifocal w/o cpb .......................... 31.23 NA NA 10.03 13.53 4.60 NA NA 45.86 49.36 090 33926 ......... ............ A Repr pul art, unifocal w/cpb .......................... 44.66 NA NA 14.31 16.88 6.20 NA NA 65.17 67.74 090 33935 ......... ............ R Transplantation, heart/lung ............................ 61.56 NA NA 28.07 28.66 9.03 NA NA 98.66 99.25 090 33945 ......... ............ R Transplantation of heart ................................ 50.14 NA NA 19.19 20.89 6.24 NA NA 75.57 77.27 090 33960 ......... ............ A External circulation assist .............................. 19.33 NA NA 5.63 5.10 2.66 NA NA 27.62 27.09 000 33961 ......... ............ A External circulation assist .............................. 10.91 NA NA 2.85 3.43 0.88 NA NA 14.64 15.22 ZZZ 33967 ......... ............ A Insert ia percut device ................................... 4.84 NA NA 2.50 2.01 0.35 NA NA 7.69 7.20 000 33968 ......... ............ A Remove aortic assist device ......................... 0.64 NA NA 0.27 0.24 0.07 NA NA 0.98 0.95 000 33970 ......... ............ A Aortic circulation assist .................................. 6.74 NA NA 2.59 2.37 0.82 NA NA 10.15 9.93 000 33971 ......... ............ A Aortic circulation assist .................................. 11.89 NA NA 6.17 6.06 1.25 NA NA 19.31 19.20 090 33973 ......... ............ A Insert balloon device ..................................... 9.75 NA NA 3.94 3.48 1.26 NA NA 14.95 14.49 000 33974 ......... ............ A Remove intra-aortic balloon .......................... 14.89 NA NA 7.90 7.90 1.73 NA NA 24.52 24.52 090 33975 ......... ............ A Implant ventricular device ............................. 20.97 NA NA 6.72 6.41 3.06 NA NA 30.75 30.44 XXX 33976 ......... ............ A Implant ventricular device ............................. 22.97 NA NA 7.98 7.67 3.25 NA NA 34.20 33.89 XXX 33977 ......... ............ A Remove ventricular device ............................ 19.99 NA NA 9.49 10.70 2.80 NA NA 32.28 33.49 090 33978 ......... ............ A Remove ventricular device ............................ 22.43 NA NA 10.66 11.50 3.30 NA NA 36.39 37.23 090 33979 ......... ............ A Insert intracorporeal device ........................... 45.93 NA NA 14.55 14.86 6.95 NA NA 67.43 67.74 XXX 33980 ......... ............ A Remove intracorporeal device ...................... 64.76 NA NA 25.28 25.30 8.56 NA NA 98.60 98.62 090 34001 ......... ............ A Removal of artery clot ................................... 17.74 NA NA 7.02 6.80 1.84 NA NA 26.60 26.38 090 34051 ......... ............ A Removal of artery clot ................................... 16.85 NA NA 7.07 7.62 2.20 NA NA 26.12 26.67 090 34101 ......... ............ A Removal of artery clot ................................... 10.81 NA NA 4.59 5.18 1.41 NA NA 16.81 17.40 090 34111 ......... ............ A Removal of arm artery clot ............................ 10.81 NA NA 4.66 5.19 1.40 NA NA 16.87 17.40 090 34151 ......... ............ A Removal of artery clot ................................... 26.35 NA NA 9.02 10.08 3.55 NA NA 38.92 39.98 090 34201 ......... ............ A Removal of artery clot ................................... 18.40 NA NA 6.72 5.75 1.45 NA NA 26.57 25.60 090 34203 ......... ............ A Removal of leg artery clot ............................. 17.67 NA NA 6.85 7.77 2.35 NA NA 26.87 27.79 090 34401 ......... ............ A Removal of vein clot ...................................... 26.35 NA NA 9.79 10.47 3.09 NA NA 39.23 39.91 090 34421 ......... ............ A Removal of vein clot ...................................... 13.25 NA NA 5.62 6.14 1.55 NA NA 20.42 20.94 090 34451 ......... ............ A Removal of vein clot ...................................... 28.35 NA NA 10.09 11.13 3.83 NA NA 42.27 43.31 090 34471 ......... ............ A Removal of vein clot ...................................... 20.94 NA NA 7.58 5.89 1.18 NA NA 29.70 28.01 090 34490 ......... ............ A Removal of vein clot ...................................... 10.79 NA NA 4.63 5.24 1.41 NA NA 16.83 17.44 090 34501 ......... ............ A Repair valve, femoral vein ............................ 16.68 NA NA 7.16 8.17 2.34 NA NA 26.18 27.19 090 34502 ......... ............ A Reconstruct vena cava .................................. 27.80 NA NA 11.03 12.01 3.62 NA NA 42.45 43.43 090 34510 ......... ............ A Transposition of vein valve ........................... 19.74 NA NA 7.19 8.88 2.32 NA NA 29.25 30.94 090 34520 ......... ............ A Cross-over vein graft ..................................... 18.99 NA NA 9.51 8.73 2.28 NA NA 30.78 30.00 090 34530 ......... ............ A Leg vein fusion .............................................. 17.69 NA NA 8.10 8.50 1.73 NA NA 27.52 27.92 090 34800 ......... ............ A Endovas aaa repr w/sm tube ........................ 21.42 NA NA 7.73 8.83 2.45 NA NA 31.60 32.70 090 34802 ......... ............ A Endovas aaa repr w/2-p part ........................ 23.67 NA NA 8.64 9.52 2.32 NA NA 34.63 35.51 09034803 ......... ............ A Endovas aaa repr w/3-p part ........................ 24.70 NA NA 8.62 9.84 2.00 NA NA 35.32 36.54 09034804 ......... ............ A Endovas aaa repr w/1-p part ........................ 23.67 NA NA 8.47 9.49 2.29 NA NA 34.43 35.45 09034805 ......... ............ A Endovas aaa repr w/long tube ...................... 22.55 NA NA 7.66 9.17 2.00 NA NA 32.21 33.72 090 34808 ......... ............ A Endovas iliac a device addon ....................... 4.12 NA NA 1.16 1.32 0.59 NA NA 5.87 6.03 ZZZ 34812 ......... ............ A Xpose for endoprosth, femorl ........................ 6.74 NA NA 1.79 2.13 1.18 NA NA 9.71 10.05 000 34813 ......... ............ A Femoral endovas graft add-on ...................... 4.79 NA NA 1.25 1.49 0.67 NA NA 6.71 6.95 ZZZ 34820 ......... ............ A Xpose for endoprosth, iliac ........................... 9.74 NA NA 2.56 3.07 1.50 NA NA 13.80 14.31 000 34825 ......... ............ A Endovasc extend prosth, init ......................... 12.68 NA NA 5.43 5.98 1.28 NA NA 19.39 19.94 090 34826 ......... ............ A Endovasc exten prosth, addIl ........................ 4.12 NA NA 1.21 1.33 0.44 NA NA 5.77 5.89 ZZZ 34830 ......... ............ A Open aortic tube prosth repr ......................... 35.04 NA NA 11.14 13.08 4.54 NA NA 50.72 52.66 090 34831 ......... ............ A Open aortoiliac prosth repr ........................... 37.79 NA NA 12.55 11.96 4.88 NA NA 55.22 54.63 090 34832 ......... ............ A Open aortofemor prosth repr ........................ 37.79 NA NA 12.04 14.01 4.84 NA NA 54.67 56.64 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37305 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

34833 ......... ............ A Xpose for endoprosth, iliac ........................... 11.98 NA NA 3.47 4.20 1.69 NA NA 17.14 17.87 000 34834 ......... ............ A Xpose, endoprosth, brachial ......................... 5.34 NA NA 1.70 2.08 0.76 NA NA 7.80 8.18 000 34900 ......... ............ A Endovasc iliac repr w/graft ............................ 16.73 NA NA 6.61 7.35 1.99 NA NA 25.33 26.07 090 35001 ......... ............ A Repair defect of artery .................................. 20.63 NA NA 7.84 9.15 2.80 NA NA 31.27 32.58 090 35002 ......... ............ A Repair artery rupture, neck ........................... 22.05 NA NA 8.09 9.31 2.99 NA NA 33.13 34.35 090 35005 ......... ............ A Repair defect of artery .................................. 19.11 NA NA 8.75 8.84 1.76 NA NA 29.62 29.71 090 35011 ......... ............ A Repair defect of artery .................................. 18.46 NA NA 6.61 7.65 2.54 NA NA 27.61 28.65 090 35013 ......... ............ A Repair artery rupture, arm ............................. 23.04 NA NA 8.23 9.33 3.09 NA NA 34.36 35.46 090 35021 ......... ............ A Repair defect of artery .................................. 22.03 NA NA 8.89 9.30 2.86 NA NA 33.78 34.19 090 35022 ......... ............ A Repair artery rupture, chest .......................... 25.56 NA NA 9.66 9.83 3.16 NA NA 38.38 38.55 090 35045 ......... ............ A Repair defect of arm artery ........................... 17.91 NA NA 6.59 7.29 2.44 NA NA 26.94 27.64 090 35081 ......... ............ A Repair defect of artery .................................. 33.31 NA NA 10.82 11.32 4.00 NA NA 48.13 48.63 090 35082 ......... ............ A Repair artery rupture, aorta ........................... 41.87 NA NA 13.45 14.86 5.42 NA NA 60.74 62.15 090 35091 ......... ............ A Repair defect of artery .................................. 35.35 NA NA 10.80 12.90 5.12 NA NA 51.27 53.37 090 35092 ......... ............ A Repair artery rupture, aorta ........................... 50.75 NA NA 15.57 17.15 6.38 NA NA 72.70 74.28 090 35102 ......... ............ A Repair defect of artery .................................. 36.31 NA NA 11.47 12.16 4.47 NA NA 52.25 52.94 090 35103 ......... ............ A Repair artery rupture, groin ........................... 43.43 NA NA 13.58 15.31 5.74 NA NA 62.75 64.48 090 35111 ......... ............ A Repair defect of artery .................................. 26.11 NA NA 8.80 10.07 3.46 NA NA 38.37 39.64 090 35112 ......... ............ A Repair artery rupture,spleen ......................... 32.38 NA NA 10.60 11.64 4.07 NA NA 47.05 48.09 090 35121 ......... ............ A Repair defect of artery .................................. 31.35 NA NA 10.75 11.99 4.29 NA NA 46.39 47.63 090 35122 ......... ............ A Repair artery rupture, belly ........................... 37.70 NA NA 12.21 13.43 4.74 NA NA 54.65 55.87 090 35131 ......... ............ A Repair defect of artery .................................. 26.23 NA NA 9.13 10.36 3.79 NA NA 39.15 40.38 090 35132 ......... ............ A Repair artery rupture, groin ........................... 32.38 NA NA 10.56 11.95 4.29 NA NA 47.23 48.62 090 35141 ......... ............ A Repair defect of artery .................................. 20.79 NA NA 7.41 8.56 2.89 NA NA 31.09 32.24 090 35142 ......... ............ A Repair artery rupture, thigh ........................... 24.97 NA NA 8.77 9.99 3.35 NA NA 37.09 38.31 090 35151 ......... ............ A Repair defect of artery .................................. 23.55 NA NA 8.27 9.58 3.23 NA NA 35.05 36.36 090 35152 ......... ............ A Repair artery rupture, knee ........................... 27.47 NA NA 9.47 10.92 3.60 NA NA 40.54 41.99 090 35180 ......... ............ A Repair blood vessel lesion ............................ 14.95 NA NA 6.66 6.89 1.00 NA NA 22.61 22.84 090 35182 ......... ............ A Repair blood vessel lesion ............................ 31.52 NA NA 11.86 12.59 4.35 NA NA 47.73 48.46 090 35184 ......... ............ A Repair blood vessel lesion ............................ 18.67 NA NA 7.18 8.03 2.52 NA NA 28.37 29.22 090 35188 ......... ............ A Repair blood vessel lesion ............................ 14.98 NA NA 6.43 7.35 2.15 NA NA 23.56 24.48 090 35189 ......... ............ A Repair blood vessel lesion ............................ 29.79 NA NA 10.22 11.54 4.00 NA NA 44.01 45.33 090 35190 ......... ............ A Repair blood vessel lesion ............................ 13.27 NA NA 5.54 6.25 1.79 NA NA 20.60 21.31 090 35201 ......... ............ A Repair blood vessel lesion ............................ 16.78 NA NA 6.59 7.66 2.33 NA NA 25.70 26.77 090 35206 ......... ............ A Repair blood vessel lesion ............................ 13.72 NA NA 5.49 6.30 1.86 NA NA 21.07 21.88 090 35207 ......... ............ A Repair blood vessel lesion ............................ 10.79 NA NA 6.44 7.14 1.48 NA NA 18.71 19.41 090 35211 ......... ............ A Repair blood vessel lesion ............................ 24.44 NA NA 10.23 10.54 3.19 NA NA 37.86 38.17 090 35216 ......... ............ A Repair blood vessel lesion ............................ 36.43 NA NA 13.50 10.13 2.64 NA NA 52.57 49.20 090 35221 ......... ............ A Repair blood vessel lesion ............................ 26.50 NA NA 8.67 9.64 3.36 NA NA 38.53 39.50 090 35226 ......... ............ A Repair blood vessel lesion ............................ 15.18 NA NA 6.07 7.11 2.01 NA NA 23.26 24.30 090 35231 ......... ............ A Repair blood vessel lesion ............................ 21.04 NA NA 7.87 9.31 2.88 NA NA 31.79 33.23 090 35236 ......... ............ A Repair blood vessel lesion ............................ 17.90 NA NA 6.64 7.59 2.42 NA NA 26.96 27.91 090 35241 ......... ............ A Repair blood vessel lesion ............................ 25.44 NA NA 10.08 10.88 3.52 NA NA 39.04 39.84 090 35246 ......... ............ A Repair blood vessel lesion ............................ 28.11 NA NA 12.33 11.67 3.85 NA NA 44.29 43.63 090 35251 ......... ............ A Repair blood vessel lesion ............................ 31.79 NA NA 9.95 11.35 4.12 NA NA 45.86 47.26 090 35256 ......... ............ A Repair blood vessel lesion ............................ 18.94 NA NA 6.83 7.99 2.62 NA NA 28.39 29.55 090 35261 ......... ............ A Repair blood vessel lesion ............................ 18.84 NA NA 7.43 7.88 2.60 NA NA 28.87 29.32 090 35266 ......... ............ A Repair blood vessel lesion ............................ 15.71 NA NA 5.87 6.73 2.09 NA NA 23.67 24.53 090 35271 ......... ............ A Repair blood vessel lesion ............................ 24.44 NA NA 9.78 10.35 3.15 NA NA 37.37 37.94 090 35276 ......... ............ A Repair blood vessel lesion ............................ 25.66 NA NA 9.72 10.85 3.48 NA NA 38.86 39.99 090 35281 ......... ............ A Repair blood vessel lesion ............................ 29.87 NA NA 10.04 11.31 3.96 NA NA 43.87 45.14 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37306 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

35286 ......... ............ A Repair blood vessel lesion ............................ 17.00 NA NA 6.66 7.72 2.34 NA NA 26.00 27.06 090 35301 ......... ............ A Rechanneling of artery .................................. 19.49 NA NA 7.03 8.10 2.67 NA NA 29.19 30.26 090 35311 ......... ............ A Rechanneling of artery .................................. 28.48 NA NA 9.84 11.29 3.41 NA NA 41.73 43.18 090 35321 ......... ............ A Rechanneling of artery .................................. 16.47 NA NA 6.14 7.09 2.24 NA NA 24.85 25.80 090 35331 ......... ............ A Rechanneling of artery .................................. 27.55 NA NA 9.29 10.77 3.82 NA NA 40.66 42.14 090 35341 ......... ............ A Rechanneling of artery .................................. 26.03 NA NA 8.88 10.39 3.77 NA NA 38.68 40.19 090 35351 ......... ............ A Rechanneling of artery .................................. 24.49 NA NA 8.14 9.25 3.34 NA NA 35.97 37.08 090 35355 ......... ............ A Rechanneling of artery .................................. 19.74 NA NA 6.78 7.77 2.66 NA NA 29.18 30.17 090 35361 ......... ............ A Rechanneling of artery .................................. 30.05 NA NA 10.02 11.30 4.14 NA NA 44.21 45.49 090 35363 ......... ............ A Rechanneling of artery .................................. 32.16 NA NA 10.84 12.18 4.32 NA NA 47.32 48.66 090 35371 ......... ............ A Rechanneling of artery .................................. 15.19 NA NA 5.75 6.67 2.13 NA NA 23.07 23.99 090 35372 ......... ............ A Rechanneling of artery .................................. 18.46 NA NA 6.61 7.70 2.62 NA NA 27.69 28.78 090 35381 ......... ............ A Rechanneling of artery .................................. 16.63 NA NA 6.57 7.52 2.25 NA NA 25.45 26.40 090 35390 ......... ............ A Reoperation, carotid add-on .......................... 3.19 NA NA 0.88 1.02 0.46 NA NA 4.53 4.67 ZZZ 35400 ......... ............ A Angioscopy .................................................... 3.00 NA NA 0.78 1.03 0.43 NA NA 4.21 4.46 ZZZ 35450 ......... ............ A Repair arterial blockage ................................ 10.05 NA NA 3.33 3.51 1.25 NA NA 14.63 14.81 000 35452 ......... ............ A Repair arterial blockage ................................ 6.90 NA NA 2.18 2.50 0.94 NA NA 10.02 10.34 000 35454 ......... ............ A Repair arterial blockage ................................ 6.03 NA NA 1.88 2.21 0.87 NA NA 8.78 9.11 000 35456 ......... ............ A Repair arterial blockage ................................ 7.34 NA NA 2.36 2.67 1.04 NA NA 10.74 11.05 000 35458 ......... ............ A Repair arterial blockage ................................ 9.48 NA NA 2.97 3.35 1.26 NA NA 13.71 14.09 000 35459 ......... ............ A Repair arterial blockage ................................ 8.62 NA NA 2.59 3.03 1.21 NA NA 12.42 12.86 000 35460 ......... ............ A Repair venous blockage ................................ 6.03 NA NA 1.81 2.16 0.83 NA NA 8.67 9.02 00035470 ......... ............ A Repair arterial blockage ................................ 8.62 63.65 82.75 3.64 3.43 0.69 72.96 92.06 12.95 12.74 000 35471 ......... ............ A Repair arterial blockage ................................ 10.05 68.40 92.51 4.87 4.19 0.67 79.12 103.2 15.59 14.91 000 35472 ......... ............ A Repair arterial blockage ................................ 6.90 49.41 60.76 2.91 2.79 0.58 56.89 68.24 10.39 10.27 000 35473 ......... ............ A Repair arterial blockage ................................ 6.03 48.33 57.09 2.62 2.48 0.51 54.87 63.63 9.16 9.02 000 35474 ......... ............ A Repair arterial blockage ................................ 7.35 62.75 81.67 3.14 2.96 0.57 70.67 89.59 11.06 10.88 000 35475 ......... ............ R Repair arterial blockage ................................ 9.48 50.48 54.82 3.56 3.57 0.62 60.58 64.92 13.66 13.67 000 35476 ......... ............ A Repair venous blockage ................................ 6.03 38.73 43.33 2.28 2.34 0.34 45.10 49.70 8.65 8.71 000 35480 ......... ............ A Atherectomy, open ........................................ 11.06 NA NA 4.03 4.05 1.28 NA NA 16.37 16.39 000 35481 ......... ............ A Atherectomy, open ........................................ 7.60 NA NA 2.54 2.80 1.13 NA NA 11.27 11.53 000 35482 ......... ............ A Atherectomy, open ........................................ 6.64 NA NA 2.17 2.47 0.89 NA NA 9.70 10.00 000 35483 ......... ............ A Atherectomy, open ........................................ 8.09 NA NA 2.84 2.98 1.15 NA NA 12.08 12.22 000 35484 ......... ............ A Atherectomy, open ........................................ 10.42 NA NA 3.10 3.61 1.27 NA NA 14.79 15.30 000 35485 ......... ............ A Atherectomy, open ........................................ 9.48 NA NA 3.08 3.43 1.35 NA NA 13.91 14.26 000 35490 ......... ............ A Atherectomy, percutaneous .......................... 11.06 NA NA 6.42 5.14 0.71 NA NA 18.19 16.91 00035491 ......... ............ A Atherectomy, percutaneous .......................... 7.60 NA NA 3.98 3.47 0.74 NA NA 12.32 11.81 000 35492 ......... ............ A Atherectomy, percutaneous .......................... 6.64 NA NA 3.73 3.33 0.43 NA NA 10.80 10.40 000 35493 ......... ............ A Atherectomy, percutaneous .......................... 8.09 NA NA 4.29 3.93 0.56 NA NA 12.94 12.58 000 35494 ......... ............ A Atherectomy, percutaneous .......................... 10.42 NA NA 5.43 4.71 0.59 NA NA 16.44 15.72 00035495 ......... ............ A Atherectomy, percutaneous .......................... 9.48 NA NA 4.79 4.50 0.69 NA NA 14.96 14.67 000 35500 ......... ............ A Harvest vein for bypass ................................ 6.44 NA NA 1.74 1.96 0.93 NA NA 9.11 9.33 ZZZ 35501 ......... ............ A Artery bypass graft ........................................ 19.70 NA NA 7.54 8.25 2.80 NA NA 30.04 30.75 090 35506 ......... ............ A Artery bypass graft ........................................ 25.19 NA NA 9.06 9.38 2.86 NA NA 37.11 37.43 090 35507 ......... ............ A Artery bypass graft ........................................ 20.60 NA NA 7.83 9.05 2.84 NA NA 31.27 32.49 090 35508 ......... ............ A Artery bypass graft ........................................ 25.95 NA NA 9.84 9.56 2.77 NA NA 38.56 38.28 090 35509 ......... ............ A Artery bypass graft ........................................ 18.94 NA NA 7.06 8.36 2.61 NA NA 28.61 29.91 090 35510 ......... ............ A Artery bypass graft ........................................ 24.25 NA NA 7.98 9.65 2.11 NA NA 34.34 36.01 090 35511 ......... ............ A Artery bypass graft ........................................ 22.08 NA NA 7.57 8.93 2.90 NA NA 32.55 33.91 090 35512 ......... ............ A Artery bypass graft ........................................ 23.75 NA NA 7.83 9.48 2.11 NA NA 33.69 35.34 090 35515 ......... ............ A Artery bypass graft ........................................ 25.95 NA NA 9.26 9.30 2.77 NA NA 37.98 38.02 090 35516 ......... ............ A Artery bypass graft ........................................ 24.07 NA NA 8.46 7.23 2.33 NA NA 34.86 33.63 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37307 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

35518 ......... ............ A Artery bypass graft ........................................ 22.53 NA NA 7.70 8.68 3.02 NA NA 33.25 34.23 090 35521 ......... ............ A Artery bypass graft ........................................ 23.94 NA NA 8.36 9.49 3.12 NA NA 35.42 36.55 090 35522 ......... ............ A Artery bypass graft ........................................ 23.01 NA NA 7.69 9.26 2.11 NA NA 32.81 34.38 090 35525 ......... ............ A Artery bypass graft ........................................ 21.55 NA NA 7.36 8.89 2.11 NA NA 31.02 32.55 090 35526 ......... ............ A Artery bypass graft ........................................ 31.43 NA NA 18.64 14.07 3.62 NA NA 53.69 49.12 090 35531 ......... ............ A Artery bypass graft ........................................ 38.92 NA NA 12.26 13.95 5.16 NA NA 56.34 58.03 090 35533 ......... ............ A Artery bypass graft ........................................ 29.73 NA NA 10.16 11.35 3.84 NA NA 43.73 44.92 090 35536 ......... ............ A Artery bypass graft ........................................ 33.54 NA NA 11.17 12.53 4.61 NA NA 49.32 50.68 090 35541 ......... ............ A Artery bypass graft ........................................ 26.90 NA NA 9.38 10.77 3.70 NA NA 39.98 41.37 090 35546 ......... ............ A Artery bypass graft ........................................ 26.40 NA NA 9.20 10.47 3.69 NA NA 39.29 40.56 090 35548 ......... ............ A Artery bypass graft ........................................ 22.50 NA NA 8.14 9.12 2.97 NA NA 33.61 34.59 090 35549 ......... ............ A Artery bypass graft ........................................ 24.27 NA NA 9.28 10.12 3.29 NA NA 36.84 37.68 090 35551 ......... ............ A Artery bypass graft ........................................ 27.65 NA NA 10.01 11.14 3.74 NA NA 41.40 42.53 090 35556 ......... ............ A Artery bypass graft ........................................ 26.56 NA NA 9.13 9.60 3.09 NA NA 38.78 39.25 090 35558 ......... ............ A Artery bypass graft ........................................ 22.94 NA NA 8.33 9.26 2.99 NA NA 34.26 35.19 090 35560 ......... ............ A Artery bypass graft ........................................ 33.84 NA NA 11.10 12.79 4.74 NA NA 49.68 51.37 090 35563 ......... ............ A Artery bypass graft ........................................ 25.93 NA NA 8.83 10.12 3.51 NA NA 38.27 39.56 090 35565 ......... ............ A Artery bypass graft ........................................ 24.94 NA NA 8.72 9.80 3.29 NA NA 36.95 38.03 090 35566 ......... ............ A Artery bypass graft ........................................ 32.16 NA NA 10.55 11.20 3.82 NA NA 46.53 47.18 090 35571 ......... ............ A Artery bypass graft ........................................ 25.33 NA NA 9.02 10.41 3.42 NA NA 37.77 39.16 090 35572 ......... ............ A Harvest femoropopliteal vein ......................... 6.81 NA NA 1.90 2.16 0.99 NA NA 9.70 9.96 ZZZ 35583 ......... ............ A Vein bypass graft .......................................... 27.56 NA NA 9.54 10.02 3.16 NA NA 40.26 40.74 090 35585 ......... ............ A Vein bypass graft .......................................... 32.16 NA NA 10.81 11.89 4.01 NA NA 46.98 48.06 090 35587 ......... ............ A Vein bypass graft .......................................... 26.02 NA NA 9.44 10.97 3.51 NA NA 38.97 40.50 090 35600 ......... ............ A Harvest artery for cabg ................................. 4.94 NA NA 1.56 1.61 0.73 NA NA 7.23 7.28 ZZZ 35601 ......... ............ A Artery bypass graft ........................................ 18.31 NA NA 6.91 8.21 2.49 NA NA 27.71 29.01 090 35606 ......... ............ A Artery bypass graft ........................................ 22.32 NA NA 8.25 8.84 2.69 NA NA 33.26 33.85 090 35612 ......... ............ A Artery bypass graft ........................................ 16.64 NA NA 6.63 7.58 2.08 NA NA 25.35 26.30 090 35616 ......... ............ A Artery bypass graft ........................................ 21.70 NA NA 7.75 8.03 2.19 NA NA 31.64 31.92 090 35621 ......... ............ A Artery bypass graft ........................................ 20.91 NA NA 7.22 8.33 2.91 NA NA 31.04 32.15 090 35623 ......... ............ A Bypass graft, not vein ................................... 25.73 NA NA 8.87 10.11 3.45 NA NA 38.05 39.29 090 35626 ......... ............ A Artery bypass graft ........................................ 29.02 NA NA 10.55 11.64 4.07 NA NA 43.64 44.73 090 35631 ......... ............ A Artery bypass graft ........................................ 35.84 NA NA 11.44 13.26 4.95 NA NA 52.23 54.05 090 35636 ......... ............ A Artery bypass graft ........................................ 31.56 NA NA 10.19 11.80 4.09 NA NA 45.84 47.45 090 35641 ......... ............ A Artery bypass graft ........................................ 26.24 NA NA 9.44 10.68 3.53 NA NA 39.21 40.45 090 35642 ......... ............ A Artery bypass graft ........................................ 18.79 NA NA 7.91 8.51 2.27 NA NA 28.97 29.57 090 35645 ......... ............ A Artery bypass graft ........................................ 18.28 NA NA 7.66 8.13 2.49 NA NA 28.43 28.90 090 35646 ......... ............ A Artery bypass graft ........................................ 32.78 NA NA 11.10 12.63 4.43 NA NA 48.31 49.84 090 35647 ......... ............ A Artery bypass graft ........................................ 29.56 NA NA 10.01 11.35 3.98 NA NA 43.55 44.89 090 35650 ......... ............ A Artery bypass graft ........................................ 20.04 NA NA 7.05 8.05 2.71 NA NA 29.80 30.80 090 35651 ......... ............ A Artery bypass graft ........................................ 25.90 NA NA 8.90 10.29 3.35 NA NA 38.15 39.54 090 35654 ......... ............ A Artery bypass graft ........................................ 26.11 NA NA 8.83 10.22 3.52 NA NA 38.46 39.85 090 35656 ......... ............ A Artery bypass graft ........................................ 20.35 NA NA 7.28 8.29 2.79 NA NA 30.42 31.43 090 35661 ......... ............ A Artery bypass graft ........................................ 20.16 NA NA 7.56 8.60 2.71 NA NA 30.43 31.47 090 35663 ......... ............ A Artery bypass graft ........................................ 23.74 NA NA 8.36 9.59 3.10 NA NA 35.20 36.43 090 35665 ......... ............ A Artery bypass graft ........................................ 22.16 NA NA 7.87 9.07 3.00 NA NA 33.03 34.23 090 35666 ......... ............ A Artery bypass graft ........................................ 23.47 NA NA 8.92 10.23 3.15 NA NA 35.54 36.85 090 35671 ......... ............ A Artery bypass graft ........................................ 20.58 NA NA 8.05 9.06 2.77 NA NA 31.40 32.41 090 35681 ......... ............ A Composite bypass graft ................................ 1.60 NA NA 0.43 0.51 0.23 NA NA 2.26 2.34 ZZZ35682 ......... ............ A Composite bypass graft ................................ 7.19 NA NA 1.86 2.26 1.03 NA NA 10.08 10.48 ZZZ 35683 ......... ............ A Composite bypass graft ................................ 8.49 NA NA 2.21 2.68 1.20 NA NA 11.90 12.37 ZZZ 35685 ......... ............ A Bypass graft patency/patch ........................... 4.04 NA NA 1.05 1.28 0.58 NA NA 5.67 5.90 ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37308 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

35686 ......... ............ A Bypass graft/av fist patency .......................... 3.34 NA NA 0.87 1.07 0.47 NA NA 4.68 4.88 ZZZ35691 ......... ............ A Arterial transposition ...................................... 18.26 NA NA 6.61 7.97 2.58 NA NA 27.45 28.81 090 35693 ......... ............ A Arterial transposition ...................................... 15.58 NA NA 6.45 7.42 2.21 NA NA 24.24 25.21 090 35694 ......... ............ A Arterial transposition ...................................... 19.13 NA NA 6.86 8.18 2.69 NA NA 28.68 30.00 090 35695 ......... ............ A Arterial transposition ...................................... 19.91 NA NA 6.96 8.17 2.73 NA NA 29.60 30.81 090 35697 ......... ............ A Reimplant artery each ................................... 3.00 NA NA 0.80 0.97 0.41 NA NA 4.21 4.38 ZZZ 35700 ......... ............ A Reoperation, bypass graft ............................. 3.08 NA NA 0.82 0.97 0.44 NA NA 4.34 4.49 ZZZ35701 ......... ............ A Exploration, carotid artery ............................. 9.07 NA NA 4.35 4.96 1.12 NA NA 14.54 15.15 090 35721 ......... ............ A Exploration, femoral artery ............................ 7.62 NA NA 3.84 4.29 1.03 NA NA 12.49 12.94 090 35741 ......... ............ A Exploration popliteal artery ............................ 8.57 NA NA 4.09 4.53 1.12 NA NA 13.78 14.22 090 35761 ......... ............ A Exploration of artery/vein .............................. 5.78 NA NA 3.57 3.91 0.75 NA NA 10.10 10.44 090 35800 ......... ............ A Explore neck vessels .................................... 7.94 NA NA 4.06 4.51 0.95 NA NA 12.95 13.40 090 35820 ......... ............ A Explore chest vessels ................................... 30.08 NA NA 11.49 8.29 1.94 NA NA 43.51 40.31 090 35840 ......... ............ A Explore abdominal vessels ........................... 10.81 NA NA 4.91 5.20 1.34 NA NA 17.06 17.35 090 35860 ......... ............ A Explore limb vessels ..................................... 6.66 NA NA 3.66 3.95 0.78 NA NA 11.10 11.39 090 35870 ......... ............ A Repair vessel graft defect ............................. 24.31 NA NA 8.48 9.46 3.00 NA NA 35.79 36.77 090 35875 ......... ............ A Removal of clot in graft ................................. 10.60 NA NA 4.55 5.04 1.41 NA NA 16.56 17.05 090 35876 ......... ............ A Removal of clot in graft ................................. 17.70 NA NA 6.37 7.24 2.39 NA NA 26.46 27.33 090 35879 ......... ............ A Revise graft w/vein ........................................ 17.24 NA NA 6.34 7.37 2.27 NA NA 25.85 26.88 090 35881 ......... ............ A Revise graft w/vein ........................................ 19.16 NA NA 7.00 8.27 2.55 NA NA 28.71 29.98 090 35901 ......... ............ A Excision, graft, neck ...................................... 8.18 NA NA 4.41 5.09 1.15 NA NA 13.74 14.42 090 35903 ......... ............ A Excision, graft, extremity ............................... 9.38 NA NA 5.27 5.95 1.30 NA NA 15.95 16.63 090 35905 ......... ............ A Excision, graft, thorax .................................... 33.33 NA NA 11.04 12.68 4.43 NA NA 48.80 50.44 090 35907 ......... ............ A Excision, graft, abdomen ............................... 37.08 NA NA 11.75 13.59 4.91 NA NA 53.74 55.58 090 36000 ......... ............ A Place needle in vein ...................................... 0.18 0.47 0.55 0.06 0.05 0.01 0.66 0.74 0.25 0.24 XXX 36002 ......... ............ A Pseudoaneurysm injection trt ........................ 1.96 2.33 2.74 0.88 0.95 0.17 4.46 4.87 3.01 3.08 000 36005 ......... ............ A Injection ext venography ............................... 0.95 8.80 7.95 0.39 0.33 0.05 9.80 8.95 1.39 1.33 000 36010 ......... ............ A Place catheter in vein .................................... 2.43 11.57 17.41 0.79 0.79 0.20 14.20 20.04 3.42 3.42 XXX 36011 ......... ............ A Place catheter in vein .................................... 3.14 20.19 25.97 1.01 1.05 0.27 23.60 29.38 4.42 4.46 XXX 36012 ......... ............ A Place catheter in vein .................................... 3.51 21.19 19.55 1.29 1.22 0.23 24.93 23.29 5.03 4.96 XXX 36013 ......... ............ A Place catheter in artery ................................. 2.52 19.63 20.97 0.98 0.76 0.25 22.40 23.74 3.75 3.53 XXX 36014 ......... ............ A Place catheter in artery ................................. 3.02 19.93 20.12 1.12 1.05 0.19 23.14 23.33 4.33 4.26 XXX 36015 ......... ............ A Place catheter in artery ................................. 3.51 18.70 22.47 1.00 1.14 0.21 22.42 26.19 4.72 4.86 XXX 36100 ......... ............ A Establish access to artery ............................. 3.02 11.49 11.96 1.24 1.14 0.26 14.77 15.24 4.52 4.42 XXX 36120 ......... ............ A Establish access to artery ............................. 2.01 9.57 10.44 0.61 0.64 0.14 11.72 12.59 2.76 2.79 XXX 36140 ......... ............ A Establish access to artery ............................. 2.01 10.78 12.30 0.73 0.66 0.16 12.95 14.47 2.90 2.83 XXX 36145 ......... ............ A Artery to vein shunt ....................................... 2.01 10.73 12.13 0.67 0.66 0.11 12.85 14.25 2.79 2.78 XXX 36160 ......... ............ A Establish access to aorta .............................. 2.52 12.09 13.16 0.78 0.83 0.26 14.87 15.94 3.56 3.61 XXX 36200 ......... ............ A Place catheter in aorta .................................. 3.02 14.20 15.97 1.06 1.02 0.24 17.46 19.23 4.32 4.28 XXX 36215 ......... ............ A Place catheter in artery ................................. 4.67 26.82 27.04 1.93 1.69 0.27 31.76 31.98 6.87 6.63 XXX 36216 ......... ............ A Place catheter in artery ................................. 5.27 29.00 29.12 2.12 1.88 0.31 34.58 34.70 7.70 7.46 XXX 36217 ......... ............ A Place catheter in artery ................................. 6.29 47.85 53.66 2.46 2.25 0.44 54.58 60.39 9.19 8.98 XXX 36218 ......... ............ A Place catheter in artery ................................. 1.01 3.91 4.80 0.39 0.35 0.07 4.99 5.88 1.47 1.43 ZZZ 36245 ......... ............ A Place catheter in artery ................................. 4.67 29.77 31.58 2.18 1.81 0.31 34.75 36.56 7.16 6.79 XXX 36246 ......... ............ A Place catheter in artery ................................. 5.27 28.57 29.68 2.07 1.89 0.38 34.22 35.33 7.72 7.54 XXX 36247 ......... ............ A Place catheter in artery ................................. 6.29 47.04 49.00 2.47 2.23 0.47 53.80 55.76 9.23 8.99 XXX 36248 ......... ............ A Place catheter in artery ................................. 1.01 3.31 3.87 0.39 0.35 0.07 4.39 4.95 1.47 1.43 ZZZ 36260 ......... ............ A Insertion of infusion pump ............................. 9.76 NA NA 4.92 4.90 1.29 NA NA 15.97 15.95 090 36261 ......... ............ A Revision of infusion pump ............................. 5.50 NA NA 3.36 3.59 0.70 NA NA 9.56 9.79 09036262 ......... ............ A Removal of infusion pump ............................ 4.01 NA NA 2.74 2.76 0.54 NA NA 7.29 7.31 090 36400 ......... ............ A Bl draw < 3 yrs fem/jugular ........................... 0.38 0.34 0.30 0.11 0.10 0.03 0.75 0.71 0.52 0.51 XXX 36405 ......... ............ A Bl draw < 3 yrs scalp vein ............................ 0.31 0.28 0.27 0.08 0.08 0.03 0.62 0.61 0.42 0.42 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37309 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

36406 ......... ............ A Bl draw < 3 yrs other vein ............................. 0.18 0.30 0.29 0.08 0.06 0.01 0.49 0.48 0.27 0.25 XXX 36410 ......... ............ A Non-routine bl draw > 3 yrs .......................... 0.18 0.32 0.30 0.05 0.05 0.01 0.51 0.49 0.24 0.24 XXX 36420 ......... ............ A Vein access cutdown < 1 yr .......................... 1.01 0.20 0.31 0.20 0.25 0.07 1.28 1.39 1.28 1.33 XXX 36425 ......... ............ A Vein access cutdown > 1 yr .......................... 0.76 NA NA 0.22 0.22 0.06 NA NA 1.04 1.04 XXX 36430 ......... ............ A Blood transfusion service .............................. 0.00 0.94 0.99 NA NA 0.06 1.00 1.05 NA NA XXX 36440 ......... ............ A Bl push transfuse, 2 yr or < .......................... 1.03 NA NA 0.44 0.33 0.10 NA NA 1.57 1.46 XXX36450 ......... ............ A Bl exchange/transfuse, nb ............................. 2.23 NA NA 0.79 0.73 0.21 NA NA 3.23 3.17 XXX36455 ......... ............ A Bl exchange/transfuse non-nb ...................... 2.43 NA NA 0.74 0.94 0.15 NA NA 3.32 3.52 XXX 36460 ......... ............ A Transfusion service, fetal .............................. 6.58 NA NA 1.64 2.10 0.79 NA NA 9.01 9.47 XXX 36470 ......... ............ A Injection therapy of vein ................................ 1.09 2.48 2.64 0.66 0.71 0.12 3.69 3.85 1.87 1.92 010 36471 ......... ............ A Injection therapy of veins .............................. 1.57 2.62 2.97 0.81 0.92 0.19 4.38 4.73 2.57 2.68 010 36475 ......... ............ A Endovenous rf, 1st vein ................................ 6.72 37.50 48.03 2.03 2.41 0.37 44.59 55.12 9.12 9.50 000 36476 ......... ............ A Endovenous rf, vein add-on .......................... 3.38 6.18 7.47 0.92 1.09 0.18 9.74 11.03 4.48 4.65 ZZZ 36478 ......... ............ A Endovenous laser, 1st vein ........................... 6.72 34.37 43.78 2.14 2.44 0.37 41.46 50.87 9.23 9.53 000 36479 ......... ............ A Endovenous laser vein addon ....................... 3.38 6.67 7.68 1.04 1.12 0.18 10.23 11.24 4.60 4.68 ZZZ 36481 ......... ............ A Insertion of catheter, vein .............................. 6.98 3.02 5.07 2.18 2.50 0.55 10.55 12.60 9.71 10.03 000 36500 ......... ............ A Insertion of catheter, vein .............................. 3.51 NA NA 1.33 1.36 0.20 NA NA 5.04 5.07 000 36510 ......... ............ A Insertion of catheter, vein .............................. 1.09 1.08 3.20 0.30 0.53 0.10 2.27 4.39 1.49 1.72 000 36511 ......... ............ A Apheresis wbc ............................................... 1.74 NA NA 0.57 0.69 0.08 NA NA 2.39 2.51 000 36512 ......... ............ A Apheresis rbc ................................................ 1.74 NA NA 0.60 0.71 0.08 NA NA 2.42 2.53 000 36513 ......... ............ A Apheresis platelets ........................................ 1.74 NA NA 0.50 0.67 0.17 NA NA 2.41 2.58 000 36514 ......... ............ A Apheresis plasma .......................................... 1.74 10.47 15.38 0.52 0.66 0.08 12.29 17.20 2.34 2.48 000 36515 ......... ............ A Apheresis, adsorp/reinfuse ............................ 1.74 45.04 61.13 0.50 0.62 0.08 46.86 62.95 2.32 2.44 000 36516 ......... ............ A Apheresis, selective ...................................... 1.22 49.76 75.66 0.37 0.45 0.08 51.06 76.96 1.67 1.75 000 36522 ......... ............ A Photopheresis ............................................... 1.67 35.01 33.10 0.85 0.93 0.13 36.81 34.90 2.65 2.73 000 36550 ......... ............ A Office/outpatient visit, est .............................. 0.17 0.33 0.38 0.06 0.31 0.01 0.51 0.56 0.24 0.49 XXX 36555 ......... ............ A Insert non-tunnel cv cath ............................... 2.68 4.17 5.37 0.61 0.75 0.11 6.96 8.16 3.40 3.54 000 36556 ......... ............ A Insert non-tunnel cv cath ............................... 2.50 2.92 4.96 0.57 0.70 0.19 5.61 7.65 3.26 3.39 000 36557 ......... ............ A Insert tunneled cv cath .................................. 5.09 15.41 19.75 2.48 2.62 0.57 21.07 25.41 8.14 8.28 010 36558 ......... ............ A Insert tunneled cv cath .................................. 4.79 15.45 19.69 2.40 2.52 0.57 20.81 25.05 7.76 7.88 010 36560 ......... ............ A Insert tunneled cv cath .................................. 6.24 21.33 27.65 2.55 2.92 0.57 28.14 34.46 9.36 9.73 010 36561 ......... ............ A Insert tunneled cv cath .................................. 5.99 22.76 27.94 2.65 2.88 0.57 29.32 34.50 9.21 9.44 010 36563 ......... ............ A Insert tunneled cv cath .................................. 6.19 23.31 25.94 2.61 2.90 0.84 30.34 32.97 9.64 9.93 010 36565 ......... ............ A Insert tunneled cv cath .................................. 5.99 18.05 23.09 2.55 2.86 0.57 24.61 29.65 9.11 9.42 010 36566 ......... ............ A Insert tunneled cv cath .................................. 6.49 115.6 48.08 2.69 3.01 0.57 122.7 55.14 9.75 10.07 010 36568 ......... ............ A Insert picc cath .............................................. 1.92 5.86 7.13 0.58 0.58 0.11 7.89 9.16 2.61 2.61 000 36569 ......... ............ A Insert picc cath .............................................. 1.82 4.68 6.69 0.67 0.60 0.19 6.69 8.70 2.68 2.61 000 36570 ......... ............ A Insert picvad cath .......................................... 5.31 23.71 30.88 2.42 2.65 0.57 29.59 36.76 8.30 8.53 010 36571 ......... ............ A Insert picvad cath .......................................... 5.29 25.38 31.35 2.46 2.66 0.57 31.24 37.21 8.32 8.52 010 36575 ......... ............ A Repair tunneled cv cath ................................ 0.67 3.41 3.90 0.24 0.26 0.20 4.28 4.77 1.11 1.13 000 36576 ......... ............ A Repair tunneled cv cath ................................ 3.19 5.98 6.72 1.57 1.78 0.19 9.36 10.10 4.95 5.16 010 36578 ......... ............ A Replace tunneled cv cath .............................. 3.49 9.39 10.72 2.00 2.23 0.19 13.07 14.40 5.68 5.91 010 36580 ......... ............ A Replace cvad cath ......................................... 1.31 4.11 6.25 0.43 0.42 0.19 5.61 7.75 1.93 1.92 000 36581 ......... ............ A Replace tunneled cv cath .............................. 3.43 16.22 18.72 1.77 1.89 0.19 19.84 22.34 5.39 5.51 010 36582 ......... ............ A Replace tunneled cv cath .............................. 5.19 21.14 24.85 2.36 2.74 0.19 26.52 30.23 7.74 8.12 010 36583 ......... ............ A Replace tunneled cv cath .............................. 5.24 21.73 25.02 2.55 2.81 0.19 27.16 30.45 7.98 8.24 010 36584 ......... ............ A Replace picc cath .......................................... 1.20 4.16 6.28 0.62 0.57 0.19 5.55 7.67 2.01 1.96 000 36585 ......... ............ A Replace picvad cath ...................................... 4.79 23.48 26.80 2.42 2.66 0.19 28.46 31.78 7.40 7.64 010 36589 ......... ............ A Removal tunneled cv cath ............................. 2.27 1.92 2.17 1.26 1.36 0.24 4.43 4.68 3.77 3.87 010 36590 ......... ............ A Removal tunneled cv cath ............................. 3.30 3.68 3.46 1.60 1.69 0.44 7.42 7.20 5.34 5.43 010 36595 ......... ............ A Mech remov tunneled cv cath ....................... 3.59 11.33 15.81 1.43 1.45 0.21 15.13 19.61 5.23 5.25 000 36596 ......... ............ A Mech remov tunneled cv cath ....................... 0.75 2.70 3.45 0.45 0.49 0.05 3.50 4.25 1.25 1.29 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37310 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

36597 ......... ............ A Reposition venous catheter ........................... 1.21 2.12 2.34 0.45 0.44 0.07 3.40 3.62 1.73 1.72 000 36598 ......... ............ T Inj w/fluor, eval cv device .............................. 0.74 2.33 2.57 0.28 2.06 0.05 3.12 3.36 1.07 2.85 000 36600 ......... ............ A Withdrawal of arterial blood .......................... 0.32 0.49 0.49 0.07 0.09 0.02 0.83 0.83 0.41 0.43 XXX 36620 ......... ............ A Insertion catheter, artery ............................... 1.15 NA NA 0.17 0.22 0.07 NA NA 1.39 1.44 000 36625 ......... ............ A Insertion catheter, artery ............................... 2.11 NA NA 0.49 0.52 0.26 NA NA 2.86 2.89 000 36640 ......... ............ A Insertion catheter, artery ............................... 2.10 NA NA 0.90 1.01 0.21 NA NA 3.21 3.32 000 36660 ......... ............ A Insertion catheter, artery ............................... 1.40 NA NA 0.19 0.38 0.14 NA NA 1.73 1.92 000 36680 ......... ............ A Insert needle, bone cavity ............................. 1.20 NA NA 0.32 0.45 0.11 NA NA 1.63 1.76 000 36800 ......... ............ A Insertion of cannula ....................................... 2.43 NA NA 1.55 1.75 0.25 NA NA 4.23 4.43 000 36810 ......... ............ A Insertion of cannula ....................................... 3.96 NA NA 1.37 1.60 0.45 NA NA 5.78 6.01 000 36815 ......... ............ A Insertion of cannula ....................................... 2.62 NA NA 1.03 1.14 0.35 NA NA 4.00 4.11 000 36818 ......... ............ A Av fuse, uppr arm, cephalic .......................... 11.77 NA NA 4.97 5.78 1.89 NA NA 18.63 19.44 090 36819 ......... ............ A Av fuse, uppr arm, basilic ............................. 14.35 NA NA 5.34 6.13 1.95 NA NA 21.64 22.43 090 36820 ......... ............ A Av fusion/forearm vein .................................. 14.35 NA NA 5.40 6.15 1.94 NA NA 21.69 22.44 090 36821 ......... ............ A Av fusion direct any site ................................ 9.10 NA NA 4.09 4.52 1.23 NA NA 14.42 14.85 090 36822 ......... ............ A Insertion of cannula(s) ................................... 5.47 NA NA 3.85 4.26 0.79 NA NA 10.11 10.52 090 36823 ......... ............ A Insertion of cannula(s) ................................... 22.74 NA NA 8.87 9.27 2.88 NA NA 34.49 34.89 090 36825 ......... ............ A Artery-vein autograft ...................................... 9.95 NA NA 4.37 4.89 1.35 NA NA 15.67 16.19 090 36830 ......... ............ A Artery-vein nonautograft ................................ 11.98 NA NA 4.31 5.02 1.66 NA NA 17.95 18.66 090 36831 ......... ............ A Open thrombect av fistula ............................. 7.99 NA NA 3.38 3.81 1.09 NA NA 12.46 12.89 090 36832 ......... ............ A Av fistula revision, open ................................ 10.48 NA NA 3.91 4.53 1.44 NA NA 15.83 16.45 090 36833 ......... ............ A Av fistula revision .......................................... 11.93 NA NA 4.31 4.99 1.65 NA NA 17.89 18.57 090 36834 ......... ............ A Repair A-V aneurysm .................................... 11.07 NA NA 4.40 4.70 1.37 NA NA 16.84 17.14 090 36835 ......... ............ A Artery to vein shunt ....................................... 7.38 NA NA 3.93 4.23 0.98 NA NA 12.29 12.59 090 36838 ......... ............ A Dist revas ligation, hemo ............................... 21.55 NA NA 7.32 8.89 3.01 NA NA 31.88 33.45 090 36860 ......... ............ A External cannula declotting ........................... 2.01 3.36 2.18 0.61 0.66 0.11 5.48 4.30 2.73 2.78 000 36861 ......... ............ A Cannula declotting ......................................... 2.52 NA NA 1.27 1.44 0.27 NA NA 4.06 4.23 000 36870 ......... ............ A Percut thrombect av fistula ........................... 5.15 42.53 50.52 2.83 3.08 0.29 47.97 55.96 8.27 8.52 090 37140 ......... ............ A Revision of circulation ................................... 25.04 NA NA 9.21 10.19 2.01 NA NA 36.26 37.24 090 37145 ......... ............ A Revision of circulation ................................... 26.05 NA NA 8.94 10.40 3.25 NA NA 38.24 39.70 090 37160 ......... ............ A Revision of circulation ................................... 23.05 NA NA 8.28 9.03 2.81 NA NA 34.14 34.89 090 37180 ......... ............ A Revision of circulation ................................... 26.05 NA NA 8.97 9.98 3.34 NA NA 38.36 39.37 090 37181 ......... ............ A Splice spleen/kidney veins ............................ 28.18 NA NA 9.33 10.61 3.40 NA NA 40.91 42.19 090 37182 ......... ............ A Insert hepatic shunt (tips) .............................. 16.97 NA NA 6.32 6.14 1.00 NA NA 24.29 24.11 000 37183 ......... ............ A Remove hepatic shunt (tips) ......................... 7.99 NA NA 3.09 3.04 0.47 NA NA 11.55 11.50 00037184 ......... ............ A Prim art mech thrombectomy ........................ 8.66 51.62 66.83 3.22 3.33 0.55 60.83 76.04 12.43 12.54 000 37185 ......... ............ A Prim art m-thrombect add-on ........................ 3.28 16.78 21.41 1.10 1.11 0.21 20.27 24.90 4.59 4.60 ZZZ 37186 ......... ............ A Sec art m-thrombect add-on ......................... 4.92 35.40 46.00 1.64 1.66 0.32 40.64 51.24 6.88 6.90 ZZZ 37187 ......... ............ A Venous mech thrombectomy ........................ 8.03 50.43 65.39 3.01 3.12 0.51 58.97 73.93 11.55 11.66 000 37188 ......... ............ A Venous m-thrombectomy add-on .................. 5.71 43.99 57.61 2.23 2.34 0.37 50.07 63.69 8.31 8.42 000 37200 ......... ............ A Transcatheter biopsy ..................................... 4.55 NA NA 1.65 1.54 0.27 NA NA 6.47 6.36 000 37201 ......... ............ A Transcatheter therapy infuse ........................ 4.99 NA NA 2.40 2.51 0.33 NA NA 7.72 7.83 000 37202 ......... ............ A Transcatheter therapy infuse ........................ 5.67 NA NA 3.47 3.15 0.43 NA NA 9.57 9.25 000 37203 ......... ............ A Transcatheter retrieval .................................. 5.02 31.47 32.60 2.10 2.06 0.29 36.78 37.91 7.41 7.37 000 37204 ......... ............ A Transcatheter occlusion ................................ 18.11 NA NA 6.29 6.01 1.48 NA NA 25.88 25.60 000 37205 ......... ............ A Transcath iv stent, percut .............................. 8.27 NA NA 4.08 3.84 0.60 NA NA 12.95 12.71 000 37206 ......... ............ A Transcath iv stent/perc addl .......................... 4.12 NA NA 1.67 1.49 0.31 NA NA 6.10 5.92 ZZZ37207 ......... ............ A Transcath iv stent, open ................................ 8.27 NA NA 2.52 3.01 1.17 NA NA 11.96 12.45 000 37208 ......... ............ A Transcath iv stent/open addl ......................... 4.12 NA NA 1.10 1.31 0.59 NA NA 5.81 6.02 ZZZ 37209 ......... ............ A Change iv cath at thromb tx .......................... 2.27 NA NA 0.80 0.76 0.15 NA NA 3.22 3.18 000 37215 ......... ............ R Transcath stent, cca w/eps ........................... 19.54 NA NA 10.47 9.46 1.09 NA NA 31.10 30.09 090 37216 ......... ............ N Transcath stent, cca w/o eps ........................ 18.81 NA NA 9.14 8.92 1.04 NA NA 28.99 28.77 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37311 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

37250 ......... ............ A Iv us first vessel add-on ................................ 2.10 NA NA 0.83 0.77 0.21 NA NA 3.14 3.08 ZZZ 37251 ......... ............ A Iv us each add vessel add-on ....................... 1.60 NA NA 0.54 0.55 0.19 NA NA 2.33 2.34 ZZZ 37500 ......... ............ A Endoscopy ligate perf veins .......................... 11.48 NA NA 5.54 6.54 1.54 NA NA 18.56 19.56 090 37565 ......... ............ A Ligation of neck vein ..................................... 11.93 NA NA 5.11 5.51 1.33 NA NA 18.37 18.77 090 37600 ......... ............ A Ligation of neck artery ................................... 12.30 NA NA 4.94 6.22 1.41 NA NA 18.65 19.93 090 37605 ......... ............ A Ligation of neck artery ................................... 14.16 NA NA 5.69 6.61 1.98 NA NA 21.83 22.75 090 37606 ......... ............ A Ligation of neck artery ................................... 8.65 NA NA 5.03 4.69 1.23 NA NA 14.91 14.57 090 37607 ......... ............ A Ligation of a-v fistula ..................................... 6.15 NA NA 3.14 3.46 0.85 NA NA 10.14 10.46 090 37609 ......... ............ A Temporal artery procedure ............................ 3.00 4.22 4.44 1.82 1.93 0.36 7.58 7.80 5.18 5.29 010 37615 ......... ............ A Ligation of neck artery ................................... 7.67 NA NA 3.97 4.08 0.68 NA NA 12.32 12.43 090 37616 ......... ............ A Ligation of chest artery .................................. 18.84 NA NA 8.00 8.08 2.32 NA NA 29.16 29.24 090 37617 ......... ............ A Ligation of abdomen artery ........................... 23.67 NA NA 7.93 8.88 2.97 NA NA 34.57 35.52 090 37618 ......... ............ A Ligation of extremity artery ............................ 5.89 NA NA 3.43 3.57 0.67 NA NA 9.99 10.13 090 37620 ......... ............ A Revision of major vein ................................... 11.44 NA NA 5.57 5.69 0.91 NA NA 17.92 18.04 090 37650 ......... ............ A Revision of major vein ................................... 8.37 NA NA 4.29 4.59 1.01 NA NA 13.67 13.97 090 37660 ......... ............ A Revision of major vein ................................... 22.16 NA NA 8.33 8.89 2.48 NA NA 32.97 33.53 090 37700 ......... ............ A Revise leg vein .............................................. 3.72 NA NA 2.48 2.72 0.53 NA NA 6.73 6.97 090 37718 ......... ............ A Ligate/strip short leg vein .............................. 7.01 NA NA 3.56 3.94 0.14 NA NA 10.71 11.09 090 37722 ......... ............ A Ligate/strip long leg vein ............................... 8.04 NA NA 3.83 4.27 0.86 NA NA 12.73 13.17 090 37735 ......... ............ A Removal of leg veins/lesion .......................... 10.75 NA NA 4.73 5.32 1.48 NA NA 16.96 17.55 090 37760 ......... ............ A Ligation, leg veins, open ............................... 10.63 NA NA 4.60 5.17 1.44 NA NA 16.67 17.24 090 37765 ......... ............ A Phleb veins - extrem - to 20 ......................... 7.59 NA NA 3.66 4.39 0.48 NA NA 11.73 12.46 090 37766 ......... ............ A Phleb veins - extrem 20+ .............................. 9.54 NA NA 4.21 5.06 0.48 NA NA 14.23 15.08 090 37780 ......... ............ A Revision of leg vein ....................................... 3.83 NA NA 2.53 2.78 0.53 NA NA 6.89 7.14 090 37785 ......... ............ A Ligate/divide/excise vein ............................... 3.83 5.00 5.16 2.62 2.70 0.54 9.37 9.53 6.99 7.07 090 37788 ......... ............ A Revascularization, penis ............................... 23.13 NA NA 12.17 9.88 2.25 NA NA 37.55 35.26 090 37790 ......... ............ A Penile venous occlusion ................................ 8.33 NA NA 5.20 4.59 0.59 NA NA 14.12 13.51 090 38100 ......... ............ A Removal of spleen, total ............................... 19.43 NA NA 6.85 6.36 1.91 NA NA 28.19 27.70 090 38101 ......... ............ A Removal of spleen, partial ............................ 19.43 NA NA 7.33 6.74 2.04 NA NA 28.80 28.21 090 38102 ......... ............ A Removal of spleen, total ............................... 4.79 NA NA 1.25 1.54 0.63 NA NA 6.67 6.96 ZZZ 38115 ......... ............ A Repair of ruptured spleen ............................. 21.76 NA NA 7.50 6.87 2.08 NA NA 31.34 30.71 090 38120 ......... ............ A Laparoscopy, splenectomy ............................ 16.97 NA NA 6.90 7.28 2.24 NA NA 26.11 26.49 090 38200 ......... ............ A Injection for spleen x-ray ............................... 2.64 NA NA 1.03 0.93 0.14 NA NA 3.81 3.71 000 38205 ......... ............ R Harvest allogenic stem cells ......................... 1.50 NA NA 0.54 0.64 0.07 NA NA 2.11 2.21 000 38206 ......... ............ R Harvest auto stem cells ................................. 1.50 NA NA 0.53 0.64 0.07 NA NA 2.10 2.21 000 38220 ......... ............ A Bone marrow aspiration ................................ 1.08 2.69 3.47 0.44 0.50 0.05 3.82 4.60 1.57 1.63 XXX 38221 ......... ............ A Bone marrow biopsy ..................................... 1.37 2.81 3.66 0.57 0.63 0.07 4.25 5.10 2.01 2.07 XXX 38230 ......... ............ R Bone marrow collection ................................. 4.78 NA NA 2.73 3.11 0.48 NA NA 7.99 8.37 010 38240 ......... ............ R Bone marrow/stem transplant ....................... 2.24 NA NA 0.94 1.01 0.11 NA NA 3.29 3.36 XXX 38241 ......... ............ R Bone marrow/stem transplant ....................... 2.24 NA NA 0.93 1.01 0.11 NA NA 3.28 3.36 XXX 38242 ......... ............ A Lymphocyte infuse transplant ....................... 1.71 NA NA 0.70 0.76 0.08 NA NA 2.49 2.55 000 38300 ......... ............ A Drainage, lymph node lesion ........................ 2.24 3.74 4.17 1.81 2.00 0.25 6.23 6.66 4.30 4.49 010 38305 ......... ............ A Drainage, lymph node lesion ........................ 6.49 NA NA 3.58 4.23 0.88 NA NA 10.95 11.60 090 38308 ......... ............ A Incision of lymph channels ............................ 6.69 NA NA 3.56 3.70 0.85 NA NA 11.10 11.24 090 38380 ......... ............ A Thoracic duct procedure ............................... 8.26 NA NA 4.63 5.43 0.74 NA NA 13.63 14.43 090 38381 ......... ............ A Thoracic duct procedure ............................... 13.28 NA NA 6.16 6.72 1.84 NA NA 21.28 21.84 090 38382 ......... ............ A Thoracic duct procedure ............................... 10.42 NA NA 5.50 5.70 1.37 NA NA 17.29 17.49 090 38500 ......... ............ A Biopsy/removal, lymph nodes ....................... 3.74 3.75 3.71 2.02 2.07 0.49 7.98 7.94 6.25 6.30 010 38505 ......... ............ A Needle biopsy, lymph nodes ......................... 1.14 2.14 2.08 0.72 0.77 0.09 3.37 3.31 1.95 2.00 000 38510 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.67 5.16 5.46 2.92 3.35 0.72 12.55 12.85 10.31 10.74 010 38520 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.91 NA NA 3.68 3.97 0.84 NA NA 11.43 11.72 090 38525 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.31 NA NA 3.46 3.34 0.80 NA NA 10.57 10.45 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37312 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

38530 ......... ............ A Biopsy/removal, lymph nodes ....................... 8.22 NA NA 4.10 4.33 1.12 NA NA 13.44 13.67 090 38542 ......... ............ A Explore deep node(s), neck .......................... 6.02 NA NA 3.69 4.29 0.60 NA NA 10.31 10.91 09038550 ......... ............ A Removal, neck/armpit lesion ......................... 6.91 NA NA 4.21 3.99 0.88 NA NA 12.00 11.78 09038555 ......... ............ A Removal, neck/armpit lesion ......................... 15.30 NA NA 7.18 8.21 1.75 NA NA 24.23 25.26 090 38562 ......... ............ A Removal, pelvic lymph nodes ....................... 10.83 NA NA 5.74 5.78 1.20 NA NA 17.77 17.81 090 38564 ......... ............ A Removal, abdomen lymph nodes ................. 11.23 NA NA 5.21 5.25 1.32 NA NA 17.76 17.80 090 38570 ......... ............ A Laparoscopy, lymph node biop ..................... 9.24 NA NA 3.99 3.98 1.13 NA NA 14.36 14.35 010 38571 ......... ............ A Laparoscopy, lymphadenectomy ................... 14.66 NA NA 7.03 6.00 1.15 NA NA 22.84 21.81 010 38572 ......... ............ A Laparoscopy, lymphadenectomy ................... 16.82 NA NA 6.08 6.84 1.90 NA NA 24.80 25.56 010 38700 ......... ............ A Removal of lymph nodes, neck ..................... 12.62 NA NA 5.93 6.17 0.72 NA NA 19.27 19.51 090 38720 ......... ............ A Removal of lymph nodes, neck ..................... 21.64 NA NA 8.82 9.24 1.20 NA NA 31.66 32.08 090 38724 ......... ............ A Removal of lymph nodes, neck ..................... 23.64 NA NA 9.38 9.74 1.28 NA NA 34.30 34.66 090 38740 ......... ............ A Remove armpit lymph nodes ........................ 10.51 NA NA 4.96 4.95 1.32 NA NA 16.79 16.78 090 38745 ......... ............ A Remove armpit lymph nodes ........................ 13.65 NA NA 5.99 6.07 1.73 NA NA 21.37 21.45 090 38746 ......... ............ A Remove thoracic lymph nodes ...................... 4.88 NA NA 1.46 1.57 0.72 NA NA 7.06 7.17 ZZZ 38747 ......... ............ A Remove abdominal lymph nodes .................. 4.88 NA NA 1.26 1.57 0.64 NA NA 6.78 7.09 ZZZ 38760 ......... ............ A Remove groin lymph nodes .......................... 13.43 NA NA 5.89 6.08 1.71 NA NA 21.03 21.22 090 38765 ......... ............ A Remove groin lymph nodes .......................... 21.72 NA NA 8.71 8.80 2.47 NA NA 32.90 32.99 090 38770 ......... ............ A Remove pelvis lymph nodes ......................... 13.93 NA NA 6.96 6.06 1.40 NA NA 22.29 21.39 090 38780 ......... ............ A Remove abdomen lymph nodes ................... 17.47 NA NA 7.92 8.15 1.88 NA NA 27.27 27.50 090 38790 ......... ............ A Inject for lymphatic x-ray ............................... 1.29 5.25 6.84 0.75 0.76 0.13 6.67 8.26 2.17 2.18 000 38792 ......... ............ A Identify sentinel node .................................... 0.52 NA NA 0.49 0.45 0.06 NA NA 1.07 1.03 000 38794 ......... ............ A Access thoracic lymph duct .......................... 4.44 NA NA 3.24 3.41 0.32 NA NA 8.00 8.17 090 39000 ......... ............ A Exploration of chest ....................................... 7.45 NA NA 4.40 4.60 0.89 NA NA 12.74 12.94 090 39010 ......... ............ A Exploration of chest ....................................... 13.07 NA NA 6.23 7.23 1.75 NA NA 21.05 22.05 090 39200 ......... ............ A Removal chest lesion .................................... 15.02 NA NA 6.30 7.24 2.02 NA NA 23.34 24.28 090 39220 ......... ............ A Removal chest lesion .................................... 18.42 NA NA 7.69 8.97 2.45 NA NA 28.56 29.84 090 39400 ......... ............ A Visualization of chest .................................... 5.97 NA NA 3.65 4.56 0.82 NA NA 10.44 11.35 010 39501 ......... ............ A Repair diaphragm laceration ......................... 13.83 NA 5.87 6.32 1.77 NA NA 21.47 21.92 090 39502 ......... ............ A Repair paraesophageal hernia ...................... 17.03 NA NA 6.55 7.01 2.16 NA NA 25.74 26.20 090 39503 ......... ............ A Repair of diaphragm hernia .......................... 108.57 NA NA 31.89 33.08 10.95 NA NA 151.4 152.6 090 39520 ......... ............ A Repair of diaphragm hernia .......................... 16.56 NA NA 6.87 7.76 2.23 NA NA 25.66 26.55 090 39530 ......... ............ A Repair of diaphragm hernia .......................... 16.17 NA NA 6.35 6.95 2.10 NA NA 24.62 25.22 090 39531 ......... ............ A Repair of diaphragm hernia .......................... 17.18 NA NA 6.56 7.19 2.21 NA NA 25.95 26.58 090 39540 ......... ............ A Repair of diaphragm hernia .......................... 14.47 NA NA 5.56 6.07 1.79 NA NA 21.82 22.33 090 39541 ......... ............ A Repair of diaphragm hernia .......................... 15.62 NA NA 6.13 6.48 1.92 NA NA 23.67 24.02 090 39545 ......... ............ A Revision of diaphragm .................................. 14.52 NA NA 7.28 7.49 1.83 NA NA 23.63 23.84 090 39560 ......... ............ A Resect diaphragm, simple ............................. 12.91 NA NA 5.55 6.11 1.59 NA NA 20.05 20.61 090 39561 ......... ............ A Resect diaphragm, complex .......................... 19.69 NA NA 9.43 9.38 2.44 NA NA 31.56 31.51 09040490 ......... ............ A Biopsy of lip ................................................... 1.22 2.04 1.73 0.56 0.60 0.05 3.31 3.00 1.83 1.87 000 40500 ......... ............ A Partial excision of lip ..................................... 4.27 7.63 7.09 4.16 4.30 0.38 12.28 11.74 8.81 8.95 090 40510 ......... ............ A Partial excision of lip ..................................... 4.69 6.48 6.59 3.44 3.88 0.49 11.66 11.77 8.62 9.06 090 40520 ......... ............ A Partial excision of lip ..................................... 4.66 6.74 7.36 3.64 4.00 0.52 11.92 12.54 8.82 9.18 090 40525 ......... ............ A Reconstruct lip with flap ................................ 7.54 NA NA 5.14 6.03 0.85 NA NA 13.53 14.42 090 40527 ......... ............ A Reconstruct lip with flap ................................ 9.12 NA NA 5.75 6.97 0.97 NA NA 15.84 17.06 090 40530 ......... ............ A Partial removal of lip ..................................... 5.39 7.19 7.67 4.01 4.45 0.55 13.13 13.61 9.95 10.39 090 40650 ......... ............ A Repair lip ....................................................... 3.63 5.86 6.57 3.09 3.25 0.38 9.87 10.58 7.10 7.26 090 40652 ......... ............ A Repair lip ....................................................... 4.25 6.94 7.56 3.92 4.18 0.52 11.71 12.33 8.69 8.95 090 40654 ......... ............ A Repair lip ....................................................... 5.30 7.92 8.45 4.55 4.84 0.60 13.82 14.35 10.45 10.74 090 40700 ......... ............ A Repair cleft lip/nasal ...................................... 13.89 NA NA 9.24 9.14 0.95 NA NA 24.08 23.98 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37313 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

40701 ......... ............ A Repair cleft lip/nasal ...................................... 16.95 NA NA 10.87 11.24 1.65 NA NA 29.47 29.84 090 40702 ......... ............ A Repair cleft lip/nasal ...................................... 14.01 NA NA 7.06 7.97 1.23 NA NA 22.30 23.21 090 40720 ......... ............ A Repair cleft lip/nasal ...................................... 14.46 NA NA 8.73 9.62 1.79 NA NA 24.98 25.87 090 40761 ......... ............ A Repair cleft lip/nasal ...................................... 15.63 NA NA 8.62 9.88 1.93 NA NA 26.18 27.44 090 40800 ......... ............ A Drainage of mouth lesion .............................. 1.17 3.84 3.19 1.87 1.80 0.13 5.14 4.49 3.17 3.10 010 40801 ......... ............ A Drainage of mouth lesion .............................. 2.53 4.84 4.23 2.54 2.70 0.31 7.68 7.07 5.38 5.54 010 40804 ......... ............ A Removal, foreign body, mouth ...................... 1.24 3.62 3.46 1.75 1.83 0.11 4.97 4.81 3.10 3.18 010 40805 ......... ............ A Removal, foreign body, mouth ...................... 2.69 5.04 4.63 2.55 2.75 0.32 8.05 7.64 5.56 5.76 010 40806 ......... ............ A Incision of lip fold .......................................... 0.31 2.38 1.98 0.50 0.50 0.04 2.73 2.33 0.85 0.85 000 40808 ......... ............ A Biopsy of mouth lesion .................................. 0.96 3.51 2.87 1.57 1.50 0.10 4.57 3.93 2.63 2.56 010 40810 ......... ............ A Excision of mouth lesion ............................... 1.31 3.55 3.06 1.65 1.66 0.13 4.99 4.50 3.09 3.10 010 40812 ......... ............ A Excise/repair mouth lesion ............................ 2.31 4.50 3.92 2.25 2.37 0.28 7.09 6.51 4.84 4.96 010 40814 ......... ............ A Excise/repair mouth lesion ............................ 3.41 5.61 5.12 3.63 3.83 0.41 9.43 8.94 7.45 7.65 090 40816 ......... ............ A Excision of mouth lesion ............................... 3.66 5.77 5.33 3.67 3.93 0.40 9.83 9.39 7.73 7.99 090 40818 ......... ............ A Excise oral mucosa for graft ......................... 2.66 5.73 5.32 3.67 3.90 0.21 8.60 8.19 6.54 6.77 090 40819 ......... ............ A Excise lip or cheek fold ................................. 2.41 4.87 4.29 3.06 3.09 0.29 7.57 6.99 5.76 5.79 090 40820 ......... ............ A Treatment of mouth lesion ............................ 1.28 5.11 4.23 2.82 2.54 0.11 6.50 5.62 4.21 3.93 010 40830 ......... ............ A Repair mouth laceration ................................ 1.76 4.07 3.82 1.99 2.07 0.19 6.02 5.77 3.94 4.02 010 40831 ......... ............ A Repair mouth laceration ................................ 2.46 5.30 4.83 2.71 2.97 0.30 8.06 7.59 5.47 5.73 010 40840 ......... ............ R Reconstruction of mouth ............................... 8.97 9.90 9.83 5.46 6.61 1.08 19.95 19.88 15.51 16.66 090 40842 ......... ............ R Reconstruction of mouth ............................... 8.97 9.68 9.99 5.29 6.42 1.08 19.73 20.04 15.34 16.47 090 40843 ......... ............ R Reconstruction of mouth ............................... 12.56 11.83 11.94 6.07 7.39 1.39 25.78 25.89 20.02 21.34 090 40844 ......... ............ R Reconstruction of mouth ............................... 16.47 14.78 15.55 8.74 10.88 1.99 33.24 34.01 27.20 29.34 090 40845 ......... ............ R Reconstruction of mouth ............................... 19.03 14.86 16.55 9.31 12.27 2.00 35.89 37.58 30.34 33.30 090 41000 ......... ............ A Drainage of mouth lesion .............................. 1.30 2.48 2.36 1.28 1.38 0.12 3.90 3.78 2.70 2.80 010 41005 ......... ............ A Drainage of mouth lesion .............................. 1.26 4.22 3.56 1.71 1.72 0.12 5.60 4.94 3.09 3.10 010 41006 ......... ............ A Drainage of mouth lesion .............................. 3.24 5.27 4.92 2.71 3.06 0.35 8.86 8.51 6.30 6.65 090 41007 ......... ............ A Drainage of mouth lesion .............................. 3.10 5.31 5.19 2.69 2.95 0.31 8.72 8.60 6.10 6.36 090 41008 ......... ............ A Drainage of mouth lesion .............................. 3.36 5.39 4.87 2.77 3.10 0.42 9.17 8.65 6.55 6.88 090 41009 ......... ............ A Drainage of mouth lesion .............................. 3.58 5.78 5.18 3.10 3.46 0.47 9.83 9.23 7.15 7.51 090 41010 ......... ............ A Incision of tongue fold ................................... 1.06 3.49 3.45 1.40 1.55 0.07 4.62 4.58 2.53 2.68 010 41015 ......... ............ A Drainage of mouth lesion .............................. 3.95 6.19 5.61 3.91 4.09 0.46 10.60 10.02 8.32 8.50 090 41016 ......... ............ A Drainage of mouth lesion .............................. 4.06 6.12 5.75 3.99 4.17 0.53 10.71 10.34 8.58 8.76 090 41017 ......... ............ A Drainage of mouth lesion .............................. 4.06 6.29 5.81 4.06 4.25 0.53 10.88 10.40 8.65 8.84 090 41018 ......... ............ A Drainage of mouth lesion .............................. 5.09 6.51 6.24 4.29 4.51 0.68 12.28 12.01 10.06 10.28 090 41100 ......... ............ A Biopsy of tongue ........................................... 1.37 2.58 2.47 1.12 1.35 0.15 4.10 3.99 2.64 2.87 010 41105 ......... ............ A Biopsy of tongue ........................................... 1.42 2.54 2.37 1.12 1.27 0.13 4.09 3.92 2.67 2.82 010 41108 ......... ............ A Biopsy of floor of mouth ................................ 1.05 2.38 2.16 1.01 1.10 0.10 3.53 3.31 2.16 2.25 010 41110 ......... ............ A Excision of tongue lesion .............................. 1.51 3.43 3.10 1.52 1.61 0.13 5.07 4.74 3.16 3.25 010 41112 ......... ............ A Excision of tongue lesion .............................. 2.73 5.07 4.63 3.11 3.20 0.28 8.08 7.64 6.12 6.21 090 41113 ......... ............ A Excision of tongue lesion .............................. 3.19 5.36 4.90 3.28 3.43 0.34 8.89 8.43 6.81 6.96 090 41114 ......... ............ A Excision of tongue lesion .............................. 8.64 NA NA 5.88 6.88 0.83 NA NA 15.35 16.35 090 41115 ......... ............ A Excision of tongue fold .................................. 1.74 4.26 3.54 1.74 1.83 0.18 6.18 5.46 3.66 3.75 010 41116 ......... ............ A Excision of mouth lesion ............................... 2.44 5.28 4.59 2.63 2.77 0.23 7.95 7.26 5.30 5.44 090 41120 ......... ............ A Partial removal of tongue .............................. 10.83 NA NA 13.77 14.96 0.79 NA NA 25.39 26.58 090 41130 ......... ............ A Partial removal of tongue .............................. 15.43 NA NA 15.08 15.95 0.93 NA NA 31.44 32.31 090 41135 ......... ............ A Tongue and neck surgery ............................. 29.71 NA NA 19.78 22.41 1.88 NA NA 51.37 54.00 090 41140 ......... ............ A Removal of tongue ........................................ 28.69 NA NA 21.51 25.44 2.26 NA NA 52.46 56.39 090 41145 ......... ............ A Tongue removal, neck surgery ..................... 37.47 NA NA 26.58 29.62 2.54 NA NA 66.59 69.63 09041150 ......... ............ A Tongue, mouth, jaw surgery ......................... 29.40 NA NA 21.26 23.90 1.94 NA NA 52.60 55.24 090 41153 ......... ............ A Tongue, mouth, neck surgery ....................... 33.16 NA NA 22.28 24.39 2.00 NA NA 57.44 59.55 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37314 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

41155 ......... ............ A Tongue, jaw, & neck surgery ........................ 39.84 NA NA 23.96 26.15 2.33 NA NA 66.13 68.32 090 41250 ......... ............ A Repair tongue laceration ............................... 1.91 3.76 3.00 1.57 1.28 0.18 5.85 5.09 3.66 3.37 010 41251 ......... ............ A Repair tongue laceration ............................... 2.27 3.12 3.24 1.62 1.57 0.22 5.61 5.73 4.11 4.06 010 41252 ......... ............ A Repair tongue laceration ............................... 2.97 4.31 4.00 1.94 2.18 0.29 7.57 7.26 5.20 5.44 010 41500 ......... ............ A Fixation of tongue .......................................... 3.70 NA NA 6.46 7.22 0.30 NA NA 10.46 11.22 090 41510 ......... ............ A Tongue to lip surgery .................................... 3.41 NA NA 6.94 7.70 0.20 NA NA 10.55 11.31 090 41520 ......... ............ A Reconstruction, tongue fold .......................... 2.73 5.71 4.90 3.19 3.52 0.27 8.71 7.90 6.19 6.52 090 41800 ......... ............ A Drainage of gum lesion ................................. 1.17 4.75 3.14 2.09 1.48 0.12 6.04 4.43 3.38 2.77 010 41805 ......... ............ A Removal foreign body, gum .......................... 1.24 4.73 3.19 2.75 2.35 0.13 6.10 4.56 4.12 3.72 010 41806 ......... ............ A Removal foreign body,jawbone ..................... 2.69 5.89 4.17 3.37 3.12 0.37 8.95 7.23 6.43 6.18 010 41822 ......... ............ R Excision of gum lesion .................................. 2.31 4.67 4.09 1.78 1.86 0.31 7.29 6.71 4.40 4.48 010 41823 ......... ............ R Excision of gum lesion .................................. 3.55 6.52 5.82 3.76 3.96 0.47 10.54 9.84 7.78 7.98 090 41825 ......... ............ A Excision of gum lesion .................................. 1.31 3.61 3.21 1.42 2.04 0.15 5.07 4.67 2.88 3.50 010 41826 ......... ............ A Excision of gum lesion .................................. 2.31 5.12 3.11 2.58 2.23 0.30 7.73 5.72 5.19 4.84 010 41827 ......... ............ A Excision of gum lesion .................................. 3.66 6.61 5.80 3.35 3.59 0.35 10.62 9.81 7.36 7.60 090 41828 ......... ............ R Excision of gum lesion .................................. 3.09 4.13 3.89 1.65 2.64 0.44 7.66 7.42 5.18 6.17 010 41830 ......... ............ R Removal of gum tissue ................................. 3.34 6.05 5.24 3.14 3.51 0.44 9.83 9.02 6.92 7.29 010 41872 ......... ............ R Repair gum .................................................... 2.84 5.80 5.22 3.19 3.40 0.30 8.94 8.36 6.33 6.54 090 41874 ......... ............ R Repair tooth socket ....................................... 3.09 5.76 5.08 2.76 3.08 0.45 9.30 8.62 6.30 6.62 090 42000 ......... ............ A Drainage mouth roof lesion ........................... 1.23 2.31 2.51 1.12 1.22 0.12 3.66 3.86 2.47 2.57 010 42100 ......... ............ A Biopsy roof of mouth ..................................... 1.31 2.16 2.11 1.19 1.32 0.13 3.60 3.55 2.63 2.76 010 42104 ......... ............ A Excision lesion, mouth roof ........................... 1.64 3.41 2.77 1.57 1.56 0.16 5.21 4.57 3.37 3.36 010 42106 ......... ............ A Excision lesion, mouth roof ........................... 2.10 4.40 3.52 2.03 2.35 0.25 6.75 5.87 4.38 4.70 010 42107 ......... ............ A Excision lesion, mouth roof ........................... 4.43 6.27 5.87 3.51 3.85 0.44 11.14 10.74 8.38 8.72 090 42120 ......... ............ A Remove palate/lesion .................................... 11.62 NA NA 12.17 11.89 0.52 NA NA 24.31 24.03 090 42140 ......... ............ A Excision of uvula ........................................... 1.62 4.18 3.84 1.90 2.05 0.13 5.93 5.59 3.65 3.80 090 42145 ......... ............ A Repair palate, pharynx/uvula ........................ 9.57 NA NA 6.64 7.29 0.65 NA NA 16.86 17.51 09042160 ......... ............ A Treatment mouth roof lesion ......................... 1.80 3.59 4.09 1.58 2.12 0.17 5.56 6.06 3.55 4.09 010 42180 ......... ............ A Repair palate ................................................. 2.50 3.19 3.11 1.75 2.02 0.21 5.90 5.82 4.46 4.73 010 42182 ......... ............ A Repair palate ................................................. 3.82 3.95 3.90 2.32 2.86 0.40 8.17 8.12 6.54 7.08 010 42200 ......... ............ A Reconstruct cleft palate ................................. 12.35 NA NA 7.99 9.68 1.27 NA NA 21.61 23.30 090 42205 ......... ............ A Reconstruct cleft palate ................................. 13.51 NA NA 7.37 9.42 1.58 NA NA 22.46 24.51 090 42210 ......... ............ A Reconstruct cleft palate ................................. 14.85 NA NA 9.59 11.02 2.16 NA NA 26.60 28.03 090 42215 ......... ............ A Reconstruct cleft palate ................................. 8.81 NA NA 7.08 8.60 1.31 NA NA 17.20 18.72 090 42220 ......... ............ A Reconstruct cleft palate ................................. 7.01 NA NA 6.72 6.78 0.73 NA NA 14.46 14.52 090 42225 ......... ............ A Reconstruct cleft palate ................................. 9.59 NA NA 11.81 15.79 0.86 NA NA 22.26 26.24 090 42226 ......... ............ A Lengthening of palate .................................... 10.17 NA NA 11.17 13.85 1.01 NA NA 22.35 25.03 090 42227 ......... ............ A Lengthening of palate .................................... 9.75 NA NA 9.54 14.08 0.98 NA NA 20.27 24.81 090 42235 ......... ............ A Repair palate ................................................. 7.86 NA NA 10.32 11.50 0.72 NA NA 18.90 20.08 090 42260 ......... ............ A Repair nose to lip fistula ............................... 10.04 9.41 10.02 5.71 6.74 1.26 20.71 21.32 17.01 18.04 090 42280 ......... ............ A Preparation, palate mold ............................... 1.54 2.26 2.04 0.84 1.07 0.19 3.99 3.77 2.57 2.80 010 42281 ......... ............ A Insertion, palate prosthesis ........................... 1.93 2.79 2.68 1.53 1.79 0.17 4.89 4.78 3.63 3.89 010 42300 ......... ............ A Drainage of salivary gland ............................ 1.93 2.89 2.85 1.58 1.76 0.16 4.98 4.94 3.67 3.85 010 42305 ......... ............ A Drainage of salivary gland ............................ 6.18 NA NA 3.59 4.45 0.51 NA NA 10.28 11.14 090 42310 ......... ............ A Drainage of salivary gland ............................ 1.56 2.16 2.24 1.30 1.48 0.13 3.85 3.93 2.99 3.17 010 42320 ......... ............ A Drainage of salivary gland ............................ 2.35 3.51 3.34 1.74 2.01 0.21 6.07 5.90 4.30 4.57 010 42330 ......... ............ A Removal of salivary stone ............................. 2.21 3.15 3.15 1.57 1.78 0.19 5.55 5.55 3.97 4.18 010 42335 ......... ............ A Removal of salivary stone ............................. 3.31 5.38 5.03 2.62 3.02 0.29 8.98 8.63 6.22 6.62 090 42340 ......... ............ A Removal of salivary stone ............................. 4.59 6.22 6.10 3.17 3.75 0.42 11.23 11.11 8.18 8.76 090 42400 ......... ............ A Biopsy of salivary gland ................................ 0.78 1.91 1.72 0.60 0.69 0.06 2.75 2.56 1.44 1.53 000 42405 ......... ............ A Biopsy of salivary gland ................................ 3.29 3.66 3.92 1.95 2.33 0.28 7.23 7.49 5.52 5.90 010 42408 ......... ............ A Excision of salivary cyst ................................ 4.53 6.03 5.96 3.02 3.47 0.45 11.01 10.94 8.00 8.45 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37315 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

42409 ......... ............ A Drainage of salivary cyst ............................... 2.81 5.02 4.65 2.35 2.67 0.27 8.10 7.73 5.43 5.75 090 42410 ......... ............ A Excise parotid gland/lesion ........................... 9.39 NA NA 4.81 5.88 0.91 NA NA 15.11 16.18 090 42415 ......... ............ A Excise parotid gland/lesion ........................... 17.91 NA NA 7.53 10.05 1.43 NA NA 26.87 29.39 090 42420 ......... ............ A Excise parotid gland/lesion ........................... 20.79 NA NA 8.32 11.39 1.65 NA NA 30.76 33.83 090 42425 ......... ............ A Excise parotid gland/lesion ........................... 13.24 NA NA 5.92 7.95 1.05 NA NA 20.21 22.24 090 42426 ......... ............ A Excise parotid gland/lesion ........................... 22.46 NA NA 8.59 11.94 1.80 NA NA 32.85 36.20 090 42440 ......... ............ A Excise submaxillary gland ............................. 7.02 NA NA 3.40 4.45 0.59 NA NA 11.01 12.06 090 42450 ......... ............ A Excise sublingual gland ................................. 4.61 5.81 5.89 3.61 4.10 0.42 10.84 10.92 8.64 9.13 090 42500 ......... ............ A Repair salivary duct ....................................... 4.29 5.73 5.71 3.57 4.04 0.41 10.43 10.41 8.27 8.74 090 42505 ......... ............ A Repair salivary duct ....................................... 6.17 6.66 7.02 4.26 5.10 0.55 13.38 13.74 10.98 11.82 090 42507 ......... ............ A Parotid duct diversion .................................... 6.10 NA NA 5.82 6.37 0.49 NA NA 12.41 12.96 090 42508 ......... ............ A Parotid duct diversion .................................... 9.15 NA NA 7.45 8.13 1.04 NA NA 17.64 18.32 090 42509 ......... ............ A Parotid duct diversion .................................... 11.58 NA NA 8.61 9.82 0.93 NA NA 21.12 22.33 090 42510 ......... ............ A Parotid duct diversion .................................... 8.20 NA NA 6.24 7.42 0.66 NA NA 15.10 16.28 090 42550 ......... ............ A Injection for salivary x-ray ............................. 1.25 2.36 3.01 0.44 0.42 0.07 3.68 4.33 1.76 1.74 000 42600 ......... ............ A Closure of salivary fistula .............................. 4.81 6.40 6.55 3.27 3.92 0.43 11.64 11.79 8.51 9.16 090 42650 ......... ............ A Dilation of salivary duct ................................. 0.77 1.18 1.12 0.60 0.68 0.07 2.02 1.96 1.44 1.52 000 42660 ......... ............ A Dilation of salivary duct ................................. 1.13 1.43 1.37 0.73 0.82 0.09 2.65 2.59 1.95 2.04 000 42665 ......... ............ A Ligation of salivary duct ................................ 2.53 4.66 4.30 2.17 2.49 0.23 7.42 7.06 4.93 5.25 090 42700 ......... ............ A Drainage of tonsil abscess ............................ 1.62 2.71 2.67 1.49 1.65 0.13 4.46 4.42 3.24 3.40 010 42720 ......... ............ A Drainage of throat abscess ........................... 6.31 4.22 4.69 2.79 3.55 0.44 10.97 11.44 9.54 10.30 010 42725 ......... ............ A Drainage of throat abscess ........................... 12.22 NA NA 6.46 7.80 0.91 NA NA 19.59 20.93 090 42800 ......... ............ A Biopsy of throat ............................................. 1.39 2.24 2.20 1.16 1.34 0.11 3.74 3.70 2.66 2.84 010 42802 ......... ............ A Biopsy of throat ............................................. 1.54 3.79 4.53 1.50 1.93 0.12 5.45 6.19 3.16 3.59 010 42804 ......... ............ A Biopsy of upper nose/throat .......................... 1.24 3.29 3.64 1.35 1.64 0.10 4.63 4.98 2.69 2.98 010 42806 ......... ............ A Biopsy of upper nose/throat .......................... 1.58 3.51 3.94 1.45 1.82 0.13 5.22 5.65 3.16 3.53 010 42808 ......... ............ A Excise pharynx lesion ................................... 2.30 2.93 3.06 1.42 1.81 0.19 5.42 5.55 3.91 4.30 010 42809 ......... ............ A Remove pharynx foreign body ...................... 1.81 2.10 2.28 1.23 1.31 0.16 4.07 4.25 3.20 3.28 010 42810 ......... ............ A Excision of neck cyst ..................................... 3.25 5.67 5.72 3.36 3.50 0.29 9.21 9.26 6.90 7.04 090 42815 ......... ............ A Excision of neck cyst ..................................... 7.18 NA NA 5.62 6.23 0.61 NA NA 13.41 14.02 090 42820 ......... ............ A Remove tonsils and adenoids ....................... 4.15 NA NA 2.48 3.10 0.31 NA NA 6.94 7.56 090 42821 ......... ............ A Remove tonsils and adenoids ....................... 4.28 NA NA 2.63 3.29 0.35 NA NA 7.26 7.92 090 42825 ......... ............ A Removal of tonsils ......................................... 3.41 NA NA 2.38 2.98 0.25 NA NA 6.04 6.64 090 42826 ......... ............ A Removal of tonsils ......................................... 3.37 NA NA 2.38 2.88 0.27 NA NA 6.02 6.52 090 42830 ......... ............ A Removal of adenoids .................................... 2.57 NA NA 2.16 2.47 0.20 NA NA 4.93 5.24 090 42831 ......... ............ A Removal of adenoids .................................... 2.71 NA NA 2.37 2.73 0.22 NA NA 5.30 5.66 090 42835 ......... ............ A Removal of adenoids .................................... 2.30 NA NA 1.76 2.29 0.21 NA NA 4.27 4.80 090 42836 ......... ............ A Removal of adenoids .................................... 3.18 NA NA 2.37 2.82 0.26 NA NA 5.81 6.26 090 42842 ......... ............ A Extensive surgery of throat ........................... 11.94 NA NA 10.34 10.85 0.71 NA NA 22.99 23.50 090 42844 ......... ............ A Extensive surgery of throat ........................... 17.49 NA NA 14.26 15.78 1.16 NA NA 32.91 34.43 090 42845 ......... ............ A Extensive surgery of throat ........................... 32.27 NA NA 20.22 22.49 1.98 NA NA 54.47 56.74 090 42860 ......... ............ A Excision of tonsil tags ................................... 2.22 NA NA 2.07 2.33 0.18 NA NA 4.47 4.73 090 42870 ......... ............ A Excision of lingual tonsil ................................ 5.39 NA NA 7.88 8.41 0.44 NA NA 13.71 14.24 090 42890 ......... ............ A Partial removal of pharynx ............................ 18.84 NA NA 13.48 14.01 1.05 NA NA 33.37 33.90 090 42892 ......... ............ A Revision of pharyngeal walls ........................ 25.67 NA NA 16.85 17.13 1.28 NA NA 43.80 44.08 090 42894 ......... ............ A Revision of pharyngeal walls ........................ 33.49 NA NA 20.21 21.61 1.86 NA NA 55.56 56.96 090 42900 ......... ............ A Repair throat wound ...................................... 5.24 NA NA 2.66 3.42 0.50 NA NA 8.40 9.16 010 42950 ......... ............ A Reconstruction of throat ................................ 8.09 NA NA 10.08 11.45 0.72 NA NA 18.89 20.26 090 42953 ......... ............ A Repair throat, esophagus .............................. 9.25 NA NA 12.70 16.21 0.88 NA NA 22.83 26.34 090 42955 ......... ............ A Surgical opening of throat ............................. 7.86 NA NA 9.33 10.36 0.80 NA NA 17.99 19.02 090 42960 ......... ............ A Control throat bleeding .................................. 2.33 NA NA 1.57 1.87 0.19 NA NA 4.09 4.39 010 42961 ......... ............ A Control throat bleeding .................................. 5.64 NA NA 4.03 4.74 0.45 NA NA 10.12 10.83 090 42962 ......... ............ A Control throat bleeding .................................. 7.25 NA NA 4.61 5.60 0.58 NA NA 12.44 13.43 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37316 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

42970 ......... ............ A Control nose/throat bleeding ......................... 5.72 NA NA 3.44 4.00 0.39 NA NA 9.55 10.11 09042971 ......... ............ A Control nose/throat bleeding ......................... 6.50 NA NA 4.01 4.85 0.51 NA NA 11.02 11.86 090 42972 ......... ............ A Control nose/throat bleeding ......................... 7.49 NA NA 4.35 5.38 0.62 NA NA 12.46 13.49 090 43020 ......... ............ A Incision of esophagus ................................... 8.08 NA NA 4.29 5.15 0.87 NA NA 13.24 14.10 090 43030 ......... ............ A Throat muscle surgery .................................. 7.86 NA NA 4.07 5.15 0.70 NA NA 12.63 13.71 090 43045 ......... ............ A Incision of esophagus ................................... 21.62 NA NA 10.14 10.58 2.58 NA NA 34.34 34.78 090 43100 ......... ............ A Excision of esophagus lesion ........................ 9.48 NA NA 4.97 5.92 0.93 NA NA 15.38 16.33 09043101 ......... ............ A Excision of esophagus lesion ........................ 16.94 NA NA 7.23 7.73 2.31 NA NA 26.48 26.98 090 43107 ......... ............ A Removal of esophagus ................................. 43.89 NA NA 16.66 17.90 5.22 NA NA 65.77 67.01 090 43108 ......... ............ A Removal of esophagus ................................. 63.23 NA NA 19.92 15.67 4.07 NA NA 87.22 82.97 090 43112 ......... ............ A Removal of esophagus ................................. 47.21 NA NA 17.22 18.87 5.79 NA NA 70.22 71.87 090 43113 ......... ............ A Removal of esophagus ................................. 46.95 NA NA 17.97 15.86 4.42 NA NA 69.34 67.23 090 43116 ......... ............ A Partial removal of esophagus ....................... 71.39 NA NA 21.91 18.03 3.05 NA NA 96.35 92.47 090 43117 ......... ............ A Partial removal of esophagus ....................... 43.46 NA NA 15.41 16.84 5.17 NA NA 64.04 65.47 090 43118 ......... ............ A Partial removal of esophagus ....................... 52.07 NA NA 16.85 14.58 4.10 NA NA 73.02 70.75 090 43121 ......... ............ A Partial removal of esophagus ....................... 46.35 NA NA 16.28 14.35 3.90 NA NA 66.53 64.60 090 43122 ......... ............ A Partial removal of esophagus ....................... 43.89 NA NA 15.66 17.00 5.40 NA NA 64.95 66.29 090 43123 ......... ............ A Partial removal of esophagus ....................... 63.83 NA NA 20.07 15.62 4.15 NA NA 88.05 83.60 090 43124 ......... ............ A Removal of esophagus ................................. 64.63 NA NA 21.43 15.20 3.73 NA NA 89.79 83.56 090 43130 ......... ............ A Removal of esophagus pouch ...................... 12.33 NA NA 5.82 7.14 1.16 NA NA 19.31 20.63 090 43135 ......... ............ A Removal of esophagus pouch ...................... 22.37 NA NA 9.07 8.35 2.33 NA NA 33.77 33.05 090 43200 ......... ............ A Esophagus endoscopy .................................. 1.59 3.55 3.99 0.91 1.03 0.13 5.27 5.71 2.63 2.75 000 43201 ......... ............ A Esoph scope w/submucous inj ...................... 2.09 5.69 4.90 1.21 1.13 0.15 7.93 7.14 3.45 3.37 000 43202 ......... ............ A Esophagus endoscopy, biopsy ..................... 1.89 5.22 5.48 0.99 0.95 0.15 7.26 7.52 3.03 2.99 000 43204 ......... ............ A Esoph scope w/sclerosis inj .......................... 3.76 NA NA 2.01 1.64 0.30 NA NA 6.07 5.70 000 43205 ......... ............ A Esophagus endoscopy/ligation ...................... 3.78 NA NA 2.12 1.67 0.28 NA NA 6.18 5.73 000 43215 ......... ............ A Esophagus endoscopy .................................. 2.60 NA NA 1.29 1.22 0.22 NA NA 4.11 4.04 000 43216 ......... ............ A Esophagus endoscopy/lesion ........................ 2.40 NA NA 1.24 1.11 0.20 NA NA 3.84 3.71 000 43217 ......... ............ A Esophagus endoscopy .................................. 2.90 6.72 6.91 1.43 1.25 0.26 9.88 10.07 4.59 4.41 000 43219 ......... ............ A Esophagus endoscopy .................................. 2.80 NA NA 1.58 1.41 0.24 NA NA 4.62 4.45 000 43220 ......... ............ A Esoph endoscopy, dilation ............................ 2.10 NA NA 1.15 1.02 0.17 NA NA 3.42 3.29 000 43226 ......... ............ A Esoph endoscopy, dilation ............................ 2.34 NA NA 1.32 1.10 0.19 NA NA 3.85 3.63 000 43227 ......... ............ A Esoph endoscopy, repair .............................. 3.59 NA NA 1.88 1.56 0.28 NA NA 5.75 5.43 000 43228 ......... ............ A Esoph endoscopy, ablation ........................... 3.76 NA NA 1.90 1.64 0.34 NA NA 6.00 5.74 000 43231 ......... ............ A Esoph endoscopy w/us exam ....................... 3.19 NA NA 1.79 1.43 0.23 NA NA 5.21 4.85 000 43232 ......... ............ A Esoph endoscopy w/us fn bx ........................ 4.47 NA NA 2.44 1.98 0.34 NA NA 7.25 6.79 000 43234 ......... ............ A Upper GI endoscopy, exam .......................... 2.01 5.07 5.27 1.03 0.91 0.17 7.25 7.45 3.21 3.09 000 43235 ......... ............ A Uppr gi endoscopy, diagnosis ....................... 2.39 5.42 5.24 1.40 1.12 0.19 8.00 7.82 3.98 3.70 000 43236 ......... ............ A Uppr gi scope w/submuc inj .......................... 2.92 6.90 6.54 1.71 1.34 0.21 10.03 9.67 4.84 4.47 000 43237 ......... ............ A Endoscopic us exam, esoph ......................... 3.98 NA NA 2.23 1.75 0.43 NA NA 6.64 6.16 000 43238 ......... ............ A Uppr gi endoscopy w/us fn bx ...................... 5.02 NA NA 2.63 2.14 0.43 NA NA 8.08 7.59 000 43239 ......... ............ A Upper GI endoscopy, biopsy ......................... 2.87 6.20 5.85 1.61 1.30 0.22 9.29 8.94 4.70 4.39 000 43240 ......... ............ A Esoph endoscope w/drain cyst ..................... 6.85 NA NA 3.58 2.85 0.56 NA NA 10.99 10.26 000 43241 ......... ............ A Upper GI endoscopy with tube ..................... 2.59 NA NA 1.46 1.19 0.21 NA NA 4.26 3.99 000 43242 ......... ............ A Uppr gi endoscopy w/us fn bx ...................... 7.30 NA NA 3.81 3.01 0.53 NA NA 11.64 10.84 000 43243 ......... ............ A Upper gi endoscopy & inject ......................... 4.56 NA NA 2.45 1.96 0.33 NA NA 7.34 6.85 000 43244 ......... ............ A Upper GI endoscopy/ligation ......................... 5.04 NA NA 2.74 2.16 0.37 NA NA 8.15 7.57 000 43245 ......... ............ A Uppr gi scope dilate strictr ............................ 3.18 NA NA 1.68 1.40 0.26 NA NA 5.12 4.84 000 43246 ......... ............ A Place gastrostomy tube ................................. 4.32 NA NA 2.18 1.81 0.34 NA NA 6.84 6.47 000 43247 ......... ............ A Operative upper GI endoscopy ..................... 3.38 NA NA 1.84 1.49 0.27 NA NA 5.49 5.14 000 43248 ......... ............ A Uppr gi endoscopy/guide wire ....................... 3.15 NA NA 1.85 1.45 0.23 NA NA 5.23 4.83 000 43249 ......... ............ A Esoph endoscopy, dilation ............................ 2.90 NA NA 1.68 1.33 0.22 NA NA 4.80 4.45 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37317 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

43250 ......... ............ A Upper GI endoscopy/tumor ........................... 3.20 NA NA 1.68 1.40 0.26 NA NA 5.14 4.86 000 43251 ......... ............ A Operative upper GI endoscopy ..................... 3.69 NA NA 1.99 1.61 0.29 NA NA 5.97 5.59 000 43255 ......... ............ A Operative upper GI endoscopy ..................... 4.81 NA NA 2.62 2.07 0.35 NA NA 7.78 7.23 000 43256 ......... ............ A Uppr gi endoscopy w/stent ............................ 4.34 NA NA 2.33 1.87 0.32 NA NA 6.99 6.53 000 43257 ......... ............ A Uppr gi scope w/thrml txmnt ......................... 5.50 NA NA 2.07 2.18 0.36 NA NA 7.93 8.04 000 43258 ......... ............ A Operative upper GI endoscopy ..................... 4.54 NA NA 2.47 1.96 0.33 NA NA 7.34 6.83 000 43259 ......... ............ A Endoscopic ultrasound exam ........................ 5.19 NA NA 2.78 2.20 0.35 NA NA 8.32 7.74 000 43260 ......... ............ A Endo cholangiopancreatograph .................... 5.95 NA NA 3.18 2.51 0.43 NA NA 9.56 8.89 000 43261 ......... ............ A Endo cholangiopancreatograph .................... 6.26 NA NA 3.34 2.64 0.46 NA NA 10.06 9.36 000 43262 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.87 3.06 0.54 NA NA 11.79 10.98 000 43263 ......... ............ A Endo cholangiopancreatograph .................... 7.28 NA NA 3.88 3.05 0.54 NA NA 11.70 10.87 000 43264 ......... ............ A Endo cholangiopancreatograph .................... 8.89 NA NA 4.62 3.65 0.65 NA NA 14.16 13.19 000 43265 ......... ............ A Endo cholangiopancreatograph .................... 10.00 NA NA 5.14 4.06 0.73 NA NA 15.87 14.79 000 43267 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.77 3.04 0.54 NA NA 11.69 10.96 000 43268 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 4.04 3.18 0.54 NA NA 11.96 11.10 000 43269 ......... ............ A Endo cholangiopancreatograph .................... 8.20 NA NA 4.27 3.38 0.60 NA NA 13.07 12.18 000 43271 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.88 3.06 0.54 NA NA 11.80 10.98 000 43272 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.96 3.08 0.54 NA NA 11.88 11.00 000 43280 ......... ............ A Laparoscopy, fundoplasty ............................. 17.96 NA NA 6.64 7.13 2.27 NA NA 26.87 27.36 090 43300 ......... ............ A Repair of esophagus ..................................... 9.13 NA NA 5.13 6.08 1.12 NA NA 15.38 16.33 090 43305 ......... ............ A Repair esophagus and fistula ....................... 17.90 NA NA 7.32 9.87 1.54 NA NA 26.76 29.31 09043310 ......... ............ A Repair of esophagus ..................................... 26.13 NA NA 10.16 10.86 3.60 NA NA 39.89 40.59 090 43312 ......... ............ A Repair esophagus and fistula ....................... 29.22 NA NA 10.01 11.44 4.00 NA NA 43.23 44.66 090 43313 ......... ............ A Esophagoplasty congenital ........................... 48.07 NA NA 17.09 18.42 5.45 NA NA 70.61 71.94 090 43314 ......... ............ A Tracheo-esophagoplasty cong ...................... 53.05 NA NA 18.47 19.05 6.63 NA NA 78.15 78.73 09043320 ......... ............ A Fuse esophagus & stomach ......................... 23.12 NA NA 8.80 9.12 2.73 NA NA 34.65 34.97 090 43324 ......... ............ A Revise esophagus & stomach ...................... 22.80 NA NA 8.30 8.67 2.75 NA NA 33.85 34.22 090 43325 ......... ............ A Revise esophagus & stomach ...................... 22.41 NA NA 8.35 8.70 2.59 NA NA 33.35 33.70 090 43326 ......... ............ A Revise esophagus & stomach ...................... 22.09 NA NA 9.37 9.33 2.84 NA NA 34.30 34.26 090 43330 ......... ............ A Repair of esophagus ..................................... 22.00 NA NA 8.13 8.45 2.62 NA NA 32.75 33.07 090 43331 ......... ............ A Repair of esophagus ..................................... 22.87 NA NA 9.61 9.76 2.93 NA NA 35.41 35.56 090 43340 ......... ............ A Fuse esophagus & intestine .......................... 22.80 NA NA 9.05 9.01 2.45 NA NA 34.30 34.26 090 43341 ......... ............ A Fuse esophagus & intestine .......................... 24.04 NA NA 10.24 10.09 2.91 NA NA 37.19 37.04 090 43350 ......... ............ A Surgical opening, esophagus ........................ 19.23 NA NA 7.98 8.34 1.42 NA NA 28.63 28.99 09043351 ......... ............ A Surgical opening, esophagus ........................ 21.79 NA NA 9.61 9.77 2.46 NA NA 33.86 34.02 09043352 ......... ............ A Surgical opening, esophagus ........................ 17.62 NA NA 8.17 8.34 2.05 NA NA 27.84 28.01 09043360 ......... ............ A Gastrointestinal repair ................................... 39.82 NA NA 15.84 15.29 4.96 NA NA 60.62 60.07 090 43361 ......... ............ A Gastrointestinal repair ................................... 45.42 NA NA 16.90 16.92 4.49 NA NA 66.81 66.83 090 43400 ......... ............ A Ligate esophagus veins ................................ 25.41 NA NA 13.84 10.56 1.95 NA NA 41.20 37.92 090 43401 ......... ............ A Esophagus surgery for veins ........................ 26.30 NA NA 9.37 9.48 3.04 NA NA 38.71 38.82 09043405 ......... ............ A Ligate/staple esophagus ............................... 24.47 NA NA 10.39 9.81 2.83 NA NA 37.69 37.11 090 43410 ......... ............ A Repair esophagus wound ............................. 16.22 NA NA 7.48 7.61 1.71 NA NA 25.41 25.54 09043415 ......... ............ A Repair esophagus wound ............................. 28.62 NA NA 11.95 11.82 3.52 NA NA 44.09 43.96 090 43420 ......... ............ A Repair esophagus opening ........................... 16.59 NA NA 6.72 7.25 1.43 NA NA 24.74 25.27 09043425 ......... ............ A Repair esophagus opening ........................... 24.85 NA NA 10.23 10.06 3.02 NA NA 38.10 37.93 090 43450 ......... ............ A Dilate esophagus ........................................... 1.38 2.75 2.67 0.96 0.76 0.11 4.24 4.16 2.45 2.25 000 43453 ......... ............ A Dilate esophagus ........................................... 1.51 6.50 6.19 1.05 0.81 0.11 8.12 7.81 2.67 2.43 000 43456 ......... ............ A Dilate esophagus ........................................... 2.57 13.40 13.69 1.51 1.20 0.20 16.17 16.46 4.28 3.97 000 43458 ......... ............ A Dilate esophagus ........................................... 3.06 7.13 6.79 1.67 1.38 0.24 10.43 10.09 4.97 4.68 000 43460 ......... ............ A Pressure treatment esophagus ..................... 3.79 NA NA 1.77 1.56 0.31 NA NA 5.87 5.66 000 43500 ......... ............ A Surgical opening of stomach ......................... 12.67 NA NA 5.22 5.04 1.45 NA NA 19.34 19.16 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37318 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

43501 ......... ............ A Surgical repair of stomach ............................ 22.41 NA NA 8.06 8.26 2.64 NA NA 33.11 33.31 090 43502 ......... ............ A Surgical repair of stomach ............................ 25.50 NA NA 8.95 9.35 3.09 NA NA 37.54 37.94 090 43510 ......... ............ A Surgical opening of stomach ......................... 14.95 NA NA 6.81 6.65 1.48 NA NA 23.24 23.08 090 43520 ......... ............ A Incision of pyloric muscle .............................. 11.17 NA NA 4.88 5.17 1.36 NA NA 17.41 17.70 090 43600 ......... ............ A Biopsy of stomach ......................................... 1.91 NA NA 0.83 0.70 0.14 NA NA 2.88 2.75 000 43605 ......... ............ A Biopsy of stomach ......................................... 13.60 NA NA 5.39 5.32 1.58 NA NA 20.57 20.50 090 43610 ......... ............ A Excision of stomach lesion ............................ 16.22 NA NA 6.02 6.13 1.93 NA NA 24.17 24.28 090 43611 ......... ............ A Excision of stomach lesion ............................ 20.19 NA NA 7.49 7.56 2.35 NA NA 30.03 30.10 090 43620 ......... ............ A Removal of stomach ..................................... 33.85 NA NA 11.02 11.62 3.95 NA NA 48.82 49.42 090 43621 ......... ............ A Removal of stomach ..................................... 39.34 NA NA 12.36 12.09 4.03 NA NA 55.73 55.46 090 43622 ......... ............ A Removal of stomach ..................................... 39.84 NA NA 12.48 12.59 4.29 NA NA 56.61 56.72 090 43631 ......... ............ A Removal of stomach, partial ......................... 24.32 NA NA 8.55 9.02 2.98 NA NA 35.85 36.32 090 43632 ......... ............ A Removal of stomach, partial ......................... 34.95 NA NA 11.24 9.70 2.98 NA NA 49.17 47.63 090 43633 ......... ............ A Removal of stomach, partial ......................... 32.95 NA NA 10.74 9.70 3.05 NA NA 46.74 45.70 090 43634 ......... ............ A Removal of stomach, partial ......................... 36.45 NA NA 11.69 10.51 3.32 NA NA 51.46 50.28 090 43635 ......... ............ A Removal of stomach, partial ......................... 2.06 NA NA 0.52 0.66 0.27 NA NA 2.85 2.99 ZZZ 43640 ......... ............ A Vagotomy & pylorus repair ............................ 19.37 NA NA 7.27 7.27 2.25 NA NA 28.89 28.89 090 43641 ......... ............ A Vagotomy & pylorus repair ............................ 19.62 NA NA 7.30 7.36 2.24 NA NA 29.16 29.22 090 43644 ......... ............ A Lap gastric bypass/roux-en-y ........................ 29.18 NA NA 10.13 10.96 3.15 NA NA 42.46 43.29 090 43645 ......... ............ A Lap gastr bypass incl smll i ........................... 31.31 NA NA 11.28 11.85 3.53 NA NA 46.12 46.69 090 43651 ......... ............ A Laparoscopy, vagus nerve ............................ 10.13 NA NA 4.59 4.73 1.33 NA NA 16.05 16.19 090 43652 ......... ............ A Laparoscopy, vagus nerve ............................ 12.13 NA NA 5.10 5.60 1.55 NA NA 18.78 19.28 090 43653 ......... ............ A Laparoscopy, gastrostomy ............................ 8.34 NA NA 4.34 4.23 1.01 NA NA 13.69 13.58 09043750 ......... ............ A Place gastrostomy tube ................................. 4.60 NA NA 1.77 2.09 0.43 NA NA 6.80 7.12 010 43752 ......... ............ A Nasal/orogastric w/stent ................................ 0.81 0.26 0.28 0.26 0.26 0.02 1.09 1.11 1.09 1.09 000 43760 ......... ............ A Change gastrostomy tube ............................. 1.10 13.41 4.92 0.40 0.44 0.09 14.60 6.11 1.59 1.63 000 43761 ......... ............ A Reposition gastrostomy tube ......................... 2.01 1.05 1.14 0.69 0.67 0.13 3.19 3.28 2.83 2.81 000 43770 ......... ............ A Lap, place gastr adjust band ......................... 17.79 NA NA 7.53 7.68 2.18 NA NA 27.50 27.65 090 43771 ......... ............ A Lap, revise adjust gast band ......................... 20.58 NA NA 8.10 8.48 2.54 NA NA 31.22 31.60 090 43772 ......... ............ A Lap, remove adjust gast band ...................... 15.58 NA NA 5.94 6.32 1.92 NA NA 23.44 23.82 090 43773 ......... ............ A Lap, change adjust gast band ....................... 20.58 NA NA 8.10 8.48 2.55 NA NA 31.23 31.61 09043774 ......... ............ A Lap remov adj gast band/port ....................... 15.62 NA NA 6.19 6.48 1.84 NA NA 23.65 23.94 09043800 ......... ............ A Reconstruction of pylorus .............................. 15.31 NA NA 5.79 5.88 1.81 NA NA 22.91 23.00 090 43810 ......... ............ A Fusion of stomach and bowel ....................... 16.76 NA NA 6.13 6.18 1.93 NA NA 24.82 24.87 090 43820 ......... ............ A Fusion of stomach and bowel ....................... 22.34 NA NA 7.54 6.70 2.03 NA NA 31.91 31.07 090 43825 ......... ............ A Fusion of stomach and bowel ....................... 21.57 NA NA 7.82 7.98 2.53 NA NA 31.92 32.08 090 43830 ......... ............ A Place gastrostomy tube ................................. 10.71 NA NA 5.13 4.92 1.25 NA NA 17.09 16.88 090 43831 ......... ............ A Place gastrostomy tube ................................. 8.31 NA NA 5.11 4.67 1.03 NA NA 14.45 14.01 090 43832 ......... ............ A Place gastrostomy tube ................................. 17.22 NA NA 7.09 6.92 1.97 NA NA 26.28 26.11 090 43840 ......... ............ A Repair of stomach lesion .............................. 22.64 NA NA 8.10 7.11 2.05 NA NA 32.79 31.80 090 43842 ......... ............ N V-band gastroplasty ...................................... 20.84 NA NA 7.63 7.77 2.44 NA NA 30.91 31.05 090 43843 ......... ............ A Gastroplasty w/o v-band ............................... 21.02 NA NA 7.76 7.78 2.45 NA NA 31.23 31.25 090 43845 ......... ............ A Gastroplasty duodenal switch ....................... 33.04 9.83 10.56 12.86 11.32 4.05 46.92 47.65 49.95 48.41 090 43846 ......... ............ A Gastric bypass for obesity ............................. 27.15 NA NA 9.90 10.01 3.18 NA NA 40.23 40.34 090 43847 ......... ............ A Gastric bypass incl small i ............................ 30.02 NA NA 10.55 10.83 3.55 NA NA 44.12 44.40 090 43848 ......... ............ A Revision gastroplasty .................................... 32.49 NA NA 11.17 11.67 3.87 NA NA 47.53 48.03 090 43850 ......... ............ A Revise stomach-bowel fusion ....................... 27.39 NA NA 9.28 9.70 3.27 NA NA 39.94 40.36 090 43855 ......... ............ A Revise stomach-bowel fusion ....................... 28.50 NA NA 9.61 10.17 3.46 NA NA 41.57 42.13 09043860 ......... ............ A Revise stomach-bowel fusion ....................... 27.70 NA NA 9.38 9.84 3.30 NA NA 40.38 40.84 090 43865 ......... ............ A Revise stomach-bowel fusion ....................... 28.86 NA NA 9.93 10.38 3.50 NA NA 42.29 42.74 09043870 ......... ............ A Repair stomach opening ............................... 11.32 NA NA 4.97 4.63 1.27 NA NA 17.56 17.22 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37319 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

43880 ......... ............ A Repair stomach-bowel fistula ........................ 26.99 NA NA 9.22 9.75 3.26 NA NA 39.47 40.00 090 43886 ......... ............ A Revise gastric port, open .............................. 4.50 NA NA 3.47 3.22 0.25 NA NA 8.22 7.97 090 43887 ......... ............ A Remove gastric port, open ............................ 4.20 NA NA 3.02 2.84 0.51 NA NA 7.73 7.55 090 43888 ......... ............ A Change gastric port, open ............................. 6.30 NA NA 3.96 3.82 0.70 NA NA 10.96 10.82 090 44005 ......... ............ A Freeing of bowel adhesion ............................ 18.34 NA NA 6.53 6.68 2.14 NA NA 27.01 27.16 090 44010 ......... ............ A Incision of small bowel .................................. 14.14 NA NA 5.47 5.46 1.64 NA NA 21.25 21.24 090 44015 ......... ............ A Insert needle cath bowel ............................... 2.62 NA NA 0.68 0.83 0.35 NA NA 3.65 3.80 ZZZ 44020 ......... ............ A Explore small intestine .................................. 16.10 NA NA 5.93 5.95 1.85 NA NA 23.88 23.90 090 44021 ......... ............ A Decompress small bowel .............................. 16.19 NA NA 6.23 6.04 1.86 NA NA 24.28 24.09 090 44025 ......... ............ A Incision of large bowel .................................. 16.39 NA NA 6.06 6.05 1.89 NA NA 24.34 24.33 090 44050 ......... ............ A Reduce bowel obstruction ............................. 15.40 NA NA 5.76 5.92 1.85 NA NA 23.01 23.17 090 44055 ......... ............ A Correct malrotation of bowel ......................... 25.49 NA NA 8.43 8.67 2.90 NA NA 36.82 37.06 090 44100 ......... ............ A Biopsy of bowel ............................................. 2.01 NA NA 0.92 0.76 0.17 NA NA 3.10 2.94 000 44110 ......... ............ A Excise intestine lesion(s) ............................... 13.92 NA NA 5.47 5.30 1.55 NA NA 20.94 20.77 090 44111 ......... ............ A Excision of bowel lesion(s) ............................ 16.40 NA NA 6.07 6.11 1.86 NA NA 24.33 24.37 090 44120 ......... ............ A Removal of small intestine ............................ 20.70 NA NA 7.25 7.13 2.24 NA NA 30.19 30.07 090 44121 ......... ............ A Removal of small intestine ............................ 4.44 NA NA 1.12 1.42 0.58 NA NA 6.14 6.44 ZZZ44125 ......... ............ A Removal of small intestine ............................ 19.89 NA NA 7.00 7.20 2.26 NA NA 29.15 29.35 090 44126 ......... ............ A Enterectomy w/o taper, cong ........................ 41.94 NA NA 13.72 14.04 4.68 NA NA 60.34 60.66 090 44127 ......... ............ A Enterectomy w/taper, cong ........................... 49.01 NA NA 14.56 15.46 5.75 NA NA 69.32 70.22 090 44128 ......... ............ A Enterectomy cong, add-on ............................ 4.44 NA NA 1.04 1.41 0.61 NA NA 6.09 6.46 ZZZ 44130 ......... ............ A Bowel to bowel fusion ................................... 21.92 NA NA 7.56 6.56 1.87 NA NA 31.35 30.35 090 44139 ......... ............ A Mobilization of colon ...................................... 2.23 NA NA 0.55 0.71 0.28 NA NA 3.06 3.22 ZZZ 44140 ......... ............ A Partial removal of colon ................................ 22.40 NA NA 8.06 8.52 2.70 NA NA 33.16 33.62 090 44141 ......... ............ A Partial removal of colon ................................ 29.69 NA NA 12.06 10.57 2.52 NA NA 44.27 42.78 090 44143 ......... ............ A Partial removal of colon ................................ 27.57 NA NA 10.85 10.75 3.04 NA NA 41.46 41.36 090 44144 ......... ............ A Partial removal of colon ................................ 29.69 NA NA 10.91 9.96 2.85 NA NA 43.45 42.50 090 44145 ......... ............ A Partial removal of colon ................................ 28.39 NA NA 10.06 10.64 3.28 NA NA 41.73 42.31 090 44146 ......... ............ A Partial removal of colon ................................ 35.08 NA NA 13.52 13.05 3.40 NA NA 52.00 51.53 090 44147 ......... ............ A Partial removal of colon ................................ 33.50 NA NA 11.29 9.36 2.55 NA NA 47.34 45.41 090 44150 ......... ............ A Removal of colon .......................................... 29.91 NA NA 12.96 12.28 3.03 NA NA 45.90 45.22 090 44151 ......... ............ A Removal of colon/ileostomy .......................... 34.65 NA NA 14.61 13.73 3.48 NA NA 52.74 51.86 090 44152 ......... ............ A Removal of colon/ileostomy .......................... 29.91 NA NA 10.38 11.31 3.51 NA NA 43.80 44.73 090 44153 ......... ............ A Removal of colon/ileostomy .......................... 33.17 NA NA 14.25 14.37 3.54 NA NA 50.96 51.08 090 44155 ......... ............ A Removal of colon/ileostomy .......................... 34.15 NA NA 14.02 13.51 3.27 NA NA 51.44 50.93 090 44156 ......... ............ A Removal of colon/ileostomy .......................... 37.15 NA NA 15.47 15.17 3.94 NA NA 56.56 56.26 090 44160 ......... ............ A Removal of colon .......................................... 20.72 NA NA 7.49 7.69 2.36 NA NA 30.57 30.77 090 44180 ......... ............ A Lap, enterolysis ............................................. 15.15 NA NA 5.79 6.14 1.85 NA NA 22.79 23.14 090 44186 ......... ............ A Lap, jejunostomy ........................................... 10.26 NA NA 4.58 4.75 1.27 NA NA 16.11 16.28 090 44187 ......... ............ A Lap, ileo/jejuno-stomy ................................... 17.21 NA NA 8.15 8.26 1.95 NA NA 27.31 27.42 090 44188 ......... ............ A Lap, colostomy .............................................. 19.14 NA NA 8.72 8.83 2.23 NA NA 30.09 30.20 090 44202 ......... ............ A Lap, enterectomy ........................................... 23.20 NA NA 8.28 8.78 2.84 NA NA 34.32 34.82 090 44203 ......... ............ A Lap resect s/intestine, addl ........................... 4.44 NA NA 1.12 1.41 0.57 NA NA 6.13 6.42 ZZZ 44204 ......... ............ A Laparo partial colectomy ............................... 26.23 NA NA 8.86 9.70 3.10 NA NA 38.19 39.03 090 44205 ......... ............ A Lap colectomy part w/ileum .......................... 22.80 NA NA 7.77 8.60 2.74 NA NA 33.31 34.14 090 44206 ......... ............ A Lap part colectomy w/stoma ......................... 29.57 NA NA 10.45 11.07 3.45 NA NA 43.47 44.09 090 44207 ......... ............ A L colectomy/coloproctostomy ........................ 31.73 NA NA 10.06 11.15 3.66 NA NA 45.45 46.54 090 44208 ......... ............ A L colectomy/coloproctostomy ........................ 33.80 NA NA 11.98 12.87 3.87 NA NA 49.65 50.54 090 44210 ......... ............ A Laparo total proctocolectomy ........................ 29.80 NA NA 11.12 11.71 3.41 NA NA 44.33 44.92 090 44211 ......... ............ A Laparo total proctocolectomy ........................ 36.79 NA NA 13.67 14.45 4.16 NA NA 54.62 55.40 090 44212 ......... ............ A Laparo total proctocolectomy ........................ 34.29 NA NA 13.17 13.58 3.77 NA NA 51.23 51.64 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37320 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

44213 ......... ............ A Lap, mobil splenic fl add-on .......................... 3.50 NA NA 0.87 1.13 0.44 NA NA 4.81 5.07 ZZZ44227 ......... ............ A Lap, close enterostomy ................................. 28.43 NA NA 9.45 10.35 3.37 NA NA 41.25 42.15 090 44300 ......... ............ A Open bowel to skin ....................................... 13.61 NA NA 5.58 5.52 1.60 NA NA 20.79 20.73 090 44310 ......... ............ A Ileostomy/jejunostomy ................................... 17.45 NA NA 6.37 6.63 1.98 NA NA 25.80 26.06 090 44312 ......... ............ A Revision of ileostomy .................................... 9.29 NA NA 4.64 4.16 0.92 NA NA 14.85 14.37 090 44314 ......... ............ A Revision of ileostomy .................................... 16.55 NA NA 6.84 6.64 1.74 NA NA 25.13 24.93 090 44316 ......... ............ A Devise bowel pouch ...................................... 23.40 NA NA 9.33 8.75 2.37 NA NA 35.10 34.52 090 44320 ......... ............ A Colostomy ...................................................... 19.69 NA NA 7.58 7.65 2.25 NA NA 29.52 29.59 090 44322 ......... ............ A Colostomy with biopsies ................................ 13.04 NA NA 9.43 8.80 1.54 NA NA 24.01 23.38 090 44340 ......... ............ A Revision of colostomy ................................... 9.06 NA NA 4.94 4.44 0.99 NA NA 14.99 14.49 090 44345 ......... ............ A Revision of colostomy ................................... 17.00 NA NA 6.89 6.90 1.96 NA NA 25.85 25.86 090 44346 ......... ............ A Revision of colostomy ................................... 19.41 NA NA 7.51 7.43 2.12 NA NA 29.04 28.96 090 44360 ......... ............ A Small bowel endoscopy ................................ 2.59 NA NA 1.56 1.22 0.19 NA NA 4.34 4.00 000 44361 ......... ............ A Small bowel endoscopy/biopsy ..................... 2.87 NA NA 1.71 1.33 0.21 NA NA 4.79 4.41 000 44363 ......... ............ A Small bowel endoscopy ................................ 3.49 NA NA 2.02 1.54 0.27 NA NA 5.78 5.30 000 44364 ......... ............ A Small bowel endoscopy ................................ 3.73 NA NA 2.10 1.64 0.27 NA NA 6.10 5.64 000 44365 ......... ............ A Small bowel endoscopy ................................ 3.31 NA NA 1.85 1.48 0.24 NA NA 5.40 5.03 000 44366 ......... ............ A Small bowel endoscopy ................................ 4.40 NA NA 2.48 1.93 0.32 NA NA 7.20 6.65 000 44369 ......... ............ A Small bowel endoscopy ................................ 4.51 NA NA 2.51 1.93 0.33 NA NA 7.35 6.77 000 44370 ......... ............ A Small bowel endoscopy/stent ........................ 4.79 NA NA 2.66 2.15 0.37 NA NA 7.82 7.31 000 44372 ......... ............ A Small bowel endoscopy ................................ 4.40 NA NA 2.20 1.86 0.35 NA NA 6.95 6.61 000 44373 ......... ............ A Small bowel endoscopy ................................ 3.49 NA NA 1.82 1.52 0.27 NA NA 5.58 5.28 000 44376 ......... ............ A Small bowel endoscopy ................................ 5.25 NA NA 2.53 2.16 0.42 NA NA 8.20 7.83 000 44377 ......... ............ A Small bowel endoscopy/biopsy ..................... 5.52 NA NA 2.90 2.33 0.40 NA NA 8.82 8.25 000 44378 ......... ............ A Small bowel endoscopy ................................ 7.12 NA NA 3.69 2.95 0.52 NA NA 11.33 10.59 000 44379 ......... ............ A S bowel endoscope w/stent .......................... 7.46 NA NA 3.38 3.04 0.62 NA NA 11.46 11.12 000 44380 ......... ............ A Small bowel endoscopy ................................ 1.05 NA NA 0.77 0.61 0.08 NA NA 1.90 1.74 000 44382 ......... ............ A Small bowel endoscopy ................................ 1.27 NA NA 0.81 0.68 0.12 NA NA 2.20 2.07 000 44383 ......... ............ A Ileoscopy w/stent ........................................... 2.94 NA NA 1.68 1.37 0.21 NA NA 4.83 4.52 000 44385 ......... ............ A Endoscopy of bowel pouch ........................... 1.82 4.99 3.77 0.90 0.79 0.15 6.96 5.74 2.87 2.76 000 44386 ......... ............ A Endoscopy, bowel pouch/biop ...................... 2.12 6.90 6.72 1.07 0.93 0.20 9.22 9.04 3.39 3.25 000 44388 ......... ............ A Colonoscopy .................................................. 2.82 6.25 5.38 1.38 1.21 0.26 9.33 8.46 4.46 4.29 000 44389 ......... ............ A Colonoscopy with biopsy ............................... 3.13 7.27 6.80 1.62 1.36 0.27 10.67 10.20 5.02 4.76 000 44390 ......... ............ A Colonoscopy for foreign body ....................... 3.82 8.17 7.39 1.84 1.58 0.32 12.31 11.53 5.98 5.72 000 44391 ......... ............ A Colonoscopy for bleeding .............................. 4.31 9.24 8.87 2.29 1.84 0.34 13.89 13.52 6.94 6.49 000 44392 ......... ............ A Colonoscopy & polypectomy ......................... 3.81 7.52 6.83 1.74 1.55 0.34 11.67 10.98 5.89 5.70 000 44393 ......... ............ A Colonoscopy, lesion removal ........................ 4.83 8.05 7.20 2.09 1.93 0.42 13.30 12.45 7.34 7.18 000 44394 ......... ............ A Colonoscopy w/snare .................................... 4.42 8.70 8.05 2.12 1.82 0.38 13.50 12.85 6.92 6.62 000 44397 ......... ............ A Colonoscopy w/stent ..................................... 4.70 NA NA 2.37 1.94 0.39 NA NA 7.46 7.03 000 44500 ......... ............ A Intro, gastrointestinal tube ............................. 0.49 NA NA 0.17 0.16 0.03 NA NA 0.69 0.68 000 44602 ......... ............ A Suture, small intestine ................................... 24.60 NA NA 7.61 6.71 2.11 NA NA 34.32 33.42 090 44603 ......... ............ A Suture, small intestine ................................... 27.97 NA NA 8.46 7.58 2.41 NA NA 38.84 37.96 090 44604 ......... ............ A Suture, large intestine ................................... 18.02 NA NA 6.05 6.37 2.11 NA NA 26.18 26.50 090 44605 ......... ............ A Repair of bowel lesion ................................... 21.96 NA NA 7.86 8.27 2.51 NA NA 32.33 32.74 090 44615 ......... ............ A Intestinal stricturoplasty ................................. 18.04 NA NA 6.54 6.65 2.06 NA NA 26.64 26.75 090 44620 ......... ............ A Repair bowel opening ................................... 14.31 NA NA 5.48 5.38 1.51 NA NA 21.30 21.20 090 44625 ......... ............ A Repair bowel opening ................................... 17.16 NA NA 6.14 6.28 1.85 NA NA 25.15 25.29 090 44626 ......... ............ A Repair bowel opening ................................... 27.78 NA NA 8.89 9.60 3.26 NA NA 39.93 40.64 090 44640 ......... ............ A Repair bowel-skin fistula ............................... 24.08 NA NA 8.03 8.45 2.77 NA NA 34.88 35.30 090 44650 ......... ............ A Repair bowel fistula ....................................... 25.00 NA NA 8.27 8.75 2.92 NA NA 36.19 36.67 090 44660 ......... ............ A Repair bowel-bladder fistula .......................... 23.79 NA NA 9.84 8.73 2.13 NA NA 35.76 34.65 090 44661 ......... ............ A Repair bowel-bladder fistula .......................... 27.23 NA NA 9.42 9.54 2.80 NA NA 39.45 39.57 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37321 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

44680 ......... ............ A Surgical revision, intestine ............................ 17.84 NA NA 6.56 6.49 1.99 NA NA 26.39 26.32 090 44700 ......... ............ A Suspend bowel w/prosthesis ......................... 17.36 NA NA 6.18 6.56 1.83 NA NA 25.37 25.75 09044701 ......... ............ A Intraop colon lavage add-on ......................... 3.10 NA NA 0.76 0.99 0.37 NA NA 4.23 4.46 ZZZ 44720 ......... ............ A Prep donor intestine/venous ......................... 5.00 NA NA 1.22 1.59 0.37 NA NA 6.59 6.96 XXX 44721 ......... ............ A Prep donor intestine/artery ............................ 7.00 NA NA 1.77 2.24 0.97 NA NA 9.74 10.21 XXX 44800 ......... ............ A Excision of bowel pouch ............................... 11.87 NA NA 5.51 5.43 1.47 NA NA 18.85 18.77 090 44820 ......... ............ A Excision of mesentery lesion ........................ 13.59 NA NA 5.59 5.52 1.59 NA NA 20.77 20.70 090 44850 ......... ............ A Repair of mesentery ...................................... 11.99 NA NA 4.99 5.01 1.39 NA NA 18.37 18.39 090 44900 ......... ............ A Drain app abscess, open .............................. 12.38 NA NA 5.02 4.78 1.33 NA NA 18.73 18.49 090 44901 ......... ............ A Drain app abscess, percut ............................ 3.37 20.70 26.15 1.16 1.12 0.22 24.29 29.74 4.75 4.71 000 44950 ......... ............ A Appendectomy ............................................... 10.48 NA NA 4.04 4.25 1.31 NA NA 15.83 16.04 090 44955 ......... ............ A Appendectomy add-on .................................. 1.53 NA NA 0.40 0.51 0.20 NA NA 2.13 2.24 ZZZ 44960 ......... ............ A Appendectomy ............................................... 14.33 NA NA 5.39 5.36 1.63 NA NA 21.35 21.32 090 44970 ......... ............ A Laparoscopy, appendectomy ........................ 9.31 NA NA 4.19 4.12 1.14 NA NA 14.64 14.57 090 45000 ......... ............ A Drainage of pelvic abscess ........................... 6.16 NA NA 3.59 3.13 0.52 NA NA 10.27 9.81 09045005 ......... ............ A Drainage of rectal abscess ........................... 1.99 3.99 4.04 1.59 1.58 0.25 6.23 6.28 3.83 3.82 010 45020 ......... ............ A Drainage of rectal abscess ........................... 8.37 NA NA 4.58 3.61 0.55 NA NA 13.50 12.53 090 45100 ......... ............ A Biopsy of rectum ........................................... 3.92 NA NA 2.83 2.49 0.44 NA NA 7.19 6.85 090 45108 ......... ............ A Removal of anorectal lesion .......................... 5.00 NA NA 3.06 2.85 0.59 NA NA 8.65 8.44 090 45110 ......... ............ A Removal of rectum ........................................ 30.49 NA NA 11.83 12.28 3.35 NA NA 45.67 46.12 090 45111 ......... ............ A Partial removal of rectum .............................. 17.81 NA NA 6.98 7.13 2.06 NA NA 26.85 27.00 090 45112 ......... ............ A Removal of rectum ........................................ 32.99 NA NA 10.24 11.40 3.42 NA NA 46.65 47.81 090 45113 ......... ............ A Partial proctectomy ........................................ 33.03 NA NA 11.44 12.33 3.48 NA NA 47.95 48.84 090 45114 ......... ............ A Partial removal of rectum .............................. 30.57 NA NA 10.29 10.75 3.35 NA NA 44.21 44.67 090 45116 ......... ............ A Partial removal of rectum .............................. 27.50 NA NA 9.35 9.88 2.87 NA NA 39.72 40.25 090 45119 ......... ............ A Remove rectum w/reservoir .......................... 33.29 NA NA 11.56 12.26 3.35 NA NA 48.20 48.90 090 45120 ......... ............ A Removal of rectum ........................................ 26.15 NA NA 9.31 9.94 2.89 NA NA 38.35 38.98 090 45121 ......... ............ A Removal of rectum and colon ....................... 28.83 NA NA 10.19 10.90 3.24 NA NA 42.26 42.97 090 45123 ......... ............ A Partial proctectomy ........................................ 18.64 NA NA 6.99 6.90 1.85 NA NA 27.48 27.39 090 45126 ......... ............ A Pelvic exenteration ........................................ 48.81 NA NA 17.12 18.73 4.32 NA NA 70.25 71.86 090 45130 ......... ............ A Excision of rectal prolapse ............................ 18.31 NA NA 6.65 6.75 1.79 NA NA 26.75 26.85 090 45135 ......... ............ A Excision of rectal prolapse ............................ 22.07 NA NA 9.27 8.64 2.35 NA NA 33.69 33.06 090 45136 ......... ............ A Excise ileoanal reservior ............................... 30.55 NA NA 11.74 12.35 2.81 NA NA 45.10 45.71 090 45150 ......... ............ A Excision of rectal stricture ............................. 5.72 NA NA 3.39 3.08 0.61 NA NA 9.72 9.41 090 45160 ......... ............ A Excision of rectal lesion ................................ 16.11 NA NA 6.53 6.63 1.67 NA NA 24.31 24.41 090 45170 ......... ............ A Excision of rectal lesion ................................ 12.42 NA NA 5.35 5.28 1.35 NA NA 19.12 19.05 090 45190 ......... ............ A Destruction, rectal tumor ............................... 10.23 NA NA 4.94 4.71 1.13 NA NA 16.30 16.07 090 45300 ......... ............ A Proctosigmoidoscopy dx ............................... 0.38 2.00 1.65 0.35 0.30 0.04 2.42 2.07 0.77 0.72 000 45303 ......... ............ A Proctosigmoidoscopy dilate ........................... 0.44 19.69 18.97 0.38 0.34 0.05 20.18 19.46 0.87 0.83 000 45305 ......... ............ A Proctosigmoidoscopy w/bx ............................ 1.01 3.31 2.81 0.53 0.51 0.11 4.43 3.93 1.65 1.63 000 45307 ......... ............ A Proctosigmoidoscopy fb ................................ 0.94 3.50 3.16 0.50 0.49 0.11 4.55 4.21 1.55 1.54 000 45308 ......... ............ A Proctosigmoidoscopy removal ...................... 0.83 3.31 2.33 0.49 0.45 0.09 4.23 3.25 1.41 1.37 000 45309 ......... ............ A Proctosigmoidoscopy removal ...................... 2.01 3.74 3.05 0.83 0.84 0.22 5.97 5.28 3.06 3.07 000 45315 ......... ............ A Proctosigmoidoscopy removal ...................... 1.40 3.75 3.09 0.65 0.64 0.15 5.30 4.64 2.20 2.19 000 45317 ......... ............ A Proctosigmoidoscopy bleed .......................... 1.50 3.85 2.79 0.66 0.66 0.15 5.50 4.44 2.31 2.31 000 45320 ......... ............ A Proctosigmoidoscopy ablate ......................... 1.58 4.53 3.32 0.76 0.72 0.16 6.27 5.06 2.50 2.46 000 45321 ......... ............ A Proctosigmoidoscopy volvul .......................... 1.17 NA NA 0.66 0.59 0.13 NA NA 1.96 1.89 000 45327 ......... ............ A Proctosigmoidoscopy w/stent ........................ 1.65 NA NA 0.86 0.73 0.16 NA NA 2.67 2.54 000 45330 ......... ............ A Diagnostic sigmoidoscopy ............................. 0.96 2.54 2.35 0.63 0.53 0.08 3.58 3.39 1.67 1.57 000 45331 ......... ............ A Sigmoidoscopy and biopsy ........................... 1.15 3.34 3.15 0.81 0.65 0.09 4.58 4.39 2.05 1.89 000 45332 ......... ............ A Sigmoidoscopy w/fb removal ........................ 1.79 5.77 5.20 1.06 0.87 0.16 7.72 7.15 3.01 2.82 000 45333 ......... ............ A Sigmoidoscopy & polypectomy ..................... 1.79 5.76 5.10 1.01 0.85 0.15 7.70 7.04 2.95 2.79 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37322 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

45334 ......... ............ A Sigmoidoscopy for bleeding .......................... 2.73 NA NA 1.58 1.25 0.20 NA NA 4.51 4.18 000 45335 ......... ............ A Sigmoidoscopy w/submuc inj ........................ 1.46 5.47 3.78 0.93 0.75 0.11 7.04 5.35 2.50 2.32 000 45337 ......... ............ A Sigmoidoscopy & decompress ...................... 2.36 NA NA 1.27 1.07 0.21 NA NA 3.84 3.64 000 45338 ......... ............ A Sigmoidoscopy w/tumr remove ..................... 2.34 6.02 5.43 1.31 1.08 0.19 8.55 7.96 3.84 3.61 000 45339 ......... ............ A Sigmoidoscopy w/ablate tumr ....................... 3.14 5.92 4.08 1.73 1.39 0.26 9.32 7.48 5.13 4.79 000 45340 ......... ............ A Sig w/balloon dilation .................................... 1.89 10.51 7.27 1.07 0.89 0.15 12.55 9.31 3.11 2.93 000 45341 ......... ............ A Sigmoidoscopy w/ultrasound ......................... 2.60 NA NA 1.51 1.18 0.19 NA NA 4.30 3.97 000 45342 ......... ............ A Sigmoidoscopy w/us guide bx ....................... 4.05 NA NA 2.25 1.72 0.30 NA NA 6.60 6.07 000 45345 ......... ............ A Sigmoidoscopy w/stent .................................. 2.92 NA NA 1.60 1.27 0.23 NA NA 4.75 4.42 000 45355 ......... ............ A Surgical colonoscopy .................................... 3.51 NA NA 1.59 1.43 0.36 NA NA 5.46 5.30 000 45378 ......... ............ A Diagnostic colonoscopy ................................. 3.69 6.55 6.26 1.88 1.57 0.30 10.54 10.25 5.87 5.56 000 45378 ......... 53 ....... A Diagnostic sigmoidoscopy ............................. 0.96 2.54 2.35 0.63 0.53 0.08 3.58 3.39 1.67 1.57 000 45379 ......... ............ A Colonoscopy w/fb removal ............................ 4.68 8.37 7.85 2.28 1.94 0.39 13.44 12.92 7.35 7.01 000 45380 ......... ............ A Colonoscopy and biopsy ............................... 4.43 7.96 7.40 2.31 1.88 0.35 12.74 12.18 7.09 6.66 000 45381 ......... ............ A Colonoscopy, submucous inj ........................ 4.19 7.94 7.33 2.24 1.80 0.30 12.43 11.82 6.73 6.29 000 45382 ......... ............ A Colonoscopy/control bleeding ....................... 5.68 10.67 10.15 3.00 2.39 0.41 16.76 16.24 9.09 8.48 000 45383 ......... ............ A Lesion removal colonoscopy ......................... 5.86 8.78 8.15 2.73 2.36 0.48 15.12 14.49 9.07 8.70 000 45384 ......... ............ A Lesion remove colonoscopy .......................... 4.69 7.40 6.97 2.27 1.94 0.38 12.47 12.04 7.34 7.01 000 45385 ......... ............ A Lesion removal colonoscopy ......................... 5.30 8.59 8.01 2.67 2.20 0.42 14.31 13.73 8.39 7.92 000 45386 ......... ............ A Colonoscopy dilate stricture .......................... 4.57 12.65 12.49 2.25 1.91 0.39 17.61 17.45 7.21 6.87 000 45387 ......... ............ A Colonoscopy w/stent ..................................... 5.90 NA NA 3.01 2.51 0.48 NA NA 9.39 8.89 000 45391 ......... ............ A Colonoscopy w/endoscope us ...................... 5.09 NA NA 2.66 2.15 0.42 NA NA 8.17 7.66 000 45392 ......... ............ A Colonoscopy w/endoscopic fnb ..................... 6.54 NA NA 3.23 2.68 0.42 NA NA 10.19 9.64 000 45395 ......... ............ A Lap, removal of rectum ................................. 32.71 NA NA 12.90 13.51 3.62 NA NA 49.23 49.84 090 45397 ......... ............ A Lap, remove rectum w/pouch ........................ 36.21 NA NA 13.43 14.08 3.66 NA NA 53.30 53.95 090 45400 ......... ............ A Laparoscopic proctopexy .............................. 19.25 NA NA 7.09 7.66 2.02 NA NA 28.36 28.93 090 45402 ......... ............ A Lap proctopexy w/sig resect ......................... 26.32 NA NA 8.74 9.69 2.81 NA NA 37.87 38.82 090 45500 ......... ............ A Repair of rectum ............................................ 7.58 NA NA 3.79 3.60 0.75 NA NA 12.12 11.93 090 45505 ......... ............ A Repair of rectum ............................................ 8.14 NA NA 4.52 4.03 0.86 NA NA 13.52 13.03 090 45520 ......... ............ A Treatment of rectal prolapse ......................... 0.55 3.08 2.00 0.41 0.38 0.05 3.68 2.60 1.01 0.98 000 45540 ......... ............ A Correct rectal prolapse .................................. 17.98 NA NA 5.73 6.54 1.84 NA NA 25.55 26.36 090 45541 ......... ............ A Correct rectal prolapse .................................. 14.66 NA NA 5.96 5.96 1.55 NA NA 22.17 22.17 090 45550 ......... ............ A Repair rectum/remove sigmoid ..................... 24.61 NA NA 8.34 9.02 2.61 NA NA 35.56 36.24 090 45560 ......... ............ A Repair of rectocele ........................................ 11.38 NA NA 4.95 5.03 1.13 NA NA 17.46 17.54 090 45562 ......... ............ A Exploration/repair of rectum .......................... 17.74 NA NA 7.58 7.15 1.83 NA NA 27.15 26.72 090 45563 ......... ............ A Exploration/repair of rectum .......................... 26.14 NA NA 10.28 10.48 3.10 NA NA 39.52 39.72 090 45800 ......... ............ A Repair rect/bladder fistula ............................. 20.12 NA NA 8.67 7.75 1.85 NA NA 30.64 29.72 090 45805 ......... ............ A Repair fistula w/colostomy ............................ 23.13 NA NA 8.51 9.28 2.02 NA NA 33.66 34.43 090 45820 ......... ............ A Repair rectourethral fistula ............................ 20.18 NA NA 8.82 7.94 1.58 NA NA 30.58 29.70 090 45825 ......... ............ A Repair fistula w/colostomy ............................ 23.93 NA NA 10.39 9.98 2.31 NA NA 36.63 36.22 090 45900 ......... ............ A Reduction of rectal prolapse ......................... 2.94 NA NA 1.68 1.55 0.30 NA NA 4.92 4.79 010 45905 ......... ............ A Dilation of anal sphincter ............................... 2.30 NA NA 1.65 1.49 0.27 NA NA 4.22 4.06 010 45910 ......... ............ A Dilation of rectal narrowing ........................... 2.80 NA NA 1.81 1.70 0.30 NA NA 4.91 4.80 010 45915 ......... ............ A Remove rectal obstruction ............................ 3.14 4.26 4.31 2.04 2.09 0.30 7.70 7.75 5.48 5.53 010 45990 ......... ............ A Surg dx exam, anorectal ............................... 1.80 NA NA 0.78 0.79 0.17 NA NA 2.75 2.76 00046020 ......... ............ A Placement of seton ....................................... 2.90 3.27 2.57 2.35 1.98 0.31 6.48 5.78 5.56 5.19 010 46030 ......... ............ A Removal of rectal marker .............................. 1.23 1.89 1.49 0.81 0.74 0.14 3.26 2.86 2.18 2.11 010 46040 ......... ............ A Incision of rectal abscess .............................. 5.20 6.71 5.81 4.14 3.73 0.62 12.53 11.63 9.96 9.55 090 46045 ......... ............ A Incision of rectal abscess .............................. 5.75 NA NA 3.83 3.13 0.54 NA NA 10.12 9.42 090 46050 ......... ............ A Incision of anal abscess ................................ 1.19 3.19 2.71 0.97 0.87 0.14 4.52 4.04 2.30 2.20 010 46060 ......... ............ A Incision of rectal abscess .............................. 6.18 NA NA 3.82 3.39 0.67 NA NA 10.67 10.24 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37323 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

46070 ......... ............ A Incision of anal septum ................................. 2.71 NA NA 1.86 1.85 0.36 NA NA 4.93 4.92 090 46080 ......... ............ A Incision of anal sphincter .............................. 2.49 3.07 2.55 1.12 1.13 0.30 5.86 5.34 3.91 3.92 010 46083 ......... ............ A Incise external hemorrhoid ............................ 1.40 2.34 2.48 0.94 0.93 0.15 3.89 4.03 2.49 2.48 010 46200 ......... ............ A Removal of anal fissure ................................ 3.41 6.30 4.47 3.72 3.08 0.39 10.10 8.27 7.52 6.88 090 46210 ......... ............ A Removal of anal crypt ................................... 2.67 5.96 5.33 3.36 2.81 0.31 8.94 8.31 6.34 5.79 090 46211 ......... ............ A Removal of anal crypts ................................. 4.24 7.18 5.86 4.12 3.66 0.48 11.90 10.58 8.84 8.38 090 46220 ......... ............ A Removal of anal tag ...................................... 1.56 3.00 2.48 1.09 0.99 0.17 4.73 4.21 2.82 2.72 010 46221 ......... ............ A Ligation of hemorrhoid(s) .............................. 2.29 3.74 2.92 2.00 1.81 0.23 6.26 5.44 4.52 4.33 010 46230 ......... ............ A Removal of anal tags .................................... 2.57 3.50 3.19 1.32 1.30 0.30 6.37 6.06 4.19 4.17 010 46250 ......... ............ A Hemorrhoidectomy ........................................ 4.13 5.99 5.49 2.84 2.68 0.48 10.60 10.10 7.45 7.29 090 46255 ......... ............ A Hemorrhoidectomy ........................................ 4.84 6.41 5.99 3.10 2.91 0.58 11.83 11.41 8.52 8.33 090 46257 ......... ............ A Remove hemorrhoids & fissure ..................... 5.64 NA NA 3.22 2.97 0.64 NA NA 9.50 9.25 090 46258 ......... ............ A Remove hemorrhoids & fistula ...................... 6.22 NA NA 3.85 3.42 0.68 NA NA 10.75 10.32 090 46260 ......... ............ A Hemorrhoidectomy ........................................ 6.61 NA NA 3.46 3.26 0.76 NA NA 10.83 10.63 090 46261 ......... ............ A Remove hemorrhoids & fissure ..................... 7.57 NA NA 4.17 3.75 0.79 NA NA 12.53 12.11 090 46262 ......... ............ A Remove hemorrhoids & fistula ...................... 7.74 NA NA 4.09 3.83 0.83 NA NA 12.66 12.40 090 46270 ......... ............ A Removal of anal fistula .................................. 4.75 5.94 5.24 3.53 3.01 0.46 11.15 10.45 8.74 8.22 090 46275 ......... ............ A Removal of anal fistula .................................. 5.25 6.28 5.05 3.63 3.14 0.52 12.05 10.82 9.40 8.91 090 46280 ......... ............ A Removal of anal fistula .................................. 6.22 NA NA 3.79 3.39 0.66 NA NA 10.67 10.27 090 46285 ......... ............ A Removal of anal fistula .................................. 5.25 6.07 4.35 3.46 2.93 0.44 11.76 10.04 9.15 8.62 090 46288 ......... ............ A Repair anal fistula ......................................... 7.62 NA NA 4.09 3.78 0.79 NA NA 12.50 12.19 090 46320 ......... ............ A Removal of hemorrhoid clot .......................... 1.61 2.41 2.20 0.88 0.86 0.18 4.20 3.99 2.67 2.65 010 46500 ......... ............ A Injection into hemorrhoid(s) ........................... 1.61 3.61 2.49 1.24 1.17 0.16 5.38 4.26 3.01 2.94 010 46505 ......... ............ A Chemodenervation anal musc ...................... 3.11 3.28 3.11 2.29 2.05 0.14 6.53 6.36 5.54 5.30 010 46600 ......... ............ A Diagnostic anoscopy ..................................... 0.50 1.48 1.54 0.37 0.35 0.05 2.03 2.09 0.92 0.90 000 46604 ......... ............ A Anoscopy and dilation ................................... 1.31 12.66 10.03 0.58 0.61 0.12 14.09 11.46 2.01 2.04 000 46606 ......... ............ A Anoscopy and biopsy .................................... 0.81 4.01 3.85 0.47 0.44 0.09 4.91 4.75 1.37 1.34 000 46608 ......... ............ A Anoscopy, remove for body .......................... 1.51 4.04 4.32 0.61 0.64 0.16 5.71 5.99 2.28 2.31 000 46610 ......... ............ A Anoscopy, remove lesion .............................. 1.32 4.32 4.11 0.67 0.63 0.15 5.79 5.58 2.14 2.10 000 46611 ......... ............ A Anoscopy ....................................................... 1.81 2.88 3.23 0.72 0.77 0.19 4.88 5.23 2.72 2.77 000 46612 ......... ............ A Anoscopy, remove lesions ............................ 2.34 5.54 5.29 0.95 0.97 0.28 8.16 7.91 3.57 3.59 000 46614 ......... ............ A Anoscopy, control bleeding ........................... 2.01 2.79 2.45 0.83 0.84 0.20 5.00 4.66 3.04 3.05 000 46615 ......... ............ A Anoscopy ....................................................... 2.68 2.42 2.47 0.96 1.04 0.33 5.43 5.48 3.97 4.05 000 46700 ......... ............ A Repair of anal stricture .................................. 9.62 NA NA 4.55 4.30 0.94 NA NA 15.11 14.86 090 46705 ......... ............ A Repair of anal stricture .................................. 7.25 NA NA 3.55 3.66 0.91 NA NA 11.71 11.82 090 46706 ......... ............ A Repr of anal fistula w/glue ............................ 2.39 NA NA 1.44 1.30 0.28 NA NA 4.11 3.97 010 46710 ......... ............ A Repr per/vag pouch sngl proc ....................... 16.95 NA NA 7.70 7.75 1.38 NA NA 26.03 26.08 09046712 ......... ............ A Repr per/vag pouch dbl proc ........................ 36.26 NA NA 13.98 14.81 3.66 NA NA 53.90 54.73 090 46715 ......... ............ A Rep perf anoper fistu .................................... 7.49 NA NA 3.24 3.50 0.92 NA NA 11.65 11.91 090 46716 ......... ............ A Rep perf anoper/vestib fistu .......................... 17.04 NA NA 8.96 8.23 1.58 NA NA 27.58 26.85 090 46730 ......... ............ A Construction of absent anus ......................... 30.05 NA NA 10.92 11.77 2.46 NA NA 43.43 44.28 090 46735 ......... ............ A Construction of absent anus ......................... 35.54 NA NA 12.73 13.37 3.20 NA NA 51.47 52.11 090 46740 ......... ............ A Construction of absent anus ......................... 33.30 NA NA 13.86 13.41 2.41 NA NA 49.57 49.12 090 46742 ......... ............ A Repair of imperforated anus ......................... 39.54 NA NA 15.36 16.91 3.19 NA NA 58.09 59.64 090 46744 ......... ............ A Repair of cloacal anomaly ............................. 58.34 NA NA 20.47 21.00 6.38 NA NA 85.19 85.72 090 46746 ......... ............ A Repair of cloacal anomaly ............................. 64.79 NA NA 18.82 23.61 7.68 NA NA 91.29 96.08 090 46748 ......... ............ A Repair of cloacal anomaly ............................. 70.77 NA NA 20.16 22.82 3.36 NA NA 94.29 96.95 090 46750 ......... ............ A Repair of anal sphincter ................................ 11.96 NA NA 5.19 5.09 1.10 NA NA 18.25 18.15 090 46751 ......... ............ A Repair of anal sphincter ................................ 9.12 NA NA 3.91 5.05 0.94 NA NA 13.97 15.11 090 46753 ......... ............ A Reconstruction of anus ................................. 8.77 NA NA 4.01 3.89 0.94 NA NA 13.72 13.60 090 46754 ......... ............ A Removal of suture from anus ........................ 2.82 3.70 3.63 2.25 1.82 0.19 6.71 6.64 5.26 4.83 010 46760 ......... ............ A Repair of anal sphincter ................................ 17.11 NA NA 7.67 7.24 1.59 NA NA 26.37 25.94 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37324 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

46761 ......... ............ A Repair of anal sphincter ................................ 15.10 NA NA 5.83 5.97 1.43 NA NA 22.36 22.50 090 46762 ......... ............ A Implant artificial sphincter .............................. 14.58 NA NA 6.23 5.71 1.24 NA NA 22.05 21.53 090 46900 ......... ............ A Destruction, anal lesion(s) ............................. 1.91 3.62 2.85 1.29 1.28 0.17 5.70 4.93 3.37 3.36 010 46910 ......... ............ A Destruction, anal lesion(s) ............................. 1.86 3.88 3.15 1.19 1.09 0.19 5.93 5.20 3.24 3.14 010 46916 ......... ............ A Cryosurgery, anal lesion(s) ........................... 1.86 3.73 3.30 1.55 1.43 0.11 5.70 5.27 3.52 3.40 010 46917 ......... ............ A Laser surgery, anal lesions ........................... 1.86 8.71 9.04 1.20 1.14 0.21 10.78 11.11 3.27 3.21 010 46922 ......... ............ A Excision of anal lesion(s) .............................. 1.86 4.13 3.49 1.19 1.10 0.22 6.21 5.57 3.27 3.18 010 46924 ......... ............ A Destruction, anal lesion(s) ............................. 2.76 9.62 8.94 1.52 1.39 0.26 12.64 11.96 4.54 4.41 010 46934 ......... ............ A Destruction of hemorrhoids ........................... 3.75 5.42 5.17 2.80 2.92 0.32 9.49 9.24 6.87 6.99 090 46935 ......... ............ A Destruction of hemorrhoids ........................... 2.43 3.68 3.52 1.07 1.18 0.23 6.34 6.18 3.73 3.84 010 46936 ......... ............ A Destruction of hemorrhoids ........................... 3.68 6.25 5.22 2.64 2.54 0.34 10.27 9.24 6.66 6.56 090 46937 ......... ............ A Cryotherapy of rectal lesion .......................... 2.69 4.06 3.10 1.82 1.37 0.14 6.89 5.93 4.65 4.20 010 46938 ......... ............ A Cryotherapy of rectal lesion .......................... 4.65 5.81 4.45 3.63 3.20 0.58 11.04 9.68 8.86 8.43 090 46940 ......... ............ A Treatment of anal fissure .............................. 2.32 2.84 2.21 1.03 1.08 0.23 5.39 4.76 3.58 3.63 010 46942 ......... ............ A Treatment of anal fissure .............................. 2.04 2.81 2.08 0.95 1.00 0.19 5.04 4.31 3.18 3.23 010 46945 ......... ............ A Ligation of hemorrhoids ................................. 2.09 4.86 3.67 3.01 2.61 0.19 7.14 5.95 5.29 4.89 090 46946 ......... ............ A Ligation of hemorrhoids ................................. 2.58 4.70 3.97 2.69 2.47 0.27 7.55 6.82 5.54 5.32 090 46947 ......... ............ A Hemorrhoidopexy by stapling ........................ 5.45 NA NA 3.09 2.81 0.75 NA NA 9.29 9.01 090 47000 ......... ............ A Needle biopsy of liver .................................... 1.90 8.03 4.32 0.69 0.65 0.12 10.05 6.34 2.71 2.67 000 47001 ......... ............ A Needle biopsy, liver add-on .......................... 1.90 NA NA 0.48 0.61 0.25 NA NA 2.63 2.76 ZZZ 47010 ......... ............ A Open drainage, liver lesion ........................... 19.21 NA NA 8.30 8.38 1.80 NA NA 29.31 29.39 090 47011 ......... ............ A Percut drain, liver lesion ................................ 3.69 NA NA 1.30 1.23 0.22 NA NA 5.21 5.14 000 47015 ......... ............ A Inject/aspirate liver cyst ................................. 18.31 NA NA 7.77 7.57 1.83 NA NA 27.91 27.71 090 47100 ......... ............ A Wedge biopsy of liver .................................... 12.72 NA NA 6.19 6.09 1.53 NA NA 20.44 20.34 090 47120 ......... ............ A Partial removal of liver .................................. 38.74 NA NA 13.87 14.85 4.65 NA NA 57.26 58.24 090 47122 ......... ............ A Extensive removal of liver ............................. 59.29 NA NA 18.54 20.76 7.19 NA NA 85.02 87.24 090 47125 ......... ............ A Partial removal of liver .................................. 52.85 NA NA 16.83 18.88 6.45 NA NA 76.13 78.18 090 47130 ......... ............ A Partial removal of liver .................................. 57.00 NA NA 17.83 20.22 6.94 NA NA 81.77 84.16 090 47135 ......... ............ R Transplantation of liver .................................. 83.15 NA NA 27.52 30.57 9.93 NA NA 120.6 123.7 090 47136 ......... ............ R Transplantation of liver .................................. 70.25 NA NA 23.37 26.16 8.41 NA NA 102.0 104.8 090 47140 ......... ............ A Partial removal, donor liver ........................... 59.14 NA NA 21.53 22.13 5.17 NA NA 85.84 86.44 090 47141 ......... ............ A Partial removal, donor liver ........................... 71.17 NA NA 25.24 26.55 5.17 NA NA 101.6 102.9 090 47142 ......... ............ A Partial removal, donor liver ........................... 79.11 NA NA 27.24 28.97 5.17 NA NA 111.5 113.3 090 47146 ......... ............ A Prep donor liver/venous ................................ 6.00 NA NA 1.51 1.92 0.83 NA NA 8.34 8.75 XXX 47147 ......... ............ A Prep donor liver/arterial ................................. 7.00 NA NA 1.76 2.24 0.97 NA NA 9.73 10.21 XXX 47300 ......... ............ A Surgery for liver lesion .................................. 17.95 NA NA 7.50 7.31 1.98 NA NA 27.43 27.24 090 47350 ......... ............ A Repair liver wound ........................................ 22.30 NA NA 8.72 8.85 2.58 NA NA 33.60 33.73 090 47360 ......... ............ A Repair liver wound ........................................ 31.12 NA NA 11.32 11.53 3.37 NA NA 45.81 46.02 090 47361 ......... ............ A Repair liver wound ........................................ 52.41 NA NA 16.60 18.07 5.85 NA NA 74.86 76.33 090 47362 ......... ............ A Repair liver wound ........................................ 23.35 NA NA 9.10 8.83 2.50 NA NA 34.95 34.68 090 47370 ......... ............ A Laparo ablate liver tumor rf ........................... 20.61 NA NA 7.64 8.02 2.55 NA NA 30.80 31.18 090 47371 ......... ............ A Laparo ablate liver cryosurg .......................... 20.61 NA NA 8.10 8.15 2.60 NA NA 31.31 31.36 090 47380 ......... ............ A Open ablate liver tumor rf ............................. 24.37 NA NA 8.60 9.19 2.86 NA NA 35.83 36.42 090 47381 ......... ............ A Open ablate liver tumor cryo ......................... 24.64 NA NA 9.12 9.49 2.84 NA NA 36.60 36.97 090 47382 ......... ............ A Percut ablate liver rf ...................................... 15.17 NA NA 6.21 6.12 0.96 NA NA 22.34 22.25 010 47400 ......... ............ A Incision of liver duct ...................................... 36.17 NA NA 13.15 13.39 3.07 NA NA 52.39 52.63 090 47420 ......... ............ A Incision of bile duct ....................................... 21.86 NA NA 8.44 8.70 2.62 NA NA 32.92 33.18 090 47425 ......... ............ A Incision of bile duct ....................................... 22.14 NA NA 8.48 8.74 2.61 NA NA 33.23 33.49 090 47460 ......... ............ A Incise bile duct sphincter ............................... 20.35 NA NA 9.00 8.54 2.20 NA NA 31.55 31.09 090 47480 ......... ............ A Incision of gallbladder ................................... 13.06 NA NA 6.55 6.08 1.42 NA NA 21.03 20.56 090 47490 ......... ............ A Incision of gallbladder ................................... 8.00 NA NA 5.29 5.51 0.43 NA NA 13.72 13.94 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37325 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

47500 ......... ............ A Injection for liver x-rays ................................. 1.96 NA NA 0.70 0.66 0.12 NA NA 2.78 2.74 000 47505 ......... ............ A Injection for liver x-rays ................................. 0.76 NA NA 0.27 0.26 0.04 NA NA 1.07 1.06 000 47510 ......... ............ A Insert catheter, bile duct ................................ 7.88 NA NA 4.69 4.94 0.46 NA NA 13.03 13.28 090 47511 ......... ............ A Insert bile duct drain ...................................... 10.72 NA NA 5.09 5.09 0.62 NA NA 16.43 16.43 090 47525 ......... ............ A Change bile duct catheter ............................. 5.54 15.68 15.27 2.74 2.79 0.33 21.55 21.14 8.61 8.66 010 47530 ......... ............ A Revise/reinsert bile tube ................................ 5.90 32.21 33.46 3.52 3.67 0.37 38.48 39.73 9.79 9.94 090 47550 ......... ............ A Bile duct endoscopy add-on .......................... 3.02 NA NA 0.77 0.96 0.40 NA NA 4.19 4.38 ZZZ 47552 ......... ............ A Biliary endoscopy thru skin ........................... 6.03 NA NA 2.52 2.42 0.42 NA NA 8.97 8.87 00047553 ......... ............ A Biliary endoscopy thru skin ........................... 6.34 NA NA 2.25 2.12 0.37 NA NA 8.96 8.83 00047554 ......... ............ A Biliary endoscopy thru skin ........................... 9.05 NA NA 3.27 3.34 0.96 NA NA 13.28 13.35 000 47555 ......... ............ A Biliary endoscopy thru skin ........................... 7.55 NA NA 2.76 2.54 0.45 NA NA 10.76 10.54 000 47556 ......... ............ A Biliary endoscopy thru skin ........................... 8.55 NA NA 3.07 2.86 0.50 NA NA 12.12 11.91 000 47560 ......... ............ A Laparoscopy w/cholangio .............................. 4.88 NA NA 1.24 1.56 0.65 NA NA 6.77 7.09 000 47561 ......... ............ A Laparo w/cholangio/biopsy ............................ 5.17 NA NA 1.55 1.83 0.66 NA NA 7.38 7.66 000 47562 ......... ............ A Laparoscopic cholecystectomy ..................... 11.57 NA NA 4.87 4.96 1.46 NA NA 17.90 17.99 090 47563 ......... ............ A Laparo cholecystectomy/graph ..................... 11.98 NA NA 5.06 5.25 1.58 NA NA 18.62 18.81 090 47564 ......... ............ A Laparo cholecystectomy/explr ....................... 14.21 NA NA 5.42 5.83 1.88 NA NA 21.51 21.92 09047570 ......... ............ A Laparo cholecystoenterostomy ..................... 12.56 NA NA 5.04 5.30 1.65 NA NA 19.25 19.51 090 47600 ......... ............ A Removal of gallbladder ................................. 15.44 NA NA 6.12 6.14 1.79 NA NA 23.35 23.37 090 47605 ......... ............ A Removal of gallbladder ................................. 15.86 NA NA 6.24 6.44 1.94 NA NA 24.04 24.24 090 47610 ......... ............ A Removal of gallbladder ................................. 20.80 NA NA 7.54 7.84 2.48 NA NA 30.82 31.12 090 47612 ......... ............ A Removal of gallbladder ................................. 21.09 NA NA 7.55 7.81 2.47 NA NA 31.11 31.37 090 47620 ......... ............ A Removal of gallbladder ................................. 22.95 NA NA 8.05 8.41 2.73 NA NA 33.73 34.09 090 47630 ......... ............ A Remove bile duct stone ................................ 9.52 NA NA 4.86 4.88 0.65 NA NA 15.03 15.05 090 47700 ......... ............ A Exploration of bile ducts ................................ 16.32 NA NA 7.11 7.34 2.06 NA NA 25.49 25.72 090 47701 ......... ............ A Bile duct revision ........................................... 28.55 NA NA 9.85 11.09 3.67 NA NA 42.07 43.31 090 47711 ......... ............ A Excision of bile duct tumor ............................ 25.71 NA NA 9.40 9.81 3.04 NA NA 38.15 38.56 090 47712 ......... ............ A Excision of bile duct tumor ............................ 33.53 NA NA 11.36 12.17 3.92 NA NA 48.81 49.62 090 47715 ......... ............ A Excision of bile duct cyst ............................... 21.36 NA NA 8.40 8.43 2.48 NA NA 32.24 32.27 090 47716 ......... ............ A Fusion of bile duct cyst ................................. 19.01 NA NA 7.73 7.81 2.14 NA NA 28.88 28.96 090 47720 ......... ............ A Fuse gallbladder & bowel .............................. 18.15 NA NA 7.57 7.50 2.10 NA NA 27.82 27.75 090 47721 ......... ............ A Fuse upper gi structures ............................... 21.80 NA NA 8.44 8.54 2.52 NA NA 32.76 32.86 090 47740 ......... ............ A Fuse gallbladder & bowel .............................. 21.04 NA NA 8.33 8.37 2.41 NA NA 31.78 31.82 090 47741 ......... ............ A Fuse gallbladder & bowel .............................. 24.02 NA NA 9.08 9.25 2.82 NA NA 35.92 36.09 090 47760 ......... ............ A Fuse bile ducts and bowel ............................ 38.08 NA NA 12.57 11.29 3.41 NA NA 54.06 52.78 090 47765 ......... ............ A Fuse liver ducts & bowel ............................... 51.95 NA NA 16.38 12.20 3.29 NA NA 71.62 67.44 090 47780 ......... ............ A Fuse bile ducts and bowel ............................ 42.08 NA NA 13.80 11.87 3.49 NA NA 59.37 57.44 090 47785 ......... ............ A Fuse bile ducts and bowel ............................ 55.95 NA NA 17.31 14.03 4.09 NA NA 77.35 74.07 090 47800 ......... ............ A Reconstruction of bile ducts .......................... 25.98 NA NA 9.56 9.94 3.07 NA NA 38.61 38.99 090 47801 ......... ............ A Placement, bile duct support ......................... 17.41 NA NA 8.57 8.26 1.16 NA NA 27.14 26.83 090 47802 ......... ............ A Fuse liver duct & intestine ............................. 24.74 NA NA 9.35 9.60 2.85 NA NA 36.94 37.19 090 47900 ......... ............ A Suture bile duct injury ................................... 22.25 NA NA 8.56 8.80 2.64 NA NA 33.45 33.69 090 48000 ......... ............ A Drainage of abdomen .................................... 31.76 NA NA 10.94 11.38 3.47 NA NA 46.17 46.61 090 48001 ......... ............ A Placement of drain, pancreas ....................... 39.50 NA NA 12.54 13.56 4.68 NA NA 56.72 57.74 090 48005 ......... ............ A Resect/debride pancreas .............................. 48.97 NA NA 15.75 16.38 5.54 NA NA 70.26 70.89 090 48020 ......... ............ A Removal of pancreatic stone ........................ 18.90 NA NA 7.43 7.34 2.12 NA NA 28.45 28.36 09048100 ......... ............ A Biopsy of pancreas, open ............................. 14.34 NA NA 5.79 5.65 1.62 NA NA 21.75 21.61 090 48102 ......... ............ A Needle biopsy, pancreas ............................... 4.67 10.07 8.50 1.91 1.94 0.28 15.02 13.45 6.86 6.89 010 48120 ......... ............ A Removal of pancreas lesion .......................... 18.29 NA NA 6.76 6.84 2.09 NA NA 27.14 27.22 090 48140 ......... ............ A Partial removal of pancreas .......................... 26.13 NA NA 9.21 9.47 3.02 NA NA 38.36 38.62 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37326 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

48145 ......... ............ A Partial removal of pancreas .......................... 27.20 NA NA 9.56 9.77 3.17 NA NA 39.93 40.14 090 48146 ......... ............ A Pancreatectomy ............................................ 30.34 NA NA 11.72 11.93 3.49 NA NA 45.55 45.76 090 48148 ......... ............ A Removal of pancreatic duct .......................... 20.20 NA NA 7.93 7.69 2.29 NA NA 30.42 30.18 090 48150 ......... ............ A Partial removal of pancreas .......................... 52.55 NA NA 17.87 19.12 6.30 NA NA 76.72 77.97 090 48152 ......... ............ A Pancreatectomy ............................................ 48.39 NA NA 16.44 17.78 5.78 NA NA 70.61 71.95 090 48153 ......... ............ A Pancreatectomy ............................................ 52.53 NA NA 17.71 19.11 6.29 NA NA 76.53 77.93 090 48154 ......... ............ A Pancreatectomy ............................................ 48.62 NA NA 16.73 17.88 5.82 NA NA 71.17 72.32 090 48155 ......... ............ A Removal of pancreas .................................... 29.19 NA NA 11.82 11.72 3.26 NA NA 44.27 44.17 090 48180 ......... ............ A Fuse pancreas and bowel ............................. 27.90 NA NA 9.76 10.07 3.27 NA NA 40.93 41.24 090 48400 ......... ............ A Injection, intraop add-on ................................ 1.95 NA NA 0.88 0.70 0.15 NA NA 2.98 2.80 ZZZ 48500 ......... ............ A Surgery of pancreatic cyst ............................ 17.97 NA NA 7.95 7.49 2.02 NA NA 27.94 27.48 090 48510 ......... ............ A Drain pancreatic pseudocyst ......................... 17.00 NA NA 7.48 7.46 1.82 NA NA 26.30 26.28 090 48511 ......... ............ A Drain pancreatic pseudocyst ......................... 3.99 21.19 21.01 1.41 1.34 0.24 25.42 25.24 5.64 5.57 000 48520 ......... ............ A Fuse pancreas cyst and bowel ..................... 18.03 NA NA 6.63 6.69 2.05 NA NA 26.71 26.77 090 48540 ......... ............ A Fuse pancreas cyst and bowel ..................... 21.82 NA NA 7.59 7.99 2.60 NA NA 32.01 32.41 090 48545 ......... ............ A Pancreatorrhaphy .......................................... 22.04 NA NA 7.98 7.99 2.37 NA NA 32.39 32.40 090 48547 ......... ............ A Duodenal exclusion ....................................... 30.19 NA NA 10.16 10.42 3.41 NA NA 43.76 44.02 090 48552 ......... ............ A Prep donor pancreas/venous ........................ 4.30 NA NA 1.13 1.38 0.31 NA NA 5.74 5.99 XXX 48554 ......... ............ R Transpl allograft pancreas ............................. 36.77 NA NA 20.52 18.86 4.18 NA NA 61.47 59.81 090 48556 ......... ............ A Removal, allograft pancreas ......................... 19.16 NA NA 9.41 8.41 2.07 NA NA 30.64 29.64 090 49000 ......... ............ A Exploration of abdomen ................................ 12.40 NA NA 5.20 5.34 1.52 NA NA 19.12 19.26 090 49002 ......... ............ A Reopening of abdomen ................................. 17.51 NA NA 6.65 5.43 1.37 NA NA 25.53 24.31 090 49010 ......... ............ A Exploration behind abdomen ........................ 15.94 NA NA 6.63 6.09 1.51 NA NA 24.08 23.54 090 49020 ......... ............ A Drain abdominal abscess .............................. 26.38 NA NA 9.92 10.14 2.84 NA NA 39.14 39.36 090 49021 ......... ............ A Drain abdominal abscess .............................. 3.37 20.65 21.00 1.19 1.13 0.20 24.22 24.57 4.76 4.70 000 49040 ......... ............ A Drain, open, abdom abscess ........................ 16.35 NA NA 6.53 6.46 1.69 NA NA 24.57 24.50 090 49041 ......... ............ A Drain, percut, abdom abscess ...................... 3.99 20.90 19.90 1.41 1.34 0.24 25.13 24.13 5.64 5.57 000 49060 ......... ............ A Drain, open, retrop abscess .......................... 18.36 NA NA 7.38 7.43 1.74 NA NA 27.48 27.53 090 49061 ......... ............ A Drain, percut, retroper absc .......................... 3.69 20.77 19.95 1.31 1.24 0.22 24.68 23.86 5.22 5.15 000 49062 ......... ............ A Drain to peritoneal cavity .............................. 12.08 NA NA 5.27 5.40 1.39 NA NA 18.74 18.87 090 49080 ......... ............ A Puncture, peritoneal cavity ............................ 1.35 2.84 3.70 0.48 0.47 0.08 4.27 5.13 1.91 1.90 000 49081 ......... ............ A Removal of abdominal fluid ........................... 1.26 3.04 2.70 0.47 0.44 0.09 4.39 4.05 1.82 1.79 000 49085 ......... ............ A Remove abdomen foreign body .................... 13.97 NA NA 5.56 5.52 1.62 NA NA 21.15 21.11 090 49180 ......... ............ A Biopsy, abdominal mass ............................... 1.73 2.57 2.98 0.61 0.58 0.10 4.40 4.81 2.44 2.41 000 49200 ......... ............ A Removal of abdominal lesion ........................ 10.89 NA NA 4.88 4.99 1.24 NA NA 17.01 17.12 09049201 ......... ............ A Remove abdom lesion, complex ................... 15.60 NA NA 6.39 6.88 1.87 NA NA 23.86 24.35 090 49215 ......... ............ A Excise sacral spine tumor ............................. 37.60 NA NA 12.46 13.68 4.37 NA NA 54.43 55.65 090 49220 ......... ............ A Multiple surgery, abdomen ............................ 15.64 NA NA 6.23 6.54 1.88 NA NA 23.75 24.06 090 49250 ......... ............ A Excision of umbilicus ..................................... 8.88 NA NA 4.27 4.27 1.08 NA NA 14.23 14.23 090 49255 ......... ............ A Removal of omentum .................................... 12.35 NA NA 5.61 5.62 1.43 NA NA 19.39 19.40 090 49320 ......... ............ A Diag laparo separate proc ............................. 5.34 NA NA 2.50 2.61 0.65 NA NA 8.49 8.60 01049321 ......... ............ A Laparoscopy, biopsy ..................................... 5.39 NA NA 2.55 2.63 0.70 NA NA 8.64 8.72 010 49322 ......... ............ A Laparoscopy, aspiration ................................ 5.94 NA NA 2.62 2.91 0.71 NA NA 9.27 9.56 010 49323 ......... ............ A Laparo drain lymphocele ............................... 10.09 NA NA 4.70 4.55 1.20 NA NA 15.99 15.84 090 49400 ......... ............ A Air injection into abdomen ............................. 1.88 2.55 2.95 0.62 0.62 0.15 4.58 4.98 2.65 2.65 000 49419 ......... ............ A Insrt abdom cath for chemotx ....................... 7.01 NA NA 3.54 3.56 0.81 NA NA 11.36 11.38 090 49420 ......... ............ A Insert abdom drain, temp .............................. 2.22 NA NA 1.21 1.12 0.21 NA NA 3.64 3.55 00049421 ......... ............ A Insert abdom drain, perm .............................. 5.83 NA NA 3.17 3.16 0.74 NA NA 9.74 9.73 09049422 ......... ............ A Remove perm cannula/catheter .................... 6.24 NA NA 2.64 2.84 0.83 NA NA 9.71 9.91 010 49423 ......... ............ A Exchange drainage catheter ......................... 1.46 13.85 14.05 0.56 0.53 0.09 15.40 15.60 2.11 2.08 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37327 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

49424 ......... ............ A Assess cyst, contrast inject ........................... 0.76 3.24 3.60 0.30 0.29 0.04 4.04 4.40 1.10 1.09 000 49425 ......... ............ A Insert abdomen-venous drain ....................... 12.07 NA NA 5.31 5.54 1.54 NA NA 18.92 19.15 090 49426 ......... ............ A Revise abdomen-venous shunt ..................... 10.28 NA NA 4.55 4.72 1.28 NA NA 16.11 16.28 090 49427 ......... ............ A Injection, abdominal shunt ............................ 0.89 NA NA 0.31 0.30 0.07 NA NA 1.27 1.26 00049428 ......... ............ A Ligation of shunt ............................................ 6.75 NA NA 3.04 3.71 0.80 NA NA 10.59 11.26 010 49429 ......... ............ A Removal of shunt .......................................... 7.39 NA NA 3.01 3.33 1.02 NA NA 11.42 11.74 010 49491 ......... ............ A Rpr hern preemie reduc ................................ 12.36 NA NA 5.39 5.14 1.40 NA NA 19.15 18.90 090 49492 ......... ............ A Rpr ing hern premie, blocked ........................ 15.26 NA NA 5.76 6.03 1.80 NA NA 22.82 23.09 090 49495 ......... ............ A Rpr ing hernia baby, reduc ........................... 6.13 NA NA 2.97 2.96 0.74 NA NA 9.84 9.83 090 49496 ......... ............ A Rpr ing hernia baby, blocked ........................ 9.28 NA NA 4.36 4.30 1.07 NA NA 14.71 14.65 09049500 ......... ............ A Rpr ing hernia, init, reduce ............................ 5.72 NA NA 3.57 3.23 0.71 NA NA 10.00 9.66 090 49501 ......... ............ A Rpr ing hernia, init blocked ........................... 9.24 NA NA 4.24 4.22 1.12 NA NA 14.60 14.58 090 49505 ......... ............ A Prp i/hern init reduc >5 yr ............................. 7.84 NA NA 3.88 3.78 1.03 NA NA 12.75 12.65 090 49507 ......... ............ A Prp i/hern init block >5 yr .............................. 9.93 NA NA 4.45 4.46 1.27 NA NA 15.65 15.66 090 49520 ......... ............ A Rerepair ing hernia, reduce .......................... 9.87 NA NA 4.37 4.42 1.28 NA NA 15.52 15.57 090 49521 ......... ............ A Rerepair ing hernia, blocked ......................... 12.32 NA NA 4.98 5.18 1.59 NA NA 18.89 19.09 090 49525 ......... ............ A Repair ing hernia, sliding .............................. 8.81 NA NA 4.13 4.09 1.13 NA NA 14.07 14.03 090 49540 ......... ............ A Repair lumbar hernia ..................................... 10.62 NA NA 4.63 4.72 1.37 NA NA 16.62 16.71 090 49550 ......... ............ A Rpr rem hernia, init, reduce .......................... 8.87 NA NA 4.10 4.12 1.14 NA NA 14.11 14.13 090 49553 ......... ............ A Rpr fem hernia, init blocked .......................... 9.80 NA NA 4.40 4.42 1.24 NA NA 15.44 15.46 090 49555 ......... ............ A Rerepair fem hernia, reduce ......................... 9.27 NA NA 4.21 4.26 1.20 NA NA 14.68 14.73 09049557 ......... ............ A Rerepair fem hernia, blocked ........................ 11.50 NA NA 4.84 4.95 1.47 NA NA 17.81 17.92 090 49560 ......... ............ A Rpr ventral hern init, reduc ........................... 11.80 NA NA 4.86 5.08 1.52 NA NA 18.18 18.40 090 49561 ......... ............ A Rpr ventral hern init, block ............................ 15.26 NA NA 5.79 6.00 1.88 NA NA 22.93 23.14 090 49565 ......... ............ A Rerepair ventrl hern, reduce ......................... 12.25 NA NA 5.10 5.20 1.52 NA NA 18.87 18.97 090 49566 ......... ............ A Rerepair ventrl hern, block ............................ 15.41 NA NA 5.84 6.07 1.90 NA NA 23.15 23.38 090 49568 ......... ............ A Hernia repair w/mesh .................................... 4.88 NA NA 1.24 1.56 0.64 NA NA 6.76 7.08 ZZZ 49570 ......... ............ A Rpr epigastric hern, reduce ........................... 5.93 NA NA 3.33 3.21 0.75 NA NA 10.01 9.89 090 49572 ......... ............ A Rpr epigastric hern, blocked ......................... 7.75 NA NA 3.82 3.56 0.88 NA NA 12.45 12.19 090 49580 ......... ............ A Rpr umbil hern, reduc < 5 yr ......................... 4.35 NA NA 3.00 2.70 0.54 NA NA 7.89 7.59 090 49582 ......... ............ A Rpr umbil hern, block < 5 yr ......................... 7.01 NA NA 3.60 3.50 0.88 NA NA 11.49 11.39 090 49585 ......... ............ A Rpr umbil hern, reduc > 5 yr ......................... 6.47 NA NA 3.51 3.35 0.82 NA NA 10.80 10.64 090 49587 ......... ............ A Rpr umbil hern, block > 5 yr ......................... 7.92 NA NA 3.86 3.77 0.99 NA NA 12.77 12.68 090 49590 ......... ............ A Repair spigelian hernia ................................. 8.78 NA NA 4.09 4.09 1.13 NA NA 14.00 14.00 090 49600 ......... ............ A Repair umbilical lesion .................................. 11.42 NA NA 5.18 5.30 1.32 NA NA 17.92 18.04 090 49605 ......... ............ A Repair umbilical lesion .................................. 86.79 NA NA 26.31 28.01 9.36 NA NA 122.5 124.2 090 49606 ......... ............ A Repair umbilical lesion .................................. 18.87 NA NA 6.57 7.42 2.45 NA NA 27.89 28.74 090 49610 ......... ............ A Repair umbilical lesion .................................. 10.78 NA NA 4.75 5.10 1.07 NA NA 16.60 16.95 090 49611 ......... ............ A Repair umbilical lesion .................................. 9.21 NA NA 3.87 6.21 0.78 NA NA 13.86 16.20 090 49650 ......... ............ A Laparo hernia repair initial ............................ 6.26 NA NA 3.34 3.24 0.93 NA NA 10.53 10.43 090 49651 ......... ............ A Laparo hernia repair recur ............................ 8.23 NA NA 4.16 4.08 1.14 NA NA 13.53 13.45 090 49900 ......... ............ A Repair of abdominal wall ............................... 12.26 NA NA 6.26 6.25 1.62 NA NA 20.14 20.13 090 49904 ......... ............ A Omental flap, extra-abdom ............................ 22.06 NA NA 11.99 14.44 2.69 NA NA 36.74 39.19 090 49905 ......... ............ A Omental flap, intra-abdom ............................. 6.54 NA NA 1.72 2.16 0.75 NA NA 9.01 9.45 ZZZ50010 ......... ............ A Exploration of kidney ..................................... 12.07 NA NA 7.02 5.68 0.93 NA NA 20.02 18.68 090 50020 ......... ............ A Renal abscess, open drain ........................... 17.80 NA NA 8.80 8.02 1.34 NA NA 27.94 27.16 090 50021 ......... ............ A Renal abscess, percut drain ......................... 3.37 22.24 21.84 1.21 1.13 0.20 25.81 25.41 4.78 4.70 000 50040 ......... ............ A Drainage of kidney ........................................ 16.40 NA NA 9.23 7.42 1.03 NA NA 26.66 24.85 090 50045 ......... ............ A Exploration of kidney ..................................... 16.61 NA NA 8.73 7.14 1.24 NA NA 26.58 24.99 090 50060 ......... ............ A Removal of kidney stone ............................... 20.74 NA NA 11.44 8.74 1.36 NA NA 33.54 30.84 090 50065 ......... ............ A Incision of kidney ........................................... 22.11 NA NA 12.04 7.58 1.59 NA NA 35.74 31.28 090 50070 ......... ............ A Incision of kidney ........................................... 21.64 NA NA 11.85 9.14 1.44 NA NA 34.93 32.22 090 50075 ......... ............ A Removal of kidney stone ............................... 26.83 NA NA 14.21 10.99 1.80 NA NA 42.84 39.62 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37328 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

50080 ......... ............ A Removal of kidney stone ............................... 15.55 NA NA 8.91 6.95 1.04 NA NA 25.50 23.54 090 50081 ......... ............ A Removal of kidney stone ............................... 23.24 NA NA 12.70 9.76 1.54 NA NA 37.48 34.54 090 50100 ......... ............ A Revise kidney blood vessels ......................... 17.24 NA NA 7.21 7.65 2.06 NA NA 26.51 26.95 090 50120 ......... ............ A Exploration of kidney ..................................... 17.00 NA NA 9.16 7.38 1.21 NA NA 27.37 25.59 090 50125 ......... ............ A Explore and drain kidney .............................. 17.61 NA NA 10.15 7.77 1.43 NA NA 29.19 26.81 090 50130 ......... ............ A Removal of kidney stone ............................... 18.61 NA NA 10.41 7.99 1.22 NA NA 30.24 27.82 090 50135 ......... ............ A Exploration of kidney ..................................... 20.38 NA NA 11.11 8.62 1.33 NA NA 32.82 30.33 090 50200 ......... ............ A Biopsy of kidney ............................................ 2.63 NA NA 1.19 1.27 0.16 NA NA 3.98 4.06 000 50205 ......... ............ A Biopsy of kidney ............................................ 12.15 NA NA 5.62 5.17 1.30 NA NA 19.07 18.62 090 50220 ......... ............ A Remove kidney, open ................................... 18.47 NA NA 9.89 7.91 1.35 NA NA 29.71 27.73 090 50225 ......... ............ A Removal kidney open, complex .................... 21.67 NA NA 11.46 8.99 1.50 NA NA 34.63 32.16 090 50230 ......... ............ A Removal kidney open, radical ....................... 23.62 NA NA 12.16 9.48 1.55 NA NA 37.33 34.65 090 50234 ......... ............ A Removal of kidney & ureter .......................... 23.84 NA NA 12.56 9.78 1.59 NA NA 37.99 35.21 090 50236 ......... ............ A Removal of kidney & ureter .......................... 26.66 NA NA 14.52 11.33 1.76 NA NA 42.94 39.75 090 50240 ......... ............ A Partial removal of kidney ............................... 23.93 NA NA 13.15 10.06 1.55 NA NA 38.63 35.54 090 50250 ......... ............ A Cryoablate renal mass open ......................... 21.98 NA NA 11.56 9.78 1.39 NA NA 34.93 33.15 090 50280 ......... ............ A Removal of kidney lesion .............................. 16.88 NA NA 9.60 7.43 1.19 NA NA 27.67 25.50 090 50290 ......... ............ A Removal of kidney lesion .............................. 15.94 NA NA 8.37 6.95 1.41 NA NA 25.72 24.30 090 50320 ......... ............ A Remove kidney, living donor ......................... 22.18 NA NA 12.63 11.17 2.35 NA NA 37.16 35.70 090 50327 ......... ............ A Prep renal graft/venous ................................. 4.00 NA NA 1.09 1.29 0.29 NA NA 5.38 5.58 XXX 50328 ......... ............ A Prep renal graft/arterial ................................. 3.50 NA NA 0.97 1.13 0.26 NA NA 4.73 4.89 XXX 50329 ......... ............ A Prep renal graft/ureteral ................................ 3.34 NA NA 0.99 1.10 0.25 NA NA 4.58 4.69 XXX 50340 ......... ............ A Removal of kidney ......................................... 13.78 NA NA 7.64 6.79 1.65 NA NA 23.07 22.22 090 50360 ......... ............ A Transplantation of kidney .............................. 40.27 NA NA 18.85 16.35 3.81 NA NA 62.93 60.43 090 50365 ......... ............ A Transplantation of kidney .............................. 45.49 NA NA 19.38 18.53 4.42 NA NA 69.29 68.44 090 50370 ......... ............ A Remove transplanted kidney ......................... 18.60 NA NA 9.32 7.70 1.67 NA NA 29.59 27.97 09050380 ......... ............ A Reimplantation of kidney ............................... 29.47 NA NA 16.48 13.16 2.50 NA NA 48.45 45.13 090 50382 ......... ............ A Change ureter stent, percut .......................... 5.50 27.61 34.07 2.04 1.91 0.34 33.45 39.91 7.88 7.75 000 50384 ......... ............ A Remove ureter stent, percut ......................... 5.00 26.44 33.10 1.86 1.75 0.31 31.75 38.41 7.17 7.06 000 50387 ......... ............ A Change ext/int ureter stent ............................ 2.00 13.31 17.02 0.73 0.69 0.12 15.43 19.14 2.85 2.81 000 50389 ......... ............ A Remove renal tube w/fluoro .......................... 1.10 7.05 11.35 0.40 0.38 0.07 8.22 12.52 1.57 1.55 000 50390 ......... ............ A Drainage of kidney lesion .............................. 1.96 NA NA 0.70 0.66 0.12 NA NA 2.78 2.74 000 50391 ......... ............ A Instll rx agnt into rnal tub .............................. 1.96 1.55 1.57 0.82 0.68 0.14 3.65 3.67 2.92 2.78 000 50392 ......... ............ A Insert kidney drain ......................................... 3.37 NA NA 1.53 1.52 0.20 NA NA 5.10 5.09 000 50393 ......... ............ A Insert ureteral tube ........................................ 4.15 NA NA 1.81 1.80 0.25 NA NA 6.21 6.20 000 50394 ......... ............ A Injection for kidney x-ray ............................... 0.76 1.97 2.51 0.60 0.65 0.05 2.78 3.32 1.41 1.46 000 50395 ......... ............ A Create passage to kidney ............................. 3.37 NA NA 1.59 1.52 0.21 NA NA 5.17 5.10 000 50396 ......... ............ A Measure kidney pressure .............................. 2.09 NA NA 1.10 1.09 0.13 NA NA 3.32 3.31 000 50398 ......... ............ A Change kidney tube ...................................... 1.46 12.52 15.40 0.57 0.53 0.09 14.07 16.95 2.12 2.08 000 50400 ......... ............ A Revision of kidney/ureter ............................... 21.06 NA NA 11.45 8.78 1.38 NA NA 33.89 31.22 090 50405 ......... ............ A Revision of kidney/ureter ............................... 25.60 NA NA 13.53 10.17 1.78 NA NA 40.91 37.55 090 50500 ......... ............ A Repair of kidney wound ................................ 21.01 NA NA 9.37 8.64 2.01 NA NA 32.39 31.66 090 50520 ......... ............ A Close kidney-skin fistula ................................ 18.67 NA NA 9.59 7.98 1.49 NA NA 29.75 28.14 090 50525 ......... ............ A Repair renal-abdomen fistula ........................ 24.13 NA NA 11.13 9.55 1.83 NA NA 37.09 35.51 090 50526 ......... ............ A Repair renal-abdomen fistula ........................ 26.05 NA NA 7.99 9.41 1.96 NA NA 36.00 37.42 090 50540 ......... ............ A Revision of horseshoe kidney ....................... 20.89 NA NA 11.09 9.03 1.36 NA NA 33.34 31.28 090 50541 ......... ............ A Laparo ablate renal cyst ................................ 16.72 NA NA 9.08 7.15 1.13 NA NA 26.93 25.00 090 50542 ......... ............ A Laparo ablate renal mass ............................. 21.12 NA NA 11.61 9.02 1.39 NA NA 34.12 31.53 090 50543 ......... ............ A Laparo partial nephrectomy .......................... 27.10 NA NA 14.62 11.32 1.80 NA NA 43.52 40.22 090 50544 ......... ............ A Laparoscopy, pyeloplasty .............................. 23.23 NA NA 11.87 9.37 1.58 NA NA 36.68 34.18 090 50545 ......... ............ A Laparo radical nephrectomy .......................... 24.89 NA NA 12.72 10.09 1.70 NA NA 39.31 36.68 090 50546 ......... ............ A Laparoscopic nephrectomy ........................... 21.63 NA NA 11.70 9.21 1.57 NA NA 34.90 32.41 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37329 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

50547 ......... ............ A Laparo removal donor kidney ....................... 26.20 NA NA 12.68 11.52 2.76 NA NA 41.64 40.48 090 50548 ......... ............ A Laparo remove w/ureter ................................ 25.22 NA NA 12.65 10.06 1.72 NA NA 39.59 37.00 090 50551 ......... ............ A Kidney endoscopy ......................................... 5.59 4.73 4.30 2.74 2.17 0.40 10.72 10.29 8.73 8.16 000 50553 ......... ............ A Kidney endoscopy ......................................... 5.98 4.65 4.44 2.70 2.31 0.39 11.02 10.81 9.07 8.68 000 50555 ......... ............ A Kidney endoscopy & biopsy .......................... 6.52 5.27 4.93 3.13 2.54 0.45 12.24 11.90 10.10 9.51 000 50557 ......... ............ A Kidney endoscopy & treatment ..................... 6.61 5.42 4.80 3.16 2.52 0.47 12.50 11.88 10.24 9.60 000 50561 ......... ............ A Kidney endoscopy & treatment ..................... 7.58 5.99 5.32 3.56 2.88 0.54 14.11 13.44 11.68 11.00 000 50562 ......... ............ A Renal scope w/tumor resect ......................... 10.90 NA NA 5.59 4.64 0.73 NA NA 17.22 16.27 09050570 ......... ............ A Kidney endoscopy ......................................... 9.53 NA NA 4.41 3.52 0.68 NA NA 14.62 13.73 000 50572 ......... ............ A Kidney endoscopy ......................................... 10.33 NA NA 4.75 3.82 0.85 NA NA 15.93 15.00 000 50574 ......... ............ A Kidney endoscopy & biopsy .......................... 11.00 NA NA 5.03 4.07 0.77 NA NA 16.80 15.84 00050575 ......... ............ A Kidney endoscopy ......................................... 13.96 NA NA 6.25 5.04 0.99 NA NA 21.20 19.99 000 50576 ......... ............ A Kidney endoscopy & treatment ..................... 10.97 NA NA 5.02 4.01 0.78 NA NA 16.77 15.76 000 50580 ......... ............ A Kidney endoscopy & treatment ..................... 11.84 NA NA 5.34 4.31 0.83 NA NA 18.01 16.98 000 50590 ......... ............ A Fragmenting of kidney stone ......................... 9.58 17.79 13.77 6.49 4.71 0.65 28.02 24.00 16.72 14.94 090 50592 ......... ............ A Perc rf ablate renal tumor ............................. 6.75 79.58 132.0 2.99 2.99 0.43 86.76 139.2 10.17 10.17 010 50600 ......... ............ A Exploration of ureter ...................................... 16.98 NA NA 8.78 7.21 1.13 NA NA 26.89 25.32 090 50605 ......... ............ A Insert ureteral support ................................... 16.60 NA NA 8.15 7.10 1.45 NA NA 26.20 25.15 090 50610 ......... ............ A Removal of ureter stone ................................ 17.06 NA NA 9.30 7.56 1.43 NA NA 27.79 26.05 090 50620 ......... ............ A Removal of ureter stone ................................ 16.24 NA NA 9.22 7.07 1.07 NA NA 26.53 24.38 090 50630 ......... ............ A Removal of ureter stone ................................ 16.02 NA NA 8.49 6.84 1.09 NA NA 25.60 23.95 090 50650 ......... ............ A Removal of ureter .......................................... 18.61 NA NA 10.44 8.04 1.23 NA NA 30.28 27.88 090 50660 ......... ............ A Removal of ureter .......................................... 20.81 NA NA 11.16 8.77 1.38 NA NA 33.35 30.96 090 50684 ......... ............ A Injection for ureter x-ray ................................ 0.76 4.25 4.80 0.66 0.52 0.05 5.06 5.61 1.47 1.33 000 50686 ......... ............ A Measure ureter pressure ............................... 1.51 2.04 3.10 0.70 0.79 0.11 3.66 4.72 2.32 2.41 000 50688 ......... ............ A Change of ureter tube/stent .......................... 1.17 NA NA 0.98 1.04 0.07 NA NA 2.22 2.28 010 50690 ......... ............ A Injection for ureter x-ray ................................ 1.16 1.50 1.75 0.76 0.73 0.07 2.73 2.98 1.99 1.96 000 50700 ......... ............ A Revision of ureter .......................................... 16.48 NA NA 8.79 7.55 1.27 NA NA 26.54 25.30 090 50715 ......... ............ A Release of ureter ........................................... 20.43 NA NA 8.61 8.72 2.13 NA NA 31.17 31.28 090 50722 ......... ............ A Release of ureter ........................................... 17.74 NA NA 8.01 7.87 1.90 NA NA 27.65 27.51 090 50725 ......... ............ A Release/revise ureter .................................... 19.99 NA NA 9.87 8.51 1.52 NA NA 31.38 30.02 090 50727 ......... ............ A Revise ureter ................................................. 8.17 NA NA 5.91 4.69 0.61 NA NA 14.69 13.47 090 50728 ......... ............ A Revise ureter ................................................. 12.00 NA NA 7.35 6.02 1.00 NA NA 20.35 19.02 090 50740 ......... ............ A Fusion of ureter & kidney .............................. 19.86 NA NA 9.13 8.10 1.96 NA NA 30.95 29.92 090 50750 ......... ............ A Fusion of ureter & kidney .............................. 21.01 NA NA 9.98 8.50 1.38 NA NA 32.37 30.89 090 50760 ......... ............ A Fusion of ureters ........................................... 19.86 NA NA 10.02 8.27 1.55 NA NA 31.43 29.68 090 50770 ......... ............ A Splicing of ureters ......................................... 21.01 NA NA 10.99 8.74 1.45 NA NA 33.45 31.20 090 50780 ......... ............ A Reimplant ureter in bladder ........................... 19.74 NA NA 10.38 8.30 1.51 NA NA 31.63 29.55 090 50782 ......... ............ A Reimplant ureter in bladder ........................... 19.51 NA NA 8.49 8.72 1.61 NA NA 29.61 29.84 090 50783 ......... ............ A Reimplant ureter in bladder ........................... 20.52 NA NA 10.24 8.73 1.98 NA NA 32.74 31.23 090 50785 ......... ............ A Reimplant ureter in bladder ........................... 22.02 NA NA 11.48 9.10 1.45 NA NA 34.95 32.57 090 50800 ......... ............ A Implant ureter in bowel .................................. 16.15 NA NA 9.59 7.26 1.19 NA NA 26.93 24.60 090 50810 ......... ............ A Fusion of ureter & bowel ............................... 22.28 NA NA 9.60 9.23 2.31 NA NA 34.19 33.82 090 50815 ......... ............ A Urine shunt to intestine ................................. 21.98 NA NA 11.93 9.33 1.54 NA NA 35.45 32.85 090 50820 ......... ............ A Construct bowel bladder ............................... 23.81 NA NA 12.30 9.57 1.89 NA NA 38.00 35.27 090 50825 ......... ............ A Construct bowel bladder ............................... 30.40 NA NA 15.50 12.24 2.07 NA NA 47.97 44.71 090 50830 ......... ............ A Revise urine flow ........................................... 33.49 NA NA 16.37 13.24 2.37 NA NA 52.23 49.10 090 50840 ......... ............ A Replace ureter by bowel ............................... 22.11 NA NA 12.26 9.40 1.47 NA NA 35.84 32.98 090 50845 ......... ............ A Appendico-vesicostomy ................................. 22.11 NA NA 12.76 9.88 1.57 NA NA 36.44 33.56 090 50860 ......... ............ A Transplant ureter to skin ............................... 16.87 NA NA 9.41 7.33 1.29 NA NA 27.57 25.49 090 50900 ......... ............ A Repair of ureter ............................................. 14.83 NA NA 8.28 6.68 1.14 NA NA 24.25 22.65 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37330 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

50920 ......... ............ A Closure ureter/skin fistula .............................. 15.60 NA NA 8.79 7.13 1.01 NA NA 25.40 23.74 090 50930 ......... ............ A Closure ureter/bowel fistula ........................... 19.98 NA NA 10.54 8.62 1.28 NA NA 31.80 29.88 090 50940 ......... ............ A Release of ureter ........................................... 15.72 NA NA 8.41 6.91 1.26 NA NA 25.39 23.89 090 50945 ......... ............ A Laparoscopy ureterolithotomy ....................... 17.83 NA NA 9.01 7.54 1.36 NA NA 28.20 26.73 09050947 ......... ............ A Laparo new ureter/bladder ............................ 25.57 NA NA 12.82 10.49 2.16 NA NA 40.55 38.22 090 50948 ......... ............ A Laparo new ureter/bladder ............................ 23.65 NA NA 12.39 9.63 1.70 NA NA 37.74 34.98 090 50951 ......... ............ A Endoscopy of ureter ...................................... 5.83 4.99 4.47 2.87 2.26 0.41 11.23 10.71 9.11 8.50 000 50953 ......... ............ A Endoscopy of ureter ...................................... 6.23 5.19 4.61 3.41 2.63 0.43 11.85 11.27 10.07 9.29 000 50955 ......... ............ A Ureter endoscopy & biopsy ........................... 6.74 5.45 6.19 3.65 2.93 0.48 12.67 13.41 10.87 10.15 000 50957 ......... ............ A Ureter endoscopy & treatment ...................... 6.78 5.53 4.81 3.26 2.60 0.48 12.79 12.07 10.52 9.86 000 50961 ......... ............ A Ureter endoscopy & treatment ...................... 6.04 5.00 4.53 2.93 2.38 0.41 11.45 10.98 9.38 8.83 000 50970 ......... ............ A Ureter endoscopy .......................................... 7.13 NA NA 3.40 2.70 0.52 NA NA 11.05 10.35 000 50972 ......... ............ A Ureter endoscopy & catheter ........................ 6.88 NA NA 3.28 2.67 0.49 NA NA 10.65 10.04 000 50974 ......... ............ A Ureter endoscopy & biopsy ........................... 9.16 NA NA 4.14 3.37 0.64 NA NA 13.94 13.17 00050976 ......... ............ A Ureter endoscopy & treatment ...................... 9.03 NA NA 3.95 3.29 0.66 NA NA 13.64 12.98 000 50980 ......... ............ A Ureter endoscopy & treatment ...................... 6.84 NA NA 3.25 2.60 0.48 NA NA 10.57 9.92 000 51000 ......... ............ A Drainage of bladder ....................................... 0.78 0.96 1.70 0.28 0.25 0.05 1.79 2.53 1.11 1.08 000 51005 ......... ............ A Drainage of bladder ....................................... 1.02 2.44 4.14 0.30 0.33 0.10 3.56 5.26 1.42 1.45 000 51010 ......... ............ A Drainage of bladder ....................................... 4.25 4.90 5.44 2.44 2.02 0.28 9.43 9.97 6.97 6.55 010 51020 ......... ............ A Incise & treat bladder .................................... 7.50 NA NA 5.45 4.26 0.47 NA NA 13.42 12.23 090 51030 ......... ............ A Incise & treat bladder .................................... 7.62 NA NA 4.70 4.16 0.58 NA NA 12.90 12.36 090 51040 ......... ............ A Incise & drain bladder ................................... 4.39 NA NA 3.82 3.03 0.31 NA NA 8.52 7.73 090 51045 ......... ............ A Incise bladder/drain ureter ............................ 7.62 NA NA 5.40 4.30 0.52 NA NA 13.54 12.44 090 51050 ......... ............ A Removal of bladder stone ............................. 7.83 NA NA 5.53 4.12 0.49 NA NA 13.85 12.44 090 51060 ......... ............ A Removal of ureter stone ................................ 9.76 NA NA 6.60 5.03 0.62 NA NA 16.98 15.41 090 51065 ......... ............ A Remove ureter calculus ................................ 9.76 NA NA 6.53 4.90 0.63 NA NA 16.92 15.29 090 51080 ......... ............ A Drainage of bladder abscess ........................ 6.57 NA NA 4.49 3.79 0.43 NA NA 11.49 10.79 090 51500 ......... ............ A Removal of bladder cyst ............................... 10.86 NA NA 5.84 5.22 1.03 NA NA 17.73 17.11 090 51520 ......... ............ A Removal of bladder lesion ............................ 10.02 NA NA 6.68 5.18 0.69 NA NA 17.39 15.89 090 51525 ......... ............ A Removal of bladder lesion ............................ 15.23 NA NA 8.91 6.83 0.99 NA NA 25.13 23.05 090 51530 ......... ............ A Removal of bladder lesion ............................ 13.52 NA NA 7.47 6.19 1.05 NA NA 22.04 20.76 090 51535 ......... ............ A Repair of ureter lesion ................................... 13.71 NA NA 7.68 6.51 1.23 NA NA 22.62 21.45 090 51550 ......... ............ A Partial removal of bladder ............................. 17.04 NA NA 9.12 7.34 1.31 NA NA 27.47 25.69 090 51555 ......... ............ A Partial removal of bladder ............................. 22.97 NA NA 11.82 9.47 1.69 NA NA 36.48 34.13 090 51565 ......... ............ A Revise bladder & ureter(s) ............................ 23.42 NA NA 12.37 9.83 1.63 NA NA 37.42 34.88 090 51570 ......... ............ A Removal of bladder ....................................... 27.24 NA NA 13.72 10.75 1.71 NA NA 42.67 39.70 090 51575 ......... ............ A Removal of bladder & nodes ........................ 33.93 NA NA 17.31 13.37 2.16 NA NA 53.40 49.46 090 51580 ......... ............ A Remove bladder/revise tract ......................... 35.05 NA NA 18.16 13.93 2.24 NA NA 55.45 51.22 090 51585 ......... ............ A Removal of bladder & nodes ........................ 39.32 NA NA 20.24 15.36 2.48 NA NA 62.04 57.16 090 51590 ......... ............ A Remove bladder/revise tract ......................... 36.08 NA NA 18.00 13.98 2.27 NA NA 56.35 52.33 090 51595 ......... ............ A Remove bladder/revise tract ......................... 41.03 NA NA 20.38 15.72 2.59 NA NA 64.00 59.34 090 51596 ......... ............ A Remove bladder/create pouch ...................... 43.90 NA NA 22.03 16.95 2.77 NA NA 68.70 63.62 09051597 ......... ............ A Removal of pelvic structures ......................... 42.51 NA NA 20.66 16.31 2.81 NA NA 65.98 61.63 090 51600 ......... ............ A Injection for bladder x-ray ............................. 0.88 4.41 4.90 0.33 0.30 0.06 5.35 5.84 1.27 1.24 000 51605 ......... ............ A Preparation for bladder xray ......................... 0.64 3.04 5.31 0.44 0.37 0.04 3.72 5.99 1.12 1.05 000 51610 ......... ............ A Injection for bladder x-ray ............................. 1.05 1.99 2.22 0.73 0.63 0.07 3.11 3.34 1.85 1.75 000 51700 ......... ............ A Irrigation of bladder ....................................... 0.88 1.55 1.59 0.35 0.30 0.06 2.49 2.53 1.29 1.24 000 51701 ......... ............ A Insert bladder catheter .................................. 0.50 1.06 1.45 0.25 0.21 0.04 1.60 1.99 0.79 0.75 000 51702 ......... ............ A Insert temp bladder cath ............................... 0.50 1.56 1.96 0.35 0.27 0.04 2.10 2.50 0.89 0.81 000 51703 ......... ............ A Insert bladder cath, complex ......................... 1.47 2.34 2.64 0.84 0.63 0.10 3.91 4.21 2.41 2.20 000 51705 ......... ............ A Change of bladder tube ................................ 1.02 2.08 2.23 0.87 0.68 0.07 3.17 3.32 1.96 1.77 010 51710 ......... ............ A Change of bladder tube ................................ 1.49 2.82 3.21 1.22 0.88 0.11 4.42 4.81 2.82 2.48 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37331 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

51715 ......... ............ A Endoscopic injection/implant ......................... 3.73 2.84 3.64 1.80 1.46 0.29 6.86 7.66 5.82 5.48 000 51720 ......... ............ A Treatment of bladder lesion .......................... 1.50 1.68 1.73 0.78 0.71 0.14 3.32 3.37 2.42 2.35 000 51725 ......... ............ A Simple cystometrogram ................................. 1.51 4.39 5.30 NA NA 0.16 6.06 6.97 NA NA 00051725 ......... 26 ....... A Simple cystometrogram ................................. 1.51 0.58 0.51 0.58 0.51 0.12 2.21 2.14 2.21 2.14 000 51725 ......... TC ...... A Simple cystometrogram ................................. 0.00 3.81 4.79 NA NA 0.04 3.85 4.83 NA NA 000 51726 ......... ............ A Complex cystometrogram ............................. 1.71 7.29 7.46 NA NA 0.18 9.18 9.35 NA NA 000 51726 ......... 26 ....... A Complex cystometrogram ............................. 1.71 0.66 0.59 0.66 0.59 0.13 2.50 2.43 2.50 2.43 000 51726 ......... TC ...... A Complex cystometrogram ............................. 0.00 6.63 6.88 NA NA 0.05 6.68 6.93 NA NA 000 51736 ......... ............ A Urine flow measurement ............................... 0.61 0.92 0.67 NA NA 0.06 1.59 1.34 NA NA 000 51736 ......... 26 ....... A Urine flow measurement ............................... 0.61 0.23 0.21 0.23 0.21 0.05 0.89 0.87 0.89 0.87 000 51736 ......... TC ...... A Urine flow measurement ............................... 0.00 0.69 0.46 NA NA 0.01 0.70 0.47 NA NA 000 51741 ......... ............ A Electro-uroflowmetry, first .............................. 1.14 1.30 0.92 NA NA 0.11 2.55 2.17 NA NA 000 51741 ......... 26 ....... A Electro-uroflowmetry, first .............................. 1.14 0.46 0.39 0.46 0.39 0.09 1.69 1.62 1.69 1.62 000 51741 ......... TC ...... A Electro-uroflowmetry, first .............................. 0.00 0.84 0.53 NA NA 0.02 0.86 0.55 NA NA 000 51772 ......... ............ A Urethra pressure profile ................................ 1.61 5.12 5.47 NA NA 0.20 6.93 7.28 NA NA 000 51772 ......... 26 ....... A Urethra pressure profile ................................ 1.61 0.56 0.55 0.56 0.55 0.15 2.32 2.31 2.32 2.31 000 51772 ......... TC ...... A Urethra pressure profile ................................ 0.00 4.57 4.92 NA NA 0.05 4.62 4.97 NA NA 000 51784 ......... ............ A Anal/urinary muscle study ............................. 1.53 3.89 3.97 NA NA 0.16 5.58 5.66 NA NA 00051784 ......... 26 ....... A Anal/urinary muscle study ............................. 1.53 0.52 0.51 0.52 0.51 0.12 2.17 2.16 2.17 2.16 000 51784 ......... TC ...... A Anal/urinary muscle study ............................. 0.00 3.36 3.46 NA NA 0.04 3.40 3.50 NA NA 000 51785 ......... ............ A Anal/urinary muscle study ............................. 1.53 4.59 4.49 NA NA 0.15 6.27 6.17 NA NA 00051785 ......... 26 ....... A Anal/urinary muscle study ............................. 1.53 0.57 0.52 0.57 0.52 0.11 2.21 2.16 2.21 2.16 000 51785 ......... TC ...... A Anal/urinary muscle study ............................. 0.00 4.02 3.97 NA NA 0.04 4.06 4.01 NA NA 000 51792 ......... ............ A Urinary reflex study ....................................... 1.10 5.07 5.78 NA NA 0.20 6.37 7.08 NA NA 000 51792 ......... 26 ....... A Urinary reflex study ....................................... 1.10 0.40 0.41 0.40 0.41 0.07 1.57 1.58 1.57 1.58 000 51792 ......... TC ...... A Urinary reflex study ....................................... 0.00 4.67 5.37 NA NA 0.13 4.80 5.50 NA NA 000 51795 ......... ............ A Urine voiding pressure study ........................ 1.53 6.89 7.21 NA NA 0.22 8.64 8.96 NA NA 000 51795 ......... 26 ....... A Urine voiding pressure study ........................ 1.53 0.59 0.52 0.59 0.52 0.12 2.24 2.17 2.24 2.17 000 51795 ......... TC ...... A Urine voiding pressure study ........................ 0.00 6.30 6.68 NA NA 0.10 6.40 6.78 NA NA 000 51797 ......... ............ A Intraabdominal pressure test ......................... 1.60 4.96 5.59 NA NA 0.17 6.73 7.36 NA NA 000 51797 ......... 26 ....... A Intraabdominal pressure test ......................... 1.60 0.62 0.55 0.62 0.55 0.12 2.34 2.27 2.34 2.27 000 51797 ......... TC ...... A Intraabdominal pressure test ......................... 0.00 4.34 5.04 NA NA 0.05 4.39 5.09 NA NA 000 51798 ......... ............ A Us urine capacity measure ........................... 0.00 0.61 0.41 NA NA 0.08 0.69 0.49 NA NA XXX 51800 ......... ............ A Revision of bladder/urethra ........................... 18.68 NA NA 10.38 8.28 1.32 NA NA 30.38 28.28 090 51820 ......... ............ A Revision of urinary tract ................................ 19.33 NA NA 10.81 8.93 1.74 NA NA 31.88 30.00 090 51840 ......... ............ A Attach bladder/urethra ................................... 11.23 NA NA 5.82 5.64 1.06 NA NA 18.11 17.93 090 51841 ......... ............ A Attach bladder/urethra ................................... 13.55 NA NA 6.91 6.52 1.24 NA NA 21.70 21.31 090 51845 ......... ............ A Repair bladder neck ...................................... 10.02 NA NA 5.98 5.06 0.79 NA NA 16.79 15.87 090 51860 ......... ............ A Repair of bladder wound ............................... 12.42 NA NA 6.93 6.06 1.16 NA NA 20.51 19.64 090 51865 ......... ............ A Repair of bladder wound ............................... 15.62 NA NA 8.67 7.19 1.23 NA NA 25.52 24.04 090 51880 ......... ............ A Repair of bladder opening ............................. 7.77 NA NA 4.79 4.17 0.72 NA NA 13.28 12.66 090 51900 ......... ............ A Repair bladder/vagina lesion ......................... 14.42 NA NA 8.19 6.61 1.21 NA NA 23.82 22.24 090 51920 ......... ............ A Close bladder-uterus fistula .......................... 13.20 NA NA 7.97 6.23 1.18 NA NA 22.35 20.61 090 51925 ......... ............ A Hysterectomy/bladder repair ......................... 17.27 NA NA 10.57 9.12 2.03 NA NA 29.87 28.42 090 51940 ......... ............ A Correction of bladder defect .......................... 30.40 NA NA 11.32 11.91 2.14 NA NA 43.86 44.45 090 51960 ......... ............ A Revision of bladder & bowel ......................... 25.12 NA NA 13.51 10.62 1.63 NA NA 40.26 37.37 090 51980 ......... ............ A Construct bladder opening ............................ 12.38 NA NA 7.48 5.91 0.86 NA NA 20.72 19.15 090 51990 ......... ............ A Laparo urethral suspension ........................... 13.22 NA NA 5.96 6.11 1.39 NA NA 20.57 20.72 090 51992 ......... ............ A Laparo sling operation ................................... 14.73 NA NA 6.65 6.33 1.41 NA NA 22.79 22.47 090 52000 ......... ............ A Cystoscopy .................................................... 2.23 3.15 3.27 1.20 0.87 0.14 5.52 5.64 3.57 3.24 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37332 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

52001 ......... ............ A Cystoscopy, removal of clots ........................ 5.44 4.84 5.02 2.57 2.05 0.39 10.67 10.85 8.40 7.88 000 52005 ......... ............ A Cystoscopy & ureter catheter ........................ 2.37 5.54 5.57 1.32 1.00 0.17 8.08 8.11 3.86 3.54 000 52007 ......... ............ A Cystoscopy and biopsy ................................. 3.02 11.07 15.14 1.69 1.29 0.22 14.31 18.38 4.93 4.53 000 52010 ......... ............ A Cystoscopy & duct catheter .......................... 3.02 8.38 10.18 1.69 1.29 0.21 11.61 13.41 4.92 4.52 000 52204 ......... ............ A Cystoscopy .................................................... 2.59 8.58 13.06 1.44 1.04 0.17 11.34 15.82 4.20 3.80 000 52214 ......... ............ A Cystoscopy and treatment ............................ 3.70 20.50 33.78 1.91 1.48 0.26 24.46 37.74 5.87 5.44 000 52224 ......... ............ A Cystoscopy and treatment ............................ 3.14 19.66 32.34 1.68 1.28 0.22 23.02 35.70 5.04 4.64 000 52234 ......... ............ A Cystoscopy and treatment ............................ 4.62 NA NA 2.38 1.84 0.33 NA NA 7.33 6.79 000 52235 ......... ............ A Cystoscopy and treatment ............................ 5.44 NA NA 2.76 2.15 0.39 NA NA 8.59 7.98 000 52240 ......... ............ A Cystoscopy and treatment ............................ 9.71 NA NA 4.56 3.62 0.69 NA NA 14.96 14.02 00052250 ......... ............ A Cystoscopy and radiotracer .......................... 4.49 NA NA 2.42 1.84 0.32 NA NA 7.23 6.65 000 52260 ......... ............ A Cystoscopy and treatment ............................ 3.91 NA NA 2.03 1.57 0.28 NA NA 6.22 5.76 000 52265 ......... ............ A Cystoscopy and treatment ............................ 2.94 7.89 12.01 1.57 1.23 0.22 11.05 15.17 4.73 4.39 000 52270 ......... ............ A Cystoscopy & revise urethra ......................... 3.36 7.24 10.11 1.82 1.39 0.24 10.84 13.71 5.42 4.99 000 52275 ......... ............ A Cystoscopy & revise urethra ......................... 4.69 9.61 14.10 2.38 1.84 0.33 14.63 19.12 7.40 6.86 000 52276 ......... ............ A Cystoscopy and treatment ............................ 4.99 NA NA 2.56 1.98 0.35 NA NA 7.90 7.32 000 52277 ......... ............ A Cystoscopy and treatment ............................ 6.16 NA NA 2.97 2.42 0.44 NA NA 9.57 9.02 000 52281 ......... ............ A Cystoscopy and treatment ............................ 2.80 5.28 6.65 1.62 1.22 0.20 8.28 9.65 4.62 4.22 000 52282 ......... ............ A Cystoscopy, implant stent ............................. 6.39 NA NA 3.10 2.46 0.45 NA NA 9.94 9.30 00052283 ......... ............ A Cystoscopy and treatment ............................ 3.73 3.97 3.96 1.97 1.53 0.26 7.96 7.95 5.96 5.52 000 52285 ......... ............ A Cystoscopy and treatment ............................ 3.60 4.19 4.06 1.94 1.48 0.26 8.05 7.92 5.80 5.34 000 52290 ......... ............ A Cystoscopy and treatment ............................ 4.58 NA NA 2.37 1.83 0.32 NA NA 7.27 6.73 000 52300 ......... ............ A Cystoscopy and treatment ............................ 5.30 NA NA 2.72 2.11 0.38 NA NA 8.40 7.79 000 52301 ......... ............ A Cystoscopy and treatment ............................ 5.50 NA NA 2.15 2.03 0.46 NA NA 8.11 7.99 000 52305 ......... ............ A Cystoscopy and treatment ............................ 5.30 NA NA 2.61 2.05 0.38 NA NA 8.29 7.73 000 52310 ......... ............ A Cystoscopy and treatment ............................ 2.81 4.15 4.56 1.49 1.15 0.20 7.16 7.57 4.50 4.16 000 52315 ......... ............ A Cystoscopy and treatment ............................ 5.20 6.87 8.24 2.59 2.03 0.37 12.44 13.81 8.16 7.60 000 52317 ......... ............ A Remove bladder stone .................................. 6.71 17.64 26.18 3.14 2.50 0.48 24.83 33.37 10.33 9.69 000 52318 ......... ............ A Remove bladder stone .................................. 9.18 NA NA 4.24 3.39 0.65 NA NA 14.07 13.22 000 52320 ......... ............ A Cystoscopy and treatment ............................ 4.69 NA NA 2.31 1.80 0.33 NA NA 7.33 6.82 000 52325 ......... ............ A Cystoscopy, stone removal ........................... 6.15 NA NA 2.95 2.33 0.44 NA NA 9.54 8.92 000 52327 ......... ............ A Cystoscopy, inject material ........................... 5.18 18.36 28.52 2.43 1.97 0.37 23.91 34.07 7.98 7.52 000 52330 ......... ............ A Cystoscopy and treatment ............................ 5.03 21.07 34.47 2.46 1.94 0.36 26.46 39.86 7.85 7.33 000 52332 ......... ............ A Cystoscopy and treatment ............................ 2.83 4.44 5.43 1.55 1.18 0.21 7.48 8.47 4.59 4.22 000 52334 ......... ............ A Create passage to kidney ............................. 4.82 NA NA 2.42 1.91 0.35 NA NA 7.59 7.08 000 52341 ......... ............ A Cysto w/ureter stricture tx ............................. 5.99 NA NA 3.14 2.45 0.43 NA NA 9.56 8.87 000 52342 ......... ............ A Cysto w/up stricture tx ................................... 6.49 NA NA 3.36 2.60 0.46 NA NA 10.31 9.55 000 52343 ......... ............ A Cysto w/renal stricture tx ............................... 7.19 NA NA 3.65 2.86 0.51 NA NA 11.35 10.56 000 52344 ......... ............ A Cysto/uretero, stricture tx .............................. 7.69 NA NA 4.03 3.11 0.55 NA NA 12.27 11.35 000 52345 ......... ............ A Cysto/uretero w/up stricture .......................... 8.19 NA NA 4.25 3.28 0.58 NA NA 13.02 12.05 000 52346 ......... ............ A Cystouretero w/renal strict ............................ 9.22 NA NA 4.66 3.63 0.65 NA NA 14.53 13.50 000 52351 ......... ............ A Cystouretero & or pyeloscope ....................... 5.85 NA NA 3.09 2.39 0.41 NA NA 9.35 8.65 000 52352 ......... ............ A Cystouretero w/stone remove ....................... 6.87 NA NA 3.63 2.79 0.49 NA NA 10.99 10.15 000 52353 ......... ............ A Cystouretero w/lithotripsy .............................. 7.96 NA NA 4.09 3.17 0.57 NA NA 12.62 11.70 000 52354 ......... ............ A Cystouretero w/biopsy ................................... 7.33 NA NA 3.82 2.97 0.52 NA NA 11.67 10.82 000 52355 ......... ............ A Cystouretero w/excise tumor ......................... 8.81 NA NA 4.43 3.47 0.63 NA NA 13.87 12.91 00052400 ......... ............ A Cystouretero w/congen repr .......................... 10.04 NA NA 5.64 4.22 0.68 NA NA 16.36 14.94 090 52402 ......... ............ A Cystourethro cut ejacul duct ......................... 5.27 NA NA 2.27 1.84 0.40 NA NA 7.94 7.51 000 52450 ......... ............ A Incision of prostate ........................................ 7.63 NA NA 5.71 4.19 0.54 NA NA 13.88 12.36 090 52500 ......... ............ A Revision of bladder neck ............................... 9.33 NA NA 6.42 4.55 0.60 NA NA 16.35 14.48 090 52510 ......... ............ A Dilation prostatic urethra ............................... 7.45 NA NA 5.09 3.61 0.48 NA NA 13.02 11.54 090 52601 ......... ............ A Prostatectomy (TURP) .................................. 15.07 NA NA 8.66 6.00 0.87 NA NA 24.60 21.94 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37333 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

52606 ......... ............ A Control postop bleeding ................................ 8.80 NA NA 5.73 4.10 0.57 NA NA 15.10 13.47 090 52612 ......... ............ A Prostatectomy, first stage .............................. 9.01 NA NA 6.11 4.33 0.56 NA NA 15.68 13.90 090 52614 ......... ............ A Prostatectomy, second stage ........................ 7.75 NA NA 5.60 3.91 0.48 NA NA 13.83 12.14 090 52620 ......... ............ A Remove residual prostate ............................. 7.15 NA NA 4.77 3.44 0.47 NA NA 12.39 11.06 090 52630 ......... ............ A Remove prostate regrowth ............................ 7.61 NA NA 4.99 3.65 0.51 NA NA 13.11 11.77 09052640 ......... ............ A Relieve bladder contracture .......................... 6.85 NA NA 4.58 3.37 0.47 NA NA 11.90 10.69 090 52647 ......... ............ A Laser surgery of prostate .............................. 11.09 41.57 66.01 7.17 5.20 0.73 53.39 77.83 18.99 17.02 090 52648 ......... ............ A Laser surgery of prostate .............................. 11.94 41.88 66.08 7.51 5.48 0.79 54.61 78.81 20.24 18.21 090 52700 ......... ............ A Drainage of prostate abscess ....................... 7.35 NA NA 5.14 3.68 0.48 NA NA 12.97 11.51 090 53000 ......... ............ A Incision of urethra .......................................... 2.28 NA NA 1.86 1.62 0.16 NA NA 4.30 4.06 010 53010 ......... ............ A Incision of urethra .......................................... 4.31 NA NA 3.90 3.17 0.24 NA NA 8.45 7.72 090 53020 ......... ............ A Incision of urethra .......................................... 1.77 1.95 2.75 0.99 0.75 0.13 3.85 4.65 2.89 2.65 000 53025 ......... ............ A Incision of urethra .......................................... 1.13 1.74 3.24 0.69 0.56 0.08 2.95 4.45 1.90 1.77 000 53040 ......... ............ A Drainage of urethra abscess ......................... 6.45 NA NA 4.58 3.73 0.45 NA NA 11.48 10.63 09053060 ......... ............ A Drainage of urethra abscess ......................... 2.63 1.99 2.07 1.46 1.39 0.28 4.90 4.98 4.37 4.30 010 53080 ......... ............ A Drainage of urinary leakage .......................... 6.78 NA NA 5.05 5.74 0.52 NA NA 12.35 13.04 090 53085 ......... ............ A Drainage of urinary leakage .......................... 10.99 NA NA 4.50 6.69 0.92 NA NA 16.41 18.60 090 53200 ......... ............ A Biopsy of urethra ........................................... 2.59 1.75 1.43 1.34 1.07 0.20 4.54 4.22 4.13 3.86 000 53210 ......... ............ A Removal of urethra ........................................ 13.53 NA NA 8.00 6.39 0.89 NA NA 22.42 20.81 090 53215 ......... ............ A Removal of urethra ........................................ 16.66 NA NA 9.49 7.35 1.10 NA NA 27.25 25.11 090 53220 ......... ............ A Treatment of urethra lesion ........................... 7.49 NA NA 5.16 4.08 0.49 NA NA 13.14 12.06 090 53230 ......... ............ A Removal of urethra lesion ............................. 10.25 NA NA 6.67 5.21 0.73 NA NA 17.65 16.19 090 53235 ......... ............ A Removal of urethra lesion ............................. 10.80 NA NA 7.17 5.48 0.72 NA NA 18.69 17.00 090 53240 ......... ............ A Surgery for urethra pouch ............................. 6.94 NA NA 4.90 3.87 0.52 NA NA 12.36 11.33 090 53250 ......... ............ A Removal of urethra gland .............................. 6.38 NA NA 4.85 3.69 0.49 NA NA 11.72 10.56 090 53260 ......... ............ A Treatment of urethra lesion ........................... 2.98 2.52 2.32 1.89 1.54 0.25 5.75 5.55 5.12 4.77 010 53265 ......... ............ A Treatment of urethra lesion ........................... 3.12 3.05 2.80 2.07 1.58 0.24 6.41 6.16 5.43 4.94 010 53270 ......... ............ A Removal of urethra gland .............................. 3.09 2.31 2.24 1.72 1.59 0.30 5.70 5.63 5.11 4.98 010 53275 ......... ............ A Repair of urethra defect ................................ 4.52 NA NA 2.86 2.41 0.32 NA NA 7.70 7.25 010 53400 ......... ............ A Revise urethra, stage 1 ................................. 13.92 NA NA 8.45 6.64 0.98 NA NA 23.35 21.54 090 53405 ......... ............ A Revise urethra, stage 2 ................................. 15.45 NA NA 9.23 7.06 1.10 NA NA 25.78 23.61 090 53410 ......... ............ A Reconstruction of urethra .............................. 17.47 NA NA 10.13 7.84 1.16 NA NA 28.76 26.47 090 53415 ......... ............ A Reconstruction of urethra .............................. 20.49 NA NA 11.33 8.35 1.37 NA NA 33.19 30.21 090 53420 ......... ............ A Reconstruct urethra, stage 1 ......................... 14.98 NA NA 6.53 6.36 0.96 NA NA 22.47 22.30 090 53425 ......... ............ A Reconstruct urethra, stage 2 ......................... 16.88 NA NA 9.59 7.57 1.13 NA NA 27.60 25.58 090 53430 ......... ............ A Reconstruction of urethra .............................. 17.24 NA NA 8.90 7.48 1.15 NA NA 27.29 25.87 090 53431 ......... ............ A Reconstruct urethra/bladder .......................... 20.97 NA NA 11.37 8.90 1.41 NA NA 33.75 31.28 090 53440 ......... ............ A Male sling procedure ..................................... 15.33 NA NA 9.58 6.89 0.96 NA NA 25.87 23.18 090 53442 ......... ............ A Remove/revise male sling ............................. 13.28 NA NA 8.73 6.27 0.82 NA NA 22.83 20.37 090 53444 ......... ............ A Insert tandem cuff ......................................... 14.00 NA NA 8.32 6.50 0.94 NA NA 23.26 21.44 090 53445 ......... ............ A Insert uro/ves nck sphincter .......................... 15.15 NA NA 9.53 7.71 0.99 NA NA 25.67 23.85 090 53446 ......... ............ A Remove uro sphincter ................................... 10.83 NA NA 7.30 5.75 0.72 NA NA 18.85 17.30 090 53447 ......... ............ A Remove/replace ur sphincter ........................ 14.09 NA NA 8.73 7.01 0.95 NA NA 23.77 22.05 09053448 ......... ............ A Remov/replc ur sphinctr comp ...................... 23.20 NA NA 12.90 10.03 1.50 NA NA 37.60 34.73 090 53449 ......... ............ A Repair uro sphincter ...................................... 10.37 NA NA 6.90 5.27 0.68 NA NA 17.95 16.32 090 53450 ......... ............ A Revision of urethra ........................................ 6.63 NA NA 4.91 3.70 0.43 NA NA 11.97 10.76 090 53460 ......... ............ A Revision of urethra ........................................ 7.61 NA NA 5.31 4.10 0.50 NA NA 13.42 12.21 090 53500 ......... ............ A Urethrlys, transvag w/ scope ......................... 12.81 NA NA 7.64 6.58 0.90 NA NA 21.35 20.29 090 53502 ......... ............ A Repair of urethra injury ................................. 8.12 NA NA 5.16 4.28 0.62 NA NA 13.90 13.02 090 53505 ......... ............ A Repair of urethra injury ................................. 8.12 NA NA 5.59 4.30 0.54 NA NA 14.25 12.96 090 53510 ......... ............ A Repair of urethra injury ................................. 10.77 NA NA 6.97 5.62 0.74 NA NA 18.48 17.13 090 53515 ......... ............ A Repair of urethra injury ................................. 14.03 NA NA 8.09 6.48 1.05 NA NA 23.17 21.56 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37334 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

53520 ......... ............ A Repair of urethra defect ................................ 9.29 NA NA 6.34 4.95 0.61 NA NA 16.24 14.85 090 53600 ......... ............ A Dilate urethra stricture ................................... 1.21 1.19 1.15 0.59 0.47 0.09 2.49 2.45 1.89 1.77 000 53601 ......... ............ A Dilate urethra stricture ................................... 0.98 1.41 1.31 0.54 0.41 0.07 2.46 2.36 1.59 1.46 000 53605 ......... ............ A Dilate urethra stricture ................................... 1.28 NA NA 0.53 0.44 0.09 NA NA 1.90 1.81 000 53620 ......... ............ A Dilate urethra stricture ................................... 1.62 1.76 1.94 0.87 0.66 0.11 3.49 3.67 2.60 2.39 000 53621 ......... ............ A Dilate urethra stricture ................................... 1.35 1.87 2.03 0.70 0.54 0.10 3.32 3.48 2.15 1.99 000 53660 ......... ............ A Dilation of urethra .......................................... 0.71 1.35 1.32 0.47 0.35 0.05 2.11 2.08 1.23 1.11 000 53661 ......... ............ A Dilation of urethra .......................................... 0.72 1.34 1.31 0.43 0.33 0.05 2.11 2.08 1.20 1.10 000 53665 ......... ............ A Dilation of urethra .......................................... 0.76 NA NA 0.27 0.26 0.06 NA NA 1.09 1.08 000 53850 ......... ............ A Prostatic microwave thermotx ....................... 9.94 50.76 83.44 6.12 4.49 0.67 61.37 94.05 16.73 15.10 090 53852 ......... ............ A Prostatic rf thermotx ...................................... 10.62 47.85 78.74 6.94 5.02 0.70 59.17 90.06 18.26 16.34 090 53853 ......... ............ A Prostatic water thermother ............................ 5.48 30.02 49.13 4.52 3.28 0.37 35.87 54.98 10.37 9.13 090 54000 ......... ............ A Slitting of prepuce ......................................... 1.54 2.79 2.89 1.53 1.08 0.11 4.44 4.54 3.18 2.73 010 54001 ......... ............ A Slitting of prepuce ......................................... 2.19 3.14 3.18 1.72 1.26 0.15 5.48 5.52 4.06 3.60 010 54015 ......... ............ A Drain penis lesion .......................................... 5.31 NA NA 3.30 2.75 0.38 NA NA 8.99 8.44 010 54050 ......... ............ A Destruction, penis lesion(s) ........................... 1.24 2.07 1.76 1.38 1.12 0.08 3.39 3.08 2.70 2.44 010 54055 ......... ............ A Destruction, penis lesion(s) ........................... 1.22 2.01 1.68 1.26 0.92 0.08 3.31 2.98 2.56 2.22 010 54056 ......... ............ A Cryosurgery, penis lesion(s) ......................... 1.24 2.33 1.85 1.50 1.22 0.06 3.63 3.15 2.80 2.52 010 54057 ......... ............ A Laser surg, penis lesion(s) ............................ 1.24 2.67 2.33 1.39 0.97 0.09 4.00 3.66 2.72 2.30 010 54060 ......... ............ A Excision of penis lesion(s) ............................ 1.93 3.17 3.13 1.68 1.22 0.13 5.23 5.19 3.74 3.28 010 54065 ......... ............ A Destruction, penis lesion(s) ........................... 2.42 3.28 2.80 1.98 1.42 0.13 5.83 5.35 4.53 3.97 010 54100 ......... ............ A Biopsy of penis .............................................. 1.90 3.36 2.95 1.37 0.96 0.10 5.36 4.95 3.37 2.96 000 54105 ......... ............ A Biopsy of penis .............................................. 3.49 4.13 4.25 2.54 2.09 0.25 7.87 7.99 6.28 5.83 010 54110 ......... ............ A Treatment of penis lesion .............................. 10.73 NA NA 6.77 5.26 0.72 NA NA 18.22 16.71 090 54111 ......... ............ A Treat penis lesion, graft ................................ 14.23 NA NA 8.37 6.43 0.96 NA NA 23.56 21.62 090 54112 ......... ............ A Treat penis lesion, graft ................................ 16.77 NA NA 9.70 7.53 1.11 NA NA 27.58 25.41 090 54115 ......... ............ A Treatment of penis lesion .............................. 6.76 6.01 4.79 5.16 3.89 0.43 13.20 11.98 12.35 11.08 090 54120 ......... ............ A Partial removal of penis ................................ 10.82 NA NA 7.01 5.26 0.68 NA NA 18.51 16.76 090 54125 ......... ............ A Removal of penis .......................................... 14.37 NA NA 8.48 6.50 0.95 NA NA 23.80 21.82 090 54130 ......... ............ A Remove penis & nodes ................................. 21.58 NA NA 11.74 9.08 1.52 NA NA 34.84 32.18 090 54135 ......... ............ A Remove penis & nodes ................................. 27.91 NA NA 14.75 11.33 1.87 NA NA 44.53 41.11 090 54150 ......... ............ A Circumcision .................................................. 1.81 2.61 3.92 0.58 0.67 0.16 4.58 5.89 2.55 2.64 000 54152 ......... ............ A Circumcision .................................................. 2.31 NA NA 1.76 1.34 0.19 NA NA 4.26 3.84 010 54160 ......... ............ A Circumcision .................................................. 2.48 3.77 4.06 1.49 1.19 0.19 6.44 6.73 4.16 3.86 010 54161 ......... ............ A Circumcision .................................................. 3.27 NA NA 2.28 1.74 0.23 NA NA 5.78 5.24 010 54162 ......... ............ A Lysis penil circumic lesion ............................. 3.25 4.12 4.53 2.32 1.66 0.21 7.58 7.99 5.78 5.12 010 54163 ......... ............ A Repair of circumcision ................................... 3.25 NA NA 2.97 2.25 0.21 NA NA 6.43 5.71 010 54164 ......... ............ A Frenulotomy of penis ..................................... 2.75 NA NA 2.72 2.06 0.18 NA NA 5.65 4.99 010 54200 ......... ............ A Treatment of penis lesion .............................. 1.06 2.07 1.87 1.34 1.06 0.08 3.21 3.01 2.48 2.20 010 54205 ......... ............ A Treatment of penis lesion .............................. 8.78 NA NA 6.47 5.14 0.56 NA NA 15.81 14.48 090 54220 ......... ............ A Treatment of penis lesion .............................. 2.42 3.42 3.74 1.41 1.07 0.17 6.01 6.33 4.00 3.66 000 54230 ......... ............ A Prepare penis study ...................................... 1.34 1.45 1.17 0.94 0.71 0.09 2.88 2.60 2.37 2.14 000 54231 ......... ............ A Dynamic cavernosometry .............................. 2.04 1.91 1.51 1.21 0.96 0.16 4.11 3.71 3.41 3.16 000 54235 ......... ............ A Penile injection .............................................. 1.19 1.44 1.08 0.92 0.67 0.08 2.71 2.35 2.19 1.94 000 54240 ......... ............ A Penis study .................................................... 1.31 1.57 1.17 NA NA 0.17 3.05 2.65 NA NA 000 54240 ......... 26 ....... A Penis study .................................................... 1.31 0.51 0.45 0.51 0.45 0.11 1.93 1.87 1.93 1.87 000 54240 ......... TC ...... A Penis study .................................................... 0.00 1.06 0.72 NA NA 0.06 1.12 0.78 NA NA 000 54250 ......... ............ A Penis study .................................................... 2.22 1.28 1.00 NA NA 0.18 3.68 3.40 NA NA 000 54250 ......... 26 ....... A Penis study .................................................... 2.22 0.90 0.76 0.90 0.76 0.16 3.28 3.14 3.28 3.14 000 54250 ......... TC ...... A Penis study .................................................... 0.00 0.38 0.25 NA NA 0.02 0.40 0.27 NA NA 000 54300 ......... ............ A Revision of penis ........................................... 11.01 NA NA 7.29 6.01 0.76 NA NA 19.06 17.78 090 54304 ......... ............ A Revision of penis ........................................... 13.09 NA NA 8.30 6.83 0.88 NA NA 22.27 20.80 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37335 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

54308 ......... ............ A Reconstruction of urethra .............................. 12.43 NA NA 8.11 6.51 0.84 NA NA 21.38 19.78 090 54312 ......... ............ A Reconstruction of urethra .............................. 14.30 NA NA 9.14 7.54 1.24 NA NA 24.68 23.08 090 54316 ......... ............ A Reconstruction of urethra .............................. 17.84 NA NA 10.55 8.61 1.21 NA NA 29.60 27.66 090 54318 ......... ............ A Reconstruction of urethra .............................. 12.22 NA NA 6.56 5.99 1.39 NA NA 20.17 19.60 090 54322 ......... ............ A Reconstruction of urethra .............................. 13.79 NA NA 8.41 6.96 0.92 NA NA 23.12 21.67 090 54324 ......... ............ A Reconstruction of urethra .............................. 17.34 NA NA 10.37 8.57 1.14 NA NA 28.85 27.05 090 54326 ......... ............ A Reconstruction of urethra .............................. 16.81 NA NA 10.11 8.37 1.11 NA NA 28.03 26.29 090 54328 ......... ............ A Revise penis/urethra ..................................... 16.68 NA NA 10.11 7.97 0.98 NA NA 27.77 25.63 090 54332 ......... ............ A Revise penis/urethra ..................................... 18.16 NA NA 10.69 8.48 1.21 NA NA 30.06 27.85 090 54336 ......... ............ A Revise penis/urethra ..................................... 21.36 NA NA 12.42 10.84 2.20 NA NA 35.98 34.40 090 54340 ......... ............ A Secondary urethral surgery ........................... 9.52 NA NA 6.79 5.48 0.63 NA NA 16.94 15.63 090 54344 ......... ............ A Secondary urethral surgery ........................... 16.85 NA NA 10.18 8.37 1.54 NA NA 28.57 26.76 090 54348 ......... ............ A Secondary urethral surgery ........................... 18.11 NA NA 6.36 7.86 1.23 NA NA 25.70 27.20 090 54352 ......... ............ A Reconstruct urethra/penis ............................. 25.87 NA NA 14.32 11.98 2.24 NA NA 42.43 40.09 090 54360 ......... ............ A Penis plastic surgery ..................................... 12.59 NA NA 8.07 6.55 0.84 NA NA 21.50 19.98 090 54380 ......... ............ A Repair penis .................................................. 13.97 NA NA 5.70 6.39 0.93 NA NA 20.60 21.29 090 54385 ......... ............ A Repair penis .................................................. 16.30 NA NA 8.77 8.40 0.86 NA NA 25.93 25.56 090 54390 ......... ............ A Repair penis and bladder .............................. 22.51 NA NA 7.50 8.95 1.54 NA NA 31.55 33.00 090 54400 ......... ............ A Insert semi-rigid prosthesis ........................... 9.04 NA NA 5.97 4.76 0.64 NA NA 15.65 14.44 090 54401 ......... ............ A Insert self-contd prosthesis ........................... 10.26 NA NA 8.50 6.43 0.73 NA NA 19.49 17.42 090 54405 ......... ............ A Insert multi-comp penis pros ......................... 14.33 NA NA 8.48 6.57 0.95 NA NA 23.76 21.85 090 54406 ......... ............ A Remove muti-comp penis pros ..................... 12.70 NA NA 7.92 6.05 0.86 NA NA 21.48 19.61 090 54408 ......... ............ A Repair multi-comp penis pros ....................... 13.67 NA NA 8.55 6.44 0.90 NA NA 23.12 21.01 09054410 ......... ............ A Remove/replace penis prosth ....................... 16.42 NA NA 9.73 7.41 1.10 NA NA 27.25 24.93 090 54411 ......... ............ A Remov/replc penis pros, comp ..................... 18.06 NA NA 10.80 7.99 1.13 NA NA 29.99 27.18 090 54415 ......... ............ A Remove self-contd penis pros ...................... 8.69 NA NA 6.23 4.71 0.58 NA NA 15.50 13.98 090 54416 ......... ............ A Remv/repl penis contain pros ....................... 11.79 NA NA 8.18 6.08 0.77 NA NA 20.74 18.64 09054417 ......... ............ A Remv/replc penis pros, compl ....................... 15.88 NA NA 9.26 6.95 1.00 NA NA 26.14 23.83 09054420 ......... ............ A Revision of penis ........................................... 12.20 NA NA 7.78 6.13 0.81 NA NA 20.79 19.14 090 54430 ......... ............ A Revision of penis ........................................... 10.87 NA NA 7.18 5.63 0.72 NA NA 18.77 17.22 090 54435 ......... ............ A Revision of penis ........................................... 6.67 NA NA 5.11 3.99 0.43 NA NA 12.21 11.09 090 54450 ......... ............ A Preputial stretching ........................................ 1.12 0.88 0.93 0.50 0.46 0.08 2.08 2.13 1.70 1.66 000 54500 ......... ............ A Biopsy of testis .............................................. 1.31 0.64 0.62 0.82 0.63 0.10 2.05 2.03 2.23 2.04 000 54505 ......... ............ A Biopsy of testis .............................................. 3.45 NA NA 2.47 2.06 0.27 NA NA 6.19 5.78 010 54512 ......... ............ A Excise lesion testis ........................................ 9.19 NA NA 5.87 4.57 0.67 NA NA 15.73 14.43 090 54520 ......... ............ A Removal of testis ........................................... 5.22 NA NA 3.81 3.05 0.50 NA NA 9.53 8.77 090 54522 ......... ............ A Orchiectomy, partial ...................................... 10.11 NA NA 5.89 5.13 0.89 NA NA 16.89 16.13 090 54530 ......... ............ A Removal of testis ........................................... 9.25 NA NA 6.26 4.75 0.66 NA NA 16.17 14.66 090 54535 ......... ............ A Extensive testis surgery ................................ 13.00 NA NA 7.77 6.11 0.95 NA NA 21.72 20.06 090 54550 ......... ............ A Exploration for testis ...................................... 8.27 NA NA 5.47 4.23 0.59 NA NA 14.33 13.09 090 54560 ......... ............ A Exploration for testis ...................................... 11.91 NA NA 6.56 5.51 0.90 NA NA 19.37 18.32 090 54600 ......... ............ A Reduce testis torsion ..................................... 7.50 NA NA 5.29 3.99 0.51 NA NA 13.30 12.00 090 54620 ......... ............ A Suspension of testis ...................................... 5.14 NA NA 3.37 2.67 0.37 NA NA 8.88 8.18 010 54640 ......... ............ A Suspension of testis ...................................... 7.53 NA NA 5.59 4.20 0.62 NA NA 13.74 12.35 090 54650 ......... ............ A Orchiopexy (Fowler-Stephens) ...................... 12.18 NA NA 7.95 6.05 1.16 NA NA 21.29 19.39 090 54660 ......... ............ A Revision of testis ........................................... 5.60 NA NA 4.52 3.38 0.44 NA NA 10.56 9.42 090 54670 ......... ............ A Repair testis injury ......................................... 6.52 NA NA 4.91 3.88 0.47 NA NA 11.90 10.87 090 54680 ......... ............ A Relocation of testis(es) .................................. 13.85 NA NA 7.87 6.59 1.16 NA NA 22.88 21.60 090 54690 ......... ............ A Laparoscopy, orchiectomy ............................ 11.56 NA NA 6.31 5.28 1.02 NA NA 18.89 17.86 090 54692 ......... ............ A Laparoscopy, orchiopexy .............................. 13.60 NA NA 7.89 6.05 1.30 NA NA 22.79 20.95 090 54700 ......... ............ A Drainage of scrotum ...................................... 3.42 NA NA 2.46 2.07 0.28 NA NA 6.16 5.77 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37336 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

54800 ......... ............ A Biopsy of epididymis ..................................... 2.33 0.87 0.92 1.01 0.93 0.23 3.43 3.48 3.57 3.49 000 54820 ......... ............ A Exploration of epididymis .............................. 5.63 NA NA 4.38 3.30 0.40 NA NA 10.41 9.33 090 54830 ......... ............ A Remove epididymis lesion ............................ 5.87 NA NA 4.56 3.41 0.41 NA NA 10.84 9.69 090 54840 ......... ............ A Remove epididymis lesion ............................ 5.19 NA NA 3.90 3.06 0.37 NA NA 9.46 8.62 090 54860 ......... ............ A Removal of epididymis .................................. 6.81 NA NA 5.02 3.74 0.45 NA NA 12.28 11.00 090 54861 ......... ............ A Removal of epididymis .................................. 9.51 NA NA 6.46 4.85 0.63 NA NA 16.60 14.99 090 54900 ......... ............ A Fusion of spermatic ducts ............................. 13.99 NA NA 5.12 5.63 0.93 NA NA 20.04 20.55 090 54901 ......... ............ A Fusion of spermatic ducts ............................. 18.84 NA NA 6.43 7.26 1.82 NA NA 27.09 27.92 090 55000 ......... ............ A Drainage of hydrocele ................................... 1.43 1.90 2.03 0.94 0.72 0.11 3.44 3.57 2.48 2.26 000 55040 ......... ............ A Removal of hydrocele ................................... 5.35 NA NA 4.04 3.19 0.43 NA NA 9.82 8.97 090 55041 ......... ............ A Removal of hydroceles .................................. 8.35 NA NA 5.85 4.44 0.60 NA NA 14.80 13.39 090 55060 ......... ............ A Repair of hydrocele ....................................... 6.01 NA NA 4.54 3.45 0.46 NA NA 11.01 9.92 090 55100 ......... ............ A Drainage of scrotum abscess ....................... 2.38 3.58 3.66 2.16 1.71 0.17 6.13 6.21 4.71 4.26 010 55110 ......... ............ A Explore scrotum ............................................ 6.19 NA NA 4.63 3.51 0.43 NA NA 11.25 10.13 090 55120 ......... ............ A Removal of scrotum lesion ............................ 5.58 NA NA 4.41 3.32 0.39 NA NA 10.38 9.29 09055150 ......... ............ A Removal of scrotum ...................................... 7.95 NA NA 5.62 4.29 0.56 NA NA 14.13 12.80 090 55175 ......... ............ A Revision of scrotum ....................................... 5.73 NA NA 4.49 3.38 0.37 NA NA 10.59 9.48 090 55180 ......... ............ A Revision of scrotum ....................................... 11.57 NA NA 7.47 5.90 0.90 NA NA 19.94 18.37 090 55200 ......... ............ A Incision of sperm duct ................................... 4.48 8.46 11.38 3.47 2.65 0.33 13.27 16.19 8.28 7.46 090 55250 ......... ............ A Removal of sperm duct(s) ............................. 3.29 7.88 10.60 3.06 2.43 0.25 11.42 14.14 6.60 5.97 090 55300 ......... ............ A Prepare, sperm duct x-ray ............................ 3.50 NA NA 1.83 1.44 0.25 NA NA 5.58 5.19 000 55400 ......... ............ A Repair of sperm duct ..................................... 8.48 NA NA 5.66 4.46 0.64 NA NA 14.78 13.58 090 55450 ......... ............ A Ligation of sperm duct ................................... 4.36 6.15 6.80 2.94 2.14 0.29 10.80 11.45 7.59 6.79 010 55500 ......... ............ A Removal of hydrocele ................................... 6.08 NA NA 4.29 3.39 0.55 NA NA 10.92 10.02 090 55520 ......... ............ A Removal of sperm cord lesion ...................... 6.52 NA NA 3.80 3.39 0.75 NA NA 11.07 10.66 090 55530 ......... ............ A Revise spermatic cord veins ......................... 5.65 NA NA 4.23 3.32 0.45 NA NA 10.33 9.42 090 55535 ......... ............ A Revise spermatic cord veins ......................... 7.05 NA NA 4.96 3.79 0.47 NA NA 12.48 11.31 09055540 ......... ............ A Revise hernia & sperm veins ........................ 8.16 NA NA 4.25 3.91 0.94 NA NA 13.35 13.01 090 55550 ......... ............ A Laparo ligate spermatic vein ......................... 7.06 NA NA 4.66 3.64 0.57 NA NA 12.29 11.27 090 55600 ......... ............ A Incise sperm duct pouch ............................... 6.87 NA NA 5.05 3.76 0.62 NA NA 12.54 11.25 090 55605 ......... ............ A Incise sperm duct pouch ............................... 8.57 NA NA 4.95 4.46 0.64 NA NA 14.16 13.67 090 55650 ......... ............ A Remove sperm duct pouch ........................... 12.46 NA NA 7.46 5.83 0.92 NA NA 20.84 19.21 090 55680 ......... ............ A Remove sperm pouch lesion ........................ 5.55 NA NA 3.93 3.21 0.47 NA NA 9.95 9.23 090 55700 ......... ............ A Biopsy of prostate ......................................... 2.58 3.84 4.11 1.39 0.83 0.11 6.53 6.80 4.08 3.52 000 55705 ......... ............ A Biopsy of prostate ......................................... 4.56 NA NA 2.97 2.47 0.32 NA NA 7.85 7.35 010 55720 ......... ............ A Drainage of prostate abscess ....................... 7.63 NA NA 4.98 4.11 0.95 NA NA 13.56 12.69 090 55725 ......... ............ A Drainage of prostate abscess ....................... 9.84 NA NA 6.67 5.04 0.70 NA NA 17.21 15.58 090 55801 ......... ............ A Removal of prostate ...................................... 19.54 NA NA 10.98 8.46 1.34 NA NA 31.86 29.34 090 55810 ......... ............ A Extensive prostate surgery ............................ 24.08 NA NA 12.91 9.94 1.60 NA NA 38.59 35.62 090 55812 ......... ............ A Extensive prostate surgery ............................ 29.61 NA NA 15.54 12.13 2.04 NA NA 47.19 43.78 090 55815 ......... ............ A Extensive prostate surgery ............................ 32.67 NA NA 17.02 13.18 2.16 NA NA 51.85 48.01 090 55821 ......... ............ A Removal of prostate ...................................... 15.57 NA NA 9.06 6.92 1.01 NA NA 25.64 23.50 090 55831 ......... ............ A Removal of prostate ...................................... 17.00 NA NA 9.67 7.41 1.10 NA NA 27.77 25.51 090 55840 ......... ............ A Extensive prostate surgery ............................ 24.37 NA NA 13.24 10.28 1.61 NA NA 39.22 36.26 090 55842 ......... ............ A Extensive prostate surgery ............................ 26.23 NA NA 14.08 10.91 1.72 NA NA 42.03 38.86 090 55845 ......... ............ A Extensive prostate surgery ............................ 30.46 NA NA 15.54 12.09 2.02 NA NA 48.02 44.57 090 55859 ......... ............ A Percut/needle insert, pros ............................. 13.25 NA NA 8.12 6.42 0.89 NA NA 22.26 20.56 090 55860 ......... ............ A Surgical exposure, prostate .......................... 15.65 NA NA 9.01 7.06 1.02 NA NA 25.68 23.73 090 55862 ......... ............ A Extensive prostate surgery ............................ 19.83 NA NA 11.17 8.68 1.49 NA NA 32.49 30.00 090 55865 ......... ............ A Extensive prostate surgery ............................ 24.31 NA NA 13.36 10.29 1.63 NA NA 39.30 36.23 090 55866 ......... ............ A Laparo radical prostatectomy ........................ 32.17 NA NA 16.64 12.96 2.16 NA NA 50.97 47.29 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37337 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

55870 ......... ............ A Electroejaculation .......................................... 2.58 2.53 1.78 1.49 1.18 0.16 5.27 4.52 4.23 3.92 000 55873 ......... ............ A Cryoablate prostate ....................................... 20.19 NA NA 11.73 9.65 1.38 NA NA 33.30 31.22 090 56405 ......... ............ A I & D of vulva/perineum ................................ 1.44 1.16 1.29 1.14 1.14 0.17 2.77 2.90 2.75 2.75 010 56420 ......... ............ A Drainage of gland abscess ........................... 1.39 1.50 2.09 0.76 0.97 0.16 3.05 3.64 2.31 2.52 010 56440 ......... ............ A Surgery for vulva lesion ................................ 2.84 NA NA 1.51 1.66 0.34 NA NA 4.69 4.84 010 56441 ......... ............ A Lysis of labial lesion(s) .................................. 1.97 1.72 1.80 1.56 1.45 0.20 3.89 3.97 3.73 3.62 010 56501 ......... ............ A Destroy, vulva lesions, sim ........................... 1.53 1.62 1.75 1.21 1.23 0.18 3.33 3.46 2.92 2.94 010 56515 ......... ............ A Destroy vulva lesion/s compl ........................ 3.01 2.34 2.50 1.70 1.79 0.33 5.68 5.84 5.04 5.13 010 56605 ......... ............ A Biopsy of vulva/perineum .............................. 1.10 0.89 1.03 0.34 0.43 0.13 2.12 2.26 1.57 1.66 000 56606 ......... ............ A Biopsy of vulva/perineum .............................. 0.55 0.36 0.46 0.15 0.20 0.07 0.98 1.08 0.77 0.82 ZZZ 56620 ......... ............ A Partial removal of vulva ................................. 8.38 NA NA 4.28 4.67 0.90 NA NA 13.56 13.95 090 56625 ......... ............ A Complete removal of vulva ........................... 9.49 NA NA 4.68 5.17 1.02 NA NA 15.19 15.68 09056630 ......... ............ A Extensive vulva surgery ................................ 14.61 NA NA 6.07 6.66 1.49 NA NA 22.17 22.76 090 56631 ......... ............ A Extensive vulva surgery ................................ 18.75 NA NA 7.60 8.52 1.95 NA NA 28.30 29.22 090 56632 ......... ............ A Extensive vulva surgery ................................ 21.51 NA NA 9.02 9.41 2.38 NA NA 32.91 33.30 090 56633 ......... ............ A Extensive vulva surgery ................................ 19.41 NA NA 7.54 8.34 1.97 NA NA 28.92 29.72 090 56634 ......... ............ A Extensive vulva surgery ................................ 20.42 NA NA 8.03 9.10 2.16 NA NA 30.61 31.68 090 56637 ......... ............ A Extensive vulva surgery ................................ 24.51 NA NA 9.15 10.61 2.60 NA NA 36.26 37.72 090 56640 ......... ............ A Extensive vulva surgery ................................ 24.59 NA NA 9.02 10.24 2.88 NA NA 36.49 37.71 090 56700 ......... ............ A Partial removal of hymen .............................. 2.77 NA NA 1.75 1.82 0.30 NA NA 4.82 4.89 01056720 ......... ............ A Incision of hymen .......................................... 0.68 NA NA 0.51 0.51 0.08 NA NA 1.27 1.27 000 56740 ......... ............ A Remove vagina gland lesion ......................... 4.81 NA NA 2.28 2.50 0.56 NA NA 7.65 7.87 010 56800 ......... ............ A Repair of vagina ............................................ 3.88 NA NA 1.97 2.14 0.44 NA NA 6.29 6.46 010 56805 ......... ............ A Repair clitoris ................................................. 19.69 NA NA 11.06 9.85 2.14 NA NA 32.89 31.68 090 56810 ......... ............ A Repair of perineum ........................................ 4.24 NA NA 2.03 2.23 0.49 NA NA 6.76 6.96 010 56820 ......... ............ A Exam of vulva w/scope ................................. 1.50 1.18 1.28 0.52 0.62 0.18 2.86 2.96 2.20 2.30 000 56821 ......... ............ A Exam/biopsy of vulva w/scope ...................... 2.05 1.52 1.70 0.67 0.85 0.25 3.82 4.00 2.97 3.15 000 57000 ......... ............ A Exploration of vagina ..................................... 2.97 NA NA 1.70 1.72 0.31 NA NA 4.98 5.00 010 57010 ......... ............ A Drainage of pelvic abscess ........................... 6.70 NA NA 3.80 3.81 0.71 NA NA 11.21 11.22 090 57020 ......... ............ A Drainage of pelvic fluid .................................. 1.50 0.75 0.89 0.43 0.55 0.18 2.43 2.57 2.11 2.23 000 57022 ......... ............ A I & d vaginal hematoma, pp .......................... 2.68 NA NA 1.42 1.47 0.26 NA NA 4.36 4.41 010 57023 ......... ............ A I & d vag hematoma, non-ob ........................ 5.11 NA NA 2.36 2.53 0.58 NA NA 8.05 8.22 010 57061 ......... ............ A Destroy vag lesions, simple .......................... 1.25 1.50 1.61 1.10 1.12 0.15 2.90 3.01 2.50 2.52 010 57065 ......... ............ A Destroy vag lesions, complex ....................... 2.61 1.99 2.22 1.47 1.62 0.31 4.91 5.14 4.39 4.54 010 57100 ......... ............ A Biopsy of vagina ............................................ 1.20 0.92 1.04 0.36 0.45 0.14 2.26 2.38 1.70 1.79 000 57105 ......... ............ A Biopsy of vagina ............................................ 1.69 1.57 1.74 1.32 1.40 0.20 3.46 3.63 3.21 3.29 010 57106 ......... ............ A Remove vagina wall, partial .......................... 7.29 NA NA 4.15 4.18 0.73 NA NA 12.17 12.20 090 57107 ......... ............ A Remove vagina tissue, part .......................... 24.37 NA NA 8.88 10.09 2.71 NA NA 35.96 37.17 090 57109 ......... ............ A Vaginectomy partial w/nodes ........................ 28.19 NA NA 10.14 10.99 3.21 NA NA 41.54 42.39 090 57110 ......... ............ A Remove vagina wall, complete ..................... 15.34 NA NA 6.11 7.00 1.73 NA NA 23.18 24.07 090 57111 ......... ............ A Remove vagina tissue, compl ....................... 28.19 NA NA 9.99 11.99 3.17 NA NA 41.35 43.35 09057112 ......... ............ A Vaginectomy w/nodes, compl ....................... 30.31 NA NA 11.45 11.96 3.07 NA NA 44.83 45.34 09057120 ......... ............ A Closure of vagina .......................................... 8.14 NA NA 4.12 4.49 0.89 NA NA 13.15 13.52 090 57130 ......... ............ A Remove vagina lesion ................................... 2.43 1.96 2.11 1.47 1.52 0.29 4.68 4.83 4.19 4.24 010 57135 ......... ............ A Remove vagina lesion ................................... 2.67 2.01 2.21 1.51 1.62 0.31 4.99 5.19 4.49 4.60 010 57150 ......... ............ A Treat vagina infection .................................... 0.55 0.57 0.97 0.15 0.20 0.07 1.19 1.59 0.77 0.82 000 57155 ......... ............ A Insert uteri tandems/ovoids ........................... 6.75 NA NA 3.14 4.21 0.43 NA NA 10.32 11.39 090 57160 ......... ............ A Insert pessary/other device ........................... 0.89 1.04 1.02 0.25 0.32 0.10 2.03 2.01 1.24 1.31 000 57170 ......... ............ A Fitting of diaphragm/cap ................................ 0.91 2.68 1.78 0.25 0.31 0.11 3.70 2.80 1.27 1.33 000 57180 ......... ............ A Treat vaginal bleeding ................................... 1.58 1.83 2.09 0.91 1.17 0.19 3.60 3.86 2.68 2.94 010 57200 ......... ............ A Repair of vagina ............................................ 4.30 NA NA 2.90 2.90 0.46 NA NA 7.66 7.66 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37338 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

57210 ......... ............ A Repair vagina/perineum ................................ 5.59 NA NA 3.20 3.38 0.62 NA NA 9.41 9.59 09057220 ......... ............ A Revision of urethra ........................................ 4.73 NA NA 2.95 3.07 0.51 NA NA 8.19 8.31 090 57230 ......... ............ A Repair of urethral lesion ................................ 6.18 NA NA 3.76 3.50 0.54 NA NA 10.48 10.22 090 57240 ......... ............ A Repair bladder & vagina ............................... 11.38 NA NA 5.55 4.25 0.62 NA NA 17.55 16.25 090 57250 ......... ............ A Repair rectum & vagina ................................ 11.38 NA NA 4.82 3.89 0.65 NA NA 16.85 15.92 090 57260 ......... ............ A Repair of vagina ............................................ 14.32 NA NA 5.82 5.09 0.97 NA NA 21.11 20.38 090 57265 ......... ............ A Extensive repair of vagina ............................. 15.82 NA NA 6.29 6.11 1.32 NA NA 23.43 23.25 090 57267 ......... ............ A Insert mesh/pelvic flr addon .......................... 4.88 NA NA 1.50 1.86 0.64 NA NA 7.02 7.38 ZZZ57268 ......... ............ A Repair of bowel bulge ................................... 7.43 NA NA 3.95 4.14 0.79 NA NA 12.17 12.36 090 57270 ......... ............ A Repair of bowel pouch .................................. 13.53 NA NA 5.60 6.10 1.42 NA NA 20.55 21.05 090 57280 ......... ............ A Suspension of vagina .................................... 16.58 NA NA 6.94 7.27 1.67 NA NA 25.19 25.52 090 57282 ......... ............ A Colpopexy, extraperitoneal ............................ 7.78 NA NA 4.35 4.47 1.02 NA NA 13.15 13.27 090 57283 ......... ............ A Colpopexy, intraperitoneal ............................. 11.54 NA NA 5.15 5.74 1.02 NA NA 17.71 18.30 090 57284 ......... ............ A Repair paravaginal defect ............................. 13.43 NA NA 6.69 7.04 1.41 NA NA 21.53 21.88 090 57287 ......... ............ A Revise/remove sling repair ............................ 11.43 NA NA 6.54 5.75 0.90 NA NA 18.87 18.08 090 57288 ......... ............ A Repair bladder defect .................................... 13.95 NA NA 7.12 6.22 1.12 NA NA 22.19 21.29 090 57289 ......... ............ A Repair bladder & vagina ............................... 12.63 NA NA 6.19 6.09 1.21 NA NA 20.03 19.93 090 57291 ......... ............ A Construction of vagina .................................. 8.50 NA NA 4.23 4.76 0.93 NA NA 13.66 14.19 090 57292 ......... ............ A Construct vagina with graft ........................... 13.87 NA NA 5.90 6.69 1.58 NA NA 21.35 22.14 090 57295 ......... ............ A Change vaginal graft ..................................... 7.70 NA NA 3.65 4.24 0.91 NA NA 12.26 12.85 090 57300 ......... ............ A Repair rectum-vagina fistula ......................... 8.52 NA NA 4.40 4.32 0.87 NA NA 13.79 13.71 090 57305 ......... ............ A Repair rectum-vagina fistula ......................... 15.18 NA NA 6.11 6.24 1.72 NA NA 23.01 23.14 090 57307 ......... ............ A Fistula repair & colostomy ............................. 16.96 NA NA 6.77 6.95 2.01 NA NA 25.74 25.92 090 57308 ......... ............ A Fistula repair, transperine ............................. 10.42 NA NA 4.76 5.02 1.14 NA NA 16.32 16.58 090 57310 ......... ............ A Repair urethrovaginal lesion ......................... 7.51 NA NA 5.16 4.17 0.54 NA NA 13.21 12.22 090 57311 ......... ............ A Repair urethrovaginal lesion ......................... 8.77 NA NA 5.22 4.40 0.65 NA NA 14.64 13.82 090 57320 ......... ............ A Repair bladder-vagina lesion ........................ 8.74 NA NA 5.40 4.63 0.69 NA NA 14.83 14.06 09057330 ......... ............ A Repair bladder-vagina lesion ........................ 13.07 NA NA 7.29 6.11 1.06 NA NA 21.42 20.24 090 57335 ......... ............ A Repair vagina ................................................ 19.81 NA NA 8.95 9.03 1.91 NA NA 30.67 30.75 090 57400 ......... ............ A Dilation of vagina ........................................... 2.27 NA NA 0.97 1.08 0.26 NA NA 3.50 3.61 000 57410 ......... ............ A Pelvic examination ........................................ 1.75 1.39 1.86 0.92 0.90 0.18 3.32 3.79 2.85 2.83 000 57415 ......... ............ A Remove vaginal foreign body ....................... 2.42 NA NA 1.50 1.44 0.24 NA NA 4.16 4.10 010 57420 ......... ............ A Exam of vagina w/scope ............................... 1.60 1.22 1.32 0.55 0.64 0.19 3.01 3.11 2.34 2.43 000 57421 ......... ............ A Exam/biopsy of vag w/scope ........................ 2.20 1.58 1.78 0.71 0.90 0.27 4.05 4.25 3.18 3.37 000 57425 ......... ............ A Laparoscopy, surg, colpopexy ...................... 16.89 NA NA 6.77 6.68 1.75 NA NA 25.41 25.32 090 57452 ......... ............ A Exam of cervix w/scope ................................ 1.50 1.17 1.25 0.73 0.75 0.18 2.85 2.93 2.41 2.43 000 57454 ......... ............ A Bx/curett of cervix w/scope ........................... 2.33 1.38 1.58 0.94 1.10 0.28 3.99 4.19 3.55 3.71 000 57455 ......... ............ A Biopsy of cervix w/scope ............................... 1.99 1.48 1.66 0.65 0.82 0.24 3.71 3.89 2.88 3.05 000 57456 ......... ............ A Endocerv curettage w/scope ......................... 1.85 1.44 1.60 0.62 0.77 0.22 3.51 3.67 2.69 2.84 000 57460 ......... ............ A Bx of cervix w/scope, leep ............................ 2.83 4.27 5.46 1.08 1.31 0.34 7.44 8.63 4.25 4.48 000 57461 ......... ............ A Conz of cervix w/scope, leep ........................ 3.43 4.57 5.73 1.05 1.37 0.41 8.41 9.57 4.89 5.21 000 57500 ......... ............ A Biopsy of cervix ............................................. 1.20 2.00 2.41 0.64 0.63 0.12 3.32 3.73 1.96 1.95 000 57505 ......... ............ A Endocervical curettage .................................. 1.14 1.30 1.42 1.05 1.09 0.14 2.58 2.70 2.33 2.37 010 57510 ......... ............ A Cauterization of cervix ................................... 1.90 1.29 1.49 0.89 1.00 0.23 3.42 3.62 3.02 3.13 010 57511 ......... ............ A Cryocautery of cervix .................................... 1.90 1.58 1.77 1.25 1.34 0.23 3.71 3.90 3.38 3.47 010 57513 ......... ............ A Laser surgery of cervix .................................. 1.90 1.55 1.68 1.26 1.37 0.23 3.68 3.81 3.39 3.50 010 57520 ......... ............ A Conization of cervix ....................................... 4.03 3.33 3.79 2.47 2.78 0.49 7.85 8.31 6.99 7.30 090 57522 ......... ............ A Conization of cervix ....................................... 3.60 2.74 3.06 2.23 2.40 0.41 6.75 7.07 6.24 6.41 090 57530 ......... ............ A Removal of cervix .......................................... 5.15 NA NA 3.06 3.31 0.58 NA NA 8.79 9.04 090 57531 ......... ............ A Removal of cervix, radical ............................. 29.71 NA NA 10.39 12.50 3.34 NA NA 43.44 45.55 090 57540 ......... ............ A Removal of residual cervix ............................ 13.15 NA NA 5.49 6.06 1.49 NA NA 20.13 20.70 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37339 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

57545 ......... ............ A Remove cervix/repair pelvis .......................... 13.96 NA NA 6.16 6.56 1.52 NA NA 21.64 22.04 090 57550 ......... ............ A Removal of residual cervix ............................ 6.20 NA NA 3.58 3.77 0.67 NA NA 10.45 10.64 090 57555 ......... ............ A Remove cervix/repair vagina ......................... 9.80 NA NA 4.71 5.00 1.09 NA NA 15.60 15.89 09057556 ......... ............ A Remove cervix, repair bowel ......................... 9.22 NA NA 4.65 4.81 0.92 NA NA 14.79 14.95 09057700 ......... ............ A Revision of cervix .......................................... 4.16 NA NA 3.16 3.12 0.41 NA NA 7.73 7.69 090 57720 ......... ............ A Revision of cervix .......................................... 4.49 NA NA 2.86 3.05 0.49 NA NA 7.84 8.03 090 57800 ......... ............ A Dilation of cervical canal ............................... 0.77 0.70 0.75 0.41 0.46 0.09 1.56 1.61 1.27 1.32 000 57820 ......... ............ A D & c of residual cervix ................................. 1.67 1.33 1.44 1.03 1.11 0.20 3.20 3.31 2.90 2.98 010 58100 ......... ............ A Biopsy of uterus lining ................................... 1.53 1.12 1.27 0.57 0.68 0.18 2.83 2.98 2.28 2.39 000 58110 ......... ............ A Bx done w/colposcopy add-on ...................... 0.77 0.39 0.51 0.21 0.29 0.09 1.25 1.37 1.07 1.15 ZZZ 58120 ......... ............ A Dilation and curettage ................................... 3.52 2.07 2.25 1.63 1.82 0.39 5.98 6.16 5.54 5.73 010 58140 ......... ............ A Myomectomy abdom method ........................ 15.65 NA NA 6.11 6.87 1.81 NA NA 23.57 24.33 090 58145 ......... ............ A Myomectomy vag method ............................. 8.77 NA NA 4.18 4.65 0.97 NA NA 13.92 14.39 090 58146 ......... ............ A Myomectomy abdom complex ...................... 20.20 NA NA 7.16 8.56 2.32 NA NA 29.68 31.08 090 58150 ......... ............ A Total hysterectomy ........................................ 17.17 NA NA 6.42 7.23 1.84 NA NA 25.43 26.24 090 58152 ......... ............ A Total hysterectomy ........................................ 21.67 NA NA 7.99 9.41 2.47 NA NA 32.13 33.55 090 58180 ......... ............ A Partial hysterectomy ...................................... 16.46 NA NA 6.22 7.16 1.64 NA NA 24.32 25.26 090 58200 ......... ............ A Extensive hysterectomy ................................ 22.96 NA NA 7.94 9.50 2.54 NA NA 33.44 35.00 090 58210 ......... ............ A Extensive hysterectomy ................................ 30.70 NA NA 10.43 12.53 3.37 NA NA 44.50 46.60 090 58240 ......... ............ A Removal of pelvis contents ........................... 43.13 NA NA 15.63 17.15 4.22 NA NA 62.98 64.50 090 58260 ......... ............ A Vaginal hysterectomy .................................... 13.98 NA NA 5.69 6.46 1.57 NA NA 21.24 22.01 090 58262 ......... ............ A Vag hyst including t/o .................................... 15.77 NA NA 6.15 7.09 1.79 NA NA 23.71 24.65 090 58263 ......... ............ A Vag hyst w/t/o & vag repair ........................... 17.06 NA NA 6.50 7.55 1.94 NA NA 25.50 26.55 090 58267 ......... ............ A Vag hyst w/urinary repair .............................. 18.17 NA NA 6.88 8.01 2.06 NA NA 27.11 28.24 090 58270 ......... ............ A Vag hyst w/enterocele repair ........................ 15.16 NA NA 5.84 6.77 1.73 NA NA 22.73 23.66 090 58275 ......... ............ A Hysterectomy/revise vagina .......................... 16.84 NA NA 6.54 7.48 1.91 NA NA 25.29 26.23 090 58280 ......... ............ A Hysterectomy/revise vagina .......................... 18.14 NA NA 6.90 7.93 2.06 NA NA 27.10 28.13 090 58285 ......... ............ A Extensive hysterectomy ................................ 23.26 NA NA 7.73 9.41 2.70 NA NA 33.69 35.37 090 58290 ......... ............ A Vag hyst complex .......................................... 20.13 NA NA 7.24 8.67 2.29 NA NA 29.66 31.09 090 58291 ......... ............ A Vag hyst incl t/o, complex ............................. 21.92 NA NA 7.66 9.34 2.52 NA NA 32.10 33.78 090 58292 ......... ............ A Vag hyst t/o & repair, compl ......................... 23.21 NA NA 8.13 9.83 2.67 NA NA 34.01 35.71 090 58293 ......... ............ A Vag hyst w/uro repair, compl ........................ 24.19 NA NA 8.32 10.09 2.78 NA NA 35.29 37.06 090 58294 ......... ............ A Vag hyst w/enterocele, compl ....................... 21.41 NA NA 7.04 8.95 2.39 NA NA 30.84 32.75 09058300 ......... ............ N Insert intrauterine device ............................... 1.01 0.62 1.22 0.23 0.34 0.12 1.75 2.35 1.36 1.47 XXX 58301 ......... ............ A Remove intrauterine device .......................... 1.27 1.04 1.25 0.34 0.45 0.15 2.46 2.67 1.76 1.87 000 58321 ......... ............ A Artificial insemination ..................................... 0.92 0.96 1.10 0.24 0.34 0.10 1.98 2.12 1.26 1.36 000 58322 ......... ............ A Artificial insemination ..................................... 1.10 1.03 1.16 0.30 0.39 0.13 2.26 2.39 1.53 1.62 000 58323 ......... ............ A Sperm washing .............................................. 0.23 0.15 0.44 0.07 0.09 0.03 0.41 0.70 0.33 0.35 000 58340 ......... ............ A Catheter for hysterography ........................... 0.88 2.17 2.92 0.57 0.63 0.09 3.14 3.89 1.54 1.60 000 58345 ......... ............ A Reopen fallopian tube ................................... 4.65 NA NA 2.06 2.35 0.41 NA NA 7.12 7.41 010 58346 ......... ............ A Insert heyman uteri capsule .......................... 7.44 NA NA 3.38 3.79 0.56 NA NA 11.38 11.79 090 58350 ......... ............ A Reopen fallopian tube ................................... 1.01 1.32 1.45 0.86 0.91 0.12 2.45 2.58 1.99 2.04 010 58353 ......... ............ A Endometr ablate, thermal .............................. 3.55 22.89 32.54 1.68 1.97 0.43 26.87 36.52 5.66 5.95 010 58356 ......... ............ A Endometrial cryoablation ............................... 6.36 43.33 57.04 1.80 2.48 0.82 50.51 64.22 8.98 9.66 010 58400 ......... ............ A Suspension of uterus .................................... 7.02 NA NA 3.80 3.91 0.75 NA NA 11.57 11.68 090 58410 ......... ............ A Suspension of uterus .................................... 13.66 NA NA 5.79 6.29 1.45 NA NA 20.90 21.40 090 58520 ......... ............ A Repair of ruptured uterus .............................. 13.34 NA NA 5.35 5.88 1.47 NA NA 20.16 20.69 090 58540 ......... ............ A Revision of uterus ......................................... 15.57 NA NA 6.09 6.75 1.78 NA NA 23.44 24.10 090 58545 ......... ............ A Laparoscopic myomectomy ........................... 15.65 NA NA 5.88 6.87 1.77 NA NA 23.30 24.29 090 58546 ......... ............ A Laparo-myomectomy, complex ..................... 20.20 NA NA 7.06 8.47 2.30 NA NA 29.56 30.97 090 58550 ......... ............ A Laparo-asst vag hysterectomy ...................... 14.91 NA NA 6.05 7.00 1.72 NA NA 22.68 23.63 090 58552 ......... ............ A Laparo-vag hyst incl t/o ................................. 16.23 NA NA 6.33 7.61 1.72 NA NA 24.28 25.56 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37340 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

58553 ......... ............ A Laparo-vag hyst, complex ............................. 20.13 NA NA 7.04 8.47 2.30 NA NA 29.47 30.90 090 58554 ......... ............ A Laparo-vag hyst w/t/o, compl ........................ 23.13 NA NA 8.18 9.86 2.27 NA NA 33.58 35.26 090 58555 ......... ............ A Hysteroscopy, dx, sep proc ........................... 3.33 1.88 2.12 1.22 1.47 0.40 5.61 5.85 4.95 5.20 000 58558 ......... ............ A Hysteroscopy, biopsy .................................... 4.74 NA NA 1.63 2.04 0.57 NA NA 6.94 7.35 000 58559 ......... ............ A Hysteroscopy, lysis ........................................ 6.16 NA NA 2.01 2.56 0.74 NA NA 8.91 9.46 000 58560 ......... ............ A Hysteroscopy, resect septum ........................ 6.99 NA NA 2.24 2.88 0.84 NA NA 10.07 10.71 000 58561 ......... ............ A Hysteroscopy, remove myoma ...................... 9.99 NA NA 3.07 3.99 1.21 NA NA 14.27 15.19 000 58562 ......... ............ A Hysteroscopy, remove fb .............................. 5.20 NA NA 1.73 2.20 0.63 NA NA 7.56 8.03 000 58563 ......... ............ A Hysteroscopy, ablation .................................. 6.16 37.31 51.59 2.02 2.58 0.74 44.21 58.49 8.92 9.48 000 58565 ......... ............ A Hysteroscopy, sterilization ............................. 7.02 34.36 45.87 3.31 3.76 1.19 42.57 54.08 11.52 11.97 090 58600 ......... ............ A Division of fallopian tube ............................... 5.84 NA NA 2.85 3.22 0.66 NA NA 9.35 9.72 090 58605 ......... ............ A Division of fallopian tube ............................... 5.23 NA NA 2.62 3.00 0.59 NA NA 8.44 8.82 090 58611 ......... ............ A Ligate oviduct(s) add-on ................................ 1.45 NA NA 0.39 0.53 0.18 NA NA 2.02 2.16 ZZZ 58615 ......... ............ A Occlude fallopian tube(s) .............................. 3.89 NA NA 1.95 2.52 0.47 NA NA 6.31 6.88 010 58660 ......... ............ A Laparoscopy, lysis ......................................... 11.52 NA NA 4.34 5.04 1.40 NA NA 17.26 17.96 090 58661 ......... ............ A Laparoscopy, remove adnexa ....................... 11.28 NA NA 3.93 4.83 1.34 NA NA 16.55 17.45 010 58662 ......... ............ A Laparoscopy, excise lesions ......................... 12.05 NA NA 4.61 5.50 1.43 NA NA 18.09 18.98 090 58670 ......... ............ A Laparoscopy, tubal cautery ........................... 5.84 NA NA 2.79 3.16 0.67 NA NA 9.30 9.67 090 58671 ......... ............ A Laparoscopy, tubal block .............................. 5.84 NA NA 2.80 3.16 0.68 NA NA 9.32 9.68 09058672 ......... ............ A Laparoscopy, fimbrioplasty ............................ 12.86 NA NA 4.69 5.82 1.60 NA NA 19.15 20.28 090 58673 ......... ............ A Laparoscopy, salpingostomy ......................... 13.97 NA NA 5.12 6.22 1.69 NA NA 20.78 21.88 09058700 ......... ............ A Removal of fallopian tube ............................. 12.80 NA NA 5.45 5.86 1.51 NA NA 19.76 20.17 090 58720 ......... ............ A Removal of ovary/tube(s) .............................. 12.04 NA NA 5.01 5.60 1.39 NA NA 18.44 19.03 090 58740 ......... ............ A Revise fallopian tube(s) ................................. 14.75 NA NA 5.97 6.86 1.71 NA NA 22.43 23.32 090 58750 ......... ............ A Repair oviduct ............................................... 15.52 NA NA 5.97 7.03 1.84 NA NA 23.33 24.39 090 58752 ......... ............ A Revise ovarian tube(s) .................................. 15.52 NA NA 5.93 6.70 1.80 NA NA 23.25 24.02 090 58760 ......... ............ A Remove tubal obstruction ............................. 13.81 NA NA 5.51 6.43 1.79 NA NA 21.11 22.03 090 58770 ......... ............ A Create new tubal opening ............................. 14.65 NA NA 5.66 6.61 1.73 NA NA 22.04 22.99 090 58800 ......... ............ A Drainage of ovarian cyst(s) ........................... 4.50 3.24 3.55 2.71 2.86 0.43 8.17 8.48 7.64 7.79 090 58805 ......... ............ A Drainage of ovarian cyst(s) ........................... 6.30 NA NA 3.50 3.51 0.69 NA NA 10.49 10.50 090 58820 ......... ............ A Drain ovary abscess, open ........................... 4.58 NA NA 2.82 3.18 0.52 NA NA 7.92 8.28 090 58822 ......... ............ A Drain ovary abscess, percut ......................... 11.67 NA NA 5.20 5.22 1.16 NA NA 18.03 18.05 090 58823 ......... ............ A Drain pelvic abscess, percut ......................... 3.37 20.91 21.26 1.14 1.13 0.24 24.52 24.87 4.75 4.74 000 58825 ......... ............ A Transposition, ovary(s) .................................. 11.66 NA NA 4.85 5.57 1.32 NA NA 17.83 18.55 090 58900 ......... ............ A Biopsy of ovary(s) ......................................... 6.47 NA NA 3.48 3.56 0.69 NA NA 10.64 10.72 090 58920 ......... ............ A Partial removal of ovary(s) ............................ 11.83 NA NA 5.15 5.48 1.43 NA NA 18.41 18.74 090 58925 ......... ............ A Removal of ovarian cyst(s) ........................... 12.29 NA NA 5.20 5.58 1.41 NA NA 18.90 19.28 090 58940 ......... ............ A Removal of ovary(s) ...................................... 8.08 NA NA 4.11 4.11 0.91 NA NA 13.10 13.10 090 58943 ......... ............ A Removal of ovary(s) ...................................... 19.38 NA NA 7.12 8.28 2.22 NA NA 28.72 29.88 090 58950 ......... ............ A Resect ovarian malignancy ........................... 18.18 NA NA 7.13 8.10 2.04 NA NA 27.35 28.32 090 58951 ......... ............ A Resect ovarian malignancy ........................... 24.11 NA NA 8.42 9.96 2.63 NA NA 35.16 36.70 090 58952 ......... ............ A Resect ovarian malignancy ........................... 27.09 NA NA 9.57 11.23 3.02 NA NA 39.68 41.34 090 58953 ......... ............ A Tah, rad dissect for debulk ........................... 33.91 NA NA 11.33 13.77 3.83 NA NA 49.07 51.51 090 58954 ......... ............ A Tah rad debulk/lymph remove ...................... 36.91 NA NA 12.15 14.85 4.17 NA NA 53.23 55.93 09058956 ......... ............ A Bso, omentectomy w/tah ............................... 22.59 NA NA 8.38 9.85 4.00 NA NA 34.97 36.44 090 58960 ......... ............ A Exploration of abdomen ................................ 15.64 NA NA 6.19 7.08 1.79 NA NA 23.62 24.51 090 58970 ......... ............ A Retrieval of oocyte ........................................ 3.52 1.79 2.19 1.23 1.43 0.43 5.74 6.14 5.18 5.38 000 58976 ......... ............ A Transfer of embryo ........................................ 3.82 1.92 2.50 1.18 1.67 0.47 6.21 6.79 5.47 5.96 000 59000 ......... ............ A Amniocentesis, diagnostic ............................. 1.30 1.73 1.99 0.54 0.64 0.31 3.34 3.60 2.15 2.25 000 59001 ......... ............ A Amniocentesis, therapeutic ........................... 3.00 NA NA 1.06 1.32 0.71 NA NA 4.77 5.03 000 59012 ......... ............ A Fetal cord puncture,prenatal ......................... 3.44 NA NA 1.13 1.44 0.82 NA NA 5.39 5.70 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37341 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

59015 ......... ............ A Chorion biopsy .............................................. 2.20 1.41 1.52 0.79 0.98 0.52 4.13 4.24 3.51 3.70 000 59020 ......... ............ A Fetal contract stress test ............................... 0.66 1.07 0.85 NA NA 0.26 1.99 1.77 NA NA 000 59020 ......... 26 ....... A Fetal contract stress test ............................... 0.66 0.18 0.24 0.18 0.24 0.16 1.00 1.06 1.00 1.06 000 59020 ......... TC ...... A Fetal contract stress test ............................... 0.00 0.89 0.61 NA NA 0.10 0.99 0.71 NA NA 000 59025 ......... ............ A Fetal non-stress test ...................................... 0.53 0.62 0.49 NA NA 0.15 1.30 1.17 NA NA 000 59025 ......... 26 ....... A Fetal non-stress test ...................................... 0.53 0.14 0.19 0.14 0.19 0.13 0.80 0.85 0.80 0.85 000 59025 ......... TC ...... A Fetal non-stress test ...................................... 0.00 0.48 0.29 NA NA 0.02 0.50 0.31 NA NA 000 59030 ......... ............ A Fetal scalp blood sample .............................. 1.99 NA NA 0.54 0.71 0.47 NA NA 3.00 3.17 00059050 ......... ............ A Fetal monitor w/report ................................... 0.89 NA NA 0.26 0.33 0.21 NA NA 1.36 1.43 XXX 59051 ......... ............ A Fetal monitor/interpret only ........................... 0.74 NA NA 0.20 0.27 0.17 NA NA 1.11 1.18 XXX 59070 ......... ............ A Transabdom amnioinfus w/us ....................... 5.24 4.40 4.97 1.77 2.18 0.28 9.92 10.49 7.29 7.70 000 59072 ......... ............ A Umbilical cord occlud w/us ............................ 8.99 NA NA 2.80 3.05 0.16 NA NA 11.95 12.20 000 59074 ......... ............ A Fetal fluid drainage w/us ............................... 5.24 3.84 4.40 1.66 2.16 0.28 9.36 9.92 7.18 7.68 000 59076 ......... ............ A Fetal shunt placement, w/us ......................... 8.99 NA NA 2.34 2.93 0.16 NA NA 11.49 12.08 00059100 ......... ............ A Remove uterus lesion ................................... 13.22 NA NA 5.68 6.27 2.94 NA NA 21.84 22.43 090 59120 ......... ............ A Treat ectopic pregnancy ................................ 12.52 NA NA 5.34 6.03 2.72 NA NA 20.58 21.27 090 59121 ......... ............ A Treat ectopic pregnancy ................................ 12.60 NA NA 5.28 6.08 2.78 NA NA 20.66 21.46 090 59130 ......... ............ A Treat ectopic pregnancy ................................ 14.94 NA NA 5.99 5.10 3.38 NA NA 24.31 23.42 090 59135 ......... ............ A Treat ectopic pregnancy ................................ 14.78 NA NA 4.98 6.68 3.30 NA NA 23.06 24.76 090 59136 ......... ............ A Treat ectopic pregnancy ................................ 14.11 NA NA 5.62 6.37 3.13 NA NA 22.86 23.61 090 59140 ......... ............ A Treat ectopic pregnancy ................................ 5.82 1.31 1.99 2.85 2.38 1.29 8.42 9.10 9.96 9.49 090 59150 ......... ............ A Treat ectopic pregnancy ................................ 12.15 NA NA 5.00 5.76 2.78 NA NA 19.93 20.69 090 59151 ......... ............ A Treat ectopic pregnancy ................................ 11.97 NA NA 4.89 5.78 2.73 NA NA 19.59 20.48 090 59160 ......... ............ A D & c after delivery ....................................... 2.71 1.97 2.97 1.16 1.90 0.64 5.32 6.32 4.51 5.25 010 59200 ......... ............ A Insert cervical dilator ..................................... 0.79 0.93 1.13 0.22 0.28 0.19 1.91 2.11 1.20 1.26 000 59300 ......... ............ A Episiotomy or vaginal repair .......................... 2.41 2.19 2.18 1.01 0.97 0.57 5.17 5.16 3.99 3.95 000 59320 ......... ............ A Revision of cervix .......................................... 2.48 NA NA 0.99 1.18 0.59 NA NA 4.06 4.25 000 59325 ......... ............ A Revision of cervix .......................................... 4.06 NA NA 1.20 1.73 0.88 NA NA 6.14 6.67 000 59350 ......... ............ A Repair of uterus ............................................. 4.94 NA NA 1.36 1.75 1.17 NA NA 7.47 7.86 000 59400 ......... ............ A Obstetrical care ............................................. 26.52 NA NA 14.06 15.04 5.48 NA NA 46.06 47.04 MMM 59409 ......... ............ A Obstetrical care ............................................. 13.48 NA NA 3.64 4.90 3.21 NA NA 20.33 21.59 MMM 59410 ......... ............ A Obstetrical care ............................................. 15.25 NA NA 4.83 5.95 3.51 NA NA 23.59 24.71 MMM 59412 ......... ............ A Antepartum manipulation .............................. 1.71 NA NA 0.63 0.77 0.40 NA NA 2.74 2.88 MMM 59414 ......... ............ A Deliver placenta ............................................. 1.61 NA NA 0.43 0.59 0.38 NA NA 2.42 2.58 MMM 59425 ......... ............ A Antepartum care only .................................... 6.12 4.18 4.20 1.62 1.80 1.14 11.44 11.46 8.88 9.06 MMM 59426 ......... ............ A Antepartum care only .................................... 10.84 7.68 7.59 2.88 3.14 1.97 20.49 20.40 15.69 15.95 MMM 59430 ......... ............ A Care after delivery ......................................... 2.13 1.02 1.18 0.64 0.87 0.50 3.65 3.81 3.27 3.50 MMM 59510 ......... ............ A Cesarean delivery ......................................... 30.04 NA NA 15.69 16.91 6.23 NA NA 51.96 53.18 MMM 59514 ......... ............ A Cesarean delivery only .................................. 15.95 NA NA 4.36 5.76 3.79 NA NA 24.10 25.50 MMM 59515 ......... ............ A Cesarean delivery ......................................... 18.20 NA NA 6.07 7.41 4.12 NA NA 28.39 29.73 MMM 59525 ......... ............ A Remove uterus after cesarean ...................... 8.53 NA NA 2.32 3.06 1.94 NA NA 12.79 13.53 ZZZ 59610 ......... ............ A Vbac delivery ................................................. 27.95 NA NA 14.30 15.51 5.85 NA NA 48.10 49.31 MMM 59612 ......... ............ A Vbac delivery only ......................................... 15.04 NA NA 4.14 5.59 3.58 NA NA 22.76 24.21 MMM 59614 ......... ............ A Vbac care after delivery ................................ 16.57 NA NA 5.03 6.47 3.88 NA NA 25.48 26.92 MMM 59618 ......... ............ A Attempted vbac delivery ................................ 31.48 NA NA 16.02 17.72 6.59 NA NA 54.09 55.79 MMM 59620 ......... ............ A Attempted vbac delivery only ........................ 17.50 NA NA 4.65 6.25 4.16 NA NA 26.31 27.91 MMM 59622 ......... ............ A Attempted vbac after care ............................. 19.64 NA NA 6.50 8.12 4.49 NA NA 30.63 32.25 MMM 59812 ......... ............ A Treatment of miscarriage .............................. 4.37 NA NA 2.32 2.49 0.95 NA NA 7.64 7.81 09059820 ......... ............ A Care of miscarriage ....................................... 4.64 4.03 4.33 3.43 3.54 0.95 9.62 9.92 9.02 9.13 090 59821 ......... ............ A Treatment of miscarriage .............................. 4.94 3.78 4.16 3.12 3.34 1.06 9.78 10.16 9.12 9.34 090 59830 ......... ............ A Treat uterus infection .................................... 6.47 NA NA 3.40 3.84 1.44 NA NA 11.31 11.75 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37342 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

59840 ......... ............ R Abortion ......................................................... 3.01 NA NA 1.77 2.04 0.71 NA NA 5.49 5.76 010 59841 ......... ............ R Abortion ......................................................... 5.55 3.12 3.41 2.55 2.87 1.24 9.91 10.20 9.34 9.66 010 59850 ......... ............ R Abortion ......................................................... 5.90 NA NA 2.61 3.10 1.28 NA NA 9.79 10.28 090 59851 ......... ............ R Abortion ......................................................... 5.92 NA NA 3.26 3.63 1.28 NA NA 10.46 10.83 090 59852 ......... ............ R Abortion ......................................................... 8.23 NA NA 3.68 4.71 1.80 NA NA 13.71 14.74 090 59855 ......... ............ R Abortion ......................................................... 6.36 NA NA 2.89 3.39 1.45 NA NA 10.70 11.20 090 59856 ......... ............ R Abortion ......................................................... 7.72 NA NA 4.04 4.06 1.78 NA NA 13.54 13.56 090 59857 ......... ............ R Abortion ......................................................... 9.28 NA NA 3.11 4.32 2.01 NA NA 14.40 15.61 090 59866 ......... ............ R Abortion (mpr) ............................................... 3.99 NA NA 1.22 1.73 0.87 NA NA 6.08 6.59 000 59870 ......... ............ A Evacuate mole of uterus ............................... 6.32 NA NA 4.08 4.39 1.42 NA NA 11.82 12.13 090 59871 ......... ............ A Remove cerclage suture ............................... 2.13 1.12 1.59 0.92 1.08 0.50 3.75 4.22 3.55 3.71 000 60000 ......... ............ A Drain thyroid/tongue cyst .............................. 1.76 2.05 1.96 1.66 1.70 0.15 3.96 3.87 3.57 3.61 010 60001 ......... ............ A Aspirate/inject thyriod cyst ............................ 0.97 1.98 1.55 0.29 0.32 0.07 3.02 2.59 1.33 1.36 000 60100 ......... ............ A Biopsy of thyroid ............................................ 1.56 1.33 1.38 0.50 0.52 0.10 2.99 3.04 2.16 2.18 000 60200 ......... ............ A Remove thyroid lesion ................................... 9.84 NA NA 5.13 5.78 1.01 NA NA 15.98 16.63 090 60210 ......... ............ A Partial thyroid excision .................................. 11.11 NA NA 4.96 5.48 1.23 NA NA 17.30 17.82 090 60212 ......... ............ A Partial thyroid excision .................................. 16.26 NA NA 6.45 7.38 1.94 NA NA 24.65 25.58 090 60220 ......... ............ A Partial removal of thyroid .............................. 12.25 NA NA 5.28 5.94 1.32 NA NA 18.85 19.51 090 60225 ......... ............ A Partial removal of thyroid .............................. 14.59 NA NA 6.55 7.20 1.64 NA NA 22.78 23.43 090 60240 ......... ............ A Removal of thyroid ........................................ 16.16 NA NA 6.04 7.21 1.85 NA NA 24.05 25.22 090 60252 ......... ............ A Removal of thyroid ........................................ 21.82 NA NA 8.23 9.65 2.29 NA NA 32.34 33.76 090 60254 ......... ............ A Extensive thyroid surgery .............................. 28.23 NA NA 10.07 13.15 2.60 NA NA 40.90 43.98 090 60260 ......... ............ A Repeat thyroid surgery .................................. 18.14 NA NA 6.84 8.21 1.93 NA NA 26.91 28.28 090 60270 ......... ............ A Removal of thyroid ........................................ 23.01 NA NA 8.81 10.06 2.32 NA NA 34.14 35.39 090 60271 ......... ............ A Removal of thyroid ........................................ 17.50 NA NA 6.65 8.11 1.74 NA NA 25.89 27.35 090 60280 ......... ............ A Remove thyroid duct lesion ........................... 5.98 NA NA 4.01 4.51 0.54 NA NA 10.53 11.03 090 60281 ......... ............ A Remove thyroid duct lesion ........................... 8.64 NA NA 4.65 5.55 0.73 NA NA 14.02 14.92 090 60500 ......... ............ A Explore parathyroid glands ........................... 16.63 NA NA 6.64 7.23 2.00 NA NA 25.27 25.86 090 60502 ......... ............ A Re-explore parathyroids ................................ 20.92 NA NA 8.34 9.12 2.53 NA NA 31.79 32.57 090 60505 ......... ............ A Explore parathyroid glands ........................... 22.81 NA NA 9.13 10.50 2.64 NA NA 34.58 35.95 090 60512 ......... ............ A Autotransplant parathyroid ............................ 4.44 NA NA 1.15 1.50 0.53 NA NA 6.12 6.47 ZZZ60520 ......... ............ A Removal of thymus gland ............................. 17.03 NA NA 6.90 7.96 2.19 NA NA 26.12 27.18 090 60521 ......... ............ A Removal of thymus gland ............................. 19.09 NA NA 8.37 9.27 2.81 NA NA 30.27 31.17 090 60522 ......... ............ A Removal of thymus gland ............................. 23.31 NA NA 9.87 10.94 3.26 NA NA 36.44 37.51 090 60540 ......... ............ A Explore adrenal gland ................................... 17.84 NA NA 8.20 7.75 1.74 NA NA 27.78 27.33 090 60545 ......... ............ A Explore adrenal gland ................................... 20.75 NA NA 8.93 8.65 2.07 NA NA 31.75 31.47 090 60600 ......... ............ A Remove carotid body lesion .......................... 24.95 NA NA 9.76 10.68 2.19 NA NA 36.90 37.82 090 60605 ......... ............ A Remove carotid body lesion .......................... 31.82 NA NA 13.01 12.47 2.49 NA NA 47.32 46.78 090 60650 ......... ............ A Laparoscopy adrenalectomy ......................... 20.59 NA NA 8.15 8.04 2.28 NA NA 31.02 30.91 090 61000 ......... ............ A Remove cranial cavity fluid ........................... 1.58 NA NA 1.22 1.02 0.13 NA NA 2.93 2.73 00061001 ......... ............ A Remove cranial cavity fluid ........................... 1.49 NA NA 1.20 1.10 0.16 NA NA 2.85 2.75 00061020 ......... ............ A Remove brain cavity fluid .............................. 1.51 NA NA 1.54 1.39 0.34 NA NA 3.39 3.24 000 61026 ......... ............ A Injection into brain canal ............................... 1.69 NA NA 1.48 1.41 0.33 NA NA 3.50 3.43 000 61050 ......... ............ A Remove brain canal fluid .............................. 1.51 NA NA 1.16 1.24 0.11 NA NA 2.78 2.86 00061055 ......... ............ A Injection into brain canal ............................... 2.10 NA NA 1.34 1.40 0.17 NA NA 3.61 3.67 000 61070 ......... ............ A Brain canal shunt procedure ......................... 0.89 NA NA 1.17 1.05 0.17 NA NA 2.23 2.11 000 61105 ......... ............ A Twist drill hole ............................................... 5.38 NA NA 4.77 4.15 1.32 NA NA 11.47 10.85 090 61107 ......... ............ A Drill skull for implantation .............................. 4.99 NA NA 1.79 2.35 1.29 NA NA 8.07 8.63 000 61108 ......... ............ A Drill skull for drainage ................................... 11.45 NA NA 8.21 7.42 2.63 NA NA 22.29 21.50 090 61120 ......... ............ A Burr hole for puncture ................................... 9.48 NA NA 6.51 6.14 2.09 NA NA 18.08 17.71 090 61140 ......... ............ A Pierce skull for biopsy ................................... 17.04 NA NA 10.11 9.96 4.11 NA NA 31.26 31.11 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37343 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

61150 ......... ............ A Pierce skull for drainage ............................... 18.76 NA NA 10.49 10.42 4.31 NA NA 33.56 33.49 090 61151 ......... ............ A Pierce skull for drainage ............................... 13.37 NA NA 8.25 7.94 3.00 NA NA 24.62 24.31 090 61154 ......... ............ A Pierce skull & remove clot ............................ 16.86 NA NA 10.07 9.65 4.20 NA NA 31.13 30.71 090 61156 ......... ............ A Pierce skull for drainage ............................... 17.33 NA NA 9.62 9.80 4.22 NA NA 31.17 31.35 090 61210 ......... ............ A Pierce skull, implant device ........................... 5.83 NA NA 2.11 2.72 1.50 NA NA 9.44 10.05 000 61215 ......... ............ A Insert brain-fluid device ................................. 5.73 NA NA 5.30 4.33 1.26 NA NA 12.29 11.32 090 61250 ......... ............ A Pierce skull & explore ................................... 11.37 NA NA 7.33 6.99 2.76 NA NA 21.46 21.12 090 61253 ......... ............ A Pierce skull & explore ................................... 13.37 NA NA 7.59 7.70 2.61 NA NA 23.57 23.68 090 61304 ......... ............ A Open skull for exploration ............................. 23.27 NA NA 12.24 12.71 5.61 NA NA 41.12 41.59 090 61305 ......... ............ A Open skull for exploration ............................. 28.45 NA NA 14.62 15.17 6.07 NA NA 49.14 49.69 090 61312 ......... ............ A Open skull for drainage ................................. 30.03 NA NA 16.63 15.47 6.34 NA NA 53.00 51.84 090 61313 ......... ............ A Open skull for drainage ................................. 27.88 NA NA 15.03 14.89 6.43 NA NA 49.34 49.20 090 61314 ......... ............ A Open skull for drainage ................................. 25.71 NA NA 13.81 13.26 6.26 NA NA 45.78 45.23 090 61315 ......... ............ A Open skull for drainage ................................. 29.46 NA NA 15.10 15.82 7.14 NA NA 51.70 52.42 090 61316 ......... ............ A Implt cran bone flap to abdo ......................... 1.39 NA NA 0.51 0.58 0.35 NA NA 2.25 2.32 ZZZ 61320 ......... ............ A Open skull for drainage ................................. 27.28 NA NA 13.87 14.56 6.60 NA NA 47.75 48.44 090 61321 ......... ............ A Open skull for drainage ................................. 30.34 NA NA 13.87 15.60 7.12 NA NA 51.33 53.06 090 61322 ......... ............ A Decompressive craniotomy ........................... 34.00 NA NA 17.25 16.10 7.61 NA NA 58.86 57.71 090 61323 ......... ............ A Decompressive lobectomy ............................ 34.87 NA NA 16.53 16.23 8.01 NA NA 59.41 59.11 090 61330 ......... ............ A Decompress eye socket ................................ 25.11 NA NA 11.52 13.20 2.31 NA NA 38.94 40.62 090 61332 ......... ............ A Explore/biopsy eye socket ............................ 28.46 NA NA 13.05 14.99 4.82 NA NA 46.33 48.27 090 61333 ......... ............ A Explore orbit/remove lesion ........................... 29.13 NA NA 12.91 14.94 3.91 NA NA 45.95 47.98 090 61334 ......... ............ A Explore orbit/remove object .......................... 19.46 NA NA 8.87 10.21 1.74 NA NA 30.07 31.41 090 61340 ......... ............ A Subtemporal decompression ......................... 19.97 NA NA 11.06 11.13 4.83 NA NA 35.86 35.93 090 61343 ......... ............ A Incise skull (press relief) ............................... 31.67 NA NA 15.47 16.51 7.62 NA NA 54.76 55.80 090 61345 ......... ............ A Relieve cranial pressure ................................ 29.04 NA NA 14.59 15.22 7.02 NA NA 50.65 51.28 090 61440 ......... ............ A Incise skull for surgery .................................. 28.47 NA NA 13.33 14.01 6.88 NA NA 48.68 49.36 090 61450 ......... ............ A Incise skull for surgery .................................. 27.55 NA NA 12.17 13.78 5.77 NA NA 45.49 47.10 090 61458 ......... ............ A Incise skull for brain wound .......................... 28.65 NA NA 14.37 15.26 7.01 NA NA 50.03 50.92 090 61460 ......... ............ A Incise skull for surgery .................................. 30.05 NA NA 14.50 15.97 6.02 NA NA 50.57 52.04 090 61470 ......... ............ A Incise skull for surgery .................................. 27.48 NA NA 12.55 13.56 5.88 NA NA 45.91 46.92 090 61480 ......... ............ A Incise skull for surgery .................................. 27.91 NA NA 7.88 13.45 6.71 NA NA 42.50 48.07 090 61490 ......... ............ A Incise skull for surgery .................................. 27.08 NA NA 13.14 14.06 6.90 NA NA 47.12 48.04 090 61500 ......... ............ A Removal of skull lesion ................................. 18.99 NA NA 10.15 10.66 4.10 NA NA 33.24 33.75 090 61501 ......... ............ A Remove infected skull bone .......................... 16.16 NA NA 9.12 9.20 3.21 NA NA 28.49 28.57 090 61510 ......... ............ A Removal of brain lesion ................................ 30.55 NA NA 16.38 16.65 7.33 NA NA 54.26 54.53 090 61512 ......... ............ A Remove brain lining lesion ............................ 36.93 NA NA 17.81 19.25 9.05 NA NA 63.79 65.23 090 61514 ......... ............ A Removal of brain abscess ............................. 27.04 NA NA 13.90 14.33 6.52 NA NA 47.46 47.89 090 61516 ......... ............ A Removal of brain lesion ................................ 26.39 NA NA 13.67 14.14 6.33 NA NA 46.39 46.86 090 61517 ......... ............ A Implt brain chemotx add-on .......................... 1.38 NA NA 0.50 0.61 0.35 NA NA 2.23 2.34 ZZZ 61518 ......... ............ A Removal of brain lesion ................................ 39.61 NA NA 19.64 20.77 9.62 NA NA 68.87 70.00 090 61519 ......... ............ A Remove brain lining lesion ............................ 43.22 NA NA 19.98 22.03 10.60 NA NA 73.80 75.85 090 61520 ......... ............ A Removal of brain lesion ................................ 56.81 NA NA 24.67 28.98 11.18 NA NA 92.66 96.97 090 61521 ......... ............ A Removal of brain lesion ................................ 46.78 NA NA 21.28 23.53 11.36 NA NA 79.42 81.67 090 61522 ......... ............ A Removal of brain abscess ............................. 31.35 NA NA 14.89 16.07 7.60 NA NA 53.84 55.02 090 61524 ......... ............ A Removal of brain lesion ................................ 29.70 NA NA 15.09 15.56 7.14 NA NA 51.93 52.40 090 61526 ......... ............ A Removal of brain lesion ................................ 53.84 NA NA 20.86 27.39 7.05 NA NA 81.75 88.28 090 61530 ......... ............ A Removal of brain lesion ................................ 45.37 NA NA 17.57 23.23 6.13 NA NA 69.07 74.73 090 61531 ......... ............ A Implant brain electrodes ................................ 16.24 NA NA 9.79 9.31 3.78 NA NA 29.81 29.33 090 61533 ......... ............ A Implant brain electrodes ................................ 21.32 NA NA 11.23 11.48 5.10 NA NA 37.65 37.90 090 61534 ......... ............ A Removal of brain lesion ................................ 22.82 NA NA 12.62 12.25 5.42 NA NA 40.86 40.49 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37344 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

61535 ......... ............ A Remove brain electrodes .............................. 13.01 NA NA 8.47 7.70 3.01 NA NA 24.49 23.72 090 61536 ......... ............ A Removal of brain lesion ................................ 37.53 NA NA 17.70 19.31 9.18 NA NA 64.41 66.02 090 61537 ......... ............ A Removal of brain tissue ................................ 36.31 NA NA 17.68 15.51 6.92 NA NA 60.91 58.74 090 61538 ......... ............ A Removal of brain tissue ................................ 39.31 NA NA 18.75 16.20 6.92 NA NA 64.98 62.43 090 61539 ......... ............ A Removal of brain tissue ................................ 34.09 NA NA 14.79 17.06 8.30 NA NA 57.18 59.45 090 61540 ......... ............ A Removal of brain tissue ................................ 31.24 NA NA 15.44 16.83 8.30 NA NA 54.98 56.37 090 61541 ......... ............ A Incision of brain tissue .................................. 30.75 NA NA 15.41 16.04 6.58 NA NA 52.74 53.37 090 61542 ......... ............ A Removal of brain tissue ................................ 32.97 NA NA 16.18 17.45 8.01 NA NA 57.16 58.43 090 61543 ......... ............ A Removal of brain tissue ................................ 31.12 NA NA 15.64 16.23 7.54 NA NA 54.30 54.89 090 61544 ......... ............ A Remove & treat brain lesion ......................... 27.22 NA NA 13.75 13.83 5.95 NA NA 46.92 47.00 090 61545 ......... ............ A Excision of brain tumor ................................. 46.15 NA NA 21.88 23.68 10.60 NA NA 78.63 80.43 090 61546 ......... ............ A Removal of pituitary gland ............................ 33.25 NA NA 15.92 17.14 7.65 NA NA 56.82 58.04 090 61548 ......... ............ A Removal of pituitary gland ............................ 23.23 NA NA 10.87 12.33 3.42 NA NA 37.52 38.98 090 61550 ......... ............ A Release of skull seams ................................. 15.38 NA NA 3.61 6.12 0.98 NA NA 19.97 22.48 090 61552 ......... ............ A Release of skull seams ................................. 20.21 NA NA 6.42 8.46 1.06 NA NA 27.69 29.73 090 61556 ......... ............ A Incise skull/sutures ........................................ 23.96 NA NA 12.20 11.59 4.64 NA NA 40.80 40.19 090 61557 ......... ............ A Incise skull/sutures ........................................ 23.10 NA NA 13.12 13.53 5.78 NA NA 42.00 42.41 090 61558 ......... ............ A Excision of skull/sutures ................................ 26.29 NA NA 7.91 12.65 1.36 NA NA 35.56 40.30 090 61559 ......... ............ A Excision of skull/sutures ................................ 33.74 NA NA 18.22 19.08 8.48 NA NA 60.44 61.30 090 61563 ......... ............ A Excision of skull tumor .................................. 28.31 NA NA 13.71 14.89 5.15 NA NA 47.17 48.35 090 61564 ......... ............ A Excision of skull tumor .................................. 34.53 NA NA 15.61 17.65 8.75 NA NA 58.89 60.93 090 61566 ......... ............ A Removal of brain tissue ................................ 32.26 NA NA 16.15 17.40 6.92 NA NA 55.33 56.58 090 61567 ......... ............ A Incision of brain tissue .................................. 36.76 NA NA 15.60 19.45 6.52 NA NA 58.88 62.73 090 61570 ......... ............ A Remove foreign body, brain .......................... 26.32 NA NA 13.55 13.85 5.86 NA NA 45.73 46.03 090 61571 ......... ............ A Incise skull for brain wound .......................... 28.23 NA NA 14.54 15.02 6.77 NA NA 49.54 50.02 090 61575 ......... ............ A Skull base/brainstem surgery ........................ 36.37 NA NA 14.97 18.51 5.32 NA NA 56.66 60.20 090 61576 ......... ............ A Skull base/brainstem surgery ........................ 55.03 NA NA 25.34 32.46 5.56 NA NA 85.93 93.05 090 61580 ......... ............ A Craniofacial approach, skull .......................... 34.26 NA NA 20.27 24.31 3.36 NA NA 57.89 61.93 090 61581 ......... ............ A Craniofacial approach, skull .......................... 38.78 NA NA 24.44 23.74 3.91 NA NA 67.13 66.43 090 61582 ......... ............ A Craniofacial approach, skull .......................... 34.83 NA NA 30.11 28.06 7.19 NA NA 72.13 70.08 090 61583 ......... ............ A Craniofacial approach, skull .......................... 38.37 NA NA 25.25 25.20 9.18 NA NA 72.80 72.75 090 61584 ......... ............ A Orbitocranial approach/skull .......................... 37.57 NA NA 24.96 24.68 8.16 NA NA 70.69 70.41 090 61585 ......... ............ A Orbitocranial approach/skull .......................... 42.40 NA NA 24.18 25.97 7.01 NA NA 73.59 75.38 090 61586 ......... ............ A Resect nasopharynx, skull ............................ 27.20 NA NA 23.74 22.92 4.36 NA NA 55.30 54.48 090 61590 ......... ............ A Infratemporal approach/skull ......................... 46.79 NA NA 22.77 27.22 5.29 NA NA 74.85 79.30 090 61591 ......... ............ A Infratemporal approach/skull ......................... 46.81 NA NA 23.24 28.02 5.64 NA NA 75.69 80.47 090 61592 ......... ............ A Orbitocranial approach/skull .......................... 42.94 NA NA 26.82 26.64 10.04 NA NA 79.80 79.62 090 61595 ......... ............ A Transtemporal approach/skull ....................... 33.49 NA NA 18.82 21.51 3.97 NA NA 56.28 58.97 090 61596 ......... ............ A Transcochlear approach/skull ....................... 39.25 NA NA 18.02 22.89 3.39 NA NA 60.66 65.53 090 61597 ......... ............ A Transcondylar approach/skull ....................... 40.67 NA NA 22.37 22.89 8.81 NA NA 71.85 72.37 090 61598 ......... ............ A Transpetrosal approach/skull ........................ 36.35 NA NA 20.60 22.63 5.68 NA NA 62.63 64.66 090 61600 ......... ............ A Resect/excise cranial lesion .......................... 29.76 NA NA 17.83 19.33 3.78 NA NA 51.37 52.87 090 61601 ......... ............ A Resect/excise cranial lesion .......................... 31.00 NA NA 21.93 20.90 6.61 NA NA 59.54 58.51 090 61605 ......... ............ A Resect/excise cranial lesion .......................... 32.32 NA NA 17.26 20.83 2.85 NA NA 52.43 56.00 090 61606 ......... ............ A Resect/excise cranial lesion .......................... 41.88 NA NA 23.64 24.83 8.94 NA NA 74.46 75.65 090 61607 ......... ............ A Resect/excise cranial lesion .......................... 40.76 NA NA 20.04 22.90 6.88 NA NA 67.68 70.54 090 61608 ......... ............ A Resect/excise cranial lesion .......................... 45.39 NA NA 25.77 26.44 10.72 NA NA 81.88 82.55 090 61609 ......... ............ A Transect artery, sinus .................................... 9.88 NA NA 3.60 4.55 2.55 NA NA 16.03 16.98 ZZZ 61610 ......... ............ A Transect artery, sinus .................................... 29.63 NA NA 10.81 12.59 7.66 NA NA 48.10 49.88 ZZZ 61611 ......... ............ A Transect artery, sinus .................................... 7.41 NA NA 2.70 3.55 1.88 NA NA 11.99 12.84 ZZZ 61612 ......... ............ A Transect artery, sinus .................................... 27.84 NA NA 7.90 11.99 4.30 NA NA 40.04 44.13 ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37345 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

61613 ......... ............ A Remove aneurysm, sinus .............................. 44.88 NA NA 26.76 26.45 8.42 NA NA 80.06 79.75 090 61615 ......... ............ A Resect/excise lesion, skull ............................ 35.57 NA NA 18.86 21.81 4.72 NA NA 59.15 62.10 090 61616 ......... ............ A Resect/excise lesion, skull ............................ 46.54 NA NA 25.81 28.00 8.24 NA NA 80.59 82.78 090 61618 ......... ............ A Repair dura .................................................... 18.52 NA NA 9.63 10.26 3.71 NA NA 31.86 32.49 090 61619 ......... ............ A Repair dura .................................................... 21.95 NA NA 10.50 11.84 3.94 NA NA 36.39 37.73 090 61623 ......... ............ A Endovasc tempory vessel occl ...................... 9.95 NA NA 3.63 3.98 1.05 NA NA 14.63 14.98 000 61624 ......... ............ A Transcath occlusion, cns ............................... 20.12 NA NA 7.25 7.00 1.95 NA NA 29.32 29.07 000 61626 ......... ............ A Transcath occlusion, non-cns ....................... 16.60 NA NA 5.93 5.63 1.24 NA NA 23.77 23.47 00061630 ......... ............ N Intracranial angioplasty ................................. 22.03 NA NA 6.30 10.97 2.01 NA NA 30.34 35.01 090 61635 ......... ............ N Intracran angioplsty w/stent .......................... 24.24 NA NA 6.80 11.89 2.20 NA NA 33.24 38.33 090 61680 ......... ............ A Intracranial vessel surgery ............................ 32.34 NA NA 16.16 17.15 7.93 NA NA 56.43 57.42 090 61682 ......... ............ A Intracranial vessel surgery ............................ 63.27 NA NA 26.23 30.78 15.85 NA NA 105.4 109.9 090 61684 ......... ............ A Intracranial vessel surgery ............................ 41.43 NA NA 19.63 21.45 10.28 NA NA 71.34 73.16 090 61686 ......... ............ A Intracranial vessel surgery ............................ 67.26 NA NA 29.13 33.40 16.66 NA NA 113.1 117.3 090 61690 ......... ............ A Intracranial vessel surgery ............................ 31.14 NA NA 15.24 16.39 6.92 NA NA 53.30 54.45 090 61692 ......... ............ A Intracranial vessel surgery ............................ 54.39 NA NA 23.81 26.62 13.39 NA NA 91.59 94.40 090 61697 ......... ............ A Brain aneurysm repr, complx ........................ 63.16 NA NA 28.59 28.22 12.81 NA NA 104.6 104.2 090 61698 ......... ............ A Brain aneurysm repr, complx ........................ 69.39 NA NA 30.54 27.71 12.50 NA NA 112.4 109.6 090 61700 ......... ............ A Brain aneurysm repr, simple ......................... 50.44 NA NA 23.58 26.81 12.98 NA NA 87.00 90.23 090 61702 ......... ............ A Inner skull vessel surgery ............................. 59.80 NA NA 25.60 25.98 10.76 NA NA 96.16 96.54 090 61703 ......... ............ A Clamp neck artery ......................................... 18.66 NA NA 10.41 10.47 4.05 NA NA 33.12 33.18 090 61705 ......... ............ A Revise circulation to head ............................. 37.91 NA NA 17.47 18.85 8.84 NA NA 64.22 65.60 090 61708 ......... ............ A Revise circulation to head ............................. 37.01 NA NA 14.20 14.94 2.50 NA NA 53.71 54.45 090 61710 ......... ............ A Revise circulation to head ............................. 31.15 NA NA 13.64 13.67 4.51 NA NA 49.30 49.33 090 61711 ......... ............ A Fusion of skull arteries .................................. 38.04 NA NA 17.80 19.35 9.39 NA NA 65.23 66.78 090 61720 ......... ............ A Incise skull/brain surgery ............................... 17.48 NA NA 7.79 9.45 2.78 NA NA 28.05 29.71 090 61735 ......... ............ A Incise skull/brain surgery ............................... 22.16 NA NA 11.16 11.94 2.72 NA NA 36.04 36.82 090 61750 ......... ............ A Incise skull/brain biopsy ................................ 19.69 NA NA 10.45 10.59 4.71 NA NA 34.85 34.99 090 61751 ......... ............ A Brain biopsy w/ct/mr guide ............................ 18.58 NA NA 10.91 10.87 4.55 NA NA 34.04 34.00 090 61760 ......... ............ A Implant brain electrodes ................................ 22.24 NA NA 11.38 9.40 5.40 NA NA 39.02 37.04 090 61770 ......... ............ A Incise skull for treatment ............................... 23.05 NA NA 9.50 11.59 3.54 NA NA 36.09 38.18 090 61790 ......... ............ A Treat trigeminal nerve ................................... 11.46 NA NA 7.37 6.29 2.81 NA NA 21.64 20.56 090 61791 ......... ............ A Treat trigeminal tract ..................................... 15.27 NA NA 7.23 8.51 3.39 NA NA 25.89 27.17 090 61793 ......... ............ A Focus radiation beam .................................... 17.71 NA NA 9.34 9.95 4.45 NA NA 31.50 32.11 090 61795 ......... ............ A Brain surgery using computer ....................... 4.03 NA NA 1.32 1.86 0.79 NA NA 6.14 6.68 ZZZ 61850 ......... ............ A Implant neuroelectrodes ................................ 13.22 NA NA 5.29 7.09 3.21 NA NA 21.72 23.52 090 61860 ......... ............ A Implant neuroelectrodes ................................ 22.12 NA NA 10.67 11.74 4.94 NA NA 37.73 38.80 090 61863 ......... ............ A Implant neuroelectrode .................................. 20.50 NA NA 12.13 11.88 5.41 NA NA 38.04 37.79 090 61864 ......... ............ A Implant neuroelectrde, addl ........................... 4.49 NA NA 1.64 2.13 5.41 NA NA 11.54 12.03 ZZZ 61867 ......... ............ A Implant neuroelectrode .................................. 32.82 NA NA 16.19 17.60 5.41 NA NA 54.42 55.83 090 61868 ......... ............ A Implant neuroelectrde, addIl .......................... 7.91 NA NA 2.86 3.73 5.41 NA NA 16.18 17.05 ZZZ 61870 ......... ............ A Implant neuroelectrodes ................................ 16.20 NA NA 8.23 9.36 3.86 NA NA 28.29 29.42 090 61875 ......... ............ A Implant neuroelectrodes ................................ 16.32 NA NA 5.14 7.73 2.94 NA NA 24.40 26.99 090 61880 ......... ............ A Revise/remove neuroelectrode ..................... 6.83 NA NA 5.14 4.72 1.66 NA NA 13.63 13.21 090 61885 ......... ............ A Insrt/redo neurostim 1 array .......................... 7.29 NA NA 7.07 5.76 1.59 NA NA 15.95 14.64 090 61886 ......... ............ A Implant neurostim arrays ............................... 9.65 NA NA 8.33 6.86 1.96 NA NA 19.94 18.47 090 61888 ......... ............ A Revise/remove neuroreceiver ....................... 5.18 NA NA 3.50 3.64 1.33 NA NA 10.01 10.15 010 62000 ......... ............ A Treat skull fracture ........................................ 13.79 NA NA 7.25 5.96 1.06 NA NA 22.10 20.81 090 62005 ......... ............ A Treat skull fracture ........................................ 17.49 NA NA 9.03 8.87 3.86 NA NA 30.38 30.22 090 62010 ......... ............ A Treatment of head injury ............................... 21.24 NA NA 11.37 11.65 5.12 NA NA 37.73 38.01 090 62100 ......... ............ A Repair brain fluid leakage ............................. 23.34 NA NA 11.34 12.45 4.83 NA NA 39.51 40.62 090 62115 ......... ............ A Reduction of skull defect ............................... 22.63 NA NA 13.36 12.09 5.49 NA NA 41.48 40.21 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37346 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

62116 ......... ............ A Reduction of skull defect ............................... 24.82 NA NA 12.71 13.23 6.09 NA NA 43.62 44.14 090 62117 ......... ............ A Reduction of skull defect ............................... 28.20 NA NA 14.04 15.07 4.52 NA NA 46.76 47.79 090 62120 ......... ............ A Repair skull cavity lesion ............................... 24.31 NA NA 15.50 17.77 2.99 NA NA 42.80 45.07 090 62121 ......... ............ A Incise skull repair .......................................... 22.89 NA NA 13.70 15.04 4.16 NA NA 40.75 42.09 090 62140 ......... ............ A Repair of skull defect .................................... 14.41 NA NA 8.17 8.30 3.46 NA NA 26.04 26.17 090 62141 ......... ............ A Repair of skull defect .................................... 15.93 NA NA 8.85 9.02 3.75 NA NA 28.53 28.70 090 62142 ......... ............ A Remove skull plate/flap ................................. 11.69 NA NA 7.34 7.09 2.72 NA NA 21.75 21.50 090 62143 ......... ............ A Replace skull plate/flap ................................. 14.01 NA NA 8.34 8.13 3.36 NA NA 25.71 25.50 090 62145 ......... ............ A Repair of skull & brain ................................... 19.95 NA NA 9.81 10.64 4.49 NA NA 34.25 35.08 090 62146 ......... ............ A Repair of skull with graft ............................... 17.14 NA NA 8.64 9.41 3.61 NA NA 29.39 30.16 090 62147 ......... ............ A Repair of skull with graft ............................... 20.53 NA NA 10.11 11.03 4.31 NA NA 34.95 35.87 090 62148 ......... ............ A Retr bone flap to fix skull .............................. 2.00 NA NA 0.73 0.83 0.48 NA NA 3.21 3.31 ZZZ 62160 ......... ............ A Neuroendoscopy add-on ............................... 3.00 NA NA 1.08 1.42 0.77 NA NA 4.85 5.19 ZZZ 62161 ......... ............ A Dissect brain w/scope ................................... 21.04 NA NA 11.77 12.04 5.17 NA NA 37.98 38.25 090 62162 ......... ............ A Remove colloid cyst w/scope ........................ 26.61 NA NA 13.45 14.53 5.89 NA NA 45.95 47.03 090 62163 ......... ............ A Neuroendoscopy w/fb removal ...................... 16.34 NA NA 10.23 10.02 4.00 NA NA 30.57 30.36 09062164 ......... ............ A Remove brain tumor w/scope ....................... 29.19 NA NA 14.54 14.88 5.36 NA NA 49.09 49.43 09062165 ......... ............ A Remove pituit tumor w/scope ........................ 23.04 NA NA 11.12 12.85 3.00 NA NA 37.16 38.89 090 62180 ......... ............ A Establish brain cavity shunt .......................... 22.41 NA NA 11.45 12.10 4.97 NA NA 38.83 39.48 090 62190 ......... ............ A Establish brain cavity shunt .......................... 12.03 NA NA 7.28 7.15 2.79 NA NA 22.10 21.97 090 62192 ......... ............ A Establish brain cavity shunt .......................... 13.21 NA NA 7.96 7.72 3.01 NA NA 24.18 23.94 090 62194 ......... ............ A Replace/irrigate catheter ............................... 5.64 NA NA 3.72 2.76 0.92 NA NA 10.28 9.32 010 62200 ......... ............ A Establish brain cavity shunt .......................... 19.15 NA NA 10.18 10.70 4.64 NA NA 33.97 34.49 090 62201 ......... ............ A Brain cavity shunt w/scope ........................... 15.83 NA NA 10.02 9.61 3.67 NA NA 29.52 29.11 090 62220 ......... ............ A Establish brain cavity shunt .......................... 13.96 NA NA 7.99 8.00 3.34 NA NA 25.29 25.30 090 62223 ......... ............ A Establish brain cavity shunt .......................... 13.84 NA NA 8.98 8.44 3.13 NA NA 25.95 25.41 090 62225 ......... ............ A Replace/irrigate catheter ............................... 6.07 NA NA 5.15 4.36 1.39 NA NA 12.61 11.82 090 62230 ......... ............ A Replace/revise brain shunt ............................ 11.31 NA NA 6.89 6.60 2.70 NA NA 20.90 20.61 090 62252 ......... ............ A Csf shunt reprogram ..................................... 0.74 1.74 1.54 NA NA 0.21 2.69 2.49 NA NA XXX 62252 ......... 26 ....... A Csf shunt reprogram ..................................... 0.74 0.26 0.34 0.26 0.34 0.19 1.19 1.27 1.19 1.27 XXX 62252 ......... TC ...... A Csf shunt reprogram ..................................... 0.00 1.48 1.20 NA NA 0.02 1.50 1.22 NA NA XXX 62256 ......... ............ A Remove brain cavity shunt ............................ 7.26 NA NA 5.53 4.91 1.71 NA NA 14.50 13.88 090 62258 ......... ............ A Replace brain cavity shunt ............................ 15.50 NA NA 8.81 8.76 3.73 NA NA 28.04 27.99 090 62263 ......... ............ A Epidural lysis mult sessions .......................... 6.37 9.12 11.83 2.84 3.11 0.41 15.90 18.61 9.62 9.89 010 62264 ......... ............ A Epidural lysis on single day .......................... 4.42 5.74 7.25 1.28 1.39 0.27 10.43 11.94 5.97 6.08 010 62268 ......... ............ A Drain spinal cord cyst .................................... 4.73 6.99 10.42 1.84 2.07 0.43 12.15 15.58 7.00 7.23 000 62269 ......... ............ A Needle biopsy, spinal cord ............................ 5.01 7.00 12.79 1.73 1.92 0.37 12.38 18.17 7.11 7.30 000 62270 ......... ............ A Spinal fluid tap, diagnostic ............................ 1.37 2.44 2.86 0.57 0.56 0.08 3.89 4.31 2.02 2.01 000 62272 ......... ............ A Drain cerebro spinal fluid .............................. 1.35 3.19 3.51 0.62 0.69 0.18 4.72 5.04 2.15 2.22 000 62273 ......... ............ A Inject epidural patch ...................................... 2.15 1.70 2.47 0.58 0.68 0.13 3.98 4.75 2.86 2.96 000 62280 ......... ............ A Treat spinal cord lesion ................................. 2.63 4.23 6.27 1.05 1.02 0.30 7.16 9.20 3.98 3.95 010 62281 ......... ............ A Treat spinal cord lesion ................................. 2.66 3.77 5.20 0.90 0.89 0.19 6.62 8.05 3.75 3.74 010 62282 ......... ............ A Treat spinal canal lesion ............................... 2.33 3.95 7.27 1.06 0.96 0.17 6.45 9.77 3.56 3.46 010 62284 ......... ............ A Injection for myelogram ................................. 1.54 3.95 4.72 0.71 0.69 0.13 5.62 6.39 2.38 2.36 000 62287 ......... ............ A Percutaneous diskectomy ............................. 8.82 NA NA 4.22 5.23 0.58 NA NA 13.62 14.63 09062290 ......... ............ A Inject for spine disk x-ray .............................. 3.00 4.49 6.49 1.14 1.32 0.23 7.72 9.72 4.37 4.55 000 62291 ......... ............ A Inject for spine disk x-ray .............................. 2.91 4.29 5.54 1.08 1.19 0.26 7.46 8.71 4.25 4.36 000 62292 ......... ............ A Injection into disk lesion ................................ 9.10 NA NA 3.16 4.15 0.82 NA NA 13.08 14.07 090 62294 ......... ............ A Injection into spinal artery ............................. 12.73 NA NA 5.58 5.60 1.24 NA NA 19.55 19.57 090 62310 ......... ............ A Inject spine c/t ............................................... 1.91 3.05 4.38 0.57 0.63 0.12 5.08 6.41 2.60 2.66 000 62311 ......... ............ A Inject spine l/s (cd) ........................................ 1.54 2.70 4.37 0.53 0.58 0.09 4.33 6.00 2.16 2.21 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37347 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

62318 ......... ............ A Inject spine w/cath, c/t ................................... 2.04 3.24 5.12 0.47 0.61 0.12 5.40 7.28 2.63 2.77 000 62319 ......... ............ A Inject spine w/cath l/s (cd) ............................ 1.87 2.89 4.47 0.47 0.58 0.11 4.87 6.45 2.45 2.56 000 62350 ......... ............ A Implant spinal canal cath .............................. 7.96 NA NA 4.02 3.97 1.02 NA NA 13.00 12.95 090 62351 ......... ............ A Implant spinal canal cath .............................. 11.46 NA NA 7.39 7.20 2.24 NA NA 21.09 20.90 090 62355 ......... ............ A Remove spinal canal catheter ....................... 6.54 NA NA 3.44 3.24 0.71 NA NA 10.69 10.49 090 62360 ......... ............ A Insert spine infusion device ........................... 3.60 NA NA 3.31 2.85 0.34 NA NA 7.25 6.79 090 62361 ......... ............ A Implant spine infusion pump ......................... 6.51 NA NA 3.87 3.92 0.80 NA NA 11.18 11.23 09062362 ......... ............ A Implant spine infusion pump ......................... 8.50 NA NA 4.61 4.43 1.18 NA NA 14.29 14.11 09062365 ......... ............ A Remove spine infusion device ...................... 6.51 NA NA 3.78 3.64 0.86 NA NA 11.15 11.01 090 62367 ......... ............ A Analyze spine infusion pump ........................ 0.48 0.41 0.56 0.11 0.10 0.03 0.92 1.07 0.62 0.61 XXX 62368 ......... ............ A Analyze spine infusion pump ........................ 0.75 0.60 0.67 0.18 0.17 0.06 1.41 1.48 0.99 0.98 XXX 63001 ......... ............ A Removal of spinal lamina .............................. 17.47 NA NA 9.62 9.56 3.76 NA NA 30.85 30.79 090 63003 ......... ............ A Removal of spinal lamina .............................. 17.60 NA NA 9.54 9.80 3.72 NA NA 30.86 31.12 090 63005 ......... ............ A Removal of spinal lamina .............................. 16.22 NA NA 9.53 9.88 3.34 NA NA 29.09 29.44 090 63011 ......... ............ A Removal of spinal lamina .............................. 15.72 NA NA 9.00 8.47 3.37 NA NA 28.09 27.56 090 63012 ......... ............ A Removal of spinal lamina .............................. 16.66 NA NA 9.59 10.01 3.48 NA NA 29.73 30.15 090 63015 ......... ............ A Removal of spinal lamina .............................. 20.64 NA NA 11.68 11.85 4.75 NA NA 37.07 37.24 090 63016 ......... ............ A Removal of spinal lamina .............................. 21.85 NA NA 11.63 11.77 4.58 NA NA 38.06 38.20 090 63017 ......... ............ A Removal of spinal lamina .............................. 17.12 NA NA 10.16 10.36 3.63 NA NA 30.91 31.11 090 63020 ......... ............ A Neck spine disk surgery ................................ 15.99 NA NA 9.73 9.71 3.71 NA NA 29.43 29.41 090 63030 ......... ............ A Low back disk surgery .................................. 12.97 NA NA 8.46 8.45 3.00 NA NA 24.43 24.42 090 63035 ......... ............ A Spinal disk surgery add-on ........................... 3.15 NA NA 1.17 1.49 0.79 NA NA 5.11 5.43 ZZZ 63040 ......... ............ A Laminotomy, single cervical .......................... 20.12 NA NA 10.80 11.35 4.67 NA NA 35.59 36.14 090 63042 ......... ............ A Laminotomy, single lumbar ........................... 18.55 NA NA 10.41 11.13 4.25 NA NA 33.21 33.93 090 63045 ......... ............ A Removal of spinal lamina .............................. 17.76 NA NA 10.13 10.32 3.98 NA NA 31.87 32.06 090 63046 ......... ............ A Removal of spinal lamina .............................. 17.06 NA NA 9.63 10.07 3.55 NA NA 30.24 30.68 090 63047 ......... ............ A Removal of spinal lamina .............................. 15.16 NA NA 9.18 9.74 3.23 NA NA 27.57 28.13 090 63048 ......... ............ A Remove spinal lamina add-on ...................... 3.26 NA NA 1.21 1.55 0.72 NA NA 5.19 5.53 ZZZ 63050 ......... ............ A Cervical laminoplasty .................................... 21.82 NA NA 8.68 11.07 4.66 NA NA 35.16 37.55 090 63051 ......... ............ A C-laminoplasty w/graft/plate .......................... 25.32 NA NA 11.43 12.99 4.66 NA NA 41.41 42.97 090 63055 ......... ............ A Decompress spinal cord ................................ 23.36 NA NA 12.07 12.90 5.27 NA NA 40.70 41.53 090 63056 ......... ............ A Decompress spinal cord ................................ 21.67 NA NA 11.11 12.23 4.75 NA NA 37.53 38.65 090 63057 ......... ............ A Decompress spine cord add-on .................... 5.25 NA NA 1.91 2.46 1.22 NA NA 8.38 8.93 ZZZ 63064 ......... ............ A Decompress spinal cord ................................ 26.03 NA NA 13.04 14.11 5.69 NA NA 44.76 45.83 090 63066 ......... ............ A Decompress spine cord add-on .................... 3.26 NA NA 1.20 1.55 0.69 NA NA 5.15 5.50 ZZZ 63075 ......... ............ A Neck spine disk surgery ................................ 19.41 NA NA 10.99 11.84 4.62 NA NA 35.02 35.87 090 63076 ......... ............ A Neck spine disk surgery ................................ 4.04 NA NA 1.49 1.92 0.96 NA NA 6.49 6.92 ZZZ 63077 ......... ............ A Spine disk surgery, thorax ............................ 22.69 NA NA 10.94 12.36 3.98 NA NA 37.61 39.03 090 63078 ......... ............ A Spine disk surgery, thorax ............................ 3.28 NA NA 1.17 1.52 0.66 NA NA 5.11 5.46 ZZZ63081 ......... ............ A Removal of vertebral body ............................ 25.92 NA NA 13.25 14.08 5.54 NA NA 44.71 45.54 090 63082 ......... ............ A Remove vertebral body add-on ..................... 4.36 NA NA 1.61 2.08 1.02 NA NA 6.99 7.46 ZZZ 63085 ......... ............ A Removal of vertebral body ............................ 29.29 NA NA 13.49 15.01 4.48 NA NA 47.26 48.78 090 63086 ......... ............ A Remove vertebral body add-on ..................... 3.19 NA NA 1.14 1.48 0.59 NA NA 4.92 5.26 ZZZ 63087 ......... ............ A Removal of vertebral body ............................ 37.32 NA NA 16.46 18.75 6.20 NA NA 59.98 62.27 090 63088 ......... ............ A Remove vertebral body add-on ..................... 4.32 NA NA 1.59 2.03 0.82 NA NA 6.73 7.17 ZZZ 63090 ......... ............ A Removal of vertebral body ............................ 30.71 NA NA 13.90 15.54 4.21 NA NA 48.82 50.46 090 63091 ......... ............ A Remove vertebral body add-on ..................... 3.03 NA NA 1.10 1.37 0.48 NA NA 4.61 4.88 ZZZ 63101 ......... ............ A Removal of vertebral body ............................ 33.84 NA NA 16.71 18.68 5.69 NA NA 56.24 58.21 090 63102 ......... ............ A Removal of vertebral body ............................ 33.84 NA NA 16.45 18.61 5.69 NA NA 55.98 58.14 090 63103 ......... ............ A Remove vertebral body add-on ..................... 4.82 NA NA 1.72 2.31 0.69 NA NA 7.23 7.82 ZZZ 63170 ......... ............ A Incise spinal cord tract(s) .............................. 22.03 NA NA 12.28 11.99 4.86 NA NA 39.17 38.88 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37348 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

63172 ......... ............ A Drainage of spinal cyst .................................. 19.61 NA NA 10.97 10.75 4.48 NA NA 35.06 34.84 090 63173 ......... ............ A Drainage of spinal cyst .................................. 24.13 NA NA 13.00 12.88 5.68 NA NA 42.81 42.69 090 63180 ......... ............ A Revise spinal cord ligaments ........................ 20.35 NA NA 10.70 10.93 3.95 NA NA 35.00 35.23 090 63182 ......... ............ A Revise spinal cord ligaments ........................ 22.64 NA NA 7.04 10.00 5.30 NA NA 34.98 37.94 090 63185 ......... ............ A Incise spinal column/nerves .......................... 16.30 NA NA 9.87 8.55 2.79 NA NA 28.96 27.64 090 63190 ......... ............ A Incise spinal column/nerves .......................... 18.70 NA NA 9.93 10.10 3.24 NA NA 31.87 32.04 090 63191 ......... ............ A Incise spinal column/nerves .......................... 18.73 NA NA 10.50 10.50 6.34 NA NA 35.57 35.57 090 63194 ......... ............ A Incise spinal column & cord .......................... 21.91 NA NA 7.01 10.56 3.26 NA NA 32.18 35.73 090 63195 ......... ............ A Incise spinal column & cord .......................... 21.50 NA NA 11.83 11.26 4.87 NA NA 38.20 37.63 090 63196 ......... ............ A Incise spinal column & cord .......................... 25.08 NA NA 13.47 13.43 5.76 NA NA 44.31 44.27 090 63197 ......... ............ A Incise spinal column & cord .......................... 23.89 NA NA 13.04 12.44 5.36 NA NA 42.29 41.69 090 63198 ......... ............ A Incise spinal column & cord .......................... 29.69 NA NA 8.74 8.52 6.43 NA NA 44.86 44.64 090 63199 ......... ............ A Incise spinal column & cord .......................... 31.26 NA NA 9.10 13.58 1.40 NA NA 41.76 46.24 090 63200 ......... ............ A Release of spinal cord .................................. 21.26 NA NA 11.23 11.30 4.96 NA NA 37.45 37.52 090 63250 ......... ............ A Revise spinal cord vessels ............................ 43.68 NA NA 20.22 20.04 9.01 NA NA 72.91 72.73 090 63251 ......... ............ A Revise spinal cord vessels ............................ 44.42 NA NA 20.50 22.11 10.41 NA NA 75.33 76.94 090 63252 ......... ............ A Revise spinal cord vessels ............................ 44.41 NA NA 20.68 21.89 10.64 NA NA 75.73 76.94 090 63265 ......... ............ A Excise intraspinal lesion ................................ 23.64 NA NA 12.53 12.73 5.43 NA NA 41.60 41.80 090 63266 ......... ............ A Excise intraspinal lesion ................................ 24.50 NA NA 12.72 13.09 5.54 NA NA 42.76 43.13 090 63267 ......... ............ A Excise intraspinal lesion ................................ 19.26 NA NA 10.74 11.01 4.37 NA NA 34.37 34.64 090 63268 ......... ............ A Excise intraspinal lesion ................................ 19.83 NA NA 10.30 10.37 3.69 NA NA 33.82 33.89 090 63270 ......... ............ A Excise intraspinal lesion ................................ 29.62 NA NA 15.05 15.39 6.82 NA NA 51.49 51.83 090 63271 ......... ............ A Excise intraspinal lesion ................................ 29.74 NA NA 14.72 15.39 6.90 NA NA 51.36 52.03 090 63272 ......... ............ A Excise intraspinal lesion ................................ 27.31 NA NA 13.73 14.47 6.18 NA NA 47.22 47.96 090 63273 ......... ............ A Excise intraspinal lesion ................................ 26.28 NA NA 13.25 14.09 5.74 NA NA 45.27 46.11 090 63275 ......... ............ A Biopsy/excise spinal tumor ............................ 25.67 NA NA 12.95 13.59 5.80 NA NA 44.42 45.06 090 63276 ......... ............ A Biopsy/excise spinal tumor ............................ 25.50 NA NA 13.17 13.58 5.83 NA NA 44.50 44.91 090 63277 ......... ............ A Biopsy/excise spinal tumor ............................ 22.20 NA NA 11.66 12.33 5.01 NA NA 38.87 39.54 090 63278 ......... ............ A Biopsy/excise spinal tumor ............................ 21.93 NA NA 11.58 12.21 4.55 NA NA 38.06 38.69 090 63280 ......... ............ A Biopsy/excise spinal tumor ............................ 30.08 NA NA 15.35 16.10 7.27 NA NA 52.70 53.45 090 63281 ......... ............ A Biopsy/excise spinal tumor ............................ 29.78 NA NA 15.16 15.95 7.17 NA NA 52.11 52.90 090 63282 ......... ............ A Biopsy/excise spinal tumor ............................ 27.94 NA NA 14.49 15.14 6.76 NA NA 49.19 49.84 090 63283 ......... ............ A Biopsy/excise spinal tumor ............................ 26.55 NA NA 13.62 14.42 6.26 NA NA 46.43 47.23 090 63285 ......... ............ A Biopsy/excise spinal tumor ............................ 37.84 NA NA 18.27 19.56 9.18 NA NA 65.29 66.58 090 63286 ......... ............ A Biopsy/excise spinal tumor ............................ 37.41 NA NA 18.03 19.47 9.21 NA NA 64.65 66.09 090 63287 ......... ............ A Biopsy/excise spinal tumor ............................ 39.86 NA NA 18.69 20.03 9.39 NA NA 67.94 69.28 090 63290 ......... ............ A Biopsy/excise spinal tumor ............................ 40.60 NA NA 19.25 20.29 9.02 NA NA 68.87 69.91 090 63295 ......... ............ A Repair of laminectomy defect ....................... 5.25 NA NA 1.29 1.94 1.03 NA NA 7.57 8.22 ZZZ 63300 ......... ............ A Removal of vertebral body ............................ 26.62 NA NA 13.00 14.00 5.97 NA NA 45.59 46.59 090 63301 ......... ............ A Removal of vertebral body ............................ 31.35 NA NA 14.54 15.33 5.39 NA NA 51.28 52.07 090 63302 ......... ............ A Removal of vertebral body ............................ 30.93 NA NA 14.36 15.51 5.53 NA NA 50.82 51.97 090 63303 ......... ............ A Removal of vertebral body ............................ 33.37 NA NA 14.23 16.27 4.68 NA NA 52.28 54.32 090 63304 ......... ............ A Removal of vertebral body ............................ 33.64 NA NA 16.35 17.07 6.41 NA NA 56.40 57.12 090 63305 ......... ............ A Removal of vertebral body ............................ 36.03 NA NA 16.98 17.81 5.71 NA NA 58.72 59.55 090 63306 ......... ............ A Removal of vertebral body ............................ 35.33 NA NA 15.42 17.24 8.33 NA NA 59.08 60.90 090 63307 ......... ............ A Removal of vertebral body ............................ 34.74 NA NA 16.93 16.87 4.46 NA NA 56.13 56.07 090 63308 ......... ............ A Remove vertebral body add-on ..................... 5.24 NA NA 1.88 2.43 1.29 NA NA 8.41 8.96 ZZZ 63600 ......... ............ A Remove spinal cord lesion ............................ 14.98 NA NA 4.52 5.19 1.52 NA NA 21.02 21.69 090 63610 ......... ............ A Stimulation of spinal cord .............................. 8.72 13.99 48.39 1.50 2.07 0.86 23.57 57.97 11.08 11.65 000 63615 ......... ............ A Remove lesion of spinal cord ........................ 17.18 NA NA 5.83 8.43 2.84 NA NA 25.85 28.45 090 63650 ......... ............ A Implant neuroelectrodes ................................ 7.53 NA NA 2.85 3.10 0.53 NA NA 10.91 11.16 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37349 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

63655 ......... ............ A Implant neuroelectrodes ................................ 11.37 NA NA 7.47 7.05 2.43 NA NA 21.27 20.85 090 63660 ......... ............ A Revise/remove neuroelectrode ..................... 6.83 NA NA 3.21 3.52 0.78 NA NA 10.82 11.13 090 63685 ......... ............ A Insrt/redo spine n generator .......................... 7.83 NA NA 3.59 4.01 1.05 NA NA 12.47 12.89 090 63688 ......... ............ A Revise/remove neuroreceiver ....................... 6.06 NA NA 3.44 3.53 0.89 NA NA 10.39 10.48 090 63700 ......... ............ A Repair of spinal herniation ............................ 17.26 NA NA 9.40 10.10 3.52 NA NA 30.18 30.88 090 63702 ......... ............ A Repair of spinal herniation ............................ 19.20 NA NA 10.51 10.92 4.12 NA NA 33.83 34.24 090 63704 ......... ............ A Repair of spinal herniation ............................ 22.15 NA NA 12.16 12.75 4.57 NA NA 38.88 39.47 090 63706 ......... ............ A Repair of spinal herniation ............................ 25.07 NA NA 14.44 13.82 6.23 NA NA 45.74 45.12 090 63707 ......... ............ A Repair spinal fluid leakage ............................ 12.46 NA NA 7.56 7.68 2.51 NA NA 22.53 22.65 090 63709 ......... ............ A Repair spinal fluid leakage ............................ 15.46 NA NA 8.69 9.24 3.09 NA NA 27.24 27.79 090 63710 ......... ............ A Graft repair of spine defect ........................... 15.21 NA NA 8.85 9.01 3.40 NA NA 27.46 27.62 090 63740 ......... ............ A Install spinal shunt ......................................... 12.44 NA NA 7.87 7.49 2.93 NA NA 23.24 22.86 090 63741 ......... ............ A Install spinal shunt ......................................... 8.98 NA NA 4.66 4.74 1.66 NA NA 15.30 15.38 090 63744 ......... ............ A Revision of spinal shunt ................................ 8.82 NA NA 5.76 5.39 1.89 NA NA 16.47 16.10 090 63746 ......... ............ A Removal of spinal shunt ................................ 7.21 NA NA 4.48 3.96 1.53 NA NA 13.22 12.70 090 64400 ......... ............ A N block inj, trigeminal .................................... 1.11 1.40 1.78 0.44 0.43 0.07 2.58 2.96 1.62 1.61 000 64402 ......... ............ A N block inj, facial ........................................... 1.25 1.44 1.57 0.52 0.58 0.09 2.78 2.91 1.86 1.92 000 64405 ......... ............ A N block inj, occipital ...................................... 1.32 1.16 1.39 0.49 0.47 0.08 2.56 2.79 1.89 1.87 000 64408 ......... ............ A N block inj, vagus .......................................... 1.41 1.44 1.55 0.69 0.81 0.10 2.95 3.06 2.20 2.32 000 64410 ......... ............ A N block inj, phrenic ........................................ 1.43 1.82 2.34 0.52 0.48 0.09 3.34 3.86 2.04 2.00 000 64412 ......... ............ A N block inj, spinal accessor .......................... 1.18 2.03 2.50 0.54 0.46 0.08 3.29 3.76 1.80 1.72 000 64413 ......... ............ A N block inj, cervical plexus ............................ 1.40 1.29 1.71 0.47 0.49 0.08 2.77 3.19 1.95 1.97 000 64415 ......... ............ A N block inj, brachial plexus ........................... 1.48 1.49 2.48 0.34 0.43 0.09 3.06 4.05 1.91 2.00 000 64416 ......... ............ A N block cont infuse, b plex ............................ 3.85 NA NA 0.56 0.73 0.31 NA NA 4.72 4.89 010 64417 ......... ............ A N block inj, axillary ........................................ 1.44 1.50 2.66 0.35 0.46 0.11 3.05 4.21 1.90 2.01 000 64418 ......... ............ A N block inj, suprascapular ............................. 1.32 1.88 2.44 0.51 0.46 0.07 3.27 3.83 1.90 1.85 000 64420 ......... ............ A N block inj, intercost, sng .............................. 1.18 2.38 3.51 0.44 0.43 0.08 3.64 4.77 1.70 1.69 000 64421 ......... ............ A N block inj, intercost, mlt ............................... 1.68 3.52 5.46 0.52 0.52 0.11 5.31 7.25 2.31 2.31 000 64425 ......... ............ A N block inj, ilio-ing/hypogi ............................. 1.75 1.33 1.57 0.55 0.54 0.13 3.21 3.45 2.43 2.42 000 64430 ......... ............ A N block inj, pudendal ..................................... 1.46 2.47 2.51 0.81 0.62 0.10 4.03 4.07 2.37 2.18 000 64435 ......... ............ A N block inj, paracervical ................................ 1.45 1.97 2.39 0.54 0.65 0.16 3.58 4.00 2.15 2.26 000 64445 ......... ............ A N block inj, sciatic, sng ................................. 1.48 1.65 2.42 0.51 0.50 0.10 3.23 4.00 2.09 2.08 000 64446 ......... ............ A N blk inj, sciatic, cont inf ............................... 3.61 NA NA 0.57 0.89 0.20 NA NA 4.38 4.70 010 64447 ......... ............ A N block inj fem, single ................................... 1.50 NA NA 0.20 0.37 0.09 NA NA 1.79 1.96 000 64448 ......... ............ A N block inj fem, cont inf ................................ 3.36 NA NA 0.46 0.72 0.18 NA NA 4.00 4.26 010 64449 ......... ............ A N block inj, lumbar plexus ............................. 3.24 NA NA 0.48 0.84 0.15 NA NA 3.87 4.23 010 64450 ......... ............ A N block, other peripheral ............................... 1.27 1.28 1.25 0.49 0.48 0.13 2.68 2.65 1.89 1.88 000 64470 ......... ............ A Inj paravertebral c/t ....................................... 1.85 3.84 6.40 0.70 0.71 0.11 5.80 8.36 2.66 2.67 000 64472 ......... ............ A Inj paravertebral c/t add-on ........................... 1.29 1.22 2.06 0.33 0.34 0.08 2.59 3.43 1.70 1.71 ZZZ 64475 ......... ............ A Inj paravertebral l/s ........................................ 1.41 3.70 6.10 0.59 0.62 0.10 5.21 7.61 2.10 2.13 000 64476 ......... ............ A Inj paravertebral l/s add-on ........................... 0.98 1.11 1.88 0.23 0.24 0.07 2.16 2.93 1.28 1.29 ZZZ 64479 ......... ............ A Inj foramen epidural c/t ................................. 2.20 3.78 6.58 0.81 0.87 0.12 6.10 8.90 3.13 3.19 000 64480 ......... ............ A Inj foramen epidural add-on .......................... 1.54 1.48 2.51 0.37 0.45 0.10 3.12 4.15 2.01 2.09 ZZZ 64483 ......... ............ A Inj foramen epidural l/s .................................. 1.90 3.83 6.89 0.75 0.81 0.11 5.84 8.90 2.76 2.82 000 64484 ......... ............ A Inj foramen epidural add-on .......................... 1.33 1.61 2.87 0.32 0.36 0.08 3.02 4.28 1.73 1.77 ZZZ 64505 ......... ............ A N block, spenopalatine gangl ........................ 1.36 1.10 1.21 0.71 0.67 0.10 2.56 2.67 2.17 2.13 000 64508 ......... ............ A N block, carotid sinus s/p .............................. 1.12 1.88 2.97 0.48 0.68 0.07 3.07 4.16 1.67 1.87 000 64510 ......... ............ A N block, stellate ganglion .............................. 1.22 1.91 3.07 0.43 0.49 0.07 3.20 4.36 1.72 1.78 000 64517 ......... ............ A N block inj, hypogas plxs .............................. 2.20 1.69 2.47 0.66 0.82 0.11 4.00 4.78 2.97 3.13 000 64520 ......... ............ A N block, lumbar/thoracic ................................ 1.35 2.62 4.52 0.52 0.54 0.08 4.05 5.95 1.95 1.97 000 64530 ......... ............ A N block inj, celiac pelus ................................ 1.58 2.66 4.01 0.60 0.64 0.10 4.34 5.69 2.28 2.32 000 64550 ......... ............ A Apply neurostimulator .................................... 0.18 0.20 0.26 0.06 0.05 0.01 0.39 0.45 0.25 0.24 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37350 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

64553 ......... ............ A Implant neuroelectrodes ................................ 2.31 2.47 2.75 1.33 1.73 0.18 4.96 5.24 3.82 4.22 010 64555 ......... ............ A Implant neuroelectrodes ................................ 2.27 2.56 2.97 1.35 1.23 0.19 5.02 5.43 3.81 3.69 010 64560 ......... ............ A Implant neuroelectrodes ................................ 2.36 2.51 2.61 1.34 1.30 0.22 5.09 5.19 3.92 3.88 010 64561 ......... ............ A Implant neuroelectrodes ................................ 7.05 20.42 27.71 3.96 3.08 0.51 27.98 35.27 11.52 10.64 010 64565 ......... ............ A Implant neuroelectrodes ................................ 1.76 2.42 3.07 1.25 1.26 0.13 4.31 4.96 3.14 3.15 010 64573 ......... ............ A Implant neuroelectrodes ................................ 8.11 NA NA 5.17 5.24 1.60 NA NA 14.88 14.95 090 64575 ......... ............ A Implant neuroelectrodes ................................ 4.34 NA NA 1.89 2.48 0.61 NA NA 6.84 7.43 090 64577 ......... ............ A Implant neuroelectrodes ................................ 4.61 NA NA 2.74 3.15 1.04 NA NA 8.39 8.80 090 64580 ......... ............ A Implant neuroelectrodes ................................ 4.11 NA NA 2.56 3.31 0.36 NA NA 7.03 7.78 090 64581 ......... ............ A Implant neuroelectrodes ................................ 14.13 NA NA 6.89 5.77 1.05 NA NA 22.07 20.95 090 64585 ......... ............ A Revise/remove neuroelectrode ..................... 2.06 5.88 9.95 2.27 2.17 0.20 8.14 12.21 4.53 4.43 010 64590 ......... ............ A Insrt/redo perph n generator ......................... 2.40 6.54 7.01 2.51 2.35 0.19 9.13 9.60 5.10 4.94 010 64595 ......... ............ A Revise/remove neuroreceiver ....................... 1.73 6.62 9.47 2.24 2.01 0.19 8.54 11.39 4.16 3.93 010 64600 ......... ............ A Injection treatment of nerve .......................... 3.44 5.25 8.35 1.56 1.63 0.34 9.03 12.13 5.34 5.41 010 64605 ......... ............ A Injection treatment of nerve .......................... 5.60 7.56 9.08 2.34 2.23 0.79 13.95 15.47 8.73 8.62 010 64610 ......... ............ A Injection treatment of nerve .......................... 7.15 9.23 8.98 3.43 3.65 1.58 17.96 17.71 12.16 12.38 010 64612 ......... ............ A Destroy nerve, face muscle .......................... 1.96 1.49 2.24 1.31 1.32 0.11 3.56 4.31 3.38 3.39 010 64613 ......... ............ A Destroy nerve, neck muscle .......................... 1.96 1.33 2.54 1.10 1.19 0.11 3.40 4.61 3.17 3.26 010 64614 ......... ............ A Destroy nerve, extrem musc ......................... 2.20 1.59 2.82 1.28 1.30 0.10 3.89 5.12 3.58 3.60 010 64620 ......... ............ A Injection treatment of nerve .......................... 2.84 3.44 4.66 1.16 1.29 0.20 6.48 7.70 4.20 4.33 010 64622 ......... ............ A Destr paravertebrl nerve l/s ........................... 3.00 4.07 6.85 1.25 1.34 0.18 7.25 10.03 4.43 4.52 010 64623 ......... ............ A Destr paravertebral n add-on ........................ 0.99 1.64 2.64 0.21 0.22 0.06 2.69 3.69 1.26 1.27 ZZZ 64626 ......... ............ A Destr paravertebrl nerve c/t .......................... 3.78 4.70 7.03 1.84 1.94 0.20 8.68 11.01 5.82 5.92 010 64627 ......... ............ A Destr paravertebral n add-on ........................ 1.16 2.37 4.00 0.24 0.26 0.07 3.60 5.23 1.47 1.49 ZZZ 64630 ......... ............ A Injection treatment of nerve .......................... 3.00 2.82 2.76 1.89 1.53 0.22 6.04 5.98 5.11 4.75 010 64640 ......... ............ A Injection treatment of nerve .......................... 2.76 2.41 3.75 1.41 1.74 0.29 5.46 6.80 4.46 4.79 010 64650 ......... ............ A Chemodenerv eccrine glands ....................... 0.70 0.77 0.85 0.17 0.27 0.06 1.53 1.61 0.93 1.03 000 64653 ......... ............ A Chemodenerv eccrine glands ....................... 0.88 0.81 0.89 0.21 0.34 0.08 1.77 1.85 1.17 1.30 000 64680 ......... ............ A Injection treatment of nerve .......................... 2.62 4.03 6.06 1.10 1.35 0.18 6.83 8.86 3.90 4.15 010 64681 ......... ............ A Injection treatment of nerve .......................... 3.78 4.90 8.22 1.30 1.88 0.28 8.96 12.28 5.36 5.94 010 64702 ......... ............ A Revise finger/toe nerve ................................. 6.02 NA NA 4.02 3.91 0.61 NA NA 10.65 10.54 090 64704 ......... ............ A Revise hand/foot nerve ................................. 4.56 NA NA 3.02 3.25 0.61 NA NA 8.19 8.42 090 64708 ......... ............ A Revise arm/leg nerve .................................... 6.17 NA NA 4.08 4.67 0.96 NA NA 11.21 11.80 090 64712 ......... ............ A Revision of sciatic nerve ............................... 7.92 NA NA 4.30 4.80 0.95 NA NA 13.17 13.67 090 64713 ......... ............ A Revision of arm nerve(s) ............................... 11.22 NA NA 6.29 5.99 1.82 NA NA 19.33 19.03 090 64714 ......... ............ A Revise low back nerve(s) .............................. 10.37 NA NA 4.69 4.33 1.19 NA NA 16.25 15.89 090 64716 ......... ............ A Revision of cranial nerve ............................... 6.80 NA NA 5.04 5.75 0.63 NA NA 12.47 13.18 090 64718 ......... ............ A Revise ulnar nerve at elbow ......................... 6.98 NA NA 5.98 6.00 1.05 NA NA 14.01 14.03 09064719 ......... ............ A Revise ulnar nerve at wrist ........................... 4.84 NA NA 3.96 4.39 0.77 NA NA 9.57 10.00 090 64721 ......... ............ A Carpal tunnel surgery .................................... 4.78 NA NA 4.64 5.20 0.73 NA NA 10.15 10.71 090 64722 ......... ............ A Relieve pressure on nerve(s) ........................ 4.69 NA NA 2.70 2.96 0.48 NA NA 7.87 8.13 090 64726 ......... ............ A Release foot/toe nerve .................................. 4.17 NA NA 2.57 2.74 0.54 NA NA 7.28 7.45 090 64727 ......... ............ A Internal nerve revision ................................... 3.10 NA NA 1.19 1.42 0.48 NA NA 4.77 5.00 ZZZ 64732 ......... ............ A Incision of brow nerve ................................... 4.77 NA NA 4.02 3.64 0.98 NA NA 9.77 9.39 090 64734 ......... ............ A Incision of cheek nerve ................................. 5.41 NA NA 4.38 4.14 0.89 NA NA 10.68 10.44 090 64736 ......... ............ A Incision of chin nerve .................................... 5.09 NA NA 3.70 3.95 0.52 NA NA 9.31 9.56 090 64738 ......... ............ A Incision of jaw nerve ..................................... 6.22 NA NA 4.04 4.48 1.08 NA NA 11.34 11.78 090 64740 ......... ............ A Incision of tongue nerve ................................ 6.08 NA NA 4.37 4.94 0.69 NA NA 11.14 11.71 090 64742 ......... ............ A Incision of facial nerve .................................. 6.71 NA NA 4.14 4.57 0.73 NA NA 11.58 12.01 090 64744 ......... ............ A Incise nerve, back of head ............................ 5.60 NA NA 4.33 3.92 1.16 NA NA 11.09 10.68 090 64746 ......... ............ A Incise diaphragm nerve ................................. 6.42 NA NA 3.77 4.33 0.82 NA NA 11.01 11.57 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37351 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

64752 ......... ............ A Incision of vagus nerve ................................. 7.55 NA NA 3.91 4.20 0.93 NA NA 12.39 12.68 090 64755 ......... ............ A Incision of stomach nerves ........................... 14.93 NA NA 5.63 5.65 1.83 NA NA 22.39 22.41 090 64760 ......... ............ A Incision of vagus nerve ................................. 7.45 NA NA 3.70 3.52 0.81 NA NA 11.96 11.78 090 64761 ......... ............ A Incision of pelvis nerve .................................. 6.90 NA NA 3.87 3.62 0.53 NA NA 11.30 11.05 090 64763 ......... ............ A Incise hip/thigh nerve .................................... 7.42 NA NA 4.83 5.12 0.94 NA NA 13.19 13.48 090 64766 ......... ............ A Incise hip/thigh nerve .................................... 9.28 NA NA 5.07 5.21 1.06 NA NA 15.41 15.55 090 64771 ......... ............ A Sever cranial nerve ....................................... 7.96 NA NA 5.05 5.44 1.23 NA NA 14.24 14.63 090 64772 ......... ............ A Incision of spinal nerve ................................. 7.70 NA NA 5.06 4.96 1.40 NA NA 14.16 14.06 090 64774 ......... ............ A Remove skin nerve lesion ............................. 5.66 NA NA 3.79 3.83 0.74 NA NA 10.19 10.23 090 64776 ......... ............ A Remove digit nerve lesion ............................. 5.48 NA NA 3.56 3.66 0.76 NA NA 9.80 9.90 09064778 ......... ............ A Digit nerve surgery add-on ............................ 3.11 NA NA 1.16 1.42 0.46 NA NA 4.73 4.99 ZZZ64782 ......... ............ A Remove limb nerve lesion ............................. 6.72 NA NA 3.91 3.81 0.86 NA NA 11.49 11.39 090 64783 ......... ............ A Limb nerve surgery add-on ........................... 3.71 NA NA 1.37 1.72 0.51 NA NA 5.59 5.94 ZZZ 64784 ......... ............ A Remove nerve lesion .................................... 10.43 NA NA 5.95 6.45 1.38 NA NA 17.76 18.26 090 64786 ......... ............ A Remove sciatic nerve lesion ......................... 16.06 NA NA 8.63 9.55 2.60 NA NA 27.29 28.21 090 64787 ......... ............ A Implant nerve end ......................................... 4.29 NA NA 1.55 1.99 0.58 NA NA 6.42 6.86 ZZZ 64788 ......... ............ A Remove skin nerve lesion ............................. 5.10 NA NA 3.68 3.52 0.73 NA NA 9.51 9.35 090 64790 ......... ............ A Removal of nerve lesion ............................... 11.91 NA NA 6.60 7.07 2.10 NA NA 20.61 21.08 090 64792 ......... ............ A Removal of nerve lesion ............................... 15.65 NA NA 8.11 8.67 2.48 NA NA 26.24 26.80 090 64795 ......... ............ A Biopsy of nerve ............................................. 3.01 NA NA 1.42 1.53 0.52 NA NA 4.95 5.06 000 64802 ......... ............ A Remove sympathetic nerves ......................... 10.18 NA NA 4.08 4.88 1.29 NA NA 15.55 16.35 090 64804 ......... ............ A Remove sympathetic nerves ......................... 15.72 NA NA 6.10 6.91 2.14 NA NA 23.96 24.77 090 64809 ......... ............ A Remove sympathetic nerves ......................... 14.57 NA NA 6.58 5.98 1.50 NA NA 22.65 22.05 090 64818 ......... ............ A Remove sympathetic nerves ......................... 11.20 NA NA 4.32 5.06 1.33 NA NA 16.85 17.59 090 64820 ......... ............ A Remove sympathetic nerves ......................... 10.60 NA NA 6.76 7.05 1.49 NA NA 18.85 19.14 090 64821 ......... ............ A Remove sympathetic nerves ......................... 9.11 NA NA 6.51 7.15 1.24 NA NA 16.86 17.50 090 64822 ......... ............ A Remove sympathetic nerves ......................... 9.11 NA NA 6.32 7.02 1.30 NA NA 16.73 17.43 090 64823 ......... ............ A Remove sympathetic nerves ......................... 10.72 NA NA 7.08 7.88 1.57 NA NA 19.37 20.17 090 64831 ......... ............ A Repair of digit nerve ...................................... 10.17 NA NA 6.41 6.92 1.41 NA NA 17.99 18.50 090 64832 ......... ............ A Repair nerve add-on ..................................... 5.65 NA NA 2.28 2.78 0.85 NA NA 8.78 9.28 ZZZ 64834 ......... ............ A Repair of hand or foot nerve ......................... 10.67 NA NA 6.32 6.91 1.54 NA NA 18.53 19.12 090 64835 ......... ............ A Repair of hand or foot nerve ......................... 11.54 NA NA 7.03 7.54 1.73 NA NA 20.30 20.81 090 64836 ......... ............ A Repair of hand or foot nerve ......................... 11.54 NA NA 6.78 7.46 1.67 NA NA 19.99 20.67 090 64837 ......... ............ A Repair nerve add-on ..................................... 6.25 NA NA 2.62 3.09 0.97 NA NA 9.84 10.31 ZZZ 64840 ......... ............ A Repair of leg nerve ........................................ 13.81 NA NA 4.86 7.42 1.37 NA NA 20.04 22.60 090 64856 ......... ............ A Repair/transpose nerve ................................. 14.88 NA NA 8.36 9.00 2.12 NA NA 25.36 26.00 090 64857 ......... ............ A Repair arm/leg nerve ..................................... 15.63 NA NA 8.61 9.40 2.21 NA NA 26.45 27.24 090 64858 ......... ............ A Repair sciatic nerve ....................................... 17.63 NA NA 9.80 10.55 3.33 NA NA 30.76 31.51 090 64859 ......... ............ A Nerve surgery ................................................ 4.25 NA NA 1.83 2.11 0.67 NA NA 6.75 7.03 ZZZ 64861 ......... ............ A Repair of arm nerves .................................... 20.68 NA NA 9.71 11.28 4.08 NA NA 34.47 36.04 090 64862 ......... ............ A Repair of low back nerves ............................ 20.88 NA NA 6.55 10.61 4.31 NA NA 31.74 35.80 090 64864 ......... ............ A Repair of facial nerve .................................... 13.27 NA NA 6.90 8.32 1.26 NA NA 21.43 22.85 090 64865 ......... ............ A Repair of facial nerve .................................... 15.90 NA NA 9.72 12.60 1.50 NA NA 27.12 30.00 090 64866 ......... ............ A Fusion of facial/other nerve ........................... 16.64 NA NA 12.02 12.91 2.04 NA NA 30.70 31.59 090 64868 ......... ............ A Fusion of facial/other nerve ........................... 14.76 NA NA 8.96 10.84 1.43 NA NA 25.15 27.03 090 64870 ......... ............ A Fusion of facial/other nerve ........................... 16.89 NA NA 8.06 8.58 1.30 NA NA 26.25 26.77 090 64872 ......... ............ A Subsequent repair of nerve ........................... 1.99 NA NA 0.79 1.01 0.29 NA NA 3.07 3.29 ZZZ 64874 ......... ............ A Repair & revise nerve add-on ....................... 2.98 NA NA 1.17 1.44 0.42 NA NA 4.57 4.84 ZZZ 64876 ......... ............ A Repair nerve/shorten bone ............................ 3.37 NA NA 0.76 1.50 0.47 NA NA 4.60 5.34 ZZZ 64885 ......... ............ A Nerve graft, head or neck ............................. 17.50 NA NA 8.66 10.89 1.63 NA NA 27.79 30.02 090 64886 ......... ............ A Nerve graft, head or neck ............................. 20.72 NA NA 9.55 12.57 2.08 NA NA 32.35 35.37 090 64890 ......... ............ A Nerve graft, hand or foot ............................... 16.05 NA NA 8.75 9.70 2.29 NA NA 27.09 28.04 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37352 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

64891 ......... ............ A Nerve graft, hand or foot ............................... 17.16 NA NA 9.52 8.08 1.63 NA NA 28.31 26.87 090 64892 ......... ............ A Nerve graft, arm or leg .................................. 15.55 NA NA 8.62 8.82 2.47 NA NA 26.64 26.84 090 64893 ......... ............ A Nerve graft, arm or leg .................................. 16.68 NA NA 9.32 9.75 2.61 NA NA 28.61 29.04 090 64895 ......... ............ A Nerve graft, hand or foot ............................... 20.20 NA NA 9.73 9.69 2.57 NA NA 32.50 32.46 090 64896 ......... ............ A Nerve graft, hand or foot ............................... 21.75 NA NA 11.49 11.13 3.16 NA NA 36.40 36.04 090 64897 ......... ............ A Nerve graft, arm or leg .................................. 19.19 NA NA 10.05 10.55 2.54 NA NA 31.78 32.28 090 64898 ......... ............ A Nerve graft, arm or leg .................................. 20.76 NA NA 10.88 11.59 2.77 NA NA 34.41 35.12 090 64901 ......... ............ A Nerve graft add-on ........................................ 10.20 NA NA 3.71 4.89 1.37 NA NA 15.28 16.46 ZZZ 64902 ......... ............ A Nerve graft add-on ........................................ 11.81 NA NA 4.14 5.52 1.55 NA NA 17.50 18.88 ZZZ 64905 ......... ............ A Nerve pedicle transfer ................................... 14.92 NA NA 6.59 8.03 2.00 NA NA 23.51 24.95 090 64907 ......... ............ A Nerve pedicle transfer ................................... 19.84 NA NA 6.14 10.96 3.16 NA NA 29.14 33.96 090 65091 ......... ............ A Revise eye ..................................................... 7.07 NA NA 6.66 7.94 0.32 NA NA 14.05 15.33 090 65093 ......... ............ A Revise eye with implant ................................ 6.86 NA NA 6.76 8.25 0.34 NA NA 13.96 15.45 090 65101 ......... ............ A Removal of eye ............................................. 8.02 NA NA 7.86 9.13 0.35 NA NA 16.23 17.50 090 65103 ......... ............ A Remove eye/insert implant ............................ 8.56 NA NA 8.09 9.34 0.37 NA NA 17.02 18.27 090 65105 ......... ............ A Remove eye/attach implant ........................... 9.60 NA NA 8.74 10.05 0.42 NA NA 18.76 20.07 090 65110 ......... ............ A Removal of eye ............................................. 15.30 NA NA 11.16 13.07 0.81 NA NA 27.27 29.18 090 65112 ......... ............ A Remove eye/revise socket ............................ 18.04 NA NA 12.57 15.28 1.30 NA NA 31.91 34.62 090 65114 ......... ............ A Remove eye/revise socket ............................ 19.18 NA NA 13.21 15.60 1.02 NA NA 33.41 35.80 090 65125 ......... ............ A Revise ocular implant .................................... 3.12 6.73 8.31 3.13 3.49 0.19 10.04 11.62 6.44 6.80 090 65130 ......... ............ A Insert ocular implant ...................................... 8.14 NA NA 7.69 8.82 0.35 NA NA 16.18 17.31 090 65135 ......... ............ A Insert ocular implant ...................................... 8.32 NA NA 7.68 8.93 0.36 NA NA 16.36 17.61 090 65140 ......... ............ A Attach ocular implant ..................................... 9.13 NA NA 8.27 9.49 0.40 NA NA 17.80 19.02 090 65150 ......... ............ A Revise ocular implant .................................... 6.25 NA NA 6.24 7.55 0.31 NA NA 12.80 14.11 090 65155 ......... ............ A Reinsert ocular implant ................................. 9.77 NA NA 8.52 10.01 0.50 NA NA 18.79 20.28 090 65175 ......... ............ A Removal of ocular implant ............................ 7.14 NA NA 7.03 8.13 0.31 NA NA 14.48 15.58 090 65205 ......... ............ A Remove foreign body from eye ..................... 0.71 0.57 0.62 0.32 0.30 0.03 1.31 1.36 1.06 1.04 000 65210 ......... ............ A Remove foreign body from eye ..................... 0.84 0.72 0.79 0.39 0.38 0.04 1.60 1.67 1.27 1.26 000 65220 ......... ............ A Remove foreign body from eye ..................... 0.71 0.59 0.63 0.28 0.28 0.05 1.35 1.39 1.04 1.04 000 65222 ......... ............ A Remove foreign body from eye ..................... 0.93 0.79 0.87 0.42 0.39 0.04 1.76 1.84 1.39 1.36 000 65235 ......... ............ A Remove foreign body from eye ..................... 8.68 NA NA 6.44 6.68 0.37 NA NA 15.49 15.73 090 65260 ......... ............ A Remove foreign body from eye ..................... 12.19 NA NA 8.59 9.41 0.57 NA NA 21.35 22.17 090 65265 ......... ............ A Remove foreign body from eye ..................... 13.94 NA NA 9.40 10.34 0.62 NA NA 23.96 24.90 090 65270 ......... ............ A Repair of eye wound ..................................... 1.90 3.76 4.87 1.16 1.33 0.09 5.75 6.86 3.15 3.32 010 65272 ......... ............ A Repair of eye wound ..................................... 4.43 6.23 7.36 3.10 3.25 0.19 10.85 11.98 7.72 7.87 090 65273 ......... ............ A Repair of eye wound ..................................... 4.97 NA NA 3.30 3.52 0.22 NA NA 8.49 8.71 090 65275 ......... ............ A Repair of eye wound ..................................... 6.08 6.21 6.30 3.82 3.92 0.26 12.55 12.64 10.16 0.26 090 65280 ......... ............ A Repair of eye wound ..................................... 8.77 NA NA 5.65 6.10 0.38 NA NA 14.80 15.25 090 65285 ......... ............ A Repair of eye wound ..................................... 14.31 NA NA 8.19 8.98 0.64 NA NA 23.14 23.93 090 65286 ......... ............ A Repair of eye wound ..................................... 6.37 8.69 10.55 4.34 4.56 0.27 15.33 17.19 10.98 11.20 090 65290 ......... ............ A Repair of eye socket wound ......................... 6.27 NA NA 4.36 4.65 0.31 NA NA 10.94 11.23 090 65400 ......... ............ A Removal of eye lesion ................................... 7.17 7.51 8.14 5.89 6.08 0.30 14.98 15.61 13.36 13.55 090 65410 ......... ............ A Biopsy of cornea ........................................... 1.47 1.69 2.01 0.87 0.95 0.07 3.23 3.55 2.41 2.49 000 65420 ......... ............ A Removal of eye lesion ................................... 4.16 6.91 8.39 3.98 4.33 0.21 11.28 12.76 8.35 8.70 090 65426 ......... ............ A Removal of eye lesion ................................... 5.85 8.26 9.72 4.60 4.85 0.25 14.36 15.82 10.70 10.95 090 65430 ......... ............ A Corneal smear ............................................... 1.47 1.10 1.24 0.87 0.95 0.07 2.64 2.78 2.41 2.49 000 65435 ......... ............ A Curette/treat cornea ...................................... 0.92 0.87 0.97 0.66 0.70 0.04 1.83 1.93 1.62 1.66 000 65436 ......... ............ A Curette/treat cornea ...................................... 4.68 3.79 4.02 3.46 3.63 0.21 8.68 8.91 8.35 8.52 090 65450 ......... ............ A Treatment of corneal lesion .......................... 3.27 3.68 3.98 3.61 3.87 0.16 7.11 7.41 7.04 7.30 090 65600 ......... ............ A Revision of cornea ........................................ 4.01 4.43 4.87 3.43 3.38 0.17 8.61 9.05 7.61 7.56 090 65710 ......... ............ A Corneal transplant ......................................... 13.97 NA NA 10.39 11.02 0.61 NA NA 24.97 25.60 090 65730 ......... ............ A Corneal transplant ......................................... 15.87 NA NA 10.90 11.76 0.70 NA NA 27.47 28.33 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37353 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

65750 ......... ............ A Corneal transplant ......................................... 16.48 NA NA 10.72 11.68 0.74 NA NA 27.94 28.90 090 65755 ......... ............ A Corneal transplant ......................................... 16.37 NA NA 10.69 11.61 0.73 NA NA 27.79 28.71 090 65770 ......... ............ A Revise cornea with implant ........................... 19.27 NA NA 11.83 12.89 0.87 NA NA 31.97 33.03 090 65772 ......... ............ A Correction of astigmatism ............................. 4.90 4.89 5.39 3.95 4.09 0.21 10.00 10.50 9.06 9.20 090 65775 ......... ............ A Correction of astigmatism ............................. 6.65 NA NA 5.51 5.86 0.28 NA NA 12.44 12.79 090 65780 ......... ............ A Ocular reconst, transplant ............................. 10.23 NA NA 8.98 9.99 0.44 NA NA 19.65 20.66 090 65781 ......... ............ A Ocular reconst, transplant ............................. 17.64 NA NA 11.64 13.19 0.44 NA NA 29.72 31.27 090 65782 ......... ............ A Ocular reconst, transplant ............................. 14.98 NA NA 10.27 11.58 0.44 NA NA 25.69 27.00 090 65800 ......... ............ A Drainage of eye ............................................. 1.91 1.42 1.71 1.04 1.15 0.09 3.42 3.71 3.04 3.15 000 65805 ......... ............ A Drainage of eye ............................................. 1.91 1.72 2.07 1.04 1.15 0.09 3.72 4.07 3.04 3.15 000 65810 ......... ............ A Drainage of eye ............................................. 5.61 NA NA 4.49 4.66 0.24 NA NA 10.34 10.51 090 65815 ......... ............ A Drainage of eye ............................................. 5.79 7.92 9.50 4.56 4.76 0.25 13.96 15.54 10.60 10.80 090 65820 ......... ............ A Relieve inner eye pressure ........................... 8.62 NA NA 7.60 8.71 0.40 NA NA 16.62 17.73 090 65850 ......... ............ A Incision of eye ............................................... 11.14 NA NA 7.27 8.16 0.52 NA NA 18.93 19.82 090 65855 ......... ............ A Laser surgery of eye ..................................... 3.84 3.52 4.12 2.64 2.99 0.19 7.55 8.15 6.67 7.02 010 65860 ......... ............ A Incise inner eye adhesions ........................... 3.54 3.29 3.86 2.10 2.41 0.18 7.01 7.58 5.82 6.13 090 65865 ......... ............ A Incise inner eye adhesions ........................... 5.59 NA NA 4.77 5.42 0.28 NA NA 10.64 11.29 090 65870 ......... ............ A Incise inner eye adhesions ........................... 7.13 NA NA 5.79 6.27 0.31 NA NA 13.23 13.71 090 65875 ......... ............ A Incise inner eye adhesions ........................... 7.53 NA NA 6.20 6.66 0.32 NA NA 14.05 14.51 090 65880 ......... ............ A Incise inner eye adhesions ........................... 8.08 NA NA 6.41 6.89 0.35 NA NA 14.84 15.32 090 65900 ......... ............ A Remove eye lesion ........................................ 12.16 NA NA 9.00 9.96 0.54 NA NA 21.70 22.66 090 65920 ......... ............ A Remove implant of eye ................................. 9.64 NA NA 7.50 8.02 0.41 NA NA 17.55 18.07 090 65930 ......... ............ A Remove blood clot from eye ......................... 8.18 NA NA 6.02 6.64 0.37 NA NA 14.57 15.19 090 66020 ......... ............ A Injection treatment of eye .............................. 1.59 2.44 2.96 1.28 1.40 0.08 4.11 4.63 2.95 3.07 010 66030 ......... ............ A Injection treatment of eye .............................. 1.25 2.32 2.81 1.16 1.25 0.06 3.63 4.12 2.47 2.56 010 66130 ......... ............ A Remove eye lesion ........................................ 7.68 7.41 9.09 4.79 5.42 0.38 15.47 17.15 12.85 13.48 090 66150 ......... ............ A Glaucoma surgery ......................................... 10.04 NA NA 8.78 9.27 0.46 NA NA 19.28 19.77 090 66155 ......... ............ A Glaucoma surgery ......................................... 10.03 NA NA 8.77 9.23 0.41 NA NA 19.21 19.67 090 66160 ......... ............ A Glaucoma surgery ......................................... 11.90 NA NA 9.50 10.04 0.50 NA NA 21.90 22.44 090 66165 ......... ............ A Glaucoma surgery ......................................... 9.75 NA NA 8.72 9.13 0.40 NA NA 18.87 19.28 090 66170 ......... ............ A Glaucoma surgery ......................................... 14.39 NA NA 11.45 12.06 0.60 NA NA 26.44 27.05 090 66172 ......... ............ A Incision of eye ............................................... 18.02 NA NA 14.39 15.03 0.74 NA NA 33.15 33.79 090 66180 ......... ............ A Implant eye shunt .......................................... 15.90 NA NA 9.74 10.53 0.71 NA NA 26.35 27.14 090 66185 ......... ............ A Revise eye shunt ........................................... 9.25 NA NA 7.20 7.35 0.40 NA NA 16.85 17.00 090 66220 ......... ............ A Repair eye lesion .......................................... 8.88 NA NA 6.86 7.06 0.40 NA NA 16.14 16.34 090 66225 ......... ............ A Repair/graft eye lesion .................................. 12.28 NA NA 8.22 8.63 0.55 NA NA 21.05 21.46 090 66250 ......... ............ A Follow-up surgery of eye ............................... 6.84 9.23 11.10 5.21 5.43 0.30 16.37 18.24 12.35 12.57 090 66500 ......... ............ A Incision of iris ................................................ 3.70 NA NA 3.87 4.46 0.18 NA NA 7.75 8.34 090 66505 ......... ............ A Incision of iris ................................................ 4.07 NA NA 4.20 4.80 0.20 NA NA 8.47 9.07 090 66600 ......... ............ A Remove iris and lesion .................................. 9.79 NA NA 8.16 8.22 0.43 NA NA 18.38 18.44 090 66505 ......... ............ A Removal of iris .............................................. 13.89 NA NA 9.29 9.86 0.77 NA NA 23.95 24.52 090 66625 ......... ............ A Removal of iris .............................................. 12 NA NA 4.15 4.59 0.26 NA NA 9.53 9.97 090 66630 ......... ............ A Removal of iris .............................................. 7.02 NA NA 5.30 5.62 0.31 NA NA 12.63 12.95 090 66635 ......... ............ A Removal of iris .............................................. 7.11 NA NA 5.33 5.65 0.31 NA NA 12.75 13.07 090 66680 ......... ............ A Repair iris & ciliary body ............................... 6.18 NA NA 5.18 5.26 0.27 NA NA 11.63 11.71 090 66682 ......... ............ A Repair iris & ciliary body ............................... 7.07 NA NA 6.64 6.63 0.31 NA NA 14.02 14.01 090 66700 ......... ............ A Destruction, ciliary body ................................ 5.02 4.78 5.14 3.60 3.86 0.24 10.04 10.40 8.86 9.12 090 66710 ......... ............ A Ciliary transsleral therapy .............................. 5.02 4.47 5.00 3.51 3.77 0.23 9.72 10.25 8.76 9.02 090 66711 ......... ............ A Ciliary endoscopic ablation ........................... 7.60 NA NA 6.22 6.42 0.30 NA NA 14.12 14.32 090 66720 ......... ............ A Destruction, ciliary body ................................ 4.77 5.21 5.66 4.20 4.60 0.26 10.24 10.69 9.23 9.63 090 66740 ......... ............ A Destruction, ciliary body ................................ 5.02 4.49 4.95 3.61 3.89 0.23 9.74 10.20 8.86 9.14 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37354 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

66761 ......... ............ A Revision of iris ............................................... 4.81 4.99 5.46 4.19 4.29 0.20 10.00 10.47 9.20 9.30 090 66762 ......... ............ A Revision of iris ............................................... 5.19 5.07 5.52 4.07 4.24 0.23 10.49 10.94 9.49 9.66 090 66770 ......... ............ A Removal of inner eye lesion ......................... 5.92 5.51 5.95 4.60 4.76 0.26 11.69 12.13 10.78 10.94 090 66820 ......... ............ A Incision, secondary cataract .......................... 3.88 NA NA 4.59 5.52 0.19 NA NA 8.66 9.59 09066821 ......... ............ A After cataract laser surgery ........................... 3.28 3.89 4.05 3.46 3.59 0.11 7.28 7.44 6.85 6.98 090 66825 ......... ............ A Reposition intraocular lens ............................ 8.72 NA NA 7.61 8.72 0.40 NA NA 16.73 17.84 090 66830 ......... ............ A Removal of lens lesion .................................. 9.19 NA NA 6.42 6.83 0.36 NA NA 15.97 16.38 090 66840 ......... ............ A Removal of lens material .............................. 8.90 NA NA 6.37 6.75 0.39 NA NA 15.66 16.04 090 66850 ......... ............ A Removal of lens material .............................. 10.22 NA NA 7.12 7.53 0.45 NA NA 17.79 18.20 090 66852 ......... ............ A Removal of lens material .............................. 11.08 NA NA 7.44 7.95 0.49 NA NA 19.01 19.52 090 66920 ......... ............ A Extraction of lens ........................................... 9.85 NA NA 6.71 7.17 0.44 NA NA 17.00 17.46 090 66930 ......... ............ A Extraction of lens ........................................... 11.28 NA NA 7.52 8.00 0.49 NA NA 19.29 19.77 090 66940 ......... ............ A Extraction of lens ........................................... 10.04 NA NA 7.06 7.48 0.43 NA NA 17.53 17.95 090 66982 ......... ............ A Cataract surgery, complex ............................ 14.73 NA NA 9.07 9.69 0.63 NA NA 24.43 25.05 090 66983 ......... ............ A Cataract surg w/iol, 1 stage .......................... 10.10 NA NA 6.14 6.13 0.14 NA NA 16.38 16.37 090 66984 ......... ............ A Cataract surg w/iol, 1 stage .......................... 10.28 NA NA 6.46 7.20 0.39 NA NA 17.13 17.87 090 66985 ......... ............ A Insert lens prosthesis .................................... 9.63 NA NA 7.11 7.38 0.36 NA NA 17.10 17.37 090 66986 ......... ............ A Exchange lens prosthesis ............................. 12.26 NA NA 8.00 8.90 0.60 NA NA 20.86 21.76 090 66990 ......... ............ A Ophthalmic endoscope add-on ..................... 1.51 NA NA 0.55 0.66 0.07 NA NA 2.13 2.24 ZZZ 67005 ......... ............ A Partial removal of eye fluid ........................... 5.69 NA NA 4.37 4.75 0.28 NA NA 10.34 10.72 090 67010 ......... ............ A Partial removal of eye fluid ........................... 6.86 NA NA 4.79 5.27 0.34 NA NA 11.99 12.47 090 67015 ......... ............ A Release of eye fluid ...................................... 6.91 NA NA 5.54 6.24 0.34 NA NA 12.79 13.49 090 67025 ......... ............ A Replace eye fluid ........................................... 7.83 7.81 8.89 5.87 6.15 0.34 15.98 17.06 14.04 14.32 090 67027 ......... ............ A Implant eye drug system ............................... 11.33 NA NA 7.30 7.84 0.54 NA NA 19.17 19.71 090 67028 ......... ............ A Injection eye drug .......................................... 2.52 2.16 2.57 1.26 1.41 0.12 4.80 5.21 3.90 4.05 000 67030 ......... ............ A Incise inner eye strands ................................ 5.83 NA NA 5.48 5.77 0.24 NA NA 11.55 11.84 090 67031 ......... ............ A Laser surgery, eye strands ........................... 4.28 4.03 4.47 3.42 3.59 0.18 8.49 8.93 7.88 8.05 090 67036 ......... ............ A Removal of inner eye fluid ............................ 12.99 NA NA 8.24 8.92 0.58 NA NA 21.81 22.49 090 67038 ......... ............ A Strip retinal membrane .................................. 23.14 NA NA 13.80 15.10 1.04 NA NA 37.98 39.28 090 67039 ......... ............ A Laser treatment of retina ............................... 16.25 NA NA 11.05 11.93 0.71 NA NA 28.01 28.89 090 67040 ......... ............ A Laser treatment of retina ............................... 19.07 NA NA 12.34 13.38 0.85 NA NA 32.26 33.30 090 67101 ......... ............ A Repair detached retina .................................. 8.52 8.45 8.98 6.13 6.45 0.37 17.34 17.87 15.02 15.34 090 67105 ......... ............ A Repair detached retina .................................. 8.27 7.37 7.92 5.76 6.07 0.37 16.01 16.56 14.40 14.71 090 67107 ......... ............ A Repair detached retina .................................. 16.26 NA NA 10.36 11.09 0.73 NA NA 27.35 28.08 090 67108 ......... ............ A Repair detached retina .................................. 22.39 NA NA 12.97 14.09 1.02 NA NA 36.38 37.50 090 67110 ......... ............ A Repair detached retina .................................. 9.92 8.88 9.92 6.92 7.29 0.44 19.24 20.28 17.28 17.65 090 67112 ......... ............ A Rerepair detached retina ............................... 18.33 NA NA 10.82 11.59 0.83 NA NA 29.98 30.75 090 67115 ......... ............ A Release encircling material ........................... 5.85 NA NA 4.87 5.04 0.25 NA NA 10.97 11.14 090 67120 ......... ............ A Remove eye implant material ....................... 6.84 7.31 8.28 5.24 5.47 0.29 14.44 15.41 12.37 12.60 090 67121 ......... ............ A Remove eye implant material ....................... 11.90 NA NA 7.92 8.39 0.53 NA NA 20.35 20.82 090 67141 ......... ............ A Treatment of retina ........................................ 5.94 5.37 5.75 4.63 4.81 0.26 11.57 11.95 10.83 11.01 090 67145 ......... ............ A Treatment of retina ........................................ 6.11 5.29 5.63 4.68 4.88 0.27 11.67 12.01 11.06 11.26 090 67208 ......... ............ A Treatment of retinal lesion ............................ 7.44 5.60 6.01 5.18 5.44 0.33 13.37 13.78 12.95 13.21 090 67210 ......... ............ A Treatment of retinal lesion ............................ 9.31 5.73 6.38 5.27 5.74 0.44 15.48 16.13 15.02 15.49 090 67218 ......... ............ A Treatment of retinal lesion ............................ 20.14 NA NA 10.59 11.79 0.92 NA NA 31.65 32.85 090 67220 ......... ............ A Treatment of choroid lesion .......................... 14.11 9.19 10.14 8.15 8.82 0.65 23.95 24.90 22.91 23.58 090 67221 ......... ............ R Ocular photodynamic ther ............................. 3.45 2.96 4.00 1.40 1.71 0.20 6.61 7.65 5.05 5.36 000 67225 ......... ............ A Eye photodynamic ther add-on ..................... 0.47 0.23 0.25 0.17 0.20 0.02 0.72 0.74 0.66 0.69 ZZZ 67227 ......... ............ A Treatment of retinal lesion ............................ 7.32 5.96 6.44 5.13 5.44 0.33 13.61 14.09 12.78 13.09 090 67228 ......... ............ A Treatment of retinal lesion ............................ 13.59 9.99 11.13 7.68 8.34 0.63 24.21 25.35 21.90 22.56 090 67250 ......... ............ A Reinforce eye wall ......................................... 9.40 NA NA 7.57 8.79 0.47 NA NA 17.44 18.66 090 67255 ......... ............ A Reinforce/graft eye wall ................................. 9.89 NA NA 8.31 9.52 0.44 NA NA 18.64 19.85 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37355 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

67311 ......... ............ A Revise eye muscle ........................................ 7.51 NA NA 5.58 5.93 0.37 NA NA 13.46 13.81 090 67312 ......... ............ A Revise two eye muscles ............................... 9.40 NA NA 6.20 6.63 0.43 NA NA 16.03 16.46 090 67314 ......... ............ A Revise eye muscle ........................................ 8.51 NA NA 6.15 6.47 0.39 NA NA 15.05 15.37 090 67316 ......... ............ A Revise two eye muscles ............................... 10.65 NA NA 6.93 7.37 0.49 NA NA 18.07 18.51 090 67318 ......... ............ A Revise eye muscle(s) .................................... 8.84 NA NA 6.53 6.85 0.41 NA NA 15.78 16.10 090 67320 ......... ............ A Revise eye muscle(s) add-on ....................... 4.32 NA NA 1.56 1.86 0.22 NA NA 6.10 6.40 ZZZ 67331 ......... ............ A Eye surgery follow-up add-on ....................... 4.05 NA NA 1.46 1.75 0.21 NA NA 5.72 6.01 ZZZ 67332 ......... ............ A Rerevise eye muscles add-on ....................... 4.48 NA NA 1.62 1.93 0.23 NA NA 6.33 6.64 ZZZ 67334 ......... ............ A Revise eye muscle w/suture ......................... 3.97 NA NA 1.42 1.71 0.20 NA NA 5.59 5.88 ZZZ 67335 ......... ............ A Eye suture during surgery ............................. 2.49 NA NA 0.90 1.07 0.13 NA NA 3.52 3.69 ZZZ67340 ......... ............ A Revise eye muscle add-on ............................ 4.92 NA NA 1.77 2.10 0.25 NA NA 6.94 7.27 ZZZ 67343 ......... ............ A Release eye tissue ........................................ 8.21 NA NA 6.05 6.41 0.37 NA NA 14.63 14.99 090 67345 ......... ............ A Destroy nerve of eye muscle ........................ 2.96 2.23 2.50 1.73 1.95 0.17 5.36 5.63 4.86 5.08 010 67350 ......... ............ A Biopsy eye muscle ........................................ 2.87 NA NA 1.64 1.82 0.15 NA NA 4.66 4.84 000 67400 ......... ............ A Explore/biopsy eye socket ............................ 10.87 NA NA 9.25 10.78 0.56 NA NA 20.68 22.21 090 67405 ......... ............ A Explore/drain eye socket ............................... 8.92 NA NA 8.09 9.37 0.44 NA NA 17.45 18.73 090 67412 ......... ............ A Explore/treat eye socket ................................ 10.11 NA NA 8.50 10.35 0.48 NA NA 19.09 20.94 090 67413 ......... ............ A Explore/treat eye socket ................................ 9.99 NA NA 8.48 10.22 0.50 NA NA 18.97 20.71 090 67414 ......... ............ A Explr/decompress eye socket ....................... 17.72 NA NA 11.56 11.94 0.65 NA NA 29.93 30.31 090 67415 ......... ............ A Aspiration, orbital contents ............................ 1.76 NA NA 0.61 0.72 0.09 NA NA 2.46 2.57 000 67420 ......... ............ A Explore/treat eye socket ................................ 21.52 NA NA 13.96 16.57 1.15 NA NA 36.63 39.24 090 67430 ......... ............ A Explore/treat eye socket ................................ 14.87 NA NA 12.07 14.22 0.86 NA NA 27.80 29.95 090 67440 ......... ............ A Explore/drain eye socket ............................... 14.44 NA NA 11.56 13.62 0.70 NA NA 26.70 28.76 090 67445 ......... ............ A Explr/decompress eye socket ....................... 18.90 NA NA 12.47 13.58 0.90 NA NA 32.27 33.38 090 67450 ......... ............ A Explore/biopsy eye socket ............................ 14.99 NA NA 12.01 14.05 0.68 NA NA 27.68 29.72 090 67500 ......... ............ A Inject/treat eye socket ................................... 1.44 0.60 0.65 0.46 0.33 0.05 2.09 2.14 1.95 1.82 000 67505 ......... ............ A Inject/treat eye socket ................................... 1.27 0.52 0.65 0.39 0.33 0.05 1.84 1.97 1.71 1.65 000 67515 ......... ............ A Inject/treat eye socket ................................... 1.40 0.78 0.64 0.62 0.44 0.03 2.21 2.07 2.05 1.87 000 67550 ......... ............ A Insert eye socket implant .............................. 11.42 NA NA 9.53 10.88 0.72 NA NA 21.67 23.02 090 67560 ......... ............ A Revise eye socket implant ............................ 11.83 NA NA 9.57 10.94 0.60 NA NA 22.00 23.37 090 67570 ......... ............ A Decompress optic nerve ............................... 14.13 NA NA 10.87 12.93 0.68 NA NA 25.68 27.74 090 67700 ......... ............ A Drainage of eyelid abscess ........................... 1.35 4.36 5.62 1.19 1.25 0.07 5.78 7.04 2.61 2.67 010 67710 ......... ............ A Incision of eyelid ............................................ 1.02 3.74 4.98 1.08 1.18 0.05 4.81 6.05 2.15 2.25 010 67715 ......... ............ A Incision of eyelid fold ..................................... 1.22 3.85 5.01 1.16 1.26 0.06 5.13 6.29 2.44 2.54 010 67800 ......... ............ A Remove eyelid lesion .................................... 1.38 1.41 1.57 0.91 1.01 0.07 2.86 3.02 2.36 2.46 010 67801 ......... ............ A Remove eyelid lesions .................................. 1.88 1.69 1.90 1.09 1.22 0.09 3.66 3.87 3.06 3.19 010 67805 ......... ............ A Remove eyelid lesions .................................. 2.22 2.21 2.45 1.42 1.59 0.11 4.54 4.78 3.75 3.92 010 67808 ......... ............ A Remove eyelid lesion(s) ................................ 4.41 NA NA 3.62 3.74 0.19 NA NA 8.22 8.34 090 67810 ......... ............ A Biopsy of eyelid ............................................. 1.48 3.86 3.47 0.66 0.68 0.06 5.40 5.01 2.20 2.22 000 67820 ......... ............ A Revise eyelashes .......................................... 0.71 0.44 0.56 0.51 0.55 0.04 1.19 1.31 1.26 1.30 000 67825 ......... ............ A Revise eyelashes .......................................... 1.38 1.41 1.66 1.27 1.38 0.07 2.86 3.11 2.72 2.83 010 67830 ......... ............ A Revise eyelashes .......................................... 1.70 4.04 5.17 1.33 1.46 0.08 5.82 6.95 3.11 3.24 010 67835 ......... ............ A Revise eyelashes .......................................... 5.55 NA NA 4.04 4.48 0.28 NA NA 9.87 10.31 090 67840 ......... ............ A Remove eyelid lesion .................................... 2.04 3.94 5.10 1.46 1.60 0.10 6.08 7.24 3.60 3.74 010 67850 ......... ............ A Treat eyelid lesion ......................................... 1.69 3.24 3.35 1.42 1.46 0.07 5.00 5.11 3.18 3.22 010 67875 ......... ............ A Closure of eyelid by suture ........................... 1.35 2.40 3.08 0.84 0.92 0.07 3.82 4.50 2.26 2.34 000 67880 ......... ............ A Revision of eyelid .......................................... 4.41 5.47 6.34 3.59 3.76 0.19 10.07 10.94 8.19 8.36 090 67882 ......... ............ A Revision of eyelid .......................................... 5.81 6.43 7.35 4.51 4.74 0.25 12.49 13.41 10.57 10.80 090 67900 ......... ............ A Repair brow defect ........................................ 6.63 7.38 8.66 4.60 5.10 0.38 14.39 15.67 11.61 12.11 090 67901 ......... ............ A Repair eyelid defect ...................................... 7.39 NA NA 5.18 5.36 0.54 NA NA 13.11 13.29 090 67902 ......... ............ A Repair eyelid defect ...................................... 9.60 NA NA 6.31 5.69 0.60 NA NA 16.51 15.89 090 67903 ......... ............ A Repair eyelid defect ...................................... 6.36 6.68 8.86 4.36 5.24 0.47 13.51 15.69 11.19 12.07 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37356 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

67904 ......... ............ A Repair eyelid defect ...................................... 7.75 7.99 9.24 5.11 5.22 0.41 16.15 17.40 13.27 13.38 090 67906 ......... ............ A Repair eyelid defect ...................................... 6.78 3.91 5.02 4.52 4.91 0.46 11.15 12.26 11.76 12.15 090 67908 ......... ............ A Repair eyelid defect ...................................... 5.12 5.47 6.36 4.08 5.04 0.28 10.87 11.76 9.48 10.44 090 67909 ......... ............ A Revise eyelid defect ...................................... 5.39 6.26 7.60 4.22 4.78 0.31 11.96 13.30 9.92 10.48 090 67911 ......... ............ A Revise eyelid defect ...................................... 7.30 NA NA 4.89 4.82 0.31 NA NA 12.50 12.43 090 67912 ......... ............ A Correction eyelid w/implant ........................... 6.17 12.98 17.48 4.64 5.32 0.28 19.43 23.93 11.09 11.77 090 67914 ......... ............ A Repair eyelid defect ...................................... 3.67 4.79 5.97 2.70 2.97 0.19 8.65 9.83 6.56 6.83 090 67915 ......... ............ A Repair eyelid defect ...................................... 3.18 4.46 5.62 2.51 2.74 0.16 7.80 8.96 5.85 6.08 090 67916 ......... ............ A Repair eyelid defect ...................................... 5.30 6.40 7.65 4.16 4.62 0.28 11.98 13.23 9.74 10.20 090 67917 ......... ............ A Repair eyelid defect ...................................... 6.01 6.78 8.06 4.43 4.92 0.36 13.15 14.43 10.80 11.29 090 67921 ......... ............ A Repair eyelid defect ...................................... 3.39 4.67 5.83 2.58 2.82 0.17 8.23 9.39 6.14 6.38 090 67922 ......... ............ A Repair eyelid defect ...................................... 3.06 4.36 5.54 2.45 2.68 0.15 7.57 8.75 5.66 5.89 090 67923 ......... ............ A Repair eyelid defect ...................................... 5.87 6.50 7.73 4.36 4.83 0.30 12.67 13.90 10.53 11.00 090 67924 ......... ............ A Repair eyelid defect ...................................... 5.78 6.98 8.46 4.09 4.54 0.30 13.06 14.54 10.17 10.62 090 67930 ......... ............ A Repair eyelid wound ...................................... 3.60 4.41 5.40 1.79 2.08 0.19 8.20 9.19 5.58 5.87 010 67935 ......... ............ A Repair eyelid wound ...................................... 6.21 6.82 8.11 3.61 4.22 0.39 13.42 14.71 10.21 10.82 090 67938 ......... ............ A Remove eyelid foreign body ......................... 1.33 3.90 5.03 1.24 1.26 0.06 5.29 6.42 2.63 2.65 010 67950 ......... ............ A Revision of eyelid .......................................... 5.81 6.67 8.16 4.37 5.02 0.36 12.84 14.33 10.54 11.19 090 67961 ......... ............ A Revision of eyelid .......................................... 5.68 6.87 8.25 4.33 4.86 0.33 12.88 14.26 10.34 10.87 090 67966 ......... ............ A Revision of eyelid .......................................... 8.75 8.02 8.88 5.43 5.54 0.37 17.14 18.00 14.55 14.66 090 67971 ......... ............ A Reconstruction of eyelid ................................ 9.78 NA NA 6.23 7.03 0.53 NA NA 16.54 17.34 090 67973 ......... ............ A Reconstruction of eyelid ................................ 12.85 NA NA 7.81 8.96 0.75 NA NA 21.41 22.56 090 67974 ......... ............ A Reconstruction of eyelid ................................ 12.82 NA NA 7.83 8.90 0.75 NA NA 21.40 22.47 090 67975 ......... ............ A Reconstruction of eyelid ................................ 9.12 NA NA 6.01 6.73 0.50 NA NA 15.63 16.35 090 68020 ......... ............ A Incise/drain eyelid lining ................................ 1.37 1.25 1.37 1.06 1.17 0.06 2.68 2.80 2.49 2.60 010 68040 ......... ............ A Treatment of eyelid lesions ........................... 0.85 0.61 0.69 0.35 0.41 0.04 1.50 1.58 1.24 1.30 000 68100 ......... ............ A Biopsy of eyelid lining ................................... 1.35 2.37 3.04 0.86 0.93 0.07 3.79 4.46 2.28 2.35 000 68110 ......... ............ A Remove eyelid lining lesion .......................... 1.77 3.10 3.86 1.49 1.61 0.09 4.96 5.72 3.35 3.47 010 68115 ......... ............ A Remove eyelid lining lesion .......................... 2.36 4.37 5.58 1.70 1.87 0.12 6.85 8.06 4.18 4.35 010 68130 ......... ............ A Remove eyelid lining lesion .......................... 4.92 6.74 8.24 4.09 4.48 0.24 11.90 13.40 9.25 9.64 090 68135 ......... ............ A Remove eyelid lining lesion .......................... 1.84 1.60 1.77 1.48 1.61 0.09 3.53 3.70 3.41 3.54 010 68200 ......... ............ A Treat eyelid by injection ................................ 0.49 0.45 0.52 0.29 0.32 0.02 0.96 1.03 0.80 0.83 000 68320 ......... ............ A Revise/graft eyelid lining ............................... 6.36 9.25 10.80 5.35 5.49 0.27 15.88 17.43 11.98 12.12 090 68325 ......... ............ A Revise/graft eyelid lining ............................... 8.35 NA NA 6.02 6.43 0.44 NA NA 14.81 15.22 090 68326 ......... ............ A Revise/graft eyelid lining ............................... 8.14 NA NA 5.97 6.32 0.35 NA NA 14.46 14.81 090 68328 ......... ............ A Revise/graft eyelid lining ............................... 9.17 NA NA 6.50 7.11 0.54 NA NA 16.21 16.82 090 68330 ......... ............ A Revise eyelid lining ....................................... 5.57 7.50 8.96 4.49 4.67 0.24 13.31 14.77 10.30 10.48 090 68335 ......... ............ A Revise/graft eyelid lining ............................... 8.18 NA NA 5.98 6.30 0.36 NA NA 14.52 14.84 090 68340 ......... ............ A Separate eyelid adhesions ............................ 4.78 6.94 8.41 3.90 4.06 0.21 11.93 13.40 8.89 9.05 090 68360 ......... ............ A Revise eyelid lining ....................................... 4.98 6.48 7.67 3.98 4.14 0.22 11.68 12.87 9.18 9.34 090 68362 ......... ............ A Revise eyelid lining ....................................... 8.33 NA NA 6.03 6.32 0.36 NA NA 14.72 15.01 090 68371 ......... ............ A Harvest eye tissue, alograft .......................... 4.89 NA NA 4.09 4.58 0.44 NA NA 9.42 9.91 01068400 ......... ............ A Incise/drain tear gland ................................... 1.69 4.30 5.52 1.16 1.66 0.08 6.07 7.29 2.93 3.43 010 68420 ......... ............ A Incise/drain tear sac ...................................... 2.30 4.55 5.80 1.39 1.93 0.11 6.96 8.21 3.80 4.34 010 68440 ......... ............ A Incise tear duct opening ................................ 0.94 1.18 1.86 1.15 1.24 0.05 2.17 2.85 2.14 2.23 010 68500 ......... ............ A Removal of tear gland ................................... 12.37 NA NA 8.65 9.48 0.55 NA NA 21.57 22.40 090 68505 ......... ............ A Partial removal, tear gland ............................ 12.29 NA NA 8.78 10.21 0.55 NA NA 21.62 23.05 090 68510 ......... ............ A Biopsy of tear gland ...................................... 4.60 5.23 6.82 2.04 2.09 0.23 10.06 11.65 6.87 6.92 000 68520 ......... ............ A Removal of tear sac ...................................... 8.50 NA NA 6.56 7.22 0.37 NA NA 15.43 16.09 090 68525 ......... ............ A Biopsy of tear sac ......................................... 4.42 NA NA 1.58 1.92 0.22 NA NA 6.22 6.56 000 68530 ......... ............ A Clearance of tear duct ................................... 3.65 5.57 7.54 2.05 2.50 0.18 9.40 11.37 5.88 6.33 010 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37357 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

68540 ......... ............ A Remove tear gland lesion ............................. 11.83 NA NA 8.28 9.14 0.52 NA NA 20.63 21.49 090 68550 ......... ............ A Remove tear gland lesion ............................. 14.74 NA NA 9.99 11.03 0.80 NA NA 25.53 26.57 090 68700 ......... ............ A Repair tear ducts ........................................... 7.59 NA NA 5.60 5.90 0.32 NA NA 13.51 13.81 090 68705 ......... ............ A Revise tear duct opening .............................. 2.06 3.06 3.90 1.60 1.75 0.10 5.22 6.06 3.76 3.91 010 68720 ......... ............ A Create tear sac drain .................................... 9.70 NA NA 6.86 7.63 0.44 NA NA 17.00 17.77 090 68745 ......... ............ A Create tear duct drain ................................... 9.62 NA NA 7.21 7.71 0.52 NA NA 17.35 17.85 090 68750 ......... ............ A Create tear duct drain ................................... 9.77 NA NA 7.38 8.06 0.43 NA NA 17.58 18.26 090 68760 ......... ............ A Close tear duct opening ................................ 1.73 2.62 3.32 1.47 1.59 0.09 4.44 5.14 3.29 3.41 010 68761 ......... ............ A Close tear duct opening ................................ 1.36 1.85 2.17 1.26 1.31 0.06 3.27 3.59 2.68 2.73 010 68770 ......... ............ A Close tear system fistula ............................... 8.01 2.90 3.12 5.74 3.83 0.35 11.26 11.48 14.10 12.19 090 68801 ......... ............ A Dilate tear duct opening ................................ 0.94 1.79 1.91 1.43 1.47 0.05 2.78 2.90 2.42 2.46 010 68810 ......... ............ A Probe nasolacrimal duct ................................ 2.59 3.42 3.61 2.70 2.69 0.10 6.11 6.30 5.39 5.38 010 68811 ......... ............ A Probe nasolacrimal duct ................................ 2.35 NA NA 2.13 2.35 0.13 NA NA 4.61 4.83 010 68815 ......... ............ A Probe nasolacrimal duct ................................ 3.20 6.46 7.81 2.44 2.73 0.17 9.83 11.18 5.81 6.10 010 68840 ......... ............ A Explore/irrigate tear ducts ............................. 1.25 1.32 1.53 1.09 1.11 0.06 2.63 2.84 2.40 2.42 010 68850 ......... ............ A Injection for tear sac x-ray ............................ 0.80 0.74 0.85 0.61 0.66 0.04 1.58 1.69 1.45 1.50 000 69000 ......... ............ A Drain external ear lesion ............................... 1.45 2.67 2.84 1.23 1.33 0.12 4.24 4.41 2.80 2.90 010 69005 ......... ............ A Drain external ear lesion ............................... 2.11 2.71 2.88 1.43 1.74 0.17 4.99 5.16 3.71 4.02 010 69020 ......... ............ A Drain outer ear canal lesion .......................... 1.48 3.80 3.95 1.74 1.99 0.12 5.40 5.55 3.34 3.59 010 69100 ......... ............ A Biopsy of external ear ................................... 0.81 1.82 1.74 0.38 0.39 0.03 2.66 2.58 1.22 1.23 000 69105 ......... ............ A Biopsy of external ear canal ......................... 0.85 2.46 2.38 0.64 0.74 0.07 3.38 3.30 1.56 1.66 000 69110 ......... ............ A Remove external ear, partial ......................... 3.43 7.49 6.94 4.22 4.42 0.30 11.22 10.67 7.95 8.15 090 69120 ......... ............ A Removal of external ear ................................ 4.04 NA NA 5.01 5.90 0.38 NA NA 9.43 10.32 090 69140 ......... ............ A Remove ear canal lesion(s) .......................... 7.96 NA NA 12.17 13.03 0.65 NA NA 20.78 21.64 090 69145 ......... ............ A Remove ear canal lesion(s) .......................... 2.62 6.47 5.97 3.06 3.25 0.21 9.30 8.80 5.89 6.08 090 69150 ......... ............ A Extensive ear canal surgery .......................... 13.41 NA NA 10.38 12.68 1.22 NA NA 25.01 27.31 090 69155 ......... ............ A Extensive ear/neck surgery ........................... 22.96 NA NA 14.75 18.39 1.92 NA NA 39.63 43.27 090 69200 ......... ............ A Clear outer ear canal .................................... 0.77 2.02 2.30 0.56 0.55 0.06 2.85 3.13 1.39 1.38 000 69205 ......... ............ A Clear outer ear canal .................................... 1.20 NA NA 1.12 1.30 0.10 NA NA 2.42 2.60 010 69210 ......... ............ A Remove impacted ear wax ........................... 0.61 0.55 0.61 0.15 0.21 0.05 1.21 1.27 0.81 0.87 000 69220 ......... ............ A Clean out mastoid cavity ............................... 0.83 2.35 2.37 0.60 0.70 0.07 3.25 3.27 1.50 1.60 000 69222 ......... ............ A Clean out mastoid cavity ............................... 1.40 3.63 3.80 1.71 1.98 0.12 5.15 5.32 3.23 3.50 010 69300 ......... ............ R Revise external ear ....................................... 6.35 NA NA 4.44 4.28 0.72 NA NA 11.51 11.35 YYY 69310 ......... ............ A Rebuild outer ear canal ................................. 10.77 NA NA 14.02 15.75 0.85 NA NA 25.64 27.37 090 69320 ......... ............ A Rebuild outer ear canal ................................. 16.93 NA NA 17.92 20.91 1.37 NA NA 36.22 39.21 090 69400 ......... ............ A Inflate middle ear canal ................................. 0.83 2.58 2.27 0.61 0.66 0.07 3.48 3.17 1.51 1.56 000 69401 ......... ............ A Inflate middle ear canal ................................. 0.63 1.45 1.29 0.55 0.63 0.05 2.13 1.97 1.23 1.31 000 69405 ......... ............ A Catheterize middle ear canal ........................ 2.63 3.34 3.47 1.75 2.18 0.21 6.18 6.31 4.59 5.02 010 69420 ......... ............ A Incision of eardrum ........................................ 1.33 3.02 3.13 1.39 1.54 0.11 4.46 4.57 2.83 2.98 010 69421 ......... ............ A Incision of eardrum ........................................ 1.73 NA NA 1.66 2.04 0.15 NA NA 3.54 3.92 010 69424 ......... ............ A Remove ventilating tube ................................ 0.85 2.15 2.18 0.61 0.66 0.07 3.07 3.10 1.53 1.58 000 69433 ......... ............ A Create eardrum opening ............................... 1.52 3.02 3.08 1.42 1.59 0.13 4.67 4.73 3.07 3.24 010 69436 ......... ............ A Create eardrum opening ............................... 1.96 NA NA 1.70 2.15 0.19 NA NA 3.85 4.30 010 69440 ......... ............ A Exploration of middle ear .............................. 7.56 NA NA 8.20 8.65 0.61 NA NA 16.37 16.82 090 69450 ......... ............ A Eardrum revision ........................................... 5.56 NA NA 6.88 7.01 0.45 NA NA 12.89 13.02 090 69501 ......... ............ A Mastoidectomy .............................................. 9.06 NA NA 7.69 8.70 0.73 NA NA 17.48 18.49 090 69502 ......... ............ A Mastoidectomy .............................................. 12.36 NA NA 9.87 11.18 1.00 NA NA 23.23 24.54 090 69505 ......... ............ A Remove mastoid structures .......................... 12.97 NA NA 14.57 16.57 1.05 NA NA 28.59 30.59 090 69511 ......... ............ A Extensive mastoid surgery ............................ 13.50 NA NA 14.69 16.81 1.09 NA NA 29.28 31.40 090 69530 ......... ............ A Extensive mastoid surgery ............................ 20.15 NA NA 17.72 20.70 1.54 NA NA 39.41 42.39 090 69535 ......... ............ A Remove part of temporal bone ..................... 37.17 NA NA 23.79 29.99 2.92 NA NA 63.88 70.08 090

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37358 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

69540 ......... ............ A Remove ear lesion ........................................ 1.20 3.58 3.71 1.68 1.91 0.10 4.88 5.01 2.98 3.21 010 69550 ......... ............ A Remove ear lesion ........................................ 10.97 NA NA 12.90 14.40 0.89 NA NA 24.76 26.26 090 69552 ......... ............ A Remove ear lesion ........................................ 19.61 NA NA 16.31 19.63 1.59 NA NA 37.51 40.83 090 69554 ......... ............ A Remove ear lesion ........................................ 35.63 NA NA 22.05 28.33 2.91 NA NA 60.59 66.87 090 69601 ......... ............ A Mastoid surgery revision ............................... 13.22 NA NA 10.68 12.20 1.07 NA NA 24.97 26.49 090 69602 ......... ............ A Mastoid surgery revision ............................... 13.56 NA NA 11.39 12.80 1.10 NA NA 26.05 27.46 090 69603 ......... ............ A Mastoid surgery revision ............................... 14.00 NA NA 14.84 17.52 1.14 NA NA 29.98 32.66 090 69604 ......... ............ A Mastoid surgery revision ............................... 14.00 NA NA 11.50 13.17 1.14 NA NA 26.64 28.31 090 69605 ......... ............ A Mastoid surgery revision ............................... 18.46 NA NA 17.26 20.07 1.50 NA NA 37.22 40.03 090 69610 ......... ............ A Repair of eardrum ......................................... 4.42 4.41 5.28 2.26 3.03 0.36 9.19 10.06 7.04 7.81 010 69620 ......... ............ A Repair of eardrum ......................................... 5.88 9.93 10.85 5.21 6.04 0.48 16.29 17.21 11.57 12.40 090 69631 ......... ............ A Repair eardrum structures ............................ 9.85 NA NA 10.36 11.01 0.80 NA NA 21.01 21.66 090 69632 ......... ............ A Rebuild eardrum structures ........................... 12.73 NA NA 11.92 13.11 1.03 NA NA 25.68 26.87 090 69633 ......... ............ A Rebuild eardrum structures ........................... 12.08 NA NA 11.75 12.76 0.98 NA NA 24.81 25.82 090 69635 ......... ............ A Repair eardrum structures ............................ 13.31 NA NA 14.64 16.25 1.08 NA NA 29.03 30.64 090 69636 ......... ............ A Rebuild eardrum structures ........................... 15.20 NA NA 16.39 18.62 1.23 NA NA 32.82 35.05 090 69637 ......... ............ A Rebuild eardrum structures ........................... 15.09 NA NA 16.37 18.55 1.22 NA NA 32.68 34.86 090 69641 ......... ............ A Revise middle ear & mastoid ........................ 12.69 NA NA 11.15 12.40 1.03 NA NA 24.87 26.12 090 69642 ......... ............ A Revise middle ear & mastoid ........................ 16.81 NA NA 13.84 15.71 1.36 NA NA 32.01 33.88 090 69643 ......... ............ A Revise middle ear & mastoid ........................ 15.36 NA NA 12.63 14.30 1.24 NA NA 29.23 30.90 090 69644 ......... ............ A Revise middle ear & mastoid ........................ 17.00 NA NA 16.86 19.56 1.37 NA NA 35.23 37.93 090 69645 ......... ............ A Revise middle ear & mastoid ........................ 16.48 NA NA 16.78 19.26 1.33 NA NA 34.59 37.07 090 69646 ......... ............ A Revise middle ear & mastoid ........................ 18.14 NA NA 17.19 19.91 1.46 NA NA 36.79 39.51 090 69650 ......... ............ A Release middle ear bone .............................. 9.65 NA NA 8.53 9.59 0.78 NA NA 18.96 20.02 090 69660 ......... ............ A Revise middle ear bone ................................ 11.88 NA NA 9.37 10.75 0.96 NA NA 22.21 23.59 090 69661 ......... ............ A Revise middle ear bone ................................ 15.72 NA NA 11.98 14.05 1.27 NA NA 28.97 31.04 090 69662 ......... ............ A Revise middle ear bone ................................ 15.42 NA NA 11.11 13.12 1.25 NA NA 27.78 29.79 090 69666 ......... ............ A Repair middle ear structures ......................... 9.74 NA NA 8.79 9.70 0.79 NA NA 19.32 20.23 090 69667 ......... ............ A Repair middle ear structures ......................... 9.75 NA NA 8.70 9.68 0.79 NA NA 19.24 20.22 090 69670 ......... ............ A Remove mastoid air cells .............................. 11.55 NA NA 10.01 11.31 0.93 NA NA 22.49 23.79 090 69676 ......... ............ A Remove middle ear nerve ............................. 9.51 NA NA 9.50 10.46 0.81 NA NA 19.82 20.78 090 69700 ......... ............ A Close mastoid fistula ..................................... 8.22 NA NA 7.54 8.84 0.67 NA NA 16.43 17.73 090 69711 ......... ............ A Remove/repair hearing aid ............................ 10.42 NA NA 9.29 10.44 0.83 NA NA 20.54 21.69 090 69714 ......... ............ A Implant temple bone w/stimul ....................... 14.23 NA NA 10.38 12.12 1.13 NA NA 25.74 27.48 090 69715 ......... ............ A Temple bne implnt w/stimulat ....................... 18.72 NA NA 11.74 14.24 1.48 NA NA 31.94 34.44 090 69717 ......... ............ A Temple bone implant revision ....................... 15.21 NA NA 11.34 13.72 0.90 NA NA 27.45 29.83 090 69718 ......... ............ A Revise temple bone implant .......................... 18.97 NA NA 19.76 16.45 3.21 NA NA 41.94 38.63 090 69720 ......... ............ A Release facial nerve ...................................... 14.48 NA NA 12.56 14.06 1.16 NA NA 28.20 29.70 090 69725 ......... ............ A Release facial nerve ...................................... 27.36 NA NA 16.01 19.15 2.44 NA NA 45.81 48.95 090 69740 ......... ............ A Repair facial nerve ........................................ 16.12 NA NA 10.97 12.83 1.27 NA NA 28.36 30.22 090 69745 ......... ............ A Repair facial nerve ........................................ 16.84 NA NA 11.69 14.18 1.14 NA NA 29.67 32.16 090 69801 ......... ............ A Incise inner ear .............................................. 8.55 NA NA 8.63 9.28 0.69 NA NA 17.87 18.52 090 69802 ......... ............ A Incise inner ear .............................................. 13.32 NA NA 10.38 11.87 1.06 NA NA 24.76 26.25 090 69805 ......... ............ A Explore inner ear ........................................... 14.49 NA NA 9.64 11.34 1.12 NA NA 25.25 26.95 090 69806 ......... ............ A Explore inner ear ........................................... 12.45 NA NA 9.22 10.61 1.00 NA NA 22.67 24.06 090 69820 ......... ............ A Establish inner ear window ........................... 10.32 NA NA 9.66 10.85 0.90 NA NA 20.88 22.07 090 69840 ......... ............ A Revise inner ear window ............................... 10.24 NA NA 11.47 12.78 0.79 NA NA 22.50 23.81 090 69905 ......... ............ A Remove inner ear .......................................... 11.08 NA NA 9.94 11.02 0.90 NA NA 21.92 23.00 090 69910 ......... ............ A Remove inner ear & mastoid ........................ 13.73 NA NA 9.64 11.37 1.07 NA NA 24.44 26.17 09069915 ......... ............ A Incise inner ear nerve ................................... 22.56 NA NA 13.10 15.66 1.69 NA NA 37.35 39.91 090 69930 ......... ............ A Implant cochlear device ................................ 17.54 NA NA 11.62 14.00 1.36 NA NA 30.52 32.90 090 69950 ......... ............ A Incise inner ear nerve ................................... 27.38 NA NA 14.99 17.96 2.28 NA NA 44.65 47.62 090 69955 ......... ............ A Release facial nerve ...................................... 29.14 NA NA 16.71 20.26 2.48 NA NA 48.33 51.88 090 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37359 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

69960 ......... ............ A Release inner ear canal ................................ 29.14 NA NA 15.12 18.86 2.17 NA NA 46.43 50.17 090 69970 ......... ............ A Remove inner ear lesion ............................... 32.13 NA NA 17.46 21.87 2.41 NA NA 52.00 56.41 090 69990 ......... ............ R Microsurgery add-on ..................................... 3.46 NA NA 1.24 1.66 0.89 NA NA 5.59 6.01 ZZZ 70010 ......... ............ A Contrast x-ray of brain .................................. 1.19 2.91 4.28 NA NA 0.27 4.37 5.74 NA NA XXX 70010 ......... 26 ....... A Contrast x-ray of brain .................................. 1.19 0.41 0.40 0.41 0.40 0.05 1.65 1.64 1.65 1.64 XXX 70010 ......... TC ...... A Contrast x-ray of brain .................................. 0.00 2.50 3.88 NA NA 0.22 2.72 4.10 NA NA XXX 70015 ......... ............ A Contrast x-ray of brain .................................. 1.19 2.99 2.05 NA NA 0.16 4.34 3.40 NA NA XXX 70015 ......... 26 ....... A Contrast x-ray of brain .................................. 1.19 0.42 0.40 0.42 0.40 0.08 1.69 1.67 1.69 1.67 XXX 70015 ......... TC ...... A Contrast x-ray of brain .................................. 0.00 2.57 1.66 NA NA 0.08 2.65 1.74 NA NA XXX 70030 ......... ............ A X-ray eye for foreign body ............................ 0.17 0.63 0.52 NA NA 0.03 0.83 0.72 NA NA XXX70030 ......... 26 ....... A X-ray eye for foreign body ............................ 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 70030 ......... TC ...... A X-ray eye for foreign body ............................ 0.00 0.57 0.46 NA NA 0.02 0.59 0.48 NA NA XXX 70100 ......... ............ A X-ray exam of jaw ......................................... 0.18 0.65 0.60 NA NA 0.03 0.86 0.81 NA NA XXX 70100 ......... 26 ....... A X-ray exam of jaw ......................................... 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 70100 ......... TC ...... A X-ray exam of jaw ......................................... 0.00 0.60 0.54 NA NA 0.02 0.62 0.56 NA NA XXX70110 ......... ............ A X-ray exam of jaw ......................................... 0.25 0.83 0.73 NA NA 0.05 1.13 1.03 NA NA XXX 70110 ......... 26 ....... A X-ray exam of jaw ......................................... 0.25 0.08 0.08 0.08 0.08 0.01 0.34 0.34 0.34 0.34 XXX 70110 ......... TC ...... A X-ray exam of jaw ......................................... 0.00 0.75 0.65 NA NA 0.04 0.79 0.69 NA NA XXX70120 ......... ............ A X-ray exam of mastoids ................................ 0.18 0.71 0.69 NA NA 0.05 0.94 0.92 NA NA XXX70120 ......... 26 ....... A X-ray exam of mastoids ................................ 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 70120 ......... TC ...... A X-ray exam of mastoids ................................ 0.00 0.65 0.63 NA NA 0.04 0.69 0.67 NA NA XXX 70130 ......... ............ A X-ray exam of mastoids ................................ 0.34 1.19 0.97 NA NA 0.07 1.60 1.38 NA NA XXX70130 ......... 26 ....... A X-ray exam of mastoids ................................ 0.34 0.11 0.11 0.11 0.11 0.02 0.47 0.47 0.47 0.47 XXX 70130 ......... TC ...... A X-ray exam of mastoids ................................ 0.00 1.08 0.86 NA NA 0.05 1.13 0.91 NA NA XXX 70134 ......... ............ A X-ray exam of middle ear .............................. 0.34 0.96 0.87 NA NA 0.07 1.37 1.28 NA NA XXX70134 ......... 26 ....... A X-ray exam of middle ear .............................. 0.34 0.11 0.11 0.11 0.11 0.02 0.47 0.47 0.47 0.47 XXX 70134 ......... TC ...... A X-ray exam of middle ear .............................. 0.00 0.84 0.76 NA NA 0.05 0.89 0.81 NA NA XXX 70140 ......... ............ A X-ray exam of facial bones ........................... 0.19 0.56 0.65 NA NA 0.05 0.80 0.89 NA NA XXX 70140 ......... 26 ....... A X-ray exam of facial bones ........................... 0.19 0.05 0.06 0.05 0.06 0.01 0.25 0.26 0.25 0.26 XXX 70140 ......... TC ...... A X-ray exam of facial bones ........................... 0.00 0.51 0.59 NA NA 0.04 0.55 0.63 NA NA XXX 70150 ......... ............ A X-ray exam of facial bones ........................... 0.26 0.88 0.87 NA NA 0.06 1.20 1.19 NA NA XXX 70150 ......... 26 ....... A X-ray exam of facial bones ........................... 0.26 0.08 0.08 0.08 0.08 0.01 0.35 0.35 0.35 0.35 XXX 70150 ......... TC ...... A X-ray exam of facial bones ........................... 0.00 0.80 0.79 NA NA 0.05 0.85 0.84 NA NA XXX 70160 ......... ............ A X-ray exam of nasal bones ........................... 0.17 0.73 0.62 NA NA 0.03 0.93 0.82 NA NA XXX 70160 ......... 26 ....... A X-ray exam of nasal bones ........................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70160 ......... TC ...... A X-ray exam of nasal bones ........................... 0.00 0.67 0.56 NA NA 0.02 0.69 0.58 NA NA XXX 70170 ......... ............ A X-ray exam of tear duct ................................ 0.30 0.10 0.81 NA NA 0.07 0.47 1.18 NA NA XXX 70170 ......... 26 ....... A X-ray exam of tear duct ................................ 0.30 0.10 0.10 0.10 0.10 0.01 0.41 0.41 0.41 0.41 XXX 70170 ......... TC ...... A X-ray exam of tear duct ................................ 0.00 0.00 0.71 NA NA 0.06 0.06 0.77 NA NA XXX 70190 ......... ............ A X-ray exam of eye sockets ........................... 0.21 0.75 0.71 NA NA 0.05 1.01 0.97 NA NA XXX 70190 ......... 26 ....... A X-ray exam of eye sockets ........................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 70190 ......... TC ...... A X-ray exam of eye sockets ........................... 0.00 0.68 0.64 NA NA 0.04 0.72 0.68 NA NA XXX 70200 ......... ............ A X-ray exam of eye sockets ........................... 0.28 0.91 0.88 NA NA 0.06 1.25 1.22 NA NA XXX 70200 ......... 26 ....... A X-ray exam of eye sockets ........................... 0.28 0.09 0.09 0.09 0.09 0.01 0.38 0.38 0.38 0.38 XXX 70200 ......... TC ...... A X-ray exam of eye sockets ........................... 0.00 0.82 0.79 NA NA 0.05 0.87 0.84 NA NA XXX 70210 ......... ............ A X-ray exam of sinuses .................................. 0.17 0.57 0.65 NA NA 0.05 0.79 0.87 NA NA XXX 70210 ......... 26 ....... A X-ray exam of sinuses .................................. 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70210 ......... TC ...... A X-ray exam of sinuses .................................. 0.00 0.53 0.60 NA NA 0.04 0.57 0.64 NA NA XXX 70220 ......... ............ A X-ray exam of sinuses .................................. 0.25 0.74 0.83 NA NA 0.06 1.05 1.14 NA NA XXX 70220 ......... 26 ....... A X-ray exam of sinuses .................................. 0.25 0.07 0.08 0.07 0.08 0.01 0.33 0.34 0.33 0.34 XXX 70220 ......... TC ...... A X-ray exam of sinuses .................................. 0.00 0.67 0.75 NA NA 0.05 0.72 0.80 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37360 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

70240 ......... ............ A X-ray exam, pituitary saddle ......................... 0.19 0.62 0.52 NA NA 0.03 0.84 0.74 NA NA XXX 70240 ......... 26 ....... A X-ray exam, pituitary saddle ......................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 70240 ......... TC ...... A X-ray exam, pituitary saddle ......................... 0.00 0.56 0.46 NA NA 0.02 0.58 0.48 NA NA XXX 70250 ......... ............ A X-ray exam of skull ....................................... 0.24 0.72 0.71 NA NA 0.05 1.01 1.00 NA NA XXX 70250 ......... 26 ....... A X-ray exam of skull ....................................... 0.24 0.07 0.08 0.07 0.08 0.01 0.32 0.33 0.32 0.33 XXX 70250 ......... TC ...... A X-ray exam of skull ....................................... 0.00 0.65 0.63 NA NA 0.04 0.69 0.67 NA NA XXX70260 ......... ............ A X-ray exam of skull ....................................... 0.34 0.91 0.98 NA NA 0.08 1.33 1.40 NA NA XXX 70260 ......... 26 ....... A X-ray exam of skull ....................................... 0.34 0.10 0.11 0.10 0.11 0.02 0.46 0.47 0.46 0.47 XXX 70260 ......... TC ...... A X-ray exam of skull ....................................... 0.00 0.81 0.87 NA NA 0.06 0.87 0.93 NA NA XXX70300 ......... ............ A X-ray exam of teeth ....................................... 0.10 0.24 0.29 NA NA 0.03 0.37 0.42 NA NA XXX 70300 ......... 26 ....... A X-ray exam of teeth ....................................... 0.10 0.03 0.05 0.03 0.05 0.01 0.14 0.16 0.14 0.16 XXX 70300 ......... TC ...... A X-ray exam of teeth ....................................... 0.00 0.21 0.25 NA NA 0.02 0.23 0.27 NA NA XXX70310 ......... ............ A X-ray exam of teeth ....................................... 0.16 0.83 0.58 NA NA 0.03 1.02 0.77 NA NA XXX 70310 ......... 26 ....... A X-ray exam of teeth ....................................... 0.16 0.05 0.07 0.05 0.07 0.01 0.22 0.24 0.22 0.24 XXX 70310 ......... TC ...... A X-ray exam of teeth ....................................... 0.00 0.78 0.51 NA NA 0.02 0.80 0.53 NA NA XXX70320 ......... ............ A Full mouth x-ray of teeth ............................... 0.22 0.98 0.89 NA NA 0.06 1.26 1.17 NA NA XXX 70320 ......... 26 ....... A Full mouth x-ray of teeth ............................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31 XXX 70320 ......... TC ...... A Full mouth x-ray of teeth ............................... 0.00 0.92 0.82 NA NA 0.05 0.97 0.87 NA NA XXX 70328 ......... ............ A X-ray exam of jaw joint ................................. 0.18 0.64 0.57 NA NA 0.03 0.85 0.78 NA NA XXX 70328 ......... 26 ....... A X-ray exam of jaw joint ................................. 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 70328 ......... TC ...... A X-ray exam of jaw joint ................................. 0.00 0.58 0.51 NA NA 0.02 0.60 0.53 NA NA XXX 70330 ......... ............ A X-ray exam of jaw joints ................................ 0.24 1.04 0.95 NA NA 0.06 1.34 1.25 NA NA XXX 70330 ......... 26 ....... A X-ray exam of jaw joints ................................ 0.24 0.08 0.08 0.08 0.08 0.01 0.33 0.33 0.33 0.33 XXX 70330 ......... TC ...... A X-ray exam of jaw joints ................................ 0.00 0.96 0.87 NA NA 0.05 1.01 0.92 NA NA XXX 70332 ......... ............ A X-ray exam of jaw joint ................................. 0.54 1.49 2.11 NA NA 0.14 2.17 2.79 NA NA XXX 70332 ......... 26 ....... A X-ray exam of jaw joint ................................. 0.54 0.17 0.19 0.17 0.19 0.02 0.73 0.75 0.73 0.75 XXX 70332 ......... TC ...... A X-ray exam of jaw joint ................................. 0.00 1.32 1.91 NA NA 0.12 1.44 2.03 NA NA XXX 70336 ......... ............ A Magnetic image, jaw joint .............................. 1.48 12.94 12.03 NA NA 0.66 15.08 14.17 NA NA XXX 70336 ......... 26 ....... A Magnetic image, jaw joint .............................. 1.48 0.53 0.50 0.53 0.50 0.07 2.08 2.05 2.08 2.05 XXX 70336 ......... TC ...... A Magnetic image, jaw joint .............................. 0.00 12.41 11.53 NA NA 0.59 13.00 12.12 NA NA XXX 70350 ......... ............ A X-ray head for orthodontia ............................ 0.17 0.33 0.42 NA NA 0.03 0.53 0.62 NA NA XXX70350 ......... 26 ....... A X-ray head for orthodontia ............................ 0.17 0.05 0.07 0.05 0.07 0.01 0.23 0.25 0.23 0.25 XXX 70350 ......... TC ...... A X-ray head for orthodontia ............................ 0.00 0.28 0.36 NA NA 0.02 0.30 0.38 NA NA XXX 70355 ......... ............ A Panoramic x-ray of jaws ................................ 0.20 0.31 0.56 NA NA 0.05 0.56 0.81 NA NA XXX 70355 ......... 26 ....... A Panoramic x-ray of jaws ................................ 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 70355 ......... TC ...... A Panoramic x-ray of jaws ................................ 0.00 0.24 0.49 NA NA 0.04 0.28 0.53 NA NA XXX 70360 ......... ............ A X-ray exam of neck ....................................... 0.17 0.59 0.51 NA NA 0.03 0.79 0.71 NA NA XXX 70360 ......... 26 ....... A X-ray exam of neck ....................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 70360 ......... TC ...... A X-ray exam of neck ....................................... 0.00 0.54 0.45 NA NA 0.02 0.56 0.47 NA NA XXX 70370 ......... ............ A Throat x-ray & fluoroscopy ............................ 0.32 1.70 1.48 NA NA 0.08 2.10 1.88 NA NA XXX70370 ......... 26 ....... A Throat x-ray & fluoroscopy ............................ 0.32 0.10 0.10 0.10 0.10 0.01 0.43 0.43 0.43 0.43 XXX 70370 ......... TC ...... A Throat x-ray & fluoroscopy ............................ 0.00 1.60 1.38 NA NA 0.07 1.67 1.45 NA NA XXX 70371 ......... ............ A Speech evaluation, complex ......................... 0.84 1.54 2.18 NA NA 0.16 2.54 3.18 NA NA XXX 70371 ......... 26 ....... A Speech evaluation, complex ......................... 0.84 0.27 0.28 0.27 0.28 0.04 1.15 1.16 1.15 1.16 XXX 70371 ......... TC ...... A Speech evaluation, complex ......................... 0.00 1.27 1.90 NA NA 0.12 1.39 2.02 NA NA XXX 70373 ......... ............ A Contrast x-ray of larynx ................................. 0.44 1.70 1.87 NA NA 0.13 2.27 2.44 NA NA XXX 70373 ......... 26 ....... A Contrast x-ray of larynx ................................. 0.44 0.13 0.14 0.13 0.14 0.02 0.59 0.60 0.59 0.60 XXX 70373 ......... TC ...... A Contrast x-ray of larynx ................................. 0.00 1.57 1.74 NA NA 0.11 1.68 1.85 NA NA XXX 70380 ......... ............ A X-ray exam of salivary gland ........................ 0.17 0.82 0.75 NA NA 0.05 1.04 0.97 NA NA XXX 70380 ......... 26 ....... A X-ray exam of salivary gland ........................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70380 ......... TC ...... A X-ray exam of salivary gland ........................ 0.00 0.77 0.70 NA NA 0.04 0.81 0.74 NA NA XXX 70390 ......... ............ A X-ray exam of salivary duct .......................... 0.38 2.44 2.04 NA NA 0.13 2.95 2.55 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37361 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

70390 ......... 26 ....... A X-ray exam of salivary duct .......................... 0.38 0.13 0.12 0.13 0.12 0.02 0.53 0.52 0.53 0.52 XXX 70390 ......... TC ...... A X-ray exam of salivary duct .......................... 0.00 2.31 1.92 NA NA 0.11 2.42 2.03 NA NA XXX 70450 ......... ............ A Ct head/brain w/o dye ................................... 0.85 5.13 5.04 NA NA 0.29 6.27 6.18 NA NA XXX 70450 ......... 26 ....... A Ct head/brain w/o dye ................................... 0.85 0.29 0.28 0.29 0.28 0.04 1.18 1.17 1.18 1.17 XXX 70450 ......... TC ...... A Ct head/brain w/o dye ................................... 0.00 4.84 4.76 NA NA 0.25 5.09 5.01 NA NA XXX 70460 ......... ............ A Ct head/brain w/dye ...................................... 1.13 6.81 6.24 NA NA 0.35 8.29 7.72 NA NA XXX 70460 ......... 26 ....... A Ct head/brain w/dye ...................................... 1.13 0.39 0.38 0.39 0.38 0.05 1.57 1.56 1.57 1.56 XXX 70460 ......... TC ...... A Ct head/brain w/dye ...................................... 0.00 6.41 5.86 NA NA 0.30 6.71 6.16 NA NA XXX 70470 ......... ............ A Ct head/brain w/o & w/dye ............................ 1.27 8.29 7.71 NA NA 0.43 9.99 9.41 NA NA XXX 70470 ......... 26 ....... A Ct head/brain w/o & w/dye ............................ 1.27 0.44 0.43 0.44 0.43 0.06 1.77 1.76 1.77 1.76 XXX 70470 ......... TC ...... A Ct head/brain w/o & w/dye ............................ 0.00 7.85 7.28 NA NA 0.37 8.22 7.65 NA NA XXX 70480 ......... ............ A Ct orbit/ear/fossa w/o dye ............................. 1.28 8.85 6.08 NA NA 0.31 10.44 7.67 NA NA XXX 70480 ......... 26 ....... A Ct orbit/ear/fossa w/o dye ............................. 1.28 0.44 0.43 0.44 0.43 0.06 1.78 1.77 1.78 1.77 XXX 70480 ......... TC ...... A Ct orbit/ear/fossa w/o dye ............................. 0.00 8.41 5.65 NA NA 0.25 8.66 5.90 NA NA XXX 70481 ......... ............ A Ct orbit/ear/fossa w/dye ................................ 1.38 10.46 7.21 NA NA 0.36 12.20 8.95 NA NA XXX 70481 ......... 26 ....... A Ct orbit/ear/fossa w/dye ................................ 1.38 0.48 0.46 0.48 0.46 0.06 1.92 1.90 1.92 1.90 XXX 70481 ......... TC ...... A Ct orbit/ear/fossa w/dye ................................ 0.00 9.98 6.76 NA NA 0.30 10.28 7.06 NA NA XXX 70482 ......... ............ A Ct orbit/ear/fossa w/o&w/dye ........................ 1.45 11.99 8.68 NA NA 0.43 13.87 10.56 NA NA XXX 70482 ......... 26 ....... A Ct orbit/ear/fossa w/o&w/dye ........................ 1.45 0.51 0.49 0.51 0.49 0.06 2.02 2.00 2.02 2.00 XXX 70482 ......... TC ...... A Ct orbit/ear/fossa w/o&w/dye ........................ 0.00 11.48 8.19 NA NA 0.37 11.85 8.56 NA NA XXX 70486 ......... ............ A Ct maxillofacial w/o dye ................................ 1.14 7.07 5.59 NA NA 0.30 8.51 7.03 NA NA XXX 70486 ......... 26 ....... A Ct maxillofacial w/o dye ................................ 1.14 0.39 0.38 0.39 0.38 0.05 1.58 1.57 1.58 1.57 XXX 70486 ......... TC ...... A Ct maxillofacial w/o dye ................................ 0.00 6.67 5.22 NA NA 0.25 6.92 5.47 NA NA XXX 70487 ......... ............ A Ct maxillofacial w/dye .................................... 1.30 8.75 6.77 NA NA 0.36 10.41 8.43 NA NA XXX 70487 ......... 26 ....... A Ct maxillofacial w/dye .................................... 1.30 0.46 0.44 0.46 0.44 0.06 1.82 1.80 1.82 1.80 XXX 70487 ......... TC ...... A Ct maxillofacial w/dye .................................... 0.00 8.29 6.33 NA NA 0.30 8.59 6.63 NA NA XXX70488 ......... ............ A Ct maxillofacial w/o & w/dye ......................... 1.42 10.86 8.38 NA NA 0.43 12.71 10.23 NA NA XXX 70488 ......... 26 ....... A Ct maxillofacial w/o & w/dye ......................... 1.42 0.49 0.47 0.49 0.47 0.06 1.97 1.95 1.97 1.95 XXX 70488 ......... TC ...... A Ct maxillofacial w/o & w/dye ......................... 0.00 10.37 7.91 NA NA 0.37 10.74 8.28 NA NA XXX 70490 ......... ............ A Ct soft tissue neck w/o dye ........................... 1.28 6.78 5.56 NA NA 0.31 8.37 7.15 NA NA XXX70490 ......... 26 ....... A Ct soft tissue neck w/o dye ........................... 1.28 0.45 0.43 0.45 0.43 0.06 1.79 1.77 1.79 1.77 XXX 70490 ......... TC ...... A Ct soft tissue neck w/o dye ........................... 0.00 6.33 5.13 NA NA 0.25 6.58 5.38 NA NA XXX 70491 ......... ............ A Ct soft tissue neck w/dye .............................. 1.38 8.39 6.70 NA NA 0.36 10.13 8.44 NA NA XXX 70491 ......... 26 ....... A Ct soft tissue neck w/dye .............................. 1.38 0.48 0.46 0.48 0.46 0.06 1.92 1.90 1.92 1.90 XXX 70491 ......... TC ...... A Ct soft tissue neck w/dye .............................. 0.00 7.91 6.24 NA NA 0.30 8.21 6.54 NA NA XXX 70492 ......... ............ A Ct sft tsue nck w/o & w/dye .......................... 1.45 10.53 8.30 NA NA 0.43 12.41 10.18 NA NA XXX 70492 ......... 26 ....... A Ct sft tsue nck w/o & w/dye .......................... 1.45 0.51 0.48 0.51 0.48 0.06 2.02 1.99 2.02 1.99 XXX 70492 ......... TC ...... A Ct sft tsue nck w/o & w/dye .......................... 0.00 10.02 7.82 NA NA 0.37 10.39 8.19 NA NA XXX 70496 ......... ............ A Ct angiography, head .................................... 1.75 17.86 12.87 NA NA 0.66 20.27 15.28 NA NA XXX 70496 ......... 26 ....... A Ct angiography, head .................................... 1.75 0.62 0.58 0.62 0.58 0.08 2.45 2.41 2.45 2.41 XXX 70496 ......... TC ...... A Ct angiography, head .................................... 0.00 17.24 12.28 NA NA 0.58 17.82 12.86 NA NA XXX 70498 ......... ............ A Ct angiography, neck .................................... 1.75 17.92 12.88 NA NA 0.66 20.33 15.29 NA NA XXX 70498 ......... 26 ....... A Ct angiography, neck .................................... 1.75 0.63 0.59 0.63 0.59 0.08 2.46 2.42 2.46 2.42 XXX 70498 ......... TC ...... A Ct angiography, neck .................................... 0.00 17.29 12.30 NA NA 0.58 17.87 12.88 NA NA XXX 70540 ......... ............ A Mri orbit/face/neck w/o dye ........................... 1.35 14.98 12.50 NA NA 0.45 16.78 14.30 NA NA XXX 70540 ......... 26 ....... A Mri orbit/face/neck w/o dye ........................... 1.35 0.48 0.45 0.48 0.45 0.06 1.89 1.86 1.89 1.86 XXX 70540 ......... TC ...... A Mri orbit/face/neck w/o dye ........................... 0.00 14.50 12.05 NA NA 0.39 14.89 12.44 NA NA XXX70542 ......... ............ A Mri orbit/face/neck w/dye .............................. 1.62 16.03 14.52 NA NA 0.54 18.19 16.68 NA NA XXX 70542 ......... 26 ....... A Mri orbit/face/neck w/dye .............................. 1.62 0.57 0.54 0.57 0.54 0.07 2.26 2.23 2.26 2.23 XXX 70542 ......... TC ...... A Mri orbit/face/neck w/dye .............................. 0.00 15.46 13.98 NA NA 0.47 15.93 14.45 NA NA XXX 70543 ......... ............ A Mri orbt/fac/nck w/o & w/dye ......................... 2.15 19.81 24.20 NA NA 0.94 22.90 27.29 NA NA XXX 70543 ......... 26 ....... A Mri orbt/fac/nck w/o & w/dye ......................... 2.15 0.76 0.72 0.76 0.72 0.10 3.01 2.97 3.01 2.97 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37362 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

70543 ......... TC ...... A Mri orbt/fac/nck w/o & w/dye ......................... 0.00 19.05 23.48 NA NA 0.84 19.89 24.32 NA NA XXX 70544 ......... ............ A Mr angiography head w/o dye ...................... 1.20 16.61 12.88 NA NA 0.64 18.45 14.72 NA NA XXX 70544 ......... 26 ....... A Mr angiography head w/o dye ...................... 1.20 0.42 0.41 0.42 0.41 0.05 1.67 1.66 1.67 1.66 XXX70544 ......... TC ...... A Mr angiography head w/o dye ...................... 0.00 16.20 12.47 NA NA 0.59 16.79 13.06 NA NA XXX 70545 ......... ............ A Mr angiography head w/dye .......................... 1.20 16.54 12.85 NA NA 0.64 18.38 14.69 NA NA XXX 70545 ......... 26 ....... A Mr angiography head w/dye .......................... 1.20 0.42 0.40 0.42 0.40 0.05 1.67 1.65 1.67 1.65 XXX 70545 ......... TC ...... A Mr angiography head w/dye .......................... 0.00 16.13 12.46 NA NA 0.59 16.72 13.05 NA NA XXX 70546 ......... ............ A Mr angiograph head w/o&w/dye ................... 1.80 25.29 23.62 NA NA 0.67 27.76 26.09 NA NA XXX 70546 ......... 26 ....... A Mr angiograph head w/o&w/dye ................... 1.80 0.63 0.60 0.63 0.60 0.08 2.51 2.48 2.51 2.48 XXX 70546 ......... TC ...... A Mr angiograph head w/o&w/dye ................... 0.00 24.66 23.02 NA NA 0.59 25.25 23.61 NA NA XXX 70547 ......... ............ A Mr angiography neck w/o dye ....................... 1.20 16.58 12.86 NA NA 0.64 18.42 14.70 NA NA XXX70547 ......... 26 ....... A Mr angiography neck w/o dye ....................... 1.20 0.42 0.40 0.42 0.40 0.05 1.67 1.65 1.67 1.65 XXX 70547 ......... TC ...... A Mr angiography neck w/o dye ....................... 0.00 16.16 12.46 NA NA 0.59 16.75 13.05 NA NA XXX 70548 ......... ............ A Mr angiography neck w/dye .......................... 1.20 17.44 13.08 NA NA 0.64 19.28 14.92 NA NA XXX 70548 ......... 26 ....... A Mr angiography neck w/dye .......................... 1.20 0.42 0.40 0.42 0.40 0.05 1.67 1.65 1.67 1.65 XXX 70548 ......... TC ...... A Mr angiography neck w/dye .......................... 0.00 17.02 12.68 NA NA 0.59 17.61 13.27 NA NA XXX 70549 ......... ............ A Mr angiograph neck w/o&w/dye .................... 1.80 25.26 23.61 NA NA 0.67 27.73 26.08 NA NA XXX 70549 ......... 26 ....... A Mr angiograph neck w/o&w/dye .................... 1.80 0.63 0.60 0.63 0.60 0.08 2.51 2.48 2.51 2.48 XXX 70549 ......... TC ...... A Mr angiograph neck w/o&w/dye .................... 0.00 24.63 23.01 NA NA 0.59 25.22 23.60 NA NA XXX 70551 ......... ............ A Mri brain w/o dye ........................................... 1.48 15.20 12.59 NA NA 0.66 17.34 14.73 NA NA XXX 70551 ......... 26 ....... A Mri brain w/o dye ........................................... 1.48 0.52 0.50 0.52 0.50 0.07 2.07 2.05 2.07 2.05 XXX 70551 ......... TC ...... A Mri brain w/o dye ........................................... 0.00 14.68 12.09 NA NA 0.59 15.27 12.68 NA NA XXX 70552 ......... ............ A Mri brain w/dye .............................................. 1.78 16.31 14.63 NA NA 0.78 18.87 17.19 NA NA XXX 70552 ......... 26 ....... A Mri brain w/dye .............................................. 1.78 0.62 0.60 0.62 0.60 0.08 2.48 2.46 2.48 2.46 XXX 70552 ......... TC ...... A Mri brain w/dye .............................................. 0.00 15.70 14.04 NA NA 0.70 16.40 14.74 NA NA XXX 70553 ......... ............ A Mri brain w/o & w/dye ................................... 2.36 19.01 24.05 NA NA 1.41 22.78 27.82 NA NA XXX 70553 ......... 26 ....... A Mri brain w/o & w/dye ................................... 2.36 0.82 0.79 0.82 0.79 0.10 3.28 3.25 3.28 3.25 XXX 70553 ......... TC ...... A Mri brain w/o & w/dye ................................... 0.00 18.19 23.26 NA NA 1.31 19.50 24.57 NA NA XXX 70557 ......... 26 ....... A Mri brain w/o dye ........................................... 2.90 1.00 1.10 1.00 1.10 0.08 3.98 4.08 3.98 4.08 XXX 70558 ......... 26 ....... A Mri brain w/dye .............................................. 3.20 1.13 1.21 1.13 1.21 0.10 4.43 4.51 4.43 4.51 XXX 70559 ......... 26 ....... A Mri brain w/o & w/dye ................................... 3.20 1.11 1.21 1.11 1.21 0.12 4.43 4.53 4.43 4.53 XXX 71010 ......... ............ A Chest x-ray .................................................... 0.18 0.45 0.51 NA NA 0.03 0.66 0.72 NA NA XXX 71010 ......... 26 ....... A Chest x-ray .................................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 71010 ......... TC ...... A Chest x-ray .................................................... 0.00 0.39 0.45 NA NA 0.02 0.41 0.47 NA NA XXX 71015 ......... ............ A Chest x-ray .................................................... 0.21 0.59 0.59 NA NA 0.03 0.83 0.83 NA NA XXX 71015 ......... 26 ....... A Chest x-ray .................................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 71015 ......... TC ...... A Chest x-ray .................................................... 0.00 0.52 0.52 NA NA 0.02 0.54 0.54 NA NA XXX 71020 ......... ............ A Chest x-ray .................................................... 0.22 0.59 0.67 NA NA 0.05 0.86 0.94 NA NA XXX 71020 ......... 26 ....... A Chest x-ray .................................................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 71020 ......... TC ...... A Chest x-ray .................................................... 0.00 0.52 0.60 NA NA 0.04 0.56 0.64 NA NA XXX 71021 ......... ............ A Chest x-ray .................................................... 0.27 0.73 0.80 NA NA 0.06 1.06 1.13 NA NA XXX 71021 ......... 26 ....... A Chest x-ray .................................................... 0.27 0.09 0.09 0.09 0.09 0.01 0.37 0.37 0.37 0.37 XXX 71021 ......... TC ...... A Chest x-ray .................................................... 0.00 0.65 0.71 NA NA 0.05 0.70 0.76 NA NA XXX 71022 ......... ............ A Chest x-ray .................................................... 0.31 0.92 0.85 NA NA 0.06 1.29 1.22 NA NA XXX 71022 ......... 26 ....... A Chest x-ray .................................................... 0.31 0.10 0.10 0.10 0.10 0.01 0.42 0.42 0.42 0.42 XXX 71022 ......... TC ...... A Chest x-ray .................................................... 0.00 0.82 0.75 NA NA 0.05 0.87 0.80 NA NA XXX 71023 ......... ............ A Chest x-ray and fluoroscopy ......................... 0.38 1.60 1.08 NA NA 0.06 2.04 1.52 NA NA XXX 71023 ......... 26 ....... A Chest x-ray and fluoroscopy ......................... 0.38 0.15 0.14 0.15 0.14 0.01 0.54 0.53 0.54 0.53 XXX 71023 ......... TC ...... A Chest x-ray and fluoroscopy ......................... 0.00 1.45 0.95 NA NA 0.05 1.50 1.00 NA NA XXX 71030 ......... ............ A Chest x-ray .................................................... 0.31 0.95 0.90 NA NA 0.06 1.32 1.27 NA NA XXX 71030 ......... 26 ....... A Chest x-ray .................................................... 0.31 0.10 0.10 0.10 0.10 0.01 0.42 0.42 0.42 0.42 XXX 71030 ......... TC ...... A Chest x-ray .................................................... 0.00 0.85 0.80 NA NA 0.05 0.90 0.85 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37363 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

71034 ......... ............ A Chest x-ray and fluoroscopy ......................... 0.46 2.13 1.73 NA NA 0.10 2.69 2.29 NA NA XXX 71034 ......... 26 ....... A Chest x-ray and fluoroscopy ......................... 0.46 0.19 0.17 0.19 0.17 0.02 0.67 0.65 0.67 0.65 XXX 71034 ......... TC ...... A Chest x-ray and fluoroscopy ......................... 0.00 1.94 1.57 NA NA 0.08 2.02 1.65 NA NA XXX 71035 ......... ............ A Chest x-ray .................................................... 0.18 0.81 0.64 NA NA 0.03 1.02 0.85 NA NA XXX 71035 ......... 26 ....... A Chest x-ray .................................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 71035 ......... TC ...... A Chest x-ray .................................................... 0.00 0.75 0.58 NA NA 0.02 0.77 0.60 NA NA XXX 71040 ......... ............ A Contrast x-ray of bronchi ............................... 0.58 2.13 1.77 NA NA 0.11 2.82 2.46 NA NA XXX 71040 ......... 26 ....... A Contrast x-ray of bronchi ............................... 0.58 0.17 0.19 0.17 0.19 0.03 0.78 0.80 0.78 0.80 XXX 71040 ......... TC ...... A Contrast x-ray of bronchi ............................... 0.00 1.96 1.59 NA NA 0.08 2.04 1.67 NA NA XXX 71060 ......... ............ A Contrast x-ray of bronchi ............................... 0.74 3.19 2.64 NA NA 0.16 4.09 3.54 NA NA XXX 71060 ......... 26 ....... A Contrast x-ray of bronchi ............................... 0.74 0.25 0.24 0.25 0.24 0.03 1.02 1.01 1.02 1.01 XXX 71060 ......... TC ...... A Contrast x-ray of bronchi ............................... 0.00 2.95 2.40 NA NA 0.13 3.08 2.53 NA NA XXX 71090 ......... ............ A X-ray & pacemaker insertion ......................... 0.54 0.29 1.49 NA NA 0.13 0.96 2.16 NA NA XXX 71090 ......... 26 ....... A X-ray & pacemaker insertion ......................... 0.54 0.29 0.23 0.29 0.23 0.02 0.85 0.79 0.85 0.79 XXX 71090 ......... TC ...... A X-ray & pacemaker insertion ......................... 0.00 0.00 1.26 NA NA 0.11 0.11 1.37 NA NA XXX 71100 ......... ............ A X-ray exam of ribs ......................................... 0.22 0.64 0.64 NA NA 0.05 0.91 0.91 NA NA XXX 71100 ......... 26 ....... A X-ray exam of ribs ......................................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 71100 ......... TC ...... A X-ray exam of ribs ......................................... 0.00 0.57 0.57 NA NA 0.04 0.61 0.61 NA NA XXX 71101 ......... ............ A X-ray exam of ribs/chest ............................... 0.27 0.79 0.77 NA NA 0.05 1.11 1.09 NA NA XXX 71101 ......... 26 ....... A X-ray exam of ribs/chest ............................... 0.27 0.09 0.09 0.09 0.09 0.01 0.37 0.37 0.37 0.37 XXX 71101 ......... TC ...... A X-ray exam of ribs/chest ............................... 0.00 0.70 0.68 NA NA 0.04 0.74 0.72 NA NA XXX 71110 ......... ............ A X-ray exam of ribs ......................................... 0.27 0.80 0.85 NA NA 0.06 1.13 1.18 NA NA XXX 71110 ......... 26 ....... A X-ray exam of ribs ......................................... 0.27 0.08 0.09 0.08 0.09 0.01 0.36 0.37 0.36 0.37 XXX 71110 ......... TC ...... A X-ray exam of ribs ......................................... 0.00 0.72 0.77 NA NA 0.05 0.77 0.82 NA NA XXX 71111 ......... ............ A X-ray exam of ribs/chest ............................... 0.32 1.10 1.02 NA NA 0.07 1.49 1.41 NA NA XXX 71111 ......... 26 ....... A X-ray exam of ribs/chest ............................... 0.32 0.10 0.10 0.10 0.10 0.01 0.43 0.43 0.43 0.43 XXX 71111 ......... TC ...... A X-ray exam of ribs/chest ............................... 0.00 1.00 0.92 NA NA 0.06 1.06 0.98 NA NA XXX 71120 ......... ............ A X-ray exam of breastbone ............................. 0.20 0.65 0.70 NA NA 0.05 0.90 0.95 NA NA XXX 71120 ......... 26 ....... A X-ray exam of breastbone ............................. 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 71120 ......... TC ...... A X-ray exam of breastbone ............................. 0.00 0.58 0.63 NA NA 0.04 0.62 0.67 NA NA XXX 71130 ......... ............ A X-ray exam of breastbone ............................. 0.22 0.78 0.78 NA NA 0.05 1.05 1.05 NA NA XXX 71130 ......... 26 ....... A X-ray exam of breastbone ............................. 0.22 0.08 0.07 0.08 0.07 0.01 0.31 0.30 0.31 0.30 XXX 71130 ......... TC ...... A X-ray exam of breastbone ............................. 0.00 0.70 0.71 NA NA 0.04 0.74 0.75 NA NA XXX 71250 ......... ............ A Ct thorax w/o dye .......................................... 1.16 6.74 6.42 NA NA 0.36 8.26 7.94 NA NA XXX 71250 ......... 26 ....... A Ct thorax w/o dye .......................................... 1.16 0.40 0.39 0.40 0.39 0.05 1.61 1.60 1.61 1.60 XXX 71250 ......... TC ...... A Ct thorax w/o dye .......................................... 0.00 6.34 6.03 NA NA 0.31 6.65 6.34 NA NA XXX 71260 ......... ............ A Ct thorax w/dye ............................................. 1.24 8.35 7.71 NA NA 0.42 10.01 9.37 NA NA XXX 71260 ......... 26 ....... A Ct thorax w/dye ............................................. 1.24 0.43 0.42 0.43 0.42 0.05 1.72 1.71 1.72 1.71 XXX 71260 ......... TC ...... A Ct thorax w/dye ............................................. 0.00 7.92 7.30 NA NA 0.37 8.29 7.67 NA NA XXX 71270 ......... ............ A Ct thorax w/o & w/dye ................................... 1.38 10.54 9.63 NA NA 0.52 12.44 11.53 NA NA XXX 71270 ......... 26 ....... A Ct thorax w/o & w/dye ................................... 1.38 0.48 0.46 0.48 0.46 0.06 1.92 1.90 1.92 1.90 XXX 71270 ......... TC ...... A Ct thorax w/o & w/dye ................................... 0.00 10.06 9.18 NA NA 0.46 10.52 9.64 NA NA XXX71275 ......... ............ A Ct angiography, chest ................................... 1.92 12.29 12.86 NA NA 0.48 14.69 15.26 NA NA XXX 71275 ......... 26 ....... A Ct angiography, chest ................................... 1.92 0.68 0.64 0.68 0.64 0.09 2.69 2.65 2.69 2.65 XXX 71275 ......... TC ...... A Ct angiography, chest ................................... 0.00 11.61 12.22 NA NA 0.39 12.00 12.61 NA NA XXX 71550 ......... ............ A Mri chest w/o dye .......................................... 1.46 17.27 13.10 NA NA 0.51 19.24 15.07 NA NA XXX 71550 ......... 26 ....... A Mri chest w/o dye .......................................... 1.46 0.52 0.49 0.52 0.49 0.06 2.04 2.01 2.04 2.01 XXX 71550 ......... TC ...... A Mri chest w/o dye .......................................... 0.00 16.76 12.61 NA NA 0.45 17.21 13.06 NA NA XXX 71551 ......... ............ A Mri chest w/dye ............................................. 1.73 18.81 15.24 NA NA 0.60 21.14 17.57 NA NA XXX 71551 ......... 26 ....... A Mri chest w/dye ............................................. 1.73 0.61 0.58 0.61 0.58 0.08 2.42 2.39 2.42 2.39 XXX 71551 ......... TC ...... A Mri chest w/dye ............................................. 0.00 18.20 14.66 NA NA 0.52 18.72 15.18 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37364 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

71552 ......... ............ A Mri chest w/o & w/dye ................................... 2.26 23.67 25.19 NA NA 0.78 26.71 28.23 NA NA XXX 71552 ......... 26 ....... A Mri chest w/o & w/dye ................................... 2.26 0.81 0.76 0.81 0.76 0.10 3.17 3.12 3.17 3.12 XXX 71552 ......... TC ...... A Mri chest w/o & w/dye ................................... 0.00 22.86 24.43 NA NA 0.68 23.54 25.11 NA NA XXX 71555 ......... ............ R Mri angio chest w or w/o dye ........................ 1.81 16.14 12.91 NA NA 0.67 18.62 15.39 NA NA XXX 71555 ......... 26 ....... R Mri angio chest w or w/o dye ........................ 1.81 0.67 0.62 0.67 0.62 0.08 2.56 2.51 2.56 2.51 XXX 71555 ......... TC ...... R Mri angio chest w or w/o dye ........................ 0.00 15.47 12.29 NA NA 0.59 16.06 12.88 NA NA XXX 72010 ......... ............ A X-ray exam of spine ...................................... 0.45 1.45 1.24 NA NA 0.08 1.98 1.77 NA NA XXX 72010 ......... 26 ....... A X-ray exam of spine ...................................... 0.45 0.13 0.15 0.13 0.15 0.02 0.60 0.62 0.60 0.62 XXX 72010 ......... TC ...... A X-ray exam of spine ...................................... 0.00 1.32 1.10 NA NA 0.06 1.38 1.16 NA NA XXX 72020 ......... ............ A X-ray exam of spine ...................................... 0.15 0.48 0.47 NA NA 0.03 0.66 0.65 NA NA XXX 72020 ......... 26 ....... A X-ray exam of spine ...................................... 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.21 0.21 XXX 72020 ......... TC ...... A X-ray exam of spine ...................................... 0.00 0.43 0.42 NA NA 0.02 0.45 0.44 NA NA XXX 72040 ......... ............ A X-ray exam of neck spine ............................. 0.22 0.79 0.70 NA NA 0.05 1.06 0.97 NA NA XXX 72040 ......... 26 ....... A X-ray exam of neck spine ............................. 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72040 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 0.72 0.63 NA NA 0.04 0.76 0.67 NA NA XXX 72050 ......... ............ A X-ray exam of neck spine ............................. 0.31 1.11 1.02 NA NA 0.07 1.49 1.40 NA NA XXX 72050 ......... 26 ....... A X-ray exam of neck spine ............................. 0.31 0.10 0.10 0.10 0.10 0.01 0.42 0.42 0.42 0.42 XXX 72050 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 1.00 0.92 NA NA 0.06 1.06 0.98 NA NA XXX 72052 ......... ............ A X-ray exam of neck spine ............................. 0.36 1.43 1.30 NA NA 0.08 1.87 1.74 NA NA XXX 72052 ......... 26 ....... A X-ray exam of neck spine ............................. 0.36 0.12 0.12 0.12 0.12 0.02 0.50 0.50 0.50 0.50 XXX 72052 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 1.31 1.18 NA NA 0.06 1.37 1.24 NA NA XXX 72069 ......... ............ A X-ray exam of trunk spine ............................. 0.22 0.78 0.62 NA NA 0.03 1.03 0.87 NA NA XXX72069 ......... 26 ....... A X-ray exam of trunk spine ............................. 0.22 0.08 0.08 0.08 0.08 0.01 0.31 0.31 0.31 0.31 XXX 72069 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.70 0.54 NA NA 0.02 0.72 0.56 NA NA XXX 72070 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.66 0.71 NA NA 0.05 0.93 0.98 NA NA XXX 72070 ......... 26 ....... A X-ray exam of thoracic spine ........................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72070 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.59 0.64 NA NA 0.04 0.63 0.68 NA NA XXX 72072 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.80 0.80 NA NA 0.06 1.08 1.08 NA NA XXX 72072 ......... 26 ....... A X-ray exam of thoracic spine ........................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72072 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.73 0.73 NA NA 0.05 0.78 0.78 NA NA XXX 72074 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.98 0.98 NA NA 0.07 1.27 1.27 NA NA XXX 72074 ......... 26 ....... A X-ray exam of thoracic spine ........................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72074 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.91 0.91 NA NA 0.06 0.97 0.97 NA NA XXX 72080 ......... ............ A X-ray exam of trunk spine ............................. 0.22 0.71 0.73 NA NA 0.05 0.98 1.00 NA NA XXX72080 ......... 26 ....... A X-ray exam of trunk spine ............................. 0.22 0.08 0.07 0.08 0.07 0.01 0.31 0.30 0.31 0.30 XXX 72080 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.63 0.66 NA NA 0.04 0.67 0.70 NA NA XXX 72090 ......... ............ A X-ray exam of trunk spine ............................. 0.28 1.04 0.83 NA NA 0.05 1.37 1.16 NA NA XXX72090 ......... 26 ....... A X-ray exam of trunk spine ............................. 0.28 0.10 0.09 0.10 0.09 0.01 0.39 0.38 0.39 0.38 XXX 72090 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.93 0.74 NA NA 0.04 0.97 0.78 NA NA XXX 72100 ......... ............ A X-ray exam of lower spine ............................ 0.22 0.83 0.76 NA NA 0.05 1.10 1.03 NA NA XXX 72100 ......... 26 ....... A X-ray exam of lower spine ............................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72100 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 0.76 0.69 NA NA 0.04 0.80 0.73 NA NA XXX 72110 ......... ............ A X-ray exam of lower spine ............................ 0.31 1.18 1.05 NA NA 0.07 1.56 1.43 NA NA XXX 72110 ......... 26 ....... A X-ray exam of lower spine ............................ 0.31 0.11 0.10 0.11 0.10 0.01 0.43 0.42 0.43 0.42 XXX 72110 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.07 0.95 NA NA 0.06 1.13 1.01 NA NA XXX 72114 ......... ............ A X-ray exam of lower spine ............................ 0.36 1.61 1.39 NA NA 0.08 2.05 1.83 NA NA XXX 72114 ......... 26 ....... A X-ray exam of lower spine ............................ 0.36 0.13 0.12 0.13 0.12 0.02 0.51 0.50 0.51 0.50 XXX 72114 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.48 1.26 NA NA 0.06 1.54 1.32 NA NA XXX 72120 ......... ............ A X-ray exam of lower spine ............................ 0.22 1.09 0.99 NA NA 0.07 1.38 1.28 NA NA XXX 72120 ......... 26 ....... A X-ray exam of lower spine ............................ 0.22 0.08 0.07 0.08 0.07 0.01 0.31 0.30 0.31 0.30 XXX 72120 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.01 0.92 NA NA 0.06 1.07 0.98 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37365 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

72125 ......... ............ A Ct neck spine w/o dye ................................... 1.16 6.75 6.42 NA NA 0.36 8.27 7.94 NA NA XXX 72125 ......... 26 ....... A Ct neck spine w/o dye ................................... 1.16 0.40 0.39 0.40 0.39 0.05 1.61 1.60 1.61 1.60 XXX 72125 ......... TC ...... A Ct neck spine w/o dye ................................... 0.00 6.34 6.03 NA NA 0.31 6.65 6.34 NA NA XXX 72126 ......... ............ A Ct neck spine w/dye ...................................... 1.22 8.37 7.71 NA NA 0.42 10.01 9.35 NA NA XXX 72126 ......... 26 ....... A Ct neck spine w/dye ...................................... 1.22 0.43 0.41 0.43 0.41 0.05 1.70 1.68 1.70 1.68 XXX 72126 ......... TC ...... A Ct neck spine w/dye ...................................... 0.00 7.95 7.31 NA NA 0.37 8.32 7.68 NA NA XXX 72127 ......... ............ A Ct neck spine w/o & w/dye ........................... 1.27 10.41 9.58 NA NA 0.52 12.20 11.37 NA NA XXX 72127 ......... 26 ....... A Ct neck spine w/o & w/dye ........................... 1.27 0.46 0.43 0.46 0.43 0.06 1.79 1.76 1.79 1.76 XXX 72127 ......... TC ...... A Ct neck spine w/o & w/dye ........................... 0.00 9.95 9.15 NA NA 0.46 10.41 9.61 NA NA XXX 72128 ......... ............ A Ct chest spine w/o dye .................................. 1.16 6.74 6.42 NA NA 0.36 8.26 7.94 NA NA XXX 72128 ......... 26 ....... A Ct chest spine w/o dye .................................. 1.16 0.40 0.39 0.40 0.39 0.05 1.61 1.60 1.61 1.60 XXX 72128 ......... TC ...... A Ct chest spine w/o dye .................................. 0.00 6.34 6.03 NA NA 0.31 6.65 6.34 NA NA XXX 72129 ......... ............ A Ct chest spine w/dye ..................................... 1.22 8.38 7.71 NA NA 0.42 10.02 9.35 NA NA XXX 72129 ......... 26 ....... A Ct chest spine w/dye ..................................... 1.22 0.43 0.41 0.43 0.41 0.05 1.70 1.68 1.70 1.68 XXX 72129 ......... TC ...... A Ct chest spine w/dye ..................................... 0.00 7.95 7.31 NA NA 0.37 8.32 7.68 NA NA XXX 72130 ......... ............ A Ct chest spine w/o & w/dye .......................... 1.27 10.37 9.57 NA NA 0.52 12.16 11.36 NA NA XXX 72130 ......... 26 ....... A Ct chest spine w/o & w/dye .......................... 1.27 0.46 0.43 0.46 0.43 0.06 1.79 1.76 1.79 1.76 XXX 72130 ......... TC ...... A Ct chest spine w/o & w/dye .......................... 0.00 9.91 9.14 NA NA 0.46 10.37 9.60 NA NA XXX 72131 ......... ............ A Ct lumbar spine w/o dye ............................... 1.16 6.73 6.42 NA NA 0.36 8.25 7.94 NA NA XXX72131 ......... 26 ....... A Ct lumbar spine w/o dye ............................... 1.16 0.40 0.39 0.40 0.39 0.05 1.61 1.60 1.61 1.60 XXX 72131 ......... TC ...... A Ct lumbar spine w/o dye ............................... 0.00 6.32 6.03 NA NA 0.31 6.63 6.34 NA NA XXX 72132 ......... ............ A Ct lumbar spine w/dye .................................. 1.22 8.37 7.71 NA NA 0.42 10.01 9.35 NA NA XXX 72132 ......... 26 ....... A Ct lumbar spine w/dye .................................. 1.22 0.43 0.41 0.43 0.41 0.05 1.70 1.68 1.70 1.68 XXX 72132 ......... TC ...... A Ct lumbar spine w/dye .................................. 0.00 7.94 7.30 NA NA 0.37 8.31 7.67 NA NA XXX 72133 ......... ............ A Ct lumbar spine w/o & w/dye ........................ 1.27 10.53 9.61 NA NA 0.52 12.32 11.40 NA NA XXX72133 ......... 26 ....... A Ct lumbar spine w/o & w/dye ........................ 1.27 0.44 0.43 0.44 0.43 0.06 1.77 1.76 1.77 1.76 XXX 72133 ......... TC ...... A Ct lumbar spine w/o & w/dye ........................ 0.00 10.09 9.18 NA NA 0.46 10.55 9.64 NA NA XXX 72141 ......... ............ A Mri neck spine w/o dye ................................. 1.60 13.15 12.11 NA NA 0.66 15.41 14.37 NA NA XXX 72141 ......... 26 ....... A Mri neck spine w/o dye ................................. 1.60 0.57 0.54 0.57 0.54 0.07 2.24 2.21 2.24 2.21 XXX 72141 ......... TC ...... A Mri neck spine w/o dye ................................. 0.00 12.58 11.57 NA NA 0.59 13.17 12.16 NA NA XXX 72142 ......... ............ A Mri neck spine w/dye .................................... 1.92 16.37 14.68 NA NA 0.79 19.08 17.39 NA NA XXX 72142 ......... 26 ....... A Mri neck spine w/dye .................................... 1.92 0.67 0.65 0.67 0.65 0.09 2.68 2.66 2.68 2.66 XXX 72142 ......... TC ...... A Mri neck spine w/dye .................................... 0.00 15.70 14.04 NA NA 0.70 16.40 14.74 NA NA XXX 72146 ......... ............ A Mri chest spine w/o dye ................................ 1.60 13.16 13.05 NA NA 0.71 15.47 15.36 NA NA XXX 72146 ......... 26 ....... A Mri chest spine w/o dye ................................ 1.60 0.56 0.54 0.56 0.54 0.07 2.23 2.21 2.23 2.21 XXX 72146 ......... TC ...... A Mri chest spine w/o dye ................................ 0.00 12.59 12.51 NA NA 0.64 13.23 13.15 NA NA XXX 72147 ......... ............ A Mri chest spine w/dye ................................... 1.92 14.19 14.13 NA NA 0.79 16.90 16.84 NA NA XXX 72147 ......... 26 ....... A Mri chest spine w/dye ................................... 1.92 0.67 0.64 0.67 0.64 0.09 2.68 2.65 2.68 2.65 XXX 72147 ......... TC ...... A Mri chest spine w/dye ................................... 0.00 13.52 13.49 NA NA 0.70 14.22 14.19 NA NA XXX 72148 ......... ............ A Mri lumbar spine w/o dye .............................. 1.48 13.11 13.01 NA NA 0.71 15.30 15.20 NA NA XXX 72148 ......... 26 ....... A Mri lumbar spine w/o dye .............................. 1.48 0.52 0.50 0.52 0.50 0.07 2.07 2.05 2.07 2.05 XXX 72148 ......... TC ...... A Mri lumbar spine w/o dye .............................. 0.00 12.59 12.51 NA NA 0.64 13.23 13.15 NA NA XXX72149 ......... ............ A Mri lumbar spine w/dye ................................. 1.78 16.32 14.64 NA NA 0.78 18.88 17.20 NA NA XXX 72149 ......... 26 ....... A Mri lumbar spine w/dye ................................. 1.78 0.63 0.61 0.63 0.61 0.08 2.49 2.47 2.49 2.47 XXX 72149 ......... TC ...... A Mri lumbar spine w/dye ................................. 0.00 15.70 14.04 NA NA 0.70 16.40 14.74 NA NA XXX 72156 ......... ............ A Mri neck spine w/o & w/dye .......................... 2.57 18.72 24.03 NA NA 1.42 22.71 28.02 NA NA XXX 72156 ......... 26 ....... A Mri neck spine w/o & w/dye .......................... 2.57 0.90 0.86 0.90 0.86 0.11 3.58 3.54 3.58 3.54 XXX 72156 ......... TC ...... A Mri neck spine w/o & w/dye .......................... 0.00 17.82 23.17 NA NA 1.31 19.13 24.48 NA NA XXX 72157 ......... ............ A Mri chest spine w/o & w/dye ......................... 2.57 17.03 23.60 NA NA 1.42 21.02 27.59 NA NA XXX 72157 ......... 26 ....... A Mri chest spine w/o & w/dye ......................... 2.57 0.90 0.86 0.90 0.86 0.11 3.58 3.54 3.58 3.54 XXX 72157 ......... TC ...... A Mri chest spine w/o & w/dye ......................... 0.00 16.13 22.75 NA NA 1.31 17.44 24.06 NA NA XXX 72158 ......... ............ A Mri lumbar spine w/o & w/dye ....................... 2.36 18.65 23.96 NA NA 1.41 22.42 27.73 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37366 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

72158 ......... 26 ....... A Mri lumbar spine w/o & w/dye ....................... 2.36 0.83 0.79 0.83 0.79 0.10 3.29 3.25 3.29 3.25 XXX 72158 ......... TC ...... A Mri lumbar spine w/o & w/dye ....................... 0.00 17.81 23.17 NA NA 1.31 19.12 24.48 NA NA XXX 72159 ......... ............ N Mr angio spine w/o&w/dye ............................ 1.80 14.64 13.38 14.64 13.38 0.74 17.18 15.92 17.18 15.92 XXX 72159 ......... 26 ....... N Mr angio spine w/o&w/dye ............................ 1.80 0.40 0.62 0.40 0.62 0.10 2.30 2.52 2.30 2.52 XXX 72159 ......... TC ...... N Mr angio spine w/o&w/dye ............................ 0.00 14.24 12.76 14.24 12.76 0.64 14.88 13.40 14.88 13.40 XXX 72170 ......... ............ A X-ray exam of pelvis ..................................... 0.17 0.51 0.56 NA NA 0.03 0.71 0.76 NA NA XXX 72170 ......... 26 ....... A X-ray exam of pelvis ..................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 72170 ......... TC ...... A X-ray exam of pelvis ..................................... 0.00 0.45 0.50 NA NA 0.02 0.47 0.52 NA NA XXX 72190 ......... ............ A X-ray exam of pelvis ..................................... 0.21 0.87 0.77 NA NA 0.05 1.13 1.03 NA NA XXX 72190 ......... 26 ....... A X-ray exam of pelvis ..................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 72190 ......... TC ...... A X-ray exam of pelvis ..................................... 0.00 0.80 0.70 NA NA 0.04 0.84 0.74 NA NA XXX 72191 ......... ............ A Ct angiograph pelv w/o&w/dye ..................... 1.81 11.92 12.48 NA NA 0.47 14.20 14.76 NA NA XXX 72191 ......... 26 ....... A Ct angiograph pelv w/o&w/dye ..................... 1.81 0.65 0.61 0.65 0.61 0.08 2.54 2.50 2.54 2.50 XXX72191 ......... TC ...... A Ct angiograph pelv w/o&w/dye ..................... 0.00 11.26 11.86 NA NA 0.39 11.65 12.25 NA NA XXX 72192 ......... ............ A Ct pelvis w/o dye ........................................... 1.09 6.29 6.29 NA NA 0.36 7.74 7.74 NA NA XXX 72192 ......... 26 ....... A Ct pelvis w/o dye ........................................... 1.09 0.38 0.37 0.38 0.37 0.05 1.52 1.51 1.52 1.51 XXX 72192 ......... TC ...... A Ct pelvis w/o dye ........................................... 0.00 5.91 5.93 NA NA 0.31 6.22 6.24 NA NA XXX 72193 ......... ............ A Ct pelvis w/dye .............................................. 1.16 7.88 7.40 NA NA 0.41 9.45 8.97 NA NA XXX 72193 ......... 26 ....... A Ct pelvis w/dye .............................................. 1.16 0.40 0.39 0.40 0.39 0.05 1.61 1.60 1.61 1.60 XXX 72193 ......... TC ...... A Ct pelvis w/dye .............................................. 0.00 7.48 7.02 NA NA 0.36 7.84 7.38 NA NA XXX 72194 ......... ............ A Ct pelvis w/o & w/dye .................................... 1.22 10.57 9.33 NA NA 0.48 12.27 11.03 NA NA XXX 72194 ......... 26 ....... A Ct pelvis w/o & w/dye .................................... 1.22 0.43 0.41 0.43 0.41 0.05 1.70 1.68 1.70 1.68 XXX 72194 ......... TC ...... A Ct pelvis w/o & w/dye .................................... 0.00 10.14 8.92 NA NA 0.43 10.57 9.35 NA NA XXX 72195 ......... ............ A Mri pelvis w/o dye ......................................... 1.46 15.17 12.58 NA NA 0.51 17.14 14.55 NA NA XXX 72195 ......... 26 ....... A Mri pelvis w/o dye ......................................... 1.46 0.52 0.49 0.52 0.49 0.06 2.04 2.01 2.04 2.01 XXX 72195 ......... TC ...... A Mri pelvis w/o dye ......................................... 0.00 14.65 12.09 NA NA 0.45 15.10 12.54 NA NA XXX 72196 ......... ............ A Mri pelvis w/dye ............................................. 1.73 16.25 14.60 NA NA 0.60 18.58 16.93 NA NA XXX 72196 ......... 26 ....... A Mri pelvis w/dye ............................................. 1.73 0.61 0.58 0.61 0.58 0.08 2.42 2.39 2.42 2.39 XXX 72196 ......... TC ...... A Mri pelvis w/dye ............................................. 0.00 15.64 14.02 NA NA 0.52 16.16 14.54 NA NA XXX 72197 ......... ............ A Mri pelvis w/o & w/dye .................................. 2.26 19.94 24.25 NA NA 1.02 23.22 27.53 NA NA XXX 72197 ......... 26 ....... A Mri pelvis w/o & w/dye .................................. 2.26 0.80 0.76 0.80 0.76 0.10 3.16 3.12 3.16 3.12 XXX 72197 ......... TC ...... A Mri pelvis w/o & w/dye .................................. 0.00 19.14 23.50 NA NA 0.92 20.06 24.42 NA NA XXX 72198 ......... ............ A Mr angio pelvis w/o & w/dye ......................... 1.80 15.89 12.84 NA NA 0.67 18.36 15.31 NA NA XXX 72198 ......... 26 ....... A Mr angio pelvis w/o & w/dye ......................... 1.80 0.65 0.61 0.65 0.61 0.08 2.53 2.49 2.53 2.49 XXX 72198 ......... TC ...... A Mr angio pelvis w/o & w/dye ......................... 0.00 15.25 12.24 NA NA 0.59 15.84 12.83 NA NA XXX 72200 ......... ............ A X-ray exam sacroiliac joints .......................... 0.17 0.62 0.59 NA NA 0.03 0.82 0.79 NA NA XXX72200 ......... 26 ....... A X-ray exam sacroiliac joints .......................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 72200 ......... TC ...... A X-ray exam sacroiliac joints .......................... 0.00 0.56 0.53 NA NA 0.02 0.58 0.55 NA NA XXX 72202 ......... ............ A X-ray exam sacroiliac joints .......................... 0.19 0.76 0.70 NA NA 0.05 1.00 0.94 NA NA XXX72202 ......... 26 ....... A X-ray exam sacroiliac joints .......................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 72202 ......... TC ...... A X-ray exam sacroiliac joints .......................... 0.00 0.70 0.64 NA NA 0.04 0.74 0.68 NA NA XXX 72220 ......... ............ A X-ray exam of tailbone .................................. 0.17 0.60 0.62 NA NA 0.05 0.82 0.84 NA NA XXX 72220 ......... 26 ....... A X-ray exam of tailbone .................................. 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 72220 ......... TC ...... A X-ray exam of tailbone .................................. 0.00 0.54 0.56 NA NA 0.04 0.58 0.60 NA NA XXX 72240 ......... ............ A Contrast x-ray of neck spine ......................... 0.91 2.64 4.45 NA NA 0.29 3.84 5.65 NA NA XXX 72240 ......... 26 ....... A Contrast x-ray of neck spine ......................... 0.91 0.31 0.30 0.31 0.30 0.04 1.26 1.25 1.26 1.25 XXX 72240 ......... TC ...... A Contrast x-ray of neck spine ......................... 0.00 2.33 4.15 NA NA 0.25 2.58 4.40 NA NA XXX 72255 ......... ............ A Contrast x-ray, thorax spine .......................... 0.91 2.35 4.05 NA NA 0.26 3.52 5.22 NA NA XXX72255 ......... 26 ....... A Contrast x-ray, thorax spine .......................... 0.91 0.29 0.28 0.29 0.28 0.04 1.24 1.23 1.24 1.23 XXX 72255 ......... TC ...... A Contrast x-ray, thorax spine .......................... 0.00 2.06 3.77 NA NA 0.22 2.28 3.99 NA NA XXX 72265 ......... ............ A Contrast x-ray, lower spine ........................... 0.83 2.61 3.90 NA NA 0.26 3.70 4.99 NA NA XXX72265 ......... 26 ....... A Contrast x-ray, lower spine ........................... 0.83 0.28 0.26 0.28 0.26 0.04 1.15 1.13 1.15 1.13 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37367 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

72265 ......... TC ...... A Contrast x-ray, lower spine ........................... 0.00 2.33 3.64 NA NA 0.22 2.55 3.86 NA NA XXX 72270 ......... ............ A Contrast x-ray, spine ..................................... 1.33 4.13 5.94 NA NA 0.39 5.85 7.66 NA NA XXX 72270 ......... 26 ....... A Contrast x-ray, spine ..................................... 1.33 0.47 0.43 0.47 0.43 0.06 1.86 1.82 1.86 1.82 XXX 72270 ......... TC ...... A Contrast x-ray, spine ..................................... 0.00 3.66 5.51 NA NA 0.33 3.99 5.84 NA NA XXX72275 ......... ............ A Epidurography ............................................... 0.76 1.72 2.16 NA NA 0.26 2.74 3.18 NA NA XXX 72275 ......... 26 ....... A Epidurography ............................................... 0.76 0.19 0.20 0.19 0.20 0.04 0.99 1.00 0.99 1.00 XXX 72275 ......... TC ...... A Epidurography ............................................... 0.00 1.53 1.97 NA NA 0.22 1.75 2.19 NA NA XXX 72285 ......... ............ A X-ray c/t spine disk ........................................ 1.16 1.45 6.93 NA NA 0.50 3.11 8.59 NA NA XXX 72285 ......... 26 ....... A X-ray c/t spine disk ........................................ 1.16 0.30 0.35 0.30 0.35 0.07 1.53 1.58 1.53 1.58 XXX 72285 ......... TC ...... A X-ray c/t spine disk ........................................ 0.00 1.15 6.59 NA NA 0.43 1.58 7.02 NA NA XXX 72295 ......... ............ A X-ray of lower spine disk ............................... 0.83 1.43 6.47 NA NA 0.46 2.72 7.76 NA NA XXX 72295 ......... 26 ....... A X-ray of lower spine disk ............................... 0.83 0.23 0.26 0.23 0.26 0.06 1.12 1.15 1.12 1.15 XXX 72295 ......... TC ...... A X-ray of lower spine disk ............................... 0.00 1.20 6.21 NA NA 0.40 1.60 6.61 NA NA XXX 73000 ......... ............ A X-ray exam of collar bone ............................. 0.16 0.57 0.57 NA NA 0.03 0.76 0.76 NA NA XXX73000 ......... 26 ....... A X-ray exam of collar bone ............................. 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73000 ......... TC ...... A X-ray exam of collar bone ............................. 0.00 0.51 0.52 NA NA 0.02 0.53 0.54 NA NA XXX 73010 ......... ............ A X-ray exam of shoulder blade ....................... 0.17 0.59 0.58 NA NA 0.03 0.79 0.78 NA NA XXX 73010 ......... 26 ....... A X-ray exam of shoulder blade ....................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73010 ......... TC ...... A X-ray exam of shoulder blade ....................... 0.00 0.53 0.52 NA NA 0.02 0.55 0.54 NA NA XXX 73020 ......... ............ A X-ray exam of shoulder ................................. 0.15 0.46 0.51 NA NA 0.03 0.64 0.69 NA NA XXX 73020 ......... 26 ....... A X-ray exam of shoulder ................................. 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.21 0.21 XXX 73020 ......... TC ...... A X-ray exam of shoulder ................................. 0.00 0.40 0.45 NA NA 0.02 0.42 0.47 NA NA XXX 73030 ......... ............ A X-ray exam of shoulder ................................. 0.18 0.58 0.62 NA NA 0.05 0.81 0.85 NA NA XXX 73030 ......... 26 ....... A X-ray exam of shoulder ................................. 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 73030 ......... TC ...... A X-ray exam of shoulder ................................. 0.00 0.52 0.56 NA NA 0.04 0.56 0.60 NA NA XXX 73040 ......... ............ A Contrast x-ray of shoulder ............................. 0.54 2.31 2.30 NA NA 0.14 2.99 2.98 NA NA XXX 73040 ......... 26 ....... A Contrast x-ray of shoulder ............................. 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 73040 ......... TC ...... A Contrast x-ray of shoulder ............................. 0.00 2.13 2.12 NA NA 0.12 2.25 2.24 NA NA XXX 73050 ......... ............ A X-ray exam of shoulders ............................... 0.20 0.74 0.74 NA NA 0.05 0.99 0.99 NA NA XXX73050 ......... 26 ....... A X-ray exam of shoulders ............................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 73050 ......... TC ...... A X-ray exam of shoulders ............................... 0.00 0.67 0.67 NA NA 0.04 0.71 0.71 NA NA XXX 73060 ......... ............ A X-ray exam of humerus ................................. 0.17 0.59 0.62 NA NA 0.05 0.81 0.84 NA NA XXX73060 ......... 26 ....... A X-ray exam of humerus ................................. 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73060 ......... TC ...... A X-ray exam of humerus ................................. 0.00 0.53 0.56 NA NA 0.04 0.57 0.60 NA NA XXX 73070 ......... ............ A X-ray exam of elbow ..................................... 0.15 0.57 0.57 NA NA 0.03 0.75 0.75 NA NA XXX 73070 ......... 26 ....... A X-ray exam of elbow ..................................... 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.21 0.21 XXX 73070 ......... TC ...... A X-ray exam of elbow ..................................... 0.00 0.52 0.52 NA NA 0.02 0.54 0.54 NA NA XXX 73080 ......... ............ A X-ray exam of elbow ..................................... 0.17 0.78 0.67 NA NA 0.05 1.00 0.89 NA NA XXX 73080 ......... 26 ....... A X-ray exam of elbow ..................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73080 ......... TC ...... A X-ray exam of elbow ..................................... 0.00 0.72 0.61 NA NA 0.04 0.76 0.65 NA NA XXX 73085 ......... ............ A Contrast x-ray of elbow ................................. 0.54 1.86 2.19 NA NA 0.14 2.54 2.87 NA NA XXX 73085 ......... 26 ....... A Contrast x-ray of elbow ................................. 0.54 0.17 0.19 0.17 0.19 0.02 0.73 0.75 0.73 0.75 XXX 73085 ......... TC ...... A Contrast x-ray of elbow ................................. 0.00 1.69 2.01 NA NA 0.12 1.81 2.13 NA NA XXX 73090 ......... ............ A X-ray exam of forearm .................................. 0.16 0.57 0.57 NA NA 0.03 0.76 0.76 NA NA XXX 73090 ......... 26 ....... A X-ray exam of forearm .................................. 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73090 ......... TC ...... A X-ray exam of forearm .................................. 0.00 0.52 0.52 NA NA 0.02 0.54 0.54 NA NA XXX 73092 ......... ............ A X-ray exam of arm, infant ............................. 0.16 0.60 0.56 NA NA 0.03 0.79 0.75 NA NA XXX73092 ......... 26 ....... A X-ray exam of arm, infant ............................. 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73092 ......... TC ...... A X-ray exam of arm, infant ............................. 0.00 0.55 0.51 NA NA 0.02 0.57 0.53 NA NA XXX 73100 ......... ............ A X-ray exam of wrist ....................................... 0.16 0.61 0.56 NA NA 0.03 0.80 0.75 NA NA XXX 73100 ......... 26 ....... A X-ray exam of wrist ....................................... 0.16 0.06 0.05 0.06 0.05 0.01 0.23 0.22 0.23 0.22 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37368 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

73100 ......... TC ...... A X-ray exam of wrist ....................................... 0.00 0.56 0.51 NA NA 0.02 0.58 0.53 NA NA XXX73110 ......... ............ A X-ray exam of wrist ....................................... 0.17 0.79 0.64 NA NA 0.03 0.99 0.84 NA NA XXX 73110 ......... 26 ....... A X-ray exam of wrist ....................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73110 ......... TC ...... A X-ray exam of wrist ....................................... 0.00 0.74 0.58 NA NA 0.02 0.76 0.60 NA NA XXX73115 ......... ............ A Contrast x-ray of wrist ................................... 0.54 2.41 1.92 NA NA 0.12 3.07 2.58 NA NA XXX 73115 ......... 26 ....... A Contrast x-ray of wrist ................................... 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 73115 ......... TC ...... A Contrast x-ray of wrist ................................... 0.00 2.23 1.74 NA NA 0.10 2.33 1.84 NA NA XXX73120 ......... ............ A X-ray exam of hand ....................................... 0.16 0.57 0.55 NA NA 0.03 0.76 0.74 NA NA XXX 73120 ......... 26 ....... A X-ray exam of hand ....................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73120 ......... TC ...... A X-ray exam of hand ....................................... 0.00 0.52 0.50 NA NA 0.02 0.54 0.52 NA NA XXX 73130 ......... ............ A X-ray exam of hand ....................................... 0.17 0.68 0.61 NA NA 0.03 0.88 0.81 NA NA XXX 73130 ......... 26 ....... A X-ray exam of hand ....................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73130 ......... TC ...... A X-ray exam of hand ....................................... 0.00 0.62 0.55 NA NA 0.02 0.64 0.57 NA NA XXX 73140 ......... ............ A X-ray exam of finger(s) ................................. 0.13 0.69 0.52 NA NA 0.03 0.85 0.68 NA NA XXX 73140 ......... 26 ....... A X-ray exam of finger(s) ................................. 0.13 0.05 0.04 0.05 0.04 0.01 0.19 0.18 0.19 0.18 XXX 73140 ......... TC ...... A X-ray exam of finger(s) ................................. 0.00 0.65 0.48 NA NA 0.02 0.67 0.50 NA NA XXX 73200 ......... ............ A Ct upper extremity w/o dye ........................... 1.09 6.69 5.67 NA NA 0.30 8.08 7.06 NA NA XXX 73200 ......... 26 ....... A Ct upper extremity w/o dye ........................... 1.09 0.38 0.37 0.38 0.37 0.05 1.52 1.51 1.52 1.51 XXX 73200 ......... TC ...... A Ct upper extremity w/o dye ........................... 0.00 6.31 5.31 NA NA 0.25 6.56 5.56 NA NA XXX 73201 ......... ............ A Ct upper extremity w/dye .............................. 1.16 8.28 6.80 NA NA 0.36 9.80 8.32 NA NA XXX73201 ......... 26 ....... A Ct upper extremity w/dye .............................. 1.16 0.41 0.39 0.41 0.39 0.05 1.62 1.60 1.62 1.60 XXX 73201 ......... TC ...... A Ct upper extremity w/dye .............................. 0.00 7.87 6.42 NA NA 0.31 8.18 6.73 NA NA XXX 73202 ......... ............ A Ct uppr extremity w/o&w/dye ........................ 1.22 11.14 8.67 NA NA 0.44 12.80 10.33 NA NA XXX73202 ......... 26 ....... A Ct uppr extremity w/o&w/dye ........................ 1.22 0.43 0.41 0.43 0.41 0.05 1.70 1.68 1.70 1.68 XXX 73202 ......... TC ...... A Ct uppr extremity w/o&w/dye ........................ 0.00 10.72 8.26 NA NA 0.39 11.11 8.65 NA NA XXX 73206 ......... ............ A Ct angio upr extrm w/o&w/dye ...................... 1.81 11.30 11.51 NA NA 0.47 13.58 13.79 NA NA XXX73206 ......... 26 ....... A Ct angio upr extrm w/o&w/dye ...................... 1.81 0.65 0.61 0.65 0.61 0.08 2.54 2.50 2.54 2.50 XXX 73206 ......... TC ...... A Ct angio upr extrm w/o&w/dye ...................... 0.00 10.65 10.91 NA NA 0.39 11.04 11.30 NA NA XXX 73218 ......... ............ A Mri upper extremity w/o dye .......................... 1.35 15.36 12.59 NA NA 0.45 17.16 14.39 NA NA XXX 73218 ......... 26 ....... A Mri upper extremity w/o dye .......................... 1.35 0.47 0.45 0.47 0.45 0.06 1.88 1.86 1.88 1.86 XXX 73218 ......... TC ...... A Mri upper extremity w/o dye .......................... 0.00 14.89 12.15 NA NA 0.39 15.28 12.54 NA NA XXX 73219 ......... ............ A Mri upper extremity w/dye ............................. 1.62 16.17 14.56 NA NA 0.54 18.33 16.72 NA NA XXX 73219 ......... 26 ....... A Mri upper extremity w/dye ............................. 1.62 0.57 0.55 0.57 0.55 0.07 2.26 2.24 2.26 2.24 XXX 73219 ......... TC ...... A Mri upper extremity w/dye ............................. 0.00 15.60 14.01 NA NA 0.47 16.07 14.48 NA NA XXX73220 ......... ............ A Mri uppr extremity w/o&w/dye ....................... 2.15 20.02 24.25 NA NA 0.94 23.11 27.34 NA NA XXX 73220 ......... 26 ....... A Mri uppr extremity w/o&w/dye ....................... 2.15 0.75 0.72 0.75 0.72 0.10 3.00 2.97 3.00 2.97 XXX 73220 ......... TC ...... A Mri uppr extremity w/o&w/dye ....................... 0.00 19.27 23.53 NA NA 0.84 20.11 24.37 NA NA XXX 73221 ......... ............ A Mri joint upr extrem w/o dye ......................... 1.35 14.27 12.32 NA NA 0.45 16.07 14.12 NA NA XXX 73221 ......... 26 ....... A Mri joint upr extrem w/o dye ......................... 1.35 0.48 0.45 0.48 0.45 0.06 1.89 1.86 1.89 1.86 XXX 73221 ......... TC ...... A Mri joint upr extrem w/o dye ......................... 0.00 13.79 11.87 NA NA 0.39 14.18 12.26 NA NA XXX 73222 ......... ............ A Mri joint upr extrem w/dye ............................. 1.62 15.10 14.28 NA NA 0.54 17.26 16.44 NA NA XXX 73222 ......... 26 ....... A Mri joint upr extrem w/dye ............................. 1.62 0.58 0.54 0.58 0.54 0.07 2.27 2.23 2.27 2.23 XXX 73222 ......... TC ...... A Mri joint upr extrem w/dye ............................. 0.00 14.52 13.74 NA NA 0.47 14.99 14.21 NA NA XXX 73223 ......... ............ A Mri joint upr extr w/o&w/dye .......................... 2.15 18.54 23.88 NA NA 0.94 21.63 26.97 NA NA XXX 73223 ......... 26 ....... A Mri joint upr extr w/o&w/dye .......................... 2.15 0.75 0.72 0.75 0.72 0.10 3.00 2.97 3.00 2.97 XXX 73223 ......... TC ...... A Mri joint upr extr w/o&w/dye .......................... 0.00 17.79 23.16 NA NA 0.84 18.63 24.00 NA NA XXX73225 ......... ............ N Mr angio upr extr w/o&w/dye ........................ 1.73 14.63 12.44 14.63 12.44 0.69 17.05 14.86 17.05 14.86 XXX 73225 ......... 26 ....... N Mr angio upr extr w/o&w/dye ........................ 1.73 0.39 0.60 0.39 0.60 0.10 2.22 2.43 2.22 2.43 XXX 73225 ......... TC ...... N Mr angio upr extr w/o&w/dye ........................ 0.00 14.24 11.84 14.24 11.84 0.59 14.83 12.43 14.83 12.43 XXX 73500 ......... ............ A X-ray exam of hip .......................................... 0.17 0.50 0.52 NA NA 0.03 0.70 0.72 NA NA XXX 73500 ......... 26 ....... A X-ray exam of hip .......................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73500 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.44 0.46 NA NA 0.02 0.46 0.48 NA NA XXX 73510 ......... ............ A X-ray exam of hip .......................................... 0.21 0.80 0.68 NA NA 0.05 1.06 0.94 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37369 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

73510 ......... 26 ....... A X-ray exam of hip .......................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 73510 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.73 0.61 NA NA 0.04 0.77 0.65 NA NA XXX 73520 ......... ............ A X-ray exam of hips ........................................ 0.26 0.81 0.77 NA NA 0.05 1.12 1.08 NA NA XXX 73520 ......... 26 ....... A X-ray exam of hips ........................................ 0.26 0.09 0.09 0.09 0.09 0.01 0.36 0.36 0.36 0.36 XXX 73520 ......... TC ...... A X-ray exam of hips ........................................ 0.00 0.72 0.68 NA NA 0.04 0.76 0.72 NA NA XXX73525 ......... ............ A Contrast x-ray of hip ...................................... 0.54 1.83 2.18 NA NA 0.15 2.52 2.87 NA NA XXX 73525 ......... 26 ....... A Contrast x-ray of hip ...................................... 0.54 0.18 0.18 0.18 0.18 0.03 0.75 0.75 0.75 0.75 XXX 73525 ......... TC ...... A Contrast x-ray of hip ...................................... 0.00 1.66 2.00 NA NA 0.12 1.78 2.12 NA NA XXX 73530 ......... ............ A X-ray exam of hip .......................................... 0.29 0.10 0.49 NA NA 0.03 0.42 0.81 NA NA XXX 73530 ......... 26 ....... A X-ray exam of hip .......................................... 0.29 0.10 0.10 0.10 0.10 0.01 0.40 0.40 0.40 0.40 XXX 73530 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.00 0.39 NA NA 0.02 0.02 0.41 NA NA XXX 73540 ......... ............ A X-ray exam of pelvis & hips .......................... 0.20 0.80 0.68 NA NA 0.05 1.05 0.93 NA NA XXX 73540 ......... 26 ....... A X-ray exam of pelvis & hips .......................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 73540 ......... TC ...... A X-ray exam of pelvis & hips .......................... 0.00 0.74 0.61 NA NA 0.04 0.78 0.65 NA NA XXX 73542 ......... ............ A X-ray exam, sacroiliac joint ........................... 0.59 1.11 1.98 NA NA 0.15 1.85 2.72 NA NA XXX 73542 ......... 26 ....... A X-ray exam, sacroiliac joint ........................... 0.59 0.14 0.16 0.14 0.16 0.03 0.76 0.78 0.76 0.78 XXX 73542 ......... TC ...... A X-ray exam, sacroiliac joint ........................... 0.00 0.98 1.83 NA NA 0.12 1.10 1.95 NA NA XXX 73550 ......... ............ A X-ray exam of thigh ....................................... 0.17 0.56 0.61 NA NA 0.05 0.78 0.83 NA NA XXX 73550 ......... 26 ....... A X-ray exam of thigh ....................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73550 ......... TC ...... A X-ray exam of thigh ....................................... 0.00 0.50 0.55 NA NA 0.04 0.54 0.59 NA NA XXX73560 ......... ............ A X-ray exam of knee, 1 or 2 ........................... 0.17 0.60 0.59 NA NA 0.03 0.80 0.79 NA NA XXX 73560 ......... 26 ....... A X-ray exam of knee, 1 or 2 ........................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73560 ......... TC ...... A X-ray exam of knee, 1 or 2 ........................... 0.00 0.54 0.53 NA NA 0.02 0.56 0.55 NA NA XXX 73562 ......... ............ A X-ray exam of knee, 3 ................................... 0.18 0.74 0.66 NA NA 0.05 0.97 0.89 NA NA XXX 73562 ......... 26 ....... A X-ray exam of knee, 3 ................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 73562 ......... TC ...... A X-ray exam of knee, 3 ................................... 0.00 0.68 0.60 NA NA 0.04 0.72 0.64 NA NA XXX 73564 ......... ............ A X-ray exam, knee, 4 or more ........................ 0.22 0.88 0.74 NA NA 0.05 1.15 1.01 NA NA XXX 73564 ......... 26 ....... A X-ray exam, knee, 4 or more ........................ 0.22 0.08 0.07 0.08 0.07 0.01 0.31 0.30 0.31 0.30 XXX 73564 ......... TC ...... A X-ray exam, knee, 4 or more ........................ 0.00 0.80 0.67 NA NA 0.04 0.84 0.71 NA NA XXX 73565 ......... ............ A X-ray exam of knees ..................................... 0.17 0.65 0.58 NA NA 0.03 0.85 0.78 NA NA XXX 73565 ......... 26 ....... A X-ray exam of knees ..................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73565 ......... TC ...... A X-ray exam of knees ..................................... 0.00 0.59 0.52 NA NA 0.02 0.61 0.54 NA NA XXX 73580 ......... ............ A Contrast x-ray of knee joint ........................... 0.54 2.41 2.70 NA NA 0.17 3.12 3.41 NA NA XXX 73580 ......... 26 ....... A Contrast x-ray of knee joint ........................... 0.54 0.18 0.17 0.18 0.17 0.03 0.75 0.74 0.75 0.74 XXX 73580 ......... TC ...... A Contrast x-ray of knee joint ........................... 0.00 2.23 2.53 NA NA 0.14 2.37 2.67 NA NA XXX 73590 ......... ............ A X-ray exam of lower leg ................................ 0.17 0.55 0.57 NA NA 0.03 0.75 0.77 NA NA XXX 73590 ......... 26 ....... A X-ray exam of lower leg ................................ 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73590 ......... TC ...... A X-ray exam of lower leg ................................ 0.00 0.50 0.52 NA NA 0.02 0.52 0.54 NA NA XXX 73592 ......... ............ A X-ray exam of leg, infant ............................... 0.16 0.61 0.56 NA NA 0.03 0.80 0.75 NA NA XXX 73592 ......... 26 ....... A X-ray exam of leg, infant ............................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73592 ......... TC ...... A X-ray exam of leg, infant ............................... 0.00 0.56 0.51 NA NA 0.02 0.58 0.53 NA NA XXX 73600 ......... ............ A X-ray exam of ankle ...................................... 0.16 0.57 0.55 NA NA 0.03 0.76 0.74 NA NA XXX 73600 ......... 26 ....... A X-ray exam of ankle ...................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73600 ......... TC ...... A X-ray exam of ankle ...................................... 0.00 0.52 0.50 NA NA 0.02 0.54 0.52 NA NA XXX 73610 ......... ............ A X-ray exam of ankle ...................................... 0.17 0.69 0.62 NA NA 0.03 0.89 0.82 NA NA XXX 73610 ......... 26 ....... A X-ray exam of ankle ...................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73610 ......... TC ...... A X-ray exam of ankle ...................................... 0.00 0.63 0.56 NA NA 0.02 0.65 0.58 NA NA XXX 73615 ......... ............ A Contrast x-ray of ankle .................................. 0.54 1.92 2.20 NA NA 0.15 2.61 2.89 NA NA XXX 73615 ......... 26 ....... A Contrast x-ray of ankle .................................. 0.54 0.17 0.18 0.17 0.18 0.03 0.74 0.75 0.74 0.75 XXX 73615 ......... TC ...... A Contrast x-ray of ankle .................................. 0.00 1.75 2.02 NA NA 0.12 1.87 2.14 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37370 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

73620 ......... ............ A X-ray exam of foot ......................................... 0.16 0.53 0.54 NA NA 0.03 0.72 0.73 NA NA XXX 73620 ......... 26 ....... A X-ray exam of foot ......................................... 0.16 0.04 0.05 0.04 0.05 0.01 0.21 0.22 0.21 0.22 XXX 73620 ......... TC ...... A X-ray exam of foot ......................................... 0.00 0.49 0.49 NA NA 0.02 0.51 0.51 NA NA XXX 73630 ......... ............ A X-ray exam of foot ......................................... 0.17 0.67 0.61 NA NA 0.03 0.87 0.81 NA NA XXX 73630 ......... 26 ....... A X-ray exam of foot ......................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73630 ......... TC ...... A X-ray exam of foot ......................................... 0.00 0.61 0.55 NA NA 0.02 0.63 0.57 NA NA XXX 73650 ......... ............ A X-ray exam of heel ........................................ 0.16 0.56 0.53 NA NA 0.03 0.75 0.72 NA NA XXX 73650 ......... 26 ....... A X-ray exam of heel ........................................ 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73650 ......... TC ...... A X-ray exam of heel ........................................ 0.00 0.51 0.48 NA NA 0.02 0.53 0.50 NA NA XXX73660 ......... ............ A X-ray exam of toe(s) ..................................... 0.13 0.65 0.51 NA NA 0.03 0.81 0.67 NA NA XXX 73660 ......... 26 ....... A X-ray exam of toe(s) ..................................... 0.13 0.04 0.04 0.04 0.04 0.01 0.18 0.18 0.18 0.18 XXX 73660 ......... TC ...... A X-ray exam of toe(s) ..................................... 0.00 0.61 0.47 NA NA 0.02 0.63 0.49 NA NA XXX 73700 ......... ............ A Ct lower extremity w/o dye ............................ 1.09 6.70 5.67 NA NA 0.30 8.09 7.06 NA NA XXX73700 ......... 26 ....... A Ct lower extremity w/o dye ............................ 1.09 0.38 0.37 0.38 0.37 0.05 1.52 1.51 1.52 1.51 XXX 73700 ......... TC ...... A Ct lower extremity w/o dye ............................ 0.00 6.32 5.31 NA NA 0.25 6.57 5.56 NA NA XXX 73701 ......... ............ A Ct lower extremity w/dye ............................... 1.16 8.32 6.81 NA NA 0.36 9.84 8.33 NA NA XXX 73701 ......... 26 ....... A Ct lower extremity w/dye ............................... 1.16 0.40 0.39 0.40 0.39 0.05 1.61 1.60 1.61 1.60 XXX 73701 ......... TC ...... A Ct lower extremity w/dye ............................... 0.00 7.91 6.43 NA NA 0.31 8.22 6.74 NA NA XXX 73702 ......... ............ A Ct lwr extremity w/o&w/dye ........................... 1.22 11.20 8.68 NA NA 0.44 12.86 10.34 NA NA XXX 73702 ......... 26 ....... A Ct lwr extremity w/o&w/dye ........................... 1.22 0.44 0.41 0.44 0.41 0.05 1.71 1.68 1.71 1.68 XXX 73702 ......... TC ...... A Ct lwr extremity w/o&w/dye ........................... 0.00 10.76 8.27 NA NA 0.39 11.15 8.66 NA NA XXX 73706 ......... ............ A Ct angio lwr extr w/o&w/dye ......................... 1.90 12.85 11.92 NA NA 0.47 15.22 14.29 NA NA XXX 73706 ......... 26 ....... A Ct angio lwr extr w/o&w/dye ......................... 1.90 0.71 0.64 0.71 0.64 0.08 2.69 2.62 2.69 2.62 XXX 73706 ......... TC ...... A Ct angio lwr extr w/o&w/dye ......................... 0.00 12.14 11.28 NA NA 0.39 12.53 11.67 NA NA XXX 73718 ......... ............ A Mri lower extremity w/o dye .......................... 1.35 15.09 12.53 NA NA 0.45 16.89 14.33 NA NA XXX 73718 ......... 26 ....... A Mri lower extremity w/o dye .......................... 1.35 0.48 0.45 0.48 0.45 0.06 1.89 1.86 1.89 1.86 XXX 73718 ......... TC ...... A Mri lower extremity w/o dye .......................... 0.00 14.61 12.08 NA NA 0.39 15.00 12.47 NA NA XXX 73719 ......... ............ A Mri lower extremity w/dye ............................. 1.62 16.15 14.55 NA NA 0.54 18.31 16.71 NA NA XXX 73719 ......... 26 ....... A Mri lower extremity w/dye ............................. 1.62 0.57 0.54 0.57 0.54 0.07 2.26 2.23 2.26 2.23 XXX 73719 ......... TC ...... A Mri lower extremity w/dye ............................. 0.00 15.58 14.01 NA NA 0.47 16.05 14.48 NA NA XXX73720 ......... ............ A Mri lwr extremity w/o&w/dye ......................... 2.15 19.99 24.24 NA NA 0.94 23.08 27.33 NA NA XXX 73720 ......... 26 ....... A Mri lwr extremity w/o&w/dye ......................... 2.15 0.75 0.71 0.75 0.71 0.10 3.00 2.96 3.00 2.96 XXX 73720 ......... TC ...... A Mri lwr extremity w/o&w/dye ......................... 0.00 19.24 23.52 NA NA 0.84 20.08 24.36 NA NA XXX 73721 ......... ............ A Mri jnt of lwr extre w/o dye ............................ 1.35 14.61 12.41 NA NA 0.45 16.41 14.21 NA NA XXX 73721 ......... 26 ....... A Mri jnt of lwr extre w/o dye ............................ 1.35 0.48 0.45 0.48 0.45 0.06 1.89 1.86 1.89 1.86 XXX 73721 ......... TC ...... A Mri jnt of lwr extre w/o dye ............................ 0.00 14.13 11.96 NA NA 0.39 14.52 12.35 NA NA XXX 73722 ......... ............ A Mri joint of lwr extr w/dye .............................. 1.62 15.29 14.33 NA NA 0.54 17.45 16.49 NA NA XXX 73722 ......... 26 ....... A Mri joint of lwr extr w/dye .............................. 1.62 0.58 0.54 0.58 0.54 0.07 2.27 2.23 2.27 2.23 XXX 73722 ......... TC ...... A Mri joint of lwr extr w/dye .............................. 0.00 14.71 13.79 NA NA 0.47 15.18 14.26 NA NA XXX 73723 ......... ............ A Mri joint lwr extr w/o&w/dye .......................... 2.15 18.48 23.87 NA NA 0.94 21.57 26.96 NA NA XXX 73723 ......... 26 ....... A Mri joint lwr extr w/o&w/dye .......................... 2.15 0.75 0.72 0.75 0.72 0.10 3.00 2.97 3.00 2.97 XXX 73723 ......... TC ...... A Mri joint lwr extr w/o&w/dye .......................... 0.00 17.73 23.15 NA NA 0.84 18.57 23.99 NA NA XXX73725 ......... ............ R Mr ang lwr ext w or w/o dye ......................... 1.82 15.93 12.86 NA NA 0.67 18.42 15.35 NA NA XXX 73725 ......... 26 ....... R Mr ang lwr ext w or w/o dye ......................... 1.82 0.65 0.61 0.65 0.61 0.08 2.55 2.51 2.55 2.51 XXX 73725 ......... TC ...... R Mr ang lwr ext w or w/o dye ......................... 0.00 15.28 12.24 NA NA 0.59 15.87 12.83 NA NA XXX 74000 ......... ............ A X-ray exam of abdomen ................................ 0.18 0.48 0.56 NA NA 0.03 0.69 0.77 NA NA XXX 74000 ......... 26 ....... A X-ray exam of abdomen ................................ 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 74000 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.42 0.50 NA NA 0.02 0.44 0.52 NA NA XXX 74010 ......... ............ A X-ray exam of abdomen ................................ 0.23 0.82 0.69 NA NA 0.05 1.10 0.97 NA NA XXX 74010 ......... 26 ....... A X-ray exam of abdomen ................................ 0.23 0.08 0.08 0.08 0.08 0.01 0.32 0.32 0.32 0.32 XXX 74010 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.74 0.61 NA NA 0.04 0.78 0.65 NA NA XXX 74020 ......... ............ A X-ray exam of abdomen ................................ 0.27 0.84 0.74 NA NA 0.05 1.16 1.06 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37371 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

74020 ......... 26 ....... A X-ray exam of abdomen ................................ 0.27 0.09 0.09 0.09 0.09 0.01 0.37 0.37 0.37 0.37 XXX 74020 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.75 0.65 NA NA 0.04 0.79 0.69 NA NA XXX 74022 ......... ............ A X-ray exam series, abdomen ........................ 0.32 1.02 0.88 NA NA 0.06 1.40 1.26 NA NA XXX 74022 ......... 26 ....... A X-ray exam series, abdomen ........................ 0.32 0.11 0.10 0.11 0.10 0.01 0.44 0.43 0.44 0.43 XXX 74022 ......... TC ...... A X-ray exam series, abdomen ........................ 0.00 0.91 0.78 NA NA 0.05 0.96 0.83 NA NA XXX 74150 ......... ............ A Ct abdomen w/o dye ..................................... 1.19 6.33 6.14 NA NA 0.35 7.87 7.68 NA NA XXX 74150 ......... 26 ....... A Ct abdomen w/o dye ..................................... 1.19 0.41 0.40 0.41 0.40 0.05 1.65 1.64 1.65 1.64 XXX 74150 ......... TC ...... A Ct abdomen w/o dye ..................................... 0.00 5.91 5.74 NA NA 0.30 6.21 6.04 NA NA XXX 74160 ......... ............ A Ct abdomen w/dye ........................................ 1.27 9.21 7.76 NA NA 0.42 10.90 9.45 NA NA XXX 74160 ......... 26 ....... A Ct abdomen w/dye ........................................ 1.27 0.44 0.43 0.44 0.43 0.06 1.77 1.76 1.77 1.76 XXX 74160 ......... TC ...... A Ct abdomen w/dye ........................................ 0.00 8.77 7.34 NA NA 0.36 9.13 7.70 NA NA XXX 74170 ......... ............ A Ct abdomen w/o & w/dye .............................. 1.40 12.75 9.92 NA NA 0.49 14.64 11.81 NA NA XXX 74170 ......... 26 ....... A Ct abdomen w/o & w/dye .............................. 1.40 0.49 0.47 0.49 0.47 0.06 1.95 1.93 1.95 1.93 XXX 74170 ......... TC ...... A Ct abdomen w/o & w/dye .............................. 0.00 12.26 9.45 NA NA 0.43 12.69 9.88 NA NA XXX 74175 ......... ............ A Ct angio abdom w/o & w/dye ........................ 1.90 12.86 12.73 NA NA 0.47 15.23 15.10 NA NA XXX74175 ......... 26 ....... A Ct angio abdom w/o & w/dye ........................ 1.90 0.69 0.64 0.69 0.64 0.08 2.67 2.62 2.67 2.62 XXX 74175 ......... TC ...... A Ct angio abdom w/o & w/dye ........................ 0.00 12.18 12.09 NA NA 0.39 12.57 12.48 NA NA XXX 74181 ......... ............ A Mri abdomen w/o dye .................................... 1.46 13.09 12.06 NA NA 0.51 15.06 14.03 NA NA XXX 74181 ......... 26 ....... A Mri abdomen w/o dye .................................... 1.46 0.51 0.49 0.51 0.49 0.06 2.03 2.01 2.03 2.01 XXX 74181 ......... TC ...... A Mri abdomen w/o dye .................................... 0.00 12.58 11.57 NA NA 0.45 13.03 12.02 NA NA XXX 74182 ......... ............ A Mri abdomen w/dye ....................................... 1.73 18.28 15.11 NA NA 0.60 20.61 17.44 NA NA XXX 74182 ......... 26 ....... A Mri abdomen w/dye ....................................... 1.73 0.60 0.58 0.60 0.58 0.08 2.41 2.39 2.41 2.39 XXX 74182 ......... TC ...... A Mri abdomen w/dye ....................................... 0.00 17.68 14.53 NA NA 0.52 18.20 15.05 NA NA XXX 74183 ......... ............ A Mri abdomen w/o & w/dye ............................ 2.26 19.98 24.26 NA NA 1.02 23.26 27.54 NA NA XXX 74183 ......... 26 ....... A Mri abdomen w/o & w/dye ............................ 2.26 0.79 0.75 0.79 0.75 0.10 3.15 3.11 3.15 3.11 XXX 74183 ......... TC ...... A Mri abdomen w/o & w/dye ............................ 0.00 19.18 23.51 NA NA 0.92 20.10 24.43 NA NA XXX 74185 ......... ............ R Mri angio, abdom w orw/o dye ...................... 1.80 15.88 12.84 NA NA 0.67 18.35 15.31 NA NA XXX74185 ......... 26 ....... R Mri angio, abdom w orw/o dye ...................... 1.80 0.64 0.60 0.64 0.60 0.08 2.52 2.48 2.52 2.48 XXX 74185 ......... TC ...... R Mri angio, abdom w orw/o dye ...................... 0.00 15.24 12.23 NA NA 0.59 15.83 12.82 NA NA XXX 74190 ......... ............ A X-ray exam of peritoneum ............................. 0.48 0.17 1.15 NA NA 0.09 0.74 1.72 NA NA XXX 74190 ......... 26 ....... A X-ray exam of peritoneum ............................. 0.48 0.17 0.16 0.17 0.16 0.02 0.67 0.66 0.67 0.66 XXX 74190 ......... TC ...... A X-ray exam of peritoneum ............................. 0.00 0.00 0.98 NA NA 0.07 0.07 1.05 NA NA XXX 74210 ......... ............ A Contrst x-ray exam of throat ......................... 0.36 1.85 1.45 NA NA 0.08 2.29 1.89 NA NA XXX 74210 ......... 26 ....... A Contrst x-ray exam of throat ......................... 0.36 0.12 0.12 0.12 0.12 0.02 0.50 0.50 0.50 0.50 XXX 74210 ......... TC ...... A Contrst x-ray exam of throat ......................... 0.00 1.72 1.32 NA NA 0.06 1.78 1.38 NA NA XXX 74220 ......... ............ A Contrast x-ray, esophagus ............................ 0.46 2.10 1.53 NA NA 0.08 2.64 2.07 NA NA XXX 74220 ......... 26 ....... A Contrast x-ray, esophagus ............................ 0.46 0.16 0.15 0.16 0.15 0.02 0.64 0.63 0.64 0.63 XXX 74220 ......... TC ...... A Contrast x-ray, esophagus ............................ 0.00 1.94 1.38 NA NA 0.06 2.00 1.44 NA NA XXX 74230 ......... ............ A Cine/vid x-ray, throat/esoph .......................... 0.53 2.03 1.62 NA NA 0.09 2.65 2.24 NA NA XXX74230 ......... 26 ....... A Cine/vid x-ray, throat/esoph .......................... 0.53 0.18 0.17 0.18 0.17 0.02 0.73 0.72 0.73 0.72 XXX 74230 ......... TC ...... A Cine/vid x-ray, throat/esoph .......................... 0.00 1.84 1.44 NA NA 0.07 1.91 1.51 NA NA XXX 74235 ......... 26 ....... A Remove esophagus obstruction .................... 1.19 0.43 0.40 0.43 0.40 0.05 1.67 1.64 1.67 1.64 XXX 74240 ......... ............ A X-ray exam, upper gi tract ............................ 0.69 2.40 1.87 NA NA 0.11 3.20 2.67 NA NA XXX74240 ......... 26 ....... A X-ray exam, upper gi tract ............................ 0.69 0.24 0.23 0.24 0.23 0.03 0.96 0.95 0.96 0.95 XXX 74240 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 2.16 1.64 NA NA 0.08 2.24 1.72 NA NA XXX 74241 ......... ............ A X-ray exam, upper gi tract ............................ 0.69 2.67 1.96 NA NA 0.11 3.47 2.76 NA NA XXX74241 ......... 26 ....... A X-ray exam, upper gi tract ............................ 0.69 0.23 0.23 0.23 0.23 0.03 0.95 0.95 0.95 0.95 XXX 74241 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 2.43 1.73 NA NA 0.08 2.51 1.81 NA NA XXX 74245 ......... ............ A X-ray exam, upper gi tract ............................ 0.91 4.13 3.05 NA NA 0.17 5.21 4.13 NA NA XXX74245 ......... 26 ....... A X-ray exam, upper gi tract ............................ 0.91 0.32 0.31 0.32 0.31 0.04 1.27 1.26 1.27 1.26 XXX 74245 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 3.81 2.75 NA NA 0.13 3.94 2.88 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37372 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

74246 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.69 2.91 2.13 NA NA 0.13 3.73 2.95 NA NA XXX 74246 ......... 26 ....... A Contrst x-ray uppr gi tract ............................. 0.69 0.24 0.23 0.24 0.23 0.03 0.96 0.95 0.96 0.95 XXX 74246 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 2.67 1.90 NA NA 0.10 2.77 2.00 NA NA XXX 74247 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.69 3.36 2.27 NA NA 0.14 4.19 3.10 NA NA XXX 74247 ......... 26 ....... A Contrst x-ray uppr gi tract ............................. 0.69 0.24 0.23 0.24 0.23 0.03 0.96 0.95 0.96 0.95 XXX 74247 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 3.12 2.04 NA NA 0.11 3.23 2.15 NA NA XXX 74249 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.91 4.53 3.29 NA NA 0.18 5.62 4.38 NA NA XXX 74249 ......... 26 ....... A Contrst x-ray uppr gi tract ............................. 0.91 0.32 0.31 0.32 0.31 0.04 1.27 1.26 1.27 1.26 XXX 74249 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 4.22 2.99 NA NA 0.14 4.36 3.13 NA NA XXX 74250 ......... ............ A X-ray exam of small bowel ............................ 0.47 2.59 1.74 NA NA 0.09 3.15 2.30 NA NA XXX 74250 ......... 26 ....... A X-ray exam of small bowel ............................ 0.47 0.16 0.15 0.16 0.15 0.02 0.65 0.64 0.65 0.64 XXX 74250 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 2.43 1.59 NA NA 0.07 2.50 1.66 NA NA XXX 74251 ......... ............ A X-ray exam of small bowel ............................ 0.69 10.48 3.78 NA NA 0.10 11.27 4.57 NA NA XXX 74251 ......... 26 ....... A X-ray exam of small bowel ............................ 0.69 0.24 0.23 0.24 0.23 0.03 0.96 0.95 0.96 0.95 XXX 74251 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 10.24 3.54 NA NA 0.07 10.31 3.61 NA NA XXX 74260 ......... ............ A X-ray exam of small bowel ............................ 0.50 8.69 3.41 NA NA 0.10 9.29 4.01 NA NA XXX 74260 ......... 26 ....... A X-ray exam of small bowel ............................ 0.50 0.17 0.16 0.17 0.16 0.02 0.69 0.68 0.69 0.68 XXX 74260 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 8.52 3.25 NA NA 0.08 8.60 3.33 NA NA XXX 74270 ......... ............ A Contrast x-ray exam of colon ........................ 0.69 3.73 2.38 NA NA 0.14 4.56 3.21 NA NA XXX 74270 ......... 26 ....... A Contrast x-ray exam of colon ........................ 0.69 0.24 0.23 0.24 0.23 0.03 0.96 0.95 0.96 0.95 XXX 74270 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 3.49 2.15 NA NA 0.11 3.60 2.26 NA NA XXX 74280 ......... ............ A Contrast x-ray exam of colon ........................ 0.99 5.17 3.21 NA NA 0.17 6.33 4.37 NA NA XXX 74280 ......... 26 ....... A Contrast x-ray exam of colon ........................ 0.99 0.34 0.33 0.34 0.33 0.04 1.37 1.36 1.37 1.36 XXX 74280 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 4.83 2.89 NA NA 0.13 4.96 3.02 NA NA XXX 74283 ......... ............ A Contrast x-ray exam of colon ........................ 2.02 3.60 3.32 NA NA 0.23 5.85 5.57 NA NA XXX 74283 ......... 26 ....... A Contrast x-ray exam of colon ........................ 2.02 0.68 0.67 0.68 0.67 0.09 2.79 2.78 2.79 2.78 XXX 74283 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 2.92 2.66 NA NA 0.14 3.06 2.80 NA NA XXX 74290 ......... ............ A Contrast x-ray, gallbladder ............................ 0.32 1.62 1.03 NA NA 0.06 2.00 1.41 NA NA XXX 74290 ......... 26 ....... A Contrast x-ray, gallbladder ............................ 0.32 0.11 0.10 0.11 0.10 0.01 0.44 0.43 0.44 0.43 XXX 74290 ......... TC ...... A Contrast x-ray, gallbladder ............................ 0.00 1.52 0.93 NA NA 0.05 1.57 0.98 NA NA XXX 74291 ......... ............ A Contrast x-rays, gallbladder .......................... 0.20 1.65 0.78 NA NA 0.03 1.88 1.01 NA NA XXX74291 ......... 26 ....... A Contrast x-rays, gallbladder .......................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 74291 ......... TC ...... A Contrast x-rays, gallbladder .......................... 0.00 1.59 0.71 NA NA 0.02 1.61 0.73 NA NA XXX 74300 ......... 26 ....... A X-ray bile ducts/pancreas .............................. 0.36 0.12 0.12 0.12 0.12 0.02 0.50 0.50 0.50 0.50 XXX 74301 ......... 26 ....... A X-rays at surgery add-on .............................. 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 ZZZ 74305 ......... ............ A X-ray bile ducts/pancreas .............................. 0.42 0.15 0.73 NA NA 0.07 0.64 1.22 NA NA XXX 74305 ......... 26 ....... A X-ray bile ducts/pancreas .............................. 0.42 0.15 0.14 0.15 0.14 0.02 0.59 0.58 0.59 0.58 XXX 74305 ......... TC ...... A X-ray bile ducts/pancreas .............................. 0.00 0.00 0.59 NA NA 0.05 0.05 0.64 NA NA XXX 74320 ......... ............ A Contrast x-ray of bile ducts ........................... 0.54 2.23 3.06 NA NA 0.19 2.96 3.79 NA NA XXX 74320 ......... 26 ....... A Contrast x-ray of bile ducts ........................... 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 74320 ......... TC ...... A Contrast x-ray of bile ducts ........................... 0.00 2.04 2.88 NA NA 0.17 2.21 3.05 NA NA XXX 74327 ......... ............ A X-ray bile stone removal ............................... 0.70 3.14 2.29 NA NA 0.14 3.98 3.13 NA NA XXX 74327 ......... 26 ....... A X-ray bile stone removal ............................... 0.70 0.25 0.24 0.25 0.24 0.03 0.98 0.97 0.98 0.97 XXX 74327 ......... TC ...... A X-ray bile stone removal ............................... 0.00 2.89 2.05 NA NA 0.11 3.00 2.16 NA NA XXX 74328 ......... ............ A X-ray bile duct endoscopy ............................. 0.70 0.26 2.61 NA NA 0.20 1.16 3.51 NA NA XXX74328 ......... 26 ....... A X-ray bile duct endoscopy ............................. 0.70 0.26 0.24 0.26 0.24 0.03 0.99 0.97 0.99 0.97 XXX 74328 ......... TC ...... A X-ray bile duct endoscopy ............................. 0.00 0.00 2.37 NA NA 0.17 0.17 2.54 NA NA XXX 74329 ......... 6 ......... A X-ray for pancreas endoscopy ...................... 0.70 0.26 0.24 0.26 0.24 0.03 0.99 0.97 0.99 0.97 XXX 74330 ......... ............ A X-ray bile/panc endoscopy ............................ 0.90 0.33 2.67 NA NA 0.21 1.44 3.78 NA NA XXX 74330 ......... 26 ....... A X-ray bile/panc endoscopy ............................ 0.90 0.33 0.30 0.33 0.30 0.04 1.27 1.24 1.27 1.24 XXX 74330 ......... TC ...... A X-ray bile/panc endoscopy ............................ 0.00 0.00 2.37 NA NA 0.17 0.17 2.54 NA NA XXX 74340 ......... ............ A X-ray guide for GI tube ................................. 0.54 0.19 2.16 NA NA 0.16 0.89 2.86 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37373 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

74340 ......... 26 ....... A X-ray guide for GI tube ................................. 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 74340 ......... TC ...... A X-ray guide for GI tube ................................. 0.00 0.00 1.97 NA NA 0.14 0.14 2.11 NA NA XXX 74350 ......... ............ A X-ray guide, stomach tube ............................ 0.76 2.33 3.14 NA NA 0.20 3.29 4.10 NA NA XXX 74350 ......... 26 ....... A X-ray guide, stomach tube ............................ 0.76 0.28 0.26 0.28 0.26 0.03 1.07 1.05 1.07 1.05 XXX 74350 ......... TC ...... A X-ray guide, stomach tube ............................ 0.00 2.06 2.89 NA NA 0.17 2.23 3.06 NA NA XXX 74355 ......... ............ A X-ray guide, intestinal tube ........................... 0.76 0.27 2.23 NA NA 0.17 1.20 3.16 NA NA XXX 74355 ......... 26 ....... A X-ray guide, intestinal tube ........................... 0.76 0.27 0.26 0.27 0.26 0.03 1.06 1.05 1.06 1.05 XXX 74355 ......... TC ...... A X-ray guide, intestinal tube ........................... 0.00 0.00 1.97 NA NA 0.14 0.14 2.11 NA NA XXX 74360 ......... ............ A X-ray guide, GI dilation ................................. 0.54 0.25 2.58 NA NA 0.19 0.98 3.31 NA NA XXX 74360 ......... 26 ....... A X-ray guide, GI dilation ................................. 0.54 0.25 0.21 0.25 0.21 0.02 0.81 0.77 0.81 0.77 XXX 74360 ......... TC ...... A X-ray guide, GI dilation ................................. 0.00 0.00 2.37 NA NA 0.17 0.17 2.54 NA NA XXX 74363 ......... 26 ....... A X-ray, bile duct dilation .................................. 0.88 0.32 0.30 0.32 0.30 0.04 1.24 1.22 1.24 1.22 XXX 74400 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 2.72 2.06 NA NA 0.13 3.34 2.68 NA NA XXX 74400 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 74400 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 2.55 1.90 NA NA 0.11 2.66 2.01 NA NA XXX 74410 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 2.83 2.30 NA NA 0.13 3.45 2.92 NA NA XXX 74410 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.49 0.18 0.17 0.18 0.17 0.02 0.69 0.68 0.69 0.68 XXX 74410 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 2.65 2.13 NA NA 0.11 2.76 2.24 NA NA XXX 74415 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 3.43 2.58 NA NA 0.14 4.06 3.21 NA NA XXX 74415 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 74415 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 3.25 2.41 NA NA 0.12 3.37 2.53 NA NA XXX 74420 ......... ............ A Contrst x-ray, urinary tract ............................ 0.36 0.13 2.10 NA NA 0.16 0.65 2.62 NA NA XXX 74420 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.36 0.13 0.12 0.13 0.12 0.02 0.51 0.50 0.51 0.50 XXX 74420 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 0.00 1.97 NA NA 0.14 0.14 2.11 NA NA XXX 74425 ......... ............ A Contrst x-ray, urinary tract ............................ 0.36 0.13 1.11 NA NA 0.09 0.58 1.56 NA NA XXX 74425 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.36 0.13 0.12 0.13 0.12 0.02 0.51 0.50 0.51 0.50 XXX 74425 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 0.00 0.98 NA NA 0.07 0.07 1.05 NA NA XXX 74430 ......... ............ A Contrast x-ray, bladder .................................. 0.32 2.04 1.37 NA NA 0.08 2.44 1.77 NA NA XXX 74430 ......... 26 ....... A Contrast x-ray, bladder .................................. 0.32 0.12 0.11 0.12 0.11 0.02 0.46 0.45 0.46 0.45 XXX 74430 ......... TC ...... A Contrast x-ray, bladder .................................. 0.00 1.93 1.27 NA NA 0.06 1.99 1.33 NA NA XXX 74440 ......... ............ A X-ray, male genital tract ................................ 0.38 2.26 1.50 NA NA 0.08 2.72 1.96 NA NA XXX 74440 ......... 26 ....... A X-ray, male genital tract ................................ 0.38 0.15 0.13 0.15 0.13 0.02 0.55 0.53 0.55 0.53 XXX 74440 ......... TC ...... A X-ray, male genital tract ................................ 0.00 2.11 1.38 NA NA 0.06 2.17 1.44 NA NA XXX 74445 ......... ............ A X-ray exam of penis ...................................... 1.14 0.46 1.24 NA NA 0.13 1.73 2.51 NA NA XXX 74445 ......... 26 ....... A X-ray exam of penis ...................................... 1.14 0.46 0.39 0.46 0.39 0.07 1.67 1.60 1.67 1.60 XXX 74445 ......... TC ...... A X-ray exam of penis ...................................... 0.00 0.00 0.85 NA NA 0.06 0.06 0.91 NA NA XXX 74450 ......... ............ A X-ray, urethra/bladder ................................... 0.33 0.12 1.21 NA NA 0.10 0.55 1.64 NA NA XXX 74450 ......... 26 ....... A X-ray, urethra/bladder ................................... 0.33 0.12 0.11 0.12 0.11 0.02 0.47 0.46 0.47 0.46 XXX 74450 ......... TC ...... A X-ray, urethra/bladder ................................... 0.00 0.00 1.10 NA NA 0.08 0.08 1.18 NA NA XXX 74455 ......... ............ A X-ray, urethra/bladder ................................... 0.33 2.26 1.83 NA NA 0.12 2.71 2.28 NA NA XXX 74455 ......... 26 ....... A X-ray, urethra/bladder ................................... 0.33 0.13 0.12 0.13 0.12 0.02 0.48 0.47 0.48 0.47 XXX 74455 ......... TC ...... A X-ray, urethra/bladder ................................... 0.00 2.13 1.72 NA NA 0.10 2.23 1.82 NA NA XXX 74470 ......... ............ A X-ray exam of kidney lesion .......................... 0.54 0.17 1.12 NA NA 0.09 0.80 1.75 NA NA XXX 74470 ......... 26 ....... A X-ray exam of kidney lesion .......................... 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 74470 ......... TC ...... A X-ray exam of kidney lesion .......................... 0.00 0.00 0.94 NA NA 0.07 0.07 1.01 NA NA XXX 74475 ......... ............ A X-ray control, cath insert ............................... 0.54 2.22 3.75 NA NA 0.24 3.00 4.53 NA NA XXX 74475 ......... 26 ....... A X-ray control, cath insert ............................... 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 74475 ......... TC ...... A X-ray control, cath insert ............................... 0.00 2.03 3.57 NA NA 0.22 2.25 3.79 NA NA XXX 74480 ......... ............ A X-ray control, cath insert ............................... 0.54 2.23 3.75 NA NA 0.24 3.01 4.53 NA NA XXX 74480 ......... 26 ....... A X-ray control, cath insert ............................... 0.54 0.20 0.19 0.20 19 0.02 0.76 0.75 0.76 0.75 XXX 74480 ......... TC ...... A X-ray control, cath insert ............................... 0.00 2.04 3.57 NA NA 0.22 2.26 3.79 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37374 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

74485 ......... ............ A X-ray guide, GU dilation ................................ 0.54 2.38 3.09 NA NA 0.20 3.12 3.83 NA NA XXX 74485 ......... 26 ....... A X-ray guide, GU dilation ................................ 0.54 0.21 0.18 0.21 0.18 0.03 0.78 0.75 0.78 0.75 XXX 74485 ......... TC ...... A X-ray guide, GU dilation ................................ 0.00 2.18 2.92 NA NA 0.17 2.35 3.09 NA NA XXX 74710 ......... ............ A X-ray measurement of pelvis ........................ 0.34 0.67 1.04 NA NA 0.08 1.09 1.46 NA NA XXX 74710 ......... 26 ....... A X-ray measurement of pelvis ........................ 0.34 0.12 0.11 0.12 0.11 0.02 0.48 0.47 0.48 0.47 XXX 74710 ......... TC ...... A X-ray measurement of pelvis ........................ 0.00 0.56 0.93 NA NA 0.06 0.62 0.99 NA NA XXX 74740 ......... ............ A X-ray, female genital tract ............................. 0.38 1.83 1.54 NA NA 0.09 2.30 2.01 NA NA XXX 74740 ......... 26 ....... A X-ray, female genital tract ............................. 0.38 0.13 0.13 0.13 0.13 0.02 0.53 0.53 0.53 0.53 XXX 74740 ......... TC ...... A X-ray, female genital tract ............................. 0.00 1.70 1.41 NA NA 0.07 1.77 1.48 NA NA XXX 74742 ......... 26 ....... A X-ray, fallopian tube ...................................... 0.61 0.19 0.20 0.19 0.20 0.03 0.83 0.84 0.83 0.84 XXX 74775 ......... ............ A X-ray exam of perineum ................................ 0.62 0.21 1.31 NA NA 0.11 0.94 2.04 NA NA XXX74775 ......... 26 ....... A X-ray exam of perineum ................................ 0.62 0.21 0.21 0.21 0.21 0.03 0.86 0.86 0.86 0.86 XXX 74775 ......... TC ...... A X-ray exam of perineum ................................ 0.00 0.00 1.10 NA NA 0.08 0.08 1.18 NA NA XXX 75552 ......... ............ A Heart mri for morph w/o dye ......................... 1.60 19.96 13.81 NA NA 0.66 22.22 16.07 NA NA XXX 75552 ......... 26 ....... A Heart mri for morph w/o dye ......................... 1.60 0.61 0.55 0.61 0.55 0.07 2.28 2.22 2.28 2.22 XXX 75552 ......... TC ...... A Heart mri for morph w/o dye ......................... 0.00 19.35 13.26 NA NA 0.59 19.94 13.85 NA NA XXX 75553 ......... ............ A Heart mri for morph w/dye ............................ 2.00 24.80 15.11 NA NA 0.66 27.46 17.77 NA NA XXX 75553 ......... 26 ....... A Heart mri for morph w/dye ............................ 2.00 0.98 0.73 0.98 0.73 0.07 3.05 2.80 3.05 2.80 XXX 75553 ......... TC ...... A Heart mri for morph w/dye ............................ 0.00 23.82 14.38 NA NA 0.59 24.41 14.97 NA NA XXX 75554 ......... ............ A Cardiac MRI/function ..................................... 1.83 27.96 15.89 NA NA 0.66 30.45 18.38 NA NA XXX 75554 ......... 26 ....... A Cardiac MRI/function ..................................... 1.83 0.84 0.69 0.84 0.69 0.07 2.74 2.59 2.74 2.59 XXX 75554 ......... TC ...... A Cardiac MRI/function ..................................... 0.00 27.12 15.20 NA NA 0.59 27.71 15.79 NA NA XXX 75555 ......... ............ A Cardiac MRI/limited study ............................. 1.74 28.19 15.95 NA NA 0.66 30.59 18.35 NA NA XXX 75555 ......... 26 ....... A Cardiac MRI/limited study ............................. 1.74 0.87 0.70 0.87 0.70 0.07 2.68 2.51 2.68 2.51 XXX 75555 ......... TC ...... A Cardiac MRI/limited study ............................. 0.00 27.32 15.25 NA NA 0.59 27.91 15.84 NA NA XXX75600 ......... ............ A Contrast x-ray exam of aorta ........................ 0.49 6.59 11.27 NA NA 0.67 7.75 12.43 NA NA XXX75600 ......... 26 ....... A Contrast x-ray exam of aorta ........................ 0.49 0.26 0.21 0.26 0.21 0.02 0.77 0.72 0.77 0.72 XXX 75600 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 6.33 11.06 NA NA 0.65 6.98 11.71 NA NA XXX 75605 ......... ............ A Contrast x-ray exam of aorta ........................ 1.14 3.70 10.71 NA NA 0.70 5.54 12.55 NA NA XXX75605 ......... 26 ....... A Contrast x-ray exam of aorta ........................ 1.14 0.52 0.43 0.52 0.43 0.05 1.71 1.62 1.71 1.62 XXX 75605 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 3.18 10.28 NA NA 0.65 3.83 10.93 NA NA XXX 75625 ......... ............ A Contrast x-ray exam of aorta ........................ 1.14 3.49 10.64 NA NA 0.71 5.34 12.49 NA NA XXX75625 ......... 26 ....... A Contrast x-ray exam of aorta ........................ 1.14 0.44 0.40 0.44 0.40 0.06 1.64 1.60 1.64 1.60 XXX 75625 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 3.05 10.24 NA NA 0.65 3.70 10.89 NA NA XXX 75630 ......... ............ A X-ray aorta, leg arteries ................................ 1.79 3.89 11.31 NA NA 0.80 6.48 13.90 NA NA XXX 75630 ......... 26 ....... A X-ray aorta, leg arteries ................................ 1.79 0.74 0.64 0.74 0.64 0.11 2.64 2.54 2.64 2.54 XXX 75630 ......... TC ...... A X-ray aorta, leg arteries ................................ 0.00 3.14 10.66 NA NA 0.69 3.83 11.35 NA NA XXX 75635 ......... ............ A Ct angio abdominal arteries .......................... 2.40 13.37 15.91 NA NA 0.50 16.27 18.81 NA NA XXX 75635 ......... 26 ....... A Ct angio abdominal arteries .......................... 2.40 0.90 0.82 0.90 0.82 0.11 3.41 3.33 3.41 3.33 XXX 75635 ......... TC ...... A Ct angio abdominal arteries .......................... 0.00 12.47 15.09 NA NA 0.39 12.86 15.48 NA NA XXX 75650 ......... ............ A Artery x-rays, head & neck ........................... 1.49 3.65 10.76 NA NA 0.72 5.86 12.97 NA NA XXX 75650 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.49 0.59 0.52 0.59 0.52 0.07 2.15 2.08 2.15 2.08 XXX 75650 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.06 10.25 NA NA 0.65 3.71 10.90 NA NA XXX 75658 ......... ............ A Artery x-rays, arm .......................................... 1.31 3.98 10.83 NA NA 0.72 6.01 12.86 NA NA XXX 75658 ......... 26 ....... A Artery x-rays, arm .......................................... 1.31 0.51 0.48 0.51 0.48 0.07 1.89 1.86 1.89 1.86 XXX 75658 ......... TC ...... A Artery x-rays, arm .......................................... 0.00 3.47 10.35 NA NA 0.65 4.12 11.00 NA NA XXX 75660 ......... ............ A Artery x-rays, head & neck ........................... 1.31 4.07 10.83 NA NA 0.71 6.09 12.85 NA NA XXX 75660 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.31 0.52 0.46 0.52 0.46 0.06 1.89 1.83 1.89 1.83 XXX 75660 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.55 10.37 NA NA 0.65 4.20 11.02 NA NA XXX 75662 ......... ............ A Artery x-rays, head & neck ........................... 1.66 5.24 11.23 NA NA 0.71 7.61 13.60 NA NA XXX 75662 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.66 0.75 0.63 0.75 0.63 0.06 2.47 2.35 2.47 2.35 XXX 75662 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 4.49 10.60 NA NA 0.65 5.14 11.25 NA NA XXX 75665 ......... ............ A Artery x-rays, head & neck ........................... 1.31 4.25 10.87 NA NA 0.74 6.30 12.92 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37375 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

75665 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.31 0.49 0.45 0.49 0.45 0.09 1.89 1.85 1.89 1.85 XXX 75665 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.76 10.42 NA NA 0.65 4.41 11.07 NA NA XXX 75671 ......... ............ A Artery x-rays, head & neck ........................... 1.66 5.28 11.21 NA NA 0.72 7.66 13.59 NA NA XXX 75671 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.66 0.65 0.58 0.65 0.58 0.07 2.38 2.31 2.38 2.31 XXX 75671 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 4.63 10.64 NA NA 0.65 5.28 11.29 NA NA XXX 75676 ......... ............ A Artery x-rays, neck ........................................ 1.31 4.00 10.81 NA NA 0.72 6.03 12.84 NA NA XXX 75676 ......... 26 ....... A Artery x-rays, neck ........................................ 1.31 0.49 0.45 0.49 0.45 0.07 1.87 1.83 1.87 1.83 XXX 75676 ......... TC ...... A Artery x-rays, neck ........................................ 0.00 3.50 10.36 NA NA 0.65 4.15 11.01 NA NA XXX 75680 ......... ............ A Artery x-rays, neck ........................................ 1.66 4.77 11.09 NA NA 0.72 7.15 13.47 NA NA XXX 75680 ......... 26 ....... A Artery x-rays, neck ........................................ 1.66 0.67 0.58 0.67 0.58 0.07 2.40 2.31 2.40 2.31 XXX 75680 ......... TC ...... A Artery x-rays, neck ........................................ 0.00 4.09 10.50 NA NA 0.65 4.74 11.15 NA NA XXX 75685 ......... ............ A Artery x-rays, spine ....................................... 1.31 4.04 10.81 NA NA 0.71 6.06 12.83 NA NA XXX 75685 ......... 26 ....... A Artery x-rays, spine ....................................... 1.31 0.52 0.45 0.52 0.45 0.06 1.89 1.82 1.89 1.82 XXX 75685 ......... TC ...... A Artery x-rays, spine ....................................... 0.00 3.52 10.36 NA NA 0.65 4.17 11.01 NA NA XXX 75705 ......... ............ A Artery x-rays, spine ....................................... 2.18 4.27 11.10 NA NA 0.78 7.23 14.06 NA NA XXX 75705 ......... 26 ....... A Artery x-rays, spine ....................................... 2.18 0.79 0.75 0.79 0.75 0.13 3.10 3.06 3.10 3.06 XXX 75705 ......... TC ...... A Artery x-rays, spine ....................................... 0.00 3.49 10.35 NA NA 0.65 4.14 11.00 NA NA XXX 75710 ......... ............ A Artery x-rays, arm/leg .................................... 1.14 4.10 10.80 NA NA 0.72 5.96 12.66 NA NA XXX 75710 ......... 26 ....... A Artery x-rays, arm/leg .................................... 1.14 0.44 0.40 0.44 0.40 0.07 1.65 1.61 1.65 1.61 XXX 75710 ......... TC ...... A Artery x-rays, arm/leg .................................... 0.00 3.66 10.40 NA NA 0.65 4.31 11.05 NA NA XXX 75716 ......... ............ A Artery x-rays, arms/legs ................................ 1.31 5.10 11.08 NA NA 0.72 7.13 13.11 NA NA XXX 75716 ......... 26 ....... A Artery x-rays, arms/legs ................................ 1.31 0.52 0.45 0.52 0.45 0.07 1.90 1.83 1.90 1.83 XXX 75716 ......... TC ...... A Artery x-rays, arms/legs ................................ 0.00 4.58 10.63 NA NA 0.65 5.23 11.28 NA NA XXX75722 ......... ............ A Artery x-rays, kidney ..................................... 1.14 4.00 10.78 NA NA 0.70 5.84 12.62 NA NA XXX 75722 ......... 26 ....... A Artery x-rays, kidney ..................................... 1.14 0.49 0.42 0.49 0.42 0.05 1.68 1.61 1.68 1.61 XXX 75722 ......... TC ...... A Artery x-rays, kidney ..................................... 0.00 3.51 10.36 NA NA 0.65 4.16 11.01 NA NA XXX 75724 ......... ............ A Artery x-rays, kidneys .................................... 1.49 5.30 11.23 NA NA 0.70 7.49 13.42 NA NA XXX 75724 ......... 26 ....... A Artery x-rays, kidneys .................................... 1.49 0.77 0.61 0.77 0.61 0.05 2.31 2.15 2.31 2.15 XXX 75724 ......... TC ...... A Artery x-rays, kidneys .................................... 0.00 4.52 10.61 NA NA 0.65 5.17 11.26 NA NA XXX 75726 ......... ............ A Artery x-rays, abdomen ................................. 1.14 3.92 10.74 NA NA 0.70 5.76 12.58 NA NA XXX 75726 ......... 26 ....... A Artery x-rays, abdomen ................................. 1.14 0.42 0.38 0.42 0.38 0.05 1.61 1.57 1.61 1.57 XXX 75726 ......... TC ...... A Artery x-rays, abdomen ................................. 0.00 3.50 10.36 NA NA 0.65 4.15 11.01 NA NA XXX 75731 ......... ............ A Artery x-rays, adrenal gland .......................... 1.14 4.05 10.77 NA NA 0.71 5.90 12.62 NA NA XXX 75731 ......... 26 ....... A Artery x-rays, adrenal gland .......................... 1.14 0.45 0.39 0.45 0.39 0.06 1.65 1.59 1.65 1.59 XXX 75731 ......... TC ...... A Artery x-rays, adrenal gland .......................... 0.00 3.60 10.38 NA NA 0.65 4.25 11.03 NA NA XXX 75733 ......... ............ A Artery x-rays, adrenals .................................. 1.31 5.42 11.17 NA NA 0.71 7.44 13.19 NA NA XXX 75733 ......... 26 ....... A Artery x-rays, adrenals .................................. 1.31 0.62 0.49 0.62 0.49 0.06 1.99 1.86 1.99 1.86 XXX 75733 ......... TC ...... A Artery x-rays, adrenals .................................. 0.00 4.80 10.68 NA NA 0.65 5.45 11.33 NA NA XXX 75736 ......... ............ A Artery x-rays, pelvis ....................................... 1.14 4.02 10.77 NA NA 0.71 5.87 12.62 NA NA XXX 75736 ......... 26 ....... A Artery x-rays, pelvis ....................................... 1.14 0.44 0.40 0.44 0.40 0.06 1.64 1.60 1.64 1.60 XXX 75736 ......... TC ...... A Artery x-rays, pelvis ....................................... 0.00 3.58 10.38 NA NA 0.65 4.23 11.03 NA NA XXX 75741 ......... ............ A Artery x-rays, lung ......................................... 1.31 3.29 10.63 NA NA 0.71 5.31 12.65 NA NA XXX 75741 ......... 26 ....... A Artery x-rays, lung ......................................... 1.31 0.49 0.45 0.49 0.45 0.06 1.86 1.82 1.86 1.82 XXX 75741 ......... TC ...... A Artery x-rays, lung ......................................... 0.00 2.81 10.18 NA NA 0.65 3.46 10.83 NA NA XXX 75743 ......... ............ A Artery x-rays, lungs ....................................... 1.66 3.70 10.81 NA NA 0.72 6.08 13.19 NA NA XXX 75743 ......... 26 ....... A Artery x-rays, lungs ....................................... 1.66 0.62 0.56 0.62 0.56 0.07 2.35 2.29 2.35 2.29 XXX 75743 ......... TC ...... A Artery x-rays, lungs ....................................... 0.00 3.08 10.25 NA NA 0.65 3.73 10.90 NA NA XXX 75746 ......... ............ A Artery x-rays, lung ......................................... 1.14 3.60 10.67 NA NA 0.70 5.44 12.51 NA NA XXX 75746 ......... 26 ....... A Artery x-rays, lung ......................................... 1.14 0.39 0.38 0.39 0.38 0.05 1.58 1.57 1.58 1.57 XXX 75746 ......... TC ...... A Artery x-rays, lung ......................................... 0.00 3.21 10.28 NA NA 0.65 3.86 10.93 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37376 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

75756 ......... ............ A Artery x-rays, chest ....................................... 1.14 4.51 10.95 NA NA 0.69 6.34 12.78 NA NA XXX 75756 ......... 26 ....... A Artery x-rays, chest ....................................... 1.14 0.62 0.49 0.62 0.49 0.04 1.80 1.67 1.80 1.67 XXX 75756 ......... TC ...... A Artery x-rays, chest ....................................... 0.00 3.90 10.46 NA NA 0.65 4.55 11.11 NA NA XXX 75774 ......... ............ A Artery x-ray, each vessel .............................. 0.36 2.61 10.22 NA NA 0.67 3.64 11.25 NA NA ZZZ 75774 ......... 26 ....... A Artery x-ray, each vessel .............................. 0.36 0.14 0.13 0.14 0.13 0.02 0.52 0.51 0.52 0.51 ZZZ 75774 ......... TC ...... A Artery x-ray, each vessel .............................. 0.00 2.47 10.10 NA NA 0.65 3.12 10.75 NA NA ZZZ 75790 ......... ............ A Visualize A-V shunt ....................................... 1.84 3.24 2.27 NA NA 0.17 5.25 4.28 NA NA XXX 75790 ......... 26 ....... A Visualize A-V shunt ....................................... 1.84 0.61 0.60 0.61 0.60 0.09 2.54 2.53 2.54 2.53 XXX 75790 ......... TC ...... A Visualize A–V shunt ...................................... 0.00 2.63 1.67 NA NA 0.08 2.71 1.75 NA NA XXX 75801 ......... ............ A Lymph vessel x-ray, arm/leg ......................... 0.81 0.22 4.33 NA NA 0.37 1.40 5.51 NA NA XXX 75801 ......... 26 ....... A Lymph vessel x-ray, arm/leg ......................... 0.81 0.22 0.26 0.22 0.26 0.08 1.11 1.15 1.11 1.15 XXX 75801 ......... TC ...... A Lymph vessel x-ray, arm/leg ......................... 0.00 0.00 4.07 NA NA 0.29 0.29 4.36 NA NA XXX 75803 ......... ............ A Lymph vessel x-ray,arms/legs ....................... 1.17 0.38 4.45 NA NA 0.34 1.89 5.96 NA NA XXX 75803 ......... 26 ....... A Lymph vessel x-ray,arms/legs ....................... 1.17 0.38 0.38 0.38 0.38 0.05 1.60 1.60 1.60 1.60 XXX 75803 ......... TC ...... A Lymph vessel x-ray,arms/legs ....................... 0.00 0.00 4.07 NA NA 0.29 0.29 4.36 NA NA XXX 75805 ......... ............ A Lymph vessel x-ray, trunk ............................. 0.81 0.23 4.85 NA NA 0.38 1.42 6.04 NA NA XXX75805 ......... 26 ....... A Lymph vessel x-ray, trunk ............................. 0.81 0.23 0.26 0.23 0.26 0.05 1.09 1.12 1.09 1.12 XXX 75805 ......... TC ...... A Lymph vessel x-ray, trunk ............................. 0.00 0.00 4.59 NA NA 0.33 0.33 4.92 NA NA XXX 75807 ......... 26 ....... A Lymph vessel x-ray, trunk ............................. 1.17 0.41 0.39 0.41 0.39 0.05 1.63 1.61 1.63 1.61 XXX 75809 ......... ............ A Nonvascular shunt, x-ray .............................. 0.47 2.28 1.27 NA NA 0.07 2.82 1.81 NA NA XXX75809 ......... 26 ....... A Nonvascular shunt, x-ray .............................. 0.47 0.16 0.15 0.16 0.15 0.02 0.65 0.64 0.65 0.64 XXX 75809 ......... TC ...... A Nonvascular shunt, x-ray .............................. 0.00 2.12 1.12 NA NA 0.05 2.17 1.17 NA NA XXX 75810 ......... ............ A Vein x-ray, spleen/liver .................................. 1.14 0.43 9.87 NA NA 0.70 2.27 11.71 NA NA XXX 75810 ......... 26 ....... A Vein x-ray, spleen/liver .................................. 1.14 0.43 0.39 0.43 0.39 0.05 1.62 1.58 1.62 1.58 XXX 75810 ......... TC ...... A Vein x-ray, spleen/liver .................................. 0.00 0.00 9.48 NA NA 0.65 0.65 10.13 NA NA XXX 75820 ......... ............ A Vein x-ray, arm/leg ........................................ 0.70 3.11 1.66 NA NA 0.09 3.90 2.45 NA NA XXX 75820 ......... 26 ....... A Vein x-ray, arm/leg ........................................ 0.70 0.29 0.25 0.29 0.25 0.03 1.02 0.98 1.02 0.98 XXX 75820 ......... TC ...... A Vein x-ray, arm/leg ........................................ 0.00 2.82 1.42 NA NA 0.06 2.88 1.48 NA NA XXX 75822 ......... ............ A Vein x-ray, arms/legs .................................... 1.06 3.32 2.20 NA NA 0.13 4.51 3.39 NA NA XXX 75822 ......... 26 ....... A Vein x-ray, arms/legs .................................... 1.06 0.38 0.36 0.38 0.36 0.05 1.49 1.47 1.49 1.47 XXX 75822 ......... TC ...... A Vein x-ray, arms/legs .................................... 0.00 2.95 1.85 NA NA 0.08 3.03 1.93 NA NA XXX 75825 ......... ............ A Vein x-ray, trunk ............................................ 1.14 3.07 10.53 NA NA 0.72 4.93 12.39 NA NA XXX 75825 ......... 26 ....... A Vein x-ray, trunk ............................................ 1.14 0.39 0.38 0.39 0.38 0.07 1.60 1.59 1.60 1.59 XXX 75825 ......... TC ...... A Vein x-ray, trunk ............................................ 0.00 2.67 10.15 NA NA 0.65 3.32 10.80 NA NA XXX 75827 ......... ............ A Vein x-ray, chest ........................................... 1.14 3.10 10.53 NA NA 0.70 4.94 12.37 NA NA XXX 75827 ......... 26 ....... A Vein x-ray, chest ........................................... 1.14 0.39 0.38 0.39 0.38 0.05 1.58 1.57 1.58 1.57 XXX 75827 ......... TC ...... A Vein x-ray, chest ........................................... 0.00 2.71 10.16 NA NA 0.65 3.36 10.81 NA NA XXX 75831 ......... ............ A Vein x-ray, kidney .......................................... 1.14 3.19 10.56 NA NA 0.71 5.04 12.41 NA NA XXX 75831 ......... 26 ....... A Vein x-ray, kidney .......................................... 1.14 0.39 0.38 0.39 0.38 0.06 1.59 1.58 1.59 1.58 XXX 75831 ......... TC ...... A Vein x-ray, kidney .......................................... 0.00 2.79 10.18 NA NA 0.65 3.44 10.83 NA NA XXX 75833 ......... ............ A Vein x-ray, kidneys ........................................ 1.49 3.86 10.81 NA NA 0.74 6.09 13.04 NA NA XXX 75833 ......... 26 ....... A Vein x-ray, kidneys ........................................ 1.49 0.51 0.50 0.51 0.50 0.09 2.09 2.08 2.09 2.08 XXX 75833 ......... TC ...... A Vein x-ray, kidneys ........................................ 0.00 3.35 10.32 NA NA 0.65 4.00 10.97 NA NA XXX 75840 ......... ............ A Vein x-ray, adrenal gland .............................. 1.14 3.41 10.62 NA NA 0.72 5.27 12.48 NA NA XXX 75840 ......... 26 ....... A Vein x-ray, adrenal gland .............................. 1.14 0.48 0.41 0.48 0.41 0.07 1.69 1.62 1.69 1.62 XXX 75840 ......... TC ...... A Vein x-ray, adrenal gland .............................. 0.00 2.93 10.21 NA NA 0.65 3.58 10.86 NA NA XXX 75842 ......... ............ A Vein x-ray, adrenal glands ............................ 1.49 3.87 10.81 NA NA 0.72 6.08 13.02 NA NA XXX 75842 ......... 26 ....... A Vein x-ray, adrenal glands ............................ 1.49 0.54 0.50 0.54 0.50 0.07 2.10 2.06 2.10 2.06 XXX 75842 ......... TC ...... A Vein x-ray, adrenal glands ............................ 0.00 3.33 10.31 NA NA 0.65 3.98 10.96 NA NA XXX 75860 ......... ............ A Vein x-ray, neck ............................................ 1.14 3.55 10.66 NA NA 0.69 5.38 12.49 NA NA XXX 75860 ......... 26 ....... A Vein x-ray, neck ............................................ 1.14 0.52 0.42 0.52 0.42 0.04 1.70 1.60 1.70 1.60 XXX 75860 ......... TC ...... A Vein x-ray, neck ............................................ 0.00 3.03 10.24 NA NA 0.65 3.68 10.89 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37377 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

75870 ......... ............ A Vein x-ray, skull ............................................. 1.14 3.35 10.61 NA NA 0.70 5.19 12.45 NA NA XXX 75870 ......... 26 ....... A Vein x-ray, skull ............................................. 1.14 0.42 0.40 0.42 0.40 0.05 1.61 1.59 1.61 1.59 XXX 75870 ......... TC ...... A Vein x-ray, skull ............................................. 0.00 2.93 10.21 NA NA 0.65 3.58 10.86 NA NA XXX 75872 ......... ............ A Vein x-ray, skull ............................................. 1.14 3.89 10.73 NA NA 0.79 5.82 12.66 NA NA XXX 75872 ......... 26 ....... A Vein x-ray, skull ............................................. 1.14 0.42 0.38 0.42 0.38 0.14 1.70 1.66 1.70 1.66 XXX 75872 ......... TC ...... A Vein x-ray, skull ............................................. 0.00 3.47 10.35 NA NA 0.65 4.12 11.00 NA NA XXX 75880 ......... ............ A Vein x-ray, eye socket ................................... 0.70 3.07 1.65 NA NA 0.09 3.86 2.44 NA NA XXX 75880 ......... 26 ....... A Vein x-ray, eye socket ................................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX 75880 ......... TC ...... A Vein x-ray, eye socket ................................... 0.00 2.83 1.42 NA NA 0.06 2.89 1.48 NA NA XXX 75885 ......... ............ A Vein x-ray, liver ............................................. 1.44 3.34 10.67 NA NA 0.71 5.49 12.82 NA NA XXX 75885 ......... 26 ....... A Vein x-ray, liver ............................................. 1.44 0.52 0.48 0.52 0.48 0.06 2.02 1.98 2.02 1.98 XXX 75885 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.82 10.19 NA NA 0.65 3.47 10.84 NA NA XXX 75887 ......... ............ A Vein x-ray, liver ............................................. 1.44 3.48 10.70 NA NA 0.71 5.63 12.85 NA NA XXX 75887 ......... 26 ....... A Vein x-ray, liver ............................................. 1.44 0.55 0.49 0.55 0.49 0.06 2.05 1.99 2.05 1.99 XXX 75887 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.94 10.22 NA NA 0.65 3.59 10.87 NA NA XXX 75889 ......... ............ A Vein x-ray, liver ............................................. 1.14 3.24 10.57 NA NA 0.70 5.08 12.41 NA NA XXX 75889 ......... 26 ....... A Vein x-ray, liver ............................................. 1.14 0.42 0.38 0.42 0.38 0.05 1.61 1.57 1.61 1.57 XXX 75889 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.82 10.19 NA NA 0.65 3.47 10.84 NA NA XXX 75891 ......... ............ A Vein x-ray, liver ............................................. 1.14 3.21 10.56 NA NA 0.70 5.05 12.40 NA NA XXX 75891 ......... 26 ....... A Vein x-ray, liver ............................................. 1.14 0.41 0.38 0.41 0.38 0.05 1.60 1.57 1.60 1.57 XXX 75891 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.80 10.18 NA NA 0.65 3.45 10.83 NA NA XXX 75893 ......... ............ A Venous sampling by catheter ........................ 0.54 2.99 10.36 NA NA 0.67 4.20 11.57 NA NA XXX 75893 ......... 26 ....... A Venous sampling by catheter ........................ 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 75893 ......... TC ...... A Venous sampling by catheter ........................ 0.00 2.80 10.18 NA NA 0.65 3.45 10.83 NA NA XXX 75894 ......... ............ A X-rays, transcath therapy .............................. 1.31 0.46 18.59 NA NA 1.35 3.12 21.25 NA NA XXX 75894 ......... 26 ....... A X-rays, transcath therapy .............................. 1.31 0.46 0.44 0.46 0.44 0.08 1.85 1.83 1.85 1.83 XXX 75894 ......... TC ...... A X-rays, transcath therapy .............................. 0.00 0.00 18.15 NA NA 1.27 1.27 19.42 NA NA XXX 75896 ......... ............ A X-rays, transcath therapy .............................. 1.31 0.54 16.26 NA NA 1.15 3.00 18.72 NA NA XXX 75896 ......... 26 ....... A X-rays, transcath therapy .............................. 1.31 0.54 0.47 0.54 0.47 0.05 1.90 1.83 1.90 1.83 XXX 75896 ......... TC ...... A X-rays, transcath therapy .............................. 0.00 0.00 15.79 NA NA 1.10 1.10 16.89 NA NA XXX 75898 ......... ............ A Follow-up angiography .................................. 1.65 0.65 1.36 NA NA 0.13 2.43 3.14 NA NA XXX 75898 ......... 26 ....... A Follow-up angiography .................................. 1.65 0.65 0.58 0.65 0.58 0.07 2.37 2.30 2.37 2.30 XXX 75898 ......... TC ...... A Follow-up angiography .................................. 0.00 0.00 0.79 NA NA 0.06 0.06 0.85 NA NA XXX 75900 ......... 26 ....... A Intravascular cath exchange ......................... 0.49 0.17 0.16 0.17 0.16 0.03 0.69 0.68 0.69 0.68 XXX 75901 ......... ............ A Remove cva device obstruct ......................... 0.49 4.39 2.20 NA NA 0.85 5.73 3.54 NA NA XXX 75901 ......... 26 ....... A Remove cva device obstruct ......................... 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 75901 ......... TC ...... A Remove cva device obstruct ......................... 0.00 4.22 2.04 NA NA 0.83 5.05 2.87 NA NA XXX 75902 ......... ............ A Remove cva lumen obstruct ......................... 0.39 1.72 1.51 NA NA 0.85 2.96 2.75 NA NA XXX 75902 ......... 26 ....... A Remove cva lumen obstruct ......................... 0.39 0.14 0.13 0.14 0.13 0.02 0.55 0.54 0.55 0.54 XXX 75902 ......... TC ...... A Remove cva lumen obstruct ......................... 0.00 1.58 1.38 NA NA 0.83 2.41 2.21 NA NA XXX 75940 ......... ............ A X-ray placement, vein filter ........................... 0.54 0.18 9.66 NA NA 0.69 1.41 10.89 NA NA XXX 75940 ......... 26 ....... A X-ray placement, vein filter ........................... 0.54 0.18 0.18 0.18 0.18 0.04 0.76 0.76 0.76 0.76 XXX 75940 ......... TC ...... A X-ray placement, vein filter ........................... 0.00 0.00 9.48 NA NA 0.65 0.65 10.13 NA NA XXX 75945 ......... ............ A Intravascular us ............................................. 0.40 0.16 3.57 NA NA 0.28 0.84 4.25 NA NA XXX 75945 ......... 26 ....... A Intravascular us ............................................. 0.40 0.16 0.15 0.16 0.15 0.04 0.60 0.59 0.60 0.59 XXX 75945 ......... TC ...... A Intravascular us ............................................. 0.00 0.00 3.43 NA NA 0.24 0.24 3.67 NA NA XXX 75946 ......... 26 ....... A Intravascular us add-on ................................. 0.40 0.13 0.14 0.13 0.14 0.05 0.58 0.59 0.58 0.59 ZZZ 75952 ......... 26 ....... A Endovasc repair abdom aorta ....................... 4.49 1.38 1.46 1.38 1.46 0.43 6.30 6.38 6.30 6.38 XXX 75953 ......... 26 ....... A Abdom aneurysm endovas rpr ...................... 1.36 0.42 0.44 0.42 0.44 0.13 1.91 1.93 1.91 1.93 XXX 75954 ......... 26 ....... A Iliac aneurysm endovas rpr ........................... 2.25 0.69 0.76 0.69 0.76 0.15 3.09 3.16 3.09 3.16 XXX 75956 ......... 26 ....... A Xray, endovasc thor ao repr ......................... 7.00 1.57 2.43 1.57 2.43 0.69 9.26 10.12 9.26 10.12 XXX 75957 ......... 26 ....... A Xray, endovasc thor ao repr ......................... 6.00 1.35 2.08 1.35 2.08 0.59 7.94 8.67 7.94 8.67 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37378 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

75958 ......... 26 ....... A Xray, place prox ext thor ao .......................... 4.00 0.90 1.39 0.90 1.39 0.39 5.29 5.78 5.29 5.78 XXX 75959 ......... 26 ....... A Xray, place dist ext thor ao ........................... 3.50 0.79 1.22 0.79 1.22 0.34 4.63 5.06 4.63 5.06 XXX 75960 ......... ............ A Transcath iv stent rs&i .................................. 0.82 0.33 11.50 NA NA 0.82 1.97 13.14 NA NA XXX 75960 ......... 26 ....... A Transcath iv stent rs&i .................................. 0.82 0.33 0.29 0.33 0.29 0.05 1.20 1.16 1.20 1.16 XXX 75960 ......... TC ...... A Transcath iv stent rs&i .................................. 0.00 0.00 11.21 NA NA 0.77 0.77 11.98 NA NA XXX 75961 ......... ............ A Retrieval, broken catheter ............................. 4.24 4.82 10.15 NA NA 0.73 9.79 15.12 NA NA XXX 75961 ......... 26 ....... A Retrieval, broken catheter ............................. 4.24 1.50 1.42 1.50 1.42 0.18 5.92 5.84 5.92 5.84 XXX 75961 ......... TC ...... A Retrieval, broken catheter ............................. 0.00 3.32 8.73 NA NA 0.55 3.87 9.28 NA NA XXX 75962 ......... ............ A Repair arterial blockage ................................ 0.54 3.63 12.89 NA NA 0.86 5.03 14.29 NA NA XXX 75962 ......... 26 ....... A Repair arterial blockage ................................ 0.54 0.21 0.19 0.21 0.19 0.03 0.78 0.76 0.78 0.76 XXX 75962 ......... TC ...... A Repair arterial blockage ................................ 0.00 3.43 12.70 NA NA 0.83 4.26 13.53 NA NA XXX75964 ......... ............ A Repair artery blockage, each ........................ 0.36 2.45 7.01 NA NA 0.46 3.27 7.83 NA NA ZZZ 75964 ......... 26 ....... A Repair artery blockage, each ........................ 0.36 0.13 0.12 0.13 0.12 0.03 0.52 0.51 0.52 0.51 ZZZ 75964 ......... TC ...... A Repair artery blockage, each ........................ 0.00 2.31 6.89 NA NA 0.43 2.74 7.32 NA NA ZZZ 75966 ......... ............ A Repair arterial blockage ................................ 1.31 4.31 13.27 NA NA 0.89 6.51 15.47 NA NA XXX 75966 ......... 26 ....... A Repair arterial blockage ................................ 1.31 0.59 0.49 0.59 0.49 0.06 1.96 1.86 1.96 1.86 XXX 75966 ......... TC ...... A Repair arterial blockage ................................ 0.00 3.72 12.77 NA NA 0.83 4.55 13.60 NA NA XXX75968 ......... ............ A Repair artery blockage, each ........................ 0.36 2.50 7.03 NA NA 0.45 3.31 7.84 NA NA ZZZ 75968 ......... 26 ....... A Repair artery blockage, each ........................ 0.36 0.16 0.14 0.16 0.14 0.02 0.54 0.52 0.54 0.52 ZZZ 75968 ......... TC ...... A Repair artery blockage, each ........................ 0.00 2.34 6.89 NA NA 0.43 2.77 7.32 NA NA ZZZ 75970 ......... ............ A Vascular biopsy ............................................. 0.83 0.31 8.97 NA NA 0.64 1.78 10.44 NA NA XXX 75970 ......... 26 ....... A Vascular biopsy ............................................. 0.83 0.31 0.29 0.31 0.29 0.04 1.18 1.16 1.18 1.16 XXX 75970 ......... TC ...... A Vascular biopsy ............................................. 0.00 0.00 8.68 NA NA 0.60 0.60 9.28 NA NA XXX 75978 ......... ............ A Repair venous blockage ................................ 0.54 3.39 12.83 NA NA 0.85 4.78 14.22 NA NA XXX 75978 ......... 26 ....... A Repair venous blockage ................................ 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.74 0.74 XXX 75978 ......... TC ...... A Repair venous blockage ................................ 0.00 3.21 12.65 NA NA 0.83 4.04 13.48 NA NA XXX 75980 ......... ............ A Contrast xray exam bile duct ........................ 1.44 0.52 4.56 NA NA 0.35 2.31 6.35 NA NA XXX 75980 ......... 26 ....... A Contrast xray exam bile duct ........................ 1.44 0.52 0.48 0.52 0.48 0.06 2.02 1.98 2.02 1.98 XXX 75980 ......... TC ...... A Contrast xray exam bile duct ........................ 0.00 0.00 4.07 NA NA 0.29 0.29 4.36 NA NA XXX 75982 ......... 26 ....... A Contrast xray exam bile duct ........................ 1.44 0.52 0.48 0.52 0.48 0.06 2.02 1.98 2.02 1.98 XXX 75984 ......... ............ A Xray control catheter change ........................ 0.72 2.43 2.25 NA NA 0.14 3.29 3.11 NA NA XXX 75984 ......... 26 ....... A Xray control catheter change ........................ 0.72 0.26 0.24 0.26 0.24 0.03 1.01 0.99 1.01 0.99 XXX 75984 ......... TC ...... A Xray control catheter change ........................ 0.00 2.17 2.01 NA NA 0.11 2.28 2.12 NA NA XXX 75989 ......... ............ A Abscess drainage under x-ray ...................... 1.19 2.33 3.25 NA NA 0.22 3.74 4.66 NA NA XXX 75989 ......... 26 ....... A Abscess drainage under x-ray ...................... 1.19 0.42 0.40 0.42 0.40 0.05 1.66 1.64 1.66 1.64 XXX 75989 ......... TC ...... A Abscess drainage under x-ray ...................... 0.00 1.91 2.85 NA NA 0.17 2.08 3.02 NA NA XXX 75992 ......... ............ A Atherectomy, x-ray exam .............................. 0.54 0.24 12.05 NA NA 0.86 1.64 13.45 NA NA XXX 75992 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.54 0.24 0.20 0.24 0.20 0.03 0.81 0.77 0.81 0.77 XXX 75992 ......... TC ...... A Atherectomy, x-ray exam .............................. 0.00 0.00 11.84 NA NA 0.83 0.83 12.67 NA NA XXX 75993 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.36 0.15 0.14 0.15 0.14 0.02 0.53 0.52 0.53 0.52 ZZZ 75994 ......... 26 ....... A Atherectomy, x-ray exam .............................. 1.31 0.63 0.50 0.63 0.50 0.07 2.01 1.88 2.01 1.88 XXX 75995 ......... 26 ....... A Atherectomy, x-ray exam .............................. 1.31 0.52 0.48 0.52 0.48 0.05 1.88 1.84 1.88 1.84 XXX 75996 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.36 0.15 0.13 0.15 0.13 0.02 0.53 0.51 0.53 0.51 ZZZ 75998 ......... ............ A Fluoroguide for vein device ........................... 0.38 2.85 1.79 NA NA 0.11 3.34 2.28 NA NA ZZZ75998 ......... 26 ....... A Fluoroguide for vein device ........................... 0.38 0.13 0.13 0.13 0.13 0.01 0.52 0.52 0.52 0.52 ZZZ 75998 ......... TC ...... A Fluoroguide for vein device ........................... 0.00 2.72 1.66 NA NA 0.10 2.82 1.76 NA NA ZZZ 76000 ......... ............ A Fluoroscope examination .............................. 0.17 2.82 1.73 NA NA 0.08 3.07 1.98 NA NA XXX 76000 ......... 26 ....... A Fluoroscope examination .............................. 0.17 0.06 0.05 0.06 0.05 0.01 0.24 0.23 0.24 0.23 XXX 76000 ......... TC ...... A Fluoroscope examination .............................. 0.00 2.76 1.67 NA NA 0.07 2.83 1.74 NA NA XXX 76001 ......... ............ A Fluoroscope exam, extensive ....................... 0.67 0.23 2.20 NA NA 0.19 1.09 3.06 NA NA XXX 76001 ......... 26 ....... A Fluoroscope exam, extensive ....................... 0.67 0.23 0.22 0.23 0.22 0.05 0.95 0.94 0.95 0.94 XXX 76001 ......... TC ...... A Fluoroscope exam, extensive ....................... 0.00 0.00 1.97 NA NA 0.14 0.14 2.11 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37379 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76003 ......... ............ A Needle localization by x-ray .......................... 0.54 1.23 1.42 NA NA 0.09 1.86 2.05 NA NA XXX76003 ......... 26 ....... A Needle localization by x-ray .......................... 0.54 0.15 0.17 0.15 0.17 0.02 0.71 0.73 0.71 0.73 XXX 76003 ......... TC ...... A Needle localization by x-ray .......................... 0.00 1.08 1.25 NA NA 0.07 1.15 1.32 NA NA XXX 76005 ......... ............ A Fluoroguide for spine inject ........................... 0.60 0.76 1.29 NA NA 0.10 1.46 1.99 NA NA XXX 76005 ......... 26 ....... A Fluoroguide for spine inject ........................... 0.60 0.14 0.15 0.14 0.15 0.03 0.77 0.78 0.77 0.78 XXX 76005 ......... TC ...... A Fluoroguide for spine inject ........................... 0.00 0.62 1.14 NA NA 0.07 0.69 1.21 NA NA XXX 76006 ......... ............ A X-ray stress view ........................................... 0.41 0.76 0.33 0.76 0.33 0.06 1.23 0.80 1.23 0.80 XXX 76010 ......... ............ A X-ray, nose to rectum .................................... 0.18 0.57 0.58 NA NA 0.03 0.78 0.79 NA NA XXX 76010 ......... 26 ....... A X-ray, nose to rectum .................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 76010 ......... TC ...... A X-ray, nose to rectum .................................... 0.00 0.51 0.52 NA NA 0.02 0.53 0.54 NA NA XXX 76012 ......... 26 ....... A Percut vertebroplasty fluor ............................ 1.31 0.47 0.47 0.47 0.47 0.10 1.88 1.88 1.88 1.88 XXX 76013 ......... 26 ....... A Percut vertebroplasty, ct ............................... 1.38 0.49 0.48 0.49 0.48 0.07 1.94 1.93 1.94 1.93 XXX 76020 ......... ............ A X-rays for bone age ...................................... 0.19 0.44 0.55 NA NA 0.03 0.66 0.77 NA NA XXX 76020 ......... 26 ....... A X-rays for bone age ...................................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 76020 ......... TC ...... A X-rays for bone age ...................................... 0.00 0.37 0.48 NA NA 0.02 0.39 0.50 NA NA XXX 76040 ......... ............ A X-rays, bone evaluation ................................ 0.27 0.68 0.82 NA NA 0.06 1.01 1.15 NA NA XXX 76040 ......... 26 ....... A X-rays, bone evaluation ................................ 0.27 0.10 0.09 0.10 0.09 0.01 0.38 0.37 0.38 0.37 XXX 76040 ......... TC ...... A X-rays, bone evaluation ................................ 0.00 0.58 0.73 NA NA 0.05 0.63 0.78 NA NA XXX 76061 ......... ............ A X-rays, bone survey ...................................... 0.45 1.49 1.24 NA NA 0.08 2.02 1.77 NA NA XXX 76061 ......... 26 ....... A X-rays, bone survey ...................................... 0.45 0.16 0.15 0.16 0.15 0.02 0.63 0.62 0.63 0.62 XXX 76061 ......... TC ...... A X-rays, bone survey ...................................... 0.00 1.34 1.09 NA NA 0.06 1.40 1.15 NA NA XXX 76062 ......... ............ A X-rays, bone survey ...................................... 0.54 2.38 1.81 NA NA 0.10 3.02 2.45 NA NA XXX 76062 ......... 26 ....... A X-rays, bone survey ...................................... 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 76062 ......... TC ...... A X-rays, bone survey ...................................... 0.00 2.19 1.63 NA NA 0.08 2.27 1.71 NA NA XXX 76065 ......... ............ A X-rays, bone evaluation ................................ 0.70 2.08 1.24 NA NA 0.08 2.86 2.02 NA NA XXX 76065 ......... 26 ....... A X-rays, bone evaluation ................................ 0.70 0.21 0.23 0.21 0.23 0.03 0.94 0.96 0.94 0.96 XXX 76065 ......... TC ...... A X-rays, bone evaluation ................................ 0.00 1.87 1.02 NA NA 0.05 1.92 1.07 NA NA XXX 76066 ......... ............ A Joint survey, single view ............................... 0.31 0.66 1.07 NA NA 0.08 1.05 1.46 NA NA XXX 76066 ......... 26 ....... A Joint survey, single view ............................... 0.31 0.11 0.10 0.11 0.10 0.02 0.44 0.43 0.44 0.43 XXX 76066 ......... TC ...... A Joint survey, single view ............................... 0.00 0.55 0.97 NA NA 0.06 0.61 1.03 NA NA XXX 76070 ......... ............ A Ct bone density, axial .................................... 0.25 4.94 3.52 NA NA 0.17 5.36 3.94 NA NA XXX 76070 ......... 26 ....... A Ct bone density, axial .................................... 0.25 0.08 0.08 0.08 0.08 0.01 0.34 0.34 0.34 0.34 XXX 76070 ......... TC ...... A Ct bone density, axial .................................... 0.00 4.85 3.43 NA NA 0.16 5.01 3.59 NA NA XXX76071 ......... ............ A Ct bone density, peripheral ........................... 0.22 0.78 2.47 NA NA 0.06 1.06 2.75 NA NA XXX76071 ......... 26 ....... A Ct bone density, peripheral ........................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 76071 ......... TC ...... A Ct bone density, peripheral ........................... 0.00 0.71 2.40 NA NA 0.05 0.76 2.45 NA NA XXX 76075 ......... ............ A Dxa bone density, axial ................................. 0.20 0.67 2.57 NA NA 0.18 1.05 2.95 NA NA XXX 76075 ......... 26 ....... A Dxa bone density, axial ................................. 0.20 0.06 0.09 0.06 0.09 0.01 0.27 0.30 0.27 0.30 XXX 76075 ......... TC ...... A Dxa bone density, axial ................................. 0.00 0.61 2.48 NA NA 0.17 0.78 2.65 NA NA XXX 76076 ......... ............ A Dxa bone density/peripheral ......................... 0.22 0.57 0.77 NA NA 0.06 0.85 1.05 NA NA XXX 76076 ......... 26 ....... A Dxa bone density/peripheral ......................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31 XXX 76076 ......... TC ...... A Dxa bone density/peripheral ......................... 0.00 0.51 0.69 NA NA 0.05 0.56 0.74 NA NA XXX 76077 ......... ............ A Dxa bone density/v-fracture .......................... 0.17 0.42 0.71 NA NA 0.06 0.65 0.94 NA NA XXX 76077 ......... 26 ....... A Dxa bone density/v-fracture .......................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 76077 ......... TC ...... A Dxa bone density/v-fracture .......................... 0.00 0.37 0.66 NA NA 0.05 0.42 0.71 NA NA XXX 76078 ......... ............ A Radiographic absorptiometry ........................ 0.20 0.38 0.71 NA NA 0.06 0.64 0.97 NA NA XXX 76078 ......... 26 ....... A Radiographic absorptiometry ........................ 0.20 0.05 0.07 0.05 0.07 0.01 0.26 0.28 0.26 0.28 XXX 76078 ......... TC ...... A Radiographic absorptiometry ........................ 0.00 0.33 0.65 NA NA 0.05 0.38 0.70 NA NA XXX 76080 ......... ............ A X-ray exam of fistula ..................................... 0.54 1.14 1.21 NA NA 0.08 1.76 1.83 NA NA XXX 76080 ......... 26 ....... A X-ray exam of fistula ..................................... 0.54 0.19 0.18 0.19 0.18 0.02 0.75 0.74 0.75 0.74 XXX 76080 ......... TC ...... A X-ray exam of fistula ..................................... 0.00 0.94 1.02 NA NA 0.06 1.00 1.08 NA NA XXX76082 ......... ............ A Computer mammogram add-on .................... 0.06 0.21 0.38 NA NA 0.02 0.29 0.46 NA NA ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37380 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76082 ......... 26 ....... A Computer mammogram add-on .................... 0.06 0.02 0.02 0.02 0.02 0.01 0.09 0.09 0.09 0.09 ZZZ 76082 ......... TC ...... A Computer mammogram add-on .................... 0.00 0.19 0.36 NA NA 0.01 0.20 0.37 NA NA ZZZ 76083 ......... ............ A Computer mammogram add-on .................... 0.06 0.21 0.38 NA NA 0.02 0.29 0.46 NA NA ZZZ 76083 ......... 26 ....... A Computer mammogram add-on .................... 0.06 0.02 0.02 0.02 0.02 0.01 0.09 0.09 0.09 0.09 ZZZ 76083 ......... TC ...... A Computer mammogram add-on .................... 0.00 0.19 0.36 NA NA 0.01 0.20 0.37 NA NA ZZZ 76086 ......... ............ A X-ray of mammary duct ................................. 0.36 1.28 2.38 NA NA 0.16 1.80 2.90 NA NA XXX76086 ......... 26 ....... A X-ray of mammary duct ................................. 0.36 0.12 0.12 0.12 0.12 0.02 0.50 0.50 0.50 0.50 XXX 76086 ......... TC ...... A X-ray of mammary duct ................................. 0.00 1.16 2.26 NA NA 0.14 1.30 2.40 NA NA XXX 76088 ......... ............ A X-ray of mammary ducts ............................... 0.45 1.75 3.30 NA NA 0.21 2.41 3.96 NA NA XXX 76088 ......... 26 ....... A X-ray of mammary ducts ............................... 0.45 0.16 0.15 0.16 0.15 0.02 0.63 0.62 0.63 0.62 XXX 76088 ......... TC ...... A X-ray of mammary ducts ............................... 0.00 1.59 3.15 NA NA 0.19 1.78 3.34 NA NA XXX 76090 ......... ............ A Mammogram, one breast .............................. 0.70 1.70 1.39 NA NA 0.09 2.49 2.18 NA NA XXX 76090 ......... 26 ....... A Mammogram, one breast .............................. 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX 76090 ......... TC ...... A Mammogram, one breast .............................. 0.00 1.46 1.15 NA NA 0.06 1.52 1.21 NA NA XXX 76091 ......... ............ A Mammogram, both breasts ........................... 0.87 2.21 1.75 NA NA 0.11 3.19 2.73 NA NA XXX 76091 ......... 26 ....... A Mammogram, both breasts ........................... 0.87 0.30 0.29 0.30 0.29 0.04 1.21 1.20 1.21 1.20 XXX 76091 ......... TC ...... A Mammogram, both breasts ........................... 0.00 1.92 1.46 NA NA 0.07 1.99 1.53 NA NA XXX 76092 ......... ............ A Mammogram, screening ................................ 0.70 1.49 1.47 NA NA 0.10 2.29 2.27 NA NA XXX 76092 ......... 26 ....... A Mammogram, screening ................................ 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX 76092 ......... TC ...... A Mammogram, screening ................................ 0.00 1.25 1.24 NA NA 0.07 1.32 1.31 NA NA XXX 76093 ......... ............ A Magnetic image, breast ................................. 1.63 22.81 19.35 NA NA 0.99 25.43 21.97 NA NA XXX 76093 ......... 26 ....... A Magnetic image, breast ................................. 1.63 0.57 0.54 0.57 0.54 0.07 2.27 2.24 2.27 2.24 XXX 76093 ......... TC ...... A Magnetic image, breast ................................. 0.00 22.24 18.81 NA NA 0.92 23.16 19.73 NA NA XXX 76094 ......... ............ A Magnetic image, both breasts ....................... 1.63 22.75 24.07 NA NA 1.31 25.69 27.01 NA NA XXX 76094 ......... 26 ....... A Magnetic image, both breasts ....................... 1.63 0.57 0.54 0.57 0.54 0.07 2.27 2.24 2.27 2.24 XXX 76094 ......... TC ...... A Magnetic image, both breasts ....................... 0.00 22.17 23.53 NA NA 1.24 23.41 24.77 NA NA XXX 76095 ......... ............ A Stereotactic breast biopsy ............................. 1.59 1.91 6.25 NA NA 0.46 3.96 8.30 NA NA XXX 76095 ......... 26 ....... A Stereotactic breast biopsy ............................. 1.59 0.52 0.52 0.52 0.52 0.09 2.20 2.20 2.20 2.20 XXX 76095 ......... TC ...... A Stereotactic breast biopsy ............................. 0.00 1.39 5.73 NA NA 0.37 1.76 6.10 NA NA XXX 76096 ......... ............ A X-ray of needle wire, breast .......................... 0.56 0.86 1.33 NA NA 0.09 1.51 1.98 NA NA XXX76096 ......... 26 ....... A X-ray of needle wire, breast .......................... 0.56 0.19 0.18 0.19 0.18 0.02 0.77 0.76 0.77 0.76 XXX 76096 ......... TC ...... A X-ray of needle wire, breast .......................... 0.00 0.67 1.15 NA NA 0.07 0.74 1.22 NA NA XXX 76098 ......... ............ A X-ray exam, breast specimen ....................... 0.16 0.33 0.44 NA NA 0.03 0.52 0.63 NA NA XXX 76098 ......... 26 ....... A X-ray exam, breast specimen ....................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 76098 ......... TC ...... A X-ray exam, breast specimen ....................... 0.00 0.28 0.39 NA NA 0.02 0.30 0.41 NA NA XXX 76100 ......... ............ A X-ray exam of body section .......................... 0.58 3.62 1.99 NA NA 0.10 4.30 2.67 NA NA XXX 76100 ......... 26 ....... A X-ray exam of body section .......................... 0.58 0.21 0.20 0.21 0.20 0.03 0.82 0.81 0.82 0.81 XXX 76100 ......... TC ...... A X-ray exam of body section .......................... 0.00 3.42 1.79 NA NA 0.07 3.49 1.86 NA NA XXX 76101 ......... ............ A Complex body section x-ray .......................... 0.58 5.37 2.55 NA NA 0.11 6.06 3.24 NA NA XXX 76101 ......... 26 ....... A Complex body section x-ray .......................... 0.58 0.19 0.19 0.19 0.19 0.03 0.80 0.80 0.80 0.80 XXX 76101 ......... TC ...... A Complex body section x-ray .......................... 0.00 5.18 2.36 NA NA 0.08 5.26 2.44 NA NA XXX 76102 ......... ............ A Complex body section x-rays ........................ 0.58 7.85 3.41 NA NA 0.14 8.57 4.13 NA NA XXX 76102 ......... 26 ....... A Complex body section x-rays ........................ 0.58 0.19 0.19 0.19 0.19 0.03 0.80 0.80 0.80 0.80 XXX 76102 ......... TC ...... A Complex body section x-rays ........................ 0.00 7.66 3.22 NA NA 0.11 7.77 3.33 NA NA XXX 76120 ......... ............ A Cine/video x-rays ........................................... 0.38 1.98 1.38 NA NA 0.08 2.44 1.84 NA NA XXX 76120 ......... 26 ....... A Cine/video x-rays ........................................... 0.38 0.15 0.14 0.15 0.14 0.02 0.55 0.54 0.55 0.54 XXX 76120 ......... TC ...... A Cine/video x-rays ........................................... 0.00 1.83 1.25 NA NA 0.06 1.89 1.31 NA NA XXX 76125 ......... ............ A Cine/video x-rays add-on .............................. 0.27 0.11 0.68 NA NA 0.06 0.44 1.01 NA NA ZZZ76125 ......... 26 ....... A Cine/video x-rays add-on .............................. 0.27 0.11 0.10 0.11 0.10 0.01 0.39 0.38 0.39 0.38 ZZZ 76125 ......... TC ...... A Cine/video x-rays add-on .............................. 0.00 0.00 0.59 NA NA 0.05 0.05 0.64 NA NA ZZZ 76150 ......... ............ A X-ray exam, dry process ............................... 0.00 0.68 0.49 NA NA 0.02 0.70 0.51 NA NA XXX76355 ......... ............ A Ct scan for localization .................................. 1.21 20.93 11.74 NA NA 0.47 22.61 13.42 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37381 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76355 ......... 26 ....... A Ct scan for localization .................................. 1.21 0.39 0.40 0.39 0.40 0.05 1.65 1.66 1.65 1.66 XXX 76355 ......... TC ...... A Ct scan for localization .................................. 0.00 20.55 11.35 NA NA 0.42 20.97 11.77 NA NA XXX 76360 ......... ............ A Ct scan for needle biopsy ............................. 1.16 2.42 7.10 NA NA 0.47 4.05 8.73 NA NA XXX76360 ......... 26 ....... A Ct scan for needle biopsy ............................. 1.16 0.41 0.39 0.41 0.39 0.05 1.62 1.60 1.62 1.60 XXX 76360 ......... TC ...... A Ct scan for needle biopsy ............................. 0.00 2.01 6.71 NA NA 0.42 2.43 7.13 NA NA XXX 76362 ......... ............ A Ct guide for tissue ablation ........................... 3.99 1.37 7.53 NA NA 1.64 7.00 13.16 NA NA XXX 76362 ......... 26 ....... A Ct guide for tissue ablation ........................... 3.99 1.37 1.32 1.37 1.32 0.18 5.54 5.49 5.54 5.49 XXX 76362 ......... TC ...... A Ct guide for tissue ablation ........................... 0.00 0.00 6.21 NA NA 1.46 1.46 7.67 NA NA XXX 76370 ......... ............ A Ct scan for therapy guide .............................. 0.85 4.51 3.56 NA NA 0.20 5.56 4.61 NA NA XXX 76370 ......... 26 ....... A Ct scan for therapy guide .............................. 0.85 0.25 0.27 0.25 0.27 0.04 1.14 1.16 1.14 1.16 XXX 76370 ......... TC ...... A Ct scan for therapy guide .............................. 0.00 4.26 3.29 NA NA 0.16 4.42 3.45 NA NA XXX 76376 ......... ............ A 3d render w/o postprocess ............................ 0.20 1.46 2.99 NA NA 0.10 1.76 3.29 NA NA XXX 76376 ......... 26 ....... A 3d render w/o postprocess ............................ 0.20 0.07 0.07 0.07 0.07 0.02 0.29 0.29 0.29 0.29 XXX 76376 ......... TC ...... A 3d render w/o postprocess ............................ 0.00 1.39 2.92 NA NA 0.08 1.47 3.00 NA NA XXX 76377 ......... ............ A 3d rendering w/postprocess .......................... 0.79 1.45 3.14 NA NA 0.39 2.63 4.32 NA NA XXX 76377 ......... 26 ....... A 3d rendering w/postprocess .......................... 0.79 0.28 0.27 0.28 0.27 0.08 1.15 1.14 1.15 1.14 XXX 76377 ......... TC ...... A 3d rendering w/postprocess .......................... 0.00 1.17 2.87 NA NA 0.31 1.48 3.18 NA NA XXX 76380 ......... ............ A CAT scan follow-up study ............................. 0.98 4.91 4.10 NA NA 0.22 6.11 5.30 NA NA XXX 76380 ......... 26 ....... A CAT scan follow-up study ............................. 0.98 0.34 0.33 0.34 0.33 0.04 1.36 1.35 1.36 1.35 XXX 76380 ......... TC ...... A CAT scan follow-up study ............................. 0.00 4.57 3.78 NA NA 0.18 4.75 3.96 NA NA XXX 76390 ......... ............ N Mr spectroscopy ............................................ 1.40 9.42 10.99 9.42 10.99 0.66 11.48 13.05 11.48 13.05 XXX 76390 ......... 26 ....... N Mr spectroscopy ............................................ 1.40 0.31 0.43 0.31 0.43 0.07 1.78 1.90 1.78 1.90 XXX 76390 ......... TC ...... N Mr spectroscopy ............................................ 0.00 9.11 10.56 9.11 10.56 0.59 9.70 11.15 9.70 11.15 XXX 76393 ......... ............ A Mr guidance for needle place ....................... 1.50 10.17 11.34 NA NA 0.64 12.31 13.48 NA NA XXX 76393 ......... 26 ....... A Mr guidance for needle place ....................... 1.50 0.53 0.51 0.53 0.51 0.09 2.12 2.10 2.12 2.10 XXX 76393 ......... TC ...... A Mr guidance for needle place ....................... 0.00 9.64 10.83 NA NA 0.55 10.19 11.38 NA NA XXX 76394 ......... ............ A Mri for tissue ablation .................................... 4.24 1.46 9.82 NA NA 1.81 7.51 15.87 NA NA XXX 76394 ......... 26 ....... A Mri for tissue ablation .................................... 4.24 1.46 1.40 1.46 1.40 0.24 5.94 5.88 5.94 5.88 XXX 76394 ......... TC ...... A Mri for tissue ablation .................................... 0.00 0.00 8.42 NA NA 1.57 1.57 9.99 NA NA XXX 76400 ......... ............ A Magnetic image, bone marrow ...................... 1.60 15.25 12.63 NA NA 0.66 17.51 14.89 NA NA XXX 76400 ......... 26 ....... A Magnetic image, bone marrow ...................... 1.60 0.59 0.54 0.59 0.54 0.07 2.26 2.21 2.26 2.21 XXX76400 ......... TC ...... A Magnetic image, bone marrow ...................... 0.00 14.66 12.09 NA NA 0.59 15.25 12.68 NA NA XXX 76506 ......... ............ A Echo exam of head ....................................... 0.63 2.90 1.97 NA NA 0.14 3.67 2.74 NA NA XXX 76506 ......... 26 ....... A Echo exam of head ....................................... 0.63 0.21 0.23 0.21 0.23 0.06 0.90 0.92 0.90 0.92 XXX 76506 ......... TC ...... A Echo exam of head ....................................... 0.00 2.69 1.74 NA NA 0.08 2.77 1.82 NA NA XXX 76510 ......... ............ A Ophth us, b & quant a ................................... 1.55 2.27 2.72 NA NA 0.10 3.92 4.37 NA NA XXX 76510 ......... 26 ....... A Ophth us, b & quant a ................................... 1.55 0.56 0.65 0.56 0.65 0.03 2.14 2.23 2.14 2.23 XXX 76510 ......... TC ...... A Ophth us, b & quant a ................................... 0.00 1.71 2.07 NA NA 0.07 1.78 2.14 NA NA XXX 76511 ......... ............ A Ophth us, quant a only .................................. 0.94 1.37 2.17 NA NA 0.10 2.41 3.21 NA NA XXX 76511 ......... 26 ....... A Ophth us, quant a only .................................. 0.94 0.34 0.39 0.34 0.39 0.03 1.31 1.36 1.31 1.36 XXX 76511 ......... TC ...... A Ophth us, quant a only .................................. 0.00 1.04 1.79 NA NA 0.07 1.11 1.86 NA NA XXX 76512 ......... ............ A Ophth us, b w/non-quant a ........................... 0.94 1.17 1.97 NA NA 0.12 2.23 3.03 NA NA XXX 76512 ......... 26 ....... A Ophth us, b w/non-quant a ........................... 0.94 0.33 0.40 0.33 0.40 0.02 1.29 1.36 1.29 1.36 XXX 76512 ......... TC ...... A Ophth us, b w/non-quant a ........................... 0.00 0.84 1.58 NA NA 0.10 0.94 1.68 NA NA XXX 76513 ......... ............ A Echo exam of eye, water bath ...................... 0.66 1.55 1.75 NA NA 0.12 2.33 2.53 NA NA XXX 76513 ......... 26 ....... A Echo exam of eye, water bath ...................... 0.66 0.24 0.28 0.24 0.28 0.02 0.92 0.96 0.92 0.96 XXX 76513 ......... TC ...... A Echo exam of eye, water bath ...................... 0.00 1.31 1.47 NA NA 0.10 1.41 1.57 NA NA XXX 76514 ......... ............ A Echo exam of eye, thickness ........................ 0.17 0.13 0.13 NA NA 0.02 0.32 0.32 NA NA XXX 76514 ......... 26 ....... A Echo exam of eye, thickness ........................ 0.17 0.06 0.08 0.06 0.08 0.01 0.24 0.26 0.24 0.26 XXX 76514 ......... TC ...... A Echo exam of eye, thickness ........................ 0.00 0.07 0.06 NA NA 0.01 0.08 0.07 NA NA XXX 76516 ......... ............ A Echo exam of eye ......................................... 0.54 1.17 1.39 NA NA 0.08 1.79 2.01 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37382 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76516 ......... 26 ....... A Echo exam of eye ......................................... 0.54 0.19 0.23 0.19 0.23 0.01 0.74 0.78 0.74 0.78 XXX 76516 ......... TC ...... A Echo exam of eye ......................................... 0.00 0.99 1.16 NA NA 0.07 1.06 1.23 NA NA XXX 76519 ......... ............ A Echo exam of eye ......................................... 0.54 1.30 1.49 NA NA 0.08 1.92 2.11 NA NA XXX 76519 ......... 26 ....... A Echo exam of eye ......................................... 0.54 0.19 0.23 0.19 0.23 0.01 0.74 0.78 0.74 0.78 XXX 76519 ......... TC ...... A Echo exam of eye ......................................... 0.00 1.11 1.26 NA NA 0.07 1.18 1.33 NA NA XXX 76529 ......... ............ A Echo exam of eye ......................................... 0.57 1.17 1.32 NA NA 0.10 1.84 1.99 NA NA XXX 76529 ......... 26 ....... A Echo exam of eye ......................................... 0.57 0.21 0.23 0.21 0.23 0.02 0.80 0.82 0.80 0.82 XXX 76529 ......... TC ...... A Echo exam of eye ......................................... 0.00 0.97 1.09 NA NA 0.08 1.05 1.17 NA NA XXX 76536 ......... ............ A Us exam of head and neck ........................... 0.56 2.77 1.89 NA NA 0.10 3.43 2.55 NA NA XXX 76536 ......... 26 ....... A Us exam of head and neck ........................... 0.56 0.18 0.18 0.18 0.18 0.02 0.76 0.76 0.76 0.76 XXX 76536 ......... TC ...... A Us exam of head and neck ........................... 0.00 2.59 1.71 NA NA 0.08 2.67 1.79 NA NA XXX 76604 ......... ............ A Us exam, chest, b-scan ................................ 0.55 1.90 1.59 NA NA 0.09 2.54 2.23 NA NA XXX76604 ......... 26 ....... A Us exam, chest, b-scan ................................ 0.55 0.19 0.18 0.19 0.18 0.02 0.76 0.75 0.76 0.75 XXX 76604 ......... TC ...... A Us exam, chest, b-scan ................................ 0.00 1.71 1.41 NA NA 0.07 1.78 1.48 NA NA XXX 76645 ......... ............ A Us exam, breast(s) ........................................ 0.54 2.20 1.47 NA NA 0.08 2.82 2.09 NA NA XXX 76645 ......... 26 ....... A Us exam, breast(s) ........................................ 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.74 0.74 XXX 76645 ......... TC ...... A Us exam, breast(s) ........................................ 0.00 2.01 1.29 NA NA 0.06 2.07 1.35 NA NA XXX76700 ......... ............ A Us exam, abdom, complete .......................... 0.81 3.13 2.47 NA NA 0.15 4.09 3.43 NA NA XXX 76700 ......... 26 ....... A Us exam, abdom, complete .......................... 0.81 0.28 0.27 0.28 0.27 0.04 1.13 1.12 1.13 1.12 XXX 76700 ......... TC ...... A Us exam, abdom, complete .......................... 0.00 2.86 2.20 NA NA 0.11 2.97 2.31 NA NA XXX 76705 ......... ............ A Echo exam of abdomen ................................ 0.59 2.45 1.82 NA NA 0.11 3.15 2.52 NA NA XXX 76705 ......... 26 ....... A Echo exam of abdomen ................................ 0.59 0.20 0.19 0.20 0.19 0.03 0.82 0.81 0.82 0.81 XXX 76705 ......... TC ...... A Echo exam of abdomen ................................ 0.00 2.25 1.63 NA NA 0.08 2.33 1.71 NA NA XXX 76770 ......... ............ A Us exam abdo back wall, comp .................... 0.74 3.04 2.43 NA NA 0.14 3.92 3.31 NA NA XXX 76770 ......... 26 ....... A Us exam abdo back wall, comp .................... 0.74 0.26 0.25 0.26 0.25 0.03 1.03 1.02 1.03 1.02 XXX 76770 ......... TC ...... A Us exam abdo back wall, comp .................... 0.00 2.78 2.18 NA NA 0.11 2.89 2.29 NA NA XXX 76775 ......... ............ A Us exam abdo back wall, lim ........................ 0.58 2.52 1.84 NA NA 0.11 3.21 2.53 NA NA XXX 76775 ......... 26 ....... A Us exam abdo back wall, lim ........................ 0.58 0.21 0.20 0.21 0.20 0.03 0.82 0.81 0.82 0.81 XXX 76775 ......... TC ...... A Us exam abdo back wall, lim ........................ 0.00 2.31 1.64 NA NA 0.08 2.39 1.72 NA NA XXX 76778 ......... ............ A Us exam kidney transplant ............................ 0.74 3.37 2.51 NA NA 0.14 4.25 3.39 NA NA XXX 76778 ......... 26 ....... A Us exam kidney transplant ............................ 0.74 0.25 0.24 0.25 0.24 0.03 1.02 1.01 1.02 1.01 XXX 76778 ......... TC ...... A Us exam kidney transplant ............................ 0.00 3.11 2.26 NA NA 0.11 3.22 2.37 NA NA XXX 76800 ......... ............ A Us exam, spinal canal ................................... 1.13 2.31 1.90 NA NA 0.13 3.57 3.16 NA NA XXX 76800 ......... 26 ....... A Us exam, spinal canal ................................... 1.13 0.29 0.33 0.29 0.33 0.05 1.47 1.51 1.47 1.51 XXX 76800 ......... TC ...... A Us exam, spinal canal ................................... 0.00 2.02 1.57 NA NA 0.08 2.10 1.65 NA NA XXX 76801 ......... ............ A Ob us < 14 wks, single fetus ........................ 0.99 2.53 2.47 NA NA 0.16 3.68 3.62 NA NA XXX 76801 ......... 26 ....... A Ob us < 14 wks, single fetus ........................ 0.99 0.32 0.34 0.32 0.34 0.04 1.35 1.37 1.35 1.37 XXX 76801 ......... TC ...... A Ob us < 14 wks, single fetus ........................ 0.00 2.22 2.14 NA NA 0.12 2.34 2.26 NA NA XXX 76802 ......... ............ A Ob us < 14 wks, addIl fetus .......................... 0.83 0.99 1.25 NA NA 0.16 1.98 2.24 NA NA ZZZ 76802 ......... 26 ....... A Ob us < 14 wks, addIl fetus .......................... 0.83 0.26 0.28 0.26 0.28 0.04 1.13 1.15 1.13 1.15 ZZZ 76802 ......... TC ...... A Ob us < 14 wks, addIl fetus .......................... 0.00 0.73 0.97 NA NA 0.12 0.85 1.09 NA NA ZZZ 76805 ......... ............ A Ob us >/= 14 wks, sngl fetus ........................ 0.99 3.10 2.61 NA NA 0.16 4.25 3.76 NA NA XXX 76805 ......... 26 ....... A Ob us >/= 14 wks, sngl fetus ........................ 0.99 0.30 0.33 0.30 0.33 0.04 1.33 1.36 1.33 1.36 XXX 76805 ......... TC ...... A Ob us >/= 14 wks, sngl fetus ........................ 0.00 2.80 2.28 NA NA 0.12 2.92 2.40 NA NA XXX 76810 ......... ............ A Ob us >/= 14 wks, addl fetus ........................ 0.98 1.68 1.46 NA NA 0.26 2.92 2.70 NA NA ZZZ 76810 ......... 26 ....... A Ob us >/= 14 wks, addl fetus ........................ 0.98 0.30 0.33 0.30 0.33 0.04 1.32 1.35 1.32 1.35 ZZZ 76810 ......... TC ...... A Ob us >/= 14 wks, addl fetus ........................ 0.00 1.39 1.14 NA NA 0.22 1.61 1.36 NA NA ZZZ 76811 ......... ............ A Ob us, detailed, sngl fetus ............................ 1.90 3.06 3.95 NA NA 0.52 5.48 6.37 NA NA XXX 76811 ......... 26 ....... A Ob us, detailed, sngl fetus ............................ 1.90 0.54 0.67 0.54 0.67 0.09 2.53 2.66 2.53 2.66 XXX 76811 ......... TC ...... A Ob us, detailed, sngl fetus ............................ 0.00 2.52 3.29 NA NA 0.43 2.95 3.72 NA NA XXX 76812 ......... ............ A Ob us, detailed, addl fetus ............................ 1.78 3.97 2.28 NA NA 0.49 6.24 4.55 NA NA ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37383 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76812 ......... 26 ....... A Ob us, detailed, addl fetus ............................ 1.78 0.51 0.62 0.51 0.62 0.08 2.37 2.48 2.37 2.48 ZZZ 76812 ......... TC ...... A Ob us, detailed, addl fetus ............................ 0.00 3.46 1.65 NA NA 0.41 3.87 2.06 NA NA ZZZ 76815 ......... ............ A Ob us, limited, fetus(s) .................................. 0.65 1.83 1.70 NA NA 0.11 2.59 2.46 NA NA XXX 76815 ......... 26 ....... A Ob us, limited, fetus(s) .................................. 0.65 0.19 0.22 0.19 0.22 0.03 0.87 0.90 0.87 0.90 XXX 76815 ......... TC ...... A Ob us, limited, fetus(s) .................................. 0.00 1.63 1.47 NA NA 0.08 1.71 1.55 NA NA XXX76816 ......... ............ A Ob us, follow-up, per fetus ............................ 0.85 2.39 1.67 NA NA 0.10 3.34 2.62 NA NA XXX 76816 ......... 26 ....... A Ob us, follow-up, per fetus ............................ 0.85 0.24 0.30 0.24 0.30 0.04 1.13 1.19 1.13 1.19 XXX 76816 ......... TC ...... A Ob us, follow-up, per fetus ............................ 0.00 2.15 1.37 NA NA 0.06 2.21 1.43 NA NA XXX 76817 ......... ............ A Transvaginal us, obstetric ............................. 0.75 2.06 1.85 NA NA 0.09 2.90 2.69 NA NA XXX 76817 ......... 26 ....... A Transvaginal us, obstetric ............................. 0.75 0.23 0.25 0.23 0.25 0.03 1.01 1.03 1.01 1.03 XXX 76817 ......... TC ...... A Transvaginal us, obstetric ............................. 0.00 1.83 1.60 NA NA 0.06 1.89 1.66 NA NA XXX 76818 ......... ............ A Fetal biophys profile w/nst ............................ 1.05 2.23 2.06 NA NA 0.15 3.43 3.26 NA NA XXX 76818 ......... 26 ....... A Fetal biophys profile w/nst ............................ 1.05 0.30 0.37 0.30 0.37 0.05 1.40 1.47 1.40 1.47 XXX 76818 ......... TC ...... A Fetal biophys profile w/nst ............................ 0.00 1.92 1.69 NA NA 0.10 2.02 1.79 NA NA XXX 76819 ......... ............ A Fetal biophys profil w/o nst ........................... 0.77 1.65 1.83 NA NA 0.13 2.55 2.73 NA NA XXX 76819 ......... 26 ....... A Fetal biophys profil w/o nst ........................... 0.77 0.23 0.27 0.23 0.27 0.03 1.03 1.07 1.03 1.07 XXX 76819 ......... TC ...... A Fetal biophys profil w/o nst ........................... 0.00 1.42 1.56 NA NA 0.10 1.52 1.66 NA NA XXX 76820 ......... ............ A Umbilical artery echo ..................................... 0.50 0.57 1.49 NA NA 0.15 1.22 2.14 NA NA XXX 76820 ......... 26 ....... A Umbilical artery echo ..................................... 0.50 0.14 0.18 0.14 0.18 0.03 0.67 0.71 0.67 0.71 XXX 76820 ......... TC ...... A Umbilical artery echo ..................................... 0.00 0.43 1.32 NA NA 0.12 0.55 1.44 NA NA XXX76821 ......... ............ A Middle cerebral artery echo .......................... 0.70 1.88 1.88 NA NA 0.15 2.73 2.73 NA NA XXX 76821 ......... 26 ....... A Middle cerebral artery echo .......................... 0.70 0.20 0.25 0.20 0.25 0.03 0.93 0.98 0.93 0.98 XXX 76821 ......... TC ...... A Middle cerebral artery echo .......................... 0.00 1.68 1.63 NA NA 0.12 1.80 1.75 NA NA XXX 76825 ......... ............ A Echo exam of fetal heart ............................... 1.67 4.34 3.02 NA NA 0.18 6.19 4.87 NA NA XXX 76825 ......... 26 ....... A Echo exam of fetal heart ............................... 1.67 0.48 0.57 0.48 0.57 0.07 2.22 2.31 2.22 2.31 XXX 76825 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 3.86 2.45 NA NA 0.11 3.97 2.56 NA NA XXX 76826 ......... ............ A Echo exam of fetal heart ............................... 0.83 2.73 1.43 NA NA 0.08 3.64 2.34 NA NA XXX 76826 ......... 26 ....... A Echo exam of fetal heart ............................... 0.83 0.23 0.28 0.23 0.28 0.03 1.09 1.14 1.09 1.14 XXX 76826 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 2.50 1.16 NA NA 0.05 2.55 1.21 NA NA XXX 76827 ......... ............ A Echo exam of fetal heart ............................... 0.58 1.07 1.72 NA NA 0.14 1.79 2.44 NA NA XXX 76827 ......... 26 ....... A Echo exam of fetal heart ............................... 0.58 0.17 0.20 0.17 0.20 0.02 0.77 0.80 0.77 0.80 XXX 76827 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 0.90 1.52 NA NA 0.12 1.02 1.64 NA NA XXX 76828 ......... ............ A Echo exam of fetal heart ............................... 0.56 0.63 1.16 NA NA 0.11 1.30 1.83 NA NA XXX 76828 ......... 26 ....... A Echo exam of fetal heart ............................... 0.56 0.15 0.20 0.15 0.20 0.03 0.74 0.79 0.74 0.79 XXX 76828 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 0.48 0.95 NA NA 0.08 0.56 1.03 NA NA XXX 76830 ......... ............ A Transvaginal us, non-ob ................................ 0.69 2.85 2.03 NA NA 0.13 3.67 2.85 NA NA XXX 76830 ......... 26 ....... A Transvaginal us, non-ob ................................ 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 76830 ......... TC ...... A Transvaginal us, non-ob ................................ 0.00 2.62 1.80 NA NA 0.10 2.72 1.90 NA NA XXX 76831 ......... ............ A Echo exam, uterus ........................................ 0.72 2.76 2.02 NA NA 0.13 3.61 2.87 NA NA XXX 76831 ......... 26 ....... A Echo exam, uterus ........................................ 0.72 0.21 0.24 0.21 0.24 0.03 0.96 0.99 0.96 0.99 XXX 76831 ......... TC ...... A Echo exam, uterus ........................................ 0.00 2.55 1.78 NA NA 0.10 2.65 1.88 NA NA XXX 76856 ......... ............ A Us exam, pelvic, complete ............................ 0.69 2.90 2.04 NA NA 0.13 3.72 2.86 NA NA XXX 76856 ......... 26 ....... A Us exam, pelvic, complete ............................ 0.69 0.24 0.23 0.24 0.23 0.03 0.96 0.95 0.96 0.95 XXX 76856 ......... TC ...... A Us exam, pelvic, complete ............................ 0.00 2.67 1.81 NA NA 0.10 2.77 1.91 NA NA XXX 76857 ......... ............ A Us exam, pelvic, limited ................................ 0.38 2.59 2.02 NA NA 0.08 3.05 2.48 NA NA XXX 76857 ......... 26 ....... A Us exam, pelvic, limited ................................ 0.38 0.15 0.13 0.15 0.13 0.02 0.55 0.53 0.55 0.53 XXX 76857 ......... TC ...... A Us exam, pelvic, limited ................................ 0.00 2.44 1.89 NA NA 0.06 2.50 1.95 NA NA XXX 76870 ......... ............ A Us exam, scrotum ......................................... 0.64 2.94 2.03 NA NA 0.13 3.71 2.80 NA NA XXX 76870 ......... 26 ....... A Us exam, scrotum ......................................... 0.64 0.23 0.22 0.23 0.22 0.03 0.90 0.89 0.90 0.89 XXX 76870 ......... TC ...... A Us exam, scrotum ......................................... 0.00 2.72 1.82 NA NA 0.10 2.82 1.92 NA NA XXX 76872 ......... ............ A Us, transrectal ............................................... 0.69 3.50 2.56 NA NA 0.14 4.33 3.39 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37384 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76872 ......... 26 ....... A Us, transrectal ............................................... 0.69 0.28 0.24 0.28 0.24 0.04 1.01 0.97 1.01 0.97 XXX 76872 ......... TC ...... A Us, transrectal ............................................... 0.00 3.22 2.33 NA NA 0.10 3.32 2.43 NA NA XXX 76873 ......... ............ A Echograp trans r, pros study ......................... 1.55 3.45 2.82 NA NA 0.25 5.25 4.62 NA NA XXX 76873 ......... 26 ....... A Echograp trans r, pros study ......................... 1.55 0.53 0.51 0.53 0.51 0.09 2.17 2.15 2.17 2.15 XXX 76873 ......... TC ...... A Echograp trans r, pros study ......................... 0.00 2.92 2.31 NA NA 0.16 3.08 2.47 NA NA XXX 76880 ......... ............ A Us exam, extremity ....................................... 0.59 3.25 2.02 NA NA 0.11 3.95 2.72 NA NA XXX 76880 ......... 26 ....... A Us exam, extremity ....................................... 0.59 0.18 0.19 0.18 0.19 0.03 0.80 0.81 0.80 0.81 XXX 76880 ......... TC ...... A Us exam, extremity ....................................... 0.00 3.07 1.83 NA NA 0.08 3.15 1.91 NA NA XXX 76885 ......... ............ A Us exam infant hips, dynamic ....................... 0.74 3.36 2.16 NA NA 0.13 4.23 3.03 NA NA XXX 76885 ......... 26 ....... A Us exam infant hips, dynamic ....................... 0.74 0.24 0.24 0.24 0.24 0.03 1.01 1.01 1.01 1.01 XXX 76885 ......... TC ...... A Us exam infant hips, dynamic ....................... 0.00 3.11 1.92 NA NA 0.10 3.21 2.02 NA NA XXX 76886 ......... ............ A Us exam infant hips, static ............................ 0.62 2.36 1.81 NA NA 0.11 3.09 2.54 NA NA XXX 76886 ......... 26 ....... A Us exam infant hips, static ............................ 0.62 0.19 0.20 0.19 0.20 0.03 0.84 0.85 0.84 0.85 XXX 76886 ......... TC ...... A Us exam infant hips, static ............................ 0.00 2.18 1.61 NA NA 0.08 2.26 1.69 NA NA XXX 76930 ......... ............ A Echo guide, cardiocentesis ........................... 0.67 2.15 1.87 NA NA 0.12 2.94 2.66 NA NA XXX 76930 ......... 26 ....... A Echo guide, cardiocentesis ........................... 0.67 0.35 0.28 0.35 0.28 0.02 1.04 0.97 1.04 0.97 XXX 76930 ......... TC ...... A Echo guide, cardiocentesis ........................... 0.00 1.80 1.59 NA NA 0.10 1.90 1.69 NA NA XXX 76932 ......... ............ A Echo guide for heart biopsy .......................... 0.67 0.36 1.42 NA NA 0.12 1.15 2.21 NA NA XXX 76932 ......... 26 ....... A Echo guide for heart biopsy .......................... 0.67 0.36 0.28 0.36 0.28 0.02 1.05 0.97 1.05 0.97 XXX 76932 ......... TC ...... A Echo guide for heart biopsy .......................... 0.00 0.00 1.14 NA NA 0.10 0.10 1.24 NA NA XXX 76936 ......... ............ A Echo guide for artery repair .......................... 1.99 6.28 6.80 NA NA 0.47 8.74 9.26 NA NA XXX76936 ......... 26 ....... A Echo guide for artery repair .......................... 1.99 0.72 0.68 0.72 0.68 0.13 2.84 2.80 2.84 2.80 XXX 76936 ......... TC ...... A Echo guide for artery repair .......................... 0.00 5.56 6.12 NA NA 0.34 5.90 6.46 NA NA XXX 76937 ......... ............ A Us guide, vascular access ............................ 0.30 0.65 0.52 NA NA 0.13 1.08 0.95 NA NA ZZZ 76937 ......... 26 ....... A Us guide, vascular access ............................ 0.30 0.10 0.10 0.10 0.10 0.03 0.43 0.43 0.43 0.43 ZZZ 76937 ......... DTC ... A Us guide, vascular access ............................ 0.00 0.54 0.42 NA NA 0.10 0.64 0.52 NA NA ZZZ 76940 ......... ............ A Us guide, tissue ablation ............................... 2.00 0.63 1.79 NA NA 0.60 3.23 4.39 NA NA XXX 76940 ......... 26 ....... A Us guide, tissue ablation ............................... 2.00 0.63 0.65 0.63 0.65 0.31 2.94 2.96 2.94 2.96 XXX 76940 ......... TC ...... A Us guide, tissue ablation ............................... 0.00 0.00 1.14 NA NA 0.29 0.29 1.43 NA NA XXX 76941 ......... ............ A Echo guide for transfusion ............................ 1.34 0.43 1.61 NA NA 0.15 1.92 3.10 NA NA XXX76941 ......... 26 ....... A Echo guide for transfusion ............................ 1.34 0.43 0.46 0.43 0.46 0.07 1.84 1.87 1.84 1.87 XXX 76941 ......... TC ...... A Echo guide for transfusion ............................ 0.00 0.00 1.15 NA NA 0.08 0.08 1.23 NA NA XXX 76942 ......... ............ A Echo guide for biopsy ................................... 0.67 4.98 3.53 NA NA 0.13 5.78 4.33 NA NA XXX 76942 ......... 26 ....... A Echo guide for biopsy ................................... 0.67 0.24 0.23 0.24 0.23 0.03 0.94 0.93 0.94 0.93 XXX 76942 ......... TC ...... A Echo guide for biopsy ................................... 0.00 4.73 3.30 NA NA 0.10 4.83 3.40 NA NA XXX 76945 ......... ............ A Echo guide, villus sampling ........................... 0.67 0.21 1.37 NA NA 0.11 0.99 2.15 NA NA XXX76945 ......... 26 ....... A Echo guide, villus sampling ........................... 0.67 0.21 0.22 0.21 0.22 0.03 0.91 0.92 0.91 0.92 XXX 76945 ......... TC ...... A Echo guide, villus sampling ........................... 0.00 0.00 1.15 NA NA 0.08 0.08 1.23 NA NA XXX 76946 ......... ............ A Echo guide for amniocentesis ....................... 0.38 0.45 1.36 NA NA 0.12 0.95 1.86 NA NA XXX 76946 ......... 26 ....... A Echo guide for amniocentesis ....................... 0.38 0.11 0.13 0.11 0.13 0.02 0.51 0.53 0.51 0.53 XXX 76946 ......... TC ...... A Echo guide for amniocentesis ....................... 0.00 0.34 1.23 NA NA 0.10 0.44 1.33 NA NA XXX 76948 ......... ............ A Echo guide, ova aspiration ............................ 0.38 0.44 1.35 NA NA 0.12 0.94 1.85 NA NA XXX76948 ......... 26 ....... A Echo guide, ova aspiration ............................ 0.38 0.10 0.12 0.10 0.12 0.02 0.50 0.52 0.50 0.52 XXX 76948 ......... TC ...... A Echo guide, ova aspiration ............................ 0.00 0.34 1.23 NA NA 0.10 0.44 1.33 NA NA XXX 76950 ......... ............ A Echo guidance radiotherapy ......................... 0.58 1.17 1.42 NA NA 0.10 1.85 2.10 NA NA XXX 76950 ......... 26 ....... A Echo guidance radiotherapy ......................... 0.58 0.16 0.18 0.16 0.18 0.03 0.77 0.79 0.77 0.79 XXX 76950 ......... TC ...... A Echo guidance radiotherapy ......................... 0.00 1.01 1.24 NA NA 0.07 1.08 1.31 NA NA XXX 76965 ......... ............ A Echo guidance radiotherapy ......................... 1.34 1.20 4.82 NA NA 0.37 2.91 6.53 NA NA XXX 76965 ......... 26 ....... A Echo guidance radiotherapy ......................... 1.34 0.49 0.45 0.49 0.45 0.08 1.91 1.87 1.91 1.87 XXX 76965 ......... TC ...... A Echo guidance radiotherapy ......................... 0.00 0.71 4.37 NA NA 0.29 1.00 4.66 NA NA XXX 76970 ......... ............ A Ultrasound exam follow-up ............................ 0.40 2.15 1.42 NA NA 0.08 2.63 1.90 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37385 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

76970 ......... 26 ....... A Ultrasound exam follow-up ............................ 0.40 0.11 0.13 0.11 0.13 0.02 0.53 0.55 0.53 0.55 XXX 76970 ......... TC ...... A Ultrasound exam follow-up ............................ 0.00 2.04 1.30 NA NA 0.06 2.10 1.36 NA NA XXX 76975 ......... ............ A GI endoscopic ultrasound ............................. 0.81 0.31 1.43 NA NA 0.14 1.26 2.38 NA NA XXX 76975 ......... 26 ....... A GI endoscopic ultrasound ............................. 0.81 0.31 0.29 0.31 0.29 0.04 1.16 1.14 1.16 1.14 XXX 76975 ......... TC ...... A GI endoscopic ultrasound ............................. 0.00 0.00 1.14 NA NA 0.10 0.10 1.24 NA NA XXX 76977 ......... ............ A Us bone density measure ............................. 0.05 0.11 0.66 NA NA 0.06 0.22 0.77 NA NA XXX 76977 ......... 26 ....... A Us bone density measure ............................. 0.05 0.01 0.02 0.01 0.02 0.01 0.07 0.08 0.07 0.08 XXX 76977 ......... TC ...... A Us bone density measure ............................. 0.00 0.09 0.64 NA NA 0.05 0.14 0.69 NA NA XXX 76986 ......... ............ A Ultrasound guide intraoper ............................ 1.20 0.35 2.36 NA NA 0.27 1.82 3.83 NA NA XXX76986 ......... 26 ....... A Ultrasound guide intraoper ............................ 1.20 0.35 0.39 0.35 0.39 0.13 1.68 1.72 1.68 1.72 XXX 76986 ......... TC ...... A Ultrasound guide intraoper ............................ 0.00 0.00 1.97 NA NA 0.14 0.14 2.11 NA NA XXX 77261 ......... ............ A Radiation therapy planning ........................... 1.39 0.42 0.49 0.42 0.49 0.07 1.88 1.95 1.88 1.95 XXX 77262 ......... ............ A Radiation therapy planning ........................... 2.11 0.59 0.71 0.59 0.71 0.11 2.81 2.93 2.81 2.93 XXX 77263 ......... ............ A Radiation therapy planning ........................... 3.14 0.88 1.05 0.88 1.05 0.16 4.18 4.35 4.18 4.35 XXX 77280 ......... ............ A Set radiation therapy field ............................. 0.70 4.39 3.87 NA NA 0.22 5.31 4.79 NA NA XXX 77280 ......... 26 ....... A Set radiation therapy field ............................. 0.70 0.20 0.22 0.20 0.22 0.04 0.94 0.96 0.94 0.96 XXX 77280 ......... TC ...... A Set radiation therapy field ............................. 0.00 4.20 3.66 NA NA 0.18 4.38 3.84 NA NA XXX 77285 ......... ............ A Set radiation therapy field ............................. 1.05 8.00 6.45 NA NA 0.35 9.40 7.85 NA NA XXX 77285 ......... 26 ....... A Set radiation therapy field ............................. 1.05 0.29 0.33 0.29 0.33 0.05 1.39 1.43 1.39 1.43 XXX 77285 ......... TC ...... A Set radiation therapy field ............................. 0.00 7.70 6.12 NA NA 0.30 8.00 6.42 NA NA XXX 77290 ......... ............ A Set radiation therapy field ............................. 1.56 13.37 8.62 NA NA 0.43 15.36 10.61 NA NA XXX 77290 ......... 26 ....... A Set radiation therapy field ............................. 1.56 0.44 0.49 0.44 0.49 0.08 2.08 2.13 2.08 2.13 XXX 77290 ......... TC ...... A Set radiation therapy field ............................. 0.00 12.93 8.13 NA NA 0.35 13.28 8.48 NA NA XXX77295 ......... ............ A Set radiation therapy field ............................. 4.56 7.00 23.85 NA NA 1.71 13.27 30.12 NA NA XXX 77295 ......... 26 ....... A Set radiation therapy field ............................. 4.56 1.28 1.42 1.28 1.42 0.23 6.07 6.21 6.07 6.21 XXX 77295 ......... TC ...... A Set radiation therapy field ............................. 0.00 5.72 22.44 NA NA 1.48 7.20 23.92 NA NA XXX77300 ......... ............ A Radiation therapy dose plan ......................... 0.62 1.10 1.43 NA NA 0.10 1.82 2.15 NA NA XXX 77300 ......... 26 ....... A Radiation therapy dose plan ......................... 0.62 0.17 0.19 0.17 0.19 0.03 0.82 0.84 0.82 0.84 XXX 77300 ......... TC ...... A Radiation therapy dose plan ......................... 0.00 0.92 1.24 NA NA 0.07 0.99 1.31 NA NA XXX 77301 ......... ............ A Radiotherapy dose plan, imrt ........................ 7.99 54.08 36.46 NA NA 1.88 63.95 46.33 NA NA XXX 77301 ......... 26 ....... A Radiotherapy dose plan, imrt ........................ 7.99 2.24 2.49 2.24 2.49 0.40 10.63 10.88 10.63 10.88 XXX 77301 ......... TC ...... A Radiotherapy dose plan, imrt ........................ 0.00 51.84 33.97 NA NA 1.48 53.32 35.45 NA NA XXX 77305 ......... ............ A Teletx isodose plan simple ............................ 0.70 0.86 1.79 NA NA 0.15 1.71 2.64 NA NA XXX77305 ......... 26 ....... A Teletx isodose plan simple ............................ 0.70 0.20 0.22 0.20 0.22 0.04 0.94 0.96 0.94 0.96 XXX 77305 ......... TC ...... A Teletx isodose plan simple ............................ 0.00 0.66 1.57 NA NA 0.11 0.77 1.68 NA NA XXX 77310 ......... ............ A Teletx isodose plan intermed ........................ 1.05 1.19 2.31 NA NA 0.18 2.42 3.54 NA NA XXX 77310 ......... 26 ....... A Teletx isodose plan intermed ........................ 1.05 0.29 0.33 0.29 0.33 0.05 1.39 1.43 1.39 1.43 XXX 77310 ......... TC ...... A Teletx isodose plan intermed ........................ 0.00 0.90 1.98 NA NA 0.13 1.03 2.11 NA NA XXX 77315 ......... ............ A Teletx isodose plan complex ......................... 1.56 1.99 2.88 NA NA 0.22 3.77 4.66 NA NA XXX 77315 ......... 26 ....... A Teletx isodose plan complex ......................... 1.56 0.44 0.49 0.44 0.49 0.08 2.08 2.13 2.08 2.13 XXX 77315 ......... TC ...... A Teletx isodose plan complex ......................... 0.00 1.56 2.39 NA NA 0.14 1.70 2.53 NA NA XXX 77321 ......... ............ A Special teletx port plan .................................. 0.95 1.40 3.61 NA NA 0.26 2.61 4.82 NA NA XXX 77321 ......... 26 ....... A Special teletx port plan .................................. 0.95 0.27 0.29 0.27 0.29 0.05 1.27 1.29 1.27 1.29 XXX 77321 ......... TC ...... A Special teletx port plan .................................. 0.00 1.13 3.32 NA NA 0.21 1.34 3.53 NA NA XXX77326 ......... ............ A Brachytx isodose calc simp ........................... 0.93 2.81 2.71 NA NA 0.18 3.92 3.82 NA NA XXX 77326 ......... 26 ....... A Brachytx isodose calc simp ........................... 0.93 0.26 0.29 0.26 0.29 0.05 1.24 1.27 1.24 1.27 XXX 77326 ......... TC ...... A Brachytx isodose calc simp ........................... 0.00 2.56 2.42 NA NA 0.13 2.69 2.55 NA NA XXX 77327 ......... ............ A Brachytx isodose calc interm ........................ 1.39 3.89 3.91 NA NA 0.25 5.53 5.55 NA NA XXX 77327 ......... 26 ....... A Brachytx isodose calc interm ........................ 1.39 0.39 0.43 0.39 0.43 0.07 1.85 1.89 1.85 1.89 XXX 77327 ......... TC ...... A Brachytx isodose calc interm ........................ 0.00 3.50 3.49 NA NA 0.18 3.68 3.67 NA NA XXX 77328 ......... ............ A Brachytx isodose plan compl ........................ 2.09 5.00 5.48 NA NA 0.36 7.45 7.93 NA NA XXX 77328 ......... 26 ....... A Brachytx isodose plan compl ........................ 2.09 0.59 0.65 0.59 0.65 0.11 2.79 2.85 2.79 2.85 XXX 77328 ......... TC ...... A Brachytx isodose plan compl ........................ 0.00 4.41 4.83 NA NA 0.25 4.66 5.08 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37386 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

77331 ......... ............ A Special radiation dosimetry ........................... 0.87 0.73 0.77 NA NA 0.06 1.66 1.70 NA NA XXX77331 ......... 26 ....... A Special radiation dosimetry ........................... 0.87 0.24 0.27 0.24 0.27 0.04 1.15 1.18 1.15 1.18 XXX 77331 ......... TC ...... A Special radiation dosimetry ........................... 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX 77332 ......... ............ A Radiation treatment aid(s) ............................. 0.54 1.54 1.52 NA NA 0.10 2.18 2.16 NA NA XXX 77332 ......... 26 ....... A Radiation treatment aid(s) ............................. 0.54 0.15 0.17 0.15 0.17 0.03 0.72 0.74 0.72 0.74 XXX 77332 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 1.38 1.35 NA NA 0.07 1.45 1.42 NA NA XXX 77333 ......... ............ A Radiation treatment aid(s) ............................. 0.84 0.47 1.75 NA NA 0.15 1.46 2.74 NA NA XXX 77333 ......... 26 ....... A Radiation treatment aid(s) ............................. 0.84 0.24 0.26 0.24 0.26 0.04 1.12 1.14 1.12 1.14 XXX 77333 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 0.23 1.48 NA NA 0.11 0.34 1.59 NA NA XXX 77334 ......... ............ A Radiation treatment aid(s) ............................. 1.24 2.64 3.41 NA NA 0.23 4.11 4.88 NA NA XXX 77334 ......... 26 ....... A Radiation treatment aid(s) ............................. 1.24 0.35 0.39 0.35 0.39 0.06 1.65 1.69 1.65 1.69 XXX 77334 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 2.30 3.02 NA NA 0.17 2.47 3.19 NA NA XXX 77336 ......... ............ A Radiation physics consult .............................. 0.00 0.93 2.48 NA NA 0.16 1.09 2.64 NA NA XXX 77370 ......... ............ A Radiation physics consult .............................. 0.00 2.36 3.22 NA NA 0.18 2.54 3.40 NA NA XXX 77401 ......... ............ A Radiation treatment delivery ......................... 0.00 0.50 1.46 NA NA 0.11 0.61 1.57 NA NA XXX 77402 ......... ............ A Radiation treatment delivery ......................... 0.00 4.20 2.39 NA NA 0.11 4.31 2.50 NA NA XXX 77403 ......... ............ A Radiation treatment delivery ......................... 0.00 3.77 2.28 NA NA 0.11 3.88 2.39 NA NA XXX 77404 ......... ............ A Radiation treatment delivery ......................... 0.00 4.22 2.39 NA NA 0.11 4.33 2.50 NA NA XXX 77406 ......... ............ A Radiation treatment delivery ......................... 0.00 4.23 2.39 NA NA 0.11 4.34 2.50 NA NA XXX 77407 ......... ............ A Radiation treatment delivery ......................... 0.00 5.44 2.94 NA NA 0.12 5.56 3.06 NA NA XXX 77408 ......... ............ A Radiation treatment delivery ......................... 0.00 5.24 2.89 NA NA 0.12 5.36 3.01 NA NA XXX 77409 ......... ............ A Radiation treatment delivery ......................... 0.00 5.84 3.04 NA NA 0.12 5.96 3.16 NA NA XXX 77411 ......... ............ A Radiation treatment delivery ......................... 0.00 5.73 3.01 NA NA 0.12 5.85 3.13 NA NA XXX 77412 ......... ............ A Radiation treatment delivery ......................... 0.00 6.85 3.47 NA NA 0.13 6.98 3.60 NA NA XXX 77413 ......... ............ A Radiation treatment delivery ......................... 0.00 6.86 3.47 NA NA 0.13 6.99 3.60 NA NA XXX 77414 ......... ............ A Radiation treatment delivery ......................... 0.00 7.74 3.69 NA NA 0.13 7.87 3.82 NA NA XXX 77416 ......... ............ A Radiation treatment delivery ......................... 0.00 7.73 3.69 NA NA 0.13 7.86 3.82 NA NA XXX 77417 ......... ............ A Radiology port film(s) .................................... 0.00 0.36 0.53 NA NA 0.04 0.40 0.57 NA NA XXX 77418 ......... ............ A Radiation tx delivery, imrt .............................. 0.00 13.15 16.84 NA NA 0.13 13.28 16.97 NA NA XXX 77421 ......... ............ A Stereoscopic x-ray guidance ......................... 0.39 1.97 3.11 NA NA 0.12 2.48 3.62 NA NA XXX 77421 ......... 26 ....... A Stereoscopic x-ray guidance ......................... 0.39 0.11 0.13 0.11 0.13 0.02 0.52 0.54 0.52 0.54 XXX 77421 ......... TC ...... A Stereoscopic x-ray guidance ......................... 0.00 1.86 2.99 NA NA 0.10 1.96 3.09 NA NA XXX 77422 ......... ............ A Neutron beam tx, simple ............................... 0.00 7.59 3.18 NA NA 0.13 7.72 3.31 NA NA XXX77423 ......... ............ A Neutron beam tx, complex ............................ 0.00 12.53 4.83 NA NA 0.13 12.66 4.96 NA NA XXX77427 ......... ............ A Radiation tx management, x5 ....................... 3.31 1.10 1.07 1.10 1.07 0.17 4.58 4.55 4.58 4.55 XXX 77431 ......... ............ A Radiation therapy management .................... 1.81 0.69 0.68 0.69 0.68 0.09 2.59 2.58 2.59 2.58 XXX 77432 ......... ............ A Stereotactic radiation trmt ............................. 7.92 2.21 2.74 2.21 2.74 0.41 10.54 11.07 10.54 11.07 XXX 77470 ......... ............ A Special radiation treatment ........................... 2.09 1.79 9.34 NA NA 0.70 4.58 12.13 NA NA XXX 77470 ......... 26 ....... A Special radiation treatment ........................... 2.09 0.58 0.65 0.58 0.65 0.11 2.78 2.85 2.78 2.85 XXX 77470 ......... TC ...... A Special radiation treatment ........................... 0.00 1.20 8.69 NA NA 0.59 1.79 9.28 NA NA XXX 77600 ......... ............ R Hyperthermia treatment ................................. 1.56 9.38 5.02 NA NA 0.24 11.18 6.82 NA NA XXX 77600 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.36 0.47 0.36 0.47 0.08 2.00 2.11 2.00 2.11 XXX 77600 ......... TC ...... R Hyperthermia treatment ................................. 0.00 9.02 4.55 NA NA 0.16 9.18 4.71 NA NA XXX 77605 ......... ............ R Hyperthermia treatment ................................. 2.09 16.95 7.79 NA NA 0.38 19.42 10.26 NA NA XXX 77605 ......... 26 ....... R Hyperthermia treatment ................................. 2.09 0.53 0.63 0.53 0.63 0.16 2.78 2.88 2.78 2.88 XXX 77605 ......... TC ...... R Hyperthermia treatment ................................. 0.00 16.42 7.16 NA NA 0.22 16.64 7.38 NA NA XXX 77610 ......... ............ R Hyperthermia treatment ................................. 1.56 16.63 6.84 NA NA 0.24 18.43 8.64 NA NA XXX 77610 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.43 0.49 0.43 0.49 0.08 2.07 2.13 2.07 2.13 XXX 77610 ......... TC ...... R Hyperthermia treatment ................................. 0.00 16.20 6.35 NA NA 0.16 16.36 6.51 NA NA XXX 77615 ......... ............ R Hyperthermia treatment ................................. 2.09 24.67 9.72 NA NA 0.33 27.09 12.14 NA NA XXX 77615 ......... 26 ....... R Hyperthermia treatment ................................. 2.09 0.56 0.64 0.56 0.64 0.11 2.76 2.84 2.76 2.84 XXX 77615 ......... TC ...... R Hyperthermia treatment ................................. 0.00 24.11 9.08 NA NA 0.22 24.33 9.30 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37387 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

77620 ......... ............ R Hyperthermia treatment ................................. 1.56 9.51 5.06 NA NA 0.36 11.43 6.98 NA NA XXX 77620 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.40 0.49 0.40 0.49 0.20 2.16 2.25 2.16 2.25 XXX 77620 ......... TC ...... R Hyperthermia treatment ................................. 0.00 9.11 4.57 NA NA 0.16 9.27 4.73 NA NA XXX 77750 ......... ............ A Infuse radioactive materials .......................... 4.90 4.26 3.25 NA NA 0.32 9.48 8.47 NA NA 09077750 ......... 26 ....... A Infuse radioactive materials .......................... 4.90 1.38 1.53 1.38 1.53 0.25 6.53 6.68 6.53 6.68 090 77750 ......... TC ...... A Infuse radioactive materials .......................... 0.00 2.88 1.72 NA NA 0.07 2.95 1.79 NA NA 090 77761 ......... ............ A Apply intrcav radiat simple ............................ 3.80 5.68 4.12 NA NA 0.33 9.81 8.25 NA NA 090 77761 ......... 26 ....... A Apply intrcav radiat simple ............................ 3.80 1.08 1.09 1.08 1.09 0.19 5.07 5.08 5.07 5.08 090 77761 ......... TC ...... A Apply intrcav radiat simple ............................ 0.00 4.60 3.03 NA NA 0.14 4.74 3.17 NA NA 090 77762 ......... ............ A Apply intrcav radiat interm ............................ 5.71 6.67 5.76 NA NA 0.48 12.86 11.95 NA NA 090 77762 ......... 26 ....... A Apply intrcav radiat interm ............................ 5.71 1.59 1.78 1.59 1.78 0.29 7.59 7.78 7.59 7.78 090 77762 ......... TC ...... A Apply intrcav radiat interm ............................ 0.00 5.08 3.99 NA NA 0.19 5.27 4.18 NA NA 090 77763 ......... ............ A Apply intrcav radiat compl ............................. 8.56 8.99 7.69 NA NA 0.66 18.21 16.91 NA NA 090 77763 ......... 26 ....... A Apply intrcav radiat compl ............................. 8.56 2.38 2.66 2.38 2.66 0.43 11.37 11.65 11.37 11.65 090 77763 ......... TC ...... A Apply intrcav radiat compl ............................. 0.00 6.61 5.03 NA NA 0.23 6.84 5.26 NA NA 090 77776 ......... ............ A Apply interstit radiat simpl ............................. 4.65 6.77 4.05 NA NA 0.57 11.99 9.27 NA NA 090 77776 ......... 26 ....... A Apply interstit radiat simpl ............................. 4.65 1.58 1.11 1.58 1.11 0.44 6.67 6.20 6.67 6.20 090 77776 ......... TC ...... A Apply interstit radiat simpl ............................. 0.00 5.19 2.94 NA NA 0.13 5.32 3.07 NA NA 090 77777 ......... ............ A Apply interstit radiat inter .............................. 7.47 7.07 6.73 NA NA 0.61 15.15 14.81 NA NA 090 77777 ......... 26 ....... A Apply interstit radiat inter .............................. 7.47 2.25 2.35 2.25 2.35 0.39 10.11 10.21 10.11 10.21 090 77778 ......... ............ A Apply interstit radiat compl ............................ 11.17 9.77 8.98 NA NA 0.84 21.78 20.99 NA NA 090 77778 ......... 26 ....... A Apply interstit radiat compl ............................ 11.17 3.15 3.47 3.15 3.47 0.57 14.89 15.21 14.89 15.21 090 77778 ......... TC ...... A Apply interstit radiat compl ............................ 0.00 6.62 5.51 NA NA 0.27 6.89 5.78 NA NA 090 77781 ......... ............ A High intensity brachytherapy ......................... 1.66 4.80 16.87 NA NA 1.14 7.60 19.67 NA NA 090 77781 ......... 26 ....... A High intensity brachytherapy ......................... 1.66 0.46 0.51 0.46 0.51 0.08 2.20 2.25 2.20 2.25 090 77781 ......... TC ...... A High intensity brachytherapy ......................... 0.00 4.34 16.36 NA NA 1.06 5.40 17.42 NA NA 090 77782 ......... ............ A High intensity brachytherapy ......................... 2.49 12.68 19.04 NA NA 1.19 16.36 22.72 NA NA 090 77782 ......... 26 ....... A High intensity brachytherapy ......................... 2.49 0.69 0.77 0.69 0.77 0.13 3.31 3.39 3.31 3.39 090 77782 ......... TC ...... A High intensity brachytherapy ......................... 0.00 11.99 18.27 NA NA 1.06 13.05 19.33 NA NA 090 77783 ......... ............ A High intensity brachytherapy ......................... 3.72 24.45 22.28 NA NA 1.25 29.42 27.25 NA NA 090 77783 ......... 26 ....... A High intensity brachytherapy ......................... 3.72 1.03 1.15 1.03 1.15 0.19 4.94 5.06 4.94 5.06 090 77783 ......... TC ...... A High intensity brachytherapy ......................... 0.00 23.42 21.13 NA NA 1.06 24.48 22.19 NA NA 090 77784 ......... ............ A High intensity brachytherapy ......................... 5.60 45.62 28.03 NA NA 1.35 52.57 34.98 NA NA 090 77784 ......... 26 ....... A High intensity brachytherapy ......................... 5.60 1.55 1.74 1.55 1.74 0.29 7.44 7.63 7.44 7.63 090 77784 ......... TC ...... A High intensity brachytherapy ......................... 0.00 44.07 26.29 NA NA 1.06 45.13 27.35 NA NA 090 77789 ......... ............ A Apply surface radiation .................................. 1.12 1.95 1.10 NA NA 0.08 3.15 2.30 NA NA 000 77789 ......... 26 ....... A Apply surface radiation .................................. 1.12 0.35 0.37 0.35 0.37 0.06 1.53 1.55 1.53 1.55 000 77789 ......... TC ...... A Apply surface radiation .................................. 0.00 1.60 0.74 NA NA 0.02 1.62 0.76 NA NA 000 77790 ......... ............ A Radiation handling ......................................... 1.05 1.18 0.93 NA NA 0.07 2.30 2.05 NA NA XXX 77790 ......... 26 ....... A Radiation handling ......................................... 1.05 0.30 0.33 0.30 0.33 0.05 1.40 1.43 1.40 1.43 XXX 77790 ......... TC ...... A Radiation handling ......................................... 0.00 0.89 0.60 NA NA 0.02 0.91 0.62 NA NA XXX 78000 ......... ............ A Thyroid, single uptake ................................... 0.19 1.92 1.25 NA NA 0.07 2.18 1.51 NA NA XXX 78000 ......... 26 ....... A Thyroid, single uptake ................................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 78000 ......... TC ...... A Thyroid, single uptake ................................... 0.00 1.86 1.19 NA NA 0.06 1.92 1.25 NA NA XXX 78001 ......... ............ A Thyroid, multiple uptakes .............................. 0.26 2.37 1.64 NA NA 0.08 2.71 1.98 NA NA XXX 78001 ......... 26 ....... A Thyroid, multiple uptakes .............................. 0.26 0.09 0.09 0.09 0.09 0.01 0.36 0.36 0.36 0.36 XXX 78001 ......... TC ...... A Thyroid, multiple uptakes .............................. 0.00 2.28 1.55 NA NA 0.07 2.35 1.62 NA NA XXX 78003 ......... ............ A Thyroid suppress/stimul ................................ 0.33 1.99 1.31 NA NA 0.07 2.39 1.71 NA NA XXX 78003 ......... 26 ....... A Thyroid suppress/stimul ................................ 0.33 0.11 0.11 0.11 0.11 0.01 0.45 0.45 0.45 0.45 XXX 78003 ......... TC ...... A Thyroid suppress/stimul ................................ 0.00 1.88 1.20 NA NA 0.06 1.94 1.26 NA NA XXX 78006 ......... ............ A Thyroid imaging with uptake ......................... 0.49 6.49 3.54 NA NA 0.15 7.13 4.18 NA NA XXX 78006 ......... 26 ....... A Thyroid imaging with uptake ......................... 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37388 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78006 ......... TC ...... A Thyroid imaging with uptake ......................... 0.00 6.32 3.37 NA NA 0.13 6.45 3.50 NA NA XXX 78007 ......... ............ A Thyroid image, mult uptakes ......................... 0.50 3.17 2.86 NA NA 0.16 3.83 3.52 NA NA XXX 78007 ......... 26 ....... A Thyroid image, mult uptakes ......................... 0.50 0.17 0.17 0.17 0.17 0.02 0.69 0.69 0.69 0.69 XXX 78007 ......... TC ...... A Thyroid image, mult uptakes ......................... 0.00 2.99 2.68 NA NA 0.14 3.13 2.82 NA NA XXX 78010 ......... ............ A Thyroid imaging ............................................. 0.39 4.36 2.56 NA NA 0.13 4.88 3.08 NA NA XXX 78010 ......... 26 ....... A Thyroid imaging ............................................. 0.39 0.13 0.13 0.13 0.13 0.02 0.54 0.54 0.54 0.54 XXX 78010 ......... TC ...... A Thyroid imaging ............................................. 0.00 4.23 2.43 NA NA 0.11 4.34 2.54 NA NA XXX 78011 ......... ............ A Thyroid imaging with flow .............................. 0.45 4.69 3.10 NA NA 0.15 5.29 3.70 NA NA XXX 78011 ......... 26 ....... A Thyroid imaging with flow .............................. 0.45 0.15 0.15 0.15 0.15 0.02 0.62 0.62 0.62 0.62 XXX 78011 ......... TC ...... A Thyroid imaging with flow .............................. 0.00 4.54 2.95 NA NA 0.13 4.67 3.08 NA NA XXX 78015 ......... ............ A Thyroid met imaging ...................................... 0.67 5.61 3.51 NA NA 0.17 6.45 4.35 NA NA XXX 78015 ......... 26 ....... A Thyroid met imaging ...................................... 0.67 0.22 0.23 0.22 0.23 0.03 0.92 0.93 0.92 0.93 XXX 78015 ......... TC ...... A Thyroid met imaging ...................................... 0.00 5.39 3.28 NA NA 0.14 5.53 3.42 NA NA XXX 78016 ......... ............ A Thyroid met imaging/studies ......................... 0.82 8.96 5.07 NA NA 0.21 9.99 6.10 NA NA XXX 78016 ......... 26 ....... A Thyroid met imaging/studies ......................... 0.82 0.28 0.28 0.28 0.28 0.03 1.13 1.13 1.13 1.13 XXX 78016 ......... TC ...... A Thyroid met imaging/studies ......................... 0.00 8.68 4.79 NA NA 0.18 8.86 4.97 NA NA XXX 78018 ......... ............ A Thyroid met imaging, body ............................ 0.86 8.25 6.37 NA NA 0.33 9.44 7.56 NA NA XXX 78018 ......... 26 ....... A Thyroid met imaging, body ............................ 0.86 0.29 0.30 0.29 0.30 0.04 1.19 1.20 1.19 1.20 XXX 78018 ......... TC ...... A Thyroid met imaging, body ............................ 0.00 7.96 6.07 NA NA 0.29 8.25 6.36 NA NA XXX 78020 ......... ............ A Thyroid met uptake ....................................... 0.60 1.85 1.60 NA NA 0.16 2.61 2.36 NA NA ZZZ 78020 ......... 26 ....... A Thyroid met uptake ....................................... 0.60 0.20 0.21 0.20 0.21 0.02 0.82 0.83 0.82 0.83 ZZZ 78020 ......... TC ...... A Thyroid met uptake ....................................... 0.00 1.65 1.40 NA NA 0.14 1.79 1.54 NA NA ZZZ 78070 ......... ............ A Parathyroid nuclear imaging ......................... 0.82 3.59 4.32 NA NA 0.15 4.56 5.29 NA NA XXX 78070 ......... 26 ....... A Parathyroid nuclear imaging ......................... 0.82 0.28 0.28 0.28 0.28 0.04 1.14 1.14 1.14 1.14 XXX 78070 ......... TC ...... A Parathyroid nuclear imaging ......................... 0.00 3.31 4.04 NA NA 0.11 3.42 4.15 NA NA XXX 78075 ......... ............ A Adrenal nuclear imaging ............................... 0.74 11.98 7.27 NA NA 0.32 13.04 8.33 NA NA XXX 78075 ......... 26 ....... A Adrenal nuclear imaging ............................... 0.74 0.25 0.26 0.25 0.26 0.03 1.02 1.03 1.02 1.03 XXX 78075 ......... TC ...... A Adrenal nuclear imaging ............................... 0.00 11.74 7.02 NA NA 0.29 12.03 7.31 NA NA XXX 78102 ......... ............ A Bone marrow imaging, ltd ............................. 0.55 4.33 2.76 NA NA 0.14 5.02 3.45 NA NA XXX 78102 ......... 26 ....... A Bone marrow imaging, ltd ............................. 0.55 0.18 0.19 0.18 0.19 0.02 0.75 0.76 0.75 0.76 XXX 78102 ......... TC ...... A Bone marrow imaging, ltd ............................. 0.00 4.14 2.57 NA NA 0.12 4.26 2.69 NA NA XXX 78103 ......... ............ A Bone marrow imaging, mult .......................... 0.75 5.63 3.99 NA NA 0.20 6.58 4.94 NA NA XXX 78103 ......... 26 ....... A Bone marrow imaging, mult .......................... 0.75 0.25 0.26 0.25 0.26 0.03 1.03 1.04 1.03 1.04 XXX 78103 ......... TC ...... A Bone marrow imaging, mult .......................... 0.00 5.38 3.73 NA NA 0.17 5.55 3.90 NA NA XXX 78104 ......... ............ A Bone marrow imaging, body ......................... 0.80 6.52 4.89 NA NA 0.25 7.57 5.94 NA NA XXX 78104 ......... 26 ....... A Bone marrow imaging, body ......................... 0.80 0.29 0.28 0.29 0.28 0.03 1.12 1.11 1.12 1.11 XXX 78104 ......... TC ...... A Bone marrow imaging, body ......................... 0.00 6.22 4.62 NA NA 0.22 6.44 4.84 NA NA XXX 78110 ......... ............ A Plasma volume, single .................................. 0.19 2.19 1.31 NA NA 0.07 2.45 1.57 NA NA XXX 78110 ......... 26 ....... A Plasma volume, single .................................. 0.19 0.06 0.07 0.06 0.07 0.01 0.26 0.27 0.26 0.27 XXX 78110 ......... TC ...... A Plasma volume, single .................................. 0.00 2.13 1.25 NA NA 0.06 2.19 1.31 NA NA XXX 78111 ......... ............ A Plasma volume, multiple ............................... 0.22 2.23 2.55 NA NA 0.15 2.60 2.92 NA NA XXX78111 ......... 26 ....... A Plasma volume, multiple ............................... 0.22 0.07 0.08 0.07 0.08 0.01 0.30 0.31 0.30 0.31 XXX 78111 ......... TC ...... A Plasma volume, multiple ............................... 0.00 2.16 2.48 NA NA 0.14 2.30 2.62 NA NA XXX 78120 ......... ............ A Red cell mass, single .................................... 0.23 2.16 1.91 NA NA 0.12 2.51 2.26 NA NA XXX 78120 ......... 26 ....... A Red cell mass, single .................................... 0.23 0.08 0.08 0.08 0.08 0.01 0.32 0.32 0.32 0.32 XXX 78120 ......... TC ...... A Red cell mass, single .................................... 0.00 2.09 1.83 NA NA 0.11 2.20 1.94 NA NA XXX 78121 ......... ............ A Red cell mass, multiple ................................. 0.32 2.26 2.84 NA NA 0.15 2.73 3.31 NA NA XXX 78121 ......... 26 ....... A Red cell mass, multiple ................................. 0.32 0.10 0.11 0.10 0.11 0.01 0.43 0.44 0.43 0.44 XXX 78121 ......... TC ...... A Red cell mass, multiple ................................. 0.00 2.16 2.73 NA NA 0.14 2.30 2.87 NA NA XXX 78122 ......... ............ A Blood volume ................................................. 0.45 2.32 4.16 NA NA 0.26 3.03 4.87 NA NA XXX 78122 ......... 26 ....... A Blood volume ................................................. 0.45 0.15 0.16 0.15 0.16 0.02 0.62 0.63 0.62 0.63 XXX 78122 ......... TC ...... A Blood volume ................................................. 0.00 2.17 4.00 NA NA 0.24 2.41 4.24 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37389 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78130 ......... ............ A Red cell survival study .................................. 0.61 3.73 3.24 NA NA 0.17 4.51 4.02 NA NA XXX 78130 ......... 26 ....... A Red cell survival study .................................. 0.61 0.22 0.21 0.22 0.21 0.03 0.86 0.85 0.86 0.85 XXX 78130 ......... TC ...... A Red cell survival study .................................. 0.00 3.52 3.03 NA NA 0.14 3.66 3.17 NA NA XXX 78135 ......... ............ A Red cell survival kinetics ............................... 0.64 8.87 6.04 NA NA 0.28 9.79 6.96 NA NA XXX 78135 ......... 26 ....... A Red cell survival kinetics ............................... 0.64 0.21 0.22 0.21 0.22 0.03 0.88 0.89 0.88 0.89 XXX 78135 ......... TC ...... A Red cell survival kinetics ............................... 0.00 8.66 5.83 NA NA 0.25 8.91 6.08 NA NA XXX 78140 ......... ............ A Red cell sequestration ................................... 0.61 3.02 3.86 NA NA 0.24 3.87 4.71 NA NA XXX 78140 ......... 26 ....... A Red cell sequestration ................................... 0.61 0.21 0.20 0.21 0.20 0.03 0.85 0.84 0.85 0.84 XXX 78140 ......... TC ...... A Red cell sequestration ................................... 0.00 2.81 3.66 NA NA 0.21 3.02 3.87 NA NA XXX 78185 ......... ............ A Spleen imaging .............................................. 0.40 5.42 3.24 NA NA 0.15 5.97 3.79 NA NA XXX 78185 ......... 26 ....... A Spleen imaging .............................................. 0.40 0.14 0.14 0.14 0.14 0.02 0.56 0.56 0.56 0.56 XXX 78185 ......... TC ...... A Spleen imaging .............................................. 0.00 5.29 3.10 NA NA 0.13 5.42 3.23 NA NA XXX 78190 ......... ............ A Platelet survival, kinetics ............................... 1.09 9.21 6.89 NA NA 0.38 10.68 8.36 NA NA XXX 78190 ......... 26 ....... A Platelet survival, kinetics ............................... 1.09 0.35 0.38 0.35 0.38 0.08 1.52 1.55 1.52 1.55 XXX 78190 ......... TC ...... A Platelet survival, kinetics ............................... 0.00 8.85 6.51 NA NA 0.30 9.15 6.81 NA NA XXX78191 ......... ............ A Platelet survival ............................................. 0.61 3.62 6.58 NA NA 0.40 4.63 7.59 NA NA XXX 78191 ......... 26 ....... A Platelet survival ............................................. 0.61 0.21 0.20 0.21 0.20 0.03 0.85 0.84 0.85 0.84 XXX 78191 ......... TC ...... A Platelet survival ............................................. 0.00 3.41 6.37 NA NA 0.37 3.78 6.74 NA NA XXX 78195 ......... ............ A Lymph system imaging ................................. 1.20 9.02 5.62 NA NA 0.28 10.50 7.10 NA NA XXX78195 ......... 26 ....... A Lymph system imaging ................................. 1.20 0.40 0.41 0.40 0.41 0.06 1.66 1.67 1.66 1.67 XXX 78195 ......... TC ...... A Lymph system imaging ................................. 0.00 8.62 5.22 NA NA 0.22 8.84 5.44 NA NA XXX 78201 ......... ............ A Liver imaging ................................................. 0.44 4.94 3.13 NA NA 0.15 5.53 3.72 NA NA XXX 78201 ......... 26 ....... A Liver imaging ................................................. 0.44 0.15 0.15 0.15 0.15 0.02 0.61 0.61 0.61 0.61 XXX 78201 ......... TC ...... A Liver imaging ................................................. 0.00 4.80 2.98 NA NA 0.13 4.93 3.11 NA NA XXX 78202 ......... ............ A Liver imaging with flow .................................. 0.51 5.50 3.67 NA NA 0.16 6.17 4.34 NA NA XXX 78202 ......... 26 ....... A Liver imaging with flow .................................. 0.51 0.17 0.17 0.17 0.17 0.02 0.70 0.70 0.70 0.70 XXX 78202 ......... TC ...... A Liver imaging with flow .................................. 0.00 5.33 3.50 NA NA 0.14 5.47 3.64 NA NA XXX 78205 ......... ............ A Liver imaging (3D) ......................................... 0.71 5.48 6.00 NA NA 0.34 6.53 7.05 NA NA XXX 78205 ......... 26 ....... A Liver imaging (3D) ......................................... 0.71 0.24 0.24 0.24 0.24 0.03 0.98 0.98 0.98 0.98 XXX 78205 ......... TC ...... A Liver imaging (3D) ......................................... 0.00 5.23 5.76 NA NA 0.31 5.54 6.07 NA NA XXX 78206 ......... ............ A Liver image (3d) with flow ............................. 0.96 15.15 8.48 NA NA 0.15 16.26 9.59 NA NA XXX 78206 ......... 26 ....... A Liver image (3d) with flow ............................. 0.96 0.33 0.33 0.33 0.33 0.04 1.33 1.33 1.33 1.33 XXX 78206 ......... TC ...... A Liver image (3d) with flow ............................. 0.00 14.82 8.15 NA NA 0.11 14.93 8.26 NA NA XXX 78215 ......... ............ A Liver and spleen imaging .............................. 0.49 5.02 3.59 NA NA 0.16 5.67 4.24 NA NA XXX78215 ......... 26 ....... A Liver and spleen imaging .............................. 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 78215 ......... TC ...... A Liver and spleen imaging .............................. 0.00 4.85 3.43 NA NA 0.14 4.99 3.57 NA NA XXX 78216 ......... ............ A Liver & spleen image/flow ............................. 0.57 2.94 3.50 NA NA 0.20 3.71 4.27 NA NA XXX78216 ......... 26 ....... A Liver & spleen image/flow ............................. 0.57 0.19 0.19 0.19 0.19 0.02 0.78 0.78 0.78 0.78 XXX 78216 ......... TC ...... A Liver & spleen image/flow ............................. 0.00 2.75 3.31 NA NA 0.18 2.93 3.49 NA NA XXX 78220 ......... ............ A Liver function study ....................................... 0.49 3.19 3.72 NA NA 0.21 3.89 4.42 NA NA XXX 78220 ......... 26 ....... A Liver function study ....................................... 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 78220 ......... TC ...... A Liver function study ....................................... 0.00 3.02 3.55 NA NA 0.19 3.21 3.74 NA NA XXX 78223 ......... ............ A Hepatobiliary imaging .................................... 0.84 8.87 5.18 NA NA 0.23 9.94 6.25 NA NA XXX 78223 ......... 26 ....... A Hepatobiliary imaging .................................... 0.84 0.29 0.28 0.29 0.28 0.04 1.17 1.16 1.17 1.16 XXX 78223 ......... TC ...... A Hepatobiliary imaging .................................... 0.00 8.58 4.90 NA NA 0.19 8.77 5.09 NA NA XXX 78230 ......... ............ A Salivary gland imaging .................................. 0.45 4.31 2.83 NA NA 0.15 4.91 3.43 NA NA XXX 78230 ......... 26 ....... A Salivary gland imaging .................................. 0.45 0.15 0.15 0.15 0.15 0.02 0.62 0.62 0.62 0.62 XXX 78230 ......... TC ...... A Salivary gland imaging .................................. 0.00 4.16 2.68 NA NA 0.13 4.29 2.81 NA NA XXX 78231 ......... ............ A Serial salivary imaging .................................. 0.52 2.89 3.24 NA NA 0.19 3.60 3.95 NA NA XXX 78231 ......... 26 ....... A Serial salivary imaging .................................. 0.52 0.17 0.18 0.17 0.18 0.02 0.71 0.72 0.71 0.72 XXX 78231 ......... TC ...... A Serial salivary imaging .................................. 0.00 2.72 3.07 NA NA 0.17 2.89 3.24 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37390 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78232 ......... ............ A Salivary gland function exam ........................ 0.47 2.86 3.50 NA NA 0.20 3.53 4.17 NA NA XXX 78232 ......... 26 ....... A Salivary gland function exam ........................ 0.47 0.15 0.16 0.15 0.16 0.02 0.64 0.65 0.64 0.65 XXX 78232 ......... TC ...... A Salivary gland function exam ........................ 0.00 2.71 3.34 NA NA 0.18 2.89 3.52 NA NA XXX 78258 ......... ............ A Esophageal motility study ............................. 0.74 6.03 3.86 NA NA 0.17 6.94 4.77 NA NA XXX78258 ......... 26 ....... A Esophageal motility study ............................. 0.74 0.28 0.26 0.28 0.26 0.03 1.05 1.03 1.05 1.03 XXX 78258 ......... TC ...... A Esophageal motility study ............................. 0.00 5.74 3.60 NA NA 0.14 5.88 3.74 NA NA XXX 78261 ......... ............ A Gastric mucosa imaging ................................ 0.69 6.33 4.85 NA NA 0.25 7.27 5.79 NA NA XXX78261 ......... 26 ....... A Gastric mucosa imaging ................................ 0.69 0.24 0.24 0.24 0.24 0.03 0.96 0.96 0.96 0.96 XXX 78261 ......... TC ...... A Gastric mucosa imaging ................................ 0.00 6.09 4.61 NA NA 0.22 6.31 4.83 NA NA XXX 78262 ......... ............ A Gastroesophageal reflux exam ..................... 0.68 6.11 4.90 NA NA 0.25 7.04 5.83 NA NA XXX 78262 ......... 26 ....... A Gastroesophageal reflux exam ..................... 0.68 0.21 0.23 0.21 0.23 0.03 0.92 0.94 0.92 0.94 XXX78262 ......... TC ...... A Gastroesophageal reflux exam ..................... 0.00 5.89 4.67 NA NA 0.22 6.11 4.89 NA NA XXX 78264 ......... ............ A Gastric emptying study .................................. 0.78 7.47 5.17 NA NA 0.25 8.50 6.20 NA NA XXX 78264 ......... 26 ....... A Gastric emptying study .................................. 0.78 0.27 0.26 0.27 0.26 0.03 1.08 1.07 1.08 1.07 XXX 78264 ......... TC ...... A Gastric emptying study .................................. 0.00 7.20 4.91 NA NA 0.22 7.42 5.13 NA NA XXX 78270 ......... ............ A Vit B-12 absorption exam .............................. 0.20 2.00 1.72 NA NA 0.11 2.31 2.03 NA NA XXX78270 ......... 26 ....... A Vit B-12 absorption exam .............................. 0.20 0.06 0.07 0.06 0.07 0.01 0.27 0.28 0.27 0.28 XXX 78270 ......... TC ...... A Vit B-12 absorption exam .............................. 0.00 1.94 1.65 NA NA 0.10 2.04 1.75 NA NA XXX 78271 ......... ............ A Vit b-12 absrp exam, int fac .......................... 0.20 1.94 1.77 NA NA 0.11 2.25 2.08 NA NA XXX78271 ......... 26 ....... A Vit b-12 absrp exam, int fac .......................... 0.20 0.05 0.07 0.05 0.07 0.01 0.26 0.28 0.26 0.28 XXX 78271 ......... TC ...... A Vit b-12 absrp exam, int fac .......................... 0.00 1.88 1.70 NA NA 0.10 1.98 1.80 NA NA XXX 78272 ......... ............ A Vit B-12 absorp, combined ............................ 0.27 2.04 2.33 NA NA 0.14 2.45 2.74 NA NA XXX 78272 ......... 26 ....... A Vit B-12 absorp, combined ............................ 0.27 0.07 0.09 0.07 0.09 0.01 0.35 0.37 0.35 0.37 XXX 78272 ......... TC ...... A Vit B-12 absorp, combined ............................ 0.00 1.97 2.24 NA NA 0.13 2.10 2.37 NA NA XXX 78278 ......... ............ A Acute GI blood loss imaging ......................... 0.99 8.96 6.15 NA NA 0.29 10.24 7.43 NA NA XXX 78278 ......... 26 ....... A Acute GI blood loss imaging ......................... 0.99 0.34 0.33 0.34 0.33 0.04 1.37 1.36 1.37 1.36 XXX 78278 ......... TC ...... A Acute GI blood loss imaging ......................... 0.00 8.62 5.82 NA NA 0.25 8.87 6.07 NA NA XXX 78282 ......... 26 ....... A GI protein loss exam ..................................... 0.38 0.13 0.13 0.13 0.13 0.02 0.53 0.53 0.53 0.53 XXX 78290 ......... ............ A MeckelIs divert exam .................................... 0.68 8.85 4.68 NA NA 0.19 9.72 5.55 NA NA XXX 78290 ......... 26 ....... A MeckelIs divert exam .................................... 0.68 0.23 0.23 0.23 0.23 0.03 0.94 0.94 0.94 0.94 XXX 78290 ......... TC ...... A MeckelIs divert exam .................................... 0.00 8.62 4.45 NA NA 0.16 8.78 4.61 NA NA XXX 78291 ......... ............ A Leveen/shunt patency exam ......................... 0.88 6.41 4.13 NA NA 0.20 7.49 5.21 NA NA XXX 78291 ......... 26 ....... A Leveen/shunt patency exam ......................... 0.88 0.30 0.30 0.30 0.30 0.04 1.22 1.22 1.22 1.22 XXX 78291 ......... TC ...... A Leveen/shunt patency exam ......................... 0.00 6.12 3.83 NA NA 0.16 6.28 3.99 NA NA XXX 78300 ......... ............ A Bone imaging, limited area ........................... 0.62 4.39 3.12 NA NA 0.17 5.18 3.91 NA NA XXX 78300 ......... 26 ....... A Bone imaging, limited area ........................... 0.62 0.21 0.21 0.21 0.21 0.03 0.86 0.86 0.86 0.86 XXX 78300 ......... TC ...... A Bone imaging, limited area ........................... 0.00 4.18 2.91 NA NA 0.14 4.32 3.05 NA NA XXX 78305 ......... ............ A Bone imaging, multiple areas ........................ 0.83 5.66 4.38 NA NA 0.23 6.72 5.44 NA NA XXX 78305 ......... 26 ....... A Bone imaging, multiple areas ........................ 0.83 0.28 0.28 0.28 0.28 0.04 1.15 1.15 1.15 1.15 XXX 78305 ......... TC ...... A Bone imaging, multiple areas ........................ 0.00 5.39 4.10 NA NA 0.19 5.58 4.29 NA NA XXX 78306 ......... ............ A Bone imaging, whole body ............................ 0.86 6.32 5.01 NA NA 0.26 7.44 6.13 NA NA XXX 78306 ......... 26 ....... A Bone imaging, whole body ............................ 0.86 0.30 0.29 0.30 0.29 0.04 1.20 1.19 1.20 1.19 XXX 78306 ......... TC ...... A Bone imaging, whole body ............................ 0.00 6.03 4.72 NA NA 0.22 6.25 4.94 NA NA XXX 78315 ......... ............ A Bone imaging, 3 phase ................................. 1.02 8.95 6.09 NA NA 0.29 10.26 7.40 NA NA XXX 78315 ......... 26 ....... A Bone imaging, 3 phase ................................. 1.02 0.35 0.34 0.35 0.34 0.04 1.41 1.40 1.41 1.40 XXX 78315 ......... TC ...... A Bone imaging, 3 phase ................................. 0.00 8.60 5.74 NA NA 0.25 8.85 5.99 NA NA XXX 78320 ......... ............ A Bone imaging (3D) ........................................ 1.04 5.57 6.11 NA NA 0.35 6.96 7.50 NA NA XXX 78320 ......... 26 ....... A Bone imaging (3D) ........................................ 1.04 0.35 0.36 0.35 0.36 0.04 1.43 1.44 1.43 1.44 XXX 78320 ......... TC ...... A Bone imaging (3D) ........................................ 0.00 5.21 5.75 NA NA 0.31 5.52 6.06 NA NA XXX 78350 ......... ............ A Bone mineral, single photon ......................... 0.22 1.91 1.09 NA NA 0.06 2.19 1.37 NA NA XXX 78350 ......... 26 ....... A Bone mineral, single photon ......................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 78350 ......... TC ...... A Bone mineral, single photon ......................... 0.00 1.84 1.02 NA NA 0.05 1.89 1.07 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37391 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78351 ......... ............ N Bone mineral, dual photon ............................ 0.30 2.77 1.98 0.07 0.11 0.01 3.08 2.29 0.38 0.42 XXX 78414 ......... 26 ....... A Non-imaging heart function ........................... 0.45 0.14 0.16 0.14 0.16 0.02 0.61 0.63 0.61 0.63 XXX 78428 ......... ............ A Cardiac shunt imaging .................................. 0.78 5.47 3.28 NA NA 0.16 6.41 4.22 NA NA XXX 78428 ......... 26 ....... A Cardiac shunt imaging .................................. 0.78 0.39 0.32 0.39 0.32 0.03 1.20 1.13 1.20 1.13 XXX 78428 ......... TC ...... A Cardiac shunt imaging .................................. 0.00 5.08 2.97 NA NA 0.13 5.21 3.10 NA NA XXX 78445 ......... ............ A Vascular flow imaging ................................... 0.49 4.73 2.71 NA NA 0.13 5.35 3.33 NA NA XXX 78445 ......... 26 ....... A Vascular flow imaging ................................... 0.49 0.19 0.18 0.19 0.18 0.02 0.70 0.69 0.70 0.69 XXX 78445 ......... TC ...... A Vascular flow imaging ................................... 0.00 4.55 2.54 NA NA 0.11 4.66 2.65 NA NA XXX 78456 ......... ............ A Acute venous thrombus image ..................... 1.00 10.25 5.81 NA NA 0.33 11.58 7.14 NA NA XXX 78456 ......... 26 ....... A Acute venous thrombus image ..................... 1.00 0.52 0.39 0.52 0.39 0.04 1.56 1.43 1.56 1.43 XXX 78456 ......... TC ...... A Acute venous thrombus image ..................... 0.00 9.74 5.43 NA NA 0.29 10.03 5.72 NA NA XXX 78457 ......... ............ A Venous thrombosis imaging .......................... 0.77 4.86 3.41 NA NA 0.17 5.80 4.35 NA NA XXX 78457 ......... 26 ....... A Venous thrombosis imaging .......................... 0.77 0.25 0.26 0.25 0.26 0.03 1.05 1.06 1.05 1.06 XXX 78458 ......... ............ A Ven thrombosis images, bilat ........................ 0.90 4.71 4.44 NA NA 0.25 5.86 5.59 NA NA XXX 78458 ......... 26 ....... A Ven thrombosis images, bilat ........................ 0.90 0.29 0.31 0.29 0.31 0.04 1.23 1.25 1.23 1.25 XXX 78458 ......... TC ...... A Ven thrombosis images, bilat ........................ 0.00 4.42 4.13 NA NA 0.21 4.63 4.34 NA NA XXX 78459 ......... 26 ....... A Heart muscle imaging (PET) ......................... 1.50 0.58 0.57 0.58 0.57 0.05 2.13 2.12 2.13 2.12 XXX 78460 ......... ............ A Heart muscle blood, single ............................ 0.86 4.86 3.21 NA NA 0.17 5.89 4.24 NA NA XXX78460 ......... 26 ....... A Heart muscle blood, single ............................ 0.86 0.31 0.30 0.31 0.30 0.04 1.21 1.20 1.21 1.20 XXX 78460 ......... TC ...... A Heart muscle blood, single ............................ 0.00 4.54 2.91 NA NA 0.13 4.67 3.04 NA NA XXX 78461 ......... ............ A Heart muscle blood, multiple ......................... 1.23 4.20 4.92 NA NA 0.30 5.73 6.45 NA NA XXX 78461 ......... 26 ....... A Heart muscle blood, multiple ......................... 1.23 0.45 0.44 0.45 0.44 0.05 1.73 1.72 1.73 1.72 XXX 78461 ......... TC ...... A Heart muscle blood, multiple ......................... 0.00 3.75 4.49 NA NA 0.25 4.00 4.74 NA NA XXX 78464 ......... ............ A Heart image (3d), single ................................ 1.09 6.05 7.12 NA NA 0.41 7.55 8.62 NA NA XXX 78464 ......... 26 ....... A Heart image (3d), single ................................ 1.09 0.51 0.41 0.51 0.41 0.04 1.64 1.54 1.64 1.54 XXX 78464 ......... TC ...... A Heart image (3d), single ................................ 0.00 5.54 6.70 NA NA 0.37 5.91 7.07 NA NA XXX 78465 ......... ............ A Heart image (3d), multiple ............................. 1.46 11.81 12.21 NA NA 0.67 13.94 14.34 NA NA XXX 78465 ......... 26 ....... A Heart image (3d), multiple ............................. 1.46 0.73 0.57 0.73 0.57 0.05 2.24 2.08 2.24 2.08 XXX 78465 ......... TC ...... A Heart image (3d), multiple ............................. 0.00 11.08 11.64 NA NA 0.62 11.70 12.26 NA NA XXX 78466 ......... ............ A Heart infarct image ........................................ 0.69 4.66 3.32 NA NA 0.17 5.52 4.18 NA NA XXX 78466 ......... 26 ....... A Heart infarct image ........................................ 0.69 0.27 0.25 0.27 0.25 0.03 0.99 0.97 0.99 0.97 XXX 78466 ......... TC ...... A Heart infarct image ........................................ 0.00 4.39 3.07 NA NA 0.14 4.53 3.21 NA NA XXX 78468 ......... ............ A Heart infarct image (ef) ................................. 0.80 6.19 4.50 NA NA 0.22 7.21 5.52 NA NA XXX 78468 ......... 26 ....... A Heart infarct image (ef) ................................. 0.80 0.43 0.31 0.43 0.31 0.03 1.26 1.14 1.26 1.14 XXX 78468 ......... TC ...... A Heart infarct image (ef) ................................. 0.00 5.76 4.19 NA NA 0.19 5.95 4.38 NA NA XXX 78469 ......... ............ A Heart infarct image (3D) ................................ 0.92 6.39 5.76 NA NA 0.31 7.62 6.99 NA NA XXX 78469 ......... 26 ....... A Heart infarct image (3D) ................................ 0.92 0.44 0.34 0.44 0.34 0.03 1.39 1.29 1.39 1.29 XXX 78469 ......... TC ...... A Heart infarct image (3D) ................................ 0.00 5.95 5.42 NA NA 0.28 6.23 5.70 NA NA XXX 78472 ......... ............ A Gated heart, planar, single ............................ 0.98 5.20 5.70 NA NA 0.34 6.52 7.02 NA NA XXX 78472 ......... 26 ....... A Gated heart, planar, single ............................ 0.98 0.42 0.36 0.42 0.36 0.04 1.44 1.38 1.44 1.38 XXX 78472 ......... TC ...... A Gated heart, planar, single ............................ 0.00 4.77 5.34 NA NA 0.30 5.07 5.64 NA NA XXX 78473 ......... ............ A Gated heart, multiple ..................................... 1.47 9.63 9.00 NA NA 0.48 11.58 10.95 NA NA XXX 78473 ......... 26 ....... A Gated heart, multiple ..................................... 1.47 0.65 0.55 0.65 0.55 0.06 2.18 2.08 2.18 2.08 XXX 78473 ......... TC ...... A Gated heart, multiple ..................................... 0.00 8.99 8.46 NA NA 0.42 9.41 8.88 NA NA XXX78478 ......... ............ A Heart wall motion add-on .............................. 0.50 0.83 1.55 NA NA 0.12 1.45 2.17 NA NA XXX78478 ......... 26 ....... A Heart wall motion add-on .............................. 0.50 0.25 0.24 0.25 0.24 0.02 0.77 0.76 0.77 0.76 XXX 78478 ......... TC ...... A Heart wall motion add-on .............................. 0.00 0.58 1.32 NA NA 0.10 0.68 1.42 NA NA XXX 78480 ......... ............ A Heart function add-on .................................... 0.30 0.73 1.52 NA NA 0.12 1.15 1.94 NA NA XXX 78480 ......... 26 ....... A Heart function add-on .................................... 0.30 0.15 0.20 0.15 0.20 0.02 0.47 0.52 0.47 0.52 XXX 78480 ......... TC ...... A Heart function add-on .................................... 0.00 0.58 1.32 NA NA 0.10 0.68 1.42 NA NA XXX 78481 ......... ............ A Heart first pass, single .................................. 0.98 1.30 4.53 NA NA 0.31 2.59 5.82 NA NA XXX 78481 ......... 26 ....... A Heart first pass, single .................................. 0.98 0.51 0.40 0.51 0.40 0.03 1.52 1.41 1.52 1.41 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37392 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78481 ......... TC ...... A Heart first pass, single .................................. 0.00 0.79 4.13 NA NA 0.28 1.07 4.41 NA NA XXX78483 ......... ............ A Heart first pass, multiple ............................... 1.47 7.41 8.18 NA NA 0.46 9.34 10.11 NA NA XXX 78483 ......... 26 ....... A Heart first pass, multiple ............................... 1.47 0.81 0.61 0.81 0.61 0.05 2.33 2.13 2.33 2.13 XXX 78483 ......... TC ...... A Heart first pass, multiple ............................... 0.00 6.61 7.57 NA NA 0.41 7.02 7.98 NA NA XXX 78491 ......... 26 ....... A Heart image (pet), single ............................... 1.50 0.65 0.61 0.65 0.61 0.06 2.21 2.17 2.21 2.17 XXX 78492 ......... 26 ....... A Heart image (pet), multiple ............................ 1.87 0.93 0.79 0.93 0.79 0.07 2.87 2.73 2.87 2.73 XXX 78494 ......... ............ A Heart image, spect ........................................ 1.19 6.42 7.24 NA NA 0.35 7.96 8.78 NA NA XXX 78494 ......... 26 ....... A Heart image, spect ........................................ 1.19 0.56 0.46 0.56 0.46 0.05 1.80 1.70 1.80 1.70 XXX 78494 ......... TC ...... A Heart image, spect ........................................ 0.00 5.86 6.78 NA NA 0.30 6.16 7.08 NA NA XXX78496 ......... ............ A Heart first pass add-on .................................. 0.50 0.95 5.69 NA NA 0.32 1.77 6.51 NA NA ZZZ 78496 ......... 26 ....... A Heart first pass add-on .................................. 0.50 0.25 0.20 0.25 0.20 0.02 0.77 0.72 0.77 0.72 ZZZ 78496 ......... TC ...... A Heart first pass add-on .................................. 0.00 0.69 5.49 NA NA 0.30 0.99 5.79 NA NA ZZZ 78580 ......... ............ A Lung perfusion imaging ................................. 0.74 5.33 4.10 NA NA 0.21 6.28 5.05 NA NA XXX 78580 ......... 26 ....... A Lung perfusion imaging ................................. 0.74 0.26 0.25 0.26 0.25 0.03 1.03 1.02 1.03 1.02 XXX 78580 ......... TC ...... A Lung perfusion imaging ................................. 0.00 5.07 3.85 NA NA 0.18 5.25 4.03 NA NA XXX 78584 ......... ............ A Lung V/Q image single breath ...................... 0.99 3.10 3.43 NA NA 0.21 4.30 4.63 NA NA XXX 78584 ......... 26 ....... A Lung V/Q image single breath ...................... 0.99 0.34 0.33 0.34 0.33 0.04 1.37 1.36 1.37 1.36 XXX 78584 ......... TC ...... A Lung V/Q image single breath ...................... 0.00 2.76 3.10 NA NA 0.17 2.93 3.27 NA NA XXX 78585 ......... ............ A Lung V/Q imaging ......................................... 1.09 8.99 6.76 NA NA 0.35 10.43 8.20 NA NA XXX 78585 ......... 26 ....... A Lung V/Q imaging ......................................... 1.09 0.37 0.36 0.37 0.36 0.05 1.51 1.50 1.51 1.50 XXX 78585 ......... TC ...... A Lung V/Q imaging ......................................... 0.00 8.61 6.40 NA NA 0.30 8.91 6.70 NA NA XXX 78586 ......... ............ A Aerosol lung image, single ............................ 0.40 4.33 3.13 NA NA 0.16 4.89 3.69 NA NA XXX78586 ......... 26 ....... A Aerosol lung image, single ............................ 0.40 0.14 0.13 0.14 0.13 0.02 0.56 0.55 0.56 0.55 XXX 78586 ......... TC ...... A Aerosol lung image, single ............................ 0.00 4.19 3.00 NA NA 0.14 4.33 3.14 NA NA XXX 78587 ......... ............ A Aerosol lung image, multiple ......................... 0.49 5.64 3.65 NA NA 0.16 6.29 4.30 NA NA XXX 78587 ......... 26 ....... A Aerosol lung image, multiple ......................... 0.49 0.17 0.17 0.17 0.17 0.02 0.68 0.68 0.68 0.68 XXX 78587 ......... TC ...... A Aerosol lung image, multiple ......................... 0.00 5.47 3.48 NA NA 0.14 5.61 3.62 NA NA XXX 78588 ......... ............ A Perfusion lung image .................................... 1.09 9.02 4.93 NA NA 0.23 10.34 6.25 NA NA XXX 78588 ......... 26 ....... A Perfusion lung image .................................... 1.09 0.37 0.36 0.37 0.36 0.05 1.51 1.50 1.51 1.50 XXX 78588 ......... TC ...... A Perfusion lung image .................................... 0.00 8.64 4.57 NA NA 0.18 8.82 4.75 NA NA XXX 78591 ......... ............ A Vent image, 1 breath, 1 proj ......................... 0.40 4.33 3.33 NA NA 0.16 4.89 3.89 NA NA XXX 78591 ......... 26 ....... A Vent image, 1 breath, 1 proj ......................... 0.40 0.14 0.13 0.14 0.13 0.02 0.56 0.55 0.56 0.55 XXX 78591 ......... TC ...... A Vent image, 1 breath, 1 proj ......................... 0.00 4.19 3.19 NA NA 0.14 4.33 3.33 NA NA XXX 78593 ......... ............ A Vent image, 1 proj, gas ................................. 0.49 5.01 3.97 NA NA 0.20 5.70 4.66 NA NA XXX 78593 ......... 26 ....... A Vent image, 1 proj, gas ................................. 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 78593 ......... TC ...... A Vent image, 1 proj, gas ................................. 0.00 4.84 3.81 NA NA 0.18 5.02 3.99 NA NA XXX 78594 ......... ............ A Vent image, mult proj, gas ............................ 0.53 5.48 5.25 NA NA 0.27 6.28 6.05 NA NA XXX78594 ......... 26 ....... A Vent image, mult proj, gas ............................ 0.53 0.17 0.18 0.17 0.18 0.02 0.72 0.73 0.72 0.73 XXX 78594 ......... TC ...... A Vent image, mult proj, gas ............................ 0.00 5.31 5.07 NA NA 0.25 5.56 5.32 NA NA XXX 78596 ......... ............ A Lung differential function ............................... 1.27 8.98 7.88 NA NA 0.42 10.67 9.57 NA NA XXX 78596 ......... 26 ....... A Lung differential function ............................... 1.27 0.39 0.41 0.39 0.41 0.05 1.71 1.73 1.71 1.73 XXX 78596 ......... TC ...... A Lung differential function ............................... 0.00 8.59 7.47 NA NA 0.37 8.96 7.84 NA NA XXX 78600 ......... ............ A Brain imaging, ltd static ................................. 0.44 7.54 4.17 NA NA 0.16 8.14 4.77 NA NA XXX 78600 ......... 26 ....... A Brain imaging, ltd static ................................. 0.44 0.15 0.15 0.15 0.15 0.02 0.61 0.61 0.61 0.61 XXX 78600 ......... TC ...... A Brain imaging, ltd static ................................. 0.00 7.39 4.02 NA NA 0.14 7.53 4.16 NA NA XXX78601 ......... ............ A Brain imaging, ltd w/flow ............................... 0.51 5.58 4.08 NA NA 0.20 6.29 4.79 NA NA XXX 78601 ......... 26 ....... A Brain imaging, ltd w/flow ............................... 0.51 0.17 0.17 0.17 0.17 0.02 0.70 0.70 0.70 0.70 XXX 78601 ......... TC ...... A Brain imaging, ltd w/flow ............................... 0.00 5.40 3.91 NA NA 0.18 5.58 4.09 NA NA XXX 78605 ......... ............ A Brain imaging, complete ................................ 0.53 4.96 3.93 NA NA 0.20 5.69 4.66 NA NA XXX 78605 ......... 26 ....... A Brain imaging, complete ................................ 0.53 0.18 0.18 0.18 0.18 0.02 0.73 0.73 0.73 0.73 XXX 78605 ......... TC ...... A Brain imaging, complete ................................ 0.00 4.78 3.75 NA NA 0.18 4.96 3.93 NA NA XXX 78606 ......... ............ A Brain imaging, compl w/flow ......................... 0.64 8.89 5.29 NA NA 0.24 9.77 6.17 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37393 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78606 ......... 26 ....... A Brain imaging, compl w/flow ......................... 0.64 0.22 0.21 0.22 0.21 0.03 0.89 0.88 0.89 0.88 XXX 78606 ......... TC ...... A Brain imaging, compl w/flow ......................... 0.00 8.67 5.08 NA NA 0.21 8.88 5.29 NA NA XXX 78607 ......... ............ A Brain imaging (3D) ........................................ 1.23 15.67 9.17 NA NA 0.40 17.30 10.80 NA NA XXX 78607 ......... 26 ....... A Brain imaging (3D) ........................................ 1.23 0.41 0.43 0.41 0.43 0.05 1.69 1.71 1.69 1.71 XXX 78607 ......... TC ...... A Brain imaging (3D) ........................................ 0.00 15.26 8.74 NA NA 0.35 15.61 9.09 NA NA XXX 78608 ......... 26 ....... A Brain imaging (PET) ...................................... 1.50 0.50 0.51 0.50 0.51 0.06 2.06 2.07 2.06 2.07 XXX 78609 ......... 26 ....... A Brain imaging (PET) ...................................... 1.50 0.52 0.51 0.52 0.51 0.06 2.08 2.07 2.08 2.07 XXX 78610 ......... ............ A Brain flow imaging only ................................. 0.30 4.62 2.42 NA NA 0.11 5.03 2.83 NA NA XXX 78610 ......... 26 ....... A Brain flow imaging only ................................. 0.30 0.10 0.11 0.10 0.11 0.01 0.41 0.42 0.41 0.42 XXX 78610 ......... TC ...... A Brain flow imaging only ................................. 0.00 4.52 2.32 NA NA 0.10 4.62 2.42 NA NA XXX 78615 ......... ............ A Cerebral vascular flow image ........................ 0.42 5.53 4.39 NA NA 0.23 6.18 5.04 NA NA XXX 78615 ......... 26 ....... A Cerebral vascular flow image ........................ 0.42 0.14 0.15 0.14 0.15 0.02 0.58 0.59 0.58 0.59 XXX 78615 ......... TC ...... A Cerebral vascular flow image ........................ 0.00 5.39 4.24 NA NA 0.21 5.60 4.45 NA NA XXX 78630 ......... ............ A Cerebrospinal fluid scan ................................ 0.68 8.99 6.21 NA NA 0.30 9.97 7.19 NA NA XXX 78630 ......... 26 ....... A Cerebrospinal fluid scan ................................ 0.68 0.23 0.23 0.23 0.23 0.03 0.94 0.94 0.94 0.94 XXX 78630 ......... TC ...... A Cerebrospinal fluid scan ................................ 0.00 8.76 5.98 NA NA 0.27 9.03 6.25 NA NA XXX 78635 ......... ............ A CSF ventriculography .................................... 0.61 8.91 4.31 NA NA 0.16 9.68 5.08 NA NA XXX 78635 ......... 26 ....... A CSF ventriculography .................................... 0.61 0.21 0.23 0.21 0.23 0.02 0.84 0.86 0.84 0.86 XXX 78635 ......... TC ...... A CSF ventriculography .................................... 0.00 8.70 4.09 NA NA 0.14 8.84 4.23 NA NA XXX 78645 ......... ............ A CSF shunt evaluation .................................... 0.57 8.80 4.92 NA NA 0.20 9.57 5.69 NA NA XXX 78645 ......... 26 ....... A CSF shunt evaluation .................................... 0.57 0.19 0.19 0.19 0.19 0.02 0.78 0.78 0.78 0.78 XXX 78645 ......... TC ...... A CSF shunt evaluation .................................... 0.00 8.61 4.73 NA NA 0.18 8.79 4.91 NA NA XXX 78647 ......... ............ A Cerebrospinal fluid scan ................................ 0.90 14.68 8.35 NA NA 0.35 15.93 9.60 NA NA XXX 78647 ......... 26 ....... A Cerebrospinal fluid scan ................................ 0.90 0.28 0.30 0.28 0.30 0.04 1.22 1.24 1.22 1.24 XXX 78647 ......... TC ...... A Cerebrospinal fluid scan ................................ 0.00 14.40 8.05 NA NA 0.31 14.71 8.36 NA NA XXX78650 ......... ............ A CSF leakage imaging .................................... 0.61 8.97 5.89 NA NA 0.27 9.85 6.77 NA NA XXX 78650 ......... 26 ....... A CSF leakage imaging .................................... 0.61 0.21 0.21 0.21 0.21 0.03 0.85 0.85 0.85 0.85 XXX 78650 ......... TC ...... A CSF leakage imaging .................................... 0.00 8.76 5.68 NA NA 0.24 9.00 5.92 NA NA XXX 78660 ......... ............ A Nuclear exam of tear flow ............................. 0.53 4.40 2.83 NA NA 0.14 5.07 3.50 NA NA XXX78660 ......... 26 ....... A Nuclear exam of tear flow ............................. 0.53 0.18 0.18 0.18 0.18 0.02 0.73 0.73 0.73 0.73 XXX 78660 ......... TC ...... A Nuclear exam of tear flow ............................. 0.00 4.22 2.65 NA NA 0.12 4.34 2.77 NA NA XXX 78700 ......... ............ A Kidney imaging, static ................................... 0.45 4.63 3.57 NA NA 0.18 5.26 4.20 NA NA XXX 78700 ......... 26 ....... A Kidney imaging, static ................................... 0.45 0.16 0.15 0.16 0.15 0.02 0.63 0.62 0.63 0.62 XXX 78700 ......... TC ...... A Kidney imaging, static ................................... 0.00 4.47 3.41 NA NA 0.16 4.63 3.57 NA NA XXX 78701 ......... ............ A Kidney imaging with flow ............................... 0.49 5.60 4.20 NA NA 0.20 6.29 4.89 NA NA XXX 78701 ......... 26 ....... A Kidney imaging with flow ............................... 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 78701 ......... TC ...... A Kidney imaging with flow ............................... 0.00 5.43 4.04 NA NA 0.18 5.61 4.22 NA NA XXX 78704 ......... ............ A Imaging renogram ......................................... 0.74 5.67 4.58 NA NA 0.24 6.65 5.56 NA NA XXX 78704 ......... 26 ....... A Imaging renogram ......................................... 0.74 0.25 0.25 0.25 0.25 0.03 1.02 1.02 1.02 1.02 XXX 78704 ......... TC ...... A Imaging renogram ......................................... 0.00 5.41 4.32 NA NA 0.21 5.62 4.53 NA NA XXX 78707 ......... ............ A Kidney flow/function image ........................... 0.96 5.71 5.03 NA NA 0.27 6.94 6.26 NA NA XXX 78707 ......... 26 ....... A Kidney flow/function image ........................... 0.96 0.33 0.32 0.33 0.32 0.04 1.33 1.32 1.33 1.32 XXX 78707 ......... TC ...... A Kidney flow/function image ........................... 0.00 5.38 4.71 NA NA 0.23 5.61 4.94 NA NA XXX 78708 ......... ............ A Kidney flow/function image ........................... 1.21 3.59 4.57 NA NA 0.28 5.08 6.06 NA NA XXX 78708 ......... 26 ....... A Kidney flow/function image ........................... 1.21 0.42 0.41 0.42 0.41 0.05 1.68 1.67 1.68 1.67 XXX 78708 ......... TC ...... A Kidney flow/function image ........................... 0.00 3.17 4.15 NA NA 0.23 3.40 4.38 NA NA XXX 78709 ......... ............ A Kidney flow/function image ........................... 1.41 9.25 6.03 NA NA 0.29 10.95 7.73 NA NA XXX78709 ......... 26 ....... A Kidney flow/function image ........................... 1.41 0.48 0.47 0.48 0.47 0.06 1.95 1.94 1.95 1.94 XXX 78709 ......... TC ...... A Kidney flow/function image ........................... 0.00 8.76 5.55 NA NA 0.23 8.99 5.78 NA NA XXX 78710 ......... ............ A Kidney imaging (3D) ...................................... 0.66 5.48 5.98 NA NA 0.34 6.48 6.98 NA NA XXX 78710 ......... 26 ....... A Kidney imaging (3D) ...................................... 0.66 0.22 0.22 0.22 0.22 0.03 0.91 0.91 0.91 0.91 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37394 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78710 ......... TC ...... A Kidney imaging (3D) ...................................... 0.00 5.26 5.76 NA NA 0.31 5.57 6.07 NA NA XXX 78715 ......... ............ A Renal vascular flow exam ............................. 0.30 97 2.51 NA NA 0.11 5.38 2.92 NA NA XXX 78715 ......... 26 ....... A Renal vascular flow exam ............................. 0.30 0.13 0.12 0.13 0.12 0.01 0.44 0.43 0.44 0.43 XXX 78715 ......... TC ...... A Renal vascular flow exam ............................. 0.00 4.84 2.40 NA NA 0.10 4.94 2.50 NA NA XXX 78725 ......... ............ A Kidney function study .................................... 0.38 2.44 2.05 NA NA 0.13 2.95 2.56 NA NA XXX 78725 ......... 26 ....... A Kidney function study .................................... 0.38 0.12 0.13 0.12 0.13 0.02 0.52 0.53 0.52 0.53 XXX 78725 ......... TC ...... A Kidney function study .................................... 0.00 2.32 1.92 NA NA 0.11 2.43 2.03 NA NA XXX 78730 ......... ............ A Urinary bladder retention ............................... 0.36 5.70 2.61 NA NA 0.10 6.16 3.07 NA NA XXX 78730 ......... 26 ....... A Urinary bladder retention ............................... 0.36 0.15 0.13 0.15 0.13 0.02 0.53 0.51 0.53 0.51 XXX 78730 ......... TC ...... A Urinary bladder retention ............................... 0.00 5.55 2.48 NA NA 0.08 5.63 2.56 NA NA XXX 78740 ......... ............ A Ureteral reflux study ...................................... 0.57 5.64 3.15 NA NA 0.15 6.36 3.87 NA NA XXX 78740 ......... 26 ....... A Ureteral reflux study ...................................... 0.57 0.19 0.19 0.19 0.19 0.03 0.79 0.79 0.79 0.79 XXX 78740 ......... TC ...... A Ureteral reflux study ...................................... 0.00 5.45 2.96 NA NA 0.12 5.57 3.08 NA NA XXX 78760 ......... ............ A Testicular imaging ......................................... 0.66 4.68 3.35 NA NA 0.17 5.51 4.18 NA NA XXX 78760 ......... 26 ....... A Testicular imaging ......................................... 0.66 0.23 0.22 0.23 0.22 0.03 0.92 0.91 0.92 0.91 XXX 78760 ......... TC ...... A Testicular imaging ......................................... 0.00 4.44 3.13 NA NA 0.14 4.58 3.27 NA NA XXX 78761 ......... ............ A Testicular imaging/flow .................................. 0.71 5.10 3.86 NA NA 0.20 6.01 4.77 NA NA XXX 78761 ......... 26 ....... A Testicular imaging/flow .................................. 0.71 0.25 0.24 0.25 0.24 0.03 0.99 0.98 0.99 0.98 XXX 78761 ......... TC ...... A Testicular imaging/flow .................................. 0.00 4.85 3.62 NA NA 0.17 5.02 3.79 NA NA XXX 78800 ......... ............ A Tumor imaging, limited area ......................... 0.66 4.44 3.83 NA NA 0.22 5.32 4.71 NA NA XXX 78800 ......... 26 ....... A Tumor imaging, limited area ......................... 0.66 0.21 0.22 0.21 0.22 0.04 0.91 0.92 0.91 0.92 XXX 78800 ......... TC ...... A Tumor imaging, limited area ......................... 0.00 4.23 3.62 NA NA 0.18 4.41 3.80 NA NA XXX 78801 ......... ............ A Tumor imaging, mult areas ........................... 0.79 6.33 4.96 NA NA 0.27 7.39 6.02 NA NA XXX 78801 ......... 26 ....... A Tumor imaging, mult areas ........................... 0.79 0.26 0.27 0.26 0.27 0.05 1.10 1.11 1.10 1.11 XXX 78801 ......... TC ...... A Tumor imaging, mult areas ........................... 0.00 6.07 4.69 NA NA 0.22 6.29 4.91 NA NA XXX 78802 ......... ............ A Tumor imaging, whole body .......................... 0.86 8.48 6.50 NA NA 0.34 9.68 7.70 NA NA XXX 78802 ......... 26 ....... A Tumor imaging, whole body .......................... 0.86 0.29 0.29 0.29 0.29 0.04 1.19 1.19 1.19 1.19 XXX 78802 ......... TC ...... A Tumor imaging, whole body .......................... 0.00 8.19 6.21 NA NA 0.30 8.49 6.51 NA NA XXX 78803 ......... ............ A Tumor imaging (3D) ...................................... 1.09 15.50 9.09 NA NA 0.40 16.99 10.58 NA NA XXX 78803 ......... 26 ....... A Tumor imaging (3D) ...................................... 1.09 0.37 0.38 0.37 0.38 0.05 1.51 1.52 1.51 1.52 XXX 78803 ......... TC ...... A Tumor imaging (3D) ...................................... 0.00 15.14 8.71 NA NA 0.35 15.49 9.06 NA NA XXX78804 ......... ............ A Tumor imaging, whole body .......................... 1.07 15.48 12.47 NA NA 0.34 16.89 13.88 NA NA XXX 78804 ......... 26 ....... A Tumor imaging, whole body .......................... 1.07 0.36 0.37 0.36 0.37 0.04 1.47 1.48 1.47 1.48 XXX 78804 ......... TC ...... A Tumor imaging, whole body .......................... 0.00 15.12 12.10 NA NA 0.30 15.42 12.40 NA NA XXX 78805 ......... ............ A Abscess imaging, ltd area ............................. 0.73 4.38 3.84 NA NA 0.21 5.32 4.78 NA NA XXX78805 ......... 26 ....... A Abscess imaging, ltd area ............................. 0.73 0.25 0.25 0.25 0.25 0.03 1.01 1.01 1.01 1.01 XXX 78805 ......... TC ...... A Abscess imaging, ltd area ............................. 0.00 4.14 3.59 NA NA 0.18 4.32 3.77 NA NA XXX 78806 ......... ............ A Abscess imaging, whole body ....................... 0.86 8.70 7.23 NA NA 0.39 9.95 8.48 NA NA XXX 78806 ......... 26 ....... A Abscess imaging, whole body ....................... 0.86 0.29 0.29 0.29 0.29 0.04 1.19 1.19 1.19 1.19 XXX 78806 ......... TC ...... A Abscess imaging, whole body ....................... 0.00 8.41 6.94 NA NA 0.35 8.76 7.29 NA NA XXX 78807 ......... ............ A Nuclear localization/abscess ......................... 1.09 14.72 8.90 NA NA 0.39 16.20 10.38 NA NA XXX 78807 ......... 26 ....... A Nuclear localization/abscess ......................... 1.09 0.36 0.38 0.36 0.38 0.04 1.49 1.51 1.49 1.51 XXX 78807 ......... TC ...... A Nuclear localization/abscess ......................... 0.00 14.36 8.52 NA NA 0.35 14.71 8.87 NA NA XXX 78811 ......... 26 ....... A Tumor imaging (pet), limited ......................... 1.54 0.53 0.53 0.53 0.53 0.11 2.18 2.18 2.18 2.18 XXX 78812 ......... 26 ....... A Tumor image (pet)/skul-thigh ........................ 1.93 0.66 0.66 0.66 0.66 0.11 2.70 2.70 2.70 2.70 XXX 78813 ......... 26 ....... A Tumor image (pet) full body .......................... 2.00 0.69 0.69 0.69 0.69 0.11 2.80 2.80 2.80 2.80 XXX 78814 ......... 26 ....... A Tumor image pet/ct, limited ........................... 2.20 0.74 0.76 0.74 0.76 0.11 3.05 3.07 3.05 3.07 XXX 78815 ......... 26 ....... A Tumorimage pet/ct skul-thigh ........................ 2.44 0.83 0.84 0.83 0.84 0.11 3.38 3.39 3.38 3.39 XXX 78816 ......... 26 ....... A Tumor image pet/ct full body ........................ 2.50 0.85 0.86 0.85 0.86 0.11 3.46 3.47 3.46 3.47 XXX 78890 ......... ............ B Nuclear medicine data proc .......................... 0.05 0.39 1.10 NA NA 0.07 0.51 1.22 NA NA XXX 78890 ......... 26 ....... B Nuclear medicine data proc .......................... 0.05 0.01 0.02 0.01 0.02 0.01 0.07 0.08 0.07 0.08 XXX 78890 ......... TC ...... B Nuclear medicine data proc .......................... 0.00 0.38 1.08 NA NA 0.06 0.44 1.14 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37395 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

78891 ......... ............ B Nuclear med data proc .................................. 0.10 0.88 2.22 NA NA 0.14 1.12 2.46 NA NA XXX 78891 ......... 26 ....... B Nuclear med data proc .................................. 0.10 0.02 0.04 0.02 0.04 0.01 0.13 0.15 0.13 0.15 XXX 78891 ......... TC ...... B Nuclear med data proc .................................. 0.00 0.85 2.19 NA NA 0.13 0.98 2.32 NA NA XXX 79005 ......... ............ A Nuclear rx, oral admin ................................... 1.80 1.85 2.89 NA NA 0.22 3.87 4.91 NA NA XXX 79005 ......... 26 ....... A Nuclear rx, oral admin ................................... 1.80 0.56 0.59 0.56 0.59 0.08 2.44 2.47 2.44 2.47 XXX 79005 ......... TC ...... A Nuclear rx, oral admin ................................... 0.00 1.29 2.30 NA NA 0.14 1.43 2.44 NA NA XXX 79101 ......... ............ A Nuclear rx, iv admin ...................................... 1.96 2.14 3.01 NA NA 0.22 4.32 5.19 NA NA XXX 79101 ......... 26 ....... A Nuclear rx, iv admin ...................................... 1.96 0.70 0.68 0.70 0.68 0.08 2.74 2.72 2.74 2.72 XXX 79101 ......... TC ...... A Nuclear rx, iv admin ...................................... 0.00 1.44 2.33 NA NA 0.14 1.58 2.47 NA NA XXX79200 ......... ............ A Nuclear rx, intracav admin ............................ 1.99 2.25 3.05 NA NA 0.23 4.47 5.27 NA NA XXX79200 ......... 26 ....... A Nuclear rx, intracav admin ............................ 1.99 0.61 0.67 0.61 0.67 0.09 2.69 2.75 2.69 2.75 XXX 79200 ......... TC ...... A Nuclear rx, intracav admin ............................ 0.00 1.64 2.38 NA NA 0.14 1.78 2.52 NA NA XXX 79300 ......... 26 ....... A Nuclr rx, interstit colloid ................................. 1.60 0.50 0.55 0.50 0.55 0.13 2.23 2.28 2.23 2.28 XXX 79403 ......... ............ A Hematopoietic nuclear tx ............................... 2.25 2.92 4.61 NA NA 0.24 5.41 7.10 NA NA XXX 79403 ......... 26 ....... A Hematopoietic nuclear tx ............................... 2.25 0.71 0.85 0.71 0.85 0.10 3.06 3.20 3.06 3.20 XXX 79403 ......... TC ...... A Hematopoietic nuclear tx ............................... 0.00 2.21 3.76 NA NA 0.14 2.35 3.90 NA NA XXX 79440 ......... ............ A Nuclear rx, intra-articular ............................... 1.99 1.90 2.99 NA NA 0.22 4.11 5.20 NA NA XXX 79440 ......... 26 ....... A Nuclear rx, intra-articular ............................... 1.99 0.68 0.71 0.68 0.71 0.08 2.75 2.78 2.75 2.78 XXX 79440 ......... TC ...... A Nuclear rx, intra-articular ............................... 0.00 1.22 2.28 NA NA 0.14 1.36 2.42 NA NA XXX79445 ......... 26 ....... A Nuclear rx, intra-arterial ................................. 2.40 0.83 0.82 0.83 0.82 0.12 3.35 3.34 3.35 3.34 XXX 80500 ......... ............ A Lab pathology consultation ........................... 0.37 0.19 0.21 0.11 0.15 0.01 0.57 0.59 0.49 0.53 XXX 80502 ......... ............ A Lab pathology consultation ........................... 1.33 0.29 0.48 0.24 0.47 0.04 1.66 1.85 1.61 1.84 XXX 83020 ......... 26 ....... A Hemoglobin electrophoresis .......................... 0.37 0.11 0.14 0.11 0.14 0.01 0.49 0.52 0.49 0.52 XXX 83912 ......... 26 ....... A Genetic examination ...................................... 0.37 0.11 0.12 0.11 0.12 0.01 0.49 0.50 0.49 0.50 XXX 84165 ......... 26 ....... A Protein e-phoresis, serum ............................. 0.37 0.11 0.13 0.11 0.13 0.01 0.49 0.51 0.49 0.51 XXX 84166 ......... 26 ....... A Protein e-phoresis/urine/csf ........................... 0.37 0.11 0.13 0.11 0.13 0.01 0.49 0.51 0.49 0.51 XXX 84181 ......... 26 ....... A Western blot test ........................................... 0.37 0.11 0.13 0.11 0.13 0.01 0.49 0.51 0.49 0.51 XXX 84182 ......... 26 ....... A Protein, western blot test .............................. 0.37 0.11 0.15 0.11 0.15 0.02 0.50 0.54 0.50 0.54 XXX 85060 ......... ............ A Blood smear interpretation ............................ 0.45 0.14 0.17 0.14 0.17 0.02 0.61 0.64 0.61 0.64 XXX 85097 ......... ............ A Bone marrow interpretation ........................... 0.94 1.29 1.76 0.27 0.38 0.04 2.27 2.74 1.25 1.36 XXX 85390 ......... 26 ....... A Fibrinolysins screen ....................................... 0.37 0.12 0.13 0.12 0.13 0.01 0.50 0.51 0.50 0.51 XXX 85396 ......... ............ A Clotting assay, whole blood .......................... 0.37 NA NA 0.04 0.13 0.04 NA NA 0.45 0.54 XXX 85576 ......... 26 ....... A Blood platelet aggregation ............................ 0.37 0.12 0.15 0.12 0.15 0.01 0.50 0.53 0.50 0.53 XXX 86077 ......... ............ A Physician blood bank service ........................ 0.94 0.37 0.39 0.29 0.37 0.03 1.34 1.36 1.26 1.34 XXX 86078 ......... ............ A Physician blood bank service ........................ 0.94 0.37 0.44 0.29 0.37 0.03 1.34 1.41 1.26 1.34 XXX 86079 ......... ............ A Physician blood bank service ........................ 0.94 0.37 0.43 0.29 0.38 0.03 1.34 1.40 1.26 1.35 XXX 86255 ......... 26 ....... A Fluorescent antibody, screen ........................ 0.37 0.11 0.14 0.11 0.14 0.01 0.49 0.52 0.49 0.52 XXX 86256 ......... 26 ....... A Fluorescent antibody, titer ............................. 0.37 0.11 0.14 0.11 0.14 0.01 0.49 0.52 0.49 0.52 XXX 86320 ......... 26 ....... A Serum immunoelectrophoresis ...................... 0.37 0.11 0.14 0.11 0.14 0.01 0.49 0.52 0.49 0.52 XXX86325 ......... 26 ....... A Other immunoelectrophoresis ....................... 0.37 0.11 0.13 0.11 0.13 0.01 0.49 0.51 0.49 0.51 XXX 86327 ......... 26 ....... A Immunoelectrophoresis assay ....................... 0.42 0.13 0.17 0.13 0.17 0.02 0.57 0.61 0.57 0.61 XXX 86334 ......... 26 ....... A Immunofix e-phoresis, serum ........................ 0.37 0.11 0.14 0.11 0.14 0.01 0.49 0.52 0.49 0.52 XXX 86335 ......... 26 ....... A Immunfix e-phorsis/urine/csf ......................... 0.37 0.11 0.13 0.11 0.13 0.01 0.49 0.51 0.49 0.51 XXX 86490 ......... ............ A Coccidioidomycosis skin test ........................ 0.00 0.12 0.25 NA NA 0.02 0.14 0.27 NA NA XXX 86510 ......... ............ A Histoplasmosis skin test ................................ 0.00 0.14 0.28 NA NA 0.02 0.16 0.30 NA NA XXX 86580 ......... ............ A TB intradermal test ........................................ 0.00 0.16 0.23 NA NA 0.02 0.18 0.25 NA NA XXX 87164 ......... 26 ....... A Dark field examination ................................... 0.37 0.12 0.12 0.12 0.12 0.01 0.50 0.50 0.50 0.50 XXX 87207 ......... 26 ....... A Smear, special stain ...................................... 0.37 0.10 0.15 0.10 0.15 0.01 0.48 0.53 0.48 0.53 XXX 88104 ......... ............ A Cytopathology, fluids ..................................... 0.56 1.15 0.93 NA NA 0.04 1.75 1.53 NA NA XXX 88104 ......... 26 ....... A Cytopathology, fluids ..................................... 0.56 0.15 0.22 0.15 0.22 0.02 0.73 0.80 0.73 0.80 XXX 88104 ......... TC ...... A Cytopathology, fluids ..................................... 0.00 1.00 0.71 NA NA 0.02 1.02 0.73 NA NA XXX

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37396 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

88106 ......... ............ A Cytopathology, fluids ..................................... 0.56 1.50 1.39 NA NA 0.04 2.10 1.99 NA NA XXX 88106 ......... 26 ....... A Cytopathology, fluids ..................................... 0.56 0.15 0.22 0.15 0.22 0.02 0.73 0.80 0.73 0.80 XXX 88106 ......... TC ...... A Cytopathology, fluids ..................................... 0.00 1.35 1.17 NA NA 0.02 1.37 1.19 NA NA XXX88107 ......... ............ A Cytopathology, fluids ..................................... 0.76 1.99 1.65 NA NA 0.05 2.80 2.46 NA NA XXX 88107 ......... 26 ....... A Cytopathology, fluids ..................................... 0.76 0.22 0.30 0.22 0.30 0.03 1.01 1.09 1.01 1.09 XXX 88107 ......... TC ...... A Cytopathology, fluids ..................................... 0.00 1.76 1.35 NA NA 0.02 1.78 1.37 NA NA XXX88108 ......... ............ A Cytopath, concentrate tech ........................... 0.56 1.47 1.28 NA NA 0.04 2.07 1.88 NA NA XXX 88108 ......... 26 ....... A Cytopath, concentrate tech ........................... 0.56 0.15 0.22 0.15 0.22 0.02 0.73 0.80 0.73 0.80 XXX 88108 ......... TC ...... A Cytopath, concentrate tech ........................... 0.00 1.32 1.06 NA NA 0.02 1.34 1.08 NA NA XXX 88112 ......... ............ A Cytopath, cell enhance tech .......................... 1.18 1.50 1.85 NA NA 0.04 2.72 3.07 NA NA XXX 88112 ......... 26 ....... A Cytopath, cell enhance tech .......................... 1.18 0.29 0.46 0.29 0.46 0.02 1.49 1.66 1.49 1.66 XXX 88112 ......... TC ...... A Cytopath, cell enhance tech .......................... 0.00 1.21 1.40 NA NA 0.02 1.23 1.42 NA NA XXX 88125 ......... ............ A Forensic cytopathology ................................. 0.26 0.25 0.27 NA NA 0.02 0.53 0.55 NA NA XXX 88125 ......... 26 ....... A Forensic cytopathology ................................. 0.26 0.06 0.10 0.06 0.10 0.01 0.33 0.37 0.33 0.37 XXX 88125 ......... TC ...... A Forensic cytopathology ................................. 0.00 0.19 0.17 NA NA 0.01 0.20 0.18 NA NA XXX 88141 ......... ............ A Cytopath, c/v, interpret .................................. 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX 88160 ......... ............ A Cytopath smear, other source ....................... 0.50 0.90 0.85 NA NA 0.04 1.44 1.39 NA NA XXX 88160 ......... 26 ....... A Cytopath smear, other source ....................... 0.50 0.13 0.19 0.13 0.19 0.02 0.65 0.71 0.65 0.71 XXX 88160 ......... TC ...... A Cytopath smear, other source ....................... 0.00 0.77 0.66 NA NA 0.02 0.79 0.68 NA NA XXX 88161 ......... ............ A Cytopath smear, other source ....................... 0.50 1.12 0.99 NA NA 0.04 1.66 1.53 NA NA XXX 88161 ......... 26 ....... A Cytopath smear, other source ....................... 0.50 0.15 0.20 0.15 0.20 0.02 0.67 0.72 0.67 0.72 XXX 88161 ......... TC ...... A Cytopath smear, other source ....................... 0.00 0.97 0.79 NA NA 0.02 0.99 0.81 NA NA XXX 88162 ......... ............ A Cytopath smear, other source ....................... 0.76 1.16 1.06 NA NA 0.05 1.97 1.87 NA NA XXX 88162 ......... 26 ....... A Cytopath smear, other source ....................... 0.76 0.16 0.29 0.16 0.29 0.03 0.95 1.08 0.95 1.08 XXX 88162 ......... TC ...... A Cytopath smear, other source ....................... 0.00 1.00 0.77 NA NA 0.02 1.02 0.79 NA NA XXX 88172 ......... ............ A Cytopathology eval of fna ............................. 0.60 0.85 0.76 NA NA 0.04 1.49 1.40 NA NA XXX88172 ......... 26 ....... A Cytopathology eval of fna ............................. 0.60 0.18 0.24 0.18 0.24 0.02 0.80 0.86 0.80 0.86 XXX 88172 ......... TC ...... A Cytopathology eval of fna ............................. 0.00 0.67 0.52 NA NA 0.02 0.69 0.54 NA NA XXX 88173 ......... ............ A Cytopath eval, fna, report .............................. 1.39 2.30 2.18 NA NA 0.07 3.76 3.64 NA NA XXX 88173 ......... 26 ....... A Cytopath eval, fna, report .............................. 1.39 0.39 0.54 0.39 0.54 0.05 1.83 1.98 1.83 1.98 XXX 88173 ......... TC ...... A Cytopath eval, fna, report .............................. 0.00 1.91 1.64 NA NA 0.02 1.93 1.66 NA NA XXX 88182 ......... ............ A Cell marker study .......................................... 0.77 1.95 1.97 NA NA 0.07 2.79 2.81 NA NA XXX 88182 ......... 26 ....... A Cell marker study .......................................... 0.77 0.12 0.28 0.12 0.28 0.03 0.92 1.08 0.92 1.08 XXX 88182 ......... TC ...... A Cell marker study .......................................... 0.00 1.83 1.70 NA NA 0.04 1.87 1.74 NA NA XXX 88184 ......... ............ A Flowcytometry/ tc, 1 marker .......................... 0.00 2.50 1.62 NA NA 0.02 2.52 1.64 NA NA XXX 88185 ......... ............ A Flowcytometry/tc, add-on .............................. 0.00 1.52 0.86 NA NA 0.02 1.54 0.88 NA NA ZZZ88187 ......... ............ A Flowcytometry/read, 2-8 ................................ 1.36 0.38 0.43 0.38 0.43 0.01 1.75 1.80 1.75 1.80 XXX 88188 ......... ............ A Flowcytometry/read, 9-15 .............................. 1.69 0.43 0.54 0.43 0.54 0.01 2.13 2.24 2.13 2.24 XXX 88189 ......... ............ A Flowcytometry/read, 16 & > .......................... 2.23 0.47 0.68 0.47 0.68 0.01 2.71 2.92 2.71 2.92 XXX 88291 ......... ............ A Cyto/molecular report .................................... 0.52 0.27 0.20 0.27 0.20 0.02 0.81 0.74 0.81 0.74 XXX 88300 ......... ............ A Surgical path, gross ...................................... 0.08 0.59 0.49 NA NA 0.02 0.69 0.59 NA NA XXX 88300 ......... 26 ....... A Surgical path, gross ...................................... 0.08 0.02 0.03 0.02 0.03 0.01 0.11 0.12 0.11 0.12 XXX 88300 ......... TC ...... A Surgical path, gross ...................................... 0.00 0.56 0.46 NA NA 0.01 0.57 0.47 NA NA XXX88302 ......... ............ A Tissue exam by pathologist .......................... 0.13 1.29 1.10 NA NA 0.03 1.45 1.26 NA NA XXX 88302 ......... 26 ....... A Tissue exam by pathologist .......................... 0.13 0.04 0.06 0.04 0.06 0.01 0.18 0.20 0.18 0.20 XXX 88302 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.25 1.04 NA NA 0.02 1.27 1.06 NA NA XXX 88304 ......... ............ A Tissue exam by pathologist .......................... 0.22 1.53 1.37 NA NA 0.03 1.78 1.62 NA NA XXX 88304 ......... 26 ....... A Tissue exam by pathologist .......................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31 XXX 88304 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.47 1.29 NA NA 0.02 1.49 1.31 NA NA XXX 88305 ......... ............ A Tissue exam by pathologist .......................... 0.75 2.18 1.98 NA NA 0.07 3.00 2.80 NA NA XXX 88305 ......... 26 ....... A Tissue exam by pathologist .......................... 0.75 0.21 0.30 0.21 0.30 0.03 0.99 1.08 0.99 1.08 XXX 88305 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.98 1.68 NA NA 0.04 2.02 1.72 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37397 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

88307 ......... ............ A Tissue exam by pathologist .......................... 1.59 4.48 3.49 NA NA 0.12 6.19 5.20 NA NA XXX 88307 ......... 26 ....... A Tissue exam by pathologist .......................... 1.59 0.47 0.63 0.47 0.63 0.06 2.12 2.28 2.12 2.28 XXX 88307 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 4.02 2.87 NA NA 0.06 4.08 2.93 NA NA XXX 88309 ......... ............ A Tissue exam by pathologist .......................... 2.80 6.28 4.87 NA NA 0.14 9.22 7.81 NA NA XXX 88309 ......... 26 ....... A Tissue exam by pathologist .......................... 2.80 0.82 0.93 0.82 0.93 0.08 3.70 3.81 3.70 3.81 XXX 88309 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 5.46 3.94 NA NA 0.06 5.52 4.00 NA NA XXX 88311 ......... ............ A Decalcify tissue ............................................. 0.24 0.25 0.24 NA NA 0.02 0.51 0.50 NA NA XXX 88311 ......... 26 ....... A Decalcify tissue ............................................. 0.24 0.07 0.09 0.07 0.09 0.01 0.32 0.34 0.32 0.34 XXX 88311 ......... TC ...... A Decalcify tissue ............................................. 0.00 0.18 0.14 NA NA 0.01 0.19 0.15 NA NA XXX 88312 ......... ............ A Special stains ................................................ 0.54 2.49 1.76 NA NA 0.03 3.06 2.33 NA NA XXX 88312 ......... 26 ....... A Special stains ................................................ 0.54 0.14 0.21 0.14 0.21 0.02 0.70 0.77 0.70 0.77 XXX 88312 ......... TC ...... A Special stains ................................................ 0.00 2.34 1.55 NA NA 0.01 2.35 1.56 NA NA XXX 88313 ......... ............ A Special stains ................................................ 0.24 1.94 1.42 NA NA 0.02 2.20 1.68 NA NA XXX 88313 ......... 26 ....... A Special stains ................................................ 0.24 0.06 0.09 0.06 0.09 0.01 0.31 0.34 0.31 0.34 XXX 88313 ......... TC ...... A Special stains ................................................ 0.00 1.88 1.33 NA NA 0.01 1.89 1.34 NA NA XXX 88314 ......... ............ A Histochemical stain ....................................... 0.45 1.98 2.05 NA NA 0.04 2.47 2.54 NA NA XXX 88314 ......... 26 ....... A Histochemical stain ....................................... 0.45 0.14 0.18 0.14 0.18 0.02 0.61 0.65 0.61 0.65 XXX 88314 ......... TC ...... A Histochemical stain ....................................... 0.00 1.84 1.87 NA NA 0.02 1.86 1.89 NA NA XXX88318 ......... ............ A Chemical histochemistry ............................... 0.42 2.98 1.98 NA NA 0.03 3.43 2.43 NA NA XXX88318 ......... 26 ....... A Chemical histochemistry ............................... 0.42 0.12 0.17 0.12 0.17 0.02 0.56 0.61 0.56 0.61 XXX 88318 ......... TC ...... A Chemical histochemistry ............................... 0.00 2.85 1.82 NA NA 0.01 2.86 1.83 NA NA XXX 88319 ......... ............ A Enzyme histochemistry ................................. 0.53 3.25 3.38 NA NA 0.04 3.82 3.95 NA NA XXX88319 ......... 26 ....... A Enzyme histochemistry ................................. 0.53 0.15 0.20 0.15 0.20 0.02 0.70 0.75 0.70 0.75 XXX 88319 ......... TC ...... A Enzyme histochemistry ................................. 0.00 3.10 3.18 NA NA 0.02 3.12 3.20 NA NA XXX 88321 ......... ............ A Microslide consultation .................................. 1.63 0.73 0.78 0.47 0.54 0.05 2.41 2.46 2.15 2.22 XXX 88323 ......... ............ A Microslide consultation .................................. 1.83 2.21 1.89 NA NA 0.07 4.11 3.79 NA NA XXX 88323 ......... 26 ....... A Microslide consultation .................................. 1.83 0.45 0.54 0.45 0.54 0.05 2.33 2.42 2.33 2.42 XXX 88323 ......... TC ...... A Microslide consultation .................................. 0.00 1.76 1.35 NA NA 0.02 1.78 1.37 NA NA XXX 88325 ......... ............ A Comprehensive review of data ..................... 2.50 2.24 2.77 0.61 0.87 0.07 4.81 5.34 3.18 3.44 XXX 88329 ......... ............ A Path consult introp ........................................ 0.67 0.68 0.66 0.20 0.27 0.02 1.37 1.35 0.89 0.96 XXX 88331 ......... ............ A Path consult intraop, 1 bloc .......................... 1.19 1.24 1.14 NA NA 0.08 2.51 2.41 NA NA XXX88331 ......... 26 ....... A Path consult intraop, 1 bloc .......................... 1.19 0.36 0.47 0.36 0.47 0.04 1.59 1.70 1.59 1.70 XXX 88331 ......... TC ...... A Path consult intraop, 1 bloc .......................... 0.00 0.87 0.66 NA NA 0.04 0.91 0.70 NA NA XXX 88332 ......... ............ A Path consult intraop, addIl ............................ 0.59 0.47 0.46 NA NA 0.04 1.10 1.09 NA NA XXX 88332 ......... 26 ....... A Path consult intraop, addIl ............................ 0.59 0.17 0.23 0.17 0.23 0.02 0.78 0.84 0.78 0.84 XXX 88332 ......... TC ...... A Path consult intraop, addIl ............................ 0.00 0.29 0.23 NA NA 0.02 0.31 0.25 NA NA XXX 88333 ......... ............ A Intraop cyto path consult, 1 ........................... 1.20 1.34 1.15 NA NA 0.08 2.62 2.43 NA NA XXX 88333 ......... 26 ....... A Intraop cyto path consult, 1 ........................... 1.20 0.37 0.49 0.37 0.49 0.04 1.61 1.73 1.61 1.73 XXX 88333 ......... TC ...... A Intraop cyto path consult, 1 ........................... 0.00 0.97 0.66 NA NA 0.04 1.01 0.70 NA NA XXX 88334 ......... ............ A Intraop cyto path consult, 2 ........................... 0.59 0.74 0.64 NA NA 0.04 1.37 1.27 NA NA XXX 88334 ......... 26 ....... A Intraop cyto path consult, 2 ........................... 0.59 0.17 0.24 0.17 0.24 0.02 0.78 0.85 0.78 0.85 XXX 88334 ......... TC ...... A Intraop cyto path consult, 2 ........................... 0.00 0.57 0.40 NA NA 0.02 0.59 0.42 NA NA XXX 88342 ......... ............ A Immunohistochemistry ................................... 0.85 2.03 1.60 NA NA 0.05 2.93 2.50 NA NA XXX 88342 ......... 26 ....... A Immunohistochemistry ................................... 0.85 0.22 0.33 0.22 0.33 0.03 1.10 1.21 1.10 1.21 XXX 88342 ......... TC ...... A Immunohistochemistry ................................... 0.00 1.81 1.28 NA NA 0.02 1.83 1.30 NA NA XXX 88346 ......... ............ A Immunofluorescent study .............................. 0.86 1.96 1.67 NA NA 0.05 2.87 2.58 NA NA XXX 88346 ......... 26 ....... A Immunofluorescent study .............................. 0.86 0.23 0.33 0.23 0.33 0.03 1.12 1.22 1.12 1.22 XXX 88346 ......... TC ...... A Immunofluorescent study .............................. 0.00 1.74 1.34 NA NA 0.02 1.76 1.36 NA NA XXX 88347 ......... ............ A Immunofluorescent study .............................. 0.86 1.34 1.28 NA NA 0.05 2.25 2.19 NA NA XXX 88347 ......... 26 ....... A Immunofluorescent study .............................. 0.86 0.19 0.31 0.19 0.31 0.03 1.08 1.20 1.08 1.20 XXX 88347 ......... TC ...... A Immunofluorescent study .............................. 0.00 1.16 0.97 NA NA 0.02 1.18 0.99 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37398 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

88348 ......... ............ A Electron microscopy ...................................... 1.51 18.07 11.55 NA NA 0.13 19.71 13.19 NA NA XXX 88348 ......... 26 ....... A Electron microscopy ...................................... 1.51 0.40 0.58 0.40 0.58 0.06 1.97 2.15 1.97 2.15 XXX 88348 ......... TC ...... A Electron microscopy ...................................... 0.00 17.67 10.97 NA NA 0.07 17.74 11.04 NA NA XXX 88349 ......... ............ A Scanning electron microscopy ...................... 0.76 8.90 4.90 NA NA 0.09 9.75 5.75 NA NA XXX 88349 ......... 26 ....... A Scanning electron microscopy ...................... 0.76 0.22 0.30 0.22 0.30 0.03 1.01 1.09 1.01 1.09 XXX 88349 ......... TC ...... A Scanning electron microscopy ...................... 0.00 8.69 4.60 NA NA 0.06 8.75 4.66 NA NA XXX 88355 ......... ............ A Analysis, skeletal muscle .............................. 1.85 3.37 7.44 NA NA 0.13 5.35 9.42 NA NA XXX 88355 ......... 26 ....... A Analysis, skeletal muscle .............................. 1.85 0.39 0.69 0.39 0.69 0.07 2.31 2.61 2.31 2.61 XXX 88355 ......... TC ...... A Analysis, skeletal muscle .............................. 0.00 2.98 6.75 NA NA 0.06 3.04 6.81 NA NA XXX 88356 ......... ............ A Analysis, nerve .............................................. 3.02 6.64 4.80 NA NA 0.19 9.85 8.01 NA NA XXX 88356 ......... 26 ....... A Analysis, nerve .............................................. 3.02 0.76 1.14 0.76 1.14 0.12 3.90 4.28 3.90 4.28 XXX 88356 ......... TC ...... A Analysis, nerve .............................................. 0.00 5.88 3.67 NA NA 0.07 5.95 3.74 NA NA XXX 88358 ......... ............ A Analysis, tumor .............................................. 0.95 1.12 0.91 NA NA 0.17 2.24 2.03 NA NA XXX 88358 ......... 26 ....... A Analysis, tumor .............................................. 0.95 0.16 0.34 0.16 0.34 0.10 1.21 1.39 1.21 1.39 XXX 88358 ......... TC ...... A Analysis, tumor .............................................. 0.00 0.96 0.57 NA NA 0.07 1.03 0.64 NA NA XXX 88360 ......... ............ A Tumor immunohistochem/manual ................. 1.10 2.31 1.88 NA NA 0.08 3.49 3.06 NA NA XXX 88360 ......... 26 ....... A Tumor immunohistochem/manual ................. 1.10 0.27 0.42 0.27 0.42 0.06 1.43 1.58 1.43 1.58 XXX 88360 ......... TC ...... A Tumor immunohistochem/manual ................. 0.00 2.03 1.45 NA NA 0.02 2.05 1.47 NA NA XXX 88361 ......... ............ A Tumor immunohistochem/comput ................. 1.18 2.76 2.96 NA NA 0.17 4.11 4.31 NA NA XXX 88361 ......... 26 ....... A Tumor immunohistochem/comput ................. 1.18 0.25 0.43 0.25 0.43 0.10 1.53 1.71 1.53 1.71 XXX 88361 ......... TC ...... A Tumor immunohistochem/comput ................. 0.00 2.51 2.53 NA NA 0.07 2.58 2.60 NA NA XXX 88362 ......... ............ A Nerve teasing preparations ........................... 2.17 5.23 4.83 NA NA 0.15 7.55 7.15 NA NA XXX 88362 ......... 26 ....... A Nerve teasing preparations ........................... 2.17 0.58 0.84 0.58 0.84 0.09 2.84 3.10 2.84 3.10 XXX 88362 ......... TC ...... A Nerve teasing preparations ........................... 0.00 4.64 4.00 NA NA 0.06 4.70 4.06 NA NA XXX 88365 ......... ............ A Insitu hybridization (fish) ............................... 1.20 2.95 2.34 NA NA 0.05 4.20 3.59 NA NA XXX 88365 ......... 26 ....... A Insitu hybridization (fish) ............................... 1.20 0.24 0.44 0.24 0.44 0.03 1.47 1.67 1.47 1.67 XXX 88365 ......... TC ...... A Insitu hybridization (fish) ............................... 0.00 2.71 1.89 NA NA 0.02 2.73 1.91 NA NA XXX88367 ......... ............ A Insitu hybridization, auto ............................... 1.30 5.27 4.35 NA NA 0.12 6.69 5.77 NA NA XXX 88367 ......... 26 ....... A Insitu hybridization, auto ............................... 1.30 0.22 0.46 0.22 0.46 0.06 1.58 1.82 1.58 1.82 XXX 88367 ......... TC ...... A Insitu hybridization, auto ............................... 0.00 5.05 3.89 NA NA 0.06 5.11 3.95 NA NA XXX 88368 ......... ............ A Insitu hybridization, manual ........................... 1.40 4.79 3.00 NA NA 0.12 6.31 4.52 NA NA XXX 88368 ......... 26 ....... A Insitu hybridization, manual ........................... 1.40 0.21 0.50 0.21 0.50 0.06 1.67 1.96 1.67 1.96 XXX 88368 ......... TC ...... A Insitu hybridization, manual ........................... 0.00 4.58 2.50 NA NA 0.06 4.64 2.56 NA NA XXX 88371 ......... 26 ....... A Protein, western blot tissue ........................... 0.37 0.10 0.12 0.10 0.12 0.01 0.48 0.50 0.48 0.50 XXX 88372 ......... 26 ....... A Protein analysis w/probe ............................... 0.37 0.11 0.15 0.11 0.15 0.01 0.49 0.53 0.49 0.53 XXX 88385 ......... ............ A Eval molecul probes, 51–250 ........................ 1.50 14.66 8.99 NA NA 0.12 16.28 10.61 NA NA XXX 88385 ......... 26 ....... A Eval molecul probes, 51–250 ........................ 1.50 0.22 0.54 0.22 0.54 0.06 1.78 2.10 1.78 2.10 XXX 88385 ......... TC ...... A Eval molecul probes, 51–250 ........................ 0.00 14.44 8.45 NA NA 0.06 14.50 8.51 NA NA XXX 88386 ......... ............ A Eval molecul probes, 251–500 ...................... 1.88 14.56 8.93 NA NA 0.16 16.60 10.97 NA NA XXX 88386 ......... 26 ....... A Eval molecul probes, 251–500 ...................... 1.88 0.28 0.69 0.28 0.69 0.08 2.24 2.65 2.24 2.65 XXX 88386 ......... TC ...... A Eval molecul probes, 251–500 ...................... 0.00 14.28 8.24 NA NA 0.08 14.36 8.32 NA NA XXX 89049 ......... ............ A Chct for mal hyperthermia ............................. 1.40 3.59 3.57 0.18 0.25 0.06 5.05 5.03 1.64 1.71 XXX 89060 ......... 26 ....... A Exam,synovial fluid crystals .......................... 0.37 0.11 0.15 0.11 0.15 0.01 0.49 0.53 0.49 0.53 XXX 89100 ......... ............ A Sample intestinal contents ............................ 0.60 9.16 3.67 0.62 0.31 0.03 9.79 4.30 1.25 0.94 XXX 89105 ......... ............ A Sample intestinal contents ............................ 0.50 7.70 3.60 0.45 0.24 0.02 8.22 4.12 0.97 0.76 XXX 89130 ......... ............ A Sample stomach contents ............................. 0.45 6.96 3.05 0.40 0.20 0.02 7.43 3.52 0.87 0.67 XXX 89132 ......... ............ A Sample stomach contents ............................. 0.19 6.56 2.80 0.30 0.12 0.01 6.76 3.00 0.50 0.32 XXX 89135 ......... ............ A Sample stomach contents ............................. 0.79 9.15 3.71 0.70 0.36 0.04 9.98 4.54 1.53 1.19 XXX 89136 ......... ............ A Sample stomach contents ............................. 0.21 7.05 3.07 0.32 0.15 0.01 7.27 3.29 0.54 0.37 XXX 89140 ......... ............ A Sample stomach contents ............................. 0.94 6.81 3.27 0.49 0.33 0.04 7.79 4.25 1.47 1.31 XXX 89141 ......... ............ A Sample stomach contents ............................. 0.85 5.59 3.50 0.41 0.35 0.03 6.47 4.38 1.29 1.23 XXX 89220 ......... ............ A Sputum specimen collection ......................... 0.00 0.36 0.41 NA NA 0.02 0.38 0.43 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37399 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

89230 ......... ............ A Collect sweat for test ..................................... 0.00 0.08 0.10 NA NA 0.02 0.10 0.12 NA NA XXX 90465 ......... ............ A Ther/proph/diag inj, sc/im .............................. 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX 90466 ......... ............ A Immune admin addl inj, < 8 y ....................... 0.15 0.12 0.13 NA NA 0.01 0.28 0.29 NA NA ZZZ 90467 ......... ............ R Immune admin o or n, < 8 yrs ...................... 0.17 0.17 0.17 0.07 0.09 0.01 0.35 0.35 0.25 0.27 XXX 90468 ......... ............ R Immune admin o/n, addl < 8 y ...................... 0.15 0.10 0.11 0.03 0.05 0.01 0.26 0.27 0.19 0.21 ZZZ 90471 ......... ............ A Ther/proph/diag inj, sc/im .............................. 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX 90472 ......... ............ A Immunization admin, each add ..................... 0.15 0.12 0.13 NA NA 0.01 0.28 0.29 NA NA ZZZ 90473 ......... ............ R Immune admin oral/nasal .............................. 0.17 0.16 0.18 0.04 0.06 0.01 0.34 0.36 0.22 0.24 XXX 90474 ......... ............ R Immune admin oral/nasal addl ...................... 0.15 0.07 0.09 0.03 0.05 0.01 0.23 0.25 0.19 0.21 ZZZ 90760 ......... ............ A Hydration iv infusion, init ............................... 0.17 1.32 1.40 NA NA 0.07 1.56 1.64 NA NA XXX 90761 ......... ............ A Hydrate iv infusion, add-on ........................... 0.09 0.32 0.38 NA NA 0.04 0.45 0.51 NA NA ZZZ90765 ......... ............ A Ther/proph/diag iv inf, init .............................. 0.21 1.63 1.73 NA NA 0.07 1.91 2.01 NA NA XXX 90766 ......... ............ A Ther/proph/dg iv inf, add-on .......................... 0.18 0.38 0.44 NA NA 0.04 0.60 0.66 NA NA ZZZ90767 ......... ............ A Tx/proph/dg addl seq iv inf ............................ 0.19 0.69 0.84 NA NA 0.04 0.92 1.07 NA NA ZZZ 90768 ......... ............ A Ther/diag concurrent inf ................................ 0.17 0.33 0.41 NA NA 0.04 0.54 0.62 NA NA ZZZ 90772 ......... ............ A Ther/proph/diag inj, sc/im .............................. 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX 90773 ......... ............ A Ther/proph/diag inj, ia ................................... 0.17 0.30 0.31 NA NA 0.02 0.49 0.50 NA NA XXX 90774 ......... ............ A Ther/proph/diag inj, iv push ........................... 0.18 1.35 1.31 NA NA 0.04 1.57 1.53 NA NA XXX 90775 ......... ............ A Ther/proph/diag inj add-on ............................ 0.10 0.51 0.56 NA NA 0.04 0.65 0.70 NA NA ZZZ90801 ......... ............ A Psy dx interview ............................................ 2.80 1.43 1.24 0.57 0.84 0.06 4.29 4.10 3.43 3.70 XXX 90802 ......... ............ A Intac psy dx interview .................................... 3.01 1.48 1.27 0.63 0.89 0.07 4.56 4.35 3.71 3.97 XXX 90804 ......... ............ A Psytx, office, 20-30 min ................................. 1.21 0.53 0.50 0.20 0.34 0.03 1.77 1.74 1.44 1.58 XXX 90805 ......... ............ A Psytx, off, 20-30 min w/e&m ......................... 1.37 0.58 0.52 0.23 0.37 0.03 1.98 1.92 1.63 1.77 XXX 90806 ......... ............ A Psytx, off, 45-50 min ..................................... 1.86 0.50 0.65 0.31 0.53 0.04 2.40 2.55 2.21 2.43 XXX 90807 ......... ............ A Psytx, off, 45-50 min w/e&m ......................... 2.02 0.68 0.70 0.34 0.56 0.05 2.75 2.77 2.41 2.63 XXX 90808 ......... ............ A Psytx, office, 75-80 min ................................. 2.79 0.65 0.94 0.47 0.79 0.06 3.50 3.79 3.32 3.64 XXX 90809 ......... ............ A Psytx, off, 75-80, w/e&m ............................... 2.95 0.83 0.96 0.50 0.82 0.07 3.85 3.98 3.52 3.84 XXX 90810 ......... ............ A Intac psytx, off, 20–30 min ............................ 1.32 0.50 0.51 0.23 0.37 0.04 1.86 1.87 1.59 1.73 XXX 90811 ......... ............ A Intac psytx, 20–30, w/e&m ............................ 1.48 0.70 0.60 0.25 0.41 0.04 2.22 2.12 1.77 1.93 XXX 90812 ......... ............ A Intac psytx, off, 45–50 min ............................ 1.97 0.62 0.75 0.33 0.56 0.04 2.63 2.76 2.34 2.57 XXX 90813 ......... ............ A Intac psytx, 45–50 min w/e&m ...................... 2.13 0.80 0.78 0.36 0.59 0.05 2.98 2.96 2.54 2.77 XXX 90814 ......... ............ A Intac psytx, off, 75–80 min ............................ 2.90 0.76 1.02 0.49 0.86 0.06 3.72 3.98 3.45 3.82 XXX 90815 ......... ............ A Intac psytx, 75–80 w/e&m ............................. 3.06 0.96 1.03 0.51 0.84 0.07 4.09 4.16 3.64 3.97 XXX 90816 ......... ............ A Psytx, hosp, 20–30 min ................................. 1.25 NA NA 0.31 0.42 0.03 NA NA 1.59 1.70 XXX 90817 ......... ............ A Psytx, hosp, 20–30 min w/e&m .................... 1.41 NA NA 0.34 0.43 0.03 NA NA 1.78 1.87 XXX 90818 ......... ............ A Psytx, hosp, 45–50 min ................................. 1.89 NA NA 0.41 0.62 0.04 NA NA 2.34 2.55 XXX 90819 ......... ............ A Psytx, hosp, 45–50 min w/e&m .................... 2.05 NA NA 0.45 0.60 0.05 NA NA 2.55 2.70 XXX 90821 ......... ............ A Psytx, hosp, 75–80 min ................................. 2.83 NA NA 0.57 0.90 0.06 NA NA 3.46 3.79 XXX 90822 ......... ............ A Psytx, hosp, 75–80 min w/e&m .................... 2.99 NA NA 0.61 0.87 0.08 NA NA 3.68 3.94 XXX 90823 ......... ............ A Intac psytx, hosp, 20–30 min ........................ 1.36 NA NA 0.33 0.44 0.03 NA NA 1.72 1.83 XXX 90824 ......... ............ A Intac psytx, hsp 20–30 w/e&m ...................... 1.52 NA NA 0.36 0.46 0.04 NA NA 1.92 2.02 XXX 90826 ......... ............ A Intac psytx, hosp, 45–50 min ........................ 2.01 NA NA 0.43 0.65 0.05 NA NA 2.49 2.71 XXX 90827 ......... ............ A Intac psytx, hsp 45–50 w/e&m ...................... 2.16 NA NA 0.46 0.63 0.05 NA NA 2.67 2.84 XXX 90828 ......... ............ A Intac psytx, hosp, 75–80 min ........................ 2.94 NA NA 0.59 0.94 0.06 NA NA 3.59 3.94 XXX 90829 ......... ............ A Intac psytx, hsp 75–80 w/e&m ...................... 3.10 NA NA 0.62 0.89 0.07 NA NA 3.79 4.06 XXX 90845 ......... ............ A Psychoanalysis .............................................. 1.79 0.37 0.53 0.30 0.49 0.04 2.20 2.36 2.13 2.32 XXX 90846 ......... ............ R Family psytx w/o patient ................................ 1.83 0.49 0.61 0.41 0.59 0.04 2.36 2.48 2.28 2.46 XXX 90847 ......... ............ R Family psytx w/patient ................................... 2.21 0.71 0.79 0.47 0.69 0.05 2.97 3.05 2.73 2.95 XXX 90849 ......... ............ R Multiple family group psytx ............................ 0.59 0.30 0.28 0.19 0.23 0.02 0.91 0.89 0.80 0.84 XXX 90853 ......... ............ A Group psychotherapy .................................... 0.59 0.26 0.25 0.19 0.22 0.01 0.86 0.85 0.79 0.82 XXX 90857 ......... ............ A Intac group psytx ........................................... 0.63 0.35 0.31 0.20 0.24 0.01 0.99 0.95 0.84 0.88 XXX 90862 ......... ............ A Medication management ............................... 0.95 0.60 0.45 0.26 0.31 0.02 1.57 1.42 1.23 1.28 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37400 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

90865 ......... ............ A Narcosynthesis .............................................. 2.84 1.16 1.31 0.62 0.84 0.12 4.12 4.27 3.58 3.80 XXX 90870 ......... ............ A Electroconvulsive therapy ............................. 1.88 1.84 1.92 0.37 0.54 0.04 3.76 3.84 2.29 2.46 000 90875 ......... ............ N Psychophysiological therapy ......................... 1.20 0.52 0.81 0.27 0.41 0.04 1.76 2.05 1.51 1.65 XXX 90876 ......... ............ N Psychophysiological therapy ......................... 1.90 0.66 1.04 0.43 0.66 0.05 2.61 2.99 2.38 2.61 XXX 90880 ......... ............ A Hypnotherapy ................................................ 2.19 0.55 0.92 0.36 0.61 0.05 2.79 3.16 2.60 2.85 XXX 90885 ......... ............ B Psy evaluation of records .............................. 0.97 0.22 0.33 0.22 0.33 0.02 1.21 1.32 1.21 1.32 XXX 90887 ......... ............ B Consultation with family ................................ 1.48 0.60 0.77 0.33 0.50 0.04 2.12 2.29 1.85 2.02 XXX 90901 ......... ............ A Biofeedback train, any meth ......................... 0.41 0.48 0.61 0.11 0.13 0.02 0.91 1.04 0.54 0.56 000 90911 ......... ............ A Biofeedback peri/uro/rectal ............................ 0.89 1.40 1.52 0.31 0.31 0.06 2.35 2.47 1.26 1.26 000 90918 ......... ............ I ESRD related services, month ...................... 11.16 4.64 5.76 3.68 5.52 0.36 16.16 17.28 15.20 17.04 XXX 90919 ......... ............ I ESRD related services, month ...................... 8.53 2.98 3.75 2.50 3.63 0.29 11.80 12.57 11.32 12.45 XXX 90920 ......... ............ I ESRD related services, month ...................... 7.26 2.70 3.50 2.23 3.38 0.23 10.19 10.99 9.72 10.87 XXX 90921 ......... ............ I ESRD related services, month ...................... 4.46 1.68 2.26 1.59 2.24 0.14 6.28 6.86 6.19 6.84 XXX 90922 ......... ............ I ESRD related services, day .......................... 0.37 0.16 0.20 0.12 0.19 0.01 0.54 0.58 0.50 0.57 XXX 90923 ......... ............ I Esrd related services, day ............................. 0.28 0.09 0.12 0.08 0.12 0.01 0.38 0.41 0.37 0.41 XXX 90924 ......... ............ I Esrd related services, day ............................. 0.24 0.09 0.11 0.07 0.11 0.01 0.34 0.36 0.32 0.36 XXX 90925 ......... ............ I Esrd related services, day ............................. 0.15 0.05 0.07 0.05 0.07 0.01 0.21 0.23 0.21 0.23 XXX 90935 ......... ............ A Hemodialysis, one evaluation ....................... 1.22 NA NA 0.53 0.64 0.04 NA NA 1.79 1.90 000 90937 ......... ............ A Hemodialysis, repeated eval ......................... 2.11 NA NA 0.76 0.92 0.07 NA NA 2.94 3.10 000 90945 ......... ............ A Dialysis, one evaluation ................................ 1.28 NA NA 0.55 0.66 0.04 NA NA 1.87 1.98 000 90947 ......... ............ A Dialysis, repeated eval .................................. 2.16 NA NA 0.78 0.94 0.07 NA NA 3.01 3.17 000 90997 ......... ............ A Hemoperfusion .............................................. 1.84 NA NA 0.49 0.62 0.06 NA NA 2.39 2.52 000 91000 ......... ............ A Esophageal intubation ................................... 0.73 2.22 0.80 NA NA 0.04 2.99 1.57 NA NA 000 91000 ......... 26 ....... A Esophageal intubation ................................... 0.73 0.24 0.25 0.24 0.25 0.03 1.00 1.01 1.00 1.01 000 91000 ......... TC ...... A Esophageal intubation ................................... 0.00 1.98 0.56 NA NA 0.01 1.99 0.57 NA NA 000 91010 ......... ............ A Esophagus motility study .............................. 1.25 4.79 4.51 NA NA 0.12 6.16 5.88 NA NA 00091010 ......... 26 ....... A Esophagus motility study .............................. 1.25 0.57 0.47 0.57 0.47 0.06 1.88 1.78 1.88 1.78 000 91010 ......... TC ...... A Esophagus motility study .............................. 0.00 4.22 4.04 NA NA 0.06 4.28 4.10 NA NA 000 91011 ......... ............ A Esophagus motility study .............................. 1.50 5.59 5.33 NA NA 0.13 7.22 6.96 NA NA 00091011 ......... 26 ....... A Esophagus motility study .............................. 1.50 0.74 0.58 0.74 0.58 0.07 2.31 2.15 2.31 2.15 000 91011 ......... TC ...... A Esophagus motility study .............................. 0.00 4.85 4.75 NA NA 0.06 4.91 4.81 NA NA 000 91012 ......... ............ A Esophagus motility study .............................. 1.46 5.78 5.77 NA NA 0.13 7.37 7.36 NA NA 00091012 ......... 26 ....... A Esophagus motility study .............................. 1.46 0.72 0.56 0.72 0.56 0.06 2.24 2.08 2.24 2.08 000 91012 ......... TC ...... A Esophagus motility study .............................. 0.00 5.06 5.21 NA NA 0.07 5.13 5.28 NA NA 000 91020 ......... ............ A Gastric motility studies .................................. 1.44 5.03 4.66 NA NA 0.13 6.60 6.23 NA NA 000 91020 ......... 26 ....... A Gastric motility studies .................................. 1.44 0.63 0.53 0.63 0.53 0.07 2.14 2.04 2.14 2.04 000 91020 ......... TC ...... A Gastric motility studies .................................. 0.00 4.40 4.13 NA NA 0.06 4.46 4.19 NA NA 00091022 ......... ............ A Duodenal motility study ................................. 1.44 3.19 4.11 NA NA 0.13 4.76 5.68 NA NA 000 91022 ......... 26 ....... A Duodenal motility study ................................. 1.44 0.63 0.54 0.63 0.54 0.07 2.14 2.05 2.14 2.05 000 91022 ......... TC ...... A Duodenal motility study ................................. 0.00 2.56 3.57 NA NA 0.06 2.62 3.63 NA NA 000 91030 ......... ............ A Acid perfusion of esophagus ......................... 0.91 3.03 2.59 NA NA 0.06 4.00 3.56 NA NA 000 91030 ......... 26 ....... A Acid perfusion of esophagus ......................... 0.91 0.45 0.35 0.45 0.35 0.04 1.40 1.30 1.40 1.30 000 91030 ......... TC ...... A Acid perfusion of esophagus ......................... 0.00 2.58 2.24 NA NA 0.02 2.60 2.26 NA NA 000 91034 ......... ............ A Gastroesophageal reflux test ........................ 0.97 5.81 5.39 NA NA 0.12 6.90 6.48 NA NA 000 91034 ......... 26 ....... A Gastroesophageal reflux test ........................ 0.97 0.43 0.36 0.43 0.36 0.06 1.46 1.39 1.46 1.39 000 91034 ......... TC ...... A Gastroesophageal reflux test ........................ 0.00 5.38 5.03 NA NA 0.06 5.44 5.09 NA NA 000 91035 ......... ............ A G-esoph reflx tst w/electrod .......................... 1.59 11.66 11.04 NA NA 0.12 13.37 12.75 NA NA 000 91035 ......... 26 ....... A G-esoph reflx tst w/electrod .......................... 1.59 0.73 0.60 0.73 0.60 0.06 2.38 2.25 2.38 2.25 000 91035 ......... TC ...... A G-esoph reflx tst w/electrod .......................... 0.00 10.93 10.44 NA NA 0.06 10.99 10.50 NA NA 00091037 ......... ............ A Esoph imped function test ............................. 0.97 3.50 3.08 NA NA 0.12 4.59 4.17 NA NA 00091037 ......... 26 ....... A Esoph imped function test ............................. 0.97 0.44 0.37 0.44 0.37 0.06 1.47 1.40 1.47 1.40 000 91037 ......... TC ...... A Esoph imped function test ............................. 0.00 3.06 2.72 NA NA 0.06 3.12 2.78 NA NA 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37401 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

91038 ......... ............ A Esoph imped funct test > 1h ......................... 1.10 2.85 2.39 NA NA 0.12 4.07 3.61 NA NA 000 91038 ......... 26 ....... A Esoph imped funct test > 1h ......................... 1.10 0.52 0.42 0.52 0.42 0.06 1.68 1.58 1.68 1.58 000 91038 ......... TC ...... A Esoph imped funct test > 1h ......................... 0.00 2.32 1.96 NA NA 0.06 2.38 2.02 NA NA 000 91040 ......... ............ A Esoph balloon distension tst ......................... 0.97 9.54 10.76 NA NA 0.12 10.63 11.85 NA NA 000 91040 ......... 26 ....... A Esoph balloon distension tst ......................... 0.97 0.39 0.35 0.39 0.35 0.06 1.42 1.38 1.42 1.38 000 91040 ......... TC ...... A Esoph balloon distension tst ......................... 0.00 9.15 10.40 NA NA 0.06 9.21 10.46 NA NA 000 91052 ......... ............ A Gastric analysis test ...................................... 0.79 3.10 2.62 NA NA 0.05 3.94 3.46 NA NA 000 91052 ......... 26 ....... A Gastric analysis test ...................................... 0.79 0.39 0.31 0.39 0.31 0.03 1.21 1.13 1.21 1.13 000 91052 ......... TC ...... A Gastric analysis test ...................................... 0.00 2.71 2.31 NA NA 0.02 2.73 2.33 NA NA 000 91055 ......... ............ A Gastric intubation for smear .......................... 0.94 2.42 2.82 NA NA 0.07 3.43 3.83 NA NA 00091055 ......... 26 ....... A Gastric intubation for smear .......................... 0.94 0.27 0.27 0.27 0.27 0.05 1.26 1.26 1.26 1.26 000 91055 ......... TC ...... A Gastric intubation for smear .......................... 0.00 2.15 2.55 NA NA 0.02 2.17 2.57 NA NA 000 91060 ......... ............ A Gastric saline load test .................................. 0.45 1.64 1.89 NA NA 0.05 2.14 2.39 NA NA 000 91060 ......... 26 ....... A Gastric saline load test .................................. 0.45 0.11 0.13 0.11 0.13 0.03 0.59 0.61 0.59 0.61 000 91060 ......... TC ...... A Gastric saline load test .................................. 0.00 1.53 1.76 NA NA 0.02 1.55 1.78 NA NA 00091065 ......... ............ A Breath hydrogen test ..................................... 0.20 1.39 1.44 NA NA 0.03 1.62 1.67 NA NA 000 91065 ......... 26 ....... A Breath hydrogen test ..................................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 000 91065 ......... TC ...... A Breath hydrogen test ..................................... 0.00 1.32 1.37 NA NA 0.02 1.34 1.39 NA NA 000 91100 ......... ............ A Pass intestine bleeding tube ......................... 1.08 2.15 2.64 0.37 0.30 0.07 3.30 3.79 1.52 1.45 000 91105 ......... ............ A Gastric intubation treatment .......................... 0.37 1.75 2.02 0.07 0.09 0.03 2.15 2.42 0.47 0.49 000 91110 ......... ............ A Gi tract capsule endoscopy ........................... 3.64 21.22 21.99 NA NA 0.16 25.02 25.79 NA NA XXX 91110 ......... 26 ....... A Gi tract capsule endoscopy ........................... 3.64 1.74 1.40 1.74 1.40 0.09 5.47 5.13 5.47 5.13 XXX 91110 ......... TC ...... A Gi tract capsule endoscopy ........................... 0.00 19.48 20.59 NA NA 0.07 19.55 20.66 NA NA XXX 91120 ......... ............ A Rectal sensation test ..................................... 0.97 9.15 10.55 NA NA 0.11 10.23 11.63 NA NA XXX 91120 ......... 26 ....... A Rectal sensation test ..................................... 0.97 0.30 0.33 0.30 0.33 0.07 1.34 1.37 1.34 1.37 XXX 91120 ......... TC ...... A Rectal sensation test ..................................... 0.00 8.85 10.22 NA NA 0.04 8.89 10.26 NA NA XXX 91122 ......... ............ A Anal pressure record ..................................... 1.77 3.83 4.79 NA NA 0.21 5.81 6.77 NA NA 000 91122 ......... 26 ....... A Anal pressure record ..................................... 1.77 0.52 0.58 0.52 0.58 0.13 2.42 2.48 2.42 2.48 000 91122 ......... TC ...... A Anal pressure record ..................................... 0.00 3.32 4.21 NA NA 0.08 3.40 4.29 NA NA 000 91132 ......... 26 ....... A Electrogastrography ...................................... 0.52 0.27 0.20 0.27 0.20 0.02 0.81 0.74 0.81 0.74 XXX 91133 ......... 26 ....... A Electrogastrography w/test ............................ 0.66 0.31 0.25 0.31 0.25 0.03 1.00 0.94 1.00 0.94 XXX 92002 ......... ............ A Eye exam, new patient .................................. 0.88 0.96 0.97 0.26 0.32 0.02 1.86 1.87 1.16 1.22 XXX 92004 ......... ............ A Eye exam, new patient .................................. 1.67 1.57 1.67 0.52 0.64 0.04 3.28 3.38 2.23 2.35 XXX 92012 ......... ............ A Eye exam established pat ............................. 0.67 0.93 1.01 0.23 0.28 0.02 1.62 1.70 0.92 0.97 XXX 92014 ......... ............ A Eye exam & treatment .................................. 1.10 1.30 1.38 0.36 0.44 0.03 2.43 2.51 1.49 1.57 XXX 92015 ......... ............ N Refraction ...................................................... 0.38 0.10 1.14 0.09 0.14 0.01 0.49 1.53 0.48 0.53 XXX 92018 ......... ............ A New eye exam & treatment .......................... 2.50 NA NA 0.88 1.02 0.07 NA NA 3.45 3.59 XXX 92019 ......... ............ A Eye exam & treatment .................................. 1.31 NA NA 0.42 0.53 0.03 NA NA 1.76 1.87 XXX92020 ......... ............ A Special eye evaluation .................................. 0.37 0.25 0.32 0.13 0.15 0.01 0.63 0.70 0.51 0.53 XXX 92060 ......... ............ A Special eye evaluation .................................. 0.69 0.77 0.74 NA NA 0.03 1.49 1.46 NA NA XXX 92060 ......... 26 ....... A Special eye evaluation .................................. 0.69 0.23 0.28 0.23 0.28 0.02 0.94 0.99 0.94 0.99 XXX 92060 ......... TC ...... A Special eye evaluation .................................. 0.00 0.55 0.47 NA NA 0.01 0.56 0.48 NA NA XXX 92065 ......... ............ A Orthoptic/pleoptic training .............................. 0.37 0.87 0.62 NA NA 0.02 1.26 1.01 NA NA XXX 92065 ......... 26 ....... A Orthoptic/pleoptic training .............................. 0.37 0.09 0.14 0.09 0.14 0.01 0.47 0.52 0.47 0.52 XXX 92065 ......... TC ...... A Orthoptic/pleoptic training .............................. 0.00 0.78 0.48 NA NA 0.01 0.79 0.49 NA NA XXX 92070 ......... ............ A Fitting of contact lens .................................... 0.70 0.92 1.03 0.23 0.30 0.02 1.64 1.75 0.95 1.02 XXX 92081 ......... ............ A Visual field examination(s) ............................ 0.36 0.96 0.95 NA NA 0.02 1.34 1.33 NA NA XXX 92081 ......... 26 ....... A Visual field examination(s) ............................ 0.36 0.11 0.14 0.11 0.14 0.01 0.48 0.51 0.48 0.51 XXX 92081 ......... TC ...... A Visual field examination(s) ............................ 0.00 0.85 0.81 NA NA 0.01 0.86 0.82 NA NA XXX 92082 ......... ............ A Visual field examination(s) ............................ 0.44 1.34 1.26 NA NA 0.02 1.80 1.72 NA NA XXX 92082 ......... 26 ....... A Visual field examination(s) ............................ 0.44 0.14 0.18 0.14 0.18 0.01 0.59 0.63 0.59 0.63 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37402 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

92082 ......... TC ...... A Visual field examination(s) ............................ 0.00 1.20 1.08 NA NA 0.01 1.21 1.09 NA NA XXX 92083 ......... ............ A Visual field examination(s) ............................ 0.50 1.54 1.46 NA NA 0.02 2.06 1.98 NA NA XXX 92083 ......... 26 ....... A Visual field examination(s) ............................ 0.50 0.17 0.21 0.17 0.21 0.01 0.68 0.72 0.68 0.72 XXX 92083 ......... TC ...... A Visual field examination(s) ............................ 0.00 1.37 1.25 NA NA 0.01 1.38 1.26 NA NA XXX 92100 ......... ............ A Serial tonometry exam(s) .............................. 0.92 1.26 1.33 0.28 0.34 0.02 2.20 2.27 1.22 1.28 XXX 92120 ......... ............ A Tonography & eye evaluation ....................... 0.81 0.99 1.05 0.25 0.30 0.02 1.82 1.88 1.08 1.13 XXX 92130 ......... ............ A Water provocation tonography ...................... 0.81 1.19 1.26 0.27 0.35 0.02 2.02 2.09 1.10 1.18 XXX 92135 ......... ............ A Opthalmic dx imaging .................................... 0.35 0.80 0.79 NA NA 0.02 1.17 1.16 NA NA XXX 92135 ......... 26 ....... A Opthalmic dx imaging .................................... 0.35 0.12 0.14 0.12 0.14 0.01 0.48 0.50 0.48 0.50 XXX 92135 ......... TC ...... A Opthalmic dx imaging .................................... 0.00 0.68 0.65 NA NA 0.01 0.69 0.66 NA NA XXX 92136 ......... ............ A Ophthalmic biometry ..................................... 0.54 1.41 1.59 NA NA 0.08 2.03 2.21 NA NA XXX 92136 ......... 26 ....... A Ophthalmic biometry ..................................... 0.54 0.19 0.23 0.19 0.23 0.01 0.74 0.78 0.74 0.78 XXX 92136 ......... TC ...... A Ophthalmic biometry ..................................... 0.00 1.22 1.36 NA NA 0.07 1.29 1.43 NA NA XXX 92140 ......... ............ A Glaucoma provocative tests .......................... 0.50 0.91 0.97 0.15 0.20 0.01 1.42 1.48 0.66 0.71 XXX 92225 ......... ............ A Special eye exam, initial ............................... 0.38 0.18 0.21 0.12 0.15 0.01 0.57 0.60 0.51 0.54 XXX 92226 ......... ............ A Special eye exam, subsequent ..................... 0.33 0.18 0.20 0.12 0.14 0.01 0.52 0.54 0.46 0.48 XXX 92230 ......... ............ A Eye exam with photos ................................... 0.60 0.69 1.32 0.20 0.20 0.02 1.31 1.94 0.82 0.82 XXX 92235 ......... ............ A Eye exam with photos ................................... 0.81 2.27 2.53 NA NA 0.08 3.16 3.42 NA NA XXX 92235 ......... 26 ....... A Eye exam with photos ................................... 0.81 0.29 0.35 0.29 0.35 0.02 1.12 1.18 1.12 1.18 XXX 92235 ......... TC ...... A Eye exam with photos ................................... 0.00 1.98 2.18 NA NA 0.06 2.04 2.24 NA NA XXX 92240 ......... ............ A Icg angiography ............................................. 1.10 4.43 5.70 NA NA 0.09 5.62 6.89 NA NA XXX 92240 ......... 26 ....... A Icg angiography ............................................. 1.10 0.40 0.48 0.40 0.48 0.03 1.53 1.61 1.53 1.61 XXX 92240 ......... TC ...... A Icg angiography ............................................. 0.00 4.03 5.22 NA NA 0.06 4.09 5.28 NA NA XXX 92250 ......... ............ A Eye exam with photos ................................... 0.44 1.31 1.48 NA NA 0.02 1.77 1.94 NA NA XXX 92250 ......... 26 ....... A Eye exam with photos ................................... 0.44 0.14 0.18 0.14 0.18 0.01 0.59 0.63 0.59 0.63 XXX 92250 ......... TC ...... A Eye exam with photos ................................... 0.00 1.16 1.30 NA NA 0.01 1.17 1.31 NA NA XXX 92260 ......... ............ A Ophthalmoscopy/dynamometry ..................... 0.20 0.19 0.24 0.07 0.09 0.01 0.40 0.45 0.28 0.30 XXX 92265 ......... ............ A Eye muscle evaluation .................................. 0.81 0.99 1.37 NA NA 0.06 1.86 2.24 NA NA XXX 92265 ......... 26 ....... A Eye muscle evaluation .................................. 0.81 0.23 0.27 0.23 0.27 0.04 1.08 1.12 1.08 1.12 XXX 92265 ......... TC ...... A Eye muscle evaluation .................................. 0.00 0.76 1.10 NA NA 0.02 0.78 1.12 NA NA XXX 92270 ......... ............ A Electro-oculography ....................................... 0.81 1.41 1.50 NA NA 0.05 2.27 2.36 NA NA XXX 92270 ......... 26 ....... A Electro-oculography ....................................... 0.81 0.24 0.31 0.24 0.31 0.03 1.08 1.15 1.08 1.15 XXX 92270 ......... TC ...... A Electro-oculography ....................................... 0.00 1.18 1.20 NA NA 0.02 1.20 1.22 NA NA XXX92275 ......... ............ A Electroretinography ....................................... 1.01 2.45 2.07 NA NA 0.05 3.51 3.13 NA NA XXX 92275 ......... 26 ....... A Electroretinography ....................................... 1.01 0.35 0.41 0.35 0.41 0.03 1.39 1.45 1.39 1.45 XXX 92275 ......... TC ...... A Electroretinography ....................................... 0.00 2.10 1.66 NA NA 0.02 2.12 1.68 NA NA XXX92283 ......... ............ A Color vision examination ............................... 0.17 1.00 0.88 NA NA 0.02 1.19 1.07 NA NA XXX 92283 ......... 26 ....... A Color vision examination ............................... 0.17 0.05 0.07 0.05 0.07 0.01 0.23 0.25 0.23 0.25 XXX 92283 ......... TC ...... A Color vision examination ............................... 0.00 0.95 0.82 NA NA 0.01 0.96 0.83 NA NA XXX 92284 ......... ............ A Dark adaptation eye exam ............................ 0.24 1.23 1.73 NA NA 0.02 1.49 1.99 NA NA XXX 92284 ......... 26 ....... A Dark adaptation eye exam ............................ 0.24 0.08 0.08 0.08 0.08 0.01 0.33 0.33 0.33 0.33 XXX 92284 ......... TC ...... A Dark adaptation eye exam ............................ 0.00 1.14 1.64 NA NA 0.01 1.15 1.65 NA NA XXX 92285 ......... ............ A Eye photography ........................................... 0.20 0.81 0.95 NA NA 0.02 1.03 1.17 NA NA XXX 92285 ......... 26 ....... A Eye photography ........................................... 0.20 0.07 0.09 0.07 0.09 0.01 0.28 0.30 0.28 0.30 XXX 92285 ......... TC ...... A Eye photography ........................................... 0.00 0.74 0.86 NA NA 0.01 0.75 0.87 NA NA XXX92286 ......... ............ A Internal eye photography .............................. 0.66 2.14 2.83 NA NA 0.04 2.84 3.53 NA NA XXX92286 ......... 26 ....... A Internal eye photography .............................. 0.66 0.23 0.28 0.23 0.28 0.02 0.91 0.96 0.91 0.96 XXX 92286 ......... TC ...... A Internal eye photography .............................. 0.00 1.92 2.56 NA NA 0.02 1.94 2.58 NA NA XXX 92287 ......... ............ A Internal eye photography .............................. 0.81 1.95 2.28 0.29 0.31 0.02 2.78 3.11 1.12 1.14 XXX 92310 ......... ............ N Contact lens fitting ......................................... 1.17 1.05 1.10 0.26 0.40 0.04 2.26 2.31 1.47 1.61 XXX 92311 ......... ............ A Contact lens fitting ......................................... 1.08 1.28 1.14 0.31 0.34 0.03 2.39 2.25 1.42 1.45 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37403 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

92312 ......... ............ A Contact lens fitting ......................................... 1.26 1.48 1.18 0.34 0.46 0.03 2.77 2.47 1.63 1.75 XXX 92313 ......... ............ A Contact lens fitting ......................................... 0.92 1.46 1.16 0.32 0.30 0.02 2.40 2.10 1.26 1.24 XXX 92314 ......... ............ N Prescription of contact lens ........................... 0.69 1.13 0.99 0.15 0.24 0.01 1.83 1.69 0.85 0.94 XXX 92315 ......... ............ A Prescription of contact lens ........................... 0.45 1.33 0.97 0.13 0.15 0.01 1.79 1.43 0.59 0.61 XXX 92316 ......... ............ A Prescription of contact lens ........................... 0.68 1.66 1.10 0.23 0.28 0.02 2.36 1.80 0.93 0.98 XXX 92317 ......... ............ A Prescription of contact lens ........................... 0.45 1.43 1.06 0.13 0.15 0.01 1.89 1.52 0.59 0.61 XXX 92325 ......... ............ A Modification of contact lens ........................... 0.00 0.84 0.51 NA NA 0.01 0.85 0.52 NA NA XXX 92326 ......... ............ A Replacement of contact lens ......................... 0.00 0.75 1.41 NA NA 0.06 0.81 1.47 NA NA XXX 92340 ......... ............ N Fitting of spectacles ...................................... 0.37 0.44 0.64 0.08 0.13 0.01 0.82 1.02 0.46 0.51 XXX 92341 ......... ............ N Fitting of spectacles ...................................... 0.47 0.46 0.67 0.11 0.16 0.01 0.94 1.15 0.59 0.64 XXX 92342 ......... ............ N Fitting of spectacles ...................................... 0.53 0.48 0.69 0.12 0.19 0.01 1.02 1.23 0.66 0.73 XXX 92352 ......... ............ B Special spectacles fitting ............................... 0.37 0.56 0.65 0.08 0.13 0.01 0.94 1.03 0.46 0.51 XXX 92353 ......... ............ B Special spectacles fitting ............................... 0.50 0.59 0.70 0.11 0.17 0.02 1.11 1.22 0.63 0.69 XXX 92354 ......... ............ B Special spectacles fitting ............................... 0.00 0.28 6.74 NA NA 0.10 0.38 6.84 NA NA XXX 92355 ......... ............ B Special spectacles fitting ............................... 0.00 0.44 3.37 NA NA 0.01 0.45 3.38 NA NA XXX 92358 ......... ............ B Eye prosthesis service .................................. 0.00 0.23 0.79 NA NA 0.05 0.28 0.84 NA NA XXX 92370 ......... ............ N Repair & adjust spectacles ........................... 0.32 0.39 0.51 0.07 0.12 0.02 0.73 0.85 0.41 0.46 XXX 92371 ......... ............ B Repair & adjust spectacles ........................... 0.00 0.24 0.53 NA NA 0.02 0.26 0.55 NA NA XXX 92502 ......... ............ A Ear and throat examination ........................... 1.51 NA NA 0.76 1.02 0.05 NA NA 2.32 2.58 000 92504 ......... ............ A Ear microscopy examination ......................... 0.18 0.55 0.51 0.05 0.08 0.01 0.74 0.70 0.24 0.27 XXX 92506 ......... ............ A Speech/hearing evaluation ............................ 0.86 3.25 2.76 0.24 0.36 0.03 4.14 3.65 1.13 1.25 XXX 92507 ......... ............ A Speech/hearing therapy ................................ 0.52 1.18 1.13 0.14 0.21 0.02 1.72 1.67 0.68 0.75 XXX 92508 ......... ............ A Speech/hearing therapy ................................ 0.26 0.52 0.51 0.08 0.11 0.01 0.79 0.78 0.35 0.38 XXX 92511 ......... ............ A Nasopharyngoscopy ...................................... 0.84 2.89 3.21 0.60 0.74 0.03 3.76 4.08 1.47 1.61 000 92512 ......... ............ A Nasal function studies ................................... 0.55 0.93 1.09 0.15 0.17 0.02 1.50 1.66 0.72 0.74 XXX 92516 ......... ............ A Facial nerve function test .............................. 0.43 1.14 1.19 0.12 0.20 0.01 1.58 1.63 0.56 0.64 XXX 92520 ......... ............ A Laryngeal function studies ............................ 0.75 0.93 0.62 0.24 0.35 0.03 1.71 1.40 1.02 1.13 XXX 92526 ......... ............ A Oral function therapy ..................................... 0.55 1.68 1.65 0.16 0.19 0.02 2.25 2.22 0.73 0.76 XXX 92541 ......... ............ A Spontaneous nystagmus test ........................ 0.40 1.14 1.06 NA NA 0.04 1.58 1.50 NA NA XXX 92541 ......... 26 ....... A Spontaneous nystagmus test ........................ 0.40 0.11 0.17 0.11 0.17 0.02 0.53 0.59 0.53 0.59 XXX 92541 ......... TC ...... A Spontaneous nystagmus test ........................ 0.00 1.02 0.89 NA NA 0.02 1.04 0.91 NA NA XXX 92542 ......... ............ A Positional nystagmus test ............................. 0.33 1.28 1.18 NA NA 0.03 1.64 1.54 NA NA XXX92542 ......... 26 ....... A Positional nystagmus test ............................. 0.33 0.09 0.14 0.09 0.14 0.01 0.43 0.48 0.43 0.48 XXX 92542 ......... TC ...... A Positional nystagmus test ............................. 0.00 1.18 1.03 NA NA 0.02 1.20 1.05 NA NA XXX 92543 ......... ............ A Caloric vestibular test .................................... 0.10 0.65 0.59 NA NA 0.02 0.77 0.71 NA NA XXX 92543 ......... 26 ....... A Caloric vestibular test .................................... 0.10 0.03 0.05 0.03 0.05 0.01 0.14 0.16 0.14 0.16 XXX 92543 ......... TC ...... A Caloric vestibular test .................................... 0.00 0.62 0.55 NA NA 0.01 0.63 0.56 NA NA XXX 92544 ......... ............ A Optokinetic nystagmus test ........................... 0.26 1.04 0.94 NA NA 0.03 1.33 1.23 NA NA XXX 92544 ......... 26 ....... A Optokinetic nystagmus test ........................... 0.26 0.07 0.11 0.07 0.11 0.01 0.34 0.38 0.34 0.38 XXX 92544 ......... TC ...... A Optokinetic nystagmus test ........................... 0.00 0.96 0.83 NA NA 0.02 0.98 0.85 NA NA XXX 92545 ......... ............ A Oscillating tracking test ................................. 0.23 1.01 0.85 NA NA 0.03 1.27 1.11 NA NA XXX 92545 ......... 26 ....... A Oscillating tracking test ................................. 0.23 0.06 0.10 0.06 0.10 0.01 0.30 0.34 0.30 0.34 XXX 92545 ......... TC ...... A Oscillating tracking test ................................. 0.00 0.95 0.76 NA NA 0.02 0.97 0.78 NA NA XXX92546 ......... ............ A Sinusoidal rotational test ............................... 0.29 1.87 1.96 NA NA 0.03 2.19 2.28 NA NA XXX 92546 ......... 26 ....... A Sinusoidal rotational test ............................... 0.29 0.08 0.12 0.08 0.12 0.01 0.38 0.42 0.38 0.42 XXX 92546 ......... TC ...... A Sinusoidal rotational test ............................... 0.00 1.78 1.84 NA NA 0.02 1.80 1.86 NA NA XXX 92547 ......... ............ A Supplemental electrical test .......................... 0.00 0.11 0.09 NA NA 0.06 0.17 0.15 NA NA ZZZ92548 ......... ............ A Posturography ............................................... 0.50 1.68 2.12 NA NA 0.15 2.33 2.77 NA NA XXX 92548 ......... 26 ....... A Posturography ............................................... 0.50 0.14 0.23 0.14 0.23 0.02 0.66 0.75 0.66 0.75 XXX 92548 ......... TC ...... A Posturography ............................................... 0.00 1.54 1.89 NA NA 0.13 1.67 2.02 NA NA XXX 92552 ......... ............ A Pure tone audiometry, air .............................. 0.00 0.56 0.47 NA NA 0.04 0.60 0.51 NA NA XXX 92553 ......... ............ A Audiometry, air & bone ................................. 0.00 0.70 0.67 NA NA 0.06 0.76 0.73 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37404 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

92555 ......... ............ A Speech threshold audiometry ....................... 0.00 0.38 0.38 NA NA 0.04 0.42 0.42 NA NA XXX 92556 ......... ............ A Speech audiometry, complete ....................... 0.00 0.51 0.56 NA NA 0.06 0.57 0.62 NA NA XXX 92557 ......... ............ A Comprehensive hearing test ......................... 0.00 1.25 1.21 NA NA 0.12 1.37 1.33 NA NA XXX 92561 ......... ............ A Bekesy audiometry, diagnosis ...................... 0.00 0.76 0.73 NA NA 0.06 0.82 0.79 NA NA XXX 92562 ......... ............ A Loudness balance test .................................. 0.00 0.67 0.48 NA NA 0.04 0.71 0.52 NA NA XXX 92563 ......... ............ A Tone decay hearing test ............................... 0.00 0.51 0.41 NA NA 0.04 0.55 0.45 NA NA XXX92564 ......... ............ A Sisi hearing test ............................................. 0.00 0.49 0.48 NA NA 0.05 0.54 0.53 NA NA XXX 92565 ......... ............ A Stenger test, pure tone ................................. 0.00 0.26 0.37 NA NA 0.04 0.30 0.41 NA NA XXX 92567 ......... ............ A Tympanometry ............................................... 0.00 0.49 0.51 NA NA 0.06 0.55 0.57 NA NA XXX 92568 ......... ............ A Acoustic refl threshold tst .............................. 0.00 0.15 0.32 NA NA 0.04 0.19 0.36 NA NA XXX 92569 ......... ............ A Acoustic reflex decay test ............................. 0.00 0.15 0.35 NA NA 0.04 0.19 0.39 NA NA XXX 92571 ......... ............ A Filtered speech hearing test .......................... 0.00 0.40 0.39 NA NA 0.04 0.44 0.43 NA NA XXX92572 ......... ............ A Staggered spondaic word test ...................... 0.00 0.60 0.22 NA NA 0.01 0.61 0.23 NA NA XXX 92573 ......... ............ A Lombard test ................................................. 0.00 0.49 0.39 NA NA 0.04 0.53 0.43 NA NA XXX 92575 ......... ............ A Sensorineural acuity test ............................... 0.00 1.09 0.50 NA NA 0.02 1.11 0.52 NA NA XXX 92576 ......... ............ A Synthetic sentence test ................................. 0.00 0.53 0.46 NA NA 0.05 0.58 0.51 NA NA XXX 92577 ......... ............ A Stenger test, speech ..................................... 0.00 0.27 0.61 NA NA 0.07 0.34 0.68 NA NA XXX 92579 ......... ............ A Visual audiometry (vra) ................................. 0.00 0.83 0.76 NA NA 0.06 0.89 0.82 NA NA XXX 92582 ......... ............ A Conditioning play audiometry ........................ 0.00 1.07 0.82 NA NA 0.06 1.13 0.88 NA NA XXX 92583 ......... ............ A Select picture audiometry .............................. 0.00 0.69 0.84 NA NA 0.08 0.77 0.92 NA NA XXX 92584 ......... ............ A Electrocochleography .................................... 0.00 1.25 2.17 NA NA 0.21 1.46 2.38 NA NA XXX 92585 ......... ............ A Auditor evoke potent, compre ....................... 0.50 1.97 2.05 NA NA 0.17 2.64 2.72 NA NA XXX 92585 ......... 26 ....... A Auditor evoke potent, compre ....................... 0.50 0.15 0.20 0.15 0.20 0.03 0.68 0.73 0.68 0.73 XXX 92585 ......... TC ...... A Auditor evoke potent, compre ....................... 0.00 1.82 1.85 NA NA 0.14 1.96 1.99 NA NA XXX 92586 ......... ............ A Auditor evoke potent, limit ............................. 0.00 1.39 1.74 NA NA 0.14 1.53 1.88 NA NA XXX 92587 ......... ............ A Evoked auditory test ...................................... 0.13 0.61 1.18 NA NA 0.12 0.86 1.43 NA NA XXX 92587 ......... 26 ....... A Evoked auditory test ...................................... 0.13 0.03 0.05 0.03 0.05 0.01 0.17 0.19 0.17 0.19 XXX 92587 ......... TC ...... A Evoked auditory test ...................................... 0.00 0.57 1.13 NA NA 0.11 0.68 1.24 NA NA XXX92588 ......... ............ A Evoked auditory test ...................................... 0.36 1.03 1.48 NA NA 0.14 1.53 1.98 NA NA XXX 92588 ......... 26 ....... A Evoked auditory test ...................................... 0.36 0.10 0.15 0.10 0.15 0.01 0.47 0.52 0.47 0.52 XXX 92588 ......... TC ...... A Evoked auditory test ...................................... 0.00 0.93 1.34 NA NA 0.13 1.06 1.47 NA NA XXX92596 ......... ............ A Ear protector evaluation ................................ 0.00 0.93 0.68 NA NA 0.06 0.99 0.74 NA NA XXX 92597 ......... ............ A Oral speech device eval ................................ 0.86 1.67 1.69 0.24 0.40 0.03 2.56 2.58 1.13 1.29 XXX 92601 ......... ............ A Cochlear implt f/up exam < 7 ........................ 0.00 4.82 3.84 NA NA 0.07 4.89 3.91 NA NA XXX 92602 ......... ............ A Reprogram cochlear implt < 7 ...................... 0.00 3.31 2.62 NA NA 0.07 3.38 2.69 NA NA XXX 92603 ......... ............ A Cochlear implt f/up exam 7 > ........................ 0.00 3.13 2.40 NA NA 0.07 3.20 2.47 NA NA XXX 92604 ......... ............ A Reprogram cochlear implt 7 > ...................... 0.00 2.07 1.53 NA NA 0.07 2.14 1.60 NA NA XXX 92607 ......... ............ A Ex for speech device rx, 1hr ......................... 0.00 4.20 3.37 NA NA 0.05 4.25 3.42 NA NA XXX 92608 ......... ............ A Ex for speech device rx addl ........................ 0.00 0.83 0.62 NA NA 0.05 0.88 0.67 NA NA XXX 92609 ......... ............ A Use of speech device service ....................... 0.00 2.27 1.76 NA NA 0.04 2.31 1.80 NA NA XXX 92610 ......... ............ A Evaluate swallowing function ........................ 0.00 1.61 2.98 NA NA 0.08 1.69 3.06 NA NA XXX 92611 ......... ............ A Motion fluoroscopy/swallow ........................... 0.00 1.93 3.06 NA NA 0.08 2.01 3.14 NA NA XXX 92612 ......... ............ A Endoscopy swallow tst (fees) ........................ 1.27 2.71 2.74 0.35 0.58 0.04 4.02 4.05 1.66 1.89 XXX 92613 ......... ............ A Endoscopy swallow tst (fees) ........................ 0.71 0.22 0.36 0.22 0.35 0.05 0.98 1.12 0.98 1.11 XXX 92614 ......... ............ A Laryngoscopic sensory test ........................... 1.27 2.21 2.44 0.35 0.58 0.04 3.52 3.75 1.66 1.89 XXX 92615 ......... ............ A Eval laryngoscopy sense tst ......................... 0.63 0.17 0.31 0.17 0.31 0.05 0.85 0.99 0.85 0.99 XXX 92616 ......... ............ A Fees w/laryngeal sense test ......................... 1.88 2.88 3.27 0.51 0.87 0.06 4.82 5.21 2.45 2.81 XXX 92617 ......... ............ A Interprt fees/laryngeal test ............................. 0.79 0.22 0.39 0.22 0.39 0.05 1.06 1.23 1.06 1.23 XXX 92620 ......... ............ A Auditory function, 60 min .............................. 0.00 1.85 1.32 NA NA 0.06 1.91 1.38 NA NA XXX 92621 ......... ............ A Auditory function, + 15 min ........................... 0.00 0.40 0.29 NA NA 0.06 0.46 0.35 NA NA ZZZ92625 ......... ............ A Tinnitus assessment ...................................... 0.00 1.80 1.29 NA NA 0.06 1.86 1.35 NA NA XXX 92626 ......... ............ A Eval aud rehab status ................................... 0.00 1.83 2.11 NA NA 0.06 1.89 2.17 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37405 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

92627 ......... ............ A Eval aud status rehab add-on ....................... 0.00 0.42 0.52 NA NA 0.02 0.44 0.54 NA NA ZZZ 92950 ......... ............ A Heart/lung resuscitation cpr .......................... 3.79 3.22 3.96 0.75 0.92 0.28 7.29 8.03 4.82 4.99 000 92953 ......... ............ A Temporary external pacing ........................... 0.23 NA NA 0.07 0.07 0.02 NA NA 0.32 0.32 000 92960 ......... ............ A Cardioversion electric, ext ............................. 2.25 4.49 5.87 1.50 1.25 0.07 6.81 8.19 3.82 3.57 000 92961 ......... ............ A Cardioversion, electric, int ............................. 4.59 NA NA 2.55 2.21 0.29 NA NA 7.43 7.09 000 92970 ......... ............ A Cardioassist, internal ..................................... 3.51 NA NA 1.65 1.21 0.16 NA NA 5.32 4.88 000 92971 ......... ............ A Cardioassist, external .................................... 1.77 NA NA 1.10 0.91 0.06 NA NA 2.93 2.74 000 92973 ......... ............ A Percut coronary thrombectomy ..................... 3.28 NA NA 1.83 1.43 0.23 NA NA 5.34 4.94 ZZZ 92974 ......... ............ A Cath place, cardio brachytx .......................... 3.00 NA NA 1.71 1.31 0.21 NA NA 4.92 4.52 ZZZ 92975 ......... ............ A Dissolve clot, heart vessel ............................ 7.24 NA NA 3.96 3.11 0.50 NA NA 11.70 10.85 000 92977 ......... ............ A Dissolve clot, heart vessel ............................ 0.00 1.75 6.49 NA NA 0.46 2.21 6.95 NA NA XXX 92978 ......... ............ A Intravasc us, heart add-on ............................ 1.80 1.00 4.21 NA NA 0.30 3.10 6.31 NA NA ZZZ92978 ......... 26 ....... A Intravasc us, heart add-on ............................ 1.80 1.00 0.78 1.00 0.78 0.06 2.86 2.64 2.86 2.64 ZZZ 92978 ......... TC ...... A Intravasc us, heart add-on ............................ 0.00 0.00 3.43 NA NA 0.24 0.24 3.67 NA NA ZZZ 92979 ......... ............ A Intravasc us, heart add-on ............................ 1.44 0.80 2.35 NA NA 0.19 2.43 3.98 NA NA ZZZ92979 ......... 26 ....... A Intravasc us, heart add-on ............................ 1.44 0.80 0.62 0.80 0.62 0.06 2.30 2.12 2.30 2.12 ZZZ 92979 ......... TC ...... A Intravasc us, heart add-on ............................ 0.00 0.00 1.73 NA NA 0.13 0.13 1.86 NA NA ZZZ 92980 ......... ............ A Insert intracoronary stent .............................. 14.82 NA NA 8.49 6.68 1.03 NA NA 24.34 22.53 000 92981 ......... ............ A Insert intracoronary stent .............................. 4.16 NA NA 2.33 1.81 0.29 NA NA 6.78 6.26 ZZZ 92982 ......... ............ A Coronary artery dilation ................................. 10.96 NA NA 6.34 4.99 0.76 NA NA 18.06 16.71 000 92984 ......... ............ A Coronary artery dilation ................................. 2.97 NA NA 1.65 1.28 0.21 NA NA 4.83 4.46 ZZZ 92986 ......... ............ A Revision of aortic valve ................................. 22.64 NA NA 16.03 12.90 1.51 NA NA 40.18 37.05 090 92987 ......... ............ A Revision of mitral valve ................................. 23.42 NA NA 16.45 13.30 1.59 NA NA 41.46 38.31 090 92990 ......... ............ A Revision of pulmonary valve ......................... 18.06 NA NA 11.35 10.20 1.20 NA NA 30.61 29.46 090 92995 ......... ............ A Coronary atherectomy ................................... 12.07 NA NA 6.96 5.47 0.84 NA NA 19.87 18.38 000 92996 ......... ............ A Coronary atherectomy add-on ...................... 3.26 NA NA 1.83 1.41 0.10 NA NA 5.19 4.77 ZZZ 92997 ......... ............ A Pul art balloon repr, percut ........................... 11.98 NA NA 5.25 4.94 0.40 NA NA 17.63 17.32 000 92998 ......... ............ A Pul art balloon repr, percut ........................... 5.99 NA NA 2.78 2.35 0.28 NA NA 9.05 8.62 ZZZ 93000 ......... ............ A Electrocardiogram, complete ......................... 0.17 0.35 0.47 NA NA 0.03 0.55 0.67 NA NA XXX 93005 ......... ............ A Electrocardiogram, tracing ............................ 0.00 0.28 0.41 NA NA 0.02 0.30 0.43 NA NA XXX93010 ......... ............ A Electrocardiogram report ............................... 0.17 0.07 0.06 0.07 0.06 0.01 0.25 0.24 0.25 0.24 XXX 93012 ......... ............ A Transmission of ecg ...................................... 0.00 1.60 4.92 NA NA 0.18 1.78 5.10 NA NA XXX 93014 ......... ............ A Report on transmitted ecg ............................. 0.52 0.21 0.20 0.21 0.20 0.02 0.75 0.74 0.75 0.74 XXX 93015 ......... ............ A Cardiovascular stress test ............................. 0.75 1.96 1.96 NA NA 0.14 2.85 2.85 NA NA XXX 93016 ......... ............ A Cardiovascular stress test ............................. 0.45 0.23 0.19 0.23 0.19 0.02 0.70 0.66 0.70 0.66 XXX 93017 ......... ............ A Cardiovascular stress test ............................. 0.00 1.58 1.66 NA NA 0.11 1.69 1.77 NA NA XXX 93018 ......... ............ A Cardiovascular stress test ............................. 0.30 0.15 0.12 0.15 0.12 0.01 0.46 0.43 0.46 0.43 XXX 93024 ......... ............ A Cardiac drug stress test ................................ 1.17 2.46 1.79 NA NA 0.12 3.75 3.08 NA NA XXX 93024 ......... 26 ....... A Cardiac drug stress test ................................ 1.17 0.60 0.49 0.60 0.49 0.04 1.81 1.70 1.81 1.70 XXX 93024 ......... TC ...... A Cardiac drug stress test ................................ 0.00 1.87 1.31 NA NA 0.08 1.95 1.39 NA NA XXX 93025 ......... ............ A Microvolt t-wave assess ................................ 0.75 4.00 6.71 NA NA 0.14 4.89 7.60 NA NA XXX 93025 ......... 26 ....... A Microvolt t-wave assess ................................ 0.75 0.39 0.32 0.39 0.32 0.03 1.17 1.10 1.17 1.10 XXX 93025 ......... TC ...... A Microvolt t-wave assess ................................ 0.00 3.61 6.39 NA NA 0.11 3.72 6.50 NA NA XXX 93040 ......... ............ A Rhythm ECG with report ............................... 0.16 0.19 0.20 NA NA 0.02 0.37 0.38 NA NA XXX 93041 ......... ............ A Rhythm ECG, tracing .................................... 0.00 0.15 0.15 NA NA 0.01 0.16 0.16 NA NA XXX 93042 ......... ............ A Rhythm ECG, report ...................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 93224 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.52 2.01 3.22 NA NA 0.24 2.77 3.98 NA NA XXX 93225 ......... ............ A ECG monitor/record, 24 hrs .......................... 0.00 1.09 1.20 NA NA 0.08 1.17 1.28 NA NA XXX 93226 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.00 0.63 1.80 NA NA 0.14 0.77 1.94 NA NA XXX 93227 ......... ............ A ECG monitor/review, 24 hrs .......................... 0.52 0.28 0.21 0.28 0.21 0.02 0.82 0.75 0.82 0.75 XXX 93230 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.52 1.81 3.38 NA NA 0.26 2.59 4.16 NA NA XXX 93231 ......... ............ A Ecg monitor/record, 24 hrs ............................ 0.00 0.95 1.38 NA NA 0.11 1.06 1.49 NA NA XXX

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37406 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

93232 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.00 0.62 1.80 NA NA 0.13 0.75 1.93 NA NA XXX 93233 ......... ............ A ECG monitor/review, 24 hrs .......................... 0.52 0.24 0.20 0.24 0.20 0.02 0.78 0.74 0.78 0.74 XXX 93235 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.45 0.22 2.15 NA NA 0.16 0.83 2.76 NA NA XXX 93236 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.00 0.00 1.97 NA NA 0.14 0.14 2.11 NA NA XXX 93237 ......... ............ A ECG monitor/review, 24 hrs .......................... 0.45 0.22 0.18 0.22 0.18 0.02 0.69 0.65 0.69 0.65 XXX 93268 ......... ............ A ECG record/review ........................................ 0.52 0.83 5.80 NA NA 0.28 1.63 6.60 NA NA XXX 93270 ......... ............ A ECG recording ............................................... 0.00 0.31 1.01 NA NA 0.08 0.39 1.09 NA NA XXX 93271 ......... ............ A Ecg/monitoring and analysis ......................... 0.00 1.98 5.02 NA NA 0.18 2.16 5.20 NA NA XXX 93272 ......... ............ A Ecg/review, interpret only .............................. 0.52 0.24 0.20 0.24 0.20 0.02 0.78 0.74 0.78 0.74 XXX 93278 ......... ............ A ECG/signal-averaged .................................... 0.25 0.59 1.09 NA NA 0.12 0.96 1.46 NA NA XXX 93278 ......... 26 ....... A ECG/signal-averaged .................................... 0.25 0.10 0.10 0.10 0.10 0.01 0.36 0.36 0.36 0.36 XXX 93278 ......... TC ...... A ECG/signal-averaged .................................... 0.00 0.49 0.99 NA NA 0.11 0.60 1.10 NA NA XXX 93303 ......... ............ A Echo transthoracic ......................................... 1.30 4.70 4.44 NA NA 0.27 6.27 6.01 NA NA XXX 93303 ......... 26 ....... A Echo transthoracic ......................................... 1.30 0.58 0.51 0.58 0.51 0.04 1.92 1.85 1.92 1.85 XXX 93303 ......... TC ...... A Echo transthoracic ......................................... 0.00 4.12 3.93 NA NA 0.23 4.35 4.16 NA NA XXX 93304 ......... ............ A Echo transthoracic ......................................... 0.75 3.22 2.48 NA NA 0.15 4.12 3.38 NA NA XXX 93304 ......... 26 ....... A Echo transthoracic ......................................... 0.75 0.32 0.29 0.32 0.29 0.02 1.09 1.06 1.09 1.06 XXX 93304 ......... TC ...... A Echo transthoracic ......................................... 0.00 2.90 2.19 NA NA 0.13 3.03 2.32 NA NA XXX 93307 ......... ............ A Echo exam of heart ....................................... 0.92 3.84 4.13 NA NA 0.26 5.02 5.31 NA NA XXX 93307 ......... 26 ....... A Echo exam of heart ....................................... 0.92 0.47 0.38 0.47 0.38 0.03 1.42 1.33 1.42 1.33 XXX 93307 ......... TC ...... A Echo exam of heart ....................................... 0.00 3.36 3.74 NA NA 0.23 3.59 3.97 NA NA XXX 93308 ......... ............ A Echo exam of heart ....................................... 0.53 2.70 2.29 NA NA 0.15 3.38 2.97 NA NA XXX 93308 ......... 26 ....... A Echo exam of heart ....................................... 0.53 0.28 0.22 0.28 0.22 0.02 0.83 0.77 0.83 0.77 XXX 93308 ......... TC ...... A Echo exam of heart ....................................... 0.00 2.41 2.07 NA NA 0.13 2.54 2.20 NA NA XXX 93312 ......... ............ A Echo transesophageal ................................... 2.20 7.67 5.35 NA NA 0.37 10.24 7.92 NA NA XXX 93312 ......... 26 ....... A Echo transesophageal .................................. 2.20 1.03 0.85 1.03 0.85 0.08 3.31 3.13 3.31 3.13 XXX 93312 ......... TC ...... A Echo transesophageal ................................... 0.00 6.64 4.50 NA NA 0.29 6.93 4.79 NA NA XXX 93313 ......... ............ A Echo transesophageal ................................... 0.95 NA NA 0.14 0.19 0.06 NA NA 1.15 1.20 XXX 93314 ......... ............ A Echo transesophageal ................................... 1.25 7.37 5.04 NA NA 0.33 8.95 6.62 NA NA XXX 93314 ......... 26 ....... A Echo transesophageal .................................. 1.25 0.58 0.50 0.58 0.50 0.04 1.87 1.79 1.87 1.79 XXX 93314 ......... TC ...... A Echo transesophageal ................................... 0.00 6.79 4.54 NA NA 0.29 7.08 4.83 NA NA XXX 93315 ......... 26 ....... A Echo transesophageal .................................. 2.78 1.35 1.10 1.35 1.10 0.09 4.22 3.97 4.22 3.97 XXX 93316 ......... ............ A Echo transesophageal ................................... 0.95 NA NA 0.26 0.25 0.05 NA NA 1.26 1.25 XXX 93317 ......... 26 ....... A Echo transesophageal .................................. 1.83 0.79 0.70 0.79 0.70 0.08 2.70 2.61 2.70 2.61 XXX 93318 ......... 26 ....... A Echo transesophageal intraop ...................... 2.20 0.90 0.59 0.90 0.59 0.14 3.24 2.93 3.24 2.93 XXX 93320 ......... ............ A Doppler echo exam, heart ............................. 0.38 1.72 1.83 NA NA 0.13 2.23 2.34 NA NA ZZZ 93320 ......... 26 ....... A Doppler echo exam, heart ............................. 0.38 0.20 0.16 0.20 0.16 0.01 0.59 0.55 0.59 0.55 ZZZ 93320 ......... TC ...... A Doppler echo exam, heart ............................. 0.00 1.53 1.67 NA NA 0.12 1.65 1.79 NA NA ZZZ 93321 ......... ............ A Doppler echo exam, heart ............................. 0.15 0.63 1.04 NA NA 0.09 0.87 1.28 NA NA ZZZ 93321 ......... 26 ....... A Doppler echo exam, heart ............................. 0.15 0.08 0.07 0.08 0.07 0.01 0.24 0.23 0.24 0.23 ZZZ 93321 ......... TC ...... A Doppler echo exam, heart ............................. 0.00 0.55 0.97 NA NA 0.08 0.63 1.05 NA NA ZZZ 93325 ......... ............ A Doppler color flow add-on ............................. 0.07 0.68 2.38 NA NA 0.22 0.97 2.67 NA NA ZZZ93325 ......... 26 ....... A Doppler color flow add-on ............................. 0.07 0.04 0.03 0.04 0.03 0.01 0.12 0.11 0.12 0.11 ZZZ 93325 ......... TC ...... A Doppler color flow add-on ............................. 0.00 0.65 2.35 NA NA 0.21 0.86 2.56 NA NA ZZZ 93350 ......... ............ A Echo transthoracic ......................................... 1.48 5.24 3.07 NA NA 0.18 6.90 4.73 NA NA XXX 93350 ......... 26 ....... A Echo transthoracic ......................................... 1.48 0.79 0.63 0.79 0.63 0.05 2.32 2.16 2.32 2.16 XXX 93350 ......... TC ...... A Echo transthoracic ......................................... 0.00 4.45 2.44 NA NA 0.13 4.58 2.57 NA NA XXX 93501 ......... ............ A Right heart catheterization ............................ 3.02 23.45 19.44 NA NA 1.26 27.73 23.72 NA NA 000 93501 ......... 26 ....... A Right heart catheterization ............................ 3.02 1.65 1.28 1.65 1.28 0.21 4.88 4.51 4.88 4.51 000 93501 ......... TC ...... A Right heart catheterization ............................ 0.00 21.80 18.16 NA NA 1.05 22.85 19.21 NA NA 000 93503 ......... ............ A Insert/place heart catheter ............................ 2.91 NA NA 0.48 0.63 0.20 NA NA 3.59 3.74 000 93505 ......... ............ A Biopsy of heart lining ..................................... 4.37 25.50 9.13 NA NA 0.46 30.33 13.96 NA NA 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37407 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

93505 ......... 26 ....... A Biopsy of heart lining ..................................... 4.37 2.39 1.86 2.39 1.86 0.30 7.06 6.53 7.06 6.53 000 93505 ......... TC ...... A Biopsy of heart lining ..................................... 0.00 23.11 7.27 NA NA 0.16 23.27 7.43 NA NA 000 93508 ......... ............ A Cath placement, angiography ....................... 4.09 18.76 15.74 NA NA 0.93 23.78 20.76 NA NA 00093508 ......... 26 ....... A Cath placement, angiography ....................... 4.09 2.28 2.14 2.28 2.14 0.28 6.65 6.51 6.65 6.51 000 93508 ......... TC ...... A Cath placement, angiography ....................... 0.00 16.47 13.60 NA NA 0.65 17.12 14.25 NA NA 000 93510 ......... ............ A Left heart catheterization ............................... 4.32 18.95 34.17 NA NA 2.61 25.88 41.10 NA NA 000 93510 ......... 26 ....... A Left heart catheterization ............................... 4.32 2.40 2.24 2.40 2.24 0.30 7.02 6.86 7.02 6.86 000 93510 ......... TC ...... A Left heart catheterization ............................... 0.00 16.55 31.93 NA NA 2.31 18.86 34.24 NA NA 000 93511 ......... ............ A Left heart catheterization ............................... 5.02 3.30 29.72 NA NA 2.59 10.91 37.33 NA NA 000 93511 ......... 26 ....... A Left heart catheterization ............................... 5.02 2.71 2.52 2.71 2.52 0.35 8.08 7.89 8.08 7.89 000 93511 ......... TC ...... A Left heart catheterization ............................... 0.00 0.59 27.20 NA NA 2.24 2.83 29.44 NA NA 000 93514 ......... 26 ....... A Left heart catheterization ............................... 7.04 3.29 3.17 3.29 3.17 0.49 10.82 10.70 10.82 10.70 000 93524 ......... ............ A Left heart catheterization ............................... 6.94 4.40 38.84 NA NA 3.43 14.77 49.21 NA NA 000 93524 ......... 26 ....... A Left heart catheterization ............................... 6.94 3.80 3.34 3.80 3.34 0.48 11.22 10.76 11.22 10.76 000 93524 ......... TC ...... A Left heart catheterization ............................... 0.00 0.60 35.51 NA NA 2.95 3.55 38.46 NA NA 000 93526 ......... ............ A Rt & Lt heart catheters .................................. 5.98 34.54 47.07 NA NA 3.46 43.98 56.51 NA NA 000 93526 ......... 26 ....... A Rt & Lt heart catheters .................................. 5.98 3.32 2.95 3.32 2.95 0.42 9.72 9.35 9.72 9.35 000 93526 ......... TC ...... A Rt & Lt heart catheters .................................. 0.00 31.22 44.13 NA NA 3.04 34.26 47.17 NA NA 000 93527 ......... ............ A Rt & Lt heart catheters .................................. 7.27 4.66 39.01 NA NA 3.46 15.39 49.74 NA NA 000 93527 ......... 26 ....... A Rt & Lt heart catheters .................................. 7.27 4.06 3.51 4.06 3.51 0.51 11.84 11.29 11.84 11.29 000 93527 ......... TC ...... A Rt & Lt heart catheters .................................. 0.00 0.60 35.51 NA NA 2.95 3.55 38.46 NA NA 000 93528 ......... ............ A Rt & Lt heart catheters .................................. 8.99 5.37 39.73 NA NA 3.57 17.93 52.29 NA NA 000 93528 ......... 26 ....... A Rt & Lt heart catheters .................................. 8.99 4.78 4.23 4.78 4.23 0.62 14.39 13.84 14.39 13.84 000 93528 ......... TC ...... A Rt & Lt heart catheters .................................. 0.00 0.59 35.50 NA NA 2.95 3.54 38.45 NA NA 000 93529 ......... ............ A Rt, lt heart catheterization ............................. 4.79 3.28 37.89 NA NA 3.28 11.35 45.96 NA NA 000 93529 ......... 26 ....... A Rt, lt heart catheterization ............................. 4.79 2.68 2.38 2.68 2.38 0.33 7.80 7.50 7.80 7.50 000 93529 ......... TC ...... A Rt, lt heart catheterization ............................. 0.00 0.60 35.51 NA NA 2.95 3.55 38.46 NA NA 000 93530 ......... ............ A Rt heart cath, congenital ............................... 4.22 2.42 14.77 NA NA 1.34 7.98 20.33 NA NA 000 93530 ......... 26 ....... A Rt heart cath, congenital ............................... 4.22 1.88 1.93 1.88 1.93 0.29 6.39 6.44 6.39 6.44 000 93530 ......... TC ...... A Rt heart cath, congenital ............................... 0.00 0.54 12.85 NA NA 1.05 1.59 13.90 NA NA 00093531 ......... ............ A R & l heart cath, congenital .......................... 8.34 4.34 40.10 NA NA 3.62 16.30 52.06 NA NA 000 93531 ......... 26 ....... A R & l heart cath, congenital .......................... 8.34 3.80 3.64 3.80 3.64 0.58 12.72 12.56 12.72 12.56 000 93531 ......... TC ...... A R & l heart cath, congenital .......................... 0.00 0.55 36.46 NA NA 3.04 3.59 39.50 NA NA 000 93532 ......... 26 ....... A R & l heart cath, congenital .......................... 9.99 4.26 4.26 4.26 4.26 0.69 14.94 14.94 14.94 14.94 000 93533 ......... 26 ....... A R & l heart cath, congenital .......................... 6.69 3.09 2.87 3.09 2.87 0.47 10.25 10.03 10.25 10.03 000 93539 ......... ............ A Injection, cardiac cath ................................... 0.40 NA NA 0.22 0.18 0.01 NA NA 0.63 0.59 000 93540 ......... ............ A Injection, cardiac cath ................................... 0.43 NA NA 0.24 0.19 0.01 NA NA 0.68 0.63 000 93541 ......... ............ A Injection for lung angiogram .......................... 0.29 NA NA 0.16 0.12 0.01 NA NA 0.46 0.42 00093542 ......... ............ A Injection for heart x-rays ............................... 0.29 NA NA 0.16 0.12 0.01 NA NA 0.46 0.42 000 93543 ......... ............ A Injection for heart x-rays ............................... 0.29 NA NA 0.16 0.12 0.01 NA NA 0.46 0.42 000 93544 ......... ............ A Injection for aortography ............................... 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 000 93545 ......... ............ A Inject for coronary x-rays .............................. 0.40 NA NA 0.22 0.18 0.01 NA NA 0.63 0.59 000 93555 ......... ............ A Imaging, cardiac cath .................................... 0.81 0.66 5.12 NA NA 0.37 1.84 6.30 NA NA XXX 93555 ......... 26 ....... A Imaging, cardiac cath .................................... 0.81 0.45 0.35 0.45 0.35 0.03 1.29 1.19 1.29 1.19 XXX 93555 ......... TC ...... A Imaging, cardiac cath .................................... 0.00 0.21 4.77 NA NA 0.34 0.55 5.11 NA NA XXX 93556 ......... ............ A Imaging, cardiac cath .................................... 0.83 0.95 7.92 NA NA 0.54 2.32 9.29 NA NA XXX 93556 ......... 26 ....... A Imaging, cardiac cath .................................... 0.83 0.46 0.36 0.46 0.36 0.03 1.32 1.22 1.32 1.22 XXX 93556 ......... TC ...... A Imaging, cardiac cath .................................... 0.00 0.49 7.56 NA NA 0.51 1.00 8.07 NA NA XXX 93561 ......... ............ A Cardiac output measurement ........................ 0.50 0.14 0.55 NA NA 0.08 0.72 1.13 NA NA 000 93561 ......... 26 ....... A Cardiac output measurement ........................ 0.50 0.14 0.16 0.14 0.16 0.02 0.66 0.68 0.66 0.68 000 93561 ......... TC ...... A Cardiac output measurement ........................ 0.00 0.00 0.39 NA NA 0.06 0.06 0.45 NA NA 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37408 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

93562 ......... ............ A Cardiac output measurement ........................ 0.16 0.03 0.29 NA NA 0.05 0.24 0.50 NA NA 000 93562 ......... 26 ....... A Cardiac output measurement ........................ 0.16 0.03 0.05 0.03 0.05 0.01 0.20 0.22 0.20 0.22 000 93562 ......... TC ...... A Cardiac output measurement ........................ 0.00 0.00 0.24 NA NA 0.04 0.04 0.28 NA NA 000 93571 ......... ............ A Heart flow reserve measure .......................... 1.80 1.00 4.19 NA NA 0.30 3.10 6.29 NA NA ZZZ 93571 ......... 26 ....... A Heart flow reserve measure .......................... 1.80 1.00 0.76 1.00 0.76 0.06 2.86 2.62 2.86 2.62 ZZZ 93571 ......... TC ...... A Heart flow reserve measure .......................... 0.00 0.00 3.43 NA NA 0.24 0.24 3.67 NA NA ZZZ 93572 ......... 26 ....... A Heart flow reserve measure .......................... 1.44 0.75 0.56 0.75 0.56 0.04 2.23 2.04 2.23 2.04 ZZZ 93580 ......... ............ A Transcath closure of asd ............................... 17.97 NA NA 9.78 8.00 1.25 NA NA 29.00 27.22 000 93581 ......... ............ A Transcath closure of vsd ............................... 24.39 NA NA 13.45 10.43 1.71 NA NA 39.55 36.53 000 93600 ......... ............ A Bundle of His recording ................................. 2.12 1.11 2.37 NA NA 0.29 3.52 4.78 NA NA 000 93600 ......... 26 ....... A Bundle of His recording ................................. 2.12 1.11 0.90 1.11 0.90 0.16 3.39 3.18 3.39 3.18 000 93600 ......... TC ...... A Bundle of His recording ................................. 0.00 0.00 1.47 NA NA 0.13 0.13 1.60 NA NA 000 93602 ......... ............ A Intra-atrial recording ...................................... 2.12 1.10 1.72 NA NA 0.24 3.46 4.08 NA NA 000 93602 ......... 26 ....... A Intra-atrial recording ...................................... 2.12 1.10 0.89 1.10 0.89 0.17 3.39 3.18 3.39 3.18 000 93602 ......... TC ...... A Intra-atrial recording ...................................... 0.00 0.00 0.83 NA NA 0.07 0.07 0.90 NA NA 000 93603 ......... ............ A Right ventricular recording ............................ 2.12 1.09 2.14 NA NA 0.29 3.50 4.55 NA NA 000 93603 ......... 26 ....... A Right ventricular recording ............................ 2.12 1.09 0.88 1.09 0.88 0.18 3.39 3.18 3.39 3.18 000 93603 ......... TC ...... A Right ventricular recording ............................ 0.00 0.00 1.26 NA NA 0.11 0.11 1.37 NA NA 000 93609 ......... ............ A Map tachycardia, add-on ............................... 4.99 2.74 4.20 NA NA 0.52 8.25 9.71 NA NA ZZZ93609 ......... 26 ....... A Map tachycardia, add-on ............................... 4.99 2.74 2.16 2.74 2.16 0.35 8.08 7.50 8.08 7.50 ZZZ 93609 ......... TC ...... A Map tachycardia, add-on ............................... 0.00 0.00 2.05 NA NA 0.17 0.17 2.22 NA NA ZZZ 93610 ......... ............ A Intra-atrial pacing ........................................... 3.02 1.54 2.27 NA NA 0.34 4.90 5.63 NA NA 000 93610 ......... 26 ....... A Intra-atrial pacing ........................................... 3.02 1.54 1.26 1.54 1.26 0.24 4.80 4.52 4.80 4.52 000 93610 ......... TC ...... A Intra-atrial pacing ........................................... 0.00 0.00 1.01 NA NA 0.10 0.10 1.11 NA NA 000 93612 ......... ............ A Intraventricular pacing ................................... 3.02 1.49 2.45 NA NA 0.36 4.87 5.83 NA NA 000 93612 ......... 26 ....... A Intraventricular pacing ................................... 3.02 1.49 1.24 1.49 1.24 0.25 4.76 4.51 4.76 4.51 000 93612 ......... TC ...... A Intraventricular pacing ................................... 0.00 0.00 1.21 NA NA 0.11 0.11 1.32 NA NA 00093613 ......... ............ A Electrophys map 3d, add-on ......................... 6.99 NA NA 3.85 3.04 0.49 NA NA 11.33 10.52 ZZZ 93615 ......... ............ A Esophageal recording ................................... 0.99 0.50 0.57 NA NA 0.05 1.54 1.61 NA NA 000 93615 ......... 26 ....... A Esophageal recording ................................... 0.99 0.50 0.33 0.50 0.33 0.03 1.52 1.35 1.52 1.35 000 93615 ......... TC ...... A Esophageal recording ................................... 0.00 0.00 0.24 NA NA 0.02 0.02 0.26 NA NA 000 93616 ......... 26 ....... A Esophageal recording ................................... 1.49 0.37 0.42 0.37 0.42 0.09 1.95 2.00 1.95 2.00 000 93618 ......... ............ A Heart rhythm pacing ...................................... 4.25 2.37 4.82 NA NA 0.54 7.16 9.61 NA NA 000 93618 ......... 26 ....... A Heart rhythm pacing ...................................... 4.25 2.37 1.85 2.37 1.85 0.30 6.92 6.40 6.92 6.40 000 93618 ......... TC ...... A Heart rhythm pacing ...................................... 0.00 0.00 2.98 NA NA 0.24 0.24 3.22 NA NA 000 93619 ......... ............ A Electrophysiology evaluation ......................... 7.31 4.37 9.28 NA NA 0.98 12.66 17.57 NA NA 000 93619 ......... 26 ....... A Electrophysiology evaluation ......................... 7.31 3.95 3.38 3.95 3.38 0.51 11.77 11.20 11.77 11.20 000 93619 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 0.42 5.90 NA NA 0.47 0.89 6.37 NA NA 000 93620 ......... 26 ....... A Electrophysiology evaluation ......................... 11.57 6.37 5.23 6.37 5.23 0.80 18.74 17.60 18.74 17.60 000 93621 ......... 26 ....... A Electrophysiology evaluation ......................... 2.10 1.16 0.91 1.16 0.91 0.15 3.41 3.16 3.41 3.16 ZZZ 93622 ......... 26 ....... A Electrophysiology evaluation ......................... 3.10 1.69 1.33 1.69 1.33 0.22 5.01 4.65 5.01 4.65 ZZZ 93623 ......... 26 ....... A Stimulation, pacing heart ............................... 2.85 1.57 1.23 1.57 1.23 0.20 4.62 4.28 4.62 4.28 ZZZ 93624 ......... ............ A Electrophysiologic study ................................ 4.80 3.12 3.92 NA NA 0.46 8.38 9.18 NA NA 000 93624 ......... 26 ....... A Electrophysiologic study ................................ 4.80 2.69 2.32 2.69 2.32 0.33 7.82 7.45 7.82 7.45 000 93624 ......... TC ...... A Electrophysiologic study ................................ 0.00 0.43 1.60 NA NA 0.13 0.56 1.73 NA NA 000 93631 ......... 26 ....... A Heart pacing, mapping .................................. 7.59 2.81 2.79 2.81 2.79 0.97 11.37 11.35 11.37 11.35 000 93640 ......... ............ A Evaluation heart device ................................. 3.51 1.93 6.90 NA NA 0.66 6.10 11.07 NA NA 000 93640 ......... 26 ....... A Evaluation heart device ................................. 3.51 1.93 1.50 1.93 1.50 0.24 5.68 5.25 5.68 5.25 000 93640 ......... TC ...... A Evaluation heart device ................................. 0.00 0.00 5.39 NA NA 0.42 0.42 5.81 NA NA 000 93641 ......... ............ A Electrophysiology evaluation ......................... 5.92 3.26 7.95 NA NA 0.83 10.01 14.70 NA NA 000 93641 ......... 26 ....... A Electrophysiology evaluation ......................... 5.92 3.26 2.56 3.26 2.56 0.41 9.59 8.89 9.59 8.89 000 93641 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 0.00 5.39 NA NA 0.42 0.42 5.81 NA NA 000 93642 ......... ............ A Electrophysiology evaluation ......................... 4.88 7.59 8.96 NA NA 0.57 13.04 14.41 NA NA 000 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37409 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

93642 ......... 26 ....... A Electrophysiology evaluation ......................... 4.88 2.69 2.34 2.69 2.34 0.15 7.72 7.37 7.72 7.37 000 93642 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 4.89 6.62 NA NA 0.42 5.31 7.04 NA NA 000 93650 ......... ............ A Ablate heart dysrhythm focus ....................... 10.49 NA NA 6.10 4.86 0.73 NA NA 17.32 16.08 00093651 ......... ............ A Ablate heart dysrhythm focus ....................... 16.23 NA NA 8.93 6.99 1.13 NA NA 26.29 24.35 00093652 ......... ............ A Ablate heart dysrhythm focus ....................... 17.65 NA NA 9.73 7.61 1.23 NA NA 28.61 26.49 00093660 ......... ............ A Tilt table evaluation ....................................... 1.89 3.11 2.59 NA NA 0.08 5.08 4.56 NA NA 000 93660 ......... 26 ....... A Tilt table evaluation ....................................... 1.89 1.01 0.81 1.01 0.81 0.06 2.96 2.76 2.96 2.76 000 93660 ......... TC ...... A Tilt table evaluation ....................................... 0.00 2.10 1.79 NA NA 0.02 2.12 1.81 NA NA 000 93662 ......... 26 ....... A Intracardiac ecg (ice) ..................................... 2.80 1.54 1.22 1.54 1.22 0.09 4.43 4.11 4.43 4.11 ZZZ 93701 ......... ............ A Bioimpedance, thoracic ................................. 0.17 0.71 0.91 NA NA 0.02 0.90 1.10 NA NA XXX 93701 ......... 26 ....... A Bioimpedance, thoracic ................................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX 93701 ......... TC ...... A Bioimpedance, thoracic ................................. 0.00 0.65 0.85 NA NA 0.01 0.66 0.86 NA NA XXX 93720 ......... ............ A Total body plethysmography ......................... 0.17 1.29 0.89 NA NA 0.07 1.53 1.13 NA NA XXX 93721 ......... ............ A Plethysmography tracing ............................... 0.00 1.14 0.82 NA NA 0.06 1.20 0.88 NA NA XXX93722 ......... ............ A Plethysmography report ................................ 0.17 0.04 0.05 0.04 0.05 0.01 0.22 0.23 0.22 0.23 XXX 93724 ......... ............ A Analyze pacemaker system .......................... 4.88 3.56 5.31 NA NA 0.39 8.83 10.58 NA NA 000 93724 ......... 26 ....... A Analyze pacemaker system .......................... 4.88 2.63 2.10 2.63 2.10 0.15 7.66 7.13 7.66 7.13 000 93724 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.93 3.21 NA NA 0.24 1.17 3.45 NA NA 000 93727 ......... ............ A Analyze ilr system ......................................... 0.52 0.66 0.32 0.66 0.32 0.02 1.20 0.86 1.20 0.86 XXX 93731 ......... ............ A Analyze pacemaker system .......................... 0.45 0.81 0.70 NA NA 0.05 1.31 1.20 NA NA XXX 93731 ......... 26 ....... A Analyze pacemaker system .......................... 0.45 0.25 0.19 0.25 0.19 0.01 0.71 0.65 0.71 0.65 XXX 93731 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.56 0.51 NA NA 0.04 0.60 0.55 NA NA XXX 93732 ......... ............ A Analyze pacemaker system .......................... 0.92 1.19 0.94 NA NA 0.07 2.18 1.93 NA NA XXX 93732 ......... 26 ....... A Analyze pacemaker system .......................... 0.92 0.50 0.39 0.50 0.39 0.03 1.45 1.34 1.45 1.34 XXX 93732 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.69 0.56 NA NA 0.04 0.73 0.60 NA NA XXX 93733 ......... ............ A Telephone analy, pacemaker ........................ 0.17 0.32 0.68 NA NA 0.07 0.56 0.92 NA NA XXX 93733 ......... 26 ....... A Telephone analy, pacemaker ........................ 0.17 0.09 0.08 0.09 0.08 0.01 0.27 0.26 0.27 0.26 XXX 93733 ......... TC ...... A Telephone analy, pacemaker ........................ 0.00 0.23 0.61 NA NA 0.06 0.29 0.67 NA NA XXX 93734 ......... ............ A Analyze pacemaker system .......................... 0.38 0.72 0.56 NA NA 0.03 1.13 0.97 NA NA XXX 93734 ......... 26 ....... A Analyze pacemaker system .......................... 0.38 0.21 0.17 0.21 0.17 0.01 0.60 0.56 0.60 0.56 XXX 93734 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.51 0.39 NA NA 0.02 0.53 0.41 NA NA XXX 93735 ......... ............ A Analyze pacemaker system .......................... 0.74 0.99 0.79 NA NA 0.06 1.79 1.59 NA NA XXX 93735 ......... 26 ....... A Analyze pacemaker system .......................... 0.74 0.40 0.31 0.40 0.31 0.02 1.16 1.07 1.16 1.07 XXX 93735 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.59 0.48 NA NA 0.04 0.63 0.52 NA NA XXX 93736 ......... ............ A Telephonic analy, pacemaker ....................... 0.15 0.28 0.59 NA NA 0.07 0.50 0.81 NA NA XXX 93736 ......... 26 ....... A Telephonic analy, pacemaker ....................... 0.15 0.08 0.07 0.08 0.07 0.01 0.24 0.23 0.24 0.23 XXX 93736 ......... TC ...... A Telephonic analy, pacemaker ....................... 0.00 0.21 0.53 NA NA 0.06 0.27 0.59 NA NA XXX 93740 ......... ............ B Temperature gradient studies ....................... 0.16 0.04 0.15 NA NA 0.02 0.22 0.33 NA NA XXX 93740 ......... 26 ....... B Temperature gradient studies ....................... 0.16 0.04 0.04 0.04 0.04 0.01 0.21 0.21 0.21 0.21 XXX 93740 ......... TC ...... B Temperature gradient studies ....................... 0.00 0.00 0.11 NA NA 0.01 0.01 0.12 NA NA XXX 93741 ......... ............ A Analyze ht pace device sngl ......................... 0.80 1.06 1.00 NA NA 0.07 1.93 1.87 NA NA XXX 93741 ......... 26 ....... A Analyze ht pace device sngl ......................... 0.80 0.44 0.34 0.44 0.34 0.03 1.27 1.17 1.27 1.17 XXX 93741 ......... TC ...... A Analyze ht pace device sngl ......................... 0.00 0.61 0.66 NA NA 0.04 0.65 0.70 NA NA XXX 93742 ......... ............ A Analyze ht pace device sngl ......................... 0.91 1.20 1.07 NA NA 0.07 2.18 2.05 NA NA XXX 93742 ......... 26 ....... A Analyze ht pace device sngl ......................... 0.91 0.51 0.40 0.51 0.40 0.03 1.45 1.34 1.45 1.34 XXX 93742 ......... TC ...... A Analyze ht pace device sngl ......................... 0.00 0.69 0.68 NA NA 0.04 0.73 0.72 NA NA XXX 93743 ......... ............ A Analyze ht pace device dual ......................... 1.03 1.24 1.16 NA NA 0.07 2.34 2.26 NA NA XXX 93743 ......... 26 ....... A Analyze ht pace device dual ......................... 1.03 0.57 0.44 0.57 0.44 0.03 1.63 1.50 1.63 1.50 XXX 93743 ......... TC ...... A Analyze ht pace device dual ......................... 0.00 0.66 0.71 NA NA 0.04 0.70 0.75 NA NA XXX 93744 ......... ............ A Analyze ht pace device dual ......................... 1.18 1.39 1.20 NA NA 0.08 2.65 2.46 NA NA XXX 93744 ......... 26 ....... A Analyze ht pace device dual ......................... 1.18 0.65 0.51 0.65 0.51 0.04 1.87 1.73 1.87 1.73 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37410 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

93744 ......... TC ...... A Analyze ht pace device dual ......................... 0.00 0.74 0.69 NA NA 0.04 0.78 0.73 NA NA XXX 93770 ......... ............ B Measure venous pressure ............................. 0.16 0.04 0.07 NA NA 0.02 0.22 0.25 NA NA XXX 93770 ......... 26 ....... B Measure venous pressure ............................. 0.16 0.04 0.05 0.04 0.05 0.01 0.21 0.22 0.21 0.22 XXX 93770 ......... TC ...... B Measure venous pressure ............................. 0.00 0.00 0.02 NA NA 0.01 0.01 0.03 NA NA XXX 93784 ......... ............ A Ambulatory BP monitoring ............................ 0.38 1.37 1.51 NA NA 0.03 1.78 1.92 NA NA XXX 93786 ......... ............ A Ambulatory BP recording .............................. 0.00 1.10 0.96 NA NA 0.01 1.11 0.97 NA NA XXX 93788 ......... ............ A Ambulatory BP analysis ................................ 0.00 0.73 0.57 NA NA 0.01 0.74 0.58 NA NA XXX93790 ......... ............ A Review/report BP recording .......................... 0.38 0.14 0.13 0.14 0.13 0.01 0.53 0.52 0.53 0.52 XXX 93797 ......... ............ A Cardiac rehab ................................................ 0.18 0.33 0.31 0.09 0.08 0.01 0.52 0.50 0.28 0.27 000 93798 ......... ............ A Cardiac rehab/monitor ................................... 0.28 0.45 0.46 0.13 0.12 0.01 0.74 0.75 0.42 0.41 000 93875 ......... ............ A Extracranial study .......................................... 0.22 2.64 2.42 NA NA 0.12 2.98 2.76 NA NA XXX 93875 ......... 26 ....... A Extracranial study .......................................... 0.22 0.08 0.08 0.08 0.08 0.01 0.31 0.31 0.31 0.31 XXX 93875 ......... TC ...... A Extracranial study .......................................... 0.00 2.57 2.34 NA NA 0.11 2.68 2.45 NA NA XXX 93880 ......... ............ A Extracranial study .......................................... 0.60 6.36 5.77 NA NA 0.39 7.35 6.76 NA NA XXX 93880 ......... 26 ....... A Extracranial study .......................................... 0.60 0.21 0.20 0.21 0.20 0.04 0.85 0.84 0.85 0.84 XXX 93880 ......... TC ...... A Extracranial study .......................................... 0.00 6.15 5.57 NA NA 0.35 6.50 5.92 NA NA XXX 93882 ......... ............ A Extracranial study .......................................... 0.40 4.23 3.69 NA NA 0.26 4.89 4.35 NA NA XXX 93882 ......... 26 ....... A Extracranial study .......................................... 0.40 0.12 0.14 0.12 0.14 0.04 0.56 0.58 0.56 0.58 XXX 93882 ......... TC ...... A Extracranial study .......................................... 0.00 4.11 3.56 NA NA 0.22 4.33 3.78 NA NA XXX 93886 ......... ............ A Intracranial study ........................................... 0.94 7.21 6.87 NA NA 0.45 8.60 8.26 NA NA XXX 93886 ......... 26 ....... A Intracranial study ........................................... 0.94 0.30 0.35 0.30 0.35 0.06 1.30 1.35 1.30 1.35 XXX 93886 ......... TC ...... A Intracranial study ........................................... 0.00 6.91 6.52 NA NA 0.39 7.30 6.91 NA NA XXX 93888 ......... ............ A Intracranial study ........................................... 0.62 4.94 4.42 NA NA 0.32 5.88 5.36 NA NA XXX 93888 ......... 26 ....... A Intracranial study ........................................... 0.62 0.20 0.22 0.20 0.22 0.05 0.87 0.89 0.87 0.89 XXX 93888 ......... TC ...... A Intracranial study ........................................... 0.00 4.74 4.20 NA NA 0.27 5.01 4.47 NA NA XXX 93890 ......... ............ A Tcd, vasoreactivity study ............................... 1.00 6.40 5.28 NA NA 0.45 7.85 6.73 NA NA XXX 93890 ......... 26 ....... A Tcd, vasoreactivity study ............................... 1.00 0.32 0.38 0.32 0.38 0.06 1.38 1.44 1.38 1.44 XXX 93890 ......... TC ...... A Tcd, vasoreactivity study ............................... 0.00 6.08 4.90 NA NA 0.39 6.47 5.29 NA NA XXX 93892 ......... ............ A Tcd, emboli detect w/o inj ............................. 1.15 6.93 5.61 NA NA 0.45 8.53 7.21 NA NA XXX 93892 ......... 26 ....... A Tcd, emboli detect w/o inj ............................. 1.15 0.37 0.44 0.37 0.44 0.06 1.58 1.65 1.58 1.65 XXX 93892 ......... TC ...... A Tcd, emboli detect w/o inj ............................. 0.00 6.57 5.18 NA NA 0.39 6.96 5.57 NA NA XXX 93893 ......... ............ A Tcd, emboli detect w/inj ................................ 1.15 6.61 5.43 NA NA 0.45 8.21 7.03 NA NA XXX 93893 ......... 26 ....... A Tcd, emboli detect w/inj ................................ 1.15 0.37 0.44 0.37 0.44 0.06 1.58 1.65 1.58 1.65 XXX 93893 ......... TC ...... A Tcd, emboli detect w/inj ................................ 0.00 6.24 5.00 NA NA 0.39 6.63 5.39 NA NA XXX 93922 ......... ............ A Extremity study .............................................. 0.25 3.20 2.82 NA NA 0.15 3.60 3.22 NA NA XXX 93922 ......... 26 ....... A Extremity study .............................................. 0.25 0.08 0.08 0.08 0.08 0.02 0.35 0.35 0.35 0.35 XXX 93922 ......... TC ...... A Extremity study .............................................. 0.00 3.12 2.74 NA NA 0.13 3.25 2.87 NA NA XXX 93923 ......... ............ A Extremity study .............................................. 0.45 4.86 4.25 NA NA 0.26 5.57 4.96 NA NA XXX 93923 ......... 26 ....... A Extremity study .............................................. 0.45 0.15 0.15 0.15 0.15 0.04 0.64 0.64 0.64 0.64 XXX 93923 ......... TC ...... A Extremity study .............................................. 0.00 4.71 4.10 NA NA 0.22 4.93 4.32 NA NA XXX 93924 ......... ............ A Extremity study .............................................. 0.50 6.12 5.13 NA NA 0.30 6.92 5.93 NA NA XXX 93924 ......... 26 ....... A Extremity study .............................................. 0.50 0.17 0.17 0.17 0.17 0.05 0.72 0.72 0.72 0.72 XXX 93924 ......... TC ...... A Extremity study .............................................. 0.00 5.95 4.96 NA NA 0.25 6.20 5.21 NA NA XXX 93925 ......... ............ A Lower extremity study ................................... 0.58 8.31 7.18 NA NA 0.39 9.28 8.15 NA NA XXX 93925 ......... 26 ....... A Lower extremity study ................................... 0.58 0.20 0.20 0.20 0.20 0.04 0.82 0.82 0.82 0.82 XXX 93925 ......... TC ...... A Lower extremity study ................................... 0.00 8.11 6.98 NA NA 0.35 8.46 7.33 NA NA XXX 93926 ......... ............ A Lower extremity study ................................... 0.39 5.37 4.39 NA NA 0.27 6.03 5.05 NA NA XXX 93926 ......... 26 ....... A Lower extremity study ................................... 0.39 0.12 0.13 0.12 0.13 0.04 0.55 0.56 0.55 0.56 XXX 93926 ......... TC ...... A Lower extremity study ................................... 0.00 5.25 4.26 NA NA 0.23 5.48 4.49 NA NA XXX 93930 ......... ............ A Upper extremity study ................................... 0.46 6.45 5.64 NA NA 0.41 7.32 6.51 NA NA XXX 93930 ......... 26 ....... A Upper extremity study ................................... 0.46 0.15 0.16 0.15 0.16 0.04 0.65 0.66 0.65 0.66 XXX 93930 ......... TC ...... A Upper extremity study ................................... 0.00 6.30 5.48 NA NA 0.37 6.67 5.85 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37411 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

93931 ......... ............ A Upper extremity study ................................... 0.31 4.40 3.72 NA NA 0.27 4.98 4.30 NA NA XXX 93931 ......... 26 ....... A Upper extremity study ................................... 0.31 0.10 0.10 0.10 0.10 0.03 0.44 0.44 0.44 0.44 XXX 93931 ......... TC ...... A Upper extremity study ................................... 0.00 4.30 3.62 NA NA 0.24 4.54 3.86 NA NA XXX 93965 ......... ............ A Extremity study .............................................. 0.35 3.14 2.89 NA NA 0.14 3.63 3.38 NA NA XXX 93965 ......... 26 ....... A Extremity study .............................................. 0.35 0.11 0.12 0.11 0.12 0.02 0.48 0.49 0.48 0.49 XXX 93965 ......... TC ...... A Extremity study .............................................. 0.00 3.02 2.77 NA NA 0.12 3.14 2.89 NA NA XXX 93970 ......... ............ A Extremity study .............................................. 0.68 6.47 5.56 NA NA 0.46 7.61 6.70 NA NA XXX 93970 ......... 26 ....... A Extremity study .............................................. 0.68 0.22 0.23 0.22 0.23 0.06 0.96 0.97 0.96 0.97 XXX 93970 ......... TC ...... A Extremity study .............................................. 0.00 6.25 5.34 NA NA 0.40 6.65 5.74 NA NA XXX 93971 ......... ............ A Extremity study .............................................. 0.45 4.25 3.76 NA NA 0.30 5.00 4.51 NA NA XXX 93971 ......... 26 ....... A Extremity study .............................................. 0.45 0.15 0.15 0.15 0.15 0.03 0.63 0.63 0.63 0.63 XXX 93971 ......... TC ...... A Extremity study .............................................. 0.00 4.10 3.61 NA NA 0.27 4.37 3.88 NA NA XXX 93975 ......... ............ A Vascular study ............................................... 1.80 8.79 7.94 NA NA 0.56 11.15 10.30 NA NA XXX 93975 ......... 26 ....... A Vascular study ............................................... 1.80 0.65 0.61 0.65 0.61 0.13 2.58 2.54 2.58 2.54 XXX 93975 ......... TC ...... A Vascular study ............................................... 0.00 8.14 7.32 NA NA 0.43 8.57 7.75 NA NA XXX 93976 ......... ............ A Vascular study ............................................... 1.21 4.77 4.45 NA NA 0.35 6.33 6.01 NA NA XXX 93976 ......... 26 ....... A Vascular study ............................................... 1.21 0.42 0.41 0.42 0.41 0.05 1.68 1.67 1.68 1.67 XXX 93976 ......... TC ...... A Vascular study ............................................... 0.00 4.34 4.04 NA NA 0.30 4.64 4.34 NA NA XXX 93978 ......... ............ A Vascular study ............................................... 0.65 6.18 4.94 NA NA 0.43 7.26 6.02 NA NA XXX 93978 ......... 26 ....... A Vascular study ............................................... 0.65 0.23 0.22 0.23 0.22 0.06 0.94 0.93 0.94 0.93 XXX 93978 ......... TC ...... A Vascular study ............................................... 0.00 5.96 4.72 NA NA 0.37 6.33 5.09 NA NA XXX 93979 ......... ............ A Vascular study ............................................... 0.44 4.45 3.53 NA NA 0.27 5.16 4.24 NA NA XXX 93979 ......... 26 ....... A Vascular study ............................................... 0.44 0.17 0.16 0.17 0.16 0.03 0.64 0.63 0.64 0.63 XXX 93979 ......... TC ...... A Vascular study ............................................... 0.00 4.28 3.37 NA NA 0.24 4.52 3.61 NA NA XXX 93980 ......... ............ A Penile vascular study .................................... 1.25 3.55 3.03 NA NA 0.42 5.22 4.70 NA NA XXX 93980 ......... 26 ....... A Penile vascular study .................................... 1.25 0.45 0.42 0.45 0.42 0.08 1.78 1.75 1.78 1.75 XXX 93980 ......... TC ...... A Penile vascular study .................................... 0.00 3.09 2.61 NA NA 0.34 3.43 2.95 NA NA XXX 93981 ......... ............ A Penile vascular study .................................... 0.44 2.93 2.89 NA NA 0.33 3.70 3.66 NA NA XXX 93981 ......... 26 ....... A Penile vascular study .................................... 0.44 0.17 0.15 0.17 0.15 0.02 0.63 0.61 0.63 0.61 XXX 93981 ......... TC ...... A Penile vascular study .................................... 0.00 2.76 2.75 NA NA 0.31 3.07 3.06 NA NA XXX 93990 ......... ............ A Doppler flow testing ....................................... 0.25 5.44 4.36 NA NA 0.26 5.95 4.87 NA NA XXX 93990 ......... 26 ....... A Doppler flow testing ....................................... 0.25 0.07 0.09 0.07 0.09 0.03 0.35 0.37 0.35 0.37 XXX 93990 ......... TC ...... A Doppler flow testing ....................................... 0.00 5.37 4.28 NA NA 0.23 5.60 4.51 NA NA XXX 94010 ......... ............ A Breathing capacity test .................................. 0.17 0.73 0.69 NA NA 0.03 0.93 0.89 NA NA XXX 94010 ......... 26 ....... A Breathing capacity test .................................. 0.17 0.04 0.05 0.04 0.05 0.01 0.22 0.23 0.22 0.23 XXX 94010 ......... TC ...... A Breathing capacity test .................................. 0.00 0.69 0.64 NA NA 0.02 0.71 0.66 NA NA XXX 94014 ......... ............ A Patient recorded spirometry .......................... 0.52 0.90 0.80 NA NA 0.03 1.45 1.35 NA NA XXX 94015 ......... ............ A Patient recorded spirometry .......................... 0.00 0.74 0.63 NA NA 0.01 0.75 0.64 NA NA XXX 94016 ......... ............ A Review patient spirometry ............................. 0.52 0.16 0.17 0.16 0.17 0.02 0.70 0.71 0.70 0.71 XXX 94060 ......... ............ A Evaluation of wheezing ................................. 0.31 1.31 1.13 NA NA 0.07 1.69 1.51 NA NA XXX 94060 ......... 26 ....... A Evaluation of wheezing ................................. 0.31 0.07 0.09 0.07 0.09 0.01 0.39 0.41 0.39 0.41 XXX 94060 ......... TC ...... A Evaluation of wheezing ................................. 0.00 1.23 1.04 NA NA 0.06 1.29 1.10 NA NA XXX 94070 ......... ............ A Evaluation of wheezing ................................. 0.60 0.99 0.86 NA NA 0.13 1.72 1.59 NA NA XXX 94070 ......... 26 ....... A Evaluation of wheezing ................................. 0.60 0.15 0.17 0.15 0.17 0.03 0.78 0.80 0.78 0.80 XXX 94070 ......... TC ...... A Evaluation of wheezing ................................. 0.00 0.84 0.69 NA NA 0.10 0.94 0.79 NA NA XXX 94150 ......... ............ B Vital capacity test .......................................... 0.07 0.48 0.47 NA NA 0.02 0.57 0.56 NA NA XXX 94150 ......... 26 ....... B Vital capacity test .......................................... 0.07 0.02 0.03 0.02 0.03 0.01 0.10 0.11 0.10 0.11 XXX 94150 ......... TC ...... B Vital capacity test .......................................... 0.00 0.46 0.45 NA NA 0.01 0.47 0.46 NA NA XXX 94200 ......... ............ A Lung function test (MBC/MVV) ..................... 0.11 0.50 0.46 NA NA 0.03 0.64 0.60 NA NA XXX 94200 ......... 26 ....... A Lung function test (MBC/MVV) ..................... 0.11 0.03 0.03 0.03 0.03 0.01 0.15 0.15 0.15 0.15 XXX94200 ......... TC ...... A Lung function test (MBC/MVV) ..................... 0.00 0.48 0.43 NA NA 0.02 0.50 0.45 NA NA XXX 94240 ......... ............ A Residual lung capacity .................................. 0.26 0.83 0.70 NA NA 0.06 1.15 1.02 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37412 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

94240 ......... 26 ....... A Residual lung capacity .................................. 0.26 0.06 0.08 0.06 0.08 0.01 0.33 0.35 0.33 0.35 XXX 94240 ......... TC ...... A Residual lung capacity .................................. 0.00 0.76 0.63 NA NA 0.05 0.81 0.68 NA NA XXX 94250 ......... ............ A Expired gas collection ................................... 0.11 0.56 0.62 NA NA 0.02 0.69 0.75 NA NA XXX 94250 ......... 26 ....... A Expired gas collection ................................... 0.11 0.03 0.03 0.03 0.03 0.01 0.15 0.15 0.15 0.15 XXX 94250 ......... TC ...... A Expired gas collection ................................... 0.00 0.52 0.59 NA NA 0.01 0.53 0.60 NA NA XXX 94260 ......... ............ A Thoracic gas volume ..................................... 0.13 0.76 0.63 NA NA 0.05 0.94 0.81 NA NA XXX 94260 ......... 26 ....... A Thoracic gas volume ..................................... 0.13 0.03 0.04 0.03 0.04 0.01 0.17 0.18 0.17 0.18 XXX 94260 ......... TC ...... A Thoracic gas volume ..................................... 0.00 0.73 0.59 NA NA 0.04 0.77 0.63 NA NA XXX 94350 ......... ............ A Lung nitrogen washout curve ........................ 0.26 0.65 0.73 NA NA 0.05 0.96 1.04 NA NA XXX 94350 ......... 26 ....... A Lung nitrogen washout curve ........................ 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35 XXX 94350 ......... TC ...... A Lung nitrogen washout curve ........................ 0.00 0.58 0.66 NA NA 0.04 0.62 0.70 NA NA XXX 94360 ......... ............ A Measure airflow resistance ........................... 0.26 0.97 0.77 NA NA 0.07 1.30 1.10 NA NA XXX 94360 ......... 26 ....... A Measure airflow resistance ........................... 0.26 0.06 0.08 0.06 0.08 0.01 0.33 0.35 0.33 0.35 XXX 94360 ......... TC ...... A Measure airflow resistance ........................... 0.00 0.91 0.69 NA NA 0.06 0.97 0.75 NA NA XXX 94370 ......... ............ A Breath airway closing volume ....................... 0.26 0.65 0.70 NA NA 0.03 0.94 0.99 NA NA XXX 94370 ......... 26 ....... A Breath airway closing volume ....................... 0.26 0.08 0.08 0.08 0.08 0.01 0.35 0.35 0.35 0.35 XXX 94370 ......... TC ...... A Breath airway closing volume ....................... 0.00 0.57 0.62 NA NA 0.02 0.59 0.64 NA NA XXX 94375 ......... ............ A Respiratory flow volume loop ........................ 0.31 0.74 0.64 NA NA 0.03 1.08 0.98 NA NA XXX 94375 ......... 26 ....... A Respiratory flow volume loop ........................ 0.31 0.08 0.09 0.08 0.09 0.01 0.40 0.41 0.40 0.41 XXX 94375 ......... TC ...... A Respiratory flow volume loop ........................ 0.00 0.66 0.55 NA NA 0.02 0.68 0.57 NA NA XXX 94400 ......... ............ A CO2 breathing response curve ..................... 0.40 1.02 0.89 NA NA 0.09 1.51 1.38 NA NA XXX 94400 ......... 26 ....... A CO2 breathing response curve ..................... 0.40 0.10 0.12 0.10 0.12 0.03 0.53 0.55 0.53 0.55 XXX94400 ......... TC ...... A CO2 breathing response curve ..................... 0.00 0.92 0.77 NA NA 0.06 0.98 0.83 NA NA XXX 94450 ......... ............ A Hypoxia response curve ................................ 0.40 1.02 0.89 NA NA 0.04 1.46 1.33 NA NA XXX94450 ......... 26 ....... A Hypoxia response curve ................................ 0.40 0.08 0.11 0.08 0.11 0.02 0.50 0.53 0.50 0.53 XXX 94450 ......... TC ...... A Hypoxia response curve ................................ 0.00 0.94 0.78 NA NA 0.02 0.96 0.80 NA NA XXX 94452 ......... ............ A Hast w/report ................................................. 0.31 1.18 1.06 NA NA 0.04 1.53 1.41 NA NA XXX 94452 ......... 26 ....... A Hast w/report ................................................. 0.31 0.08 0.09 0.08 0.09 0.02 0.41 0.42 0.41 0.42 XXX 94452 ......... TC ...... A Hast w/report ................................................. 0.00 1.10 0.97 NA NA 0.02 1.12 0.99 NA NA XXX 94453 ......... ............ A Hast w/oxygen titrate ..................................... 0.40 1.66 1.55 NA NA 0.04 2.10 1.99 NA NA XXX 94453 ......... 26 ....... A Hast w/oxygen titrate ..................................... 0.40 0.11 0.12 0.11 0.12 0.02 0.53 0.54 0.53 0.54 XXX 94453 ......... TC ...... A Hast w/oxygen titrate ..................................... 0.00 1.55 1.43 NA NA 0.02 1.57 1.45 NA NA XXX94620 ......... ............ A Pulmonary stress test/simple ........................ 0.64 0.86 2.09 NA NA 0.13 1.63 2.86 NA NA XXX 94620 ......... 26 ....... A Pulmonary stress test/simple ........................ 0.64 0.19 0.20 0.19 0.20 0.03 0.86 0.87 0.86 0.87 XXX 94620 ......... TC ...... A Pulmonary stress test/simple ........................ 0.00 0.67 1.89 NA NA 0.10 0.77 1.99 NA NA XXX 94621 ......... ............ A Pulm stress test/complex .............................. 1.42 3.17 2.45 NA NA 0.16 4.75 4.03 NA NA XXX94621 ......... 26 ....... A Pulm stress test/complex .............................. 1.42 0.44 0.44 0.44 0.44 0.06 1.92 1.92 1.92 1.92 XXX 94621 ......... TC ...... A Pulm stress test/complex .............................. 0.00 2.73 2.01 NA NA 0.10 2.83 2.11 NA NA XXX 94640 ......... ............ A Airway inhalation treatment ........................... 0.00 0.36 0.32 NA NA 0.02 0.38 0.34 NA NA XXX94656 ......... ............ A Initial ventilator mgmt .................................... 1.22 1.11 1.15 0.23 0.30 0.06 2.39 2.43 1.51 1.58 XXX 94657 ......... ............ A Continued ventilator mgmt ............................ 0.83 1.13 1.02 0.19 0.24 0.04 2.00 1.89 1.06 1.11 XXX 94660 ......... ............ A Pos airway pressure, CPAP .......................... 0.76 0.81 0.69 0.19 0.22 .04 1.61 1.49 0.99 1.02 XXX 94662 ......... ............ A Neg press ventilation, cnp ............................. 0.76 NA NA 0.18 0.22 0.03 NA NA 0.97 1.01 XXX 94664 ......... ............ A Evaluate pt use of inhaler ............................. 0.00 0.40 0.33 NA NA 0.04 0.44 0.37 NA NA XXX 94667 ......... ............ A Chest wall manipulation ................................ 0.00 0.55 0.53 NA NA 0.05 0.60 0.58 NA NA XXX 94668 ......... ............ A Chest wall manipulation ................................ 0.00 0.50 0.46 NA NA 0.02 0.52 0.48 NA NA XXX 94680 ......... ............ A Exhaled air analysis, o2 ................................ 0.26 1.10 1.68 NA NA 0.07 1.43 2.01 NA NA XXX 94680 ......... 26 ....... A Exhaled air analysis, o2 ................................ 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35 XXX 94680 ......... TC ...... A Exhaled air analysis, o2 ................................ 0.00 1.03 1.60 NA NA 0.06 1.09 1.66 NA NA XXX 94681 ......... ............ A Exhaled air analysis, o2/co2 ......................... 0.20 1.08 2.17 NA NA 0.13 1.41 2.50 NA NA XXX 94681 ......... 26 ....... A Exhaled air analysis, o2/co2 ......................... 0.20 0.05 0.06 0.05 0.06 0.01 0.26 0.27 0.26 0.27 XXX 94681 ......... TC ...... A Exhaled air analysis, o2/co2 ......................... 0.00 1.03 2.11 NA NA 0.12 1.15 2.23 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37413 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

94690 ......... ............ A Exhaled air analysis ...................................... 0.07 0.88 1.72 NA NA 0.05 1.00 1.84 NA NA XXX 94690 ......... 26 ....... A Exhaled air analysis ...................................... 0.07 0.02 0.02 0.02 0.02 0.01 0.10 0.10 0.10 0.10 XXX 94690 ......... TC ...... A Exhaled air analysis ...................................... 0.00 0.86 1.70 NA NA 0.04 0.90 1.74 NA NA XXX94720 ......... ............ A Monoxide diffusing capacity .......................... 0.26 1.16 1.04 NA NA 0.07 1.49 1.37 NA NA XXX 94720 ......... 26 ....... A Monoxide diffusing capacity .......................... 0.26 0.06 0.08 0.06 0.08 0.01 0.33 0.35 0.33 0.35 XXX 94720 ......... TC ...... A Monoxide diffusing capacity .......................... 0.00 1.10 0.97 NA NA 0.06 1.16 1.03 NA NA XXX 94725 ......... ............ A Membrane diffusion capacity ........................ 0.26 1.07 2.46 NA NA 0.13 1.46 2.85 NA NA XXX 94725 ......... 26 ....... A Membrane diffusion capacity ........................ 0.26 0.09 0.08 0.09 0.08 0.01 0.36 0.35 0.36 0.35 XXX 94725 ......... TC ...... A Membrane diffusion capacity ........................ 0.00 0.98 2.38 NA NA 0.12 1.10 2.50 NA NA XXX 94750 ......... ............ A Pulmonary compliance study ........................ 0.23 1.85 1.47 NA NA 0.05 2.13 1.75 NA NA XXX 94750 ......... 26 ....... A Pulmonary compliance study ........................ 0.23 0.07 0.07 0.07 0.07 0.01 0.31 0.31 0.31 0.31 XXX 94750 ......... TC ...... A Pulmonary compliance study ........................ 0.00 1.78 1.40 NA NA 0.04 1.82 1.44 NA NA XXX 94760 ......... ............ T Measure blood oxygen level ......................... 0.00 0.06 0.05 NA NA 0.02 0.08 0.07 NA NA XXX 94761 ......... ............ T Measure blood oxygen level ......................... 0.00 0.11 0.08 NA NA 0.06 0.17 0.14 NA NA XXX 94762 ......... ............ A Measure blood oxygen level ......................... 0.00 0.93 0.59 NA NA 0.10 1.03 0.69 NA NA XXX 94770 ......... ............ A Exhaled carbon dioxide test .......................... 0.15 0.83 0.77 NA NA 0.08 1.06 1.00 NA NA XXX 94770 ......... 26 ....... A Exhaled carbon dioxide test .......................... 0.15 0.04 0.04 0.04 0.04 0.01 0.20 0.20 0.20 0.20 XXX 94770 ......... TC ...... A Exhaled carbon dioxide test .......................... 0.00 0.79 0.73 NA NA 0.07 0.86 0.80 NA NA XXX 95004 ......... ............ A Percut allergy skin tests ................................ 0.00 0.16 0.12 NA NA 0.01 0.17 0.13 NA NA XXX 95010 ......... ............ A Percut allergy titrate test ............................... 0.15 0.29 0.31 0.04 0.06 0.01 0.45 0.47 0.20 0.22 XXX 95015 ......... ............ A Id allergy titrate-drug/bug .............................. 0.15 0.20 0.16 0.04 0.06 0.01 0.36 0.32 0.20 0.22 XXX 95024 ......... ............ A Id allergy test, drug/bug ................................ 0.00 0.21 0.17 NA NA 0.01 0.22 0.18 NA NA XXX 95027 ......... ............ A Id allergy titrate-airborne ............................... 0.00 0.24 0.17 NA NA 0.01 0.25 0.18 NA NA XXX 95028 ......... ............ A Id allergy test-delayed type ........................... 0.00 0.29 0.25 NA NA 0.01 0.30 0.26 NA NA XXX 95044 ......... ............ A Allergy patch tests ......................................... 0.00 0.15 0.19 NA NA 0.01 0.16 0.20 NA NA XXX 95052 ......... ............ A Photo patch test ............................................ 0.00 0.15 0.23 NA NA 0.01 0.16 0.24 NA NA XXX 95056 ......... ............ A Photosensitivity tests ..................................... 0.00 1.19 0.43 NA NA 0.01 1.20 0.44 NA NA XXX 95060 ......... ............ A Eye allergy tests ............................................ 0.00 0.74 0.45 NA NA 0.02 0.76 0.47 NA NA XXX 95065 ......... ............ A Nose allergy test ........................................... 0.00 0.68 0.32 NA NA 0.01 0.69 0.33 NA NA XXX 95070 ......... ............ A Bronchial allergy tests ................................... 0.00 0.79 1.92 NA NA 0.02 0.81 1.94 NA NA XXX 95071 ......... ............ A Bronchial allergy tests ................................... 0.00 0.88 2.42 NA NA 0.02 0.90 2.44 NA NA XXX 95075 ......... ............ A Ingestion challenge test ................................ 0.95 0.66 0.78 0.25 0.35 0.03 1.64 1.76 1.23 1.33 XXX 95078 ......... ............ A Provocative testing ........................................ 0.00 0.34 0.27 NA NA 0.02 0.36 0.29 NA NA XXX 95115 ......... ............ A Immunotherapy, one injection ....................... 0.00 0.22 0.35 NA NA 0.02 0.24 0.37 NA NA XXX 95117 ......... ............ A Immunotherapy injections ............................. 0.00 0.27 0.44 NA NA 0.02 0.29 0.46 NA NA XXX 95144 ......... ............ A Antigen therapy services ............................... 0.06 0.26 0.21 0.02 0.02 0.01 0.33 0.28 0.09 0.09 XXX 95145 ......... ............ A Antigen therapy services ............................... 0.06 0.35 0.33 0.02 0.02 0.01 0.42 0.40 0.09 0.09 XXX 95146 ......... ............ A Antigen therapy services ............................... 0.06 0.66 0.50 0.02 0.03 0.01 0.73 0.57 0.09 0.10 XXX 95147 ......... ............ A Antigen therapy services ............................... 0.06 0.64 0.48 0.02 0.02 0.01 0.71 0.55 0.09 0.09 XXX 95148 ......... ............ A Antigen therapy services ............................... 0.06 0.95 0.67 0.02 0.03 0.01 1.02 0.74 0.09 0.10 XXX 95149 ......... ............ A Antigen therapy services ............................... 0.06 1.27 0.92 0.02 0.03 0.01 1.34 0.99 0.09 0.10 XXX 95165 ......... ............ A Antigen therapy services ............................... 0.06 0.25 0.21 0.02 0.02 0.01 0.32 0.28 0.09 0.09 XXX 95170 ......... ............ A Antigen therapy services ............................... 0.06 0.20 0.15 0.02 0.03 0.01 0.27 0.22 0.09 0.10 XXX 95180 ......... ............ A Rapid desensitization .................................... 2.01 1.59 1.93 0.72 0.88 0.04 3.64 3.98 2.77 2.93 XXX 95250 ......... ............ A Glucose monitoring, cont .............................. 0.00 3.50 3.96 NA NA 0.01 3.51 3.97 NA NA XXX95251 ......... ............ A Gluc monitor, cont, phys i&r .......................... 0.52 0.16 0.18 0.16 0.18 0.02 0.70 0.72 0.70 0.72 XXX 95805 ......... ............ A Multiple sleep latency test ............................. 1.88 7.14 14.77 NA NA 0.43 9.45 17.08 NA NA XXX 95805 ......... 26 ....... A Multiple sleep latency test ............................. 1.88 0.49 0.62 0.49 0.62 0.09 2.46 2.59 2.46 2.59 XXX 95805 ......... TC ...... A Multiple sleep latency test ............................. 0.00 6.65 14.15 NA NA 0.34 6.99 14.49 NA NA XXX95806 ......... ............ A Sleep study, unattended ............................... 1.66 3.97 3.50 NA NA 0.39 6.02 5.55 NA NA XXX95806 ......... 26 ....... A Sleep study, unattended ............................... 1.66 0.48 0.53 0.48 0.53 0.08 2.22 2.27 2.22 2.27 XXX 95806 ......... TC ...... A Sleep study, unattended ............................... 0.00 3.48 2.97 NA NA 0.31 3.79 3.28 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37414 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

95807 ......... ............ A Sleep study, attended ................................... 1.66 13.62 12.32 NA NA 0.50 15.78 14.48 NA NA XXX 95807 ......... 26 ....... A Sleep study, attended ................................... 1.66 0.48 0.52 0.48 0.52 0.08 2.22 2.26 2.22 2.26 XXX 95807 ......... TC ...... A Sleep study, attended ................................... 0.00 13.14 11.80 NA NA 0.42 13.56 12.22 NA NA XXX 95808 ......... ............ A Polysomnography, 1–3 .................................. 2.65 16.81 14.13 NA NA 0.55 20.01 17.33 NA NA XXX 95808 ......... 26 ....... A Polysomnography, 1–3 .................................. 2.65 0.66 0.86 0.66 0.86 0.13 3.44 3.64 3.44 3.64 XXX 95808 ......... TC ...... A Polysomnography, 1–3 .................................. 0.00 16.15 13.27 NA NA 0.42 16.57 13.69 NA NA XXX 95810 ......... ............ A Polysomnography, 4 or more ........................ 3.52 19.68 18.08 NA NA 0.59 23.79 22.19 NA NA XXX95810 ......... 26 ....... A Polysomnography, 4 or more ........................ 3.52 0.94 1.12 0.94 1.12 0.17 4.63 4.81 4.63 4.81 XXX 95810 ......... TC ...... A Polysomnography, 4 or more ........................ 0.00 18.74 16.96 NA NA 0.42 19.16 17.38 NA NA XXX 95811 ......... ............ A Polysomnography w/cpap ............................. 3.79 21.86 19.90 NA NA 0.61 26.26 24.30 NA NA XXX 95811 ......... 26 ....... A Polysomnography w/cpap ............................. 3.79 1.00 1.20 1.00 1.20 0.18 4.97 5.17 4.97 5.17 XXX 95811 ......... TC ...... A Polysomnography w/cpap ............................. 0.00 20.86 18.69 NA NA 0.43 21.29 19.12 NA NA XXX 95812 ......... ............ A Eeg, 41–60 minutes ...................................... 1.08 5.82 4.49 NA NA 0.17 7.07 5.74 NA NA XXX 95812 ......... 26 ....... A Eeg, 41–60 minutes ...................................... 1.08 0.30 0.41 0.30 0.41 0.06 1.44 1.55 1.44 1.55 XXX 95812 ......... TC ...... A Eeg, 41–60 minutes ...................................... 0.00 5.53 4.08 NA NA 0.11 5.64 4.19 NA NA XXX 95813 ......... ............ A Eeg, over 1 hour ........................................... 1.73 6.55 5.41 NA NA 0.20 8.48 7.34 NA NA XXX 95813 ......... 26 ....... A Eeg, over 1 hour ........................................... 1.73 0.48 0.65 0.48 0.65 0.09 2.30 2.47 2.30 2.47 XXX 95813 ......... TC ...... A Eeg, over 1 hour ........................................... 0.00 6.07 4.77 NA NA 0.11 6.18 4.88 NA NA XXX 95816 ......... ............ A Eeg, awake and drowsy ................................ 1.08 5.22 4.10 NA NA 0.16 6.46 5.34 NA NA XXX 95816 ......... 26 ....... A Eeg, awake and drowsy ................................ 1.08 0.29 0.42 0.29 0.42 0.06 1.43 1.56 1.43 1.56 XXX 95816 ......... TC ...... A Eeg, awake and drowsy ................................ 0.00 4.93 3.68 NA NA 0.10 5.03 3.78 NA NA XXX 95819 ......... ............ A Eeg, awake and asleep ................................. 1.08 6.07 3.76 NA NA 0.16 7.31 5.00 NA NA XXX95819 ......... 26 ....... A Eeg, awake and asleep ................................. 1.08 0.29 0.42 0.29 0.42 0.06 1.43 1.56 1.43 1.56 XXX 95819 ......... TC ...... A Eeg, awake and asleep ................................. 0.00 5.77 3.34 NA NA 0.10 87 3.44 NA NA XXX 95822 ......... ............ A Eeg, coma or sleep only ............................... 1.08 5.45 4.82 NA NA 0.19 6.72 6.09 NA NA XXX95822 ......... 26 ....... A Eeg, coma or sleep only ............................... 1.08 0.29 0.42 0.29 0.42 0.06 1.43 1.56 1.43 1.56 XXX 95822 ......... TC ...... A Eeg, coma or sleep only ............................... 0.00 5.16 4.40 NA NA 0.13 5.29 4.53 NA NA XXX 95824 ......... 26 ....... A Eeg, cerebral death only ............................... 0.74 0.20 0.28 0.20 0.28 0.04 0.98 1.06 0.98 1.06 XXX 95827 ......... ............ A Eeg, all night recording ................................. 1.08 11.40 4.88 NA NA 0.19 12.67 6.15 NA NA XXX 95827 ......... 26 ....... A Eeg, all night recording ................................. 1.08 0.28 0.38 0.28 0.38 0.05 1.41 1.51 1.41 1.51 XXX 95827 ......... TC ...... A Eeg, all night recording ................................. 0.00 11.13 4.51 NA NA 0.14 11.27 4.65 NA NA XXX 95829 ......... ............ A Surgery electrocorticogram ........................... 6.20 25.15 29.61 NA NA 0.50 31.85 36.31 NA NA XXX 95829 ......... 26 ....... A Surgery electrocorticogram ........................... 6.20 1.74 2.18 1.74 2.18 0.48 8.42 8.86 8.42 8.86 XXX 95829 ......... TC ...... A Surgery electrocorticogram ........................... 0.00 23.41 27.43 NA NA 0.02 23.43 27.45 NA NA XXX 95830 ......... ............ A Insert electrodes for EEG .............................. 1.70 2.94 3.21 0.40 0.65 0.11 4.75 5.02 2.21 2.46 XXX 95831 ......... ............ A Limb muscle testing, manual ........................ 0.28 0.38 0.44 0.09 0.12 0.01 0.67 0.73 0.38 0.41 XXX 95832 ......... ............ A Hand muscle testing, manual ........................ 0.29 0.36 0.34 0.09 0.11 0.02 0.67 0.65 0.40 0.42 XXX 95833 ......... ............ A Body muscle testing, manual ........................ 0.47 0.47 0.55 0.13 0.21 0.02 0.96 1.04 0.62 0.70 XXX 95834 ......... ............ A Body muscle testing, manual ........................ 0.60 0.55 0.61 0.17 0.25 0.03 1.18 1.24 0.80 0.88 XXX 95851 ......... ............ A Range of motion measurements ................... 0.16 0.26 0.34 0.04 0.07 0.01 0.43 0.51 0.21 0.24 XXX 95852 ......... ............ A Range of motion measurements ................... 0.11 0.21 0.25 0.03 0.05 0.01 0.33 0.37 0.15 0.17 XXX 95857 ......... ............ A Tensilon test .................................................. 0.53 0.58 0.60 0.16 0.21 0.02 1.13 1.15 0.71 0.76 XXX 95860 ......... ............ A Muscle test, one limb .................................... 0.96 1.14 1.35 NA NA 0.07 2.17 2.38 NA NA XXX 95860 ......... 26 ....... A Muscle test, one limb .................................... 0.96 0.31 0.39 0.31 0.39 0.05 1.32 1.40 1.32 1.40 XXX 95860 ......... TC ...... A Muscle test, one limb .................................... 0.00 0.83 0.96 NA NA 0.02 0.85 0.98 NA NA XXX 95861 ......... ............ A Muscle test, 2 limbs ...................................... 1.54 1.64 1.47 NA NA 0.13 3.31 3.14 NA NA XXX 95861 ......... 26 ....... A Muscle test, 2 limbs ...................................... 1.54 0.49 0.63 0.49 0.63 0.07 2.10 2.24 2.10 2.24 XXX 95861 ......... TC ...... A Muscle test, 2 limbs ...................................... 0.00 1.15 0.84 NA NA 0.06 1.21 0.90 NA NA XXX95863 ......... ............ A Muscle test, 3 limbs ...................................... 1.87 1.90 1.78 NA NA 0.15 3.92 3.80 NA NA XXX 95863 ......... 26 ....... A Muscle test, 3 limbs ...................................... 1.87 0.56 0.74 0.56 0.74 0.09 2.52 2.70 2.52 2.70 XXX 95863 ......... TC ...... A Muscle test, 3 limbs ...................................... 0.00 1.34 1.04 NA NA 0.06 1.40 1.10 NA NA XXX

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37415 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

95864 ......... ............ A Muscle test, 4 limbs ...................................... 1.99 2.16 2.54 NA NA 0.21 4.36 4.74 NA NA XXX 95864 ......... 26 ....... A Muscle test, 4 limbs ...................................... 1.99 0.61 0.81 0.61 0.81 0.09 2.69 2.89 2.69 2.89 XXX 95864 ......... TC ...... A Muscle test, 4 limbs ...................................... 0.00 1.55 1.73 NA NA 0.12 1.67 1.85 NA NA XXX95865 ......... ............ A Muscle test, larynx ........................................ 1.57 1.32 1.42 NA NA 0.11 3.00 3.10 NA NA XXX 95865 ......... 26 ....... A Muscle test, larynx ........................................ 1.57 0.45 0.69 0.45 0.69 0.08 2.10 2.34 2.10 2.34 XXX 95865 ......... TC ...... A Muscle test, larynx ........................................ 0.00 0.87 0.73 NA NA 0.03 0.90 0.76 NA NA XXX 95866 ......... ............ A Muscle test, hemidiaphragm ......................... 1.25 1.31 0.90 NA NA 0.10 2.66 2.25 NA NA XXX 95866 ......... 26 ....... A Muscle test, hemidiaphragm ......................... 1.25 0.39 0.52 0.39 0.52 0.07 1.71 1.84 1.71 1.84 XXX 95866 ......... TC ...... A Muscle test, hemidiaphragm ......................... 0.00 0.92 0.38 NA NA 0.03 0.95 0.41 NA NA XXX 95867 ......... ............ A Muscle test cran nerv unilat .......................... 0.79 1.10 0.97 NA NA 0.07 1.96 1.83 NA NA XXX95867 ......... 26 ....... A Muscle test cran nerv unilat .......................... 0.79 0.22 0.32 0.22 0.32 0.03 1.04 1.14 1.04 1.14 XXX 95867 ......... TC ...... A Muscle test cran nerv unilat .......................... 0.00 0.88 0.66 NA NA 0.04 0.92 0.70 NA NA XXX 95868 ......... ............ A Muscle test cran nerve bilat .......................... 1.18 1.40 1.26 NA NA 0.10 2.68 2.54 NA NA XXX95868 ......... 26 ....... A Muscle test cran nerve bilat .......................... 1.18 0.34 0.47 0.34 0.47 0.05 1.57 1.70 1.57 1.70 XXX 95868 ......... TC ...... A Muscle test cran nerve bilat .......................... 0.00 1.07 0.79 NA NA 0.05 1.12 0.84 NA NA XXX 95869 ......... ............ A Muscle test, thor paraspinal .......................... 0.37 1.02 0.53 NA NA 0.04 1.43 0.94 NA NA XXX95869 ......... 26 ....... A Muscle test, thor paraspinal .......................... 0.37 0.11 0.15 0.11 0.15 0.02 0.50 0.54 0.50 0.54 XXX 95869 ......... TC ...... A Muscle test, thor paraspinal .......................... 0.00 0.90 0.38 NA NA 0.02 0.92 0.40 NA NA XXX 95870 ......... ............ A Muscle test, nonparaspinal ........................... 0.37 0.98 0.52 NA NA 0.04 1.39 0.93 NA NA XXX 95870 ......... 26 ....... A Muscle test, nonparaspinal ........................... 0.37 0.11 0.15 0.11 0.15 0.02 0.50 0.54 0.50 0.54 XXX 95870 ......... TC ...... A Muscle test, nonparaspinal ........................... 0.00 0.87 0.38 NA NA 0.02 0.89 0.40 NA NA XXX 95872 ......... ............ A Muscle test, one fiber .................................... 2.00 1.39 1.27 NA NA 0.13 3.52 3.40 NA NA XXX 95872 ......... 26 ....... A Muscle test, one fiber .................................... 2.00 0.62 0.63 0.62 0.63 0.08 2.70 2.71 2.70 2.71 XXX 95872 ......... TC ...... A Muscle test, one fiber .................................... 0.00 0.77 0.64 NA NA 0.05 0.82 0.69 NA NA XXX95873 ......... ............ A Guide nerv destr, elec stim ........................... 0.37 0.94 0.51 NA NA 0.04 1.35 0.92 NA NA ZZZ95873 ......... 26 ....... A Guide nerv destr, elec stim ........................... 0.37 0.11 0.15 0.11 0.15 0.02 0.50 0.54 0.50 0.54 ZZZ 95873 ......... TC ...... A Guide nerv destr, elec stim ........................... 0.00 0.82 0.36 NA NA 0.02 0.84 0.38 NA NA ZZZ 95874 ......... ............ A Guide nerv destr, needle emg ...................... 0.37 0.95 0.52 NA NA 0.04 1.36 0.93 NA NA ZZZ 95874 ......... 26 ....... A Guide nerv destr, needle emg ...................... 0.37 0.12 0.16 0.12 0.16 0.02 0.51 0.55 0.51 0.55 ZZZ 95874 ......... TC ...... A Guide nerv destr, needle emg ...................... 0.00 0.83 0.36 NA NA 0.02 0.85 0.38 NA NA ZZZ 95875 ......... ............ A Limb exercise test ......................................... 1.10 1.29 1.41 NA NA 0.11 2.50 2.62 NA NA XXX 95875 ......... 26 ....... A Limb exercise test ......................................... 1.10 0.31 0.43 0.31 0.43 0.05 1.46 1.58 1.46 1.58 XXX 95875 ......... TC ...... A Limb exercise test ......................................... 0.00 0.99 0.98 NA NA 0.06 1.05 1.04 NA NA XXX 95900 ......... ............ A Motor nerve conduction test .......................... 0.42 0.93 1.18 NA NA 0.04 1.39 1.64 NA NA XXX 95900 ......... 26 ....... A Motor nerve conduction test .......................... 0.42 0.14 0.17 0.14 0.17 0.02 0.58 0.61 0.58 0.61 XXX 95900 ......... TC ...... A Motor nerve conduction test .......................... 0.00 0.79 1.01 NA NA 0.02 0.81 1.03 NA NA XXX 95903 ......... ............ A Motor nerve conduction test .......................... 0.60 1.02 1.15 NA NA 0.05 1.67 1.80 NA NA XXX 95903 ......... 26 ....... A Motor nerve conduction test .......................... 0.60 0.17 0.24 0.17 0.24 0.03 0.80 0.87 0.80 0.87 XXX 95903 ......... TC ...... A Motor nerve conduction test .......................... 0.00 0.85 0.91 NA NA 0.02 0.87 0.93 NA NA XXX 95904 ......... ............ A Sense nerve conduction test ......................... 0.34 0.86 1.03 NA NA 0.04 1.24 1.41 NA NA XXX 95904 ......... 26 ....... A Sense nerve conduction test ......................... 0.34 0.10 0.14 0.10 0.14 0.02 0.46 0.50 0.46 0.50 XXX 95904 ......... TC ...... A Sense nerve conduction test ......................... 0.00 0.76 0.90 NA NA 0.02 0.78 0.92 NA NA XXX 95920 ......... ............ A Intraop nerve test add-on .............................. 2.11 1.76 2.12 NA NA 0.23 4.10 4.46 NA NA ZZZ 95920 ......... 26 ....... A Intraop nerve test add-on .............................. 2.11 0.64 0.86 0.64 0.86 0.16 2.91 3.13 2.91 3.13 ZZZ 95920 ......... TC ...... A Intraop nerve test add-on .............................. 0.00 1.12 1.26 NA NA 0.07 1.19 1.33 NA NA ZZZ 95921 ......... ............ A Autonomic nerv function test ......................... 0.90 1.12 0.81 NA NA 0.06 2.08 1.77 NA NA XXX 95921 ......... 26 ....... A Autonomic nerv function test ......................... 0.90 0.24 0.31 0.24 0.31 0.04 1.18 1.25 1.18 1.25 XXX 95921 ......... TC ...... A Autonomic nerv function test ......................... 0.00 0.89 0.51 NA NA 0.02 0.91 0.53 NA NA XXX 95922 ......... ............ A Autonomic nerv function test ......................... 0.96 1.63 0.99 NA NA 0.07 2.66 2.02 NA NA XXX 95922 ......... 26 ....... A Autonomic nerv function test ......................... 0.96 0.27 0.37 0.27 0.37 0.05 1.28 1.38 1.28 1.38 XXX 95922 ......... TC ...... A Autonomic nerv function test ......................... 0.00 1.37 0.63 NA NA 0.02 1.39 0.65 NA NA XXX 95923 ......... ............ A Autonomic nerv function test ......................... 0.90 2.10 1.98 NA NA 0.07 3.07 2.95 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37416 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

95923 ......... 26 ....... A Autonomic nerv function test ......................... 0.90 0.23 0.34 0.23 0.34 0.05 1.18 1.29 1.18 1.29 XXX 95923 ......... TC ...... A Autonomic nerv function test ......................... 0.00 1.87 1.64 NA NA 0.02 1.89 1.66 NA NA XXX 95925 ......... ............ A Somatosensory testing .................................. 0.54 3.15 1.64 NA NA 0.10 3.79 2.28 NA NA XXX 95925 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.16 0.21 0.16 0.21 0.04 0.74 0.79 0.74 0.79 XXX 95925 ......... TC ...... A Somatosensory testing .................................. 0.00 2.99 1.43 NA NA 0.06 3.05 1.49 NA NA XXX 95926 ......... ............ A Somatosensory testing .................................. 0.54 3.00 1.61 NA NA 0.09 3.63 2.24 NA NA XXX 95926 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.15 0.21 0.15 0.21 0.03 0.72 0.78 0.72 0.78 XXX 95926 ......... TC ...... A Somatosensory testing .................................. 0.00 2.85 1.40 NA NA 0.06 2.91 1.46 NA NA XXX 95927 ......... ............ A Somatosensory testing .................................. 0.54 3.04 1.63 NA NA 0.10 3.68 2.27 NA NA XXX 95927 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.15 0.23 0.15 0.23 0.04 0.73 0.81 0.73 0.81 XXX 95927 ......... TC ...... A Somatosensory testing .................................. 0.00 2.88 1.40 NA NA 0.06 2.94 1.46 NA NA XXX 95928 ......... ............ A C motor evoked, uppr limbs .......................... 1.50 3.93 3.26 NA NA 0.09 5.52 4.85 NA NA XXX 95928 ......... 26 ....... A C motor evoked, uppr limbs .......................... 1.50 0.44 0.60 0.44 0.60 0.06 2.00 2.16 2.00 2.16 XXX 95928 ......... TC ...... A C motor evoked, uppr limbs .......................... 0.00 3.48 2.66 NA NA 0.03 3.51 2.69 NA NA XXX 95929 ......... ............ A C motor evoked, lwr limbs ............................ 1.50 4.24 3.48 NA NA 0.09 5.83 5.07 NA NA XXX 95929 ......... 26 ....... A C motor evoked, lwr limbs ............................ 1.50 0.44 0.60 0.44 0.60 0.06 2.00 2.16 2.00 2.16 XXX 95930 ......... ............ A Visual evoked potential test .......................... 0.35 2.60 2.34 NA NA 0.03 2.98 2.72 NA NA XXX95930 ......... 26 ....... A Visual evoked potential test .......................... 0.35 0.10 0.14 0.10 0.14 0.02 0.47 0.51 0.47 0.51 XXX 95930 ......... TC ...... A Visual evoked potential test .......................... 0.00 2.50 2.20 NA NA 0.01 2.51 2.21 NA NA XXX 95933 ......... ............ A Blink reflex test .............................................. 0.59 1.08 1.04 NA NA 0.10 1.77 1.73 NA NA XXX 95933 ......... 26 ....... A Blink reflex test .............................................. 0.59 0.17 0.22 0.17 0.22 0.04 0.80 0.85 0.80 0.85 XXX 95933 ......... TC ...... A Blink reflex test .............................................. 0.00 0.92 0.82 NA NA 0.06 0.98 0.88 NA NA XXX 95934 ......... ............ A H-reflex test ................................................... 0.51 0.88 0.54 NA NA 0.04 1.43 1.09 NA NA XXX 95934 ......... 26 ....... A H-reflex test ................................................... 0.51 0.16 0.21 0.16 0.21 0.02 0.69 0.74 0.69 0.74 XXX 95934 ......... TC ...... A H-reflex test ................................................... 0.00 0.72 0.34 NA NA 0.02 0.74 0.36 NA NA XXX 95936 ......... ............ A H-reflex test ................................................... 0.55 0.60 0.49 NA NA 0.05 1.20 1.09 NA NA XXX 95936 ......... 26 ....... A H-reflex test ................................................... 0.55 0.17 0.22 0.17 0.22 0.03 0.75 0.80 0.75 0.80 XXX 95936 ......... TC ...... A H-reflex test ................................................... 0.00 0.44 0.27 NA NA 0.02 0.46 0.29 NA NA XXX 95937 ......... ............ A Neuromuscular junction test .......................... 0.65 0.90 0.68 NA NA 0.10 1.65 1.43 NA NA XXX 95937 ......... 26 ....... A Neuromuscular junction test .......................... 0.65 0.19 0.25 0.19 0.25 0.08 0.92 0.98 0.92 0.98 XXX 95937 ......... TC ...... A Neuromuscular junction test .......................... 0.00 0.71 0.43 NA NA 0.02 0.73 0.45 NA NA XXX 95950 ......... ............ A Ambulatory eeg monitoring ........................... 1.51 4.87 4.17 NA NA 0.51 6.89 6.19 NA NA XXX 95950 ......... 26 ....... A Ambulatory eeg monitoring ........................... 1.51 0.40 0.58 0.40 0.58 0.08 1.99 2.17 1.99 2.17 XXX 95950 ......... TC ...... A Ambulatory eeg monitoring ........................... 0.00 4.46 3.59 NA NA 0.43 4.89 4.02 NA NA XXX 95951 ......... 26 ....... A EEG monitoring/videorecord ......................... 5.99 1.63 2.33 1.63 2.33 0.32 7.94 8.64 7.94 8.64 XXX 95953 ......... ............ A EEG monitoring/computer ............................. 3.30 7.13 7.51 NA NA 0.60 11.03 11.41 NA NA XXX95953 ......... 26 ....... A EEG monitoring/computer ............................. 3.30 0.90 1.19 0.90 1.19 0.17 4.37 4.66 4.37 4.66 XXX 95953 ......... TC ...... A EEG monitoring/computer ............................. 0.00 6.23 6.32 NA NA 0.43 6.66 6.75 NA NA XXX 95954 ......... ............ A EEG monitoring/giving drugs ........................ 2.45 4.85 4.39 NA NA 0.19 7.49 7.03 NA NA XXX 95954 ......... 26 ....... A EEG monitoring/giving drugs ........................ 2.45 0.50 0.91 0.50 0.91 0.13 3.08 3.49 3.08 3.49 XXX 95954 ......... TC ...... A EEG monitoring/giving drugs ........................ 0.00 4.35 3.48 NA NA 0.06 4.41 3.54 NA NA XXX 95955 ......... ............ A EEG during surgery ....................................... 1.01 3.51 2.63 NA NA 0.22 4.74 3.86 NA NA XXX 95955 ......... 26 ....... A EEG during surgery ....................................... 1.01 0.28 0.34 0.28 0.34 0.05 1.34 1.40 1.34 1.40 XXX 95955 ......... TC ...... A EEG during surgery ....................................... 0.00 3.23 2.29 NA NA 0.17 3.40 2.46 NA NA XXX 95956 ......... ............ A Eeg monitoring, cable/radio .......................... 3.08 16.73 15.77 NA NA 0.59 20.40 19.44 NA NA XXX 95956 ......... 26 ....... A Eeg monitoring, cable/radio .......................... 3.08 0.97 1.22 0.97 1.22 0.16 4.21 4.46 4.21 4.46 XXX 95956 ......... TC ...... A Eeg monitoring, cable/radio .......................... 0.00 15.76 14.55 NA NA 0.43 16.19 14.98 NA NA XXX 95957 ......... ............ A EEG digital analysis ...................................... 1.98 5.80 3.36 NA NA 0.23 8.01 5.57 NA NA XXX 95957 ......... 26 ....... A EEG digital analysis ...................................... 1.98 0.54 0.77 0.54 0.77 0.11 2.63 2.86 2.63 2.86 XXX 95957 ......... TC ...... A EEG digital analysis ...................................... 0.00 5.26 2.59 NA NA 0.12 5.38 2.71 NA NA XXX95958 ......... ............ A EEG monitoring/function test ........................ 4.24 6.67 4.29 NA NA 0.34 11.25 8.87 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37417 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

95958 ......... 26 ....... A EEG monitoring/function test ........................ 4.24 1.21 1.62 1.21 1.62 0.21 5.66 6.07 5.66 6.07 XXX 95958 ......... TC ...... A EEG monitoring/function test ........................ 0.00 5.46 2.68 NA NA 0.13 5.59 2.81 NA NA XXX 95961 ......... ............ A Electrode stimulation, brain ........................... 2.97 3.06 2.74 NA NA 0.55 6.58 6.26 NA NA XXX 95961 ......... 26 ....... A Electrode stimulation, brain ........................... 2.97 0.87 1.21 0.87 1.21 0.48 4.32 4.66 4.32 4.66 XXX 95961 ......... TC ...... A Electrode stimulation, brain ........................... 0.00 2.19 1.53 NA NA 0.07 2.26 1.60 NA NA XXX 95962 ......... ............ A Electrode stim, brain add-on ......................... 3.21 2.16 2.57 NA NA 0.39 5.76 6.17 NA NA ZZZ 95962 ......... 26 ....... A Electrode stim, brain add-on ......................... 3.21 0.88 1.26 0.88 1.26 0.32 4.41 4.79 4.41 4.79 ZZZ 95962 ......... TC ...... A Electrode stim, brain add-on ......................... 0.00 1.28 1.30 NA NA 0.07 1.35 1.37 NA NA ZZZ 95965 ......... 26 ....... A Meg, spontaneous ......................................... 7.99 2.23 3.13 2.23 3.13 0.46 10.68 11.58 10.68 11.58 XXX 95966 ......... 26 ....... A Meg, evoked, single ...................................... 3.99 1.26 1.60 1.26 1.60 0.19 5.44 5.78 5.44 5.78 XXX 95967 ......... 26 ....... A Meg, evoked, each addIl ............................... 3.49 1.10 1.16 1.10 1.16 0.16 4.75 4.81 4.75 4.81 ZZZ 95970 ......... ............ A Analyze neurostim, no prog .......................... 0.45 0.88 0.86 0.12 0.14 0.03 1.36 1.34 0.60 0.62 XXX 95971 ......... ............ A Analyze neurostim, simple ............................ 0.78 0.62 0.67 0.20 0.22 0.07 1.47 1.52 1.05 1.07 XXX 95972 ......... ............ A Analyze neurostim, complex ......................... 1.50 1.20 1.21 0.46 0.48 0.14 2.84 2.85 2.10 2.12 XXX 95973 ......... ............ A Analyze neurostim, complex ......................... 0.92 0.55 0.60 0.24 0.32 0.07 1.54 1.59 1.23 1.31 ZZZ 95974 ......... ............ A Cranial neurostim, complex ........................... 3.00 1.45 1.64 0.82 1.18 0.16 4.61 4.80 3.98 4.34 XXX 95975 ......... ............ A Cranial neurostim, complex ........................... 1.70 0.72 0.85 0.46 0.66 0.12 2.54 2.67 2.28 2.48 ZZZ 95978 ......... ............ A Analyze neurostim brain/1h ........................... 3.50 1.81 1.91 1.02 1.23 0.18 5.49 5.59 4.70 4.91 XXX 95979 ......... ............ A Analyz neurostim brain addon ...................... 1.64 0.71 0.83 0.45 0.63 0.08 2.43 2.55 2.17 2.35 ZZZ 95990 ......... ............ A Spin/brain pump refil & main ......................... 0.00 1.65 1.54 NA NA 0.06 1.71 1.60 NA NA XXX 95991 ......... ............ A Spin/brain pump refil & main ......................... 0.77 1.66 1.51 0.18 0.17 0.06 2.49 2.34 1.01 1.00 XXX 96000 ......... ............ A Motion analysis, video/3d .............................. 1.80 NA NA 0.58 0.54 0.11 NA NA 2.49 2.45 XXX 96001 ......... ............ A Motion test w/ft press meas .......................... 2.15 NA NA 0.51 0.62 0.10 NA NA 2.76 2.87 XXX 96002 ......... ............ A Dynamic surface emg ................................... 0.41 NA NA 0.10 0.14 0.02 NA NA 0.53 0.57 XXX96003 ......... ............ A Dynamic fine wire emg .................................. 0.37 NA NA 0.14 0.13 0.02 NA NA 0.53 0.52 XXX 96004 ......... ............ A Phys review of motion tests .......................... 2.14 0.52 0.84 0.52 0.84 0.11 2.77 3.09 2.77 3.09 XXX 96101 ......... ............ A Psycho testing by psych/phys ....................... 1.86 0.34 0.57 0.32 0.55 0.05 2.25 2.48 2.23 2.46 XXX 96102 ......... ............ A Psycho testing by technician ......................... 0.50 1.17 0.79 0.09 0.15 0.01 1.68 1.30 0.60 0.66 XXX 96103 ......... ............ A Psycho testing admin by comp ..................... 0.51 0.12 0.19 0.09 0.15 0.02 0.65 0.72 0.62 0.68 XXX 96105 ......... ............ A Assessment of aphasia ................................. 0.00 2.04 1.84 NA NA 0.18 2.22 2.02 NA NA XXX96110 ......... ............ A Developmental test, lim ................................. 0.00 0.18 0.18 NA NA 0.18 0.36 0.36 NA NA XXX 96111 ......... ............ A Developmental test, extend ........................... 2.60 0.64 0.95 NA NA 0.18 3.42 3.73 NA NA XXX 96116 ......... ............ A Neurobehavioral status exam ....................... 1.86 0.52 0.75 0.41 0.58 0.18 2.56 2.79 2.45 2.62 XXX 96118 ......... ............ A Neuropsych tst by psych/phys ...................... 1.86 0.79 1.24 0.31 0.55 0.18 2.83 3.28 2.35 2.59 XXX 96119 ......... ............ A Neuropsych testing by tech ........................... 0.55 1.49 1.14 0.09 0.17 0.18 2.22 1.87 0.82 0.90 XXX 96120 ......... ............ A Neuropsych tst admin w/comp ...................... 0.51 0.77 0.75 0.09 0.15 0.02 1.30 1.28 0.62 0.68 XXX 96150 ......... ............ A Assess hlth/behave, init ................................ 0.50 0.10 0.16 0.09 0.16 0.01 0.61 0.67 0.60 0.67 XXX 96151 ......... ............ A Assess hlth/behave, subseq ......................... 0.48 0.09 0.16 0.08 0.15 0.01 0.58 0.65 0.57 0.64 XXX 96152 ......... ............ A Intervene hlth/behave, indiv .......................... 0.46 0.09 0.15 0.08 0.14 0.01 0.56 0.62 0.55 0.61 XXX 96153 ......... ............ A Intervene hlth/behave, group ........................ 0.10 0.02 0.04 0.02 0.03 0.01 0.13 0.15 0.13 0.14 XXX 96154 ......... ............ A Interv hlth/behav, fam w/pt ............................ 0.45 0.09 0.15 0.08 0.14 0.01 0.55 0.61 0.54 0.60 XXX 96155 ......... ............ N Interv hlth/behav fam no pt ........................... 0.44 0.10 0.16 0.10 0.15 0.02 0.56 0.62 0.56 0.61 XXX 96401 ......... ............ A Chemo, anti-neopl, sq/im .............................. 0.21 1.88 1.35 NA NA 0.01 2.10 1.57 NA NA XXX96402 ......... ............ A Chemo hormon antineopl sq/im .................... 0.19 0.73 0.94 NA NA 0.01 0.93 1.14 NA NA XXX 96405 ......... ............ A Chemo intralesional, up to 7 ......................... 0.52 3.53 2.71 0.22 0.24 0.03 4.08 3.26 0.77 0.79 000 96406 ......... ............ A Chemo intralesional over 7 ........................... 0.80 3.27 3.08 0.27 0.29 0.03 4.10 3.91 1.10 1.12 000 96409 ......... ............ A Chemo, iv push, sngl drug ............................ 0.24 2.81 2.90 NA NA 0.06 3.11 3.20 NA NA XXX 96411 ......... ............ A Chemo, iv push, addl drug ............................ 0.20 1.51 1.59 NA NA 0.06 1.77 1.85 NA NA ZZZ 96413 ......... ............ A Chemo, iv infusion, 1 hr ................................ 0.28 3.66 4.07 NA NA 0.08 4.02 4.43 NA NA XXX 96415 ......... ............ A Chemo, iv infusion, addl hr ........................... 0.19 0.66 0.74 NA NA 0.07 0.92 1.00 NA NA ZZZ96416 ......... ............ A Chemo prolong infuse w/pump ..................... 0.21 4.12 4.49 NA NA 0.08 4.41 4.78 NA NA XXX 96417 ......... ............ A Chemo iv infus each addl seq ...................... 0.21 1.74 1.90 NA NA 0.07 2.02 2.18 NA NA ZZZ 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37418 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

96420 ......... ............ A Chemo, ia, push tecnique ............................. 0.17 2.74 2.69 NA NA 0.08 2.99 2.94 NA NA XXX 96422 ......... ............ A Chemo ia infusion up to 1 hr ........................ 0.17 3.63 4.54 NA NA 0.08 3.88 4.79 NA NA XXX 96423 ......... ............ A Chemo ia infuse each addl hr ....................... 0.17 1.88 1.89 NA NA 0.02 2.07 2.08 NA NA ZZZ 96425 ......... ............ A Chemotherapy,infusion method .................... 0.17 4.56 4.50 NA NA 0.08 4.81 4.75 NA NA XXX 96440 ......... ............ A Chemotherapy, intracavitary ......................... 2.37 5.55 7.50 0.98 1.17 0.17 8.09 10.04 3.52 3.71 000 96445 ......... ............ A Chemotherapy, intracavitary ......................... 2.20 5.44 7.40 0.93 1.12 0.14 7.78 9.74 3.27 3.46 000 96450 ......... ............ A Chemotherapy, into CNS .............................. 1.53 5.11 6.51 0.85 1.18 0.09 6.73 8.13 2.47 2.80 000 96521 ......... ............ A Refill/maint, portable pump ........................... 0.21 3.17 3.62 NA NA 0.06 3.44 3.89 NA NA XXX96522 ......... ............ A Refill/maint pump/resvr syst .......................... 0.21 2.76 2.68 NA NA 0.06 3.03 2.95 NA NA XXX96523 ......... ............ T Irrig drug delivery device ............................... 0.04 0.65 0.68 NA NA 0.01 0.70 0.73 NA NA XXX 96542 ......... ............ A Chemotherapy injection ................................. 0.75 3.59 4.09 0.33 0.58 0.07 4.41 4.91 1.15 1.40 XXX 96567 ......... ............ A Photodynamic tx, skin ................................... 0.00 3.70 2.40 NA NA 0.04 3.74 2.44 NA NA XXX 96570 ......... ............ A Photodynamic tx, 30 min ............................... 1.10 NA NA 0.42 0.38 0.11 NA NA 1.63 1.59 ZZZ96571 ......... ............ A Photodynamic tx, addl 15 min ....................... 0.55 NA NA 0.20 0.19 0.03 NA NA 0.78 0.77 ZZZ 96900 ......... ............ A Ultraviolet light therapy .................................. 0.00 0.56 0.47 NA NA 0.02 0.58 0.49 NA NA XXX 96902 ......... ............ B Trichogram .................................................... 0.41 0.11 0.16 0.09 0.14 0.01 0.53 0.58 0.51 0.56 XXX 96910 ......... ............ A Photochemotherapy with UV–B .................... 0.00 1.98 1.24 NA NA 0.04 2.02 1.28 NA NA XXX 96912 ......... ............ A Photochemotherapy with UV–A .................... 0.00 2.55 1.58 NA NA 0.05 2.60 1.63 NA NA XXX 96913 ......... ............ A Photochemotherapy, UV–A or B ................... 0.00 3.60 2.16 NA NA 0.10 3.70 2.26 NA NA XXX 96920 ......... ............ A Laser tx, skin < 250 sq cm ........................... 1.15 3.54 2.79 0.55 0.56 0.02 4.71 3.96 1.72 1.73 000 96921 ......... ............ A Laser tx, skin 250–500 sq cm ....................... 1.17 3.44 2.82 0.52 0.56 0.03 4.64 4.02 1.72 1.76 000 96922 ......... ............ A Laser tx, skin > 500 sq cm ........................... 2.10 4.53 3.75 1.00 0.72 0.04 6.67 5.89 3.14 2.86 000 97001 ......... ............ A Pt evaluation .................................................. 1.20 0.69 0.74 0.30 0.41 0.05 1.94 1.99 1.55 1.66 XXX 97002 ......... ............ A Pt re-evaluation ............................................. 0.60 0.43 0.44 0.14 0.21 0.02 1.05 1.06 0.76 0.83 XXX 97003 ......... ............ A Ot evaluation ................................................. 1.20 0.78 0.86 0.36 0.39 0.06 2.04 2.12 1.62 1.65 XXX 97004 ......... ............ A Ot re-evaluation ............................................. 0.60 0.55 0.64 0.18 0.19 0.02 1.17 1.26 0.80 0.81 XXX 97010 ......... ............ B Hot or cold packs therapy ............................. 0.06 0.07 0.06 NA NA 0.01 0.14 0.13 NA NA XXX97012 ......... ............ A Mechanical traction therapy .......................... 0.25 0.15 0.14 NA NA 0.01 0.41 0.40 NA NA XXX 97014 ......... ............ I Electric stimulation therapy ........................... 0.18 0.19 0.19 0.04 0.15 0.01 0.38 0.38 0.23 0.34 XXX 97016 ......... ............ A Vasopneumatic device therapy ..................... 0.18 0.25 0.20 NA NA 0.01 0.44 0.39 NA NA XXX 97018 ......... ............ A Paraffin bath therapy ..................................... 0.06 0.17 0.12 NA NA 0.01 0.24 0.19 NA NA XXX 97022 ......... ............ A Whirlpool therapy .......................................... 0.17 0.34 0.24 NA NA 0.01 0.52 0.42 NA NA XXX 97024 ......... ............ A Diathermy e.g., microwave ............................ 0.06 0.08 0.07 NA NA 0.01 0.15 0.14 NA NA XXX 97026 ......... ............ A Infrared therapy ............................................. 0.06 0.07 0.06 NA NA 0.01 0.14 0.13 NA NA XXX 97028 ......... ............ A Ultraviolet therapy ......................................... 0.08 0.09 0.08 NA NA 0.01 0.18 0.17 NA NA XXX 97032 ......... ............ A Electrical stimulation ...................................... 0.25 0.21 0.17 NA NA 0.01 0.47 0.43 NA NA XXX 97033 ......... ............ A Electric current therapy ................................. 0.26 0.46 0.32 NA NA 0.01 0.73 0.59 NA NA XXX 97034 ......... ............ A Contrast bath therapy .................................... 0.21 0.21 0.17 NA NA 0.01 0.43 0.39 NA NA XXX 97035 ......... ............ A Ultrasound therapy ........................................ 0.21 0.11 0.10 NA NA 0.01 0.33 0.32 NA NA XXX 97036 ......... ............ A Hydrotherapy ................................................. 0.28 0.46 0.36 NA NA 0.01 0.75 0.65 NA NA XXX 97110 ......... ............ A Therapeutic exercises ................................... 0.45 0.33 0.29 NA NA 0.02 0.80 0.76 NA NA XXX 97112 ......... ............ A Neuromuscular reeducation .......................... 0.45 0.36 0.32 NA NA 0.01 0.82 0.78 NA NA XXX 97113 ......... ............ A Aquatic therapy/exercises ............................. 0.44 0.56 0.43 NA NA 0.01 1.01 0.88 NA NA XXX97116 ......... ............ A Gait training therapy ...................................... 0.40 0.29 0.25 NA NA 0.01 0.70 0.66 NA NA XXX 97124 ......... ............ A Massage therapy ........................................... 0.35 0.28 0.24 NA NA 0.01 0.64 0.60 NA NA XXX 97140 ......... ............ A Manual therapy .............................................. 0.43 0.30 0.26 NA NA 0.01 0.74 0.70 NA NA XXX 97150 ......... ............ A Group therapeutic procedures ...................... 0.27 0.23 0.19 NA NA 0.01 0.51 0.47 NA NA XXX 97530 ......... ............ A Therapeutic activities ..................................... 0.44 0.40 0.34 NA NA 0.01 0.85 0.79 NA NA XXX 97532 ......... ............ A Cognitive skills development ......................... 0.44 0.23 0.21 NA NA 0.01 0.68 0.66 NA NA XXX 97533 ......... ............ A Sensory integration ....................................... 0.44 0.28 0.25 NA NA 0.01 0.73 0.70 NA NA XXX 97535 ......... ............ A Self care mngment training ........................... 0.45 0.39 0.35 NA NA 0.01 0.85 0.81 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37419 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

97537 ......... ............ A Community/work reintegration ....................... 0.45 0.29 0.27 NA NA 0.01 0.75 0.73 NA NA XXX 97542 ......... ............ A Wheelchair mngment training ....................... 0.45 0.30 0.29 NA NA 0.01 0.76 0.75 NA NA XXX 97597 ......... ............ A Active wound care/20 cm or < ...................... 0.58 1.14 0.78 NA NA 0.05 1.77 1.41 NA NA XXX 97598 ......... ............ A Active wound care > 20 cm .......................... 0.80 1.33 0.93 NA NA 0.05 2.18 1.78 NA NA XXX 97605 ......... ............ A Neg press wound tx, < 50 cm ....................... 0.55 0.43 0.36 0.13 0.20 0.02 1.00 0.93 0.70 0.77 XXX 97606 ......... ............ A Neg press wound tx, > 50 cm ....................... 0.60 0.44 0.37 0.14 0.22 0.03 1.07 1.00 0.77 0.85 XXX 97750 ......... ............ A Physical performance test ............................. 0.45 0.35 0.33 NA NA 0.02 0.82 0.80 NA NA XXX97755 ......... ............ A Assistive technology assess ......................... 0.62 0.29 0.28 NA NA 0.02 0.93 0.92 NA NA XXX 97760 ......... ............ A Orthotic mgmt and training ............................ 0.45 0.44 0.37 0.10 0.18 0.03 0.92 0.85 0.58 0.66 XXX 97761 ......... ............ A Prosthetic training .......................................... 0.45 0.34 0.30 0.10 0.17 0.02 0.81 0.77 0.57 0.64 XXX 97762 ......... ............ A C/o for orthotic/prosth use ............................. 0.25 0.76 0.51 0.06 0.16 0.02 1.03 0.78 0.33 0.43 XXX 97802 ......... ............ A Medical nutrition, indiv, in .............................. 0.00 0.35 0.44 NA NA 0.01 0.36 0.45 NA NA XXX 97803 ......... ............ A Med nutrition, indiv, subseq .......................... 0.00 0.31 0.43 NA NA 0.01 0.32 0.44 NA NA XXX97804 ......... ............ A Medical nutrition, group ................................. 0.00 0.13 0.17 NA NA 0.01 0.14 0.18 NA NA XXX 97810 ......... ............ N Acupunct w/o stimul 15 min .......................... 0.60 0.25 0.35 0.13 0.21 0.03 0.88 0.98 0.76 0.84 XXX 97811 ......... ............ N Acupunct w/o stimul addl 15m ...................... 0.50 0.15 0.23 0.11 0.17 0.03 0.68 0.76 0.64 0.70 ZZZ 97813 ......... ............ N Acupunct w/stimul 15 min ............................. 0.65 0.27 0.37 0.15 0.23 0.03 0.95 1.05 0.83 0.91 XXX 97814 ......... ............ N Acupunct w/stimul addl 15m ......................... 0.55 0.19 0.27 0.12 0.19 0.03 0.77 0.85 0.70 0.77 ZZZ 98925 ......... ............ A Osteopathic manipulation .............................. 0.45 0.28 0.31 0.11 0.13 0.02 0.75 0.78 0.58 0.60 000 98926 ......... ............ A Osteopathic manipulation .............................. 0.65 0.36 0.40 0.16 0.23 0.03 1.04 1.08 0.84 0.91 000 98927 ......... ............ A Osteopathic manipulation .............................. 0.87 0.44 0.49 0.21 0.27 0.03 1.34 1.39 1.11 1.17 000 98928 ......... ............ A Osteopathic manipulation .............................. 1.03 0.50 0.57 0.25 0.32 0.04 1.57 1.64 1.32 1.39 000 98929 ......... ............ A Osteopathic manipulation .............................. 1.19 0.56 0.64 0.28 0.35 0.05 1.80 1.88 1.52 1.59 000 98940 ......... ............ A Chiropractic manipulation .............................. 0.45 0.20 0.22 0.12 0.12 0.01 0.66 0.68 0.58 0.58 000 98941 ......... ............ A Chiropractic manipulation .............................. 0.65 0.26 0.29 0.17 0.17 0.01 0.92 0.95 0.83 0.83 000 98942 ......... ............ A Chiropractic manipulation .............................. 0.87 0.32 0.35 0.22 0.23 0.02 1.21 1.24 1.11 1.12 000 98943 ......... ............ N Chiropractic manipulation .............................. 0.40 0.17 0.22 0.09 0.14 0.01 0.58 0.63 0.50 0.55 XXX 99170 ......... ............ A Anogenital exam, child .................................. 1.75 1.50 1.70 0.49 0.54 0.08 3.33 3.53 2.32 2.37 000 99175 ......... ............ A Induction of vomiting ..................................... 0.00 0.33 1.13 NA NA 0.10 0.43 1.23 NA NA XXX 99183 ......... ............ A Hyperbaric oxygen therapy ........................... 2.34 2.59 3.09 0.56 0.68 0.16 5.09 5.59 3.06 3.18 XXX 99185 ......... ............ A Regional hypothermia ................................... 0.00 1.67 0.90 NA NA 0.04 1.71 0.94 NA NA XXX 99186 ......... ............ A Total body hypothermia ................................. 0.00 1.41 1.70 NA NA 0.45 1.86 2.15 NA NA XXX 99195 ......... ............ A Phlebotomy ................................................... 0.00 2.62 0.99 NA NA 0.02 2.64 1.01 NA NA XXX 99201 ......... ............ A Office/outpatient visit, new ............................ 0.45 0.54 0.50 0.15 0.15 0.03 1.02 0.98 0.63 0.63 XXX 99202 ......... ............ A Office/outpatient visit, new ............................ 0.88 0.83 0.80 0.29 0.31 0.05 1.76 1.73 1.22 1.24 XXX 99203 ......... ............ A Office/outpatient visit, new ............................ 1.34 1.09 1.12 0.41 0.46 0.09 2.52 2.55 1.84 1.89 XXX 99204 ......... ............ A Office/outpatient visit, new ............................ 2.30 1.48 1.50 0.70 0.71 0.12 3.90 3.92 3.12 3.13 XXX 99205 ......... ............ A Office/outpatient visit, new ............................ 3.00 1.77 1.78 0.89 0.94 0.15 4.92 4.93 4.04 4.09 XXX 99211 ......... ............ A Office/outpatient visit, est .............................. 0.17 0.33 0.38 0.06 0.06 0.01 0.51 0.56 0.24 0.24 XXX 99212 ......... ............ A Office/outpatient visit, est .............................. 0.45 0.55 0.54 0.15 0.16 0.03 1.03 1.02 0.63 0.64 XXX 99213 ......... ............ A Office/outpatient visit, est .............................. 0.92 0.76 0.71 0.28 0.25 0.03 1.71 1.66 1.23 1.20 XXX 99214 ......... ............ A Office/outpatient visit, est .............................. 1.42 1.10 1.05 0.43 0.42 0.05 2.57 2.52 1.90 1.89 XXX 99215 ......... ............ A Office/outpatient visit, est .............................. 2.00 1.38 1.34 0.60 0.64 0.08 3.46 3.42 2.68 2.72 XXX 99217 ......... ............ A Observation care discharge .......................... 1.28 NA NA 0.50 0.52 0.06 NA NA 1.84 1.86 XXX 99218 ......... ............ A Observation care ........................................... 1.28 NA NA 0.38 0.43 0.06 NA NA 1.72 1.77 XXX 99219 ......... ............ A Observation care ........................................... 2.14 NA NA 0.59 0.69 0.10 NA NA 2.83 2.93 XXX 99220 ......... ............ A Observation care ........................................... 2.99 NA NA 0.84 0.98 0.14 NA NA 3.97 4.11 XXX 99221 ......... ............ A Initial hospital care ........................................ 1.88 NA NA 0.54 0.47 0.07 NA NA 2.49 2.42 XXX 99222 ......... ............ A Initial hospital care ........................................ 2.56 NA NA 0.70 0.73 0.10 NA NA 3.36 3.39 XXX 99223 ......... ............ A Initial hospital care ........................................ 3.78 NA NA 1.07 1.04 0.13 NA NA 4.98 4.95 XXX 99231 ......... ............ A Subsequent hospital care .............................. 0.76 NA NA 0.24 0.23 0.03 NA NA 1.03 1.02 XXX

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37420 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

99232 ......... ............ A Subsequent hospital care .............................. 1.39 NA NA 0.42 0.38 0.04 NA NA 1.85 1.81 XXX99233 ......... ............ A Subsequent hospital care .............................. 2.00 NA NA 0.59 0.54 0.06 NA NA 2.65 2.60 XXX99234 ......... ............ A Observ/hosp same date ................................ 2.56 NA NA 0.78 0.86 0.13 NA NA 3.47 3.55 XXX 99235 ......... ............ A Observ/hosp same date ................................ 3.41 NA NA 0.98 1.11 0.16 NA NA 4.55 4.68 XXX 99236 ......... ............ A Observ/hosp same date ................................ 4.26 NA NA 1.23 1.39 0.19 NA NA 5.68 5.84 XXX 99238 ......... ............ A Hospital discharge day .................................. 1.28 NA NA 0.49 0.53 0.05 NA NA 1.82 1.86 XXX 99239 ......... ............ A Hospital discharge day .................................. 1.90 NA NA 0.66 0.71 0.07 NA NA 2.63 2.68 XXX 99241 ......... ............ A Office consultation ......................................... 0.64 0.66 0.65 0.22 0.22 0.05 1.35 1.34 0.91 0.91 XXX 99242 ......... ............ A Office consultation ......................................... 1.34 1.08 1.05 0.47 0.46 0.10 2.52 2.49 1.91 1.90 XXX 99243 ......... ............ A Office consultation ......................................... 1.88 1.45 1.41 0.66 0.64 0.13 3.46 3.42 2.67 2.65 XXX 99244 ......... ............ A Office consultation ......................................... 3.02 1.95 1.86 1.09 0.96 0.16 5.13 5.04 4.27 4.14 XXX 99245 ......... ............ A Office consultation ......................................... 3.77 2.27 2.28 1.31 1.26 0.21 6.25 6.26 5.29 5.24 XXX 99251 ......... ............ A Initial inpatient consult ................................... 1.00 NA NA 0.31 0.26 0.05 NA NA 1.36 1.31 XXX 99252 ......... ............ A Initial inpatient consult ................................... 1.50 NA NA 0.50 0.50 0.09 NA NA 2.09 2.09 XXX 99253 ......... ............ A Initial inpatient consult ................................... 2.27 NA NA 0.81 0.71 0.11 NA NA 3.19 3.09 XXX 99254 ......... ............ A Initial inpatient consult ................................... 3.29 NA NA 1.20 1.04 0.13 NA NA 4.62 4.46 XXX 99255 ......... ............ A Initial inpatient consult ................................... 4.00 NA NA 1.40 1.36 0.18 NA NA 5.58 5.54 XXX 99281 ......... ............ A Emergency dept visit ..................................... 0.45 NA NA 0.09 0.09 0.02 NA NA 0.56 0.56 XXX 99282 ......... ............ A Emergency dept visit ..................................... 0.88 NA NA 0.17 0.15 0.04 NA NA 1.09 1.07 XXX 99283 ......... ............ A Emergency dept visit ..................................... 1.34 NA NA 0.24 0.29 0.09 NA NA 1.67 1.72 XXX 99284 ......... ............ A Emergency dept visit ..................................... 2.56 NA NA 0.45 0.47 0.14 NA NA 3.15 3.17 XXX 99285 ......... ............ A Emergency dept visit ..................................... 3.80 NA NA 0.65 0.70 0.23 NA NA 4.68 4.73 XXX 99289 ......... ............ A Ped crit care transport ................................... 4.79 NA NA 1.08 1.36 0.24 NA NA 6.11 6.39 XXX 99290 ......... ............ A Ped crit care transport addl ........................... 2.40 NA NA 0.58 0.75 0.12 NA NA 3.10 3.27 ZZZ 99291 ......... ............ A Critical care, first hour ................................... 4.50 2.25 2.50 1.10 1.24 0.21 6.96 7.21 5.81 5.95 XXX 99292 ......... ............ A Critical care, addIl 30 min ............................. 2.25 0.80 0.88 0.56 0.62 0.11 3.16 3.24 2.92 2.98 ZZZ 99293 ......... ............ A Ped critical care, initial .................................. 15.98 NA NA 3.48 4.44 1.12 NA NA 20.58 21.54 XXX 99294 ......... ............ A Ped critical care, subseq ............................... 7.99 NA NA 1.67 2.23 0.45 NA NA 10.11 10.67 XXX 99295 ......... ............ A Neonate crit care, initial ................................ 18.46 NA NA 4.26 5.11 1.16 NA NA 23.88 24.73 XXX 99296 ......... ............ A Neonate critical care subseq ......................... 7.99 NA NA 1.71 2.34 0.32 NA NA 10.02 10.65 XXX 99298 ......... ............ A Ic for lbw infant < 1500 gm ........................... 2.75 NA NA 0.64 0.86 0.17 NA NA 3.56 3.78 XXX99299 ......... ............ A Ic, lbw infant 1500–2500 gm ......................... 2.50 NA NA 0.78 0.84 0.16 NA NA 3.44 3.50 XXX 99300 ......... ............ A Ic, infant pbw 2501–5000 gm ........................ 2.40 NA NA 0.71 0.81 0.15 NA NA 3.26 3.36 XXX 99304 ......... ............ A Nursing facility care, init ................................ 1.20 0.44 0.48 0.44 0.48 0.05 1.69 1.73 1.69 1.73 XXX 99305 ......... ............ A Nursing facility care, init ................................ 1.61 0.55 0.61 0.55 0.61 0.07 2.23 2.29 2.23 2.29 XXX 99306 ......... ............ A Nursing facility care, init ................................ 2.01 0.64 0.72 0.64 0.72 0.09 2.74 2.82 2.74 2.82 XXX 99307 ......... ............ A Nursing fac care, subseq .............................. 0.60 0.26 0.27 0.26 0.27 0.03 0.89 0.90 0.89 0.90 XXX 99308 ......... ............ A Nursing fac care, subseq .............................. 1.00 0.42 0.44 0.42 0.44 0.04 1.46 1.48 1.46 1.48 XXX 99309 ......... ............ A Nursing fac care, subseq .............................. 1.42 0.57 0.61 0.57 0.61 0.06 2.05 2.09 2.05 2.09 XXX 99310 ......... ............ A Nursing fac care, subseq .............................. 1.77 0.71 0.76 0.71 0.76 0.08 2.56 2.61 2.56 2.61 XXX 99315 ......... ............ A Nursing fac discharge day ............................ 1.13 0.40 0.44 0.40 0.44 0.05 1.58 1.62 1.58 1.62 XXX 99316 ......... ............ A Nursing fac discharge day ............................ 1.50 0.50 0.57 0.50 0.57 0.06 2.06 2.13 2.06 2.13 XXX 99318 ......... ............ A Annual nursing fac assessmnt ...................... 1.20 0.44 0.48 0.44 0.48 0.05 1.69 1.73 1.69 1.73 XXX 99324 ......... ............ A Domicil/r-home visit new pat ......................... 1.01 0.42 0.47 NA NA 0.05 1.48 1.53 NA NA XXX 99325 ......... ............ A Domicil/r-home visit new pat ......................... 1.52 0.55 0.65 NA NA 0.07 2.14 2.24 NA NA XXX 99326 ......... ............ A Domicil/r-home visit new pat ......................... 2.27 0.71 0.87 NA NA 0.10 3.08 3.24 NA NA XXX 99327 ......... ............ A Domicil/r-home visit new pat ......................... 3.03 0.89 1.10 NA NA 0.13 4.05 4.26 NA NA XXX 99328 ......... ............ A Domicil/r-home visit new pat ......................... 3.78 1.07 1.33 NA NA 0.16 5.01 5.27 NA NA XXX 99334 ......... ............ A Domicil/r-home visit est pat ........................... 0.76 0.35 0.39 NA NA 0.04 1.15 1.19 NA NA XXX 99335 ......... ............ A Domicil/r-home visit est pat ........................... 1.26 0.47 0.55 NA NA 0.06 1.79 1.87 NA NA XXX 99336 ......... ............ A Domicil/r-home visit est pat ........................... 2.02 0.64 0.78 NA NA 0.09 2.75 2.89 NA NA XXX 99337 ......... ............ A Domicil/r-home visit est pat ........................... 3.03 0.88 1.08 NA NA 0.13 4.04 4.24 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37421 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

99341 ......... ............ A Home visit, new patient ................................. 1.01 0.25 0.42 NA NA 0.05 1.31 1.48 NA NA XXX 99342 ......... ............ A Home visit, new patient ................................. 1.52 0.38 0.61 NA NA 0.07 1.97 2.20 NA NA XXX 99343 ......... ............ A Home visit, new patient ................................. 2.27 0.57 0.85 NA NA 0.10 2.94 3.22 NA NA XXX 99344 ......... ............ A Home visit, new patient ................................. 3.03 0.72 1.07 NA NA 0.13 3.88 4.23 NA NA XXX 99345 ......... ............ A Home visit, new patient ................................. 3.78 0.88 1.29 NA NA 0.16 4.82 5.23 NA NA XXX 99347 ......... ............ A Home visit, est patient ................................... 0.76 0.19 0.35 NA NA 0.04 0.99 1.15 NA NA XXX 99348 ......... ............ A Home visit, est patient ................................... 1.26 0.31 0.51 NA NA 0.06 1.63 1.83 NA NA XXX 99349 ......... ............ A Home visit, est patient ................................... 2.02 0.48 0.74 NA NA 0.09 2.59 2.85 NA NA XXX 99350 ......... ............ A Home visit, est patient ................................... 3.03 0.72 1.07 NA NA 0.13 3.88 4.23 NA NA XXX 99354 ......... ............ A Prolonged service, office ............................... 1.77 0.65 0.74 0.49 0.62 0.08 2.50 2.59 2.34 2.47 ZZZ 99355 ......... ............ A Prolonged service, office ............................... 1.77 0.67 0.73 0.52 0.60 0.07 2.51 2.57 2.36 2.44 ZZZ 99356 ......... ............ A Prolonged service, inpatient .......................... 1.71 NA NA 0.50 0.59 0.07 NA NA 2.28 2.37 ZZZ99357 ......... ............ A Prolonged service, inpatient .......................... 1.71 NA NA 0.49 0.60 0.08 NA NA 2.28 2.39 ZZZ99374 ......... ............ B Home health care supervision ...................... 1.10 0.54 0.66 0.25 0.38 0.05 1.69 1.81 1.40 1.53 XXX 99375 ......... ............ I Home health care supervision ...................... 1.73 0.74 1.35 0.39 1.26 0.07 2.54 3.15 2.19 3.06 XXX 99377 ......... ............ B Hospice care supervision .............................. 1.10 0.54 0.66 0.25 0.38 0.05 1.69 1.81 1.40 1.53 XXX 99378 ......... ............ I Hospice care supervision .............................. 1.73 0.74 1.65 0.39 1.56 0.07 2.54 3.45 2.19 3.36 XXX 99379 ......... ............ B Nursing fac care supervision ......................... 1.10 0.54 0.66 0.25 0.38 0.04 1.68 1.80 1.39 1.52 XXX 99380 ......... ............ B Nursing fac care supervision ......................... 1.73 0.74 0.93 0.39 0.59 0.06 2.53 2.72 2.18 2.38 XXX 99381 ......... ............ N Prev visit, new, infant .................................... 1.19 0.99 1.37 0.27 0.41 0.05 2.23 2.61 1.51 1.65 XXX 99382 ......... ............ N Prev visit, new, age 1–4 ................................ 1.36 1.03 1.41 0.31 0.47 0.05 2.44 2.82 1.72 1.88 XXX 99383 ......... ............ N Prev visit, new, age 5–11 .............................. 1.36 1.02 1.37 0.31 0.47 0.05 2.43 2.78 1.72 1.88 XXX 99384 ......... ............ N Prev visit, new, age 12–17 ............................ 1.53 1.06 1.43 0.34 0.53 0.06 2.65 3.02 1.93 2.12 XXX 99385 ......... ............ N Prev visit, new, age 18–39 ............................ 1.53 1.06 1.43 0.34 0.53 0.06 2.65 3.02 1.93 2.12 XXX 99386 ......... ............ N Prev visit, new, age 40–64 ............................ 1.88 1.14 1.60 0.42 0.65 0.07 3.09 3.55 2.37 2.60 XXX 99387 ......... ............ N Prev visit, new, 65 & over ............................. 2.06 1.27 1.73 0.46 0.71 0.07 3.40 3.86 2.59 2.84 XXX 99391 ......... ............ N Prev visit, est, infant ...................................... 1.02 0.86 0.98 0.23 0.35 0.04 1.92 2.04 1.29 1.41 XXX 99392 ......... ............ N Prev visit, est, age 1–4 ................................. 1.19 0.89 1.04 0.27 0.41 0.05 2.13 2.28 1.51 1.65 XXX 99393 ......... ............ N Prev visit, est, age 5–11 ............................... 1.19 0.89 1.02 0.27 0.41 0.05 2.13 2.26 1.51 1.65 XXX 99394 ......... ............ N Prev visit, est, age 12–17 ............................. 1.36 0.93 1.08 0.31 0.47 0.05 2.34 2.49 1.72 1.88 XXX 99395 ......... ............ N Prev visit, est, age 18–39 ............................. 1.36 0.93 1.10 0.31 0.47 0.05 2.34 2.51 1.72 1.88 XXX 99396 ......... ............ N Prev visit, est, age 40–64 ............................. 1.53 0.97 1.18 0.34 0.53 0.06 2.56 2.77 1.93 2.12 XXX 99397 ......... ............ N Prev visit, est, 65 & over ............................... 1.71 1.11 1.30 0.38 0.59 0.06 2.88 3.07 2.15 2.36 XXX 99401 ......... ............ N Preventive counseling, indiv .......................... 0.48 0.36 0.56 0.11 0.17 0.01 0.85 1.05 0.60 0.66 XXX 99402 ......... ............ N Preventive counseling, indiv .......................... 0.98 0.47 0.77 0.22 0.33 0.02 1.47 1.77 1.22 1.33 XXX 99403 ......... ............ N Preventive counseling, indiv .......................... 1.46 0.58 0.96 0.33 0.50 0.04 2.08 2.46 1.83 2.00 XXX 99404 ......... ............ N Preventive counseling, indiv .......................... 1.95 0.69 1.16 0.44 0.67 0.05 2.69 3.16 2.44 2.67 XXX 99411 ......... ............ N Preventive counseling, group ........................ 0.15 0.22 0.19 0.03 0.05 0.01 0.38 0.35 0.19 0.21 XXX 99412 ......... ............ N Preventive counseling, group ........................ 0.25 0.24 0.25 0.06 0.09 0.01 0.50 0.51 0.32 0.35 XXX 99431 ......... ............ A Initial care, normal newborn .......................... 1.17 NA NA 0.26 0.35 0.05 NA NA 1.48 1.57 XXX99432 ......... ............ A Newborn care, not in hosp ............................ 1.26 1.00 0.95 0.28 0.37 0.07 2.33 2.28 1.61 1.70 XXX 99433 ......... ............ A Normal newborn care/hospital ...................... 0.62 NA NA 0.14 0.19 0.02 NA NA 0.78 0.83 XXX 99435 ......... ............ A Newborn discharge day hosp ....................... 1.50 NA NA 0.45 0.56 0.06 NA NA 2.01 2.12 XXX 99436 ......... ............ A Attendance, birth ........................................... 1.50 NA NA 0.33 0.44 0.06 NA NA 1.89 2.00 XXX 99440 ......... ............ A Newborn resuscitation ................................... 2.93 NA NA 0.66 0.86 0.12 NA NA 3.71 3.91 XXX G0101 ......... ............ A CA screen;pelvic/breast exam ...................... 0.45 0.48 0.51 0.12 0.16 0.02 0.95 0.98 0.59 0.63 XXX G0102 ......... ............ A Office/outpatient visit, est .............................. 0.17 0.33 0.38 0.06 0.06 0.01 0.51 0.56 0.24 0.24 XXX G0104 ......... ............ A Diagnostic sigmoidoscopy ............................. 0.96 2.54 2.35 0.63 0.53 0.08 3.58 3.39 1.67 1.57 000 G0105 ......... ............ A Diagnostic colonoscopy ................................. 3.69 6.55 6.26 1.88 1.57 0.30 10.54 10.25 5.87 5.56 000 G0105 ......... 53 ....... A Diagnostic sigmoidoscopy ............................. 0.96 2.54 2.35 0.63 0.53 0.08 3.58 3.39 1.67 1.57 000 G0106 ......... ............ A Contrast x-ray exam of colon ........................ 0.99 5.17 3.21 NA NA 0.17 6.33 4.37 NA NA XXX G0106 ......... 26 ....... A Contrast x-ray exam of colon ........................ 0.99 0.34 0.33 0.34 0.33 0.04 1.37 1.36 1.37 1.36 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37422 Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

G0106 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 4.83 2.89 NA NA 0.13 4.96 3.02 NA NA XXX G0108 ......... ............ A Diab manage trn per indiv ............................. 0.00 0.59 0.77 NA NA 0.01 0.60 0.78 NA NA XXXG0109 ......... ............ A Diab manage trn ind/group ........................... 0.00 0.31 0.44 NA NA 0.01 0.32 0.45 NA NA XXX G0117 ......... ............ T Glaucoma scrn hgh risk direc ....................... 0.45 0.80 0.74 0.13 0.18 0.01 1.26 1.20 0.59 0.64 XXX G0118 ......... ............ T Glaucoma scrn hgh risk direc ....................... 0.17 0.80 0.60 0.06 0.06 0.01 0.98 0.78 0.24 0.24 XXX G0120 ......... ............ A Contrast x-ray exam of colon ........................ 0.99 5.17 3.21 NA NA 0.17 6.33 4.37 NA NA XXX G0120 ......... 26 ....... A Contrast x-ray exam of colon ........................ 0.99 0.34 0.33 0.34 0.33 0.04 1.37 1.36 1.37 1.36 XXX G0120 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 4.83 2.89 NA NA 0.13 4.96 3.02 NA NA XXX G0121 ......... ............ A Diagnostic colonoscopy ................................. 3.69 6.55 6.26 1.88 1.57 0.30 10.54 10.25 5.87 5.56 000 G0121 ......... 53 ....... A Diagnostic sigmoidoscopy ............................. 0.96 2.54 2.35 0.63 0.53 0.08 3.58 3.39 1.67 1.57 000 G0122 ......... ............ N Colon ca scrn; barium enema ....................... 0.99 5.63 3.34 5.63 3.34 0.18 6.80 4.51 6.80 4.51 XXX G0122 ......... 26 ....... N Colon ca scrn; barium enema ....................... 0.99 0.22 0.34 0.22 0.34 0.05 1.26 1.38 1.26 1.38 XXX G0122 ......... TC ...... N Colon ca scrn; barium enema ....................... 0.00 5.41 3.00 5.41 3.00 0.13 5.54 3.13 5.54 3.13 XXXG0124 ......... ............ A Cytopath, c/v, interpret .................................. 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX G0127 ......... ............ R Trim nail(s) .................................................... 0.17 0.38 0.28 0.04 0.06 0.01 0.56 0.46 0.22 0.24 000 G0128 ......... ............ R CORF skilled nursing service ........................ 0.08 0.02 0.03 0.02 0.03 0.01 0.11 0.12 0.11 0.12 XXX G0130 ......... ............ A Single energy x-ray study ............................. 0.22 0.56 0.79 NA NA 0.06 0.84 1.07 NA NA XXXG0130 ......... 26 ....... A Single energy x-ray study ............................. 0.22 0.06 0.07 0.06 0.07 0.01 0.29 0.30 0.29 0.30 XXX G0130 ......... TC ...... A Single energy x-ray study ............................. 0.00 0.50 0.73 NA NA 0.05 0.55 0.78 NA NA XXX G0141 ......... ............ A Cytopath, c/v, interpret .................................. 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX G0166 ......... ............ A Extrnl counterpulse, per tx ............................ 0.07 4.62 3.84 0.04 0.03 0.01 4.70 3.92 0.12 0.11 XXX G0168 ......... ............ A Wound closure by adhesive .......................... 0.45 1.56 1.85 0.20 0.22 0.03 2.04 2.33 0.68 0.70 000 G0179 ......... ............ A MD recertification HHA PT ............................ 0.45 0.47 0.89 NA NA 0.02 0.94 1.36 NA NA XXX G0180 ......... ............ A MD certification HHA patient ......................... 0.67 0.56 1.09 NA NA 0.03 1.26 1.79 NA NA XXX G0181 ......... ............ A Home health care supervision ...................... 1.73 0.80 1.31 NA NA 0.07 2.60 3.11 NA NA XXX G0182 ......... ............ A Hospice care supervision .............................. 1.73 0.82 1.45 NA NA 0.07 2.62 3.25 NA NA XXXG0202 ......... ............ A Screeningmammographydigital ..................... 0.70 2.82 2.79 NA NA 0.10 3.62 3.59 NA NA XXX G0202 ......... 26 ....... A Screeningmammographydigital ..................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX G0202 ......... TC ...... A Screeningmammographydigital ..................... 0.00 2.58 2.56 NA NA 0.07 2.65 2.63 NA NA XXX G0204 ......... ............ A Diagnosticmammographydigital .................... 0.87 3.42 2.95 NA NA 0.11 4.40 3.93 NA NA XXX G0204 ......... 26 ....... A Diagnosticmammographydigital .................... 0.87 0.30 0.29 0.30 0.29 0.04 1.21 1.20 1.21 1.20 XXX G0204 ......... TC ...... A Diagnosticmammographydigital .................... 0.00 3.12 2.66 NA NA 0.07 3.19 2.73 NA NA XXX G0206 ......... ............ A Diagnosticmammographydigital .................... 0.70 2.68 2.37 NA NA 0.09 3.47 3.16 NA NA XXX G0206 ......... 26 ....... A Diagnosticmammographydigital .................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX G0206 ......... TC ...... A Diagnosticmammographydigital .................... 0.00 2.44 2.13 NA NA 0.06 2.50 2.19 NA NA XXX G0237 ......... ............ A Therapeutic procd strg endur ........................ 0.00 0.21 0.41 NA NA 0.02 0.23 0.43 NA NA XXX G0238 ......... ............ A Oth resp proc, indiv ....................................... 0.00 0.23 0.43 NA NA 0.02 0.25 0.45 NA NA XXX G0239 ......... ............ A Oth resp proc, group ..................................... 0.00 0.31 0.33 NA NA 0.02 0.33 0.35 NA NA XXX G0245 ......... ............ A Office/outpatient visit, new ............................ 0.88 0.83 0.80 0.29 0.31 0.05 1.76 1.73 1.22 1.24 XXX G0246 ......... ............ A Office/outpatient visit, est .............................. 0.45 0.55 0.54 0.15 0.16 0.03 1.03 1.02 0.63 0.64 XXX G0247 ......... ............ A Debride skin, partial ...................................... 0.50 0.68 0.56 0.16 0.20 0.06 1.24 1.12 0.72 0.76 ZZZ G0248 ......... ............ R Demonstrate use home inr mon ................... 0.00 3.21 5.78 NA NA 0.01 3.22 5.79 NA NA XXX G0249 ......... ............ R Provide test material,equipm ......................... 0.00 2.31 3.56 NA NA 0.01 2.32 3.57 NA NA XXX G0250 ......... ............ R MD review interpret of test ............................ 0.18 0.08 0.07 0.08 0.07 0.01 0.27 0.26 0.27 0.26 XXX G0252 ......... 26 ....... N PET imaging initial dx ................................... 1.50 0.34 0.54 0.34 0.54 0.04 1.88 2.08 1.88 2.08 XXX G0268 ......... ............ A Removal of impacted wax md ....................... 0.61 0.59 0.62 0.17 0.22 0.02 1.22 1.25 0.80 0.85 000 G0270 ......... ............ A Med nutrition, indiv, subseq .......................... 0.00 0.31 0.43 NA NA 0.01 0.32 0.44 NA NA XXXG0271 ......... ............ A Medical nutrition, group ................................. 0.00 0.13 0.17 NA NA 0.01 0.14 0.18 NA NA XXX G0275 ......... ............ A Renal angio, cardiac cath ............................. 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 ZZZ

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 37423 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS FOR 2007

—

CONTINUED

CPT 1

HCPCS2 Mod Status Description 

Physician 

work 

RVUs 3

Fully implemented nonfacility PE 

RVUs 

Year 

2007 

transitional 

non-facility PE 

RVUs 

Fully implemented facility 

PE RVUs 

Year 

2007 

transitional facility PE 

RVUs 

Mal-practice RVUs 

Fully implemented nonfacility 

total 

Year 

2007 

transitional 

non-facility total 

Fully implemented facility 

total 

Year 

2007 

transitional facility total Global 

G0278 ......... ............ A Iliac art angio,cardiac cath ............................ 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 ZZZ G0281 ......... ............ A Elec stim unattend for press ......................... 0.18 0.15 0.12 NA NA 0.01 0.34 0.31 NA NA XXX G0283 ......... ............ A Elec stim other than wound .......................... 0.18 0.15 0.12 NA NA 0.01 0.34 0.31 NA NA XXX G0288 ......... ............ A Recon, CTA for surg plan ............................. 0.00 1.03 8.24 NA NA 0.18 1.21 8.42 NA NA XXX G0289 ......... ............ A Arthro, loose body + chondro ....................... 1.48 NA NA 0.58 0.75 0.26 NA NA 2.32 2.49 ZZZ G0308 ......... ............ A ESRD related svc 4+mo < 2yrs .................... 12.74 5.43 7.78 5.43 7.78 0.42 18.59 20.94 18.59 20.94 XXX G0309 ......... ............ A ESRD related svc 2–3mo <2yrs ................... 10.61 4.77 6.53 4.77 6.53 0.36 15.74 17.50 15.74 17.50 XXX G0310 ......... ............ A ESRD related svc 1 vst <2yrs ....................... 8.49 2.79 4.97 2.79 4.97 0.28 11.56 13.74 11.56 13.74 XXX G0311 ......... ............ A ESRD related svs 4+mo 2–11yr ................... 9.73 3.50 4.42 3.50 4.42 0.34 13.57 14.49 13.57 14.49 XXX G0312 ......... ............ A ESRD relate svs 2–3 mo 2–11y ................... 8.11 2.60 3.60 2.60 3.60 0.29 11.00 12.00 11.00 12.00 XXX G0313 ......... ............ A ESRD related svs 1 mon 2–11y ................... 6.49 1.80 2.81 1.80 2.81 0.22 8.51 9.52 8.51 9.52 XXX G0314 ......... ............ A ESRD related svs 4+ mo 12–19 ................... 8.28 3.36 4.16 3.36 4.16 0.27 11.91 12.71 11.91 12.71 XXX G0315 ......... ............ A ESRD related svs 2–3mo/12–19 ................... 6.90 2.55 3.40 2.55 3.40 0.23 9.68 10.53 9.68 10.53 XXX G0316 ......... ............ A ESRD related svs 1vis/12–19y ..................... 5.52 1.65 2.63 1.65 2.63 0.17 7.34 8.32 7.34 8.32 XXX G0317 ......... ............ A ESRD related svs 4+mo 20+yrs ................... 5.09 2.23 2.71 2.23 2.71 0.17 7.49 7.97 7.49 7.97 XXX G0318 ......... ............ A ESRD related svs 2–3 mo 20+y ................... 4.24 1.67 2.21 1.67 2.21 0.14 6.05 6.59 6.05 6.59 XXX G0319 ......... ............ A ESRD related svs 1visit 20+y ....................... 3.39 1.12 1.71 1.12 1.71 0.11 4.62 5.21 4.62 5.21 XXX G0320 ......... ............ A ESD related svs home undr 2 ....................... 10.61 2.59 5.99 2.59 5.99 0.36 13.56 16.96 13.56 16.96 XXX G0321 ......... ............ A ESRDrelatedsvs home mo 2–11y ................. 8.11 1.92 3.43 1.92 3.43 0.29 10.32 11.83 10.32 11.83 XXX G0322 ......... ............ A ESRD related svs hom mo12–19 ................. 6.90 1.67 3.18 1.67 3.18 0.23 8.80 10.31 8.80 10.31 XXX G0323 ......... ............ A ESRD related svs home mo 20+ .................. 4.24 1.12 2.07 1.12 2.07 0.14 5.50 6.45 5.50 6.45 XXXG0324 ......... ............ A ESRD relate svs home/dy <2yr .................... 0.35 0.16 0.22 0.16 0.22 0.01 0.52 0.58 0.52 0.58 XXX G0325 ......... ............ A ESRD relate home/day/ 2–11yr .................... 0.23 0.09 0.11 0.09 0.11 0.01 0.33 0.35 0.33 0.35 XXX G0326 ......... ............ A ESRD relate home/dy 12–19yr ..................... 0.27 0.10 0.12 0.10 0.12 0.01 0.38 0.40 0.38 0.40 XXX G0327 ......... ............ A ESRD relate home/dy 20+yrs ....................... 0.14 0.06 0.08 0.06 0.08 0.01 0.21 0.23 0.21 0.23 XXX G0329 ......... ............ A Electromagntic tx for ulcers ........................... 0.06 0.16 0.15 0.01 0.02 0.01 0.23 0.22 0.08 0.09 XXX G0337 ......... ............ X Hospice evaluation preelecti ......................... 1.34 0.30 0.46 0.30 0.46 0.09 1.73 1.89 1.73 1.89 XXX G0341 ......... ............ A Insertion of catheter, vein .............................. 6.98 3.02 5.07 2.18 2.50 0.55 10.55 12.60 9.71 10.03 000 G0342 ......... ............ A Laparo cholecystectomy/graph ..................... 11.98 NA NA 5.06 5.25 1.58 NA NA 18.62 18.81 090 G0343 ......... ............ A Incision of bile duct ....................................... 21.86 NA NA 8.44 8.70 2.62 NA NA 32.92 33.18 090 G0344 ......... ............ A Office/outpatient visit, new ............................ 1.34 1.09 1.12 0.41 0.46 0.09 2.52 2.55 1.84 1.89 XXX G0364 ......... ............ A Bone marrow aspirate &biopsy ..................... 0.16 0.17 0.15 0.07 0.06 0.04 0.37 0.35 0.27 0.26 ZZZ G0365 ......... ............ A Doppler flow testing ....................................... 0.25 5.44 4.36 NA NA 0.26 5.95 4.87 NA NA XXX G0365 ......... 26 ....... A Doppler flow testing ....................................... 0.25 0.07 0.09 0.07 0.09 0.03 0.35 0.37 0.35 0.37 XXX G0365 ......... TC ...... A Doppler flow testing ....................................... 0.00 5.37 4.28 NA NA 0.23 5.60 4.51 NA NA XXX G0366 ......... ............ A Electrocardiogram, complete ......................... 0.17 0.35 0.47 NA NA 0.03 0.55 0.67 NA NA XXX G0367 ......... ............ A Electrocardiogram, tracing ............................ 0.00 0.28 0.41 NA NA 0.02 0.30 0.43 NA NA XXXG0368 ......... ............ A Electrocardiogram report ............................... 0.17 0.07 0.06 0.07 0.06 0.01 0.25 0.24 0.25 0.24 XXX G0372 ......... ............ A MD service required for PMD ....................... 0.17 0.04 0.30 0.04 0.06 0.01 0.22 0.48 0.22 0.24 XXX G0375 ......... ............ A Smoke/tobacco counselng 3–10 ................... 0.24 0.07 0.09 0.07 0.09 0.01 0.32 0.34 0.32 0.34 XXX G0376 ......... ............ A Smoke/tobacco counseling >10 .................... 0.48 0.13 0.17 0.13 0.16 0.01 0.62 0.66 0.62 0.65 XXX M0064 ........ ............ A Visit for drug monitoring ................................ 0.37 0.87 0.47 0.06 0.11 0.01 1.25 0.85 0.44 0.49 XXX P3001 ......... ............ A Cytopath, c/v, interpret .................................. 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX Q0035 ......... ............ A Cardiokymography ........................................ 0.17 0.30 0.41 NA NA 0.03 0.50 0.61 NA NA XXX Q0035 ......... 26 ....... A Cardiokymography ........................................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX Q0035 ......... TC ...... A Cardiokymography ........................................ 0.00 0.25 0.36 NA NA 0.02 0.27 0.38 NA NA XXX Q0091 ......... ............ A Obtaining screen pap smear ......................... 0.37 0.75 0.69 0.10 0.13 0.02 1.14 1.08 0.49 0.52 XXX Q0092 ......... ............ A Set up port xray equipment ........................... 0.00 0.46 0.36 NA NA 0.01 0.47 0.37 NA NA XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 3 Indicates RVUs are not used for Medicare payment. 


jlentini on PROD1PC65 with NOTICES2
37424 

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT

CPT 

Code 1 Mod Descriptor Proposed work RVU 

00797 ....... ........... Anesth, Surgery for Obesity ................................................................................................................................. 11.00 

10060 ....... ........... Drainage of skin abscess ..................................................................................................................................... 1.17 

11040 ....... ........... Debride skin, partial .............................................................................................................................................. 0.50 

11041 ....... ........... Debride skin, full ................................................................................................................................................... 0.82 

11042 ....... ........... Debride skin/tissue ............................................................................................................................................... 1.12 

11100 ....... ........... Biopsy, skin lesion ................................................................................................................................................ 0.81 

11400 ....... ........... Exc tr-ext b9+marg 0.5<cm .................................................................................................................................. 0.85 

11401 ....... ........... Exc tr-ext b9+marg 0.6-1cm ................................................................................................................................. 1.23 

11402 ....... ........... Exc tr-ext b9+marg 1.1-2 cm ................................................................................................................................ 1.40 

11403 ....... ........... Exc tr-ext b9+marg 2.1-3 cm ................................................................................................................................ 1.79 

11404 ....... ........... Exc tr-ext b9+marg 3.1-4 cm ................................................................................................................................ 2.06 

11406 ....... ........... Exc tr-ext b9+marg >4.0cm .................................................................................................................................. 3.45 

11420 ....... ........... Exc h-f-nk-sp b9+marg 0.5< ................................................................................................................................. 0.98 

11421 ....... ........... Exc h-f-nk-sp b9+marg 0.6-1 ................................................................................................................................ 1.42 

11422 ....... ........... Exc h-f-nk-sp b9+marg 1.1-2 ................................................................................................................................ 1.63 

11423 ....... ........... Exc h-f-nk-sp b9+marg 2.1-3 ................................................................................................................................ 2.01 

11424 ....... ........... Exc h-f-nk-sp b9+marg 3.1-4 ................................................................................................................................ 2.43 

11426 ....... ........... Exc h-f-nk-sp b9+marg >4.0 cm ........................................................................................................................... 4.02 

11440 ....... ........... Exc face-mm b9+marg 0.5 < cm .......................................................................................................................... 1.00 

11441 ....... ........... Exc face-mm b9+marg 0.6-1 cm .......................................................................................................................... 1.48 

11442 ....... ........... Exc face-mm b9+marg 1.1-2 cm .......................................................................................................................... 1.72 

11443 ....... ........... Exc face-mm b9+marg 2.1-3 cm .......................................................................................................................... 2.29 

11444 ....... ........... Exc face-mm b9+marg 3.1-4 cm .......................................................................................................................... 3.14 

11446 ....... ........... Exc face-mm b9+marg >4 cm .............................................................................................................................. 4.73 

11600 ....... ........... Exc tr-ext mlg+marg 0.5<cm ................................................................................................................................ 1.56 

11601 ....... ........... Exc tr-ext mlg+marg 0.6-1cm ............................................................................................................................... 2.00 

11602 ....... ........... Exc tr-ext mlg+marg 1.1-2cm ............................................................................................................................... 2.20 

11603 ....... ........... Exc tr-ext mlg+marg 2.1-3<cm ............................................................................................................................. 2.75 

11604 ....... ........... Exc tr-ext mlg+marg 3.1-4cm ............................................................................................................................... 3.10 

11606 ....... ........... Exc tr-ext mlg+marg >4cm ................................................................................................................................... 4.95 

11620 ....... ........... Exc h-f-nk-sp mlg+marg 0.5< ............................................................................................................................... 1.57 

11621 ....... ........... Exc h-f-nk-sp mlg+marg 0.6-1 .............................................................................................................................. 2.01 

11622 ....... ........... Exc h-f-nk-sp mlg+marg 1.1-2 .............................................................................................................................. 2.34 

11623 ....... ........... Exc h-f-nk-sp mlg+marg 2.1-3 .............................................................................................................................. 3.04 

11624 ....... ........... Exc h-f-nk-sp mlg+marg 3.1-4 .............................................................................................................................. 3.55 

11626 ....... ........... Exc h-f-nk-sp mlg+marg >4cm ............................................................................................................................. 4.54 

11640 ....... ........... Exc face-mm malig+marg 0.5< ............................................................................................................................ 1.60 

11641 ....... ........... Exc face-mm malig+marg 0.6-1 ........................................................................................................................... 2.10 

11642 ....... ........... Exc face-mm malig+marg 1.1-2 ........................................................................................................................... 2.55 

11643 ....... ........... Exc face-mm malig+marg 2.1-3 ........................................................................................................................... 3.35 

11644 ....... ........... Exc face-mm malig+marg 3.1-4 ........................................................................................................................... 4.27 

11646 ....... ........... Exc face-mm malig+marg>4 ................................................................................................................................. 6.19 

11730 ....... ........... Removal of nail plate ............................................................................................................................................ 1.13 

12052 ....... ........... Layer closure of wound(s) .................................................................................................................................... 2.77 

13121 ....... ........... Repair of wound or lesion .................................................................................................................................... 4.32 

14040 ....... ........... Skin tissue rearrangement ................................................................................................................................... 8.36 

14060 ....... ........... Skin tissue rearrangement ................................................................................................................................... 8.99 

15100 ....... ........... Skin split graft ....................................................................................................................................................... 9.66 

15240 ....... ........... Skin full graft ......................................................................................................................................................... 10.03 

15734 ....... ........... Muscle-skin graft, trunk ........................................................................................................................................ 19.52 

17003 ....... ........... Destroy lesions, 2-14 ............................................................................................................................................ 0.07 

17004 ....... ........... Destroy lesions, 15 or more ................................................................................................................................. 1.58 

17262 ....... ........... Destruction of skin lesions ................................................................................................................................... 1.58 

17281 ....... ........... Destruction of skin lesions ................................................................................................................................... 1.72 

19180 ....... ........... Removal of breast ................................................................................................................................................ 15.61 

20600 ....... ........... Drain/inject, joint/bursa ......................................................................................................................................... 0.66 

20610 ....... ........... Drain/inject, joint/bursa ......................................................................................................................................... 0.79 

20680 ....... ........... Removal of support implant .................................................................................................................................. 5.86 

21145 ....... ........... Reconstruct midface, lefort ................................................................................................................................... 23.52 

21146 ....... ........... Reconstruct midface, lefort ................................................................................................................................... 24.41 

21147 ....... ........... Reconstruct midface, lefort ................................................................................................................................... 26.01 

21395 ....... ........... Treat eye socket fracture ..................................................................................................................................... 14.58 

22520 ....... ........... Percut vertebroplasty thor .................................................................................................................................... 9.15 

22554 ....... ........... Neck spine fusion ................................................................................................................................................. 17.48 

22612 ....... ........... Lumbar spine fusion ............................................................................................................................................. 22.50 

22840 ....... ........... Insert spine fixation device ................................................................................................................................... 12.52 

24363 ....... ........... Replace elbow joint .............................................................................................................................................. 22.39 


jlentini on PROD1PC65 with NOTICES2
37425 

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT—Continued 

CPT 

Code 1 Mod Descriptor Proposed work RVU 

24430 ....... ........... Repair of humerus ................................................................................................................................................ 14.99 

25447 ....... ........... Repair wrist joint(s) ............................................................................................................................................... 10.85 

26055 ....... ........... Incise finger tendon sheath .................................................................................................................................. 2.94 

26160 ....... ........... Remove tendon sheath lesion .............................................................................................................................. 3.40 

26600 ....... ........... Treat metacarpal fracture ..................................................................................................................................... 2.40 

26951 ....... ........... Amputation of finger/thumb .................................................................................................................................. 5.75 

27130 ....... ........... Total hip arthroplasty ............................................................................................................................................ 17.40 

27236 ....... ........... Treat thigh fracture ............................................................................................................................................... 14.54 

27447 ....... ........... Total knee arthroplasty ......................................................................................................................................... 20.81 

27465 ....... ........... Shortening of thigh bone ...................................................................................................................................... 18.36 

27470 ....... ........... Repair of thigh ...................................................................................................................................................... 16.87 

27709 ....... ........... Incision of tibia and fibula ..................................................................................................................................... 17.24 

27880 ....... ........... Amputation of lower leg ........................................................................................................................................ 15.18 

28805 ....... ........... Amputation thru metatarsal .................................................................................................................................. 12.47 

29075 ....... ........... Application of forearm cast ................................................................................................................................... 0.77 

29580 ....... ........... Application of paste boot ...................................................................................................................................... 0.57 

30520 ....... ........... Repair of nasal septum ........................................................................................................................................ 7.63 

31225 ....... ........... Removal of upper jaw .......................................................................................................................................... 26.34 

31230 ....... ........... Removal of upper jaw .......................................................................................................................................... 30.46 

31360 ....... ........... Removal of larynx ................................................................................................................................................. 27.23 

31365 ....... ........... Removal of larynx ................................................................................................................................................. 34.85 

31367 ....... ........... Partial removal of larynx ....................................................................................................................................... 27.11 

31368 ....... ........... Partial removal of larynx ....................................................................................................................................... 33.73 

31370 ....... ........... Partial removal of larynx ....................................................................................................................................... 27.11 

31375 ....... ........... Partial removal of larynx ....................................................................................................................................... 25.61 

31380 ....... ........... Partial removal of larynx ....................................................................................................................................... 25.11 

31382 ....... ........... Partial removal of larynx ....................................................................................................................................... 28.11 

31390 ....... ........... Removal of larynx & pharynx ............................................................................................................................... 38.72 

31395 ....... ........... Reconstruct larynx & pharynx .............................................................................................................................. 43.34 

31575 ....... ........... Diagnostic laryngoscopy ....................................................................................................................................... 1.10 

31579 ....... ........... Diagnostic laryngoscopy ....................................................................................................................................... 2.26 

31622 ....... ........... Dx bronchoscope/wash ........................................................................................................................................ 2.78 

32141 ....... ........... Remove treat lung lesions .................................................................................................................................... 17.14 

32442 ....... ........... Sleeve pneumonectomy ....................................................................................................................................... 37.74 

32445 ....... ........... Removal of lung ................................................................................................................................................... 40.73 

32484 ....... ........... Segmentectomy .................................................................................................................................................... 22.67 

32486 ....... ........... Sleeve lobectomy ................................................................................................................................................. 31.72 

32488 ....... ........... Complection pneumonectomy .............................................................................................................................. 32.69 

32540 ....... ........... Removal of lung lesion ......................................................................................................................................... 23.68 

32651 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 16.28 

32652 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 23.34 

32653 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 19.86 

32654 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 18.49 

32655 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 14.95 

32657 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 14.54 

32662 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 17.00 

32663 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 19.96 

32665 ....... ........... Thoracoscopy, surgical ......................................................................................................................................... 17.37 

32815 ....... ........... Close bronchial fistula .......................................................................................................................................... 37.94 

33140 ....... ........... Heart vevascularize (lmr) ...................................................................................................................................... 22.72 

33141 ....... ........... Heart lmr w/other procedure ................................................................................................................................. 4.83 

33208 ....... ........... Insertion of heart pacemaker ............................................................................................................................... 8.12 

33300 ....... ........... Repair of heart wound .......................................................................................................................................... 29.93 

33305 ....... ........... Repair of heart wound .......................................................................................................................................... 33.67 

33400 ....... ........... Repair of aortic valve ............................................................................................................................................ 39.23 

33405 ....... ........... Replacement of aortic valve ................................................................................................................................. 39.97 

33406 ....... ........... Repacement of aortic valve .................................................................................................................................. 48.87 

33410 ....... ........... Replacement of aortic valve ................................................................................................................................. 38.69 

33411 ....... ........... Replacement of aortic valve ................................................................................................................................. 57.11 

33413 ....... ........... Replacement of aortic valve ................................................................................................................................. 55.27 

33414 ....... ........... Repair of aortic valve ............................................................................................................................................ 39.27 

33415 ....... ........... Revision, subvalvular tissue ................................................................................................................................. 29.70 

33416 ....... ........... Revise ventricule muscle ...................................................................................................................................... 36.39 

33425 ....... ........... Repair of mitral valve ............................................................................................................................................ 38.37 

33426 ....... ........... Repair of mitral valve ............................................................................................................................................ 41.28 

33427 ....... ........... Repair of mitral valve ............................................................................................................................................ 42.78 

33430 ....... ........... Replacement of mitral valve ................................................................................................................................. 49.81 


jlentini on PROD1PC65 with NOTICES2
37426 

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT—Continued 

CPT 

Code 1 Mod Descriptor Proposed work RVU 

33460 ....... ........... Revision of tricuspid valve .................................................................................................................................... 27.97 

33463 ....... ........... Valvuloplasty, tricuspid ......................................................................................................................................... 42.57 

33464 ....... ........... Valvuloplasty, tricuspid ......................................................................................................................................... 30.93 

33465 ....... ........... Replace tricuspid valve ........................................................................................................................................ 33.58 

33474 ....... ........... Revision of pulmonary valve ................................................................................................................................ 25.85 

33475 ....... ........... Replacement, pulmonary valve ............................................................................................................................ 44.81 

33505 ....... ........... Repair artery w/tunnel .......................................................................................................................................... 38.33 

33510 ....... ........... CABG, vein, single-vein single ............................................................................................................................. 33.45 

33511 ....... ........... CABG, vein, two ................................................................................................................................................... 34.59 

33512 ....... ........... CABG, vein, three ................................................................................................................................................ 38.73 

33513 ....... ........... CABG, vein, four .................................................................................................................................................. 39.69 

33514 ....... ........... CABG, vein, five ................................................................................................................................................... 40.50 

33516 ....... ........... Cabg, vein, six or more ........................................................................................................................................ 41.96 

33517 ....... ........... CABG, artery ........................................................................................................................................................ 2.57 

33518 ....... ........... CABG, artery-vein, two ......................................................................................................................................... 4.84 

33519 ....... ........... CABG, artery-vein, three ...................................................................................................................................... 7.11 

33521 ....... ........... CABG, artery-vein, four ........................................................................................................................................ 9.39 

33522 ....... ........... CABG, artery-vein, five ......................................................................................................................................... 11.65 

33523 ....... ........... Cabg, art-vein, six or more ................................................................................................................................... 13.93 

33530 ....... ........... Coronary artery, bypass/reop ............................................................................................................................... 5.85 

33533 ....... ........... CABG, arterial, single ........................................................................................................................................... 37.38 

33534 ....... ........... CABG, arterial, two ............................................................................................................................................... 38.81 

33535 ....... ........... CABG, arterial, three ............................................................................................................................................ 41.48 

33536 ....... ........... Cabg, arterial, four or more .................................................................................................................................. 40.79 

33542 ....... ........... Removal of heart lesion ........................................................................................................................................ 32.65 

33545 ....... ........... Repair of heart demage ....................................................................................................................................... 41.12 

33641 ....... ........... Repair heart septum defect .................................................................................................................................. 28.47 

33665 ....... ........... Repair of heart defects ......................................................................................................................................... 34.75 

33684 ....... ........... Repair heart septum defect .................................................................................................................................. 34.27 

33688 ....... ........... Repair heart septum defect .................................................................................................................................. 34.65 

33771 ....... ........... Repair great vessels defect .................................................................................................................................. 40.56 

33779 ....... ........... Repair great vessels defect .................................................................................................................................. 43.13 

33781 ....... ........... Repair great vessels defect .................................................................................................................................. 43.14 

33860 ....... ........... Ascending aortic graft ........................................................................................................................................... 43.13 

33863 ....... ........... Ascending aortic graft ........................................................................................................................................... 48.52 

33877 ....... ........... Thoracoabdominal graft ........................................................................................................................................ 57.75 

33945 ....... ........... Transplantation of heart ....................................................................................................................................... 50.14 

34001 ....... ........... Removal of artery clot .......................................................................................................................................... 17.74 

34201 ....... ........... Removal of artery clot .......................................................................................................................................... 18.40 

34471 ....... ........... Removal of vein clot ............................................................................................................................................. 20.94 

35081 ....... ........... Repair defect of artery .......................................................................................................................................... 33.31 

35102 ....... ........... Repair defect of artery .......................................................................................................................................... 36.31 

35216 ....... ........... Repair blood vessel lesion ................................................................................................................................... 36.43 

35506 ....... ........... Artery bypass graft ............................................................................................................................................... 25.19 

35508 ....... ........... Artery bypass graft ............................................................................................................................................... 25.95 

35515 ....... ........... Artery bypass graft ............................................................................................................................................... 25.95 

35516 ....... ........... Artery bypass graft ............................................................................................................................................... 24.07 

35556 ....... ........... Artery bypass graft ............................................................................................................................................... 26.56 

35566 ....... ........... Artery bypass graft ............................................................................................................................................... 32.16 

35583 ....... ........... Vein bypass graft .................................................................................................................................................. 27.56 

35585 ....... ........... Vein bypass graft .................................................................................................................................................. 32.16 

35606 ....... ........... Artery bypass graft ............................................................................................................................................... 22.32 

35616 ....... ........... Artery bypass graft ............................................................................................................................................... 21.70 

35820 ....... ........... Explore chest vessels ........................................................................................................................................... 30.08 

38100 ....... ........... Removal of spleen, total ....................................................................................................................................... 19.43 

38101 ....... ........... Removal of spleen, partial .................................................................................................................................... 19.43 

38115 ....... ........... Repair of ruptured spleen ..................................................................................................................................... 21.76 

38700 ....... ........... Removal of lymph nodes, neck ............................................................................................................................ 12.62 

38720 ....... ........... Removal of lymph nodes, neck ............................................................................................................................ 21.64 

38724 ....... ........... Removal of lymph nodes, neck ............................................................................................................................ 23.64 

39220 ....... ........... Removal chest lesion ........................................................................................................................................... 18.42 

39400 ....... ........... Visualization of chest ............................................................................................................................................ 5.97 

41100 ....... ........... Biopsy of tongue ................................................................................................................................................... 1.37 

41120 ....... ........... Partial removal of tongue ..................................................................................................................................... 10.83 

41130 ....... ........... Partial removal of tongue ..................................................................................................................................... 15.43 

41135 ....... ........... Tongue and neck surgery .................................................................................................................................... 29.71 

41140 ....... ........... Removal of tongue ............................................................................................................................................... 28.69 


jlentini on PROD1PC65 with NOTICES2
37427 

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT—Continued 

CPT 

Code 1 Mod Descriptor Proposed work RVU 

41145 ....... ........... Tongue removal, neck surgery ............................................................................................................................. 37.47 

41150 ....... ........... Tongue, mouth, jaw surgery ................................................................................................................................. 29.40 

41153 ....... ........... Tongue, mouth, neck surgery .............................................................................................................................. 33.16 

41155 ....... ........... Tongue, jaw, & neck surgery ................................................................................................................................ 39.84 

42120 ....... ........... Remove plate/lesion ............................................................................................................................................. 11.62 

42842 ....... ........... Extensive surgery of throat ................................................................................................................................... 11.94 

42844 ....... ........... Extensive surgery of throat ................................................................................................................................... 17.49 

42845 ....... ........... Extensive surgery of throat ................................................................................................................................... 32.27 

42890 ....... ........... Partial removal of pharynx ................................................................................................................................... 18.84 

42892 ....... ........... Revision of pharyngeal walls ................................................................................................................................ 25.67 

42894 ....... ........... Revision of pharyngeal walls ................................................................................................................................ 33.49 

43108 ....... ........... Removal of esophagus ......................................................................................................................................... 63.23 

43113 ....... ........... Removal of esophagus ......................................................................................................................................... 46.95 

43116 ....... ........... Partial removal of esophagus ............................................................................................................................... 71.39 

43118 ....... ........... Partial removal of esophagus ............................................................................................................................... 52.07 

43121 ....... ........... Partial removal of esophagus ............................................................................................................................... 46.35 

43123 ....... ........... Partial removal of esophagus ............................................................................................................................... 63.83 

43124 ....... ........... Removal of esophagus ......................................................................................................................................... 64.63 

43135 ....... ........... Removal of esophagus pouch .............................................................................................................................. 22.37 

43235 ....... ........... Uppr gi endoscopy, diagnosis .............................................................................................................................. 2.39 

43246 ....... ........... Place gastrostomy tube ........................................................................................................................................ 4.32 

43620 ....... ........... Removal of stomach ............................................................................................................................................. 33.85 

43621 ....... ........... Removal of stomach ............................................................................................................................................. 39.34 

43622 ....... ........... Removal of stomach ............................................................................................................................................. 39.84 

43632 ....... ........... Removal of stomach, partial ................................................................................................................................. 34.95 

43633 ....... ........... Removal of stomach, partial ................................................................................................................................. 32.95 

43634 ....... ........... Removal of stomach, partial ................................................................................................................................. 36.45 

43750 ....... ........... Place gastrostomy tube ........................................................................................................................................ 4.60 

43820 ....... ........... Fusion of stomach and bowel .............................................................................................................................. 22.34 

43840 ....... ........... Repair of stomach lesion ...................................................................................................................................... 22.64 

44120 ....... ........... Removal of small intenstive .................................................................................................................................. 20.70 

44130 ....... ........... Bowel to bowel fusion .......................................................................................................................................... 21.92 

44140 ....... ........... Partial removal of colon ........................................................................................................................................ 22.40 

44141 ....... ........... Partial removal of colon ........................................................................................................................................ 29.69 

44143 ....... ........... Partial removal of colon ........................................................................................................................................ 29.69 

44144 ....... ........... Partial removal of colon ........................................................................................................................................ 27.57 

44145 ....... ........... Partial removal of colon ........................................................................................................................................ 28.39 

44146 ....... ........... Partial removal of colon ........................................................................................................................................ 35.08 

44147 ....... ........... Partial removal of colon ........................................................................................................................................ 33.50 

44150 ....... ........... Removal of colon .................................................................................................................................................. 29.91 

44151 ....... ........... Removal of colon/leostomy .................................................................................................................................. 34.65 

44155 ....... ........... Removal of colon/leostomy .................................................................................................................................. 34.15 

44156 ....... ........... Removal of colon/leostomy .................................................................................................................................. 37.15 

44602 ....... ........... Suture, small intestine .......................................................................................................................................... 24.60 

44603 ....... ........... Suture, small intestine .......................................................................................................................................... 27.97 

45020 ....... ........... Drainage of rectal abscess ................................................................................................................................... 8.37 

45300 ....... ........... Proctosigmoidoscopy w/bx ................................................................................................................................... 0.38 

45303 ....... ........... Proctosigmoidoscoy dilate .................................................................................................................................... 0.44 

45305 ....... ........... Procosigmoidoscopy w/bx .................................................................................................................................... 1.01 

45307 ....... ........... Proctosigmoidoscopy fb ....................................................................................................................................... 0.94 

45308 ....... ........... Proctosigmoidoscopy removal .............................................................................................................................. 0.83 

45309 ....... ........... Proctosigmoidoscopy removal .............................................................................................................................. 2.01 

45315 ....... ........... Proctosigmoidoscopy removal .............................................................................................................................. 1.40 

45317 ....... ........... Proctosigmoidoscopy bleed .................................................................................................................................. 1.50 

45320 ....... ........... Proctosigmoidoscopy ablate ................................................................................................................................. 1.58 

45321 ....... ........... Proctosigmoidoscopy volvul ................................................................................................................................. 1.17 

45327 ....... ........... Proctosigmoidoscopy w/slent ............................................................................................................................... 1.65 

45330 ....... ........... Diagnostic sigmoidoscopy .................................................................................................................................... 0.96 

45378 ....... ........... Diagnostic colonoscopy ........................................................................................................................................ 3.69 

46040 ....... ........... Incision of rectal abscess ..................................................................................................................................... 5.20 

46045 ....... ........... Incision of rectal abscess ..................................................................................................................................... 5.75 

46060 ....... ........... Incision of rectal abscess ..................................................................................................................................... 6.18 

46270 ....... ........... Removal of anal fistula ......................................................................................................................................... 4.75 

46275 ....... ........... Removal of anal fistula ......................................................................................................................................... 5.25 

46280 ....... ........... Removal of anal fistula ......................................................................................................................................... 6.22 

46285 ....... ........... Removal of anal fistula ......................................................................................................................................... 5.25 

46600 ....... ........... Diagnostic anoscopy ............................................................................................................................................ 0.50 


jlentini on PROD1PC65 with NOTICES2
37428 

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT—Continued 

CPT 

Code 1 Mod Descriptor Proposed work RVU 

46604 ....... ........... Anoscopy and dilation .......................................................................................................................................... 1.31 

46606 ....... ........... Anoscopy and biopsy ........................................................................................................................................... 0.81 

46608 ....... ........... Anoscopy, remove for body .................................................................................................................................. 1.51 

46610 ....... ........... Anoscopy, remove lesion ..................................................................................................................................... 1.32 

46611 ....... ........... Anoscopy .............................................................................................................................................................. 1.81 

46612 ....... ........... Anoscopy, remove lesions ................................................................................................................................... 2.34 

46614 ....... ........... Anoscopy, control bleeding .................................................................................................................................. 2.01 

46615 ....... ........... Anoscopy .............................................................................................................................................................. 2.68 

47562 ....... ........... Laparoscopic cholecystectomy ............................................................................................................................. 11.57 

47600 ....... ........... Removal of gallbladder ......................................................................................................................................... 15.44 

47760 ....... ........... Fuse bile ducts and bowel ................................................................................................................................... 38.08 

47765 ....... ........... Fuse liver ducts and bowel ................................................................................................................................... 51.95 

47780 ....... ........... Fuse bile ducts and bowel ................................................................................................................................... 42.08 

47785 ....... ........... Fuse bile ducts and bowel ................................................................................................................................... 55.95 

49002 ....... ........... Reopening of abdomen ........................................................................................................................................ 17.51 

49010 ....... ........... Exploration behind abdomen ................................................................................................................................ 15.94 

49505 ....... ........... Prp i/hern init reduc >5 yr ..................................................................................................................................... 7.84 

50590 ....... ........... Fragmenting of kidney stone ................................................................................................................................ 9.58 

51720 ....... ........... Treatment of bladder lesion .................................................................................................................................. 1.50 

51798 ....... ........... Us urine capacity measure ................................................................................................................................... 0.00 

52000 ....... ........... Cystoscopy ........................................................................................................................................................... 2.23 

52204 ....... ........... Cystoscopy ........................................................................................................................................................... 2.59 

52601 ....... ........... Prostatectomy (TURP) .......................................................................................................................................... 15.07 

55700 ....... ........... Biopsy of prostate ................................................................................................................................................. 2.58 

57160 ....... ........... Insert pessary/other device .................................................................................................................................. 0.89 

57240 ....... ........... Repair bladder & vagina ....................................................................................................................................... 11.38 

57250 ....... ........... Repair rectum & vagina ........................................................................................................................................ 11.38 

57260 ....... ........... Repair vagina ....................................................................................................................................................... 14.32 

57265 ....... ........... Extensive repair of vagina .................................................................................................................................... 15.82 

57288 ....... ........... Repair bladder defect ........................................................................................................................................... 13.95 

57500 ....... ........... Biopsy of cervix .................................................................................................................................................... 1.20 

58120 ....... ........... Dilation and curettage .......................................................................................................................................... 3.52 

58150 ....... ........... Total hysterectomy ............................................................................................................................................... 17.17 

58720 ....... ........... Removal of ovary/tube(s) ..................................................................................................................................... 12.04 

60600 ....... ........... Remove carotid body lesion ................................................................................................................................. 24.95 

60605 ....... ........... Remove carotid body lesion ................................................................................................................................. 31.82 

61154 ....... ........... Pierce skull & remove clot .................................................................................................................................... 16.86 

61312 ....... ........... Open skull for drainage ........................................................................................................................................ 30.03 

61537 ....... ........... Removal of brain tissue ........................................................................................................................................ 36.31 

61538 ....... ........... Removal of brain tissue ........................................................................................................................................ 39.31 

61697 ....... ........... Brain aneurysm repr, complx ............................................................................................................................... 63.16 

61698 ....... ........... Brain aneurysm repr, complx ............................................................................................................................... 69.39 

61700 ....... ........... Brain aneurysm repr, simple ................................................................................................................................ 50.44 

61702 ....... ........... Inner skull vessel surgery ..................................................................................................................................... 59.80 

62270 ....... ........... Spinal fluid tap, diagnostic ................................................................................................................................... 1.37 

63047 ....... ........... Removal of spinal lamina ..................................................................................................................................... 15.16 

63048 ....... ........... Remove spinal lamina add-on .............................................................................................................................. 3.26 

63075 ....... ........... Neck spine disk surgery ....................................................................................................................................... 19.41 

64702 ....... ........... Revise finger/toe nerve ........................................................................................................................................ 6.02 

64721 ....... ........... Carpal tunnel surgery ........................................................................................................................................... 4.78 

65426 ....... ........... Removal of eye lesion .......................................................................................................................................... 5.85 

65850 ....... ........... Incision of eye ...................................................................................................................................................... 11.14 

66761 ....... ........... Revision of iris ...................................................................................................................................................... 4.81 

66821 ....... ........... After cataract laser surgery .................................................................................................................................. 3.28 

66984 ....... ........... Cataract surg w/iol, 1 stage .................................................................................................................................. 10.28 

67221 ....... ........... Ocular photodynamic ther .................................................................................................................................... 3.45 

67414 ....... ........... Explr/decompress eye socket .............................................................................................................................. 17.72 

67445 ....... ........... Explr/decompress eye socket .............................................................................................................................. 18.90 

67500 ....... ........... Inject/treat eye socket .......................................................................................................................................... 1.44 

67505 ....... ........... Inject/treat eye socket .......................................................................................................................................... 1.27 

67515 ....... ........... Inject/treat eye socket .......................................................................................................................................... 1.40 

67820 ....... ........... Revise eyelashes ................................................................................................................................................. 0.71 

67840 ....... ........... Remove eyelid lesion ........................................................................................................................................... 2.04 

67904 ....... ........... Repair eyelid defect .............................................................................................................................................. 7.75 

67911 ....... ........... Revise eyelid defect ............................................................................................................................................. 7.30 

67966 ....... ........... Revision of eyelid ................................................................................................................................................. 8.75 

68840 ....... ........... Explore/irrigate tear ducts .................................................................................................................................... 1.25 


jlentini on PROD1PC65 with NOTICES2
37429 

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT—Continued 

CPT 

Code 1 Mod Descriptor Proposed work RVU 

69210 ....... ........... Remove impacted ear wax ................................................................................................................................... 0.61 

70355 ....... ........... Panoramic x-ray of jaws ....................................................................................................................................... 0.20 

71010 ....... ........... Chest x-ray ........................................................................................................................................................... 0.18 

71020 ....... ........... Chest x-ray ........................................................................................................................................................... 0.22 

71260 ....... ........... Ct thorax w/dye .................................................................................................................................................... 1.24 

72192 ....... ........... Ct pelvis w/o dye .................................................................................................................................................. 1.09 

72193 ....... ........... Ct pelvis w/dye ..................................................................................................................................................... 1.16 

73100 ....... ........... X-ray exam of wrist ............................................................................................................................................... 0.16 

73110 ....... ........... X-ray exam of wrist ............................................................................................................................................... 0.17 

73120 ....... ........... X-ray exam of hand .............................................................................................................................................. 0.16 

73130 ....... ........... X-ray exam of hand .............................................................................................................................................. 0.17 

73140 ....... ........... X-ray exam of finger(s) ......................................................................................................................................... 0.13 

74000 ....... ........... X-ray exam of abdomen ....................................................................................................................................... 0.18 

74020 ....... ........... X-ray exam of abdomen ....................................................................................................................................... 0.27 

74022 ....... ........... X-ray exam series, abdomen ............................................................................................................................... 0.32 

74150 ....... ........... Ct abdomen w/o dye ............................................................................................................................................ 1.19 

74160 ....... ........... Ct abdomen w/dye ............................................................................................................................................... 1.27 

76075 ....... ........... Dxa bone density, axial ........................................................................................................................................ 0.20 

76519 ....... ........... Echo exam of eye ................................................................................................................................................ 0.54 

76700 ....... ........... Us exam, abdom, complete .................................................................................................................................. 0.81 

76830 ....... ........... Transvaginal us, non-ob ....................................................................................................................................... 0.69 

77263 ....... ........... Radiation therapy planning ................................................................................................................................... 3.14 

77280 ....... ........... Set radiation therapy field .................................................................................................................................... 0.70 

77290 ....... ........... Set radiation therapy field .................................................................................................................................... 1.56 

77300 ....... ........... Radiation therapy dose plan ................................................................................................................................ 0.62 

77315 ....... ........... Teletx isodose plan complex ................................................................................................................................ 1.56 

77331 ....... ........... Special radiation dosimetry .................................................................................................................................. 0.87 

77334 ....... ........... Radiation treatment aid(s) .................................................................................................................................... 1.24 

77470 ....... ........... Special radiation treatment ................................................................................................................................... 2.09 

78306 ....... ........... Bone imaging, whole body ................................................................................................................................... 0.86 

78315 ....... ........... Bone imaging, 3 phase ........................................................................................................................................ 1.02 

78465 ....... ........... Heart image (3d), multiple .................................................................................................................................... 1.46 

78478 ....... ........... Heart wall motion add-on ..................................................................................................................................... 0.50 

78480 ....... ........... Heart function add-on ........................................................................................................................................... 0.30 

88309 ....... ........... Tissue exam by pathologist .................................................................................................................................. 2.80 

88321 ....... ........... Microslide consultation ......................................................................................................................................... 1.63 

88323 ....... ........... Microslide consultation ......................................................................................................................................... 1.83 

88325 ....... ........... Comprehensive review of data ............................................................................................................................. 2.50 

92083 ....... ........... Visual field examination(s) ................................................................................................................................... 0.50 

92226 ....... ........... Special eye exam, subsequent ............................................................................................................................ 0.33 

92235 ....... ........... Eye exam with photos .......................................................................................................................................... 0.81 

92250 ....... ........... Eye exam with photos .......................................................................................................................................... 0.44 

93010 ....... ........... Electrocardiogram report ...................................................................................................................................... 0.17 

93015 ....... ........... Cardiovascular stress test .................................................................................................................................... 0.75 

93018 ....... ........... Cardiovascular stress test .................................................................................................................................... 0.30 

94010 ....... ........... Breathing capacity test ......................................................................................................................................... 0.17 

95144 ....... ........... Antigen therapy services ...................................................................................................................................... 0.06 

95165 ....... ........... Antigen therapy services ...................................................................................................................................... 0.06 

95816 ....... ........... Eeg, awake and drowsy ....................................................................................................................................... 1.08 

95819 ....... ........... Eeg, awake and asleep ........................................................................................................................................ 1.08 

95861 ....... ........... Muscle test, 2 limbs .............................................................................................................................................. 1.54 

95872 ....... ........... Muscle test, one fiber ........................................................................................................................................... 2.00 

95900 ....... ........... Motor nerve conduction test ................................................................................................................................. 0.42 

95904 ....... ........... Sense nerve conduction test ................................................................................................................................ 0.34 

95925 ....... ........... Somatosensory testing ......................................................................................................................................... 0.54 

95926 ....... ........... Somatosensory testing ......................................................................................................................................... 0.54 

95927 ....... ........... Somatosensory testing ......................................................................................................................................... 0.54 

95953 ....... ........... EEG monitoring/computer .................................................................................................................................... 3.30 

99201 ....... ........... Office/outpatient visit, new ................................................................................................................................... 0.45 

99202 ....... ........... Office/outpatient visit, new ................................................................................................................................... 0.88 

99203 ....... ........... Office/outpatient visit, new ................................................................................................................................... 1.34 

99204 ....... ........... Office/outpatient visit, new ................................................................................................................................... 2.30 

99205 ....... ........... Office/outpatient visit, new ................................................................................................................................... 3.00 

99211 ....... ........... Office/outpatient visit, est ..................................................................................................................................... 0.17 

99212 ....... ........... Office/outpatient visit, est ..................................................................................................................................... 0.45 

99213 ....... ........... Office/outpatient visit, est ..................................................................................................................................... 0.92 

99214 ....... ........... Office/outpatient visit, est ..................................................................................................................................... 1.42 


jlentini on PROD1PC65 with NOTICES2
37430 

ADDENDUM C.—CODES WITH WORK RVUS SUBJECT TO COMMENT—Continued 

CPT 

Code 1 Mod Descriptor Proposed work RVU 

99215 ....... ........... Office/outpatient visit, est ..................................................................................................................................... 2.00 

99221 ....... ........... Initial hospital care ................................................................................................................................................ 1.88 

99222 ....... ........... Initial hospital care ................................................................................................................................................ 2.56 

99223 ....... ........... Initial hospital care ................................................................................................................................................ 3.78 

99231 ....... ........... Subsequent hospital care ..................................................................................................................................... 0.76 

99232 ....... ........... Subsequent hospital care ..................................................................................................................................... 1.39 

99233 ....... ........... Subsequent hospital care ..................................................................................................................................... 2.00 

99238 ....... ........... Hospital discharge day ......................................................................................................................................... 1.28 

99239 ....... ........... Hospital discharge day ......................................................................................................................................... 1.90 

99241 ....... ........... Office consultation ................................................................................................................................................ 0.64 

99242 ....... ........... Office consultation ................................................................................................................................................ 1.34 

99243 ....... ........... Office consultation ................................................................................................................................................ 1.88 

99244 ....... ........... Office consultation ................................................................................................................................................ 3.02 

99245 ....... ........... Office consultation ................................................................................................................................................ 3.77 

99251 ....... ........... Initial inpatient consult .......................................................................................................................................... 1.00 

99252 ....... ........... Initial inpatient consult .......................................................................................................................................... 1.50 

99253 ....... ........... Initial inpatient consult .......................................................................................................................................... 2.27 

99254 ....... ........... Initial inpatient consult .......................................................................................................................................... 3.29 

99255 ....... ........... Initial inpatient consult .......................................................................................................................................... 4.00 

99281 ....... ........... Emergency dept visit ............................................................................................................................................ 0.45 

99282 ....... ........... Emergency dept visit ............................................................................................................................................ 0.88 

99283 ....... ........... Emergency dept visit ............................................................................................................................................ 1.34 

99284 ....... ........... Emergency dept visit ............................................................................................................................................ 2.56 

99285 ....... ........... Emergency dept visit ............................................................................................................................................ 3.80 

99291 ....... ........... Critical care, first hour .......................................................................................................................................... 4.50 

99292 ....... ........... Critical care, addl 30 min ...................................................................................................................................... 2.25 

1 CPT codes and descriptions only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS Apply. 

Note: The proposed work RVUs for 10- and 90-day global period codes include the application of the RUC- recommended values for the E/M services that are included as part of the 

global period for the service. 

Federal Register / Vol. 71, No. 125 / Thursday, June 29, 2006 / Notices 

[FR Doc. 06–5665 Filed 6–21–06; 8:45 am] 

BILLING CODE 4120–01–P 


jlentini on PROD1PC65 with NOTICES2