New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 54 - PHYSICIAN SERVICES › Subchapter 9 - HEALTH CARE FINANCING ADMINISTRATION (HCFA) COMMON PROCEDURE CODING SYSTEM (HCPCS) › Section 10:54-9.4 - HCPCS procedure codes and maximum fee schedule for medicine

Current through Register Vol. 56, No. 14, July 15, 2024
Maximum Fee
Anes
HCPCS
Allowance
Basic
IND
Code
Mod
S
$
NS
Units
N
99183
27.00
NA
N
99190
45.00
NA
N
99191
33.75
NA
N
99192
22.50
NA
99195
28.00
28.00
99199
BR
BR
N
99201
16.00
14.00
N
99202
16.00
14.00
N
99203
22.00
17.00
N
99204
22.00
17.00
N
99205
22.00
17.00
E N
99211
16.00
14.00
99211
WM
NA
11.20
E N
99212
16.00
14.00
99212
WM
NA
11.20
E N
99213
16.00
14.00
99213
WM
NA
11.20
E N
99214
16.00
14.00
99214
WM
NA
11.20
E N
99215
16.00
14.00
E N
99215
WM
NA
11.20
N
99217
16.00
14.00
N
99221
22.00
17.00
N
99222
22.00
17.00
N
99223
22.00
17.00
N
99231
16.00
14.00
N
99232
16.00
14.00
N
99233
16.00
14.00
99238
16.00
14.00
N
99241
44.00
NA
N
99242
44.00
NA
N
99243
44.00
NA
N
99244
62.00
NA
N
99245
62.00
NA
N
99251
44.00
NA
N
99252
44.00
NA
N
99253
44.00
NA
N
99254
62.00
NA
N
99255
62.00
NA
N
99261
16.00
14.00
N
99262
16.00
14.00
N
99263
16.00
14.00
N
99271
44.00
NA
N
99272
44.00
NA
N
99273
44.00
NA
N
99274
62.00
NA
N
99274
YY
50.00
NA
N
99274
ZZ
50.00
NA
N
99275
62.00
NA
N
9928
19.00
7.00
N
99282
9.00
7.00
N
99283
9.00
7.00
N
99284
9.00
7.00
N
99285
9.00
7.00
N
99291
45.00
40.00
N
99292
22.50
20.00
99293
435.10
369.90
99294
198.50
169.10
99299
60.00
51.00
N
99301
22.00
17.00
N
99302
22.00
17.00
N
99303
22.00
17.00
E N
99311
16.00
14.00
E N
99312
16.00
14.00
E N
99313
16.00
14.00
N
99321
22.00
17.00
N
99322
22.00
17.00
N
99323
22.00
17.00
E N
99331
16.00
14.00
E N
99332
16.00
14.00E
N
99333
16.00
14.00
N
99341
16.00
14.00
N
99341
WM
NA
11.20
N
99342
16.00
14.00
N
99342
WM
NA
11.20
N
99343
35.00
35.00
N
99351
16.00
14.00
N
99351
WM
NA
11.20
N
99352
16.00
14.00
N
99352
WM
NA
11.20
N
99353
35.00
35.00
N
99354
45.00
40.00
N
99355
22.50
20.00
N
99356
45.00
40.00
N
99357
22.50
20.00
N
99382
22.00
17.00
N
99383
22.00
17.00
N
99384
22.00
17.00
N
99385
22.00
17.00
N
99386
22.00
17.00
N
99387
22.00
17.00
N
99391
16.00
14.00
N
99392
22.00
17.00
N
99393
22.00
17.00
N
99394
22.00
17.00
N
99395
22.00
17.00
N
99396
22.00
17.00
N
99397
22.00
17.00
N
99431
27.00
23.00
99499
BR
BR
99600
BR
BR
L
H5025
8.00
6.00
N
J0690
1.92
1.92
N
J0696
10.24
10.24
N
J1100
0.80
0.80
N
J1200
0.55
0.55
N
J2550
0.42
0.42
N
J2680
9.50
9.50
N
J2790
20.40
20.40
N
J2790
22
72.07
72.07
J3395
Average Wholesale Price (AWP)
N
J9000
42.00
42.00
N
J9010
195.50
195.50
N
J9020
50.36
50.36
N
J9031
152.13
152.13
N
J9040
255.08
255.08
N
J9045
72.01
72.01
N
J9060
30.33
30.33
N
J9070
4.91
4.91
N
J9100
6.72
6.72
N
J9130
12.00
12.00
N
J9190
0.18
0.18
N
J9217
451.25
451.25
N
J9230
10.10
10.10
N
J9240
9.05
9.05
N
J9240
22
31.50
31.50
N
J9260
4.75
4.75
N
J9280
119.08
119.08
N
J9360
3.25
3.25
N
J9370
27.50
27.50
L
W9025
72.00
69.00
L
W9025
WM
NA
67.00
L
W9026
22.00
21.00
L
W9026
WM
NA
19.00
L
W9027
465.00
418.00
L
W9027
WM
371.00
L
W9028
22.00
21.00
L
W9028
WM
19.00
L
W9029
487.00
439.00
L
W9029
WM
390.00
L
W9030
867.00
802.00
L
W9030
WM
723.00
L
W9031
595.00
531.00
L
W9040
30.00
30.00
L
W9041
120.00
120.00
L
W9042
50.00
50.00
L
W9043
100.00
100.00
L
W9050
27.00
27.00
L
W9055
27.00
27.00
L
W9060
31.00
26.00
L
W9060
WT
23.00
18.00
L
W9061
31.00
26.00
L
W9061
WT
23.00
18.00
L
W9062
31.00
26.00
L
W9062
WT
23.00
18.00
L
W9063
31.00
26.00
L
W9063
WT
23.00
18.00
L
W9064
31.00
26.00
L
W9064
WT
23.00
18.00
L
W9065
31.00
26.00
L
W9065
WT
23.00
18.00
L
W9066
31.00
26.00
L
W9066
WT
23.00
18.00
L
W9067
31.00
26.00
L
W9067
WT
23.00
18.00
L
W9068
31.00
26.00
L
W9068
WT
23.00
18.00
L
W9095
6.60
6.60
L
W9096
17.46
17.46
L
W9096
22
32.79
32.79
L
W9096
52
2.50
2.50
L
W9097
17.46
17.46
L
W9097
52
2.50
2.50
L
W9098
32.79
32.79
L
W9098
52
2.50
2.50
L
W9099
63.57
63.57
L
W9099
52
2.50
2.50
L
W9170
13.00
13.00
L
W9200
12.00
NA
L
W9205
70.00
NA
L
W9210
70.00
NA
L
W9215
9.00
NA
L
W9220
16.00
NA
L
W9310
51.00
NA
L
W9333
27.88
27.88
L
W9333
52
2.50
2.50
L
W9334
27.88
27.88
L
W9334
52
2.50
2.50
L
W9335
62.09
62.09
L
W9335
52
2.50
2.50
L
W9336
36.90
36.90
L
W9337
2.34
2.34
L
W9338
30.27
30.27
L
W9339
360.63
360.63
L
W9343
451.25
451.25
L
W9344
811.25
811.25
L
W9345
902.50
902.50
L
W9378
16.00
NA
L
W9382
16.00
NA
L
W9384
16.00
NA
L
W9385
16.00
NA
L
W9386
16.00
NA
L
W9387
16.00
NA
L
W9388
16.00
NA
L
W9450
100.00
NA
L
W9450
2633.00
NA
L
W9820
23.00
18.00
L
W9840
150.00
150.00
L
W9847
63.00
NA
L
W9848
28.00
30.00
L
W9849
28.00
30.00
L
Z0250
WM
NA
40.00
L
Z0300
7.00
7.00
L
Z0310
45.00
45.00