Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END 25545 OPEN TREATMENT OF CLOSED OR OPEN ULNAR SHAFT $520.50 20060701 99999999 25560 TREATMENT OF CLOSED RADIAL AND ULNAR SHAFT $148.88 20060701 99999999 25565 TREATMENT OF CLOSED RADIAL AND ULNAR SHAFT $322.44 20060701 99999999 25574 OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FI $452.28 20060701 99999999 25575 OPEN TREATMENT OF CLOSED OR OPEN RADIAL AND $632.66 20060701 99999999 25600 TREATMENT OF CLOSED DISTAL RADIAL FRACTURE $143.02 20060701 99999999 25605 TREATMENT OF CLOSED DISTAL RADIAL FRACTURE $320.44 20060701 99999999 25606 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATIO $468.98 20070101 99999999 25607 OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATIO $466.97 20070101 99999999 25608 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATIO $531.56 20070101 99999999 25609 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATIO $676.75 20070101 99999999 25611 TREATMENT OF CLOSED, COMPLEX, DISTAL RADIAL $458.12 19990701 99999999 25620 OPEN TREATMENT OF CLOSED OR OPEN DISTAL RADIAL $497.81 19990701 99999999 25622 TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FRACTURE $145.67 20060701 99999999 25624 TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FRACTURE $245.45 20060701 99999999 25628 OPEN TREATMENT OF CLOSED OR OPEN CARPAL SCAPHOID $495.84 20060701 99999999 25630 TREATMENT OF CLOSED CARPAL BONE FRACTURE (EXCLUDING $148.52 20060701 99999999 25635 TREATMENT OF CLOSED CARPAL BONE FRACTURE (EXCLUDING $225.68 20060701 99999999 25645 OPEN TREATMENT OF CLOSED OR OPEN CARPAL BONE $442.87 20060701 99999999 25650 TREATMENT OF CLOSED ULNAR STYLOID FRACTURE $158.22 20060701 99999999 25651 PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE $283.75 20060701 99999999 25652 OPEN TREATMENT OF ULNAR STYLOID FRACTURE $420.71 20060701 99999999 25660 TREATMENT OF CLOSED RADIOCARPAL OR INTERCARPAL $242.09 20060701 99999999 25670 OPEN TREATMENT OF CLOSED OR OPEN RADIOCARPAL $474.74 20060701 99999999 25671 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR DISLOCATION $348.57 20060701 99999999 25675 TREATMENT OF CLOSED DISTAL RADIOULNAR DISLOCATION $247.58 20060701 99999999 25676 OPEN TREATMENT OF CLOSED OR OPEN DISTAL RADIOULNAR $481.38 20060701 99999999 25680 TREATMENT OF CLOSED TRANS-SCAPHOPERILUNAR TYPE $301.28 20060701 99999999 25685 OPEN TREATMENT OF CLOSED OR OPEN TRANS-SCAPHOPERILUNAR $575.41 20060701 99999999 25690 TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION $336.86 20060701 99999999 25695 OPEN TREATMENT OF LUNATE DISLOCATION $491.10 20060701 99999999 25800 ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR $612.50 20060701 99999999 25805 ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR $701.67 20060701 99999999 25810 ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR $656.09 20060701 99999999 25820 INTERCARPAL FUSION $481.56 20060701 99999999 25825 INTERCARPAL FUSION $583.69 20060701 99999999 25830 DISTAL RADIOULNAR JOINT ARTHRODESIS AND SEGMENTAL RESECTION OF ULNA (EG, SAUVE-K $647.03 20060701 99999999 25900 AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA $567.81 20060701 99999999 25905 AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA $587.54 20060701 99999999 25907 AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA $523.66 20060701 99999999 25909 AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA $552.40 20060701 99999999 25915 KRUKENBERG PROCEDURE $985.32 20060701 99999999 25920 DISARTICULATION THROUGH WRIST $498.49 20060701 99999999 25922 DISARTICULATION THROUGH WRIST $433.81 20060701 99999999 25924 DISARTICULATION THROUGH WRIST $499.26 20060701 99999999 25927 TRANSMETACARPAL AMPUTATION $539.95 20060701 99999999 25929 TRANSMETACARPAL AMPUTATION $415.89 20060701 99999999 25931 TRANSMETACARPAL AMPUTATION $514.75 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 120
PROC-CODE DESC MAC BEG END 26010 DRAINAGE OF FINGER ABSCESS $96.86 20060701 99999999 26011 DRAINAGE OF FINGER ABSCESS $165.44 20060701 99999999 26020 DRAINAGE OF TENDON SHEATH, ONE DIGIT AND/OR PALM $350.06 20060701 99999999 26025 DRAINAGE OF PALMAR BURSA $368.91 20060701 99999999 26030 DRAINAGE OF PALMAR BURSA $431.70 20060701 99999999 26034 INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR $433.23 20060701 99999999 26035 DECOMPRESSION FINGERS AND/OR HAND, INJECTION $573.05 20060701 99999999 26037 DECOMPRESSIVE FASCIOTOMY HAND (EXCLUDES 26035) $477.49 20060701 99999999 26040 FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE $290.99 20060701 99999999 26045 FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE $409.48 20060701 99999999 26055 TENDON SHEATH INCISION FOR TRIGGER FINGER $224.70 20060701 99999999 26060 TENOTOMY, SUBCUTANEOUS, SINGLE, EACH DIGIT $195.30 20060701 99999999 26070 ARTHROTOMY, FOR INFECTION, WITH EXPLORATION, DRAINAGE OR REMOVAL $283.34 20060701 99999999 26075 ARTHROTOMY, FOR INFECTION, WITH EXPLORATION, DRAINAGE OR REMOVAL $303.01 20060701 99999999 26080 ARTHROTOMY, FOR INFECTION, WITH EXPLORATION, DRAINAGE OR REMOVAL $331.00 20060701 99999999 26100 ARTHROTOMY FOR SYNOVIAL BIOPSY $262.16 20060701 99999999 26105 ARTHROTOMY FOR SYNOVIAL BIOPSY $312.36 20060701 99999999 26110 ARTHROTOMY FOR SYNOVIAL BIOPSY $296.52 20060701 99999999 26115 EXCISION, TUMOR OR VASCULAR MALFORMATION, HAND OR FINGER $241.72 20060701 99999999 26116 EXCISION, TUMOR OR VASCULAR MALFORMATION, HAND OR FINGER $388.42 20060701 99999999 26117 RAD RESECT TUMOR SOFT TISSUE OF HAND OR FINGER $524.01 20060701 99999999 26121 FASCIECTOMY PALMAR W/WO Z-PLASTY OTHER LOCAL TISSUE REARRANG $549.18 20060701 99999999 26123 FASCIECTOMY PALMAR W/WO ZPLASTY OTHER LOCAL TISSUE REARRANGE $628.70 20060701 99999999 26125 FASCIECTOMY PALMAR W/WO ZPLASTY OTHER LOCAL TISSUE REARRANGE $216.88 20060701 99999999 26130 SYNOVECTOMY, CARPOMETACARPAL JOINT $427.06 20060701 99999999 26135 SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING $490.87 20060701 99999999 26140 SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, $446.31 20060701 99999999 26145 SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOMY), $460.12 20060701 99999999 26160 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE $224.40 20060701 99999999 26170 EXCISION OF TENDON, PALM, FLEXOR, SINGLE $295.69 20060701 99999999 26180 EXCISION OF TENDON, FINGER, FLEXOR (SEPARATE PROCEDURE) $331.31 20060701 99999999 26185 SESAMOIDECTOMY, THUMB OR FINGER(SEPARATE PROCEDURE) $333.52 20060701 99999999 26200 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN $402.61 20060701 99999999 26205 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN $516.10 20060701 99999999 26210 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR $385.52 20060701 99999999 26215 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR $479.70 20060701 99999999 26230 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, $418.28 20060701 99999999 26235 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, $403.74 20060701 99999999 26236 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, $369.60 20060701 99999999 26250 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPAL $535.59 20060701 99999999 26255 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPAL $771.10 20060701 99999999 26260 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL $498.39 20060701 99999999 26261 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL $616.33 20060701 99999999 26262 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, DISTAL $420.67 20060701 99999999 26320 REMOVAL OF IMPLANT FROM FINGER OR HAND $330.21 20060701 99999999 26340 MANIPULATION, FINGER JOINT, UNDER ANESTHESIA, EACH JOINT $204.62 20060701 99999999 26350 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, NOT $523.67 20060701 99999999 26352 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, NOT $596.10 20060701 99999999 26356 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN $671.53 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 121
Page 1 and 2:
PROC-CODE DESC MAC BEG END A0130 NO
Page 3 and 4:
PROC-CODE DESC MAC BEG END A4355 3-
Page 5 and 6:
PROC-CODE DESC MAC BEG END A4431 OS
Page 7 and 8:
PROC-CODE DESC MAC BEG END A5093 OS
Page 9 and 10:
PROC-CODE DESC MAC BEG END A6231 GA
Page 11 and 12:
PROC-CODE DESC MAC BEG END A6452 HI
Page 13 and 14:
PROC-CODE DESC MAC BEG END A7504 FI
Page 15 and 16:
PROC-CODE DESC MAC BEG END ENTERAL
Page 17 and 18:
PROC-CODE DESC MAC BEG END D4210 GI
Page 19 and 20:
PROC-CODE DESC MAC BEG END D7911 SU
Page 21 and 22:
PROC-CODE DESC MAC BEG END E0248 TR
Page 23 and 24:
PROC-CODE DESC MAC BEG END E0580 NE
Page 25 and 26:
PROC-CODE DESC MAC BEG END E0911 TR
Page 27 and 28:
PROC-CODE DESC MAC BEG END E1085 HE
Page 29 and 30:
PROC-CODE DESC MAC BEG END E1638 HE
Page 31 and 32:
PROC-CODE DESC MAC BEG END E2324 PO
Page 33 and 34:
PROC-CODE DESC MAC BEG END E2605 PO
Page 35 and 36:
PROC-CODE DESC MAC BEG END G0091 IN
Page 37 and 38:
PROC-CODE DESC MAC BEG END G0206 DI
Page 39 and 40:
PROC-CODE DESC MAC BEG END K0032 SE
Page 41 and 42:
PROC-CODE DESC MAC BEG END K0130 FO
Page 43 and 44:
PROC-CODE DESC MAC BEG END K0240 HY
Page 45 and 46:
PROC-CODE DESC MAC BEG END K0529 ST
Page 47 and 48:
PROC-CODE DESC MAC BEG END K0822 PO
Page 49 and 50:
PROC-CODE DESC MAC BEG END L0350 TL
Page 51 and 52:
PROC-CODE DESC MAC BEG END L0633 LU
Page 53 and 54:
PROC-CODE DESC MAC BEG END L1685 HO
Page 55 and 56:
PROC-CODE DESC MAC BEG END L2106 AF
Page 57 and 58:
PROC-CODE DESC MAC BEG END L2670 AD
Page 59 and 60:
PROC-CODE DESC MAC BEG END L3420 FU
Page 61 and 62:
PROC-CODE DESC MAC BEG END L3906 WH
Page 63 and 64:
PROC-CODE DESC MAC BEG END L4110 RE
Page 65 and 66:
PROC-CODE DESC MAC BEG END L5622 AD
Page 67 and 68:
PROC-CODE DESC MAC BEG END L5701 AL
Page 69 and 70: PROC-CODE DESC MAC BEG END L5981 AL
Page 71 and 72: PROC-CODE DESC MAC BEG END L6646 UP
Page 73 and 74: PROC-CODE DESC MAC BEG END L6915 HA
Page 75 and 76: PROC-CODE DESC MAC BEG END L8170 EL
Page 77 and 78: PROC-CODE DESC MAC BEG END M0728 EX
Page 79 and 80: PROC-CODE DESC MAC BEG END Q4047 CA
Page 81 and 82: PROC-CODE DESC MAC BEG END V2522 CO
Page 83 and 84: PROC-CODE DESC MAC BEG END W9801 QU
Page 85 and 86: PROC-CODE DESC MAC BEG END 00530 AN
Page 95 and 96: PROC-CODE DESC MAC BEG END 11443 EX
Page 97 and 98: PROC-CODE DESC MAC BEG END 12056 LA
Page 99 and 100: PROC-CODE DESC MAC BEG END 15341 TI
Page 103 and 104: PROC-CODE DESC MAC BEG END 19110 NI
Page 105 and 106: PROC-CODE DESC MAC BEG END 20612 AS
Page 107 and 108: PROC-CODE DESC MAC BEG END 21100 AP
Page 109 and 110: PROC-CODE DESC MAC BEG END 21310 TR
Page 111 and 112: PROC-CODE DESC MAC BEG END 21920 BI
Page 113 and 114: PROC-CODE DESC MAC BEG END 22844 PO
Page 119: PROC-CODE DESC MAC BEG END 25316 FL
Page 123 and 124: PROC-CODE DESC MAC BEG END 26530 AR
Page 129 and 130: PROC-CODE DESC MAC BEG END 27513 OP
Page 133 and 134: PROC-CODE DESC MAC BEG END 28200 RE
Page 135 and 136: PROC-CODE DESC MAC BEG END 28636 PE
Page 139 and 140: PROC-CODE DESC MAC BEG END 30801 CA
Page 143 and 144: PROC-CODE DESC MAC BEG END 32310 PL
Page 153 and 154: PROC-CODE DESC MAC BEG END 35102 DI
Page 155 and 156: PROC-CODE DESC MAC BEG END TRANSLUM
Page 159 and 160: PROC-CODE DESC MAC BEG END 36555 IN
Page 161 and 162: PROC-CODE DESC MAC BEG END 37188 PE
Page 167 and 168: PROC-CODE DESC MAC BEG END 42836 AD
Page 169 and 170: PROC-CODE DESC MAC BEG END 43260 EN
Page 171 and 172:
PROC-CODE DESC MAC BEG END 43761 RE
Page 173 and 174:
PROC-CODE DESC MAC BEG END 44206 LA
Page 175 and 176:
PROC-CODE DESC MAC BEG END 45114 PR
Page 177 and 178:
PROC-CODE DESC MAC BEG END 46221 HE
Page 179 and 180:
Page 181 and 182:
PROC-CODE DESC MAC BEG END 48511 EX
Page 183 and 184:
PROC-CODE DESC MAC BEG END 49495 RE
Page 185 and 186:
PROC-CODE DESC MAC BEG END 50393 IN
Page 187 and 188:
PROC-CODE DESC MAC BEG END 50940 DE
Page 189 and 190:
PROC-CODE DESC MAC BEG END 51920 CL
Page 191 and 192:
PROC-CODE DESC MAC BEG END 52647 NO
Page 193 and 194:
PROC-CODE DESC MAC BEG END 54162 LY
Page 195 and 196:
PROC-CODE DESC MAC BEG END 55110 SC
Page 197 and 198:
PROC-CODE DESC MAC BEG END 56353 HY
Page 199 and 200:
PROC-CODE DESC MAC BEG END 57310 CL
Page 201 and 202:
Page 203 and 204:
PROC-CODE DESC MAC BEG END 59070 TR
Page 205 and 206:
PROC-CODE DESC MAC BEG END 61026 VE
Page 207 and 208:
PROC-CODE DESC MAC BEG END 61576 TR
Page 209 and 210:
PROC-CODE DESC MAC BEG END 61865 CR
Page 211 and 212:
PROC-CODE DESC MAC BEG END 62360 IM
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
PROC-CODE DESC MAC BEG END 64837 SU
Page 219 and 220:
PROC-CODE DESC MAC BEG END 65870 SE
Page 221 and 222:
PROC-CODE DESC MAC BEG END 67225 DE
Page 223 and 224:
PROC-CODE DESC MAC BEG END 68320 CO
Page 225 and 226:
PROC-CODE DESC MAC BEG END 69643 TY
Page 227 and 228:
PROC-CODE DESC MAC BEG END 70542 MA
Page 229 and 230:
PROC-CODE DESC MAC BEG END 72200 RA
Page 231 and 232:
Page 233 and 234:
PROC-CODE DESC MAC BEG END 75822 VE
Page 235 and 236:
Page 237 and 238:
PROC-CODE DESC MAC BEG END 76938 UL
Page 239 and 240:
Page 241 and 242:
PROC-CODE DESC MAC BEG END 78261 GA
Page 243 and 244:
Page 245 and 246:
PROC-CODE DESC MAC BEG END 82000 AC
Page 247 and 248:
Page 249 and 250:
PROC-CODE DESC MAC BEG END 83015 HE
Page 251 and 252:
PROC-CODE DESC MAC BEG END 83903 MO
Page 253 and 254:
PROC-CODE DESC MAC BEG END 84425 TH
Page 255 and 256:
PROC-CODE DESC MAC BEG END 85370 FI
Page 257 and 258:
PROC-CODE DESC MAC BEG END 86343 LE
Page 259 and 260:
PROC-CODE DESC MAC BEG END 86788 AN
Page 261 and 262:
PROC-CODE DESC MAC BEG END 87206 SM
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
PROC-CODE DESC MAC BEG END 88184 FL
Page 269 and 270:
PROC-CODE DESC MAC BEG END 89140 GA
Page 271 and 272:
PROC-CODE DESC MAC BEG END 90734 ME
Page 273 and 274:
PROC-CODE DESC MAC BEG END 90847 FA
Page 275 and 276:
PROC-CODE DESC MAC BEG END 92250 OP
Page 277 and 278:
PROC-CODE DESC MAC BEG END 92602 DI
Page 279 and 280:
PROC-CODE DESC MAC BEG END 93237 EL
Page 281 and 282:
Page 283 and 284:
PROC-CODE DESC MAC BEG END 94016 PA
Page 285 and 286:
PROC-CODE DESC MAC BEG END 95811 PO
Page 287 and 288:
Page 289 and 290:
PROC-CODE DESC MAC BEG END 97022 PH
Page 291 and 292:
PROC-CODE DESC MAC BEG END 99214 OF
Page 293 and 294:
PROC-CODE DESC MAC BEG END 99307 SU
Page 295:
PROC-CODE DESC MAC BEG END 99440 NE
show all

Medicaid Fee Schedule without Mods 200801

Create successful ePaper yourself

Delete template?

Save as template?